Oxytocin dosage. Injections with Oxytocin solution - instructions for use, dosage, possible side effects

Oxytocin is designed to increase excitability and enhance the contractile properties of the muscles of the uterus. Naturally, they are taken to stimulate labor. In cases where their own "strength" is not enough. Strengthening muscle contraction occurs due to an increase in the permeability of the myometrial cell membrane for potassium ions by oxytocin. Thus, its potential decreases and there is an increase in excitability.

ATX code

H01BB02 Oxytocin

Active ingredients

Oxytocin

Pharmacological group

Hormones of the hypothalamus, pituitary gland, gonadotropins and their antagonists

Uterotonics

pharmachologic effect

Uterotonic drugs

Indications for use Oxytocin

Indications for use Oxytocin - weakening of labor activity. Usually, the agent is used during a cesarean section, during the operation itself. In addition, the main indications for its use are hypotension or atony of the uterus after childbirth.

Also, the medication is also used for abortions, if it is necessary to produce it for a sufficiently long period. This will cause premature labor. With hypotonic uterine bleeding in the postpartum period, the drug is actively used. The reason for taking it may be milk stagnation in the early postpartum period, as well as too painful premenstrual syndrome. Which is characterized by severe swelling. The remedy is also used with an increase in body weight. In general, the spectrum of action of the drug is very wide. It is used exclusively by women and only on the advice of a doctor. Basically, Oxytocin is used to enhance labor activity with early discharge of amniotic fluid and stimulation of the uterus.

Release form

Release form - ampoules, the agent is administered by injection. This medication is a synthetic hormonal medication. It is an analogue of the eponymous polypeptide hormone of the posterior pituitary gland.

You can buy it in different dosages. So, they release it in the form of a solution for injection in ampoules of 1 ml. It contains 5 units of oxytocin. One package can contain 5, 10 and 50 ampoules.

There is also a slightly different dosage. One ampoule may contain 2 ml of the active substance. In this form, there are 5 ampoules in the package. There are no other variations of "packaging". The drug is not made in the form of tablets. It should have a quick effect, and only intravenous administration of the drug can allow this to be done. That is why Oxytocin is available as a solution for injection. The required dosage of the drug is prescribed by the doctor, based on the situation, it is recommended to administer one or another amount. Therefore, in what variation to buy the product, the specialist also decides.

Pharmacodynamics

Pharmacodynamics Oxytocin is a hormone of the posterior pituitary gland. It is designed to have a stimulating effect on the smooth muscles of the uterus. This results in an increase in contractile activity and, to a lesser extent, myometrial tone. This is very important in case of weak labor activity.

In small doses, the drug is able to increase the frequency and amplitude of uterine contractions. In an increased dosage, the agent, with repeated administration, helps to increase the tone of the uterus. In addition, there is an increase and intensification of its contractions, up to tetanic ones.

In addition, there is an increase in the secretion of prolactin, as well as a reduction in myoepithelial cells surrounding the alveoli of the mammary gland. Thus, it helps to increase milk production. The drug has weak vasopressin-like antidiuretic properties. That is why the tool has a wide spectrum of action and is used everywhere. Oxytocin is a drug widely used in obstetric practice.

Pharmacokinetics

Pharmacokinetics Oxytocin after administration of T1 / 2 from plasma ranges from one to several minutes. Metabolism occurs in the liver. During pregnancy, a specific enzyme oxytocinase appears in plasma, which inactivates endogenous and exogenous oxytocin. In addition to plasma, it is also found in target organs.

It is worth noting the fact that a small amount of it is excreted by the kidneys unchanged. This medication is widely used in obstetrics. It stimulates uterine contractions and maintains its tone. This is especially important with weak labor activity. A small amount of medication can help facilitate this process. In some cases, the tool is used to carry out an abortion in the later stages. This causes premature birth.

This medicine is really in demand. After all, not in all cases, it turns out, to give birth to a child on their own. Oxytocin produces stimulation and thus helps in this matter.

Use of oxytocin during pregnancy

The use of Oxytocin during pregnancy is acceptable, but only if necessary. Basically, this tool is widely used to enhance labor activity. In some cases, the tone of the uterus and the frequency of its contractions is not enough to start the birth process on its own. That is why a woman is given this hormone. It is also widely used during caesarean section.

In other cases, a pregnant girl should not be taken. It should be noted once again that the main activity of the drug is aimed at strengthening the birth process. Therefore, the accepted remedy unnecessarily can lead to the onset of premature birth. Usually, this phenomenon is achieved when carrying out an abortion for a long time. Use this tool only under the guidance of a specialist. Self-administration is prohibited, this can lead to the development of serious complications. Oxytocin is used exclusively in obstetric practice.

Contraindications

Contraindications to the use of Oxytocin are primarily hypersensitivity to certain components of the drug. In this case, the development of serious complications is possible. Including the strongest allergic reaction. For a girl in a position, this is extremely unacceptable.

It is also impossible to take the remedy for people who have a narrow pelvis. In this case, independent tribal activity is prohibited. A woman simply will not be able to give birth to a child, so it is necessary to resort to the help of a caesarean section.

If the size of the fetal head does not match the size of the pelvis, it is prohibited to use the product. A similar prohibition applies to those cases where the child has taken the wrong position in the womb. This refers to the transverse or oblique arrangement. With complete placenta previa and the threat of uterine rupture, the remedy cannot be used, this can lead to the development of serious complications. That is why Oxytocin should be taken only on the recommendations of the attending physician.

Side effects of oxytocin

Side effects Oxytocin can cause. Basically, everything manifests itself in the form of nausea, vomiting and arrhythmias. The latter phenomenon can also develop in the fetus. It is possible that the pulse slows down, both in the mother and in the child.

Pressure may rise significantly and subarachnoid bleeding may begin. Against this background, hypotension and shock are not excluded. Possible water retention in the body, up to poisoning. Usually this phenomenon occurs with too frequent and prolonged administration of the drug. This can happen against the background of an allergic reaction, which is caused by intolerance to some components of the drug.

Perhaps the appearance of sharp contractions with the further development of intrauterine hypoxia. All these phenomena are fraught with serious consequences. And this applies not only to the body of the mother, but also to the child. That is why any intervention should be carried out under the supervision of a physician. An increased dose or not ignoring some important points can lead to serious complications. Oxytocin in high doses can be harmful.

Dosage and administration

The method of administration and doses should be prescribed by the attending physician. The drug is administered intravenously and intramuscularly into the wall or vaginal part of the cervix. Nasal insertion is not ruled out.

For intravenous drip administration, 1 ml of the drug is sufficient. At the same time, it is not administered in its pure form, but diluted. The drug is diluted in 500 ml of 5% glucose solution.

To stimulate labor, the drug is administered intramuscularly at 1 unit with an interval of 30-60 minutes. In this case, much depends on the reaction of the uterus. It is advisable to administer the drug intravenously by drip method, 1-5 IU in 300-500 ml of 5% glucose solution. But at the same time, uterine contractions and fetal heartbeat should be monitored. This is done before the end of childbirth and after separation of the placenta.

With weak labor or prolonged labor, the drug is taken at 0.5–1 IU with an interval of 60 minutes, depending on the obstetric situation. During childbirth in breech presentation, 2-5 units of the drug are administered.

With hypotension and atony of the uterus, 5-10 units of Oxytocin are prescribed intravenously in 10-20 ml of a 40% glucose solution. To stimulate lactation, the drug is administered intramuscularly or into the nose at 0.5 units 5 minutes before feeding. If necessary, the injection is repeated. With premenstrual syndrome - in the nose, from the 20th day of the cycle to the 1st day of menstruation.

As a prevention and treatment of hypotonic uterine bleeding in the postpartum period, the drug is administered intramuscularly at a dose of 3-5 units. In any case, the doctor prescribes the exact dosage of Oxytocin.

Overdose

There were no cases when an overdose was observed. This drug is not capable of causing serious complications if taken in a given dosage. Only a sharp increase in dose can cause negative reactions. This is primarily due to the high concentration of the drug in the blood plasma. Therefore, it is impossible to carry out an increase in the dose without the need.

The introduction of the drug should be carried out strictly under the supervision of a physician. This will avoid serious consequences in the future. In the event of the development of strange symptoms, the administration of the medication is stopped. But the doctor must make this decision. Indeed, with a weak labor activity, it is necessary to complete what has been started in any case. This must occur either under the administration of this drug, or during a caesarean section. In this case, all possible risks are weighed, and on the basis of this, the right decision is made. Oxytocin really helps many women, but in order not to harm the body of the mother and child, it must be used carefully, without deviations from the given dose.

Interactions with other drugs

Interactions Oxytocin with other drugs with simultaneous use with inhalation drugs for anesthesia may increase the hypotensive effect of the drug and weaken its stimulating effect on the uterus. This can significantly complicate the process and lead to the impossibility of an independent birth process. In this case, you will have to resort to the help of a caesarean section.

Prostaglandins potentiate the stimulating effect of oxytocin on the uterus. The drug itself is able to potentiate the pressor action of sympathomimetic agents. Therefore, before the introduction of this drug, you must make sure that the woman is not taking any other drugs. Moreover, it is extremely unacceptable to use the simultaneous administration of drugs with the same effect. This can lead to the development of serious consequences. Oxytocin is a powerful medication that can not only improve the condition and “speed up” labor, but also, on the contrary, aggravate the situation.

The drug Oxytocin is used in obstetrics for certain difficulties, often in the last month of pregnancy. Also, the need for injections appears when late toxicosis is detected.

Important information! The instruction below describes all the actions of Oxytocin injections on the human body, tells about the treatment of the disease and the use of the drug itself, is not official and is posted for informational purposes only, so that the patient has an idea of ​​what course of treatment awaits him before buying.

You should not take all the information below as a reason to self-medicate, because in any case, consultation and examination by a professional doctor will not hurt. After all, sometimes the symptoms we are used to can indicate the presence of a more serious disease or pathology that cannot be detected on our own. It is for this reason that do not ignore the advice of doctors, always follow the suggested dosages and be healthy!

Form, composition, packaging

Oxytocin is sold in almost any pharmacy in the form of a special solution for injection. It has a transparent color and not a pronounced smell. The main substance of the drug is oxytocin, and ordinary water, chlorobutanol and a solution of acetic acid act as additional active ingredients.

Terms and conditions of storage

Store in a cool place (permitted in the refrigerator), provided that the air temperature does not fall below four on the thermometer and does not exceed fifteen degrees above zero.

You can keep them in the house for two years, focusing on the release date, which can be found on the carton or, most likely, on the outside of the bottom of the ampoule itself.

Pharmacology

This drug is prescribed if it is necessary to prematurely stimulate labor.

Pharmacokinetics

After intravenous injection, the drug begins to act immediately and reduces its effect after about an hour. With intramuscular injection, the action begins no later than five minutes and its duration does not exceed three hours, but the final effect depends on the personal characteristics of the organism. There is a rapid absorption of all components of the drug through the mucous membrane of the nasal passages.

The found relationship with proteins often does not exceed 30%. Incomplete elimination is observed within one to six minutes after exposure to the drug. In the third trimester of childbearing and during breastfeeding, this period may become even shorter. Metabolism occurs in the liver and kidneys, due to the work of which it is excreted from the body.

Oxytocin injections indications for use

Oxytocin is used in cases where it is necessary to increase the stimulation of labor or, if necessary, artificial extraction of the fetus in case of incompatibility of the Rh factor of the mother and child, during too long a pregnancy, that is, when the expected date of birth is behind, and contractions are still not close It was.

Also, the need for injections appears when preeclampsia or, as it is also called, late toxicosis is detected. Due to its negative impact on the mother's body, a gradual deterioration in the functioning of the kidneys, some parts of the brain and blood vessels occurs. It is possible to understand that a future woman in labor has gestosis by the following signs:

• periodically there is no opportunity to focus on something look;
• headache, which sometimes develops into migraines;
• jumps in blood pressure;
• by the presence of protein in the urine;
• of course, nausea and vomiting;
• slight internal swelling is observed at the beginning.

Oxytocin is also used due to the death of the fetus (at any stage of pregnancy), due to the discharge of water that occurred prematurely, partial abortion, for the prevention of bleeding.

Contraindications

It cannot be used in case of allergies or high blood pressure, therefore, these indicators must be checked before prescribing in the hospital.

It is also worth looking for alternative treatment methods if it became known about heart problems in the future mother, the uterus became very large, a very strong difference in the size of the fetus and the pelvis of the woman in labor was noticed on ultrasound.

In addition, attention is always drawn to the presence of scars and scars on the uterus that appeared there after certain surgical actions, the position of the fetus (in this situation, it should not be in a transverse or oblique position), how small the pelvic area of ​​​​the woman and other similar reasons .

Another ban on injections is in the event that hypoxia is diagnosed in the fetus, that is, oxygen starvation, hypertensive contractions of the mother's uterine passages, or an acute stage of the formation of toxins in the body.

Oxytocin instructions for use

During weak or infrequent contractions, Oxytocin injections are given intramuscularly at a maximum of 2.0 IU. If necessary, you can administer the medicinal liquid in a similar way every half an hour - an hour. If we are talking about drip administration, then one milliliter of the solution, that is, 5 IU, must be diluted in a 5% glucose solution, the amount of which should not exceed 500 milliliters. At the beginning of the procedure, no more than eight drops of the drug can enter the body within a minute, and later their number reaches forty drops in sixty seconds.

To prevent the occurrence of bleeding in the first twenty-four hours, up to 8 IU is administered at a time and this action is repeated three times in one day and for three days.

But during a cesarean section, after the extraction of the fetus, injections are injected at 5 IU into the wall of the uterus. In case of an overdose, the child may develop jaundice due to the effect of the drug on his body.

By the way, which is significant, similar injections are carried out in a similar way in veterinary practice, although the dosage is slightly different there. But the reasons for using are in fact the same, namely:

• to get rid of endometritis and mastitis;
• afterbirth delay;
• too long bearing of a cub;
• uterine bleeding, which may occur shortly after childbirth;
• to try to restore the appearance of breast milk.

Unlike humans, animals are given injections only once, without the need for a second course. For example, dogs need to enter about 10 IU - the exact amount is determined by the total weight of the animal, but cats are enough and 2 - 3 IU at a time.

In order for the effect to come as quickly as possible, veterinarians make an intravenous injection based on a glucose solution, but in this scenario, the initial dose must be reduced by 30%.

The drug is often used only once: dogs are administered - 5-10 units depending on weight, cats - 2-3 units. For a quick effect, intravenous administration is practiced in a glucose solution, in which case the dose is reduced by 30%. Subsequent administration is possible, however, the effect of the drug decreases with each new injection and it is not possible to achieve the initial effect.

Oxytocin during pregnancy

The drug Oxytocin can be used not only during pregnancy, but also to terminate it in the early stages. After the introduction of a certain dose of the solution into the patient's body, artificial contractions begin in a very short time, which provoke the premature appearance of an incompletely formed fetus.

Such methods have to be resorted to not only because of the desire of the pregnant girl herself, but also according to the results of ultrasound and tests, which may indicate the incompatibility of the fetus and mother or the pathologies that have arisen.

But still it is worth noting that in medical practice they still prefer to use other drugs of similar action for abortions, which are designed exclusively for such situations.

In some cases, Oxytocin can also be used at a later date, namely at the fourteenth week, when a fading of intrauterine life or malformations were found, in which further existence is impossible.

An abortion that is carried out with the participation of medications (and not only) must necessarily be carried out under the supervision of practitioners who must monitor the entire procedure and the patient's condition, as complications may arise or her general condition may deteriorate sharply. In addition, only a doctor can confirm the complete exit of the fetus from the body and help to cope with the bloodshed that often occurs at the end.

As for the dosage, there are no clear recommendations here, in the sense that everything depends on the frequency of uterine contractions and their duration. And since all this has an individual character, the amount of the drug administered is determined for each separately.

But it is worth noting that patients with fibroids, abnormal developments in the uterine region and scars in the same area are strictly prohibited from prescribing Oxytocin.

Side effects

When the drug begins to act, there is sometimes an increase in blood pressure, satiety, itching and redness of the skin, urinary retention, an increasing feeling of nausea and subsequent vomiting. There is a risk of rupture of the fallopian tubes as a result of too strong labor activity, and neonatal jaundice may already appear in the baby almost immediately after birth.

Overdose

There is hyperstimulation of the uterus and as a result, it ruptures and bleeds. As for the child, postpartum trauma may be found in him.

If negative manifestations are found, then the drug is administered, it is stopped immediately and diuretics are prescribed and other necessary methods of treatment are carried out.

Drug Interactions

Oxytocin provokes vasoconstriction when exposed to sympathomimetics. It can be taken with caution and under the supervision of doctors with Fluorotan and Cyclopropane, as they increase the risk of arterial hypotension. Simultaneous administration with MAO inhibitors can lead to the same result. And when using inhalation drugs for anesthesia, it leads to a weakening of its effect on the uterus.

Additional instructions

Never be taken for self-medication or for home abortion. Such a decision can significantly affect the girl's health and even lead to death.

Oxytocin analogues

The most common drug substitutes are:

• Oxytocin-Grindeks;
• Oxytocin-Ferein;
• Oxytocin-Vial;
• Oxytocin-Richter;
• Syntocinon;
• Pitocin;
• Oxytocin-MEZ.

Oxytocin price

The last fixed price within Russia is 70 rubles. But it may vary depending on the city, region or pharmacy where the purchase is made.

Oxytocin injections reviews

Here is what one of the patients who had to personally experience the effect of Oxytocin says: “During the first birth, the cervix did not open and the contractions were very weak. Therefore, doctors had to resort to additional help, in the form of injections. After that, the contractions began very strong, but the cervix did not open, and the child turned out to be very large for my physique. Therefore, the birth was very difficult and I still cannot get rid of the consequences of the injected Oxytocin.

He was prescribed to me to restore the uterus, since it could not return to its original state on its own and begin to function normally again. And it was after this treatment course that I felt, or rather saw, a really good result. Due to the effect of the drug, my uterus completely returned to normal in a very short time, the muscle tone increased, it stopped falling out, screwed well into place and there were no more unpleasant sensations and problems with it in general.

Back

Release form: Liquid dosage forms. Injection.

General characteristics. Compound:

Active ingredient: 1 ml of solution contains 5 IU of oxytocin;

excipients: chlorobutanol hemihydrate, water for injection.

Basic physical and chemical properties: transparent, colorless liquid with a specific smell.

Pharmacological properties:

Synthetic oxytocin has all the biological properties of the natural hormone secreted by the posterior pituitary gland.

Pharmacodynamics. Being a peptide hormone (octapeptide) of the posterior pituitary gland, it consists of an octapeptide cycle and a side chain of three amino acid residues (proline, leucine, glycine). Oxytocin is a drug that stimulates the muscles of the uterus. It causes especially strong contractions of the muscles of the uterus in pregnant women, which is due to its effect on the membranes of myometrial cells. The use of oxytocin increases the permeability of the membrane for potassium ions, reduces its potential and increases excitability. Oxytocin stimulates milk secretion by increasing the production of prolactin, the lactogenic hormone of the anterior pituitary gland. In addition, it activates the secretion of milk from the mammary gland due to the impact on its contractile elements. Oxytocin has a weak antidiuretic effect and does not significantly affect blood pressure levels.

Pharmacokinetics. Oxytocin in the gastrointestinal tract is destroyed under the influence of enzymes (pepsin, trypsin), and therefore it is used parenterally. Does not bind to plasma proteins, metabolized by the liver, excreted by the kidneys. The half-life is 5 minutes.

Indications for use:

Induction of labor, stimulation of labor in primary and secondary labor weakness, as well as with caution in the first and second stages of labor. Prevention and treatment of placental and atonic uterine bleeding (in the case of a caesarean section, Oxytocin is injected directly into the uterine muscle). Insufficient involution of the uterus in the postpartum period (to control subinvolution and bleeding). Incomplete or . With gynecological bleeding (after establishing a histological diagnosis).

Important! Get to know the treatment

Dosage and administration:

The drug is administered intravenously, intramuscularly, subcutaneously, as well as into the cervix or uterine wall.

For the induction or stimulation of labor, oxytocin is used exclusively as an intravenous drip infusion. Compliance with the indicated infusion rate is mandatory. The safe use of oxytocin requires the use of an infusion pump or other similar device, as well as monitoring of uterine contractions and fetal cardiac activity. In the event of an excessive increase in the contractile activity of the uterus, the infusion should be stopped immediately, as a result of which the excessive uterine activity of the uterus will quickly decrease.

To prepare a standard infusion of oxytocin in 500 ml of a solvent (0.9% sodium chloride solution or 5% glucose solution), 1 ml (5 IU) of oxytocin should be dissolved and mixed. The rate of administration of the initial dose should not exceed 5-8 drops per minute. Every 20-40 minutes it can be increased by 5 drops, but not more than until reaching 40 drops per minute, until the desired degree of contractile activity of the uterus is reached. When the degree of uterine contractions corresponding to normal labor activity is reached, the opening of the cervix by 4-6 cm, in the absence of signs of fetal distress, the infusion rate can be gradually reduced at a pace similar to its acceleration. In the terminal period of pregnancy, oxytocin can be administered faster, but caution should be exercised, since only occasionally an infusion rate of up to 40 drops per minute may be needed. It is necessary to control the fetal heartbeat, the tone of the uterus at rest, the frequency, duration and strength of its contractions. In case of excessive uterine contractions or fetal distress, oxytocin administration should be stopped immediately and oxygen therapy should be provided to the parturient woman, while both the parturient woman and the fetus should be under the supervision of a specialist doctor.

To stop uterine bleeding in the postpartum period:

1) Intravenous drip infusion: dissolve 10-40 IU of oxytocin in 1000 ml (0.9% sodium chloride solution, 5% glucose solution).

2) Intramuscularly: 1 ml (5 IU) of oxytocin after separation of the placenta.

For the prevention of atonic uterine bleeding:

Oxytocin is administered intramuscularly at 3-5 IU 2-3 times a day daily for 2-3 days.

As adjuvant therapy for incomplete abortion:

10 IU of oxytocin in 500 ml of 0.9% sodium chloride solution or a mixture of 5% dextrose with 0.9% sodium chloride solution. The rate of intravenous infusion is 20-40 drops per minute.

For cesarean section, oxytocin is injected into the uterine muscle at a dose of 5 IU.

For gynecological indications - subcutaneously or intramuscularly at a dose of 5-10 IU.

Application Features:

The use of the drug is contraindicated in the presence of a history of hypersensitivity to oxytocin.

Except in special cases, the use of oxytocin is not recommended in preterm labor; with a significant degree of narrowing of the pelvis; previous surgery on the uterus or cervix, including after a caesarean section; excessive increase in the tone of the uterus; multiple pregnancy; invasive stages of cervical carcinoma. By the time the fetal head or pelvis is in the pelvic inlet, oxytocin cannot be used to induce labor. It is the doctor's task to identify the so-called special cases due to the combination of various factors. Before proceeding with the use of oxytocin, the expected positive effects of therapy should be compared with the risks (although rarely, hypertonicity and uterus are possible).

In order to induce labor and enhance the contractile activity of the uterus, oxytocin is used exclusively intravenously, in a hospital, and under medical supervision. Each patient who receives an infusion of oxytocin should be under the constant supervision of a physician who is familiar with the drug and its side effects. A specialist doctor who has undergone special training should be nearby in case of development of side effects.

To avoid complications, you should constantly monitor the contractions of the uterus, the cardiac activity of the woman in labor and the fetus, the blood pressure of the woman in labor. At the first sign of uterine hyperactivity, the administration of oxytocin should be stopped immediately; as a result, the uterine contractions caused by the drug, as a rule, soon disappear.

When used adequately, oxytocin induces uterine contractions similar to normal childbirth. Excessive stimulation, which occurs when the drug is used incorrectly, is dangerous for both the woman in labor and the fetus.

It must be borne in mind that in cases of hypersensitivity to the drug, hypertensive contractions are possible even with adequate use of the drug. Consideration should be given to the possibility of increased bleeding and the development of afibrinogenemia.

The antidiuretic effect of the drug favors water retention in the body. The possibility of overhydration should be given special attention when using a constant infusion of oxytocin and taking liquids inside.

When administered parenterally, the drug is used either only intravenously or only intramuscularly.

There are known cases of death in parturient women as a result of hypersensitivity reactions, as well as cases of fetal death for various reasons with the parenteral use of the drug to induce labor and stimulate uterine contractions.

Side effects:

For women in labor:

From the reproductive system: large doses or hypersensitivity to the drug can cause arterial hypertension, spasms, tetany and uterine rupture; increased bleeding in the postpartum period due to afibrinogenemia and hypoprothrombinemia. Sometimes a small pelvis is possible. It is possible to achieve a reduction in the risk of bleeding in the postpartum period by systematically monitoring the course of labor.

From the side of the cardiovascular system: the use of large doses of oxytocin can cause arrhythmias, premature ventricular contractions, arterial hypertension following arterial hypotension, reflex tachycardia, bradycardia.

From the digestive system:,.

From the side of water and electrolyte metabolism: due to the antidiuretic effect of oxytocin, with its rapid intravenous administration (more than 40 drops / min), along with a large amount of liquid, severe hyperhydration is possible. The state of severe hyperhydration with convulsions and coma can also develop with a slow, more than

24-hour infusion of oxytocin.

From the immune system: anaphylactic reactions associated with dyspnea, hypotension or shock; anaphylaxis and other allergic reactions; occasionally - lethal outcome.

From the nervous system:.

From the skin: rashes on the skin.

In the fetus or newborn: a low Apgar score as determined 5 minutes after birth, neonatal jaundice, retinal hemorrhage in newborns.

In cases of severe toxemia or weak contractile labor activity of the uterus, long-term use of oxytocin is contraindicated.

Overdose:

Symptoms overdoses depend mainly on the degree of sensitivity of the uterus to oxytocin and are not associated with the presence of hypersensitivity to the active component of the drug. Hyperstimulation can lead to strong (hypertonic) and prolonged (tetanic) contractions, or to rapid labor with a characteristic base tone of 15-20 mm aq. Art. and more, which are measured between two contractions, and can also cause rupture of the body or cervix, vagina, bleeding in the postpartum period, utero-placental hypoperfusion, slowing of fetal cardiac activity, hypoxia, hypercapnia and fetal death.

Long-term use of the drug in high doses (40-50 ml / min) may be accompanied by a severe side effect - hyperhydration, which is due to the antidiuretic effect of oxytocin.

Treatment consists in stopping the infusion of oxytocin, limiting fluid intake, using diuretics, intravenous administration of hypertonic saline, correcting electrolyte balance, stopping with barbiturates, and providing professional care for a patient who is in a coma.

Storage conditions:

To store in the place protected from light at a temperature from 8 °C to 15 °C.

Leave conditions:

On prescription

Package:

Labor activity in women is regulated by the hormone oxytocin, a substance produced in the hypothalamus and accumulated in the posterior pituitary gland. In gynecology, an artificially synthesized bioactive component has been used for a long time: it is used to stimulate labor and accelerate the recovery of a woman's body in the postpartum period.

What is Oxytocin

Synthetic hormonal drug is designed to stimulate childbirth. Oxytocin does not contain any impurities in the form of other active substances of protein origin. The tool, according to the instructions, has a directed effect on the muscles of the uterus. With intravenous infusion, the hormone does not carry the risk of developing anaphylactic shock. The influence of a biologically active substance is due to an increase in the permeability of the uterine cell membranes for potassium ions, thereby increasing the conductivity of nerve impulses.

The mechanism of action of the solution is aimed at strengthening uterine contractions. After the birth of a child, Oxytocin increases the production of prolactin, a hormone that enhances lactation. In addition, the biologically active substance has a mild antidiuretic effect on the woman's body, due to which the optimal amount of fluid is retained in the body of the woman in labor, the vessels narrow, which prevents bleeding.

Composition and form of release

The medicine Oxytocin is a solution for intravenous or intramuscular administration. The drug is a clear liquid without mechanical inclusions, the active substance in which is the synthetic hormone oxytocin (5 IU in 1 ampoule). Auxiliary components are ethanol (96%), acetic acid, chlorobutanol hemihydrate, water for injection. The drug is produced in the following forms:

Pharmacodynamics and pharmacokinetics

Oxytocin, according to the instructions, has a stimulating effect on the smooth muscles of the uterus. Due to this, the contractile activity of the organ increases and the tone of the myometrium slightly increases, which is important with weak labor activity. In small quantities, the solution is able to increase the frequency and amplitude of uterine contractions. With the introduction of a large dose, the drug helps to increase the tone of the uterus, speeds up and intensifies its contractions up to tetanic.

In addition, the hormone enhances the production of prolactin and the contraction of myoepithelial cells that surround the alveoli of the mammary gland. Thus, Oxytocin increases milk production. The drug has weak vasopressin-like antidiuretic properties, due to which it has a wide spectrum of action and is used everywhere. It stimulates uterine contractions, maintains the tone of the organ, which is especially important with weak contractions during childbirth. Even a small dose of Oxytocin can facilitate the birth process.

In some cases, the drug is used for late abortion (the injection causes premature birth). The action of Oxytocin begins after 1-2 minutes after its administration. The metabolism of the drug is carried out in the liver. During pregnancy, the enzyme oxytocinase appears in plasma, which deactivates exogenous and endogenous oxytocin. In addition to plasma, the hormone is also found in target organs. A significant amount of the drug is excreted by the kidneys unchanged.

Indications for use

The use of Oxytocin during pregnancy is allowed only if necessary. Indications for the introduction of a synthetic hormone are:

• the need to induce labor;
• prevention of uterine bleeding after a miscarriage or abortion;
• swelling, weight gain before menstruation;
• the need to accelerate the process of uterine contraction after childbirth or caesarean section (after the placenta is delivered);
• insufficient patency of the ducts of the mammary gland during lactation.

A special medical indication for the introduction of Oxytocin, according to the instructions, are artificial childbirth. They are carried out in the following cases:

• with late toxicosis;
• due to fetal death
• in case of identified Rhesus conflict;
• if the amniotic fluid has departed prematurely;
• when exceeding the gestational age.

Method of application and dosage

Instructions for use of Oxytocin involves the use of a solution for intramuscular or intravenous administration. The last injection method is used to enhance labor activity, exclusively in a hospital setting. It is forbidden to simultaneously inject the solution intramuscularly and intravenously. The dosage is prescribed by the doctor by the method of selection, taking into account the individual tolerance of the drug by the woman and the fetus.

Oxytocin intramuscularly

A solution at a dosage of 1 ml is administered to a woman in labor after the fetus is released. If during the postpartum period the uterus contracts poorly, the woman is prescribed injections. The response of each patient to Oxytocin is different, so the dosage is prescribed individually, it varies from 2 to 10 IU. Sometimes the medication is prescribed for pregnant or lactating women. In the first case, the fetal heart rate is constantly monitored. Oxytocin injections for lactating women, according to the instructions, stimulate the mammary glands and normalize the movement of milk through the ducts.

Oxytocin IV

The instructions for the drug say that the bioactive substance enhances labor activity. For this purpose, the solution is injected exclusively into a vein and in a hospital. The use of the hormone requires the mandatory use of additional medical equipment. The dosage of the drug depends on the reaction of the body of the woman in labor and the fetus to the drug:

• Stimulation of labor begins by administering a saline solution to a woman, after 1 ml of Oxytocin is diluted in 1000 ml of a non-hydrating liquid and the drug is started to be administered at 2–16 drops per minute.
• To achieve the desired contractile activity of the uterine walls, the intensity is increased by 4–8 drops every 20–40 minutes.
• If the uterus has opened to the required level, the rate of administration of the hormonal agent is reduced in the reverse order.
• With artificial childbirth, taking place at a later date, the rate of administration of the solution is 32-36 drops.
• Preterm labor is an indication for increasing the infusion rate to 80 drops per minute. At the same time, the child's heartbeat, myometrial tone during contractions and at rest are necessarily monitored.
• In the prevention of uterine bleeding, 80-160 drops of the solution are administered intravenously. In this case, 2–8 ml of Oxytocin dissolves in a non-hydrating liquid (1000 ml).

Oxytocin for abortion

The action of the hormone is similar to the pharmacodynamics of natural oxytocin during childbirth. The drug causes excitation of the uterus and the opening of its cervix, due to which the birth of the fetus occurs. During an abortion, a woman is injected intravenously with a solution of 2 ml of the hormone and 500 ml of saline at a rate of 20-40 drops per minute. In some cases, the drug is prescribed after the termination of pregnancy or the birth of a child. The hormone is necessary to eliminate the hypotonicity of the uterus, its reduced contractile activity, in order to avoid:

1. congestion;
2. development of bleeding;
3. endometritis (inflammation of the walls of the organ).

For animals

In veterinary medicine, the drug is used to stimulate labor in cattle and other animals. The drug, according to the instructions, causes contractions of the smooth muscles of the uterus, promotes the natural release of the placenta during its retention. The introduction of the hormone, in addition, is indicated for atonic or uterine bleeding, reflex agalactia, uterine inflammation. Traditionally, in veterinary medicine, the drug is used to treat mastitis:

• in cows;
• pigs;
• cats, dogs;
• other types of animals.

According to the instructions, the drug is recommended to be administered intramuscularly, but intravenous or subcutaneous injections are also allowed. As prescribed by the veterinarian, the hormone is administered epidurally simultaneously with novocaine. To speed up the effect, you can inject the solution in combination with glucose. The appropriate dosage depends on the weight of the animal, it can be calculated according to the instructions.

special instructions

The introduction of Oxytocin, according to the instructions, begins after a careful comparison of the expected therapeutic effect with the possible risk of developing uterine hypertension and tetany. Labor induction should not begin until the fetal head appears. Intravenous injections of the hormone should be carried out in a hospital under the constant supervision of experienced, qualified professionals. Careful monitoring of delivery during the administration of Oxytocin reduces the risk of bleeding after childbirth.

To prevent the development of complications, the period of use of the drug is accompanied by monitoring of the cardiac activity of the fetus and mother, in addition, the blood pressure of the woman in labor and the dynamics of uterine contractions are monitored. The use of the solution according to the instructions should stimulate the work of the muscles of the uterus, similar to spontaneous childbirth. Recommendations and instructions:

• Improper use of the drug is dangerous due to excessive contractions of the organ and the development of hypersensitivity to the hormone, which is indicated in the instructions.
• According to the instructions for the drug, when using it, it is important to take into account the risk of developing afibrinogenemia (absence of fibrinogen in the blood) and increased blood loss.
• The drug has an antidiuretic property, with its constant administration and additional oral fluid intake, hyperhydration is possible.
• The agent can be combined with solutions of sodium lactate, sodium chlorate and glucose.
• Ready infusion should be used within 8 hours.
• The drug does not affect the ability of a person to drive a vehicle, complex mechanisms and does not impair his concentration.

drug interaction

The therapeutic effect of a hormonal agent worsens when combined with inhalation anesthesia, antispasmodics and prostaglandins. When using the drug together with vasoconstrictors, 3-4 hours after epidural anesthesia or in combination with sympathomimetics, severe arterial hypertension may develop. The combination of the hormone with halothane or cyclopropane can cause a change in the cardiovascular action of Oxytocin and cause the woman in labor to develop:

• arterial hypotension;
• arrhythmias;
• sinus bradycardia.

Side effects of Oxytocin

During drug therapy, some undesirable reactions are noted. With the symptoms described below, the use of a hormonal agent is canceled, while reducing the introduction of saline and carrying out accelerated diuresis. To normalize the electrolyte balance, hypertonic sodium chloride solution and barbiturates are administered.. Against the background of drug treatment, even if all the requirements specified in the instructions are followed, women may experience the following side effects:

• hypertensive syndrome;
• decrease in blood pressure;
• bradycardia or arrhythmia (in the fetus and mother);
• vomiting, nausea;
• disorder of the digestive tract;
• subarachnoid (cerebral) bleeding;
• bronchospasm;
• water retention in the body;
• neonatal (intrauterine) jaundice;
• reduction in the level of fibrinogen in the fetus;
• allergy;
• hypoxia and asphyxia in a child.

Overdose

Oxytocin in ampoules (the name of the synthetic drug is pitocin) is extremely important to use according to the instructions in order to avoid the extremely negative consequences caused by an overdose of the hormone in a woman's body. Signs of exceeding the permissible dose of the drug include:

• uterine rupture;
• hypoxia;
• tetanus of the uterus;
• water intoxication;
• postpartum bleeding;
• hypercapnia;
• uteroplacental hypoperfusion;
• birth trauma and fetal bradycardia;
• convulsions.

Contraindications

The use of the drug is prohibited in case of hypersensitivity to the active ingredient, preeclampsia (severe toxicosis that occurs in the 2nd or 3rd trimester of pregnancy). In addition, according to the instructions, the hormone is not used for:

• narrow pelvis of the woman in labor;
• prolapse or presentation of the umbilical cord;
• placental abruption;
• oblique or transverse position of the fetus, interfering with spontaneous childbirth;
• emergency situations requiring prompt intervention;
• excessive stretching of the uterus;
• uterine sepsis;
• facial presentation of the fetus, its compression;
• fetal distress long before the expected date of birth;
• severe preeclampsia (impaired kidney function, high blood pressure);
• early hypertonicity of the uterus;
• arterial hypertension;
• heart disease;
• violations of the kidneys;
• hypersensitivity to a hormonal agent;
• multiple pregnancy;
• premature birth;
• previous surgical intervention on the uterus and its cervix.

To understand what it is, it is necessary to consider its key characteristics and methods of application.

Oxytocin is a hormone in the body. After production, it is transported to the pituitary gland (posterior lobe), where it accumulates. From here, as needed, oxytocin is released into the blood.

Synthetic oxytocin (Oxytocin - Latin) is used for therapeutic purposes. In accordance with the anatomical-therapeutic-chemical classification (or ATC for short), he was assigned the code H01B B02.

The gross formula of oxytocin, characterizing its composition: C 43 H 66 N 12 O 12 S 2 . The active ingredient is Oxytocin (Latin), which contains 5 IU per milliliter of solution. Excipients include chlorobutanol hemihydrate, as well as water required for injection.

The drug is stored at a positive temperature in the range of 8-15 ° C in a place where light does not fall.

Pharmacological properties

Synthetic oxytocin used in therapeutic practice is identical in its properties to the hormone produced by the pituitary gland. Pharmacological properties determined the complex composition, represented by an octapeptide cycle, supplemented by a side chain, in which there are amino acid residues - leucine, proline, glycine. The dominant action is the stimulation of the muscles of the uterus.

Also, the drug oxytocin increases the permeability of the membrane for the passage of potassium ions, promotes the secretion of milk by stimulating the production, which is a lactogenic hormone created in the pituitary gland (anterior lobe). Subsequently, when feeding an infant, the effect of oxytocin is aimed at intensifying milk secretion by influencing the contractile elements of the mammary gland. Possessing a weak antidiuretic effect, the drug does not have a pronounced effect on blood pressure.

Since oxytocin, under the influence of certain enzymes - trypsin, pepsin is destroyed, getting into the gastrointestinal tract, parenteral methods of its administration are used. In the body, the hormone does not bind to plasma proteins. The metabolic process takes place in the liver, after which oxytocin is excreted by the kidneys. Its half-life has been found to be five minutes.

Considering oxytocin, the release form of which is directly related to the main method of its administration (injection), it should be noted that it is produced in 1 ml ampoules in the form of a 5 IU / ml solution. It can be administered both intramuscularly and intravenously. The kit includes an ampoule knife and a solution for injection.

Action on the uterus

Produced directly in the brain, oxytocin with the bloodstream enters the organs responsible for childbirth and lactation - the uterus and mammary glands. In addition to the functions associated with childbirth, the hormone, as recent studies have shown, has a positive effect on the psycho-emotional sphere, forming, in addition to a positive attitude, a manifestation of the maternal instinct.

During pregnancy, oxytocin does not change concentration, and only before the onset of labor, the level becomes higher, reaching a maximum when labor activity passes the second and third stages.

After administration in order to stimulate the contractile function of the uterus, the effect of oxytocin appears after 3 to 5 minutes, and then continues for about three hours. The drug does not have a significant effect on the fetus, since oxytocin reaches it in small quantities, quickly breaking down in the body of the uterus with the help of oxytocinase, an enzyme found in the mammary glands, uterine muscle and placenta.

Given the contractile effect exerted by oxytocin on the uterus, it is not used as an aid in normal labor.

Indications for use

In order to correctly use oxytocin, it is necessary to study what indications for use are the basis for medical prescription. One of the directions is the induction (artificial induction) of labor activity.

The reason may be the need to ensure a rapid delivery due to premature withdrawal of amniotic fluid, which caused the absence of contractions. This situation is dangerous for the fetus and the woman in labor with the possibility of infection. Rapid delivery is also required if progressive severe preeclampsia is observed during pregnancy with edema, the presence of protein in the urine, and high blood pressure. Can serve as an indication for urgent stimulation of childbirth pronounced Rhesus-conflict.

Oxytocin is also prescribed for severe weakness of labor activity. This drug is necessary if a slowdown in the process of the reverse development of the uterus after childbirth is diagnosed - subinvolution. With a stimulating effect on the uterus of oxytocin, its use avoids serious consequences after a septic or incomplete abortion.

Oxytocin can be used as a therapeutic, as well as a prophylactic agent, if there is bleeding - placental or atonic after cesarean section, which the antibiotic could not cope with.

Admission instructions

The main document regulating all actions with the drug is the instructions for use, which reflects not only its optimal dosage or withdrawal time, but also possible negative consequences and contraindications.

Given the indications for use, the doctor determines the amount and method of administration - intramuscularly, intravenously or subcutaneously, shown in the photo, while the latter method is used less often than others.

To stimulate childbirth, the instruction provides for the use of oxytocin in the form of a drip intravenous infusion with the obligatory observance of the speed of its implementation. Intravenous administration of oxytocin, the purpose of which is the induction of labor, is carried out only under medical supervision in a hospital. An experienced doctor should be nearby during the entire time of receiving the infusion in order to quickly take emergency measures if side effects develop.

With the help of devices and equipment during the procedure, monitoring is carried out with fixation of uterine contractions and monitoring of the cardiac activity of the fetus, as well as the woman in labor. If the first symptoms appear, indicating an overactive uterus, the procedure is canceled, after which excessive uterine contractions usually disappear quickly.

If you want to stop uterine bleeding after childbirth, you can give injections of oxytocin intramuscularly after the placenta has already separated. The usual dose is 5 IU. When prescribing the drug as a prevention of atonic uterine bleeding, it will take 2-3 days to put intramuscularly from two to three times 3-5 IU.

Dropping oxytocin into the nose from a pipette or administering it intramuscularly in an amount of 0.5 IU can stimulate lactation. The procedure is done before feeding, about 5 minutes before it. Subcutaneously, as well as intramuscularly, oxytocin can be prescribed for gynecological problems (5-10 IU). A prescription is required to purchase.

Side effects

Before giving injections of oxytocin, it is advisable to study what negative effects they can have. Women in childbirth may experience the following symptoms:

• tetany (constant tension) of the uterus;
• arterial hypertension;
• bleeding that worsens after childbirth;
• spasms;
• allergy;
• anaphylactic reactions;
• headache.

Perhaps the appearance of a hematoma of the pelvis. Sometimes there are problems of the cardiovascular system:

• bradycardia;
• arrhythmia;
• reflex tachycardia.

The newborn may experience jaundice, hemorrhage in the retina.

Interaction with other drugs

When a sick woman uses vasoconstrictors after the administration of oxytocin, after about 3 to 4 hours, severe arterial hypertension may develop against the background of caudal anesthesia. If anesthesia involves the use of cyclopropane, then the cardiovascular effect of oxytocin may change in a negative direction with the development of arterial hypotension. Sometimes in a similar situation sinus bradycardia is shown.

Contraindications

Contraindications characteristic of oxytocin serve as a serious warning to its use. These can be the following pathological conditions:

• hypersensitivity;
• narrow pelvis;
• transverse or oblique unfavorable position of the fetus;
• emergency situations in the well-being of the fetus or woman in labor, requiring urgent surgical intervention;
• uterine hypertonicity;
• prolapse of the umbilical cord;
• threatening uterine rupture;
• marginal or central presentation.

Caution is needed if weak contractile activity of the uterus during labor is detected, when prolonged use of oxytocin is unacceptable. It also requires careful monitoring of how the drug will act in multiple pregnancies, as well as if a woman has uterine fibroids.

Overdose

Excessive hyperstimulation sometimes acts extremely negatively, causing contractions that negatively affect the course of labor - tetanic (prolonged) or excessively strong. Rapid labor may occur. Often there are ruptures of the vagina, cervix. Another manifestation of an overdose is postpartum hemorrhage, slowing of the fetal heart rate, hypercapnia as a result of hypoxia. In the most severe cases, the fetus dies.

Long-acting oxytocin at doses of 40 to 50 ml/min can cause overhydration due to the fact that this hormone can work with an antidiuretic effect.

Overdose treatment involves the abolition of the drug, the use of diuretics, fluid restriction. A hypertonic saline solution administered intravenously is also prescribed. The electrolyte balance is corrected. Barbiturates are used to control seizures. If the patient is in a coma, then professional care will be required.