Oxytocin contraindications

Pitocin Description Pitocin (oxytocin injection, USP) is a sterile, clear, colorless aqueous solution of synthetic oxytocin, for intravenous infusion or intramuscular injection. Pitocin is a nonapeptide found in pituitary extracts from mammals. It is standardized to contain 10 units of oxytocic hormone/mL and contains 0.5% Chlorobutanol, a chloroform derivative as a preservative, 1.65 mg acetic acid and 0.16 mg ammonium acetate as buffers, and with the pH adjusted with acetic acid to achieve a targeted pH of 3.5. Pitocin may contain up to 16% of total impurities. The hormone is prepared synthetically to avoid possible contamination with vasopressin (ADH) and other small polypeptides with biologic activity. Pitocin has the empirical formula C 43H 66N 12O 12S 2 (molecular weight 1007.19). The structural formula is as follows: Pitocin - Clinical Pharmacology Uterine motility depends on the formation of the contractile protein actomyosin under the influence of the Ca 2+-dependent phosphorylating enzyme myosin light-chain kinase. Oxytocin promotes contractions by increasing the intracellular Ca 2+. Oxytocin has specific receptors in the myometrium and the receptor concentration increases greatly during pregnancy, reaching a maximum in early labor at term. The response to a given dose of oxytocin is very individualized and depends on the sensitivity of the uterus, which is determined by the oxytocin receptor concentration. However, the physician should be aware of the fact that ...

Oxytocin may also be used for other conditions as determined by your doctor. In general, oxytocin should not be used to start labor unless there are specific medical reasons. Be sure you have discussed this with your doctor before receiving this medicine. This medicine is available only with your doctor's prescription. Novartis Pharmaceuticals removed Syntocinon® nasal spray from the market in March 1995. • Portions of this document last updated: Feb. 01, 2023 Copyright: © Merative US L.P. 1973, 2023. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. • •

US Pharm. 2011;36(5):HS-36-HS-40. Generally, the third stage of labor starts with the delivery of the fetus and ends with the delivery of the placenta and its attached membranes. If there is any sign of complications during or after labor, the clinician will determine the risks and assess the situation. As a result, many authorities have named a fourth stage of labor that begins with the delivery of the placenta and lasts for several hours. The most common complication in the third and fourth stages of labor is postpartum hemorrhage (PPH). Although maternal mortality rates are coming down, PPH remains a leading cause of maternal mortality. 1 In the United States, the maternal mortality rate is approximately seven to 10 women per 100,000 live births. National statistics suggest that approximately 8% of these deaths are caused by PPH. However, the World Health Organization (WHO) statistics suggest that worldwide, 25% of maternal deaths are due to PPH, accounting for more than 100,000 maternal deaths per year. The death of these mothers has serious implications for the newborn and any other members of the family. 2 If a complication arises during or after labor, the right choice and proper use of one or two uterotonic agents can control PPH and reduce maternal mortality up to 40%. For many years, the uterotonic agent of choice has been oxytocin with or without supplemental methylergonovine. Methylergonovine ampules are unstable at room temperature and thus require special tem...

IV: Induction of labor at term. Facilitation of uterine contractions at term. Facilitation of threatened abortion. Postpartum control of bleeding after expulsion of the placenta. Intranasal: Used to promote milk letdown in lactating women. Unlabeled Use: Evaluation of fetal competence (fetal stress test). CNS: maternal: COMA, SEIZURES fetal: INTRACRANIAL HEMORRHAGE. Resp: fetal: ASPHYXIA, hypoxia. CV: maternal: hypotension; fetal: arrhythmias. F and E: maternal: hypochloremia, hyponatremia, water intoxication. Misc: maternal: increased uterine motility, painful contractions, abruptio placentae, decreased uterine blood flow, hypersensitivity. • If administered IV during childbirth, be alert for maternal seizures or decreased consciousness that progresses to coma. Report seizures or coma-like responses to the physician or nursing staff immediately. • Monitor any signs of fetal distress or asphyxia, such as decreased fetal heart rate, arrhythmias, meconium discharge, or decreased or absent fetal movements. Report these signs to the physician or nursing staff immediately. • Assess maternal blood pressure periodically and compare to normal values (See • Monitor signs of maternal fluid and electrolyte imbalances, such as low sodium levels (hyponatremia), low chloride levels (hypochloremia), or a relative increase in body fluid (water intoxication). Signs include headache, confusion, lethargy, irritability, decreased consciousness, and neuromuscular abnormalities (muscle weakness...

Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective component of this practice. Oxytocin is more effective than misoprostol for prevention and treatment of uterine atony and has fewer adverse effects. Routine episiotomy should be avoided to decrease blood loss and the risk of anal laceration. Appropriate management of postpartum hemorrhage requires prompt diagnosis and treatment. The Four T's mnemonic can be used to identify and address the four most common causes of postpartum hemorrhage (uterine atony [Tone]; laceration, hematoma, inversion, rupture [Trauma]; retained tissue or invasive placenta [Tissue]; and coagulopathy [Thrombin]). Rapid team-based care minimizes morbidity and mortality associated with postpartum hemorrhage, regardless of cause. Massive transfusion protocols allow for rapid and appropriate response to hemorrhages exceeding 1,500 mL of blood loss. The National Partnership for Maternal Safety has developed an obstetric hemorrhage consensus bundle of 13 patient- and systems-level recommendations to reduce morbidity and mortality from postpartum hemorrhage. Clinical recommendation Evidence rating References Routinely use active management of the third stage of labor, preferably with oxytocin (Pitocin). This practice will decreas...

Oxytocin (Monograph) Brand name: Drug class: Oxytocics VA class: GU600 CAS number: 50-56-6 • • • • • • Introduction Oxytocic; indirectly stimulates contraction of uterine smooth muscle; elicits all the responses of endogenous oxytocin. Uses for Oxytocin Elective induction of labor (i.e., no medical indication for induction) merely for clinician or patient convenience is not a valid indication for oxytocin use. IV infusion of dilute solutions is the method of choice for inducing labor at term and stimulating uterine contractions during the first and second stages of labor. Labor Induction Use for labor induction is indicated in term or near-term pregnancies associated with hypertension (e.g., preeclampsia, eclampsia, cardiovascular-renal disease), erythroblastosis fetalis, maternal or gestational diabetes mellitus, antepartum bleeding, premature placenta rupture (abruptio placentae) chorioamnionitis, or premature rupture of the membranes in which spontaneous labor does not ensue. Routine induction of labor with oxytocin may be indicated in prolonged pregnancies (greater than 42 weeks’ gestation). Eclampsia: if delivery is not imminent within 12 hours following an initial oxytocin infusion, consider cesarean section rather than continued oxytocin administration. Induction of labor also may be indicated in cases of uterine fetal death (demise), fetal compromise (e.g., fetal growth retardation, isoimmunization), or static or decreasing maternal weight. However, may be relative...

Oxytocin may also be used for other conditions as determined by your doctor. In general, oxytocin should not be used to start labor unless there are specific medical reasons. Be sure you have discussed this with your doctor before receiving this medicine. This medicine is available only with your doctor's prescription. Novartis Pharmaceuticals removed Syntocinon® nasal spray from the market in March 1995. Before Using In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric No information is available on the relationship of age to the effects of oxytocin in the pediatric population. Safety and efficacy have not been established. Geriatric No information is available on the relationship of age to the effects of oxytocin in geriatric patients. Breastfeeding Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake. Drug Interactions Alt...