Dangerous Drug: Oxytocin(ox i toe’ sin)
Pitocin
PREGNANCY CATEGORY X
Drug Classes
Hormone
Oxytocic
Therapeutic Actions
Synthetic form of an endogenous hormone produced in the hypothalamus and stored in the posterior pituitary; stimulates the uterus, especially the gravid uterus just before parturition, and causes myoepithelium of the lacteal glands to contract, which results in milk ejection in lactating women.
Indications
Antepartum: To initiate or improve uterine contractions to achieve early vaginal delivery; stimulation or reinforcement of labor in select cases of uterine inertia; management of inevitable or incomplete abortion; second trimester abortion
Postpartum: To produce uterine contractions during the third stage of labor and to control postpartum bleeding or hemorrhage
Lactation deficiency
Unlabeled uses: To evaluate fetal distress (oxytocin challenge test), treatment of breast engorgement
Contraindications and Cautions
Contraindicated with significant cephalopelvic disproportion, unfavorable fetal positions or presentations, obstetric emergencies that favor surgical intervention, prolonged use in severe toxemia, uterine inertia, hypertonic uterine patterns, induction or augmentation of labor when vaginal delivery is contraindicated, previous cesarean section, pregnancy.
Use cautiously with renal impairment.
Available Forms
Injection—10 units/mL
Dosages
Adjust dosage based on uterine response.
Adults
Induction or stimulation of labor: Initial dose of no more than 0.5–2 milliunits/min (0.0005–0.002 units/min) by IV infusion through an infusion pump. Increase the dose in increments of no more than 1–2 milliunits/min at 30- to 60-min intervals until a contraction pattern similar to normal labor is established. Rates exceeding 9–10 milliunits/min are rarely required. Discontinue in event of uterine hyperactivity, fetal distress.
IV
Control of postpartum uterine bleeding: Add 10–40 units to 1,000 mL of a nonhydrating diluent; infuse IV at a rate to control uterine atony. Do not exceed 40 units/1,000 mL
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