Uterine Stimulants
TERMS
□ dinoprostone (Prepidil Gel, Prostin E2)
□ oxytocin (Pitocin, Syntocinon)
□ methylerogonovine (Methergine)
QUICK LOOK AT THE CHAPTER AHEAD
Oxytocics, ergot alkaloids, and prostaglandins stimulate uterine contractions. The uterus is a very vascular and muscular organ with smooth muscle fibers extending vertically, horizontally, and obliquely.1 Oxytocin is a hormone secreted by the posterior pituitary gland, causing uterine contractions and labor, and facilitates milk ejection during lactation. Pitocin is a synthetic form of oxytocin. The ergot alkaloids increase the frequency and force of uterine contractions and have potent oxytocic effects. The prostaglandins are natural hormones involved in regulating the myometrium and may be responsible for the natural induction of labor and stimulation of Braxton Hicks contractions, seen in the final week of labor.2
Table 58-1 Uterine Stimulants | ||||||||||||
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UTERINE STIMULANTS CLIENT TEACHINGOxytocics
Instruct clients when administering nasal spray to clear nasal passages, sit upright, hold the container upright, insert into nostril, and squeeze solution into nostril on inspiration.
Nasal spray should be used before breast-feeding or pumping breasts.
Contractions will occur after administration of oxytocin.
Instruct clients when administering nasal spray to clear nasal passages, sit upright, hold the container upright, insert into nostril, and squeeze solution into nostril on inspiration.
Nasal spray should be used before breast-feeding or pumping breasts.Ergot Alkaloids
Avoid smoking as nicotine increases the effects of ergot derivatives (vasoconstriction).
Ergot alkaloids may cause discomfort from uterine contractions.
Do not double up on missed dose. Omit and resume normal dosage schedule.
Avoid smoking as nicotine increases the effects of ergot derivatives (vasoconstriction).Prostaglandins
Notify health care provider if experiencing fever, chills, foul-smelling vaginal discharge, increased bleeding, or lower abdominal pain.
Notify health care provider if experiencing fever, chills, foul-smelling vaginal discharge, increased bleeding, or lower abdominal pain.
ACTIONAll Uterine Stimulants
Stimulate uterine smooth muscle contractions, producing uterine contractions
Oxytocics
Oxytocin (Pitocin, Syntocinon)
Synthetic oxytocin also stimulates the smooth muscle of the mammary gland, facilitating lactation.
Also has antidiuretic and vasopressor effects
Ergot Alkaloids
Directly stimulate uterine and vascular smooth muscle, which also causes vasoconstriction
Prostaglandins
Also stimulate GI smooth muscle
Uterus, in early pregnancy, is more responsive to prostaglandins’ ability to stimulate contractions, which is why they are used to induce abortion.
Cervical dilation and softening
USEOxytocics
Oxytocin (Pitocin, Syntocinon)
Induction of labor
Control postpartum or postabortion hemorrhage
Intranasal: stimulation of lactation
Ergot Alkaloids
Prevention and treatment of postpartum or postabortion hemorrhage caused by uterine atony or subinvolution
Prostaglandins
Intravaginally to induce abortion from 12 to 20 weeks gestation (Carboprost tromethamine [Hemabate] given from 13 to 20 weeks)
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