Syntocinon


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Related to Syntocinon: Misoprostol, Ergometrine, Terbutaline

oxytocin

Pitocin, Syntocinon (CA) (UK), Syntometrine (UK)

Pharmacologic class: Posterior pituitary hormone

Therapeutic class: Uterine-active agent

Pregnancy risk category NR

FDA Box Warning

• Drug isn't indicated for elective induction of labor (defined as initiation of labor in pregnant woman with no medical indications for induction). Available data aren't adequate to evaluate benefits versus risk.

Action

Unknown. Thought to directly stimulate smooth muscle contractions in uterus and cervix.

Availability

Injection: 10 units/ml ampule or vial

Indications and dosages

To induce or stimulate labor

Adults: Initially, 1-ml ampule (10 units) in compatible I.V. solution infused at 1 to 2 milliunits/minute (0.001 to 0.002 units/minute). Increase rate in increments of 1 to 2 milliunits/minute q 15 to 30 minutes until acceptable contraction pattern is established.

To control postpartum bleeding

Adults: 10 to 40 units in compatible I.V. solution infused at rate adequate to control bleeding; or 10 units I.M. after placenta delivery

Incomplete abortion

Adults: 10 units in compatible I.V. solution infused at 10 to 20 milliunits/minute (0.01 to 0.02 units/minute)

Off-label uses

• Antepartal fetal heart rate testing
• Breast enlargement

Contraindications

• Hypersensitivity to drug
• Cephalopelvic disproportion
• Fetal distress when delivery is not imminent
• Prolonged use in uterine inertia or severe toxemia
• Hypertonic or hyperactive uterine pattern
• Unfavorable fetal position or presentation that's undeliverable without conversion
• Labor induction or augmentation when vaginal delivery is contraindi-cated (as in invasive cervical cancer, active genital herpes, or total placenta previa)

Precautions

Use cautiously in:
• previous cervical or uterine surgery, history of uterine sepsis
• breastfeeding patients.

Administration

• Reconstitute by adding 1 ml (10 units) to 1,000 ml of normal saline solution, lactated Ringer's solution, or dextrose 5% in water.

Don't give by I.V. bolus injection.
• Infuse I.V. using controlled-infusion device.
• Be aware that drug isn't routinely given I.M.
• Know that drug should be given only to inpatients at critical care facilities when prescriber is immediately available.

Adverse reactions

CNS: seizures, coma, neonatal brain damage, subarachnoid hemorrhage

CV: premature ventricular contractions, arrhythmias, neonatal bradycardia

GI: nausea, vomiting

GU: postpartal hemorrhage; pelvic hematoma; uterine hypertonicity, spasm, or tetanic contraction; abruptio placentae; uterine rupture (with excessive doses)

Hematologic: afibrinogenemia

Hepatic: neonatal jaundice

Other: hypersensitivity reactions including anaphylaxis, low 5-minute Apgar score (neonate)

Interactions

Drug-drug.Sympathomimetics: postpartal hypertension

Thiopental anesthetics: delayed anesthesia induction

Vasoconstrictors: severe hypertension (when given within 3 to 4 hours of oxytocin)

Drug-herbs.Ephedra (ma huang): increased hypertension

Patient monitoring

Continuously monitor contractions, fetal and maternal heart rate, and maternal blood pressure and ECG. Discontinue infusion if uterine hyper-activity occurs.

Monitor patient extremely closely during first and second stages of labor because of risk of cervical laceration, uterine rupture, and maternal and fetal death.
• When giving drug to control postpartal bleeding, monitor and record vaginal bleeding.
• Assess fluid intake and output. Watch for signs and symptoms of water intoxication.

Patient teaching

• Inform patient about risks and benefits of oxytocin-induced labor.

Teach patient to recognize and immediately report adverse drug effects.

Syntocinon

a trademark for an oxytocic (oxytocin).

Syntocinon

A brand name for the womb muscle stimulating drug OXYTOCIN.
References in periodicals archive ?
7%) women, other methods were syntocinon infusion, intracervical foley, s catheter.
Ms Okuonghae, who worked at Prince Charles Hospital in Merthyr Tydfil between 2005 and 2006, admitted in a Nursing and Midwifery Council hearing to attempting to give 10 times the correct amount of labour-inducing drug syntocinon to her patients.
Trust bossed accepted the use of Syntocinon, a drug used in obstetrics when labour is prolonged, should not have been administered when the baby showed "clear signs of foetal distress".
Lorraine enjoyed a trouble-free pregnancy and at 38 weeks was induced using the drugs prostaglandin and syntocinon in the hospital's delivery suite.
Lara and her partner had specifically requested that no Syntocinon was administered until the umbilical cord had stopped pulsating.
Cuando las contracciones son debiles y la dilatacion escasa o nula, o ante la constatacion de estres fetal, suele usarse una potente droga llamada Pitocin, o Syntocinon, cuyo fin es el de provocar o acelerar el parto estimulando contracciones continuas que llevan a una dilatacion mas rapida.
It is alleged she instructed a midwife to increase the dosage of a drug called Syntocinon, used to induce labour, from 18mls per hour, eventually up to 96mls, despite a disagreement with the midwife.
Midwife Elizabeth Cluett and multidisciplinary colleagues in Southampton, UK, have published the results of a randomised control trial showing that water immersion to address slow labour in nulliparous women reduced the need for syntocinon augmentation and for epidural analgesia.
Last week the UKCC ruled that three midwives who cared for Michelle during labour - Daphne Moore, Nicole Collins and Helen Kiddell - continued to administer Syntocinon, a labour-inducing drug, despite indications of foetal distress and failed to take appropriate action after a heart monitor showed something was wrong.
Specifically, the use or non-use of syntocinon during vacuum aspiration may have an effect.