Pitocin


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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.

Pitocin

(pĭ-tō′sĭn)
A trademark for a drug preparation of oxytocin.

Pitocin

a trademark for an oxytocic (oxytocin).

Pitocin

Obstetrics A proprietary oxytocin, see there.
References in periodicals archive ?
And then when it is time for the birth, the fetus cannot get through the birth canal on its own volition and the delivery requires Pitocin to initiate contractions.
double dagger]Includes pitocin, medical methods and manual removal of retained products.
It is interesting to see that while 50% of women either agreed strongly or agreed somewhat that intervention during labor and birth should only be used when medically necessary, half of all women surveyed, 50%, attempted induction, 94% used electronic fetal monitoring, 83% had an IV, 56% were catheterized, 47% had artificial rupture of membranes after labor began, and 47% were given Pitocin to speed up their labors.
Sinai dips into a database of 50,000 live births to examine the relationship between autism and exposure to the labor-inducing drug pitocin.
1985) (holding that for the drug Pitocin, since no alternative safer design was available, the only relevant issue was the drug's utility to users); Castrignano v.
They had a day to prepare for the labor that would be induced through an intravenous drip of pitocin, a synthetic hormone that stimulates uterine con tractions.
2 times more use of oxytocin or pitocin (to induce labor--more risk to mother and baby)
The three groups also were comparable with respect to intrapartum characteristics such as epidural use and gestational age at delivery, although those who experienced uterine rupture were more likely to have been induced and to have received Pitocin, she noted.
July 5, 2011 /PRNewswire/ -- JHP Pharmaceuticals, a leading marketer and manufacturer of sterile injectable products, is launching larger pack sizes for three products commonly used in acute care clinical settings: Adrenalin (epinephrine injection, USP), Coly-Mycin M Parenteral (colistimethate sodium, USP) and Pitocin (oxytocin injection, USP synthetic).
However, she acknowledged that it would be "important to know," since neither Cervidil nor Pitocin are appropriate when a baby is in a breech position.