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.

p

Pitocin

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

Pitocin

Obstetrics A proprietary oxytocin, see there.
References in periodicals archive ?
(249.) See Block, supra note 211, at 5-6 (collecting data showing that anywhere between 30 and 60% of pregnancies are induced, that many more are "augmented" with Pitocin, and that as many as 65% of pregnant women have their water broken manually); id.
Xu and Jin [9] investigated the effect of different proportions of SGD on primary dysmenorrhea and found that SGD could reduce the writhing time of the model rats caused by pitocin, and the 3 : 1 group achieved the best efficacy.
Without oxytocin you don't get your contractions and then one has to be given pitocin injections to induce labour."
Uterine contractions are produced either by stimulating the woman's nipples or via an intravenous administration of pitocin. Oxytocin/pitocin is a hormone that causes the uterus to contract.
This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.
6 July 2011 - US-based marketer and manufacturer of sterile injectable products JHP Pharmaceutical announced today that it 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).
6.) She failed to provide Danni Ann with extra fluids commencing at 8:05 p.m., and 7.) She failed to timely discontinue the administration of pitocin. It was undisputed that Danni Ann sustained a uterine rupture, and that Shannon Reilly was born with cerebral palsy.
These include reducing contractions in a woman with tachysystole of the uterus due to pitocin or for intrauterine resuscitation, adjunct to external cephalic version, relaxing an inverted uterus or as an adjunct to managing inversion of the uterus, transporting a patient with contractions from one location to another, and rarely when delivering a second twin if the uterus needs to be relaxed.
At 5:00 a.m., the morning after Melissa was admitted, Pitocin was started to induce labor.
Oxytocin (78) (or its synthetic form, Pitocin (79)), that brings on
Medical abortion using mifepristone or misoprostol, although becoming more common globally, was rare in any type of facility (1% of cases overall), however, pitocin (a synthetic form of the hormone oxytocin used to induce labor) was administered in 5% of cases, primarily to women in their second trimester who were treated in hospitals.