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.

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Syntocinon

A brand name for the womb muscle stimulating drug OXYTOCIN.
References in periodicals archive ?
Group NSI 100 ml NS without 2 units of syntocinon infusion (n=100) (Control) was continued at the rate of 30 to 50 drops per minute.
7%) women, other methods were syntocinon infusion, intracervical foley, s catheter.
The NMC admitted they had no direct evidence of Stewart giving Syntocinon to the mothers.
Kirsty, who said she normally saw one or two labours per shift, was the midwife who had started to administer syntocinon.
The addition of carbetocin suits the strategy of company, which earlier today signed a licensing agreement for Novartis's syntocinon, a drug it plans to use for the treatment of schizophrenia and autism, Shkreli added.
* Syntocinon 5 units by slow intravenous injection (may have repeat dose).
Two months later, Mrs Morris breached hospital guidelines when she increased another patient's dose of labour-inducing drug syntocinon past the recommended maximum.
Miacalcin from Novartis Pharmaceuticals and Fortical from Upsher-Smith Laboratories both treat osteoporosis; Pfizer's Nicotrol addresses nicotine addiction; Nascobal from Strativa Pharmaceuticals is used to treat vitamin B deficiency; Ferrin.g Pharmaceuticals produces Desmospray, which fights the dehydration associated with diabetes; Lazanda is a nasally administered opiate from Archimedes Pharma used for pain management; and Novartis delivers Syntocinon, which addresses several conditions associated with pregnancy.
If the cervix is soft and it has started efface, the following approaches are used to start uterine contractions: a) membrane stripping to bring on spontaneous labor, which is done with the help of the examiner's finger by loosening the membranes from the wall of the uterus; b) rupture of membranes, which results in breaking the water bag, helping the labor process go on; and c) an Oxytocin (Syntocinon, Pitocin) drip that triggers the uterine contractions (Fittkow et al., 2005).
They found reduced rates of syntocinon augmentation, reduced rates of epidural and general anaesthesia and increased use of water immersion and non active third stage.
Oxytocin is commonly available as a synthetic formulation (Syntocinon, Novartis Pharmaceuticals Australia Pty Ltd, North Ryde, NSW) which is identical to the peptide hormone but not contaminated with vasopressin, as was the case with the older biologically derived formulation.