Oxytocin

Indications & Dose:

Induction and augmentation of labor; missed or incomplete abortion (adjunctive); postpartum bleeding; postpartum breast engorgement,* antepartum fetal heart rate testing, (oxytocin challenge test)

DOSE 

Adults: Induction or enhancement of labour in hypotonic uterine inertia: i.v. drip infusion of a 5% dextrose solution containing 0.001 -0.004 units/ minutes increased at intervals of not less than 20 minutes untill labour pattern established max: recommended rate 0.02 units/minute (use solution containing 10 units/500ml if higher rate required). 3rd stage labour and puerperium: 5-10 i.u. i.m. or 5 i.u. i.v. slowly. Caesarean section: 5 i.u. intramurally after delivery. Missed abortion, as a solution containing 10-20 units/500mL given at a rate of 1030 drops/minute, increased in  strength of by 10-20 drops every 1/2 hour to a max. strength of 100 units/ 500mL 

Children: Not applicable.

Contraindications:

Cephalopelvic disproportion; fetal distress where delivery is not imminent; hypertonic uterus, contraindication to vaginal delivery (i.e., active herpes genitalis, placenta previa, cord presentation, or prolapse).

Pregnancy & old age: Nasal oxytocin contraindicated during pregnancy; only minimal amounts pass into breast milk 

Side Effects:

CNS: Hypertension., seizures, tetanic contractions
CV: Bradycardia, dysrhythmias, hypotension, increased pulse, premature ventricular contractions, tachycardia
FETUS: Dysrhythmias, hypoxia, intracranial hmorrhage, jaundice
GI: Anorexia, constipation, nausea, vomiting
GU: Abruptio placentae, decreased uterine blood flow
METAB: Anuria, confusion, drowsiness, headache, water intoxication
RESP: Asphyxia
SKIN: Rash 

Cautions:

Cervical or uterine surgery, uterine sepsis, fetal distress, prermaturity, cyclopropane anesthesia (maternal bradycardia), water intoxication

Precautions:

Interaction:

Drugs
Sympathomimetics: Pressor effect of sympathomimetics may be  increased leading to postpartum hypertension.
Progstaglandins: Risk of uterine rupture and cervical lacerations.
Ergotamine: Synergistic effect in control of post partum haemorrhage.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: