Oxytocin is a peptide hormone that activates receptors on Uterine smooth muscle leading to the increased frequency, strength and duration of Uterine Contraction..

1. Presented By
Dr. Dinesh Kumar G
Pharm. D

25. OXYTOCIN
DRUG NAME oxytocin (Pitocin)
CLASS Uterine stimulant, oxytocic
MECHANISM OF
ACTION
•Increases intracellular calcium in uterine smooth muscle, which causes uterine muscle contraction
•Causes contraction of the myoepithelial cells around milk-containing alveoli, resulting in milk ejection during
lactation
INDICATIONS
•Induce or augment labor
•Control postpartum bleeding
•Manage incomplete or inevitable abortion
ROA IV, IM, NAS
SIDE EFFECTS
•Uterine hyperstimulation
•Nausea, vomiting
•Hypertension
•Cardiac arrhythmias
•Amniotic fluid embolism
•Water intoxication
CONTRAINDICATIONS
AND CAUTIONS
•Cephalopelvic disproportion
•Fetal malpresentation
•Umbilical cord prolapse
•Non-reassuring fetal status
•Active genital herpes
•Hypertonic uterus
•Unripe cervix
•Grand multiparity and Uterine prolapse
•Clients at risk of uterine rupture
Avoid use in clients receiving vasopressors or prostaglandins like carboprost
Boxed warning: Should be used for medical rather than elective reasons

26. OXYTOCIN
OXYTOCIN
ADMINISTRATION
DURING LABOR
•Start a primary line with 1000 mL IV fluid, e.g. LR
•Start a second line with standardized concentration of oxytocin in IV fluid
•Ensure the bags and tubing are labeled clearly
•Insert oxytocin infusion into mainline IV by connect to port nearest to IV insertion site
•ALWAYS administer oxytocin via infusion pump
•Titrate infusion according to client and fetal response
•Document the start time, end time, dose, and any changes made during administration
MONITORING
•VS and I&O
•Frequency, duration, and force of contractions; resting uterine tone
•FHR pattern
•Side effects; uterine hyperstimulation; e.g., tachysystole (excessively frequent uterine contractions), uterine tetany
(excessively long contractions), nausea, hypertension
•Signs / symptoms of water intoxication; e.g., headache, irritability, confusion, nausea
UTERINE
HYPERSTIMULATI
ON OR ABNORMAL
(CATEGORY III)
FHR
1.Immediately stop the infusion
2.Turn the client on their side, stay with them while you ask another nurse to notify the HCP
3.Increase the rate of the mainline IV fluid (NOT the fluid containing oxytocin)
4.Provide supplemental oxygen at 8–10 L/min via face mask
5.Assess VS and FHR
6.Document your findings, interventions, and client’s response
OXYTOCIN
ADMINISTRATION
DURING
POSTPARTUM
•Administer IV or IM
•Closely monitor fundal tone, fundal height, and position; vital signs, pain, and bleeding
CLIENT
EDUCATION
•Provide client education about how oxytocin will affect their contractions
•Report headache, dizziness, palpitations, or intense pain