Oxytocin is a hormone that is used medically to induce and augment labor. It works by causing contractions of the uterus. It can be administered through intravenous infusion, with dosage protocols varying based on whether the patient is primigravid or multigravid. The hormone also acts in other areas like stimulating milk ejection and playing a role in social behaviors. While oxytocin induction and augmentation is widely used, it requires careful monitoring to avoid side effects from uterine hyperstimulation like fetal distress.
This document discusses oxytocin, a hormone and medication that stimulates contractions of the uterine smooth muscle. It is the primary mediator of contractions during labor. Oxytocin is produced naturally in pregnancy and administered exogenously to induce or augment labor. It is also used to control postpartum bleeding and promote milk ejection during breastfeeding. The document outlines the physiology, preparations, administration, indications, contraindications and risks of oxytocin use. It provides guidelines for safe administration during labor induction and monitoring for complications like uterine hyperstimulation and fetal distress.
Induction and augmentation of labor can be done when the benefits outweigh continuing the pregnancy. Induction requires no contraindications and an assessment of cervical readiness. Common induction methods include prostaglandins like misoprostol or dinoprostone for cervical ripening, and oxytocin infusion to stimulate contractions. Risks include failed induction requiring C-section, uterine hyperstimulation, and fetal distress. Oxytocin must be carefully titrated to achieve effective contractions without overstimulation.
Induction and augmentation of labor can be done when the benefits outweigh continuing the pregnancy. Induction requires a valid medical indication and favorable cervix. Common induction methods include prostaglandins like misoprostol or dinoprostone for cervical ripening, Foley catheter, and oxytocin infusion. Risks include failed induction requiring C-section, uterine hyperstimulation, and fetal distress. Oxytocin dosage is slowly increased every 30 minutes until adequate contractions occur.
OXYTOCIN, ERGOT ALKALOIDS
&
UTERINE RELAXARS
Uterine stimulants (uterotonics) are medications given to cause a woman's uterus to contract, or to increase the frequency and intensity of the contractions. These drugs are used to induce (start) or augment (speed) labor; facilitate uterine contractions following a miscarriage; induce abortion; or reduce hemorrhage following childbirth or abortion.
“Tocolytic Drugs”
Relax the uterus and arrest threatened abortion or delay premature labor.
The document discusses oxytocics, which are drugs that stimulate uterine contractions. It focuses on oxytocin, ergot alkaloids, and prostaglandins. Oxytocin acts through G protein-coupled receptors in the uterus and stimulates prostaglandin release to induce contractions. Ergot alkaloids like ergometrine act mainly on serotonin receptors in the uterus to produce powerful, prolonged contractions. Prostaglandins like PGE2 and PGF2a are synthesized locally in the uterus and membranes and help induce labor by ripening the cervix and stimulating contractions.
DRUGS USED IN GYNAECOLOGY BY COSS B.pptxTendaiSiku
This document summarizes common drugs used in gynecology. It discusses prostaglandins and oxytocics like oxytocin, ergometrine, and prostaglandins which are used to induce labor, abortion and minimize postpartum bleeding. It also discusses mifepristone, myometrial relaxants, opioid analgesics like pethidine, magnesium sulfate and calcium gluconate. It provides details on indications, contraindications, side effects and dosing for these various drugs. The document also discusses contraception methods like combined oral contraceptives and progestogen-only contraceptives.
Hope it helps.. This presentation describes about labour induction, its types, methods, management and responsibilities. also the procedure of performing the methods. pictures as per need attached for the reference. like and comment if any suggestion.
A brief introduction regarding oxytocics & tocolytics which are the indispensable drugs in obstetrics. It consists of illustrative images, classification of drugs with their dosage, uses & side-effects along with contraindications
This document discusses oxytocin, a hormone and medication that stimulates contractions of the uterine smooth muscle. It is the primary mediator of contractions during labor. Oxytocin is produced naturally in pregnancy and administered exogenously to induce or augment labor. It is also used to control postpartum bleeding and promote milk ejection during breastfeeding. The document outlines the physiology, preparations, administration, indications, contraindications and risks of oxytocin use. It provides guidelines for safe administration during labor induction and monitoring for complications like uterine hyperstimulation and fetal distress.
Induction and augmentation of labor can be done when the benefits outweigh continuing the pregnancy. Induction requires no contraindications and an assessment of cervical readiness. Common induction methods include prostaglandins like misoprostol or dinoprostone for cervical ripening, and oxytocin infusion to stimulate contractions. Risks include failed induction requiring C-section, uterine hyperstimulation, and fetal distress. Oxytocin must be carefully titrated to achieve effective contractions without overstimulation.
Induction and augmentation of labor can be done when the benefits outweigh continuing the pregnancy. Induction requires a valid medical indication and favorable cervix. Common induction methods include prostaglandins like misoprostol or dinoprostone for cervical ripening, Foley catheter, and oxytocin infusion. Risks include failed induction requiring C-section, uterine hyperstimulation, and fetal distress. Oxytocin dosage is slowly increased every 30 minutes until adequate contractions occur.
OXYTOCIN, ERGOT ALKALOIDS
&
UTERINE RELAXARS
Uterine stimulants (uterotonics) are medications given to cause a woman's uterus to contract, or to increase the frequency and intensity of the contractions. These drugs are used to induce (start) or augment (speed) labor; facilitate uterine contractions following a miscarriage; induce abortion; or reduce hemorrhage following childbirth or abortion.
“Tocolytic Drugs”
Relax the uterus and arrest threatened abortion or delay premature labor.
The document discusses oxytocics, which are drugs that stimulate uterine contractions. It focuses on oxytocin, ergot alkaloids, and prostaglandins. Oxytocin acts through G protein-coupled receptors in the uterus and stimulates prostaglandin release to induce contractions. Ergot alkaloids like ergometrine act mainly on serotonin receptors in the uterus to produce powerful, prolonged contractions. Prostaglandins like PGE2 and PGF2a are synthesized locally in the uterus and membranes and help induce labor by ripening the cervix and stimulating contractions.
DRUGS USED IN GYNAECOLOGY BY COSS B.pptxTendaiSiku
This document summarizes common drugs used in gynecology. It discusses prostaglandins and oxytocics like oxytocin, ergometrine, and prostaglandins which are used to induce labor, abortion and minimize postpartum bleeding. It also discusses mifepristone, myometrial relaxants, opioid analgesics like pethidine, magnesium sulfate and calcium gluconate. It provides details on indications, contraindications, side effects and dosing for these various drugs. The document also discusses contraception methods like combined oral contraceptives and progestogen-only contraceptives.
Hope it helps.. This presentation describes about labour induction, its types, methods, management and responsibilities. also the procedure of performing the methods. pictures as per need attached for the reference. like and comment if any suggestion.
A brief introduction regarding oxytocics & tocolytics which are the indispensable drugs in obstetrics. It consists of illustrative images, classification of drugs with their dosage, uses & side-effects along with contraindications
This document summarizes oxytocics and tocolytics drugs. Oxytocics stimulate uterine contractions and are used to induce or augment labor. Common oxytocics include oxytocin, ergot alkaloids, and prostaglandins. Tocolytics relax the uterus and are used to delay preterm labor. Common tocolytics include beta-adrenergic agonists, magnesium sulfate, calcium channel blockers, atosiban, prostaglandin inhibitors, and nitric oxide donors. The document provides details on the mechanisms of action, dosages, and administration routes for various oxytocics and tocolytics drugs.
Oxytocics are drugs that stimulate uterine contractions and are used to induce labor, treat postpartum hemorrhage, and other conditions. Oxytocin is considered the first-line oxytocic agent due to its effectiveness and low cost. Other commonly used oxytocics include ergot alkaloids like ergometrine, prostaglandins, and newer agents like carbetocin, while tocolytics are used to relax the uterus.
This document provides guidelines for using aciclovir to treat herpes simplex encephalitis and neonatal herpes simplex and varicella zoster infections. It details the indications, dosing, administration, side effects and incompatibilities of both intravenous and oral aciclovir formulations for neonatal use.
Oxytocin is a peptide hormone synthesized in the hypothalamus and secreted by the posterior pituitary gland. It stimulates uterine contractions during labor and milk ejection during breastfeeding. Clinically, oxytocin is used to induce and augment labor, to prevent postpartum hemorrhage, and in the oxytocin challenge test to assess fetal well-being. Atosiban is an oxytocin receptor antagonist used to suppress premature labor.
Medical termination of pregnancy can be performed using medical or surgical methods. Medical methods involve using medications like mifepristone and misoprostol to induce abortion. Surgical methods involve emptying the uterus using instruments. The MTP Act of 1971 legalized abortion in India and established conditions for when it can be performed and who is qualified to perform it. Common methods include mifepristone followed by misoprostol up to 9 weeks, and dilation and evacuation or prostaglandin administration in the second trimester. Effectiveness depends on gestational age and regimen used.
1. Physiologic changes in pregnancy can increase risks during general anesthesia including airway edema, difficulty with intubation, and increased risk of aspiration due to stomach displacement. Regional techniques like epidurals are preferred to avoid these risks.
2. Epidural analgesia during labor provides effective pain relief in over 85% of women but can cause hypotension requiring treatment. Combined spinal epidurals allow rapid pain relief with minimal motor block.
3. For c-sections, regional techniques like epidurals and spinals are preferred over general anesthesia due to benefits for mother and neonate, though hypotension is a risk of spinals requiring treatment. General anesthesia is used for emergencies or if regional is contra
This document summarizes drugs acting on the genitourinary system, including uterine stimulants and relaxants. It describes the classification, mechanisms of action, uses, and side effects of various oxytocics (uterine stimulants) like oxytocin, ergot alkaloids, and prostaglandins that are used to induce or accelerate labor. It also discusses uterine relaxants (tocolytics) like ritodrine, nifedipine, magnesium sulfate, and atosiban that inhibit uterine contractions to delay premature labor. The document provides details on the pharmacokinetics, dosing, and administration of these important drugs used in obstetrics.
Medical termination of pregnancy can be performed using medication or surgically. Common medication methods include mifepristone with misoprostol or methotrexate with misoprostol. Surgical termination includes vacuum aspiration. The MTP Act of 1971 legalized abortion in India and established conditions for termination up to 20 weeks gestation. Termination requires consent and can be performed by qualified practitioners in approved facilities. The most effective and commonly used regimens include mifepristone followed by misoprostol 2-3 days later or methotrexate followed by misoprostol.
Oxytocics (oxytocin, ergot alkaloids, prostaglandins) stimulate uterine contractions and are used to induce or augment labor. Oxytocin is the preferred drug as it produces normal contractions. Tocolytics (ritodrine, nifedipine, atosiban, magnesium sulfate) relax the uterus and are used to arrest premature labor. While oxytocics increase uterine motility, tocolytics decrease it.
Dinoprostone is a naturally occurring prostaglandin. It has important effect in labour. Also it stimulates osteoblasts to release factors which stimulates bone. As a prescription, it is used as a vaginal suppository, to prepare the cervix for labour and to induce labour.
This document provides information on standing orders and life-saving drugs that can be used in obstetric emergencies as approved by the Ministry of Health and Family Welfare in India. It defines standing orders as specific treatment instructions that nurses and other healthcare workers can follow when a doctor is unavailable. The document outlines common situations where standing orders may be used and objectives of having standing orders. It then provides details on several emergency drugs that can be administered under standing orders for obstetric and gynecological situations, including magnesium sulfate, calcium gluconate, nifedipine, hydralazine and nitroglycerin. For each drug, it discusses properties, mechanisms of action, indications, dosages, administration routes
The document describes four methods (A, B, C, D) to perform a biological assay of oxytocin using different animal models and physiological responses. Method A uses chickens to measure changes in blood pressure. Method B uses rat uteri to measure contractions. Method C uses lactating rats to measure milk ejection pressure. Method D uses rats to measure vasopressor activity by changes in blood pressure. The methods involve administering standard and test preparations of oxytocin and comparing their dose-response relationships.
Induction of labour involves stimulating uterine contractions before spontaneous onset of labour for the purpose of achieving vaginal delivery. It requires assessing maternal and fetal parameters and obtaining informed consent. Common indications include post-term pregnancy and medical conditions in the mother. Risks include uterine hyperstimulation and increased caesarean rates. Various techniques can be used including prostaglandins, oxytocin, amniotomy, and mechanical methods depending on cervical status. Close monitoring of mother and baby is needed during induction to watch for complications.
The document discusses medical termination of pregnancy in India. It notes that abortion was legalized in India through the Medical Termination of Pregnancy Act of 1971. The act permits abortion up to 20 weeks and also in special cases after 20 weeks. It then describes various medical and surgical methods for terminating pregnancies in the first and second trimesters, including the use of medications like mifepristone and misoprostol as well as surgical procedures like vacuum aspiration and dilation and evacuation.
The document discusses medical termination of pregnancy in India. It defines medical termination of pregnancy as the deliberate termination of a pregnancy before fetal viability, either through medical or surgical methods. The Medical Termination of Pregnancy Act of 1971 legalized abortion in India and established guidelines for legal abortions. The document then describes various medical and surgical methods for terminating a pregnancy in the first and second trimesters.
The document discusses medical termination of pregnancy in India. It was legalized in India through the Medical Termination of Pregnancy Act of 1971. The act allows for termination up to 20 weeks and in certain circumstances such as risk to woman's physical/mental health, fetal abnormalities, or cases of rape or unmarried minors. Methods of termination discussed include medication using mifepristone or prostaglandins as well as surgical procedures like vacuum aspiration or dilation and evacuation. Complications of termination are also outlined.
The document discusses various methods of providing anesthesia and analgesia during labor. It begins by defining anesthesia and analgesia. It then discusses the physiology of pain during the first and second stages of labor. It outlines maternal risk factors for anesthesia and debates whether labor pain requires analgesia. The majority of the document then examines both non-pharmacological and pharmacological methods for pain management, including sedatives, regional techniques like epidural and spinal anesthesia, and inhalation methods. It provides details on procedures, dosages, onset times and complications for each method.
This document discusses various pharmacotherapeutic agents used in obstetrics, including oxytocics, antihypertensive medications, and diuretics. It provides details on the mechanisms of action, indications, contraindications, preparations, and administration of oxytocin, ergot alkaloids, prostaglandins, methyldopa, labetalol, prazocin, hydralazine, nifedipine, and furosemide. The roles of these drugs in induction of labor, postpartum hemorrhage, and treatment of pregnancy-induced hypertension are summarized. Adverse effects on both mother and fetus are also outlined for each class of medication.
This document discusses various pharmacotherapeutic agents used in obstetrics, including oxytocics, antihypertensives, tocolytics, and diuretics. It begins by describing oxytocin and its uses for labor induction and augmentation. It then covers ergot alkaloids like ergometrine and their hemostatic effects. Prostaglandins and their roles in cervical ripening and labor induction are also discussed. The document also outlines various antihypertensive drug classes and individual medications used to treat hypertension during pregnancy. Tocolytics that delay preterm labor like beta-agonists and magnesium sulfate are also summarized.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
This document summarizes oxytocics and tocolytics drugs. Oxytocics stimulate uterine contractions and are used to induce or augment labor. Common oxytocics include oxytocin, ergot alkaloids, and prostaglandins. Tocolytics relax the uterus and are used to delay preterm labor. Common tocolytics include beta-adrenergic agonists, magnesium sulfate, calcium channel blockers, atosiban, prostaglandin inhibitors, and nitric oxide donors. The document provides details on the mechanisms of action, dosages, and administration routes for various oxytocics and tocolytics drugs.
Oxytocics are drugs that stimulate uterine contractions and are used to induce labor, treat postpartum hemorrhage, and other conditions. Oxytocin is considered the first-line oxytocic agent due to its effectiveness and low cost. Other commonly used oxytocics include ergot alkaloids like ergometrine, prostaglandins, and newer agents like carbetocin, while tocolytics are used to relax the uterus.
This document provides guidelines for using aciclovir to treat herpes simplex encephalitis and neonatal herpes simplex and varicella zoster infections. It details the indications, dosing, administration, side effects and incompatibilities of both intravenous and oral aciclovir formulations for neonatal use.
Oxytocin is a peptide hormone synthesized in the hypothalamus and secreted by the posterior pituitary gland. It stimulates uterine contractions during labor and milk ejection during breastfeeding. Clinically, oxytocin is used to induce and augment labor, to prevent postpartum hemorrhage, and in the oxytocin challenge test to assess fetal well-being. Atosiban is an oxytocin receptor antagonist used to suppress premature labor.
Medical termination of pregnancy can be performed using medical or surgical methods. Medical methods involve using medications like mifepristone and misoprostol to induce abortion. Surgical methods involve emptying the uterus using instruments. The MTP Act of 1971 legalized abortion in India and established conditions for when it can be performed and who is qualified to perform it. Common methods include mifepristone followed by misoprostol up to 9 weeks, and dilation and evacuation or prostaglandin administration in the second trimester. Effectiveness depends on gestational age and regimen used.
1. Physiologic changes in pregnancy can increase risks during general anesthesia including airway edema, difficulty with intubation, and increased risk of aspiration due to stomach displacement. Regional techniques like epidurals are preferred to avoid these risks.
2. Epidural analgesia during labor provides effective pain relief in over 85% of women but can cause hypotension requiring treatment. Combined spinal epidurals allow rapid pain relief with minimal motor block.
3. For c-sections, regional techniques like epidurals and spinals are preferred over general anesthesia due to benefits for mother and neonate, though hypotension is a risk of spinals requiring treatment. General anesthesia is used for emergencies or if regional is contra
This document summarizes drugs acting on the genitourinary system, including uterine stimulants and relaxants. It describes the classification, mechanisms of action, uses, and side effects of various oxytocics (uterine stimulants) like oxytocin, ergot alkaloids, and prostaglandins that are used to induce or accelerate labor. It also discusses uterine relaxants (tocolytics) like ritodrine, nifedipine, magnesium sulfate, and atosiban that inhibit uterine contractions to delay premature labor. The document provides details on the pharmacokinetics, dosing, and administration of these important drugs used in obstetrics.
Medical termination of pregnancy can be performed using medication or surgically. Common medication methods include mifepristone with misoprostol or methotrexate with misoprostol. Surgical termination includes vacuum aspiration. The MTP Act of 1971 legalized abortion in India and established conditions for termination up to 20 weeks gestation. Termination requires consent and can be performed by qualified practitioners in approved facilities. The most effective and commonly used regimens include mifepristone followed by misoprostol 2-3 days later or methotrexate followed by misoprostol.
Oxytocics (oxytocin, ergot alkaloids, prostaglandins) stimulate uterine contractions and are used to induce or augment labor. Oxytocin is the preferred drug as it produces normal contractions. Tocolytics (ritodrine, nifedipine, atosiban, magnesium sulfate) relax the uterus and are used to arrest premature labor. While oxytocics increase uterine motility, tocolytics decrease it.
Dinoprostone is a naturally occurring prostaglandin. It has important effect in labour. Also it stimulates osteoblasts to release factors which stimulates bone. As a prescription, it is used as a vaginal suppository, to prepare the cervix for labour and to induce labour.
This document provides information on standing orders and life-saving drugs that can be used in obstetric emergencies as approved by the Ministry of Health and Family Welfare in India. It defines standing orders as specific treatment instructions that nurses and other healthcare workers can follow when a doctor is unavailable. The document outlines common situations where standing orders may be used and objectives of having standing orders. It then provides details on several emergency drugs that can be administered under standing orders for obstetric and gynecological situations, including magnesium sulfate, calcium gluconate, nifedipine, hydralazine and nitroglycerin. For each drug, it discusses properties, mechanisms of action, indications, dosages, administration routes
The document describes four methods (A, B, C, D) to perform a biological assay of oxytocin using different animal models and physiological responses. Method A uses chickens to measure changes in blood pressure. Method B uses rat uteri to measure contractions. Method C uses lactating rats to measure milk ejection pressure. Method D uses rats to measure vasopressor activity by changes in blood pressure. The methods involve administering standard and test preparations of oxytocin and comparing their dose-response relationships.
Induction of labour involves stimulating uterine contractions before spontaneous onset of labour for the purpose of achieving vaginal delivery. It requires assessing maternal and fetal parameters and obtaining informed consent. Common indications include post-term pregnancy and medical conditions in the mother. Risks include uterine hyperstimulation and increased caesarean rates. Various techniques can be used including prostaglandins, oxytocin, amniotomy, and mechanical methods depending on cervical status. Close monitoring of mother and baby is needed during induction to watch for complications.
The document discusses medical termination of pregnancy in India. It notes that abortion was legalized in India through the Medical Termination of Pregnancy Act of 1971. The act permits abortion up to 20 weeks and also in special cases after 20 weeks. It then describes various medical and surgical methods for terminating pregnancies in the first and second trimesters, including the use of medications like mifepristone and misoprostol as well as surgical procedures like vacuum aspiration and dilation and evacuation.
The document discusses medical termination of pregnancy in India. It defines medical termination of pregnancy as the deliberate termination of a pregnancy before fetal viability, either through medical or surgical methods. The Medical Termination of Pregnancy Act of 1971 legalized abortion in India and established guidelines for legal abortions. The document then describes various medical and surgical methods for terminating a pregnancy in the first and second trimesters.
The document discusses medical termination of pregnancy in India. It was legalized in India through the Medical Termination of Pregnancy Act of 1971. The act allows for termination up to 20 weeks and in certain circumstances such as risk to woman's physical/mental health, fetal abnormalities, or cases of rape or unmarried minors. Methods of termination discussed include medication using mifepristone or prostaglandins as well as surgical procedures like vacuum aspiration or dilation and evacuation. Complications of termination are also outlined.
The document discusses various methods of providing anesthesia and analgesia during labor. It begins by defining anesthesia and analgesia. It then discusses the physiology of pain during the first and second stages of labor. It outlines maternal risk factors for anesthesia and debates whether labor pain requires analgesia. The majority of the document then examines both non-pharmacological and pharmacological methods for pain management, including sedatives, regional techniques like epidural and spinal anesthesia, and inhalation methods. It provides details on procedures, dosages, onset times and complications for each method.
This document discusses various pharmacotherapeutic agents used in obstetrics, including oxytocics, antihypertensive medications, and diuretics. It provides details on the mechanisms of action, indications, contraindications, preparations, and administration of oxytocin, ergot alkaloids, prostaglandins, methyldopa, labetalol, prazocin, hydralazine, nifedipine, and furosemide. The roles of these drugs in induction of labor, postpartum hemorrhage, and treatment of pregnancy-induced hypertension are summarized. Adverse effects on both mother and fetus are also outlined for each class of medication.
This document discusses various pharmacotherapeutic agents used in obstetrics, including oxytocics, antihypertensives, tocolytics, and diuretics. It begins by describing oxytocin and its uses for labor induction and augmentation. It then covers ergot alkaloids like ergometrine and their hemostatic effects. Prostaglandins and their roles in cervical ripening and labor induction are also discussed. The document also outlines various antihypertensive drug classes and individual medications used to treat hypertension during pregnancy. Tocolytics that delay preterm labor like beta-agonists and magnesium sulfate are also summarized.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
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TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
2. ● Oxytocin is on world health organizations list because of
it is life saving medication.
● Interestingly, amongst the general public it is known as
love harmone .
3. History:-
Dale first discovered oxytocin in 1909.
Blair Bell first showed action of posterior pituitary extract on
uterine muscle.
Watson Turnbull was the first to use it is an intravenous
Preparation.
4. Chemistry
● It is a Nonapeotide, the synthetic form is known as
Syntocinon ot Pitocin (synthetic oxytocin is a
decapeptide).
5. Site of production :-
In the Body neuropeptide oxytocin is synthesized by
supraoptic and Paraventricular nuclei of hypothalamus and
transferred to posterior Pituitary by carrier proteins by
hypothalamo hypophyseal circulation. It is a neurotransmitter,
harmone.
In endocrinology, the only example of positive feedback loop
is release of oxytocin.
6. Mechanism of action:-
Actions as a harmone:-
● Ecbolic (uterotonic)action:-
● In full term gravid uterus it causes physiological contractions I.e it
causes contractions of upper segment and retraction of the lower
uterine segment.
● It has no action on first trimester uterus and little action on Second
trimester uterus.
● Inthe last 3 weeks there is 8 fold increase in the sensitivity of Uterus
to oxytocin is increased by estrogen and decreased by
progesterone.
7. Action on:-
● Breasts:-
● It causes milk ejection by stimulating myoepithelial cells of the
mammaryglands.
● CVS:-
● Given as intravenous infusion in high concentration bolus,
it Can cause hypertension.
● ANTI DIURETIC ACTION:-
● Given in pharmacological doses it can cause water retention
( because it is closely related to antidiuretic harmone).
8. Neurotransmitter :-
The harmone of labour is also the harmone of love .
Oxytocin could increase anxiety, fear in response to future stress in
men,it creates sexual arousal, and helps them in maintaining their
elections.
Studies indicate that there may be a role for Oxytocin in treatment
of autism.
Evidences shows that Oxytocin injections have a positive influence
on wound healing.
9. Preparations available:-
● Ampoule/ vial for intravenous or intravenous intra
muscular use (pitocin:5units in 0.5 ml,partocin ,Gynotocin,
and Syntocinon:units/ml.
● Nasal spray
● Bucal tablets
● Interestingly an oxytocin -laced perfume is avail5in many
parts of the world (non-medical use)
● To preserve their potency ,synthetic oxytocin Ampoules
must be stored in refrigerator.
10. Routes of administration:-
● Orally ir is ineffective being a protein,it is rapidly destroyed by gastrointestinal tract.
● Buccal or nasal route:- Suggested by clement et al in 1962.
● Half to one tablet of buctocin (100-200units) inserted in buccal pouch. Increase by one tablet
every half an hour till uterine contractions begin or maximum 21 tablets are used.
● Nasal sprays or aerosol s are also available.
● Advantages of this route: action more predictable than intramuscular or subcutaneous route;if
there is hyperstimulation patients can spit out the drug. Patient is ambulatory during this treatment.
● Disadvantages:- erratic response.
● Intramuscular or subcutaneous route not used since the response Is erratic and
the dose cannot be titration to response.
11. Intravenous infusion:-
● It is the best and only route used. Given intravenously the
action starts in 20 - 30 seconds and half - life is only 3
minutes .
● IT CAN BE GIVEN IN VARIOUS WAYS :-
● Intra myometrial injection eg:- during cesarean delivery
has rarely been used.
12. IN OBSTERTRICS, OXYTOCIN CAN BE GIVEN
INTRAVENOUSLY IN 3 WAYS :
OXYTOCIN PHYSIOLOGICAL DOSES:-
● Theobald’s physiological drip :-
● He recommended a slow infusion in doses resembling
physiological doses I.e starting with 0.5 units in 500 ml of RL in
10 drops / min up to maximum dose of 40 Drops per minute.
● Increase the dose up to a maximum of 2 units per 500mlof RL.
13. Advantages of this regimen:No risk of over stimulation
Drawbacks:- The dose is ineffective in many women.
14. Anderson Turnbull’s titration method
The dose is titration against uterine response 3 contractions of
moderate intensity each lasting 30 - 45 sec per 10 min
Thus reducing induction delivery interval.
In modern clinical practice oxytocin is administerd low dose
regimen used in multipara
High dose regimen used primipara according to ACOG
guidelines.
15. Oxytocin pharmacological doses :-
● It is given for prophylaxis And treatment of atonic PPH .
● 10 to 20 units per 500 ml Of RL .
● OXYTOCIN IN ESCALATING DOSES :-
● It is given by escalating drp method ( Andersons logarithmic
method of titration: start with a dose of 4 units in 500 ml of 5%RL
and double the dose with every pint I.e. 8-16-32 and so on up To
a maximum of 100 units. This is not used anymore.
16. Oxytocin Low dose
protocol
High dose
protocol
INITIAL DOSE 1 to 2 mU/min 4 to 6 mU /min
INCREASE INTERVAL 30 min 15 to 30 minutes
DOSE INCREMENT 1 to 2 mU/ min 4 to 6 mU/min
USUAL DOSE FOR
GOOD LABOR
8 to 12 mU/ min 8 to 12 mU/min
MAXIMUM DOSE 30mU/min 42mU/ min
17. ● Using this knowledge and the fact that 1 ml = 15 drops one can easily
calculate the drip rate required for any particular Oxytocin dose in
mU/min as shown in this table.
● In majority of cases good response is obtained with 16mU/min I.e a
rate of 60 drops.min when 2 units of oxytocin are added to 500 ml of
RL .
● Oxytocin dosage regimens for labor induction Using infusion pump.
● There are two different dosage regimes ( recommended by ACOG)
that are used used for labor induction: a low dose regimen for
primigravida.
● The accuracy and control of the infusion can be greatly improved by
an infusion pump ( e .g .Cardiff infusion system):
18. ● The dose can be increase from 1 mu to 42 mu /min .
● It is doubled every 12.5 min .
● Once adequate response is achieved further increase is
stopped. It may be reduced.
● This is because the dose required for initiating uterine
contractions is more than that required for maintaining
them.
● Hence once cervix is > 5 cm dilated , dose can be
decreased to 7 mu /min .
● In some pumps this is done automatically if the
intrauterine pressure transducer shows hyperactivity.
19. Dosage regimens in places where infusion pump is not
available (INDIA)
In primigravida:-Take 10 units of oxytocin in 500 ml of NS or
RL and start with rate of 30 drops per min. Increase the drip
rate by 10 drops per min every 30 minutes till patient gets 3
uterine contractions every 10 min that are moderate in
intensity and lasting > 40 sec . Maintain this rate till delivery
or till side effects occure . Maximum dose that can be given is
60 drops/min .
20. In multipara:-
● Take 2.5 units of oxytocin in 500 ml of NS or RL and start with rate of 10
drops per minute (2.5 miu/min).
● Increase the drip rate by 10 drops per minute every 30 minutes till till patient
gets 3 uterine contractions every 10 min that are moderate intensity and
lasting for > 40 sec
● Maximum drip rate can be given is 60 drops per min.
● If good contraction pattern not established with infusion rate of 60 drops per
min , increase oxytocin concentration to 5 units in 500 ml of DA/NS and
start from 30 drops per min I.e 15 miu/ ml and gradually increase at the rate
of 10 dpm every 30 min. Until good contractions established or maximum
Rate of 60 dpm is reached . If labor Is still not established it should be
considered as failure of labor induction and patient maybe take up for
cesarean delivery.
21. Stop the infusion if hyperstimulation of
Uterus (contractions >60 sec or tachy
systole(>4 contractions perm10 min
..occurs.
22. Monitoring of oxytocin:-
● Oxytocin infusion is a potentially dangerous drug and requires
the following facilities for its optimal use : an adequately
equipped delivery area with trained nursing staff ,
resuscitation equipment;availability of operating room Staff and
and facilitates where caesarean section can be performed
within 30 min.
● Contionus fetal heart rate Monitoring preferably electronic.
23. Monitoring of patient during IV infusion :
● Patient must be under constant supervision
● Patient must be monitored every 5 to 10 min for uterine contractions,
● FHR and any other complications:a records of These should be maintained
on a chart.
● The accuracy and Control of infusion can be greatly controlled by infusion
pump.
● The dose can be increased from 1 mU to 32 mU.
● It is doubled every 12.5 min
● Once adequate response achieved further increase stopped.
● In some pumps it is automatically done if intrauterine pressure transducer
shows hyperactivity.
24. ● Maximum oxytocin dosage; majority of patients respond to
32mU/ml or less.
● Although there is no upper limit to permitted dose,
● It is wise to consider prostaglandin stimulation If uterus is
still inert at 100mu/min.
25. ● Administration of oxytocin in non electrolyte solutions like
dextrose should be avoided.
● Because they are more likely to be associated with water
intoxication and hyponatremia, especially when given in
large doses.
● To prevent this , most labor ward protocols use electrolyte
infusion like normal saline ,ringer lactate or apartment s
solution.
● Recent studies shown that adding 5%dextrose to normal
saline hydrating solution during an oxytocin drip produces
significant reduction in labor duration.
26. ● Beazley and colleagues (1975) suggested
that the dose required for initiating uterine
contractions is more that required for
maintaining them.
● Hence once cervix Is > 5 cm dilated,dose can
be decreased to 7 mu/min.
27. Contraindications:-
● Grand multipara (risk of rupture) .
● Vaginal delivery not feasible ( obstructed labor)
● Previously scarred uterus relative contraindication:-
● Acute intrapartum fetal distress
● Cardiac patients IV fluids contraindicated
● Previously history of Anaphylaxis shock.
28. Caution :-
● Vertex not fixed in the pelvis
● Unfavorable or unripe cervix
● Breech presentation
● Hydroponics
● Multiple Pregnancy
29. Uses :-
● Induction of labor ( given in physiological doses)
● Uterine Inertia ( given in physiological doses)
● Oxytocin challenge test (physiological doses)
● Prophylaxis of atonic postpartum hemorrhage)
● Treatment of atonic postpartum hemorrhage: given
pharmacological doses of 10 to 20 units per 500ml of RL or
DW
● Evacuation of V.mole given in escalating doses 10 to 20 units
each pint , doubling the dose up to maximum 80 units.
● Treatment of breast engorgment.
30. Side effects :-
● Side effects are hyperstimulation,
● rupture of Uterus
● Amniotic fluid embolism
● Fetal distress
● Fluid retention if used in high doses
● Neonatal jaundice may occur in babies delivered
to mothers who were given >20 units of oxytocin
throughout their labor.