Names and pronunciation
(ox-i-toe′sin) Pitocin
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Individual generic drug information
Extracted information for oxytocin only.
(ox-i-toe′sin) Pitocin
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Func. class.: Hormone
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Chem. class.: Oxytocic, uterine-active agent
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ACTION: Acts directly on myofibrils, thereby producing uterine contraction; stimulates milk ejection by the breast; vasoactive antidiuretic effect
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USES: Stimulation, induction of labor; missed or incomplete abortion; postpar- tum bleeding
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Extracted information for oxytocin only.
CONTRAINDICATIONS: Hyper- sensitivity, serum toxemia, cephalopelvic disproportion, fetal distress, hypertonic uterus, prolapsed umbilical cord, active genital herpes Precautions: Cervical/uterine surgery, uterine sepsis, primipara >35 yr, 1st/2nd O stage of labor
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Black Box Warning: Elective induction of labor Black Box Warning: Elective induction of labor: use for induction only when medi- cally necessary
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SIDE EFFECTS CNS: Seizures, tetanic contractions CV: Hypo/hypertension, dysrhythmias, increased pulse, bradycardia, tachycar- dia, PVC FETUS: Dysrhythmias, jaundice, hypoxia, intracranial hemorrhage GI: Anorexia, nausea, vomiting, constipation GU: Abruptio placentae, decreased uter- ine blood flow HEMA: Increased hyperbilirubinemia INTEG: Rash RESP: Asphyxia SYST: Water intoxication of mother
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INTERACTIONS Increase: oxytocin effects—dinoprostone Increase: QT prolongation—other drugs that increase QT interval • Increase: hypertension—vasopressors, avoid using together Drug/Herb • Increase: hypertension—ephedra
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Extracted information for oxytocin only.
DOSAGE AND ROUTES Postpartum hemorrhage • Adult: IV 10-40 units in 1000 mL non- hydrating diluent infused at 20-40 mU/min Stimulation of labor • Adult: IV 0.5-1 mU/min, increase by 1-2 mU q15-60min until contractions occur, then decrease dose Incomplete abortion • Adult: IV INFUSION 10 units/500 mL D5W or 0.9% NaCl at 10-20 mU/min, max 30 units/12 hr
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Available forms: Inj 10 units/mL
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Administer: • Give by IV infusion or IM, not used routinely IM • Before use, an IV infusion of NS should be already running for use in case of ad- verse reactions. Magnesium sulfate should be readily available if relaxation of the myometrium is needed • Visually inspect parenteral product for particulate matter and discoloration be- fore use IV infusion route • Administer using an infusion pump to ensure accurate dosing Induction of labor • Dilute 1 mL (10 units) in 1000 mL of a compatible IV infusion solution. Rotate infu- sion bottle for thorough mixing. The resul- tant infusion should contain 10 milliunits/mL Control of postpartum uterine bleeding • Dilute 10-40 units in a compatible IV solution or to an already infusing solution. The maximum concentration is 40 units in 1000 mL of solution Incomplete, inevitable, or elective abortion • Dilute 10 units in 500 mL of a compat- ible IV solution IM route • Not used routinely IM • Inject into a large muscle mass; aspi- rate before injection to avoid injection into a blood vessel Y-site compatibilities: Acyclovir, alfent- anil, allopurinol, amikacin, aminocaproic acid, aminophylline, amphotericin B lipo- some (ambisome), anidulafungin, arg- atroban, ascorbic acid injection, atenolol, atracurium, atropine, azaTHIOprine, azithromycin, aztreonam, benztropine, bivalirudin, bumetanide, buprenorphine, butorphanol, calcium chloride/gluconate, capreomycin, caspofungin, cefamandole, ceFAZolin, cefepime, cefoperazone, cefo- taxime, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cefTRIAXone, cefuroxime, chloramphenicol, chlorothiazide, chlor- pheniramine, cimetidine, ciprofloxacin, cisatracurium, clindamycin, cloxacillin, colistimethate, cyanocobalamin, cyclo- phosphamide, cycloSPORINE, DAPTOmy- cin, dexamethasone, dexmedetomidine, digoxin, dilTIAZEM, diphenhydrAMINE, DOBUTamine, dolasetron, DOPamine, doxycycline, droperidol, edetate calcium disodium, enalaprilat, ePHEDrine, EPI- NEPHrine, epoetin alfa, eptifibatide, ergonovine, ertapenem, erythromycin, es- molol, famotidine, fenoldopam, fentaNYL, fluconazole, folic acid (as sodium salt), foscarnet, fosphenytoin, furosemide, gal- lamine, ganciclovir, gatifloxacin, gentami- cin, glycopyrrolate, granisetron, heparin, hydrocortisone sodium succinate, HY- DROmorphone, hydrOXYzine, imipenem- cilastatin, isoproterenol, kanamycin, ketamine, ketorolac, labetalol, lactated Ringer’s injection, lansoprazole, lepiru- din, leucovorin, levoFLOXacin, lidocaine, lincomycin, linezolid, LORazepam, mag- nesium sulfate, mannitol, mechloretha- mine, meperidine, mephentermine, meropenem, metaraminol, methyldopate, methylPREDNISolone, metoclopramide, metoprolol, metroNIDAZOLE, midazolam, milrinone, minocycline, morphine, moxi- floxacin, multiple vitamins injection, my- cophenolate mofetil, nafcillin, nalbuphine, nalorphine, naloxone, nesiritide, netilmi- cin, niCARdipine, nitroglycerin, nitro prusside, norepinephrine, ondansetron, oxacillin, palonosetron, pamidronate, papaverine, penicillin G potassium/so- dium, pentamidine, pentazocine, PENTo- barbital, PHENobarbital, phentolamine, phenylephrine, phytonadione, piperacillin sodium, piperacillin-tazobactam, poly- myxin B, potassium acetate/chloride/ phosphates, procainamide, prochlorper- azine, promazine, promethazine, pro- pranolol, protamine, pyridoxine, quinu- pristin-dalfopristin, raNITIdine, Ringer’s injection, sodium acetate/bicarbonate/ phosphates, streptomycin, succinylcholine, SUFentanil, tacrolimus, theophylline, thia- mine hydrochloride, ticarcillin disodium, ticarcillin disodium-clavulanate potas- sium, tigecycline, tirofiban hydrochloride, tobramycin sulfate, tolazoline, trimetaphan, tubocurarine, urokinase, vancomycin, vasopressin, verapamil, vita- min B complex with B, voriconazole, war- farin, zidovudine, zoledronic acid
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Extracted information for oxytocin only.
Assess: • Assess for fetal presentation, pelvic dimensions before use • B/P, pulse; watch for changes that may indicate hemorrhage • Respiratory rate, rhythm, depth; notify prescriber of abnormalities • Monitor continuously, discontinue im- mediately if fetal distress occurs or uter- ine hyperactivity occurs • Length, intensity, duration of contraction; notify prescriber of contractions lasting >1 min or absence of contractions; turn patient on her left side; discontinue oxytocin • FHTs, fetal distress; watch for accel- eration, deceleration; notify prescriber if problems occur; fetal presentation, pelvic dimensions; turn patient on left side if FHT change in rate, give O2 • Water intoxication: confusion, anuria, drowsiness, headache; monitor I&O
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Evaluate: • Therapeutic response: stimulation of labor, control of postpartum bleeding O
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To report increased blood loss, abdomi- nal cramps, fever, foul-smelling lochia, nau- sea, blurred vision, itching, swelling • That contractions will be similar to menstrual cramps, gradually increasing in intensity HIGH ALERT
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Extracted information for oxytocin only.
PHARMACOKINETICS IM: Onset 3-7 min, duration 1 hr, half- life 12-17 min IV: Onset 1 min, duration 30 min, half- life 12-17 min
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Filter the extracted dose blocks for this individual drug.
Postpartum hemorrhage
• Adult: IV 10-40 units in 1000 mL non- hydrating diluent infused at 20-40 mU/min Stimulation of labor
Candidate age grouping · source page 1003
Postpartum hemorrhage
• Adult: IV 0.5-1 mU/min, increase by 1-2 mU q15-60min until contractions occur, then decrease dose Incomplete abortion
Candidate age grouping · source page 1003
Postpartum hemorrhage
• Adult: IV INFUSION 10 units/500 mL D5W or 0.9% NaCl at 10-20 mU/min, max 30 units/12 hr
Candidate age grouping · source page 1003