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8/2/2019 Drug Presentation -oxytocin
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Drug presentation
Drug presentation
OxytocinOxytocin
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definitiondefinition
Oxytocics are the drugs of varying chemical
nature that have the power to excite contractions
of the uterine muscles.
Pharmacology-it is a nonpeptide.It is synthesised in the supraoptic &
paraventricular nuclei of the hypothalamus.
By nerve action it is transported from thehypothalamus to the posterior pitutary where it is
stored and eventually released.
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It increases the intensity frequency andaccelerates the contraction waves through
the myometrium similar to the
physiological pattern i.e.,causing fundalcontraction with relaxation of the cervix. The
action is quick but short lived.
It is administered as continous infusion.
Action starts within 2-4 min and the peak
effects is attained within 10 15mins.
Mode of actionMode of action
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Preparations usedPrep
arations used
Synthetic oxytocin- ampoule 5iu/ml.
Syntometrine- syntocinon5units &
ergometrine 0.5mg.
Desamino oxytocin-it is 50-100% more
effective than oxytocin.it is used as buccal
tablets containing 50iu.
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IndicationsIndications
It may be conveniently used in pregnancy, labour
or puerperium. The indications are grouped as follows.
early pregnancy to accelerate abortion.
- to stop bleeding following evacuation of
uterus.
- to induce abortion along with.
late pregnancy to induce labour.
- to facilitate cervical ripening for effective induction. labour augmentation of labour.
- uterine inertia.
- inactive management of third stage. puerperium to minimise blood loss - to control pph.
-
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contraindicationscontraindications
Grand multipara
Contracted pelvis
Previous lscs
Malpresentations
Obstructed labour
Hypovolaemic stateCardiac disease
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dangersdangers
MATERNAL -
uterine rupturehypotension
antidiuresis
pitutary shock
FOETAL
Asphyxia due to impairment of
placental blood flow.
.
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Routes of administrationRoutes of administration
Controlled iv infusion
intramuscular
buccal tablets
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Principles of administrationPrinciples of administration
Start with low dose.
At optimal dose conc to be continued.To maintain normal pattern of uterine
activity.
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How to minimize the hazardsHow to minimize the hazards
Judicious selection of cases
To administer acontrolled iv infusionstarting with low dose
Meticulous supervision
To stop the infusion at the earliestmoment if any adverse feature
develops
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Nursing responsibilitiesNursing responsibilities
Explanation to relieve anxiety
Preparation of the patient.
Maintain partogram.
Observe rate of flow of infusion.
Observe uterine contractions.
Monitor FHR.
Monitor TPR.
Asses progress of labour by PV exam.
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observationobservation
Rate of flow of the infusion
Respond to uterine contraction
FHR
Maternal condition
Progress of labour
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Indications of stoping the infusionIndications of stoping the infusion
Nature of uterine contractions
Evidence of foetal distress
Appearance of untoward
maternal symptoms
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