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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