Oxytocin of "Grindeks"

General characteristics. Structure:

Active ingredient: 5 ME oxytocins.

Excipients: хлорбутанолгидрат, 1 M solution of acetic acid, water for injections.

Stimulator of patrimonial activity.

Pharmacological properties:

Pharmacodynamics. Oxytocin is the synthetic hormone similar to natural peptide of a back share of a hypophysis.

Oxytocin stimulates reduction of smooth muscles of a uterus.

Under the influence of hormone permeability of membranes for potassium ions increases, the membrane potential of cells goes down and their excitability increases. With reduction of membrane potential of cells the frequency, intensity and duration of reductions of a myometrium increases.

Oxytocin stimulates milk secretion, strengthening development of a lactogenic anterior pituitary hormone (prolactin).

Oxytocin renders weak antidiuretic effect and in therapeutic doses significantly does not influence arterial pressure.

Pharmacokinetics. At intravenous administration action of oxytocin comes immediately, intensity and frequency of reductions of a uterus increases gradually within 15-60 min. and then is stabilized.

At intramuscular introduction the effect is shown in 3-5 min. After the termination of intravenous infusion effect of drug continues 20 more min., and the patrimonial uterine activity gradually decreases. Recovery of an initial state happens approximately in 40 min., and after intramuscular use of drug – in 30-60 min.

The period of semi-elimination of oxytocin makes about 1-6 min. of a blood plasma.

Metabolism of oxytocin happens in a liver and kidneys. Drug is emitted from an organism in the form of metabolites and in small amounts in not changed look, generally with urine.

Indications to use:

For excitement and stimulation of patrimonial activity (primary and secondary weakness of patrimonial activity, need of early delivery in connection with a gestosis, a Rhesus factor conflict, pre-natal death of a fruit; postmature pregnancy, a premature bursting of waters, conducting childbirth in pelvic presentation). For prevention and treatment of hypotonic uterine bleedings after abortion (including at big durations of gestation), in an early puerperal period and for acceleration of puerperal involution of a uterus; for strengthening of sokratitelny ability of a uterus at Cesarean section (after removal of an afterbirth).

Route of administration and doses:

Oxytocin is entered in/in, in oil, into a wall or a vulval part of a neck of uterus. For initiation of childbirth enter in oil 0.5-2.0 ME oxytocins; if necessary repeat injections each 30-60 min.

For in/in drop introductions part 1 ml of oxytocin (5 ME) in 500 ml of 5% of solution of a dextrose. Introduction there begin with 5-8 drops in min., with the subsequent increase in speed depending on the nature of patrimonial activity, but no more than 40 drops in min. During infusion constant control of uterine activity and ChSS of a fruit is necessary.

Treatment of inevitable or incomplete abortion - in/in kapelno, 10 ME oxytocins on 500 ml of 5% of solution of a dextrose with a speed of 20-40 of cap/min. For prevention of hypotonic uterine bleedings oxytocin is entered in oil on 3-5 ME 2-3 times into days daily within 2-3 days, introduction in oil 10 ME right after department of a placenta is admissible.

For treatment of hypotonic uterine bleedings oxytocin is entered by 5-8 ME 2-3 times a day during 3 days. If necessary enter in/in kapelno 10-40 ME oxytocins, dissolved on 100 ml of donor blood. At operation of Cesarean section (after removal of an afterbirth) Oksitotsin Grindeks enter into a uterus wall in a dose 3-5 ME.

Features of use:

Oxytocin should be entered intravenously only in the form of drop infusion, precisely observing the speed of infusion and it is regular it controlling. During use of oxytocin it is necessary to control sokratitelny activity of a uterus, a condition of a fruit, arterial pressure and the general condition of the patient.

Extra care should be observed at:

- risk of discrepancy of the sizes of a fruit and a basin (at great risk it is necessary to avoid use of oxytocin);

- moderate or moderate severity of hypertensia owing to pregnancy and at heart diseases;

- approach of pregnancy after 35 years;

- existence in the anamnesis of Cesarean section in the lowest segment of a uterus;

- intrauterine death of a fruit or at the content of meconium in amniotic waters (the okoloplodna embolism хвод can develop).

In case of water intoxication and a hyponatremia it is necessary to avoid introduction of large volumes of liquid, besides the patient should limit liquid reception.

The effect of oxytocin amplifies at simultaneous use of prostaglandins (very careful control is necessary), and also owing to epidural anesthesia (hypertensive action of sympathomimetic angiotonic means can amplify).

If prolonged use of oxytocin is necessary, it is necessary to reduce the volume of infusion solution and to apply the solutions containing electrolytes, but not glucose (risk of water intoxication). At suspicion on disturbance of electrolytic balance determine the content of electrolytes in blood serum.

Because of increase in risk of complications to mother and a fruit during pregnancy oxytocin is applied carefully.

In very small amounts oxytocin gets into milk of mother, complications for people are not described.

Does not matter at management after introduction by vehicles, considering spetsificheskiyepokazaniye to use of oxytocin.

Side effects:

At mother:

- uterus spasms (also at use of small doses);

- a uterus hyper tone, tetanic reductions, a uterus hyperactivity with a hysterorrhesis and vagina tissues at hypersensitivity of a uterus and high doses of oxytocin;

- water intoxication with a fluid lungs, spasms, a coma, a hyponatremia and even death at infusion of large volumes of solutions of nonelectrolytes;

- nausea, vomiting, arrhythmias, rash and anaphylactoid reactions (the complicated breath, hypotension or shock);

- heavy hypertensia can become the reason of a lethal outcome, subarachnoidal bleeding;

- a life-threatening afibrinogenemiya and puerperal bleeding in case of complications of pregnancy and childbirth;

- acute short-term hypotension with erubescence and reflex tachycardia at intravenous administration of oxytocin with high speed.

At a fruit and newborn:

- bradycardia, arrhythmias, asphyxia, acute hypoxia, lethal outcome;

- jaundice, hemorrhages in a retina at newborns.

Interaction with other medicines:

Inhalation of anesthetics, perhaps, reduces action of oxytocin ( and also increases hypotensive effect and risk of arrhythmia).

Oxytocin is not applied during 6 h after vaginal administration of prostaglandins (prostaglandins strengthen uterotonichesky effect).

Simultaneous use of oxytocin and sympathomimetic vasoconstrictors increases angiotonic action.

β-adrenomimetik reduce efficiency of oxytocin.

Contraindications:

Hypersensitivity, arterial hypertension, renal failure, predisposition to a hysterorrhesis, discrepancy of the sizes of a basin of mother and fruit (a narrow basin anatomic and clinical), the cross or slanting provision of a fruit, premature births, the menacing hysterorrhesis, hems on a uterus (after the postponed earlier Cesarean section, uterus operation), uterus hyperdystension, a uterus after repeated childbirth, uterine sepsis, an invasive carcinoma of a neck of uterus, the uterus hyper tone (which arose not during childbirth), a fruit prelum, partial placental presentation, front presentation.

Overdose:

Symptoms: at overdose there can be a peeling of a placenta, an embolism of amniotic waters, a uterus hyperactivity, hypertensive and tetanic reductions. The hysterorrhesis, necks of uterus and vaginas, heavy puerperal bleedings, disturbances of cordial activity at a fruit can result, the hypoxia and even to come death. The effects connected with antidiuretic effect of drug are possible.

Treatment: to immediately stop administration of drug, it is necessary to recover a normal diuresis, to enter symptomatic means and hypertonic saline solutions. The antidote is unknown.

Storage conditions:

To store at a temperature not above 25 ºC. Not to freeze!

To store in the place, unavailable to children!

Issue conditions:

According to the recipe

Packaging:

Ampoules on 1 ml. On 5 ampoules in planimetric strip packagings. Cardboard packs.