Oxytocin

General characteristics. Structure:

Active ingredient: 5 ME oxytocins in 1 ampoule.

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

Pharmacological properties:

Pharmacodynamics. Hormonal means, polypeptide analog of hormone of a back share of a hypophysis. Possesses the uterotoniziruyushchy, stimulating patrimonial activity and lactotropic action. Has a promoting effect on a myometrium (especially at the end of pregnancy, during patrimonial activity and directly during delivery). Under the influence of oxytocin permeability of cellular membranes for Sa2+ increases, rest potential decreases and their excitability increases (reduction of membrane potential leads to increase in frequency, intensity and duration of reductions).

Stimulates secretion of breast milk, strengthening production of prolactin a front share of a hypophysis. Reduces myoepithelial cells around alveoluses of a mammary gland, stimulates intake of milk to large canals or sine, promoting strengthening of department of milk.

It is almost deprived of vasopressor and antidiuretic action (only in high doses), does not cause reduction of muscles of a bladder and intestines.

Pharmacokinetics. T1/2 - 1-6 min. (decreases on late durations of gestation and in the period of a lactation). Communication with proteins of plasma - low (30%). It is metabolized in a liver and kidneys. During pregnancy in plasma, target organs, a placenta concentration of the oxytocinase inactivating endogenous and exogenous oxytocin increases. Removal generally kidneys in not changed look.

Indications to use:

For excitement and stimulation of patrimonial activity; for prevention and treatment of hypotonic uterine bleedings in an early puerperal period and for acceleration of puerperal involution of a uterus.

Route of administration and doses:

Oxytocin is entered intravenously or intramusculary. For initiation of childbirth enter intramusculary 0,5-2,0 ME oxytocins; if necessary repeat injections each 30-60 minutes.

For intravenous drop administration part 1 ml of oxytocin (5 ME) in 500 ml of 5% of solution of glucose. Introduction there begin with 5-8 drops a minute, with the subsequent increase in speed depending on the nature of patrimonial activity, but no more than 40 drops a minute.

For prevention of hypotonic uterine bleedings oxytocin is entered intramusculary on 3-5 ME 2-3 times a day daily within 2-3 days, and for treatment of hypotonic uterine bleedings entered 5-8 ME 2-3 times a day within 3 days.

At operation of Cesarean section (after removal of an afterbirth) oxytocin is entered into a uterus wall in a dose 3-5 ME.

Features of use:

To apply only under observation of the doctor in the conditions of a hospital under control of sokratitelny activity of a uterus, a condition of a fruit, the ABP and the general condition of the woman.

Side effects:

Nausea, vomiting, arrhythmia and bradycardia (at mother and a fruit), allergic reactions, a bronchospasm, a delay of water and increase in the arterial pressure (AP), subarachnoidal bleeding, decrease in the ABP, shock, neonatal jaundice, decrease in concentration of fibrinogen at a fruit, and also excessively vigorous patrimonial activity are possible that it can cause an acute hypoxia of a fruit, premature amotio of normally located placenta, a hysterorrhesis.

At emergence of such symptoms it is necessary to stop administration of drug immediately.

Interaction with other medicines:

With care apply oxytocin in a combination with sympathomimetics (strengthens pressor action of sympathomimetics).

In combination with MAO inhibitors the risk of increase in the ABP increases.

The halothane and cyclopropane strengthen risk of development of arterial hypotension.

Contraindications:

The increased individual sensitivity to drug, arterial hypertension, a renal failure, predisposition to a hysterorrhesis, uterus hyperdystension, a uterus after repeated childbirth, existence of hems after the postponed Cesarean section or other uterus operations, a narrow basin (anatomic and clinical), the cross or slanting provision of a fruit, the front offer of a fruit, suspicion on premature placental detachment, the offer of a placenta; a pre-natal hypoxia of a fruit, premature births, the uterus hyper tone (which arose not during childbirth), a fruit prelum, uterine sepsis, an invasive carcinoma of a neck of uterus.

Overdose:

Hyper stimulation of a uterus that can lead to a hyper tone and mechanical reductions of a uterus which, in turn, can lead to a hysterorrhesis, puerperal bleeding, various changes from cordial activity of a fruit, a hypoxia, asphyxia, to birth trauma and death of a fruit. At prolonged use of oxytocin in high doses by infusion (40-50 ml/min.) there can be symptoms connected with antidiuretic effect of oxytocin (water intoxication, spasms).

At overdose it is necessary to stop immediately introduction of oxytocin, to force a diuresis, to begin performing symptomatic therapy and introduction of hypertonic saline solutions (for the purpose of normalization of electrolytic balance).

Storage conditions:

Period of validity - 2 years. Not to use after a period of validity. To store in the place protected from light at a temperature from 8 to 20 °C. To store in the place, unavailable to children.

Issue conditions:

According to the recipe

Packaging:

Solution for intravenous and intramuscular administration of 5 ME/ml in ampoules on 1 ml. On 10 ampoules in a pack (box) from a cardboard. On 5 ampoules in a blister strip packaging. On the 2nd blister strip packagings in a pack from a cardboard. Put the application instruction, a knife in each pack ampoule or the scarificator ampoule, When packaging ampoules with an overclamping the knife and the scarificator ampoule do not put.