Окситоцин-Ферейн®

General characteristics. Structure:

Active ingredient: 5 ME oxytocins.

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

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 smooth muscles of a uterus, increases sokratitelny activity of a myometrium and to a lesser extent a tone (especially at the end of pregnancy, during patrimonial activity and directly during delivery).

Under the influence of oxytocin permeability of cellular membranes for calcium ions (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 (shows them only in high doses), does not cause reduction of muscles of a bladder and intestines. The effect occurs in 1-2 min. at intramuscular introduction, 20-30 min. last; at intravenous - in 0,5-1 min.

Pharmacokinetics. An elimination half-life - 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 the maintenance 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 (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).

Hypolactation in a puerperal period.

Route of administration and doses:

Intravenously, intramusculary, in a uterus wall. For initiation of childbirth: intramusculary on 0,5-2 ME; if necessary repeat injections each 30-60 min.

Induction of childbirth: intravenously kapelno 10 ME oxytocins on 1 l of 5% of solution of a dextrose, at development of excessive reductions of a uterus quickly lead infusion delay to decrease of the activity of a myometrium. Introduction there begin from 5-8 caps/min., with the subsequent increase in speed depending on the nature of patrimonial activity, but no more than 40 caps/min. During infusion constant control of uterine activity and heart rate of a fruit is necessary.

Treatment of inevitable or incomplete abortion: intravenously 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 intramusculary on 3-5 ME 2-3 times a day daily within 2-3 days, intramuscular introduction 10 ME right after department of a placenta is admissible. For treatment of hypotonic uterine bleedings enter 5-8 ME 2-3 times a day within 3 days. If necessary enter intravenously kapelno 10-40 ME oxytocins, dissolved in 100 ml of donor blood.

Strengthening of department of milk (for prevention of mastitis because of stagnation of milk): intramusculary 2 ME.

For stimulation of a lactation in a puerperal period: intramusculary 0,5 ME in 5 min. prior to feeding.

At childbirth in pelvic presentation: 2-5 ME.

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

Features of use:

Pregnancy and lactation. In the first trimester of pregnancy oxytocin is applied only at the spontaneous or induced abortions. Numerous data on use of oxytocin, its chemical structure and pharmacological properties indicate that at observance of instructions on use, oxytocin does not influence formation of malformations of a fruit.

In small amounts gets into breast milk. At use of drug for a stop of uterine bleeding, a breast it is possible to start feeding only upon completion of a course of treatment oxytocin.

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, arterial pressure and the general condition of the woman.

Influence on ability to manage vehicles and mechanisms. It is not applicable, considering indications to use.

Side effects:

Bradycardia (at mother and a fruit), a lowering of arterial pressure, shock or increase in arterial pressure and subarachnoidal bleeding, disturbance of a heart rhythm (including at a fruit), a bronchospasm, nausea, vomiting, a water delay, neonatal jaundice, decrease in concentration of fibrinogen at a fruit, allergic reactions.

Interaction with other medicines:

Oxytocin strengthens pressor effect of symptomatic amines.

In combination with monoamine oxidase inhibitors the risk of increase in arterial pressure increases.

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

Contraindications:

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

Overdose:

Symptoms: fruit prelum, fruit asphyxia, fruit bradycardia, puerperal bleeding, uterus tetanus, hysterorrhesis, uteroplacental hypoperfusion, hypoxia, hypercapnia, death of a fruit, birth trauma of a fruit, water intoxication, spasms.

Treatment: drug withdrawal, reduction of administration of liquid, an artificial diuresis, hypertonic salt solution of sodium of chloride, normalization of electrolytic balance, barbiturates (with care), careful observation.

Storage conditions:

In the place protected from light at a temperature from 8 to 20 °C. To store in the place, unavailable to children. A period of validity - 3 years. Not to use drug after the expiry date specified on packaging.

Issue conditions:

According to the recipe

Packaging:

Solution for intravenous and intramuscular administration, 5 Meml. Packaging: on 1 ml in ampoules of neutral glass. On 5 ampoules in a blister strip packaging from a PVC film. On 5 ampoules in a blister strip packaging from a film of PVC and a foil of aluminum or flexible packaging on the basis of aluminum foil or a packing material. 1 or 2 blister strip packagings together with the application instruction and a knife for opening of ampoules or the scarificator place in a pack from a cardboard. When using ampoules with a notch, a point or a ring of a break the knife ampoule or the scarificator is not put. Packaging for hospitals: 10, 20, 25, 50, 75, 100, 200, 230, 360, 420 blister strip packagings with ampoules together with the equal number of application instructions place in a box from a cardboard.