oxytocin1.pptx

oxytocin in pregnancy , it is helpful in creating contractions
for easy delivery of placenta and fetus, highly reccomendable

1. O xytocin PRESENTED TO - Ms. LIDHA MAM LECTURER PRESENTED BY - MANDEEP KAUR ROLL NO. – 5 PB.B.SC N 1 st year

2. DRUG OXYTOCIN

3. OXYTOCIN Oxytocin is a mammalian hormone that acts primarily as a neuromodulator in the brain. Oxytocin is best known for its roles in sexual reproduction, in particular during and after childbirth. It is released in large amounts after distension of the cervix and uterus during labor , facilitating birth and after stimulation of the nipples facilitating breastfeeding.

4. DRUG FORMS Synthetic oxytocin is sold as proprietary medication under the trade names pitocin and syntocinon and also generic as oxytocin .

5. INDICATIONS labor induction to support labor in case of non-progression of parturition. It has largely replaced ergometrine as the principal agent to increase uterine tone in acute postpartum hemorrhage . Oxytocin is also used in veterinary medicine to facilitate birth and to stimulate milk release

6. CONTRAINDICATIONS Significant cephalopelvic disproportion. unfavorable fetal positions or presentations which are undeliverable without conversion prior to delivery (transverse lies); i.e., in obstetrical emergencies where the benefit-to-risk ratio for either the fetus or the mother favors surgical intervention in cases of fetal distress where delivery is not imminent

7. Contd …. prolonged use in uterine inertia or severe toxemia hypertonic uterine patterns patients with hypersensitivity to the drug. induction or augmentation of labor in those cases where vaginal delivery is contraindicated, such as cord presentation or prolapse , total placental previa , and vasa previa .

8. DOSAGES Usual Adult Dose for Labor Induction Initial dose: 0.5 to 1 milliunits IV infusion per hour. At 30 to 60 minute intervals the dose should be gradually increased in increments of 1 to 2 milliunits until the desired contraction pattern has been established.

9. Contd …. Usual Adult Dose for Postpartum Bleeding 10 to 40 units IV infusion in 1000 mL at a rate sufficient to control bleeding. 10 units IM after delivery of placenta.

10. Contd ……. Usual Adult Dose for Abortion After suction or sharp curettage for an incomplete, inevitable or elective abortion : 10 units in 500 mL IV infusion. Adjust rate to assist uterus in contraction. After intra-amniotic injection for midtrimester elective abortion : 10 to 20 milliunits per minute IV infusion. The total dose should not exceed 30 units in a 12 hour period due to the risk of water intoxication.    

11. Calculation of the dose delievered in milliunits (mu) and its correlation with drop rate per minute …………

12. Units of oxytocin mixed in 500 ml Ringer lactate soln.(1 ml=1000mu) Drops per minute(15drops=1ml) 15 (in terms of mu/min) 30 60 1 2 4 8 2 4 8 16 8 16 32 64

13. Dose of oxytocin Solution used Esca lating drop rate at intervals of 20-30 min To start with 1 unit 500ml 15 – 30 - 60 ringer solution. If no response -2 units. -Do- -Do- If still no response -8 units. -Do- -Do- Showing the convienient regime

14. SIDE EFFECTS Subarachnoid hemorrhage Increased heart rate Decreased blood pressure Cardiac arrhythmia and premature ventricular contraction Impaired uterine blood flow Pelvic hematoma Afibrinogenonemia which can lead to hemorrhage and death

15. Anaphylaxis Nausea and vomiting chest pain or difficulty breathing confusion fast or irregular heartbeat severe headache irritation at the injection s ite

16. ROLE OF NURSE

17. NURSING RESPONSIBILITIES Use with caution during first and second stage of labour . Use cautiously in pt. with invasive cervical cancer and those with previous cervical or uterine surgery , grandmultiparity ,uterine sepsis ,traumatic delivery , overdistended uterus. Drug is n’t recommended for routine IM use but 10 units may be given IM after placenta delivery to control post partum uterine bleedi ng .

18. Contd ….. Never give drug simultaneously by more then 1 route. Drug is used to induce or reinforce labour only when pelvis is known to be adequate,vaginal delivery indicated , fetal maturity assured ,fetal position favourable . Monitor fluid intake and output. Antidiuretics effect may lead to fluid overload ,seizures and coma from water intoxication .

19. Monitor and record uterine contractions ,heart rate , blood pressure ,fetal heart rate and character of blood loss every 15 min. Have mg sulphate (20%)available to relax myometrium .

20. SUMMARISATION

21. RECAPTUALISATION

22. Bibliography http://en.wikipedia.org/wiki/Oxytocin . http://www.medicinenet.com/oxytocin-injectable/article.htm

23. THANK U……..