Presentation on Medicines Oxytocin Injections

Medicines

1. 7 74 ;
# ill

{01U/4ml |
Each Ampoulecontains
Oxytocin 10iu

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2. Oxytocin

Introduction:
« This is a hormone of the posterior pituitary
gland. Oxytocin is a polypeptide, having 9
amino acids. E
Synthesis:
« Oxytocin is synthesized mainly in the
paraventricular nuclei of the
hypothalamus.

3. ACTIONL

™ It is released in large amounts after distension of cervix
and vagina, nipple stimulation.

= It contracts smooth muscle helping the expulsion of the
foetus and ejection of breastmilk.

= It also crosses the placenta and acts on the foetus
neurons to prepare it for delivery- to sedate the brain.

™ Rapid acting: 1 minute if given IV; 3-7 minutes if given
IM and lasts 30-60 minutes.

4. [MEAT
SAREACTIONS

Seizures, subarachnoid haemorrhage
Tachycardia, hypotension, arrythymias

GU: uterine rupture, pelvic hamatoma, PPH, hypertonic Ss
uterine contractions

Foetal distress from Hypertonic U- increases c/s rate
Rapid or prolonged infusion causes water retention
Neonatal jaundice —crosses placenta.

Do not give rapid IV bolus for PPH ; hypotension

5. = Augmentation labour

= Induction labour

= PPH

= Retained products conception

= PIH patients — post partum

6. Previous c/s or other uterine surgery?

Twins?

CPD? History of CPD or borderline now.
Foetal distress?

Malpresentation including cord presentation
Praevia

Bishop score ( induction)

7. 7 a cee
DOSAGES
bal Post par tum “TOU TUIT on delivery OT Daby-
Can be repeated.

= PPH & RPOC (retained products of
conception) — 20u in 1 liter MRL run @ 20ml E
/hr

= Augmentation primipara- Su in 1 liter RL
titrated via IVAC to get regular contractions
and reactive CTG (5ml/hr increasing 1 ml/hr)

= Augmentation multipara — 2 u in | liter RL
titrated via IV to give regular contractions &
reactive CTG

8. PREGNANCY

Grand All cont. in pres > rpovolemic
multipara All cont. in preg. Hypovolemic
malpresentati

on

contracted
pelvis

cephalopelvic
disproportion
prior uterine

scar
(hysterotomy)

9. NURSE'S RESPONSIBILITIES

Assess

- Intake output ratio.

- Uterine contractions and FHR.

- Blood pressure, pulse and respiration.
Administer

- By IV infusion. Monitor drop rate.

- Make crash cart available.
Evaluate:

- Length and duration of contractions.

- Notify physician of contractions lasting over 1 minute or
absence of contrcations.

Teach

- To report increased blood loss, abdominal cramps or
increased lemperature.

10. 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 .

11. Nursing Considerations

+ Nurse must frequently assess vital signs,
contraction strength and frequency, and fetal
status during administration of oxytocin

® Use of a pump for delivery is required
® Able to precisely control dosage

© Continuous fetal heart rate monitoring is

required