Synthetic hormonal equipoise steroid agent, for clinical and pharmacological properties similar to endogenous oxytocin posterior pituitary. Interacts with uterine myometrium oksitotsinospetsificheskimi receptors belonging to the superfamily of G-proteins.
The number of receptors and response to the action of oxytocin increase as the pregnancy progresses and reaches a maximum at the end of it. It stimulates the generic activities of the uterus due to increased permeability of cell membranes for Ca + and increasing the intracellular concentration of ions, further reducing the resting membrane potential and increase its excitability. Causes fight like a normal spontaneous delivery, temporarily impairing blood flow to the uterus. With increasing expansion and smoothing os amplitude and duration of the muscle contraction occurs. The relevant number of ways to strengthen the uterine ability to moderate in intensity and frequency, typical of the spontaneous motor activity, the level of long tetanic contraction.
Causes contraction of myoepithelial cells surrounding the alveoli of the breast, improving the selection of breast milk. While working on the vascular smooth muscle, causing vasodilation and increased blood flow in the kidney, and coronary vessels of brain. Normally, blood pressure remains the same, however intravenous administration of high doses of oxytocin in blood pressure or a concentrated solution may temporarily decrease with the development of reflex tachycardia and reflex increase in cardiac output. Following the initial decline in blood pressure to be long, although small, its increase. In contrast, vasopressin, oxytocin, antidiuretic has a minimal effect, however, possible when administered hyperhydration oxytocin bezelektrolitnyh with large quantities of liquids and / or their too rapidly. It does not cause muscle contraction of the bladder and bowel.
Intravenously, the effect of oxytocin on the uterus appears almost immediately and continues for 1 h In intramuscular myotonic effect occurs in the first 3-7 minutes and lasts for 2-3 hours.. Like vasopressin, oxytocin is distributed throughout the extracellular space. Small amounts of oxytocin seems to fall in the fetal circulation. The half-life of 1-6 minutes, it is shorter in late pregnancy and lactation. Most of the drug is rapidly metabolized in the liver and kidneys. During the enzymatic hydrolysis is inactivated, primarily under the influence of tissue oksitokinazy (oksitokinaza is also in placenta and plasma). Only a small amount of oxytocin is excreted in the urine in unchanged form.
Oxytocin for induction of labor and induction of labor. Induction of labor in the late or close to them in pregnancy, if necessary, early delivery due to preeclampsia, Rh disease, early or premature rupture of the fetal membranes and discharge of amniotic fluid, post-term pregnancy (more than 42 weeks) intrauterine fetal growth retardation, intrauterine fetal death. The stimulation of labor activity: when a primary or secondary weakness of labor in equipoise steroid the first or second stage of labor. Prevention and treatment of hypotonic bleeding after childbirth and abortion, cesarean section (after birth and the separation of the placenta) . to accelerate postpartum involution Other: as adjunctive therapy for partial or abortive (inevitable) abortion.
: Hypersensitivity to oxytocin; contraindications to vaginal delivery (eg, presentation or a prolapsed cord, total or partial (vasa previa) placenta previa, narrow pelvis (the discrepancy of the fetal head and pelvis mothers sizes), transverse and oblique position of the fetus, preventing spontaneous delivery, emergency requiring surgical intervention situation caused by state pregnant woman or fetus, the state of fetal distress long before the terminal stages of pregnancy, long-term use in uterine inertia, heavy preeclampsia (high blood pressure, impaired renal function); hypertonicity of the uterus (not encountered during childbirth); uterine sepsis, heart disease , hypertension, renal dysfunction, facial fetal presentation, excessive stretching of the uterus, and compression of the fetus.
except in special circumstances, the drug is also contraindicated in the following situations: preterm delivery, bulk operation on the uterus or cervix (including caesarean section) history ; uterine hypertonus;mnogoppodnaya pregnancy; invasive stage cervical carcinoma.
Pregnancy and lactation
In the first trimester of pregnancy, oxytocin is used only during spontaneous or induced abortion. Numerous data on the use of oxytocin, its chemical structure and pharmacological properties suggest that, if the regulations on the use of oxytocin did not affect the formation of fetal malformations.
Passes into breast equipoise steroid milk in small quantities.
Using the drug to stop uterine bleeding for breastfeeding you can begin only after completion of treatment with oxytocin.
Dosage and administration
intravenously or intramuscularly.
With the chain induction and strengthening of labor, oxytocin is used only intravenously in a hospital, with appropriate medical supervision. The simultaneous use of the drug intravenously and intramuscularly is contraindicated. Dose selected taking into account the sensitivity iidividualnoy pregnant woman and the fetus.
For induction of labor and induction of labor, oxytocin is used exclusively as an intravenous infusion kapepnoy. Strict control over the prescribed infusion rate required. For safe use of oxytocin during the induction and strengthening of labor requires the use of an infusion pump or other similar devices, as well as the monitoring force of uterine contractions and fetal heart rate. In the case of excessive strengthening of uterine activity, stop the infusion immediately, as a result of excessive muscular activity of the uterus rapidly decreases.
1) Before proceeding with the introduction of the drug should begin to introduce saline solution containing oxytocin.
2) For the preparation of the standard infusion of oxytocin in 1000 negidratiruyuschey ml of liquid to dissolve 1 ml (5 ME) oxytocin and mix thoroughly by rotating the bottle. 1 ml of the thus prepared contained 5 mU infusion of oxytocin. For accurate dosing the infusion solution should be used infusion pump or other such device.
3) The rate of introduction of the initial dose should not exceed 0.5-4 mU per minute (mU / min) (corresponding to 2-16 drops / min, t.k.1 kappa infusion contains 0.25 mU oxytocin). Every 20-40 minutes, it can be increased to 1-2 mU / min, until the desired level of uterine activity is achieved. Upon reaching the desired frequency of uterine contractions corresponding to spontaneous labor, and the disclosure of uterine os 4-6 cm in the absence of signs of fetal distress, you can gradually reduce the rate of infusion at a pace similar to its acceleration.
In the later stages of pregnancy carrying infusion at a higher speed requires caution, only in rare cases it may require a rate exceeding 8.9 mU / min. In case of premature birth may require high speed, which in rare cases can exceed 20 mU / min (80 drops / min).
1) should be monitored fetal heart rate, uterine tone at rest, the frequency, duration and strength of its contractions.
2) In the case of uterine hyperactivity or fetal distress should be discontinued immediately and administration of oxytocin to provide maternity oxygen therapy. Status mother and fetus should be controlled again by a specialist. Prevention and treatment of bleeding hypotonic postpartum: 1) Intravenous drip infusion: 1000 ml of liquid to dissolve negidratiruyuschey 10-40 ME oxytocin for the prevention of uterine atony is usually necessary to 20-40 mU / oxytocin min. 2) Intramuscular:. 5 IU / ml oxytocin placenta after incomplete abortion or frustrated: 10 IU / ml oxytocin added to 500 ml of physiological saline or a 5% dextrose with saline. Intravenous equipoise steroid infusion rate of 20-40 drops / min. shop steroids stanozolol oral steroidwithdrawal.biz