Oxytocin indications for use. Hormonal drug Oxytocin: instructions for use, indications for the appointment of injections, possible side effects

Oxytocin(oxytocin). Synthetic preparation - hormone of peptide type, contains 9 amino acids, is free from vasopressin and antidiurtic action. An analogue of pituitrin M. It is used to speed up the process of childbirth, with postpartum hemorrhage and after spontaneous abortions. When administered intravenously, 5 units of oxytocyp in 500 ml of 5% glucose solution causes labor pains in a minute.

Recipe:
Rp. Oxytocini sinthetici 1.0 (5 units)
D.t. d. N. 6 in ampul. S. 1 ml 1-2 times a day intramuscularly

Adiurecrine(Adiurecrinum). Powdered posterior pituitary extract: 1 mg of powder contains 1 unit. It is inhaled through the nose and quickly absorbed by the nasal mucosa, enters the bloodstream.

With non-sugar diabetes reduces the feeling of thirst. Reduces diuresis. Increases the specific gravity of urine. It is used for nighttime urinary incontinence.
At sharp and chronic rhinitis when the mucosa is affected, inhalation of adiurecrin is difficult. In these cases, it is necessary to recommend to the patient an injection of pituitrin P.

Recipe:
Rp. Adiurecrini 0.05
D.t. d. N. 60 in charta paraffinata
S. 1 powder inhaled through the nose 2-3 times a day

mammophysin(Mammophysinum). A preparation containing pituitrin and an extract of the mammary glands of lactating cows. Increases lactation, accelerates the process of childbirth. It is used for postpartum hemorrhage.

Recipe:
Rp. Mammophysini 1.0
D.t. d. N. 10 in ampul.
S. 1 ml 1-2 times a day intramuscularly

Intermedin(Intermedium). Melapocyte-stimulating hormone of the middle lobe of the pituitary gland. Promotes the deposition of pigment in the retina in albinism, retiopathy, myopia, chorioretinitis. Improves visual acuity and adaptation in the dark.
One bottle contains 0.05 g (1 unit of the drug).

Recipe:
Rp. Sol. Intermedinum 5% 10.0
D.S. In the conjunctival sac of the eye, 3 drops with an interval of 5 minutes, 2 times a day.

Hormonal preparations of the adrenal glands

Cortical layer of the adrenal glands produces hormones: glucocorticoids, mineralocorticoids, and sex hormones: estrogens, progestins and androgens.
adrenal medulla secretes adrenaline, norepinephrine - catecholamines. The intensity of hormone secretion depends on the regulatory effect of the hypothalamic-pituitary system.

Medicinal preparations are extracted from the cortex and medulla of the adrenal glands, and also synthesized, the latter have a similar effect and are widely used in medicine, being very active.
Glucocorticoids actively influence metabolic processes in the body. By promoting catabolism - the breakdown of proteins, they determine the intensity of fat synthesis. The breakdown of proteins enhances the processes of neoglucogenesis and increases blood sugar levels.

Glucocorticoids slow down inflammatory processes and prevent the formation of connective tissue. Like ACTH, they eliminate hyperplasia of lymphoid elements and thymus. Effective at allergic diseases, collagenoses and suppress immunological processes.

Glucocorticoids used for primary acute insufficiency adrenal glands and chronic, with Addison's disease. As a substitute hormone therapy they are necessary for adrenalectomy. In Simmonds and Sheehan's disease, when adrenal function decreases with ACTH loss, combined therapy with ACTH, glucocorticoids and gonadotropic hormonal drugs is justified.

With hypotonic and astheno-neurotic syndrome, the use glucocorticoids helps to increase the tone of the body. The use of glucocorticoids in the presence of adrenogenital syndrome suppresses the excess release of androgens. Massive doses of glucocorticoids reduce pituitary ACTH release and can also lead to adrenal hypoplasia.
wide application found glucocorticoids in rheumatic diseases, rheumatic heart disease.

Effective therapy for metabolic arthritis and spondylitis.
Row skin diseases also cured by the use of glucocorticoids.

In surgery glucocorticoids are used in the period of preparation for surgery, with shock therapy, with severe injuries.
Application mineralocorticoid in acute adrenal insufficiency, in collaptoid states with a sharp decrease in blood pressure, it leads to the normalization of water-salt metabolism. Mineralocorticoids increase the level of sodium chloride in the blood and eliminate dehydration of the body. Contribute to high blood pressure.

Adrenal sex hormones are analogues of sex hormones secreted by the gonads. Many of them are obtained as synthetic medicinal preparations.
Special attention attract steroid hormones from the group of androgens and progestins, devoid of virilizing action, but having an active anabolic effect on protein synthesis. They are used for growth retardation, infantilism, exhaustion, and dystrophy in children.

Gross formula

Pharmacological group of the substance Oxytocin

Nosological classification (ICD-10)

CAS code

Characteristics of the substance Oxytocin

Synthetic analogue of oxytocin, a hormone of the posterior pituitary gland. White powder, soluble in water.

Pharmacology

It has the ability to selectively increase the tone and contractile activity of the smooth muscles of the uterus, especially towards the end of pregnancy, during labor and directly during delivery. It acts on specific receptors in the myometrium and increases the intracellular Ca 2+ content. Stimulates rhythmic uterine contractions - enhances and increases their frequency. It acts on the myoepithelial elements of the mammary gland, causes contraction of the smooth muscles of the walls of the alveoli and stimulates the flow of milk into large ducts or sinuses, facilitates its release. It has pressor properties and can cause an antidiuretic effect at high doses. T 1/2 from plasma - about 1-6 minutes (decreases in late pregnancy and during lactation). After the / in the introduction of oxytocin, the reaction of the uterus appears almost immediately, and then gradually decreases within 1 hour, after the / m - after 3-7 minutes and lasts 30 minutes - 3 hours. It is well and quickly absorbed into the systemic circulation through the nasal mucosa . T 1/2 - less than 10 minutes, excreted mainly by the kidneys (only a small amount unchanged) and the liver. Actively secreted by lactating mammary glands. The effect is very individual and depends on the density of oxytocin receptors in the myometrium.

The use of the substance Oxytocin

For the excitation and stimulation of labor (primary and secondary weakness of labor, the need for early delivery due to gestosis, Rhesus conflict, intrauterine death of the fetus; post-term pregnancy, premature discharge of amniotic fluid). For the prevention and treatment of hypotension uterine bleeding after an abortion (including long-term pregnancy), in the early postpartum period and to accelerate postpartum involution uterus; to enhance the contractility of the uterus during caesarean section (after removal of the placenta). Hypolactation in the postpartum period. Painful premenstrual syndrome, accompanied by edema, weight gain.

Contraindications

Hypersensitivity, narrow pelvis (anatomical and clinical), transverse and oblique position of the fetus, facial presentation of the fetus, preterm labor, threatened uterine rupture, conditions with a predisposition to uterine rupture (including traumatic childbirth and surgery caesarean section history), excessive uterine distension, uterus after multiple births, partial placenta previa, uterine sepsis, invasive cervical carcinoma, uterine hypertonicity (not occurring during labor), fetal compression, arterial hypertension, chronic kidney failure.

Use during pregnancy and lactation

Side effects of the substance Oxytocin

Nausea, vomiting, arrhythmia (including in the fetus), bradycardia (in mother and fetus), increased blood pressure and subarachnoid bleeding or lowering blood pressure and shock, water retention (with prolonged intravenous administration), allergic reactions, bronchospasm; neonatal jaundice, a decrease in the concentration of fibrinogen in the fetus.

Interaction

Enhances the effect of sympathomimetics (combined with caution). Halothane and cyclopropane increase the risk of developing side effects.

Overdose

Symptoms: hyperstimulation of the uterus up to rupture, bleeding after childbirth, uteroplacental hypoperfusion, fetal hypoxia and hypercapnia, water intoxication (convulsions are possible).

Treatment: withdrawal of the drug, forced diuresis, normalization of electrolyte balance.

Routes of administration

V / m, in / in(single injection, drip), in the wall or vaginal part of the cervix; intranasally.

Precautions Substance Oxytocin

According to indications related to childbirth, they are used only under the supervision of a doctor in a hospital under the control of the contractile activity of the uterus, the condition of the fetus, blood pressure and general condition women.

Interactions with other active substances

Trade names

In case of violation of labor, to prevent uterine bleeding, increase lactation after the birth of a child, with painful menstrual syndrome, the drug Oxytocin is used. Injections are made strictly under medical supervision to avoid serious complications.

It is important to know the peculiarities of the impact on the body of the mother and fetus, to understand what reactions are possible with an overdose, injections without taking into account contraindications. Information about the hormonal agent will help women understand the mechanism of action of Oxytocin and possible consequences uncontrolled use of the drug.

Composition and form of release

The active ingredient is the synthetic hormone oxytocin, similar to the natural peptide of the posterior pituitary gland (1 ml of the hormone contains 5 IU active substance).

Additional components:

• water for injections,
• chlorobutanol hydrate.

The package contains 5 or 10 ampoules, the volume of a clear liquid in each container is 1 ml.

The drug belongs to pharmacological group"Hormones of the posterior pituitary". The solution is intended for injection into the cervix or the wall of the uterus and / in, intranasal application (instillation of the composition into the nose).

Action

After intramuscular or intravenous administration Oxytocin is actively absorbed, penetrates into the uterus. The drug exhibits vasopressin-like, lactotropic and mild antidiuretic action.

Hormone oxytocin:

• activates the contraction of the smooth muscles of the uterus;
• increases the tone of the myometrium and its contractile activity;
• reduces the ability to contract epithelial cells, facilitates the movement of milk during lactation into the sinuses and large ducts of the mammary glands;
• does not affect the contraction of the walls of the intestine and bladder.

The rate of manifestation of the effect of the use of a hormonal agent depends on the method of administration: with intramuscular application- after 1-2 minutes, the period of exposure - up to half an hour, intranasally - for three to four minutes. With drip administration, the active effect of the active substance is manifested in less than a minute after the start of the infusion.

Indications for use

Intravenous and intramuscular injections of Oxytocin are prescribed to pregnant women and women in childbirth:

• to start and stimulate optimal labor activity against the background of the Rhesus conflict of the mother and fetus;
• in case of urgent delivery;
• with intrauterine death of the fetus;
• with weak uterine contractions.

Other indications for the use of Oxytocin:

• low lactation after childbirth;
• prevention of bleeding after abortion different terms pregnancy;
• to activate uterine contractions to remove the placenta after cesarean section;
• for the speedy return of the uterus to its usual physiological state after childbirth;
• with severe signs of premenstrual syndrome: a sharp weight gain, pronounced swelling, pain in the ovaries and uterus.

Contraindications

Improper use of Oxytocin injections can cause serious consequences for the body, even death. It is important to take into account the limitations, assess the risk of adverse reactions depending on the condition of the mother and fetus.

The hormone Oxytocin in ampoules is not prescribed in the following situations:

• arterial hypertension;
• oblique or transverse position of the fetus;
• development of preeclamptic toxemia;
• placenta previa;
• invasive carcinoma develops in the cervical region;
• large fruit;
• excessive sensitivity to oxytocin;
• the uterus is stretched after numerous births;
• severe pathologies of the vascular network, cardiac muscle;
• there are scars on the uterus after surgical treatment or caesarean section;
• narrow pelvis;
• suspicion of placental abruption;
• intrauterine oxygen starvation fetus;
• increased risk of uterine rupture.

Instructions for use

Doctors select the dosage and method of administration of the Oxytocin solution individually. The frequency of injections is determined taking into account the condition of the patient.

Basic Rules:

• to stimulate labor activity. Intramuscular injections, from 0.5 to 2 IU of the hormone, repeated administration at intervals of 30 minutes to an hour with a weak effect of the hormonal agent;
• for labor induction. Intravenous infusions. Previously, 2 ampoules of a hormonal agent are diluted in 1 liter of a 5% dextrose solution. The initial infusion rate is from 5 to 8 drops per minute, the rate is gradually increased depending on the degree of activation of labor activity (maximum, up to 40 drops in 60 seconds). Be sure to monitor the heart rate of the fetus and the activity of the muscles of the uterus;
• in the treatment of incomplete or imminent abortion Oxytocin solution is administered intravenously by drip. For the procedure, a dextrose solution of a concentration of 5% (500 ml) is combined with 10 IU of the hormone. The optimal rate of administration of the drug is from 20 to 40 drops within 60 seconds;
• to prevent mastitis with congestion against the background of lactation, the patient receives intramuscularly 2 IU of a hormonal preparation;
• for removal of placenta after caesarean section sections in the wall of the uterus make an injection of Oxytocin, a single dose - from 3 to 5 IU of the active substance;
• to reduce the risk of hypotonic bleeding from the uterus prescribe i / m injections 2 or 3 times a day for two to three days. The optimal amount of the hormone is from 3 to 5 IU. During the period of treatment of dangerous uterine bleeding, the duration of therapy is three days, the amount of oxytocin is from 5 to 8 IU, the frequency of i / m administration is two to three times a day;
• with severe premenstrual syndrome appoint intranasal use of a hormonal agent. It is necessary to instill the solution into the nose from the 20th day menstrual cycle 1 day of the next monthly bleeding.

To reduce the risk of reflex tachycardia and a drop in blood pressure, a slow jet injection of the solution during infusion at a rate of 0.012 to 0.02 IU / min is required. When confirming optimal labor activity, it is important to gradually reduce the rate of intravenous administration.

Important! Oxytocin injections are used strictly according to indications, but with individual sensitivity or a combination of negative factors, negative reactions are possible. A drug that stimulates uterine contractions is allowed to be used only in a hospital under constant medical supervision.

Side effects

Possible side effects at mother:

• headache, dizziness;
• fluid retention in the body, nausea, vomiting;
• increased platelet levels;
• anaphylactic shock with excessive sensitization of the body;
• bradycardia, arrhythmia, decrease or increase in blood pressure, ventricular extrasystole;
• uterine cramps, uterine hypertonicity and uterine rupture;
• death during childbirth;
• hemorrhage in the pelvic area.

Complications in a newborn or fetus:

• sinus bradycardia, palpitations, arrhythmia, extrasystole;
• hemorrhage in the area of ​​the retina;
• asphyxia, in the absence of timely assistance - fetal death;
• damage to the brain and central nervous system;
• neonatal jaundice.

Uncontrolled use of the drug Oxytocin can lead to dangerous complications. Injections, infusions are carried out only in a hospital. It is important to monitor the condition of the mother and fetus, showed blood pressure, heartbeat, contractility of the uterus.

Overdose

An excess of oxytocin is dangerous to health and life: severe side reactions develop:

• convulsions;
• hypoxia;
• birth trauma;
• uterine rupture;
• hypercapnia;
• tetanus of the uterus;
• fetal bradycardia;
• asphyxia and fetal death;
• severe postpartum bleeding;
• a sharp slowing of the heartbeat in the fetus.

On the page, read the information on how to treat an ovarian cyst without surgery using medications.

Treatment:

• immediate cancellation of injections based on oxytocin;
• rapid decrease in fluid intake;
• conducting forced diuresis;
• administration of hypertonic saline (sodium chloride);
• stabilization of water and electrolyte balance;
• constant medical supervision.

drug interaction

Important nuances:

• combination with Cyclopropane and Halopan may lead to hypotension;
• when used simultaneously with MAO inhibitors, there is a high probability of an increase in blood pressure;
• the combination of Oxytocin with sympathomimetic amines increases the pressor effect of the use of ionotropic drugs that bind myocardial pt-receptors.

Price

The price of Oxytocin depends on the number of ampoules and the pharmaceutical company. Hungarian drug (manufacturer - Gideon-Richter) - price 85 rubles for 5 ampoules, Russian remedy(Moscow Endocrine Plant) - 45 rubles for 10 ampoules.

Store the drug on the bottom shelf or refrigerator door at a temperature of +2 C to +15 C. It is forbidden to freeze the medicine. Ampoules with a hormonal composition should not get to children. Solution for injection Oxytocin is suitable for three years.

Analogues

Many women leave positive reviews about oxytocin, if the hormone was used to stimulate proper labor activity. Often, a second injection is required if the contractions are not intense enough. It is important that physicians take into account contraindications to reduce the risk of adverse reactions, including life-threatening women and fetuses.

With weak labor activity, congestion in the chest during lactation, poor contraction of the uterus after an abortion or childbirth, doctors recommend injections of Oxytocin. Hormonal agent successfully used in severe manifestations of premenstrual syndrome, for the prevention of hypotonic bleeding from the uterus. An analogue of a natural hormone has an active effect on the elements reproductive system, gives positive result without serious complications for the body. If Oxytocin is used incorrectly, dangerous side reactions are possible.

Video about who and why the hormone Oxytocin is prescribed in injections:

The physiological state of a person largely depends on the hormonal background. One of the important hormones is oxytocin with an oligopeptide structure. In men, under its influence, parochial altruism increases, emotional (spiritual) ties are strengthened in relation to loved ones. In women, there is a suppression of anxiety and a sense of fear, stimulation of uterine contractility, which is important during childbirth to facilitate the passage of the fetus through the birth canal.

What oxytocin, the hormone of love and affection, consists of and how it works, what methods are known to increase it with insufficient concentration, we will consider later in the article.

Oxytocin, what kind of drug?

Oxytocin is a substance produced in men and women by the hypothalamus and then transported to the posterior pituitary gland. The effect of oxytocin on the psycho-emotional background of people has been proven. Also, on the basis of this hormone, pharmaceutical companies published the drug Oxytocin with the same name. If earlier in medicine a substance extracted from animals was used. Today, the hormone is exclusively synthetic and has found wide application in gynecology with the introduction of injections into the uterine muscle.

If the natural production of oxytocin in the hormonal background is insufficient, then the hormone can be prescribed to women:

• during childbirth in case of weak contractions of the uterus;
• during a caesarean section;
• in the postpartum period in order to normalize the contractility of the uterus, eliminate bleeding, improve the excretion of milk from the mammary glands during lactation;
• for early termination of pregnancy.

Composition and form of release

Oxytocin is produced in solutions for injection (in / in, in / m). On the appearance this is:

• clear sterile liquid;
• without special smell and color.

1 ampoule contains:

• oxytocin (5 IU);
• additional elements: chlorobutanol hydrate, purified water.

Properties

Oxytocin is considered a complex hormone in structure, but very important with the production of the hypothalamus in the brain. It has exceptionally positive properties on a person:

• increases the emotional background;
• reduces stress, anxiety, fears, anxiety;
• enhances emotional memory;
• enhances sexual desire, as it is able to increase in concentration with hugs, kisses, touches;
• helps people adapt in society, regulates communication;
• suppresses drug addiction, cravings for smoking, cocaine, alcohol;
• has a calming effect, normalizes sleep;
• stimulates the best qualities in a person: generosity, cordiality, hospitality;
• activates the body's defenses, begins to show aggression to the onslaught of stimuli.

Oxytocin of protein origin plays a big role for women:

• contributes to the regulation of behavioral reactions in women during pregnancy;
• stimulates the birth process;
• has a relaxing effect on the smooth muscles of blood vessels, leading to a short-term decrease in pressure indicators;
• has a selective effect on the myometrium in the uterine cavity, since it does not contain other hormone impurities;
• beneficial effect on the uterus and mammary glands;

• normalizes pressure;
• relaxes vascular muscles;
• facilitates the birth process in women, begins to stimulate the contractility of the uterus and the production of breast milk, and prevent the development of congestion;
• enhances the secretion of prolactin, which begins to produce breast milk and accelerate the patency of the milk ducts;
• strengthens the bond between mother and child.

REFERENCE! In the course of the studies, it was found that the concentration of oxytocin in different phases of the menstrual cycle in women in the blood practically does not change. Even during pregnancy in the 2nd-3rd trimester, with an unstable hormonal background, it can only slightly increase at night.

Pharmacology and pharmacokinetics

The mechanisms of action of Oxytocin are due to the effect on myometrial cells, leading to an increase in the excitability and permeability of their membranes for potassium ions. This is how the stimulation of the uterus and the production of lactogenic hormone in women begins.

The effect of the drug is observed immediately, approximately 3-5 after administration. After 1 hour, it begins to gradually decrease. Although the effect may be individual, since the density of the muscle cells of the uterus and oxytocin receptors in each woman is different.

Absorption of the drug into the bloodstream is fast. Metabolism of the active particles occurs in the liver. The excretion process is carried out by the kidneys.

REFERENCE! Oxytocin is not able to have a pronounced antidiuretic effect and does not affect arterial pressure. It is practically free of proteins, therefore it does not lead to anaphylactic reactions when administered intravenously.

The drug has a powerful abortive effect. Able to provoke a miscarriage or contractions in women before childbirth.

Indications for use

Oxytocin actively stimulates labor activity, therefore it is prescribed in the following cases:

• contractions to stimulate the uterine cavity;
• C-section;
• atonic bleeding;
• delayed uterine discharge in the postpartum period;
• the need for early delivery due to intrauterine growth retardation of the fetus;
• conflicting Rh factor;
• preeclampsia;
• intrauterine fetal death;
• prolonged pregnancy over 42 weeks;
• preventive measures after childbirth or abortion with hypotonic bleeding;
• conducting an inferior (failed) abortion as an additional therapy.

Indications for the introduction of oxytocin infusions for the purpose of induced (medicated) abortion:

• malformation in the fetus;
• frozen pregnancy.

The introduction of the drug to suppress pregnancy is made only in medical institutions and under medical supervision. First, it is extremely important to make sure that the fetal egg has left the uterine cavity. Doctors need to monitor the contractile functions of the uterus and the general well-being of women, since after the administration of oxytocin, the likelihood of bleeding is high.

Contraindications

Oxytocin is a drug that should be used exclusively under the supervision of doctors. Self-medication is excluded.

As a rule, the drug is administered to women to initiate, stimulate labor, but there are contraindications for use as a labor stimulator:

• incorrect (transverse, frontal) presentation of the fetus with the inability to exit the head through the birth canal in a natural way, when doctors resort to a caesarean section;
• discrepancy between the size of the pelvis and head;
• identification of hydrocephalus in case of brain pathology in the fetus;
• high risk of bleeding
• the threat of uterine rupture, which poses a danger to the life of the fetus and mother;
• excessive sensitivity to active substances oxytocin;
• narrowness of the pelvis in parturient women;
• immaturity of the cervix;
• the appearance of hyperstimulation after the introduction of oxytocin;
• premature birth;
• prolapse of the umbilical cord;
• severe gestosis;
• sepsis or severe distension of the uterus;
• heart disease (arterial hypertension);
• violation of the kidneys.

The note! For the purpose of terminating a pregnancy, the administration of oxytocin is contraindicated in a woman with fibroids or scars on the cervix.

Overdose

An overdose of the drug when administered intramuscularly can cause:

• hyperstimulation, prolonged uterine contractions;
• rapid childbirth, which can negatively affect the body of women in the event of an artificial termination of pregnancy due to Oxytocin.

In case of an overdose of oxytocin, it is necessary to carry out urgent rehydration actions:

• stop infusions;
• limit fluid intake;
• correct water and electrolyte balance;
• stop convulsions with barbiturates if necessary.

REFERENCE! An overdose of oxytocin provokes damage to the vagina and rupture of the cervix (body) of the uterus as a result of hyperactivity, severe bleeding, the development of cardiac pathologies, hypoxia in the fetus until death.

Side effects

Negative side effects may occur in case of an overdose of Oxytocin or with excessive sensitivity of the uterus to the active ingredient.

In particular, unpleasant symptoms can be caused by the reproductive system in case of:

• administration of the drug in large doses;
• uterine hypersensitivity.

Possible side effects:

• spasms, uterine rupture;
• bleeding;
• thrombocytopenia;
• hemorrhage in the pelvic organs.

Improper administration of the drug or high doses causes negative manifestations from:

• digestive system in the form of vomiting, nausea;
• cordially - vascular system with the development of hypotension, arrhythmia, ventricular extrasystole, tachycardia, bradycardia.

If Oxytocin is administered slowly and for a long time, then a failure of the water and electrolyte balance may occur, appear in women:

• convulsions;
• allergic reactions;
• bronchospasm;
• anaphylaxis up to death;
• coma.

Oxytocin should only be used under the strict guidance of a specialist, as it can lead to side effects not only in women, but also in the fetus. So if you administer the drug at high speed, then jaundice may appear, retinal hemorrhage in a newborn.

The note! Improper administration can cause asphyxia and fetal death. If the drug is administered by pregnant women at home, then the following signs should be the reason for urgent cancellation: pressure surges, spasms in the bronchi, feeling of the uterus, itching and rash on the body, swelling of the tongue, shortness of breath, convulsions, slow heartbeat.

Instructions for use

It is best to inject Oxytocin solution intramuscularly. If the detailed version does not lead to the expected results, then you can switch to the introduction into the vein, but rather slowly.

The average dosage for 1 session is 1-3 IU. According to gynecological indications, it can be increased to 10 IU. With caesarean section - 5 IU.

To terminate a pregnancy, the selection is carried out by a doctor, taking into account the duration and frequency of uterine contractions. First, Oxytocin is administered slowly (no more than 16 drops per minute). Then you can gradually increase the speed by 48 drops after 20-40 minutes in order to achieve the desired degree of contractile activity of the uterus. As the cervix opens up to 6 cm, it is recommended to reduce the rate of administration of oxytocin infusion, i.e. start injecting in reverse order with decreasing drops.

If the drug is administered for late term pregnancy, the rate of administration should not exceed 30 drops per minute. When using Oxytocin in case of preterm labor, the rate should be approximately 75-80 drops per minute. At the same time, the tone and duration of uterine contraction, the fetal heartbeat must be kept under full control.

Oxytocin tablets are used according to the following scheme:

• laying 1 piece per cheek without swallowing, leaving until complete resorption;
• taking the 2nd tablet in 30-40 minutes.

The maximum dosage per day is 500 units. If there is no effect from the reception before the medical abortion, then it is allowed to drink 1 more tablet in addition. If the abortion seems to have failed, then to stimulate labor, it is worth administering the drug intravenously at a dose of 5mU

Interaction with other drugs

1. It is likely that therapeutic effect will be reduced if an oxytocin solution is used together with drugs for inhalation under anesthesia.
2. If you combine Oxytocin with prostaglandins, then there may be a suppression of the stimulating effect, the development arterial hypertension. The same thing happens when oxytocin is combined with antispasmodics (Papaverine, no-shpa).
3. It is allowed to administer the drug with glucose, sodium lactate, sodium chloride in solutions, but maintaining intervals between doses of 6-8 hours.

Reference! It is impossible to enter at the same time a solution in / m and / in Oxytocin. When choosing the optimal doses for women in labor, it is important to take into account individual tolerance, track the strength of uterine bleeding and fetal cardiac activity.

special instructions

1. Oxytocin is an antidiuretic, so infusions or oral tablets can cause overhydration.
2. Do not use Oxytocin if you are allergic to active ingredients. Otherwise, you should be prepared for bleeding, pre-fainting.
3. Improper administration of dosages can cause uterine rupture.
4. You can not start labor stimulation with Oxytocin if the fetal head is just entering the pelvic region.
5. It is necessary to administer intravenously Oxytocin only in a hospital setting so that doctors can provide the right assistance in a timely manner. It is equally important to keep under control the dynamics of uterine contractions and cardiac activity in the mother (child).

Oxytocin may become indispensable for keeping the condition of the fetus and the birth process under control in women. But you need to enter correctly, observing the dosage, under the supervision of a specialist and cardiotocography in order to register the amplitude and frequency of contractions by the attending physician.

It happens that doctors resort to making the only correct decision to conduct a caesarean section, when the condition of the fetus changes or labor stimulation with the drug is ineffective.

Recipes 2006

1. Rp: Tab. Ampicillini 0.25

D.t.d. No. 20

S. By 2 tab. 4 r / day for 7-10 days with gestational pyelonephritis.(v-lactam a / b, semi-synthetic broad-spectrum penicillin, aminopenicillin.

2. Rp: Tab. Anaprilini 0.01

D.t.d. No. 20

S. 2 tab. 4-6 times in 30 minutes to stimulate labor.(non-selective in-adrenergic blocker).

3. Rp: Sol. « Baralgin» 5.0

D. t. d. N. 1 inamp.

S. 5 ml IM for labor pain relief.(combination drug, composition: analgin 0.5 g + anticholinergic 5 mg (pitofenone hydrochloride) + ganglion blocker 0.1 mg (feniverin bromide), analgesic and antispastic agent).

4. Rp: Gentamicini sulfatis 0.08

D.t.d. No. 10

S. Dilute in 2 ml of saline i/m 4 r/d in acute salpingitis.

(aminoglycoside a/b, bacteriostatic, acts on Gr+ and Gr-flora, contraindicated in breastfeeding)

5. Rep: Sol. Gyniprali 0.5%-5ml

D.t.d. No. 5 in ampullis

S. 0.5 mg (1 ampoule) diluted in 500 ml of 0.9% saline. r-ra, enter slowly (25 drops / min, if necessary, increase the dose by 5 drops every 5 minutes) with the threat of premature. childbirth in IIItrimester

(v-mimetic, tocolytic)

Rp: Tab. gyniprali 0,00005

D. t. d. № 20

S. Start taking the tablets. 1-2 hours before the end of the infusion: 1 tab. first every 3 hours, and then every 4-6 hours (4-8 times / day) with the threat of premature. childbirth in IIItrimester

(v-mimetic, tocolytic)

6. Rp: Sol. Dexamethazoni 0.4%-1ml

D.t.d. No. 50

S.3 ml intramuscularly after 12 hours for the prevention of SDR in a newborn with a gestational age of 28-34 weeks.

(GCS, accelerates the maturation of the surfactant; the appointment of dexamethasone to accelerate the maturation of the fetal lungs is indicated when preterm labor is performed after 2-3 days, it is dangerous during breastfeeding and pregnancy)

7. Rp: Dragee “ Diane-35” № 21

D. S. Inside, 1 tablet per day, at the same time, starting from the first day of the cycle for 21 days with a break of 7 days as a contraceptive. remedies for polycystic ovary syndrome. (low-dose monophasic COC with antiandrogenic activity, with hyperandrogenic manifestations in women: acne, seborrhea, alopecia, mild hirsutism)

8. Rp: Sol. Dicynoni 12.5%-2ml

D.t.d. No. 10 in ampullis

S. 2-4 ml in/in simultaneously with hemorrhagic shock 1 tbsp.

(angioprotector, increases the image in the walls of vessels in mucopolises of large molecular weight and increases the stability of capillaries, normalizing their permeability during pathological processes, improves microcirculation. The hemostatic effect is associated with an activating effect on the image of thromboplastin, stimulates the formation of a factorIIIfolding, normalization. aggregation Tr., does not affect prothrombin. time, does not have hypercoagulable properties and does not contribute to the formation of blood clots)

9. Rp: Tab. Dopegidi 0.25

D.t.d. No. 20

S. 1 tab. 2 r / day for hypertension in pregnant women, eukinetic type

(neurotropic hypotensive prep. methyldopa of central action, stimulates central alpha2-AR, inhibits sympathetic impulses, which leads to a decrease in blood pressure)

10. Rp: Tab. Duphastoniobductae 0.01

D. t. d. № 10

S. 1 tab. 2 r / day until 16-20 weeks of pregnancy with habitual miscarriage with malformations of the uterus (hypoplasia of the uterus and / or chorion.) 20-40 mg per day.

(synthetic progesterone, the active substance dydrogesterone, promotes the formation of normal secretory endometrium in women after prior estrogen therapy, does not suppress ovulation)

11. Rp: Tab. Indomethacini 0.025 ???????

D.t.d. No. 50

S. 1 tab. 50-100 mg 1 r / day, 7-9 days (total dose should not exceed 1000 mg) with the threat of abortion duringIIandIIItrimester.

The course of treatment can be repeated, but not earlier than after 2 weeks. the fetus has a cumulative effect.

(NSAIDs, a derivative of indolacetic to-you, have. pronounced analgesic. effect. With an increased tone of the uterus, it is the drug of choice, because. is an inhibitor of PG, penetrating the placenta, reduces the tone of the uterus. Allowed up to 32 weeks. Should not be given while breastfeeding. PD - premature. closure art. duct, prolongation of pregnancy)

12. Rp: Tab. Clotrimazoli vaginalis 0.1

D.t.d. No. 20

S. 1 vaginal tab for 10 days with vaginal candidiasis.

(antifungal agent, a derivative of imidazole and triazole, contraindicated inItrimester of pregnancy)

13. Rp: Tab. Clophelini 0.00015

D.t.d. No. 50

S. 1 tab. 2r/day of mild preeclampsia, hypokinetic type of circulation.

(an antihypertensive agent of central action, reduces the effect of adrenergic innervation on the cardiovascular system, reduces the tone of vasomotor centers)

14. Rp: Sol. Methylergometrini 0.02%-1ml

D.t.d. No. 1 in ampullis

S. Dilute 1 ml in 20 ml of saline, intravenously at the same time at the height of the last attempt to prevent bleeding after childbirth

IV 2 ml once in the early postoperative period to prevent bleeding (after CS for PN)

(ergot alkaloid, increases the tone of the myometrium, used for hypotension and atony of the uterus in the early postpartum period, CS, bleeding after abortion)

15. Rp: Tab. Metronidasololi 0.25

D.t.d. No. 20

S. 2 tab. 4 r / day for the treatment of endometritis for 7-10 days

(synthetic a/b, nitroimidazole derivative, contraindicated inItrimester take. and if breastfeeding, use with caution duringIIandIIItrimester take.)

16. Rp: Tab. Nifedipini obductae 0.01

D.t.d. No. 20

S. 1 tab. 2 r / day for mild preeclampsia, eukinetic type of hemodynamics.

(Ca antagonist, antihypertensive, dilates coronary vessels)

17. Rp: Dragee “ Novinet” № 21

D. S. 1 tablet per day, inside at the same time, starting from the first to the fifth day of the cycle for 21 days with a break of 7 days as a contraceptive. funds

(monophasic COOK)

18. Rp: Sol. No-spae 2%-2ml

D. t. d. № 1 inampullis

S. 2 ml IM for labor pain relief.

(reduced form of papaverine, antispasmodic)

19. Rp: Oxytocini5ED-1.0

D. t. d. № 5 inampullis

S. Dilute the contents of the ampoule (1 ml) in 0.9% - 500 ml of saline. solution, start infusion 6-8 drops / min, after 20-30 minutes add 6-8 drops. Max. concentration 40 drops / min - 8 ml / min. For rhodostimulation with weakness of labor activity associated with uterine atony.

(synthetic hormone of the posterior pituitary gland, it is not advisable to inject oxytocin for more than 3-5 hours if it is not effective)

20. Rp: Sol. Promedoli 2% - 1ml

D.t.d. No. 1 in ampullis

S. V / m 1 ml for pain relief in childbirth with the opening of the pharynx by 1.5 - 2 transverse fingers and will satisfy. fetal condition.

(narcotic analgesic, opioid receptor antagonist)

21. Rp: Sol. Progesteroni oleosae1 %-1ml

D. t. d. № 3 inampullis

S. V / m 1 ampoule 1 r / daywithin 2 weeks of ovulation onset for the prevention and treatment of threatened and incipient miscarriage associated with corpus luteum insufficiency

(hormone of the corpus luteum, after fertilization, promotes the transition of the uterine mucosa to the state necessary for the development of a fertilized egg. Reduces the excitability and contractility of the muscles of the uterus and fallopian tubes, stimulates the development of the terminal sections of the mammary glands)

22. Rp: Dragee “ Reguloni” № 21

D. S. 1 tablet per day, inside at the same time, starting from the first day of the cycle for 21 days with a break of 7 days as a contraceptive. funds

(monophasic COC)

23. Rp: Sol. Relanii 0.5 %-2 ml

D. t. d. № 5 inampullis

S. IM 2ml (1 ampoule) for moderate preeclampsia(tranquilizer, benzodiazepine receptor antagonist)

24. Rp: Sol. Refortani 6%-500ml

D. t. d. № 3

S. In / in drip 500 ml 1-2 r / day, the duration of therapy is determined individually, in case of violation it will reduce. the ability of the uterus in the early postpartum. period with blood loss exceeding 0.5% of body weight (350-400 ml)

(HES, plasma-substituting drug)

25. Rp: Sol. Magnesium sulfatis 25%-2 0ml

D. t. d. № 10 inampullis

S. Loading dose: in / in 1 bottle (5 g) diluted in 100-200 ml of 0.9% saline. solution or HES; then a maintenance dose depending on body weight: up to 60 kg - 1 g / h, 65-70 kg - 2 g / h, more than 70 kg - 2-3 g / h for labor pain relief or for the treatment of PE

(antihypertensive drug, antispasmodic, anticonvulsant, sedative effect)

26. Rp: GelCerviprosti 0.07% – 3 ml

D. S. For maturation of the cervix 1.5 ml into the posterior fornix of the vagina (1 syringe)

(PG E2, a means that promotes the maturation of the cervix and enhances the contractile activity of the myometrium)

27. Rp: Cephazolini 0.5

D.t.d. No. 10

S. Dilute the contents of the vial in 3 ml isot. solution, i / m deep into the muscle 1 bottle 3-4 r / day for lactation mastitis.

(1st generation cephalosporin, dangerous during pregnancy and breastfeeding)

28. Rp: Sol. Infucoli 6%-500

D. t. d. № 1

S

2 9 . Rep: Sol. Stabisoli 6%-500

D. t. d. № 1

S. For circulating blood volume in case of bleeding

30. Rp: Dragee “Sorbifer durules” #100

D. S. 1 tablet 2 times a day for the treatment of anemia

(ferrous sulfate/ascorbic acid)