GENERIC NAME: Oxytocin

BRAND NAME: Pitocin

THERAPEUTIC CLASS: Oxytocics

PHARMACOLOGIC CLASS: Exogenous hormones

MODE OF ACTION: causes strong and selective stimulation of smooth muscle in the uterus and
mammary glands.

SUGGESTED DOSE (by manufacturer):

Injectable solution – 10 units/mL

INDICATION:

Dosage Considerations – Should be given as follows:

 Incomplete, inevitable, or elective abortion

- Adults: 10 units IV infusion at 10 to 20 milli- units (20 to 40 drops)/minute. Don't
exceed 30 units in 12 hours.
 To induce or stimulate labor
- Adults: Initially, 0.5 to 1 milliunit/minute IV infusion. Increase rate by 1 to 2
milliunits/minute at 30- to 60-minute intervals until normal contraction pattern is
established. Decrease rate when labor is firmly established. Rates exceeding 9 to 10
milliunits/minute are rarely required.
 To reduce postpartum bleeding after expulsion of placenta
- Adults: 10 to 40 units in 1,000 mL of lactated Ringer solution, or NSS IV infused at
rate by needed to sustain uterine contraction and control uterine atony. Also, may
give 10 units IM after delivery of placenta.

CONTRAINDICATION:

- Contraindicated in patients hypertensive to drug

- vaginal delivery is contraindicated (invasive cervical cancer, active herpes
infection, total placenta previa, vasa previa, and cord presentation or prolapse of
the cord)
- significant cephalopelvic disproportion, in unfavorable fetal positions or
presentations which are undeliverable without conversion prior to delivery
(transverse lie)
- fetal distress where delivery is not imminent, in prematurity, in other obstetric
emergencies, and in patients with severe toxemia or hypertonic uterine patterns.
- Use cautiously, if at all, in patients with invasive cervical cancer and in those with
previous cervical or uterine surgery (including cesarean section), grand
multiparity, uterine sepsis, traumatic delivery, or overdistended uterus.

SIDE EFFECTS:
 - Nausea or vomiting
- Memory problems or confusion
- Runny nose, sore throat, or coughing
- severe headaches
- hallucinations
- Seizures and severe hypertension

ADVERSE EFFECTS:

Maternal

- CNS: subarachnoid hemorrhage, seizures, coma.

- CV: arrhythmias, HTN, PVCs, hypotension, tachycardia.
- Gl: nausea, vomiting.
- GU: abruptio placentae, tetanic uterine contractions, postpartum hemorrhage,
uterine rupture, impaired uterine blood flow, pelvic hematoma, increased uterine
motility.
- Hematologic: afibrinogenemia, possibly related to postpartum bleeding, pelvic
hematoma.
- Other: anaphylaxis, death from oxytocin induced water intoxication,
hypersensitivity reactions.

Fetal

- CNS: infant brain damage, seizures.

- CV: bradycardia, arrhythmias, PVCs.
- EENT: neonatal retinal hemorrhage.
- Hepatic: neonatal jaundice.
- Other: low Apgar scores at 5 minutes, death.

DRUG INTERACTION:

- Carboprost tromethamine: May enhance adverse/toxic effect of oxytocin. Avoid

combination.
- Cyclopropane anesthetics: May cause less pronounced bradycardia and
hypotension. Use together cautiously.
- Dinoprostone: May enhance oxytocic effects of oxytocin. Concomitant use isn't
recommended. If used sequentially, monitor uterine activity closely. Administer
oxytocin 30 minutes after removing dinoprostone vaginal insert and 6 to 12 hours
after application of dinoprostone gel.
- Drugs that prolong QT interval: May increase risk of life-threatening cardiac
arrhythmias, including torsades de pointes. Use together cautiously.
- Misoprostol: May increase oxytocin adverse effects. Don't use together.
- Vasoconstrictors: May cause severe HTN if oxytocin is given within 3 to 4 hours of
vasoconstrictor in patient receiving caudal block anesthetic. Avoid using together.

NURSING RESPONSIBILITY (atleast 10):

 1. Review medical record
R: to ensure that there are no contraindications to administration of oxytocin
2. Document administration of oxytocin including the time when it started and ends, dose,
route, and patient’s reaction to drug.
R: follow hospital’s protocol
3. Monitor and record uterine contractions, HR, BP, intrauterine pressure, fetal HR, and
character of blood loss at least every 15 minutes.
R: because uterine contractions may decrease the maternal blood flow to the placenta, and
thereby cause a reduced supply of oxygen to the fetus, it is essential that the fetal heart rate is
monitored during labor.
4. Inform patient about the indication and side effects of the medication
R: patient will be aware what to expect when given the medication.
5. Monitor side effects (headache, irritability, confusion, nausea)
R: presence of side effects mentioned can be a sign for water intoxication.
6. Administer oxytocin properly via infusion pump
R: so that the amount of oxytocin that the patient receives is precise.
7. Monitor fluid intake and output.
R: Antidiuretic effect may lead to fluid overload, seizures, and coma from water intoxication.
8. Inform patient to immediately report any unusualities.
R: so that the doctor can check up on the pt.
9. Encourage patient to verbalize feelings and concerns regarding current state while on
medication
R: verbalization builds a foundation of trust between nurse-patient relation. also allows client
to cooperate in treatment regimen/ intervention.
10.

BIBLIOGRAPHY (atleast 3):

 Nursing 2022 Drug Handbook (42nd ed.). (2022). Wolters Kluwer.

 Oxytocin: Package Insert / Prescribing Information - Drugs.com. (2022, October 25). Drugs.com.
Retrieved November 21, 2022, from https://www.drugs.com/pro/oxytocin.html
 R. (2019, September 2). Oxytocin: Functions Drugs Side Effects Contraindications
Pharmacokinetics Dynamics. Pharmawiki.in. Retrieved November 21, 2022, from
https://pharmawiki.in/oxytocin-functions-drugs-side-effects-contraindications-
pharmacokinetics-dynamics/