Oxytocin

Generic name:
Oxytocin
Brand name:
Pitocin
Classification:
Oxytocic Agents
Dosage:
Initial: 0.5 mU (milliunits)/min to 1 mU/min I.V., increased in increments of 1 to 2 mU/min every
30 to 60min, as needed; once desired frequency of contractions has been reached and labor has
progressed to 5 to 6 cm dilation, dosage may be decreased by 1 to 2 mU/min every 30 to 60 min
Frequency:
The initial infusion rate should be set at 2 to 8 drops/minute (1 to 4 milliunits/minute). It may be
gradually increased at intervals not shorter than 20 minutes and increments of not more than 1 to 2
milliunits/minute, until a contraction pattern similar to that of normal labour is established.
Route:
Intravenous
Intramuscular
IV (after vaginal delivery)
Mechanism of Action:
Synthetic oxytocin elicits the same pharmacological response produced by endogenous
oxytocin, with cervical dilation, parity, and gestational age as predictors of the dose response to
oxytocin administration for labor stimulation. Oxytocin increases the sodium permeability of uterine
myofibrils, indirectly stimulating contraction of the uterine smooth muscle. The uterus responds to
oxytocin more readily in the presence of high estrogen concentrations and with the increased duration
of pregnancy. There is a gradual increase in uterine response to oxytocin for 20 to 30 weeks gestation,
followed by a plateau from 34 weeks of gestation until term, when sensitivity increases. Women who
are in labor have a greater response to oxytocin compared to women who are not in labor; only very
large doses will elicit contractions in early pregnancy. In the term uterus, contractions produced by
exogenous oxytocin are similar to those that would occur during spontaneous labor. Oxytocin increases
the amplitude and frequency of uterine contractions, which transiently impede uterine blood flow and
decrease cervical activity, causing dilation and effacement of the cervix.
Indication:
To initiate or improve uterine contractions in situations where there are fetal or maternal
concerns, so as to achieve a vaginal delivery.