Oxytocin Richter

Induction of labour for medical reasons eg, post-term gestation, membrane premature rupture, preeclampsia. Stimulation of labour in hypotonic uterine inertia. Adjunctive therapy for incomplete, inevitable or missed abortion. Caesarean section following infant delivery. Prevention & treatment of postpartum uterine atony & haemorrhage.

Induction or enhancement of labour 5 IU drip infusion, may be gradually increased at intervals not shorter than 20 min & increments of not >1-2 milliunits/min. Max rate: 20 milliunits/min. Incomplete, inevitable or missed abortion 5 IU IV infusion, if necessary followed by IV infusion at rate of 20-40 milliunits/min. Caesarean section 5 IU IV infusion. Prevention of postpartum uterine haemorrhage 5 IU IV infusion or 5-10 IU IM after placental delivery. Treatment of postpartum uterine haemorrhage 5 IU IV infusion or 10 IU IM, followed by 5-20 IU IV infusion in severe cases. Atonic uterus 5 IU IM after placental delivery.

Hypersensitivity. Foetal distress where delivery is not imminent, hypertonic uterine contractions, delivery mechanical obstruction. Significant cephalopelvic disproportion, foetal malpresentation, placenta & vasa praevia, cord presentation or prolapse, overdistension or impaired resistance of uterus to rupture (eg, multiple pregnancy, polyhydramnios), gland multiparity, presence of uterine scar from major surgery including classic caesarean section. Not to be used for prolonged periods in oxytocin resitant uterine inertia, severe preeclamptic toxaemia or maternal CV disorders. Not to be administered w/in 6 hr after vag prostaglandins.

Not to be inj IV bolus. Avoid tumultuous labour in case of foetal death in utero &/or presence of meconium-stained amniotic fluid. Disseminated intravascular coagulation; water intoxication. Patients w/ predisposition to myocardial ischemia due to preexisting CV disease eg, hypertrophic cardiomyopathy, valvular &/or ischemic heart disease eg, coronary artery vasospasm; known long QT syndrome; presence of borderline cephalopelvic disproportion, secondary uterine inertia, mild or moderate degrees of pregnancy-induced HTN or cardiac disease, history of lower-uterine-segment caesarean section. Careful monitoring of foetal heart rate & uterine motility. Latex allergy/intolerance. Prolonged use & high-dose. Concomitant use w/ drugs prolonging QTc interval. May affect ability to drive & use machines. Hepatic & severe renal impairment. Women ≥35 yr, pregnancy complications, gestational age >40 wk. Foetal distress, asphyxia & death at excessive doses. Paed patients. Elderly ≥65 yr.

Headache; tachycardia, bradycardia; nausea, vomiting.

Potentiated uterine action w/ prostaglandins & analogues. Potentially arrhythmogenic to QT interval-prolonging drugs. Potentiated pressor effect w/ sympathomimetic vasoconstrictor agents. Enhanced vasopressor effects of vasoconstrictors, sympathomimetics, local anaesth. Diminished uterotonic effect w/ inhalation anaesth eg, cyclopropane, halothane, sevoflurane, desflurane, enflurane.

Drugs Acting on the Uterus

H01BB02 - oxytocin ; Belongs to the class of oxytocin and analogues. Used in posterior pituitary lobe hormone preparations.

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