Oxytocin-Richter, 5 me/ml 1 ml 5 pcs

Oxytocin increases the permeability of myometrial cell membranes to ions, increases its excitability and causes and enhances uterine smooth muscle contractions.

Pharmacodynamics

Stimulates lactation by promoting contraction of myoepithelial cells of mammary gland alveoli.

Indications

Active ingredient

Composition

Active ingredient:

Oxytocin;

Supplementary substances:

Lacetic acid;

Chlorobutanol hemihydrate;

ethanol (96%);

water for injection;

How to take, the dosage

Intramuscularly, intravenously (single injection, dropwise), into the wall or vaginal part of the cervix; intranasally.

In case of labor induction, intramuscularly – 1 IU at 30-60 minute intervals (depending on uterine reaction); more appropriately – intravenously drip (10-30 drops per minute) – 1-3 IU in 300-500 ml of 5% glucose solution (under control of uterine contractions rate and fetal heartbeat) before delivery and after separation of fetus.

For stimulation of labor, intramuscularly – 0.5-1 IU at intervals of 30-60 minutes, you can intravenous drip (as for labor induction), depending on the obstetric situation (opening of the uterine pharynx, etc.).

In case of breech delivery – 2-5 IU.

In hypotension and uterine atony, 5-10 IU, intravenously, in 10-20 ml of 40% glucose solution.

To stimulate lactation, intramuscularly or intranasally (with a pipette) – 0.5 IU 5 minutes before feeding; if necessary, the injection is repeated.

In premenstrual syndrome – intranasally, from the 20th day of the cycle to the 1st day of menstruation.

Interaction

If oxytocin is administered 3-4 hours after the use of vasoconstrictors in conjunction with caudal anesthesia, severe arterial hypertension is possible.

In anesthesia with cyclopropane, halothane, the cardiovascular effects of oxytocin may change with the unforeseen development of arterial hypotension, sinus bradycardia, and atrioventricular rhythm in the laboring woman during anesthesia.

Special Instructions

Before oxytocin is administered, the expected beneficial effects of therapy should be weighed against the possibility, albeit rare, of hypertension and uterine tetany.

Pending the insertion of the fetal head into the pelvic inlet, oxytocin should not be used to induce labor.

Each patient receiving intravenous oxytocin must be hospitalized under the constant supervision of experienced specialists who are familiar with the drug and recognized as skilled in recognizing complications. Immediate, if necessary, assistance from a specialist physician must be provided.

When using the drug, uterine contractions, cardiac activity of the laboring woman and fetus, and blood pressure of the laboring woman should be constantly monitored to prevent complications. If there are signs of uterine hyperactivity, the administration of oxytocin should be stopped immediately; as a result, uterine contractions induced by the drug usually subside shortly.
When adequately administered, oxytocin induces uterine contractions similar to spontaneous labor. Overstimulation of the uterus by improper use of the drug is dangerous for both the mother and the fetus. Even with adequate use of the drug and appropriate monitoring, hypertonic uterine contractions occur when the uterus is hypersensitive to oxytocin.

The risk of developing afibrinogenemia and increased blood loss must be considered.

Partum deaths due to hypersensitivity reactions, subarachnoid hemorrhage, uterine rupture and fetal death from various causes are known to occur in connection with parenteral administration of the drug for labor induction and stimulation in the first and second periods of labor.

As a result of the antidiuretic effect of oxytocin, hyperhydration may develop, especially when using continuous oxytocin infusion and fluid intake.

The drug may be diluted in sodium lactate, sodium chlorate and glucose solutions. Ready solution should be used in the first 8 hours after preparation. Compatibility studies were performed with 500 ml infusions.

Contraindications

Hypersensitivity, clinically narrow pelvis, abnormal fetal position, total placenta previa, threat of uterine rupture.

Side effects

Nausea, vomiting, arrhythmia, including in the fetus, bradycardia (mother and fetus); hypertension and subarachnoid hemorrhage or hypotension and shock; water retention (before poisoning) – with prolonged IV administration; allergic reactions.

Overdose

The symptoms mainly depend on the degree of uterine hyperactivity, regardless of the presence of hypersensitivity to the drug.

Hyper-stimulation with hypertonic and tetanic contractions or with a baseline tone ≥15-20 mm a.c. between two contractions leads to disordered labor, rupture of the body or cervix, vagina, bleeding in the postpartum period, uteroplacental insufficiency, fetal bradycardia, fetal hypoxia, hypercapnia, compression, birth trauma or death.

Hyperhydration with seizures as a result of the antidiuretic effect of oxytocin is a serious complication and develops with prolonged administration of high doses (40-50 ml/min).

The treatment of hyperhydration: withdrawal of oxytocin, restriction of fluid intake, use of diuretics to force diuresis, intravenous administration of hypertonic saline solution, correction of electrolyte imbalance, seizure management with appropriate doses of barbiturates and professional care of the comatose patient.

Pregnancy use

In the first trimester of pregnancy, oxytocin is used only for spontaneous or induced abortion.

Lots of data on the use of oxytocin, its chemical structure and pharmacological properties indicate that, if the instructions for use are followed, oxytocin has no effect on the formation of fetal malformations.

In small quantities it penetrates into breast milk.

If the drug is used to stop uterine bleeding breastfeeding can be started only after the oxytocin treatment is completed.

Similarities