Oxytocin

Question 1

Drug class

Answer 1

Oxytocic

Question 2

Pharmacology

Answer 2

Synthetic oxytocin is a uterine stimulant that causes uterine contractions by changing calcium concentrations within uterine muscle cells. Admin during 3rd stage of labour assists with placental separation, raises the tone of the uterine musculature & minimises further uterine blood loss

Question 3

Metabolism

Answer 3

By the liver & excreted by the kidneys

Question 4

Indications

Answer 4

• Active management of the third stage of labour (following confirmed delivery of all foetuses) AND prevention of primary post postpartum haemorrhage
• Mx of uncontrolled primary or secondary postpartum haemorrhage

Question 5

Contraindications

Answer 5

• Allergy and/or adverse drug reaction

* Undelivered foetuses

Question 6

Precautions

Answer 6

• Myocardial ischaemia

* May potentiate hypotension when admin with analgesia

Question 7

Side effects

Answer 7

• Nausea and/or vomiting
• Headache
• Bradycardia
• Tachycardia

Question 8

Presentation

Answer 8

10 International units (IU)/1ml

Question 9

Route

Onset

Duration

Answer 9

IM

2-4min

30-60min

Question 10

Special notes

Answer 10

• Uterotonics for prevention of postpartum haemorrhage during 3rd stage of labour is recommended for ALL births
• May wait for the cord to stop pulsating to admin. Delayed cord clamping = Pulsating cord = placental perfusion
• Skin to skin contact, initiate breastfeeding/nipper stim to promote natural oxytocin, normothermia, bonding

Question 11

Adult dosages

Answer 11

• Active management of third stage of labour (following confirmed delivery of all foetuses) AND prevention of primary postpartum haemorrhage
▪︎ IM 10 International units, single dose only

• Mx uncontrolled primary or secondary postpartum haemorrhage
▪︎IV 10IU, slow push of 2-3min
(May given in addition to dose given for prior indication)