Home Drug Guide Oxytocin

Drug Guide

Generic Name

Oxytocin

Brand Names Syntocinon, Pitocin, Oxytocin 5 Usp Units In Dextrose 5%, Oxytocin 20 Usp Units In Dextrose 5%, Oxytocin 10 Usp Units In Dextrose 5%

Classification

Therapeutic: Uterine stimulant, labor inducer, postpartum bleeding control

Pharmacological: Oxytocin receptor agonist

FDA Approved Indications

  • Induction of labor
  • Augmentation of labor
  • Control of postpartum bleeding

Mechanism of Action

Oxytocin acts on specific oxytocin receptors in the uterine myometrium, inducing uterine contractions. It also promotes milk ejection during breastfeeding.

Dosage and Administration

Adult: Administer IV infusion or IM injection; dosing varies based on indication and response. For labor induction, typically start with low doses and titrate upward.

Pediatric: Not commonly used in pediatric patients unless specific indications arise; dosing should be guided by pediatric specialists.

Geriatric: Use with caution; monitor closely due to increased risk of uterine hyperstimulation.

Renal Impairment: Adjustments not well established; use cautiously with close monitoring.

Hepatic Impairment: Use cautiously; hepatic impairment may alter drug metabolism.

Pharmacokinetics

Absorption: Rapid onset when administered IV, slower with IM

Distribution: Widely distributed; crosses placenta

Metabolism: Metabolized in the liver and kidneys

Excretion: Metabolites excreted in urine

Half Life: Approximately 1-6 minutes (IV) and 20-40 minutes (IM)

Contraindications

  • Fetal distress
  • Unfavorable fetal position
  • Women with obstetric emergencies requiring surgical intervention
  • Uterine scar from previous cesarean or uterine surgery unless otherwise advised

Precautions

  • Monitor fetal heart rate, uterine contractions, and maternal vital signs regularly. Use cautiously in women with cardiovascular disease, hypertension, or predisposition to uterine rupture.

Adverse Reactions - Common

  • Uterine hyperstimulation (Common)
  • Water intoxication (hyponatremia) (Occasional)
  • Nausea, vomiting (Common)
  • Hypotension or hypertension (Less common)

Adverse Reactions - Serious

  • Uterine rupture (Rare)
  • Fetal distress (Rare)
  • Seizures due to water intoxication (Rare)

Drug-Drug Interactions

  • Other uterotonics (e.g., ergometrine)
  • Mifepristone (antagonist, may reduce efficacy)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor uterine tone and contractions, fetal heart rate, maternal blood pressure, and water balance.

Diagnoses:

  • Risk for uterine hyperstimulation
  • Risk for fetal distress
  • Potential fluid volume overload

Implementation: Administer as per protocol, titrate carefully, and monitor continuously.

Evaluation: Assess fetal and maternal response, uterine contraction pattern, and water status.

Patient/Family Teaching

  • Report any abdominal pain, vaginal bleeding, or changes in fetal movement immediately.
  • Inform about the importance of continuous fetal monitoring during administration.
  • Discuss potential side effects, including water intoxication and uterine hyperstimulation.

Special Considerations

Black Box Warnings:

  • Potential for uterine rupture with high doses or in women with previous uterine surgery.
  • Risk of water intoxication leading to hyponatremia; use caution to prevent excessive water retention.

Genetic Factors: None established specific to genetic factors.

Lab Test Interference: May cause false results in certain blood assays due to water retention.

Overdose Management

Signs/Symptoms: Uterine hyperstimulation, water intoxication symptoms like nausea, headache, confusion, seizures, hypotension.

Treatment: Discontinue oxytocin immediately. Manage water intoxication with fluid restriction and supportive care; treat hyperstimulation with appropriate tocolytics and uterine relaxation agents if needed.

Storage and Handling

Storage: Store at room temperature (15-30°C), protected from light.

Stability: Stable under recommended storage conditions; check specific product stability data.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.