Gynotocin
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OXYTOCIN: It is a octapeptide screted by posterior pituitary along with ADH. It increases the force and frequency of uterine contracions. In creased contractility is due ot hightened electrical activity of the myometrial cell membrane-burst discharge are initiated and accentuated. Estrogens sensitize the uterus to oxtocin; nonpregnat uterus and that drung early pregnacy is rather resistant. It also contracts myoepithelium of mammary alveoli and forces milk into the bigger milk ssinusoids-milk ejecton reflex intiated by suckling. Oxytocin in high dose exerts an ADH like action.
Indications: Induction of labour, uterine inertia post partum haemorrhage. Casarean section. Abortion, breast engrogement.
Dosage : Induction or enhancement of labour. i.v. drip infusion of a 5% dextorse soln. Containing 1 i.u. oxytocin per 100 ml.rd stage labour & puerperium : 5-10 i.u. i.m. or 5 i.u. slowly. Caesarean secton : 5 i.u after delevery.
Contra Indications: Hypertonic contractions, Cephalopelvic disproportion, excessive distention of the uterus an in multiple pregnancy, hypdarmnious. Hypersensitivity to the drug. Parity gerater than4, eldery multiparae, Previous caesarean section or other surgery involing the uterus, severe involving the uterus, severe toxaemia, predisposition to amniotic fluid. Placentamia, predisposition to amniotic fluid. Placenta pravia.
Special Precautions: Use only medical reasons rather than conveniece. only under hospital condition with qualified medical supervision and careful obstetrical monitoring allowing dosage adjustment to indivdual responses.use only by i.v. infusion ¬ by i.m. or s.c.
Side-effects: Injudiclous use of oxytocin during laour can produce too strong uterine contractions forcing the preseting part through incomletelydiated birth causing matermal and meternal and foetal soft tissue injuryn, rupture of uterus, foetal asphyxia and death. Water intoxivaton, toxeamia of pregnancy and renal insufficeency due to ADH like action.
Drug Interaction: Concomitant use with prostaglandins increase risk of uterine rupture & corvical laccerations. Useful with ergotamine.