From the Guidelines
Oxytocics are medications that stimulate uterine contractions, primarily used in obstetrics to induce or augment labor, prevent or treat postpartum hemorrhage, and manage incomplete abortions, with oxytocin, ergometrine, misoprostol, and carboprost being the most commonly used drugs 1.
Definition and Uses of Oxytocics
Oxytocics work by binding to receptors on uterine smooth muscle, increasing intracellular calcium and enhancing myometrial contractility. The most commonly used oxytocic drugs include:
- Oxytocin (Pitocin)
- Ergometrine
- Misoprostol
- Carboprost These medications are used for various obstetric purposes, including labor induction, augmentation, and prevention or treatment of postpartum hemorrhage.
Administration and Dosage
The administration and dosage of oxytocics vary depending on the specific medication and the clinical scenario:
- Oxytocin (Pitocin) is typically administered intravenously at 1-2 mU/min, gradually increased to achieve adequate contractions, with a maximum dose of 20-40 mU/min for labor induction 1.
- Ergometrine is given as 0.2 mg IM or IV for postpartum hemorrhage.
- Misoprostol is administered at 600-800 mcg sublingually, orally, or rectally.
Monitoring and Potential Side Effects
When administering oxytocics, it's essential to monitor for uterine hyperstimulation, which can lead to fetal distress during labor 1. Other potential side effects include:
- Nausea
- Vomiting
- Headache
- Hypertension, particularly with ergometrine
Contraindications
Oxytocics are contraindicated in cases of:
- Obstructed labor
- Placenta previa
- Previous classical cesarean section due to the risk of uterine rupture It's crucial to carefully evaluate the patient's clinical scenario and medical history before administering oxytocics to minimize the risk of adverse effects and ensure the best possible outcome.
From the FDA Drug Label
Oxytocin injection (synthetic) acts on the smooth muscle of the uterus to stimulate contractions; response depends on the uterine threshold of excitability. Oxytocin stimulates rhythmic contractions of the uterus, increases the frequency of existing contractions and raises the tone of the uterine musculature.
- Oxytocics are medications that stimulate the smooth muscle of the uterus to induce contractions, such as oxytocin.
- The primary action of oxytocics, like oxytocin, is to stimulate the uterus, increasing the frequency and force of contractions, making them useful for induction or stimulation of labor and control of postpartum uterine bleeding 2, 2.
From the Research
Definition and Use of Oxytocics
- Oxytocics, also known as oxytocin-stimulating medications, are used to initiate or augment uterine contractions during labor [(3,4)].
- Oxytocin is a peptide hormone that plays a key role in regulating the female reproductive system, including during labor and lactation 3.
- It is produced primarily in the hypothalamus and secreted by the posterior pituitary gland [(3,4)].
Types of Oxytocics
- Oxytocin is the most commonly used oxytocic, and it can be administered as a medication to induce or augment labor [(3,4,5)].
- Other medications, such as misoprostol, can also be used to induce labor and have been shown to be effective in reducing the need for oxytocin 6.
Administration and Safety
- Oxytocin is typically administered via infusion, and the dose is titrated based on the patient's response [(3,4)].
- High-dose oxytocin regimens can shorten the length of labor, but they also increase the risk of uterine hyperstimulation and other adverse effects [(3,4,7)].
- The use of oxytocin checklists and careful monitoring of uterine activity and fetal heart rate can help minimize the risks associated with oxytocin administration 7.
Clinical Outcomes
- The use of oxytocics, particularly oxytocin, has been shown to be effective in reducing the length of labor and improving clinical outcomes [(3,4,7)].
- However, the safety and efficacy of oxytocics depend on careful administration and monitoring, and adverse effects can occur if they are not used properly [(3,4,7)].