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OXYMED
OXYTOCIN

What is oxytocin?

Oxytocin is a natural hormone produced by the pituitary gland in the brain. This natural hormone has the following effects in the body:

1.    It causes the uterus to contract
2.    It is the “feel good” hormone released in the blood stream when people touch each other. It is released in larger doses during orgasm.
3.    It causes milk to start flowing when a woman is breastfeeding.
4.    It causes the mother to relax during breastfeeding and promotes bonding with the infant.

Almost all vertebrate animals produce oxytocin or a similar hormone with roles in reproduction and care of young.


Synthetic oxytocin is used to induce labor, strengthen labor contractions during childbirth, control bleeding after childbirth, or to induce an abortion.

Oxymed is a synthetic oxytocin analogue. It used during the second stage of labor to strengthen uterine contractions to shorten the delivery period. The number of oxytocin receptors in the uterus increases as pregnancy progresses resulting in increased efficacy of Oxymed to induce uterine contractions.

Oxytocin is destroyed in the gastrointestinal tract, and therefore Oxymed must be administered by injection.

Potential adverse reactions:

Oxytocin is relatively safe when used at recommended doses. Potential side effects include:

Central nervous system: Subarachnoid hemorrhage, seizures.
Cardiovascular: Increased heart rate, blood pressure, systemic venous return, cardiac output, and arrhythmias.
Genitourinary: Impaired uterine blood flow, pelvic hematoma, tetanic uterine contractions, uterine rupture, postpartum hemorrhage.

Potential Side effects  

•    chest pain or difficulty breathing
•    confusion
•    fast or irregular heartbeat
•    severe headache
•    irritation at the injection site

Mechanism of action/Effect:

Uterine:

The uterine myometrium contains receptors specific to oxytocin.  Oxytocin stimulates
contraction of uterine smooth muscle by increasing intracellular calcium concentrations, thus mimicking contractions of normal, spontaneous labor and transiently impeding
uterine blood flow. Amplitude and duration of uterine contractions are increased, leading to dilation and effacement of the cervix. The number of oxytocin receptors and,
therefore, uterine response to oxytocin increases gradually throughout pregnancy, reaching its peak at term.

For diagnosis of fetal distress and utero-placental insufficiency:

By comparing baseline and oxytocin-induced fetal heart rate patterns and uterine
contraction patterns, the oxytocin challenge test may aid in determining if there is adequate placental reserve for continuation of a high-risk pregnancy.
The occurrence of a fetal heart rate pattern exhibiting late ecelerations with administration of oxytocin may indicate utero-placental insufficiency 

Lactation:

Stimulates smooth muscle to facilitate ejection of milk from breasts. Oxytocin does
 not increase milk production.

Biotransformation:

Enzymatic hydrolysis, primarily by tissue oxytocinase. Oxytocinase is also found in
placental tissue and plasma

Half-life:

1 to 6 minutes (decreased in late pregnancy and lactation)

Onset of action:

Intramuscular—3 to 5 minutes

Intravenous—Immediate 

Duration of action:

Intramuscular—2 to 3 hours

Intravenous—Uterine activity generally subsides within one hour

Elimination:
    Only small amounts are excreted unchanged

Precautions to Consider

Carcinogenicity/Mutagenicity

No animal or human studies have been conducted to evaluate the carcinogenic or
mutagenic potential of oxytocin.

Pregnancy/Reproduction

Pregnancy—

For augmentation or stimulation of labor

Oxytocin is not indicated for use in the first trimester of pregnancy, other than for the treatment
 of incomplete abortion or therapeutic abortion.

Labor and delivery—

Based on extensive clinical use and known pharmacologic properties of oxytocin, it is not expected to cause an increased risk of fetal abnormalities when used as indicated. Because
of maternal and fetal risks, oxytocin must be administered with caution. It has been reported
to cause fetal bradycardia, neonatal retinal hemorrhage, and neonatal jaundice, in addition to maternal effects.

Fetal deaths due to various causes have reportedly been associated with the parenteral use of oxytocics for induction or augmentation of labor.

Excessive dosage or administration of oxytocin to hypersensitive patients may cause uterine
hypertonicity with spasm and tetanic contraction or uterine rupture. Abruptio placentae, impaired uterine blood flow, amniotic fluid embolism, and fetal trauma including cardiac
 arrhythmias, intracranial hemorrhage, and asphyxia may occur as a result.

Oxytocin may inhibit, rather than promote, expulsion of the placenta and increase the risk of hemorrhage and infection