Oxytocin

Question 1

Generic Name:

Answer 1

Oxytocin

Question 2

Trade Name:

Answer 2

Pitocin

Question 3

Supplied:

Answer 3

10 units/mL

Question 4

Mechanism of Action:

Answer 4

Binds to oxytocin receptor sites on surface of uterine smooth muscles: increases force and frequency of uterine contractions.

Question 5

Indications and Field Use:

Answer 5

Postpartum hemorrhage due to uterine atony

Question 6

Contraindications:

Answer 6

Hypersensitivity

Question 7

Adverse Reactions:

Answer 7

CV: Shock, tachycardia, dysrhythmias

Resp: Anaphylaxis

GI: Nausea and vomiting

GU: If used prior to delivery, can cause uterine rupture, uterine spasm, lacerations, and fetal damage.

Other: Clotting disorders, electrolyte disturbances

Question 8

Incompatibilities/Drug Interactions:

Answer 8

None in prehospital arena

Question 9

Adult Dosage:

Answer 9

Postpartum hemorrhage: 10-20 USP units added to 1000 mL NS or LR and run at a rate necessary to control uterine atony or 10 USP units may be given IM after delivery of placenta.

Question 10

Pediatric Dosage:

Answer 10

Not applicable

Question 11

Routes of Administration:

Answer 11

• IV infusion, IM

- IV infusion on interfacility transfers requires infusion pump

Question 12

Onset of Action:

Answer 12

Seconds

Question 13

Duration of Action:

Answer 13

1 hour after discontinued

Question 14

Arizona Drug Box Minimum Supply:

Answer 14

Optional: 10 units

Question 15

Special Notes:

Answer 15

•  Post-partum hemorrhage is defined as blood loss in excess of 500 ml at delivery and during the first 24 hours after delivery. It should be remembered that all blood seen at delivery is the mother’s unless there is a spill of cord blood or trauma to the placenta.
•  Do not use if solution is discolored or contains a precipitate.
•  In addition to oxytocin, fundal massage is also indicated to remove clot formation and stimulate uterine contraction.
•  IV fluids are necessary to correct hypovolemia; if post partum hemorrhage is due to other causes such as vaginal or cervical lacerations or retained placental fragments, oxytocin and fundal massage will not be effective.
•  Oxytocin is an optional drug.