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Uterine Motility Drug (Adverse affects (Excessive effects: uterine…
Uterine Motility Drug
Adverse affects
Excessive effects: uterine hypertonicity and spasm, uterine rupture, postpartum hemorrhage, decreased fetal heart rate
Common effects: GI upset, nausea, headache, dizziness
Ergotism caused by ergonovine and methylergonovine: nausea, blood pressure changes, weak pulse, dyspnea, chest pain,
Oxytocin has caused severe water intoxication with coma and even maternal death when used for a prolonged period.
Nursing assessment
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Perform a thorough physical assessment to establish baseline data before drug therapy begins, to determine effectiveness of therapy
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Monitor laboratory test results (e.g. coagulation studies, complete blood count, etc.) to evaluate hematological studies.
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Indication
To stimulate uterine contractions like the action of the hypothalamic hormone oxytocin stored in the posterior pituitary.
They directly affect neuroreceptor sites to stimulate uterine contraction and are especially effective in the gravid uterus.
Oxytocin, a synthetic form of the hypothalamic hormone, also stimulates the lacteal glands in the breast to contract, promoting milk ejection in lactating women.
Mehanism of action
Oxytocin has specific receptors in the muscle lining of the uterus and the receptor concentration increases greatly during pregnancy, reaching a maximum in early labor at term.
Oxytocin promotes contractions by increasing the intracellular Ca2+, which in turn activates myosin's light chain kinase
Uterine motility depends on the formation of the contractile protein actomyosin under the influence of the Ca2+-dependent phosphorylating enzyme myosin light-chain kinase
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References
Kosfeld M, Heinrichs M, Zak PJ, Fischbacher U, Fehr E: Oxytocin increases trust in humans. Nature. 2005 Jun 2;435(7042):673-6
Carmichael MS, Humbert R, Dixen J, Palmisano G, Greenleaf W, Davidson JM: Plasma oxytocin increases in the human sexual response. J Clin Endocrinol Metab. 1987 Jan;64(1):27-31
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Therapeutic of action
Prevention and treatment of uterine atony after delivery, thus reducing the risk of postpartum hemorrhage.