OXYTOCICS

Actions: 1. Oxytocin stimulates the uterus and cause physiologic type of contraction

2. It also causes ejection of milk through contraction of the myo-epithelial cells
   around the alveoli of the mammary gland.
   Pharmacokinetics: It is inactivated orally and absorbed rapidly after intramuscular
   administration. It can also be absorbed from nasal and buccal membrane.
   Use: Induction of labor in women with uterine inertia, Relief of breast engorgement during
   lactation (few minutes before breast feeding) as nasal spray, Postpartum hemorrhage.
   Side effect: Oxytocin may cause over stimulation and leads to rupture of the uterus in the
   presence of cephalo-pelvic disproportion. Therefore it’s contraindicated in woman with
   uterine scar. When given intravenously may cause water retention leading to water
   intoxication.
   Prostaglandins
   They induce labor at anytime during pregnancy but most effective at the third trimester. In
   female reproductive system prostaglandin E & F are found in ovaries, endometrium and
   menstrual fluid which is responsible for initiating and maintaining normal birth process. PGF,
   PGF2ά, PGE stimulate both the tone and amplitude of the uterine contraction.
   
   Adverse reaction: nausa, vomiting, headache, diarrhea, fever, etc.
   PGs should be used cautiously in the presence of hypertension, angina, and diabetes. They are
   contraindicated in the presence of cardiac, renal, pulmonary or hepatic disease
   Ergometrine
   It is one of the ergot alkaloids with the ability to cause contraction of the uterine smooth muscle.
   It causes sustained uterine contraction. It is completely absorbed after subcutaneous and
   intravenous administration. It is metabolized in the liver and eliminated in the urine .Liver
   damage enhances the toxicity of ergot alkaloid.
   Use: after delivery of placenta if bleeding is severe (Prevent postpartum bleeding)
   Adverse effect: Nausa, vomiting but serious toxic effects are rare.