Oxytocin

Provider Level

RN/Paramedic

Class

Hormone, Uterotonic agent

Mechanism of Action

Binds to oxytocin receptors in the uterine smooth muscle, increasing intracellular calcium and stimulating forceful uterine contractions. It also exhibits mild vasopressor and antidiuretic properties.

Indications

Postpartum hemorrhage following the delivery of the infant and placenta.

Contraindications

Hypersensitivity to oxytocin, presence of an undelivered second fetus, fetal distress prior to delivery.

Routes

IM, IV

Onset / Duration

Onset: IV immediate, IM within 3 to 5 minutes. Duration: IV 20 to 30 minutes, IM 2 to 3 hours.

Adverse Effects

Tachycardia, hypotension (especially with rapid IV administration), arrhythmias, nausea, vomiting, uterine rupture, and potential water intoxication with prolonged use.

Precautions & Interactions

Ensure all fetuses and the placenta have been delivered before administration. Monitor vital signs continuously, as rapid administration can cause profound hypotension.

Special Considerations

Authorized for RN/Paramedic. Never administer via rapid IV push due to the risk of severe cardiovascular collapse. It is typically administered as an infusion or intramuscularly in the prehospital setting.