High Alert Medication

Oxytocic agent

CCP: Promote uterine contractions following normal delivery

CCP: Post-partum hemorrhage not responsive to fundal massage

• Hypersensitivity
• Uterine inversion
• Placenta previa
• Placental abruption
• Predisposition to uterine rupture (e.g., grand multiparity, overdistention of the uterus, prior caesarian delivery, other uterine surgery)

• Onset of uterine contractions: 3-5 minutes (IM); 1 minute (IV)
• Peak: unknown
• Duration: 2-3 hours (IM); 1 hour (IV)

• Cardiovascular: Cardiac arrhythmia, hypertensive crisis, hypotension, subarachnoid hemorrhage, tachycardia, premature ventricular contractions
• Endocrine & metabolic: Water intoxication (severe water intoxication with seizure and coma is associated with a slow oxytocin infusion over 24 hours)
• Gastrointestinal: Nausea, vomiting
• Genitourinary: Postpartum hemorrhage, uterine rupture
• Hematologic & oncologic: Pelvic hematoma
• Hypersensitivity: Anaphylaxis

High Alert Medication

Women working with oxytocin, and who are in the second or third trimester of pregnancy, must be aware that oxytocin may induce uterine contractions and labour through contact.  Use proper personal protective equipment when handling.

• In multiparous situations, do not administer until all babies have been delivered.
• May produce intrinsic antidiuretic effects.
• Use with extreme caution in hemodynamically unstable patients: arrhythmias, hypotension, myocardial ischemia, peripheral vasodilation, and tachycardia have been reported.