Syntometrine

http://en.wikipedia.org/wiki/Oxytocin/ergometrine

http://www.mims.com.my/Malaysia/drug/info/Syntometrine/Syntometrine%20inj

Syntometrine

What?

·        Oxytocin/ergometrine (trade name Syntometrine) is an obstetric combination drug.

·        The components are synthetically produced oxytocin, a human hormone produced in the hypothalamus, and ergometrine, an alpha-adrenergic, dopaminergic and serotonin (5-HT₂) receptor agonist.

·        Both substances cause the uterus to contract.

Indication?

 An injection of syntometrine is given in the third stage of labor, just after the birth of the child, to facilitate delivery of the placenta^[1] and to prevent postpartum hemorrhage^[1] by causing smooth muscle tissue in the blood vessel walls to narrow, thereby reducing blood flow.

Interaction with other drugs

Prostaglandins increase the effect of oxytocin and vice-versa. The contractions should be carefully monitored if oxytocin is given after a prostaglandin dose.

Contraindications

Syntometrine should not be used in:

§  Allergy to one or any of its ingredients^[1]

§  First stage of labor^[1]

§  Second stage of labor before crowning of the baby's head^[1]

§  Uterine atony during labor^[1]

§  Severe kidney disorders^[1]

§  Severe liver disorders^[1]

§  Severe heart disorders^[1]

§  Vascular diseases^[1]

§  Severe hypertension^[1]

§  Pre-eclampsia or eclampsia^[1]

§  Sepsis^[1]

It should be used with caution in:

§  Decreased kidney function^[1]

§  Decreased liver function^[1]

§  Mild heart disease^[1]

§  Mild hypertension)^[1]

§  Porphyria^[1

Possible side effects include:

§  Nausea and vomiting^[1][2]

§  Abdominal pain,^[1] feeling different than labor pains^[2]

§  Headache^[1][2]

§  Dizziness^[1][2]

§  Skin rashes^[1], itching or hives^[2]

§  Swelling of face, lips, tongue or other body parts^[2]

§  Hypertension^[1]

§  Arrhythmias (abnormal heart beats)^[1][2]

§  Chest pain^[1][2]

§  Fall in blood pressure (causing dizziness and lightheadedness)^[1]

§  Difficulty in breathing

Contents:

Per mL Synthetic oxytocin 5 iu, ergometrine maleate 0.5 mg

Dosage

Active management of the 3rd stage of labour :

·        1 mL IM following delivery of the anterior shoulder or immediately after delivery of the child. 

Prevention & treatment of postpartum haemorrhage  :

·        1 mL IM following expulsion of the placenta or when bleeding occurs; may be repeated after 2 hr. Total dose w/in 24 hr should not exceed 3 mL.