Uterotonics

Oxytocin

Syntocinon, Pitocin

Synthetic oxytocin. Causes increased contractility of smooth uterine muscle, by increasing calcium concentration.

Slow bolus injection to avoid hypotension.

Carbotocin

Long acting synthetic oxytocin analogue.

Works for up to 8hrs.

Dilute in 10ml 0.9% saline and give slowly over 60-90seconds.

Ergometrine

Causes direct uterine muscle stimulation.

Has action at alpha-adrenergic, domaminergic and 5-HT receptors.

Avoid in hypertensive disorders.

Typically causes nausea and vomiting.

Carboprost

Hemabate

Synthetic prostaglandin, binds to PGE2 receptors and causes myometrial contraction.

Avoid in asthmatics, caution in cardiovascular disorders. Avoid in severe hypertension.

May cause bronchospasm and nausea.

Misoprostal

Cytotec

Synthetic prostaglandin.

Typically given PR for PPH.

May also be used in combination with mifeprostal for termination of pregnancy.

Typically causes diarrhoea.

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