Maternity

Uterotonics (Oxytocin, Misoprostol, Methylergonovine)

Maternity & Reproductive

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Examples

oxytocinmisoprostolmethylergonovinecarboprost

Prefix / Suffix: No consistent suffix

Physiology

Uterine muscle contracts to control labor progression and compress bleeding vessels after delivery. Uterotonics strengthen these contractions, which is why they are important for induction, augmentation, and postpartum hemorrhage prevention.

Mechanism of Action

They stimulate uterine smooth muscle by different pathways: oxytocin activates oxytocin receptors, prostaglandins increase uterine tone and cervical ripening, and methylergonovine causes sustained uterine contraction.

Indications

  • Labor induction or augmentation
  • Prevention and treatment of postpartum hemorrhage
  • Cervical ripening with selected agents
  • Management of uterine atony

Side Effects / Adverse Effects

  • Uterine tachysystole causing fetal distress
  • Hypotension or hypertension depending on agent
  • Nausea, vomiting, diarrhea
  • Water intoxication with high-dose oxytocin
  • Bronchospasm with carboprost

Contraindications

  • Unfavorable fetal status when vaginal delivery is unsafe
  • Methylergonovine: hypertension or preeclampsia
  • Carboprost: asthma
  • Misoprostol for induction after certain uterine surgeries per policy

Nursing Considerations

  • Monitor contraction frequency, duration, resting tone, and fetal heart rate continuously during induction
  • Stop oxytocin and notify provider for tachysystole or nonreassuring fetal tracing
  • Assess fundal tone and bleeding after birth to evaluate response
  • Check blood pressure before methylergonovine
  • Keep emergency equipment available because excessive uterine activity can compromise fetal oxygenation

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.