DRUGS ACTING ON THE UTERUS

Oxytocin
Peptide hormone responsible for uterine
smooth muscle-stimulatory property of
posterior pituitary extract
Differs from vasopressin structurally only by
substitution of isoleucine and leucine for
phenylalanine and arginine
Potent stimulant of the gravid uterus at term
and postpartum

 Contracts myoepithelial cells of lacteal glands to

produce milk letdown during nursing
Weak antidiuretic action but can cause water
intoxication when given parenterally in a large
volume of fluid
No vasoconstriction, lowers BP
Little effect on intestinal smooth muscle and
coronary arteries
For female reproduction, but has probably other,
more general functions because males synthesize it
as well

Preparations
Oxytocin injection synthetic preparation infused IV
to induce or enhance uterine contractions in labor
- may be given IM or infused to control
postpartum bleeding
- 10 40 units in 1L of NSS
- nasal spray administered into one or both
nostrils 2 3 mins before nursing to facilitate milk
ejection

Other Drugs That Stimulate the Uterus

a1-Adrenergic receptors stimulation

B2-receptors inhibition
Muscarinic receptors stimulatory
Estrogen enhance uterine responsiveness
Progesterone decreases uterine tone and
contraction

 Ergot compounds and prostaglandins enhance

uterine contractions
Ergonovine maleate and methylergonovine maleate
decrease postpartum uterine bleeding
- administered after delivery of the placenta,
they stimulate uterine contraction which clamps off
the multiple sites of bleeding

Prostaglandins used to induce abortion by

stimulation of uterine contractions

 Carboprost tromethamine injected IM is

effective from the 13th to the 20th week of
pregnancy

- derivative of prostaglandin F2a

Dinoprostone vaginal suppositories
Prostaglandin E gel used for cervical
ripening
Misoprostol vaginal tablet
- cervical ripening and control
postpartum bleeding

Uterine Relaxants

B-Adrenergic receptor agonists and

prostaglandin synthesis inhibitors promote
relaxation of contracting uterine smooth
muscle

B-Adrenergic receptor agonists prevent

premature delivery
Prostaglandin synthesis inhibitors treat
dysmenorrhea

 Ritodrine hydrochloride preferentially stimulates

B2-adrenergic receptors
- preferred uterine relaxant in premature labor
- adverse effects: tachycardia and tremor
- contraindications: maternal eclampsia,
cardiovascular problems, hyperthyroidism and
uncontrolled DM
Other agents Magnesium sulfate, Ca++ channel
blocker,