Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01178 (oxytocin)
 15,767 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Uterine activity may be defined in terms of the frequency of contractions of the uterus and the pressure generated by these contractions. Most studies that report an effect of analgesia on labor are retrospective, and, if prospective, are nonrandomized. Drug effects on uterine activity and labor progress are probably dose related, but are also influenced by a myriad of other factors including, but not limited to, the mother's emotional state, degree of cervical change, uterine contractility pattern, phase of labor, and individual differences in pharmacokinetics and drug sensitivity. The latest phase of labor may be prolonged by excessive narcotic or inappropriate timing of regional analgesia. The normal active phase tends to be resistant to the inhibitory effects of the usual amount of any analgesia. A brief period of decreased uterine activity often follows institution of analgesia. This may effectually accelerate labor in some patients by decreasing maternal anxiety and serum concentrations of catecholamines. A combination of sedation epidural blockade, and subsequent oxytocin use may prove effective in correcting a dysfunctional or hyperstimulatory pattern during the active phase. The second stage of labor may be slightly prolonged by effective epidural analgesia, but this delay is not necessarily harmful as long as the fetal heart rate tracing is normal, maternal hydration is adequate, and maternal pain relief is sufficient.
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PMID:Effects of analgesia on labor. 152 75

The general pharmacological properties of (-)-(S)-9-fluoro-2,3-dihydro-3- methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido[1,2,3-de][1,4] benzoxazine-6-carboxylic acid hemihydrate (levofloxacin, DR-3355, CAS 100986-85-4), an optically active isomer of ofloxacin, were examined. 1. Central nervous system (CNS): DR-3355 at 200-600 mg/kg p.o. showed depressant activity on the CNS, as was indicated by the depressant syndrome (mice), decreased spontaneous motor activity (mice) and hypothermia (mice and rabbits). In the cat behavior and EEG experiments, it had both stimulant and depressant effects at 30-100 mg/kg i.p., and caused transient slow waves followed by seizures at 20-30 mg/kg i.v. DR-3355 had no effect on convulsion, hexobarbital anesthesia, pain reaction to a tail pinch, or conditioned avoidance response, except that it showed mild analgesic activity in acetic acid writhing at 600 mg/kg p.o. 2. Respiratory and cardiovascular system: DR-3355 produced a hypotensive and a bradycardiac effect after the rapid i.v. injection of 6 mg/kg or more in anesthetized dogs, accompanied by an increase in plasma histamine concentration. Both changes were markedly reduced when the test drug was administered by continuous i.v. infusion. 3. Autonomic nervous system: DR-3355 inhibited nictitating membrane contraction induced by both pre- and post-ganglionic stimulation, and inhibited the depressor response to acetylcholine at 20 mg/kg i.v. It had no influence on pupil size or on pressor response to norepinephrine. 4. Gastrointestinal system: DR-3355 at 600 mg/kg p.o. inhibited gastric secretion. Dog gastrointestinal motility was slightly inhibited, and was then stimulated over the dose range of 2-20 mg/kg i.v. It had no influence on gastrointestinal propulsion, the gastric emptying rate or the gastric mucosa. 5. Isolated smooth muscle: At a concentration of 5 x 10(-4) g/ml, DR-3355 was devoid of spasmogenic or smasmolytic activity, except for showing a slight relaxation effect (trachea), inhibition of nicotine-induced contraction (ileum) and spontaneous or oxytocin-induced motility (pregnant uterus). 6. Miscellaneous: DR-3355 inhibited the urine output and carrageenin-induced paw edema at 600 mg/kg p.o. It had no effect on skeletal muscle contraction or the corneal reflex.
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PMID:General pharmacology of the new quinolone antibacterial agent levofloxacin. 162 43

Carbetocin, a long-acting oxytocin analog, was administered by intravenous and intramuscular injection to 40 women 24 to 48 hours postpartum. Intravenous injection of 8 to 30 micrograms produced a tetanic uterine contraction within 2 minutes, lasting about 6 minutes, followed by rhythmic contractions for a further 60 +/- 18 minutes. Intramuscular injection of 10 to 70 micrograms also produced tetanic contraction in less than 2 minutes, lasting about 11 minutes, and followed by rhythmic contractions for an additional 119 +/- 69 minutes. The prolonged duration of activity after intramuscular compared with the intravenous carbetocin was significant (p = 0.020). Carbetocin produced mild lower abdominal cramping in most patients and severe pain in three patients who received 50 or 100 micrograms intravenously or 70 micrograms intramuscularly. Approximately half of the patients also experienced flushing and warmth. Although carbetocin has not yet been studied immediately postpartum, its prolonged uterine activity suggests that carbetocin may offer advantages over oxytocin in management of the third stage of labor.
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PMID:Effect of carbetocin, a long-acting oxytocin analog on the postpartum uterus. 162 93

The course of labour in 22 patients with antepartum fetal death who received epidural anaesthesia was evaluated as compared to 22 controls matched for parity and gestational age, who received narcotic pain relief. Both groups had similar preinduction cervical dilatation and the induction was performed by amniotomy and oxytocin infusion. The mean first stage of labour was 5.4 hours in the epidural group, and 8.7 hours in the controls (p = 0.0192). The mean cervical dilatation rate was 3.3 cm/hour and 1.0 cm/hour respectively (p = 0.0142). The second stage was similar in both groups. We conclude, that parturients receiving epidural anaesthesia may benefit both emotionally and physically from excellent pain relief and a shorter delivery process when going through the distressing experience of delivering a dead fetus.
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PMID:Influence of epidural anaesthesia on the course of labour in patients with antepartum fetal death. 180 84

The opioid peptide, beta-endorphin, originates from proopiomelanocortin (POMC) under the influence of corticotropin releasing hormone (CHR). It increases the threshold of pain and has a certain influence on the formation of hypophyseal hormones, especially in stress. It is found that beta-endorphin stimulates the secretion of prolactin, a growth hormone, and vasopressin; it inhibates formation of follicle-stimulating and luteinizating hormones, oxytocin and dopamine, and gonadotropin, a releasing hormone. The process of acetylization decreases its activity. The results of experimental trials revealed that acetylisation in the foetal period was absent. The aim of the study was to define beta-endorphin concentration during normal vaginal labor and Cesarean section. Samples of peripheral blood of patients with spontaneous vaginal labor (n = 15) and of those in whom labor was operatively terminated (Cesarean section) (n = 10), were analysed. Values of this opiate were determined in the umbilical cord of newborn infants, in the amniotic fluid and placental compartment. The obtained results were statistically analysed. In intrapartum beta-endorphins were significantly increased reaching the highest level during expulsion (326 pg/ml); in the placental compartment these values were higher (in retroplacental blood 514 pg/ml) reaching the highest value of 917 pg/ml, p less than 0.01 in the placenta. In Cesarean section beta-endorphin values in the peripheral blood showed no significant differences during spontaneous vaginal labor. However, increased values of this natural opiate were observed six hours after surgery. Beta-endorphin concentrations in the placental compartment and the placenta during normal vaginal labor were significantly higher in comparison with labor by Cesarean section (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The opioid peptide, beta-endorphin, in spontaneous vaginal delivery and cesarean section]. 180 97

The safety and efficacy of mid-trimester abortion induced by extra-amniotic infusion of PGF2 alpha were evaluated in a retrospective review of 178 such procedures. All pregnancy terminations were performed in 1982-87 at Australia's King George V Memorial Hospital. The mean gestational age was 17.0 weeks, with a range of 13-25 weeks. The mean age of abortion patients was 26.4 years, with a range of 12-48 years. The most common indication for 2nd-trimester abortion was psychosocial reasons (102 cases). There were 4 failures in this series and 10 cases with serious complications (hemorrhage, infection, and cervical laceration). The mean induction-abortion interval was 29.6 minutes +or- 16.3, but there was a trend toward a shorter such interval in multiparas and women undergoing the procedure due to a death in utero. 96 patients required intravenous oxytocin infusion, and 95 needed curettage for clinically incomplete abortion. The majority (160 women) required parenteral pathidine for pain relief during the induction-abortion interval. Overall, the data suggest that, while the extra-amniotic infusion of PGF2 alpha is a safe and effective method of midtrimester abortion, it is also painful and lengthy. Both an increased dose of PGF2 alpha (1000 mcg was used in this study) and pretreatment with mifepristone or laminaria could reduce the induction-abortion interval and thereby the amount of patient discomfort. On the other hand, dilatation and evacuation may be the method of choice in the 13-16 weeks gestational age range, and comparative studies should be planned to assess this impression.
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PMID:Second trimester abortion by extra-amniotic PGF2 alpha infusion: experience of 178 cases. 187 74

Two hundred ninety-four women were randomly allocated to a group in which the use of a birthing stool (experimental group) or a conventional semirecumbent position (control group) was encouraged. The birthing stool was 32 cm high and allowed the parturient to sit upright and to squat. The husband could sit close behind his wife and support her back. No differences were observed between the two groups regarding mode of delivery, length of the second stage of labor, oxytocin augmentation, perineal trauma, labial lacerations, or vulvar edema. Infant outcome measured by Apgar scores at 1 and 5 minutes postpartum and numbers of neonatal intensive care unit transfers was the same in both groups. Mean estimated blood loss and the number of mothers with a postpartum hemorrhage 600 ml or more were greater in the experimental group than in the control group. Women in the experimental group reported less pain during the second stage of labor, and they and their spouses were more satisfied with the birth position than were parents in the control group. Midwives were less satisfied with their working posture in the experimental group.
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PMID:A randomized trial of birthing stool or conventional semirecumbent position for second-stage labor. 200 63

Molar pregnancy, which results from an anomaly in the development of the trophoblastic tissue, is now easy to diagnose based on clinical evidence, beta hCG level, and sonography, although it must be histologically confirmed. Treatment remains difficult because of the danger of hemorrhage or trauma during uterine evacuation. Hydatidiform mole was diagnosed in the 1st pregnancy of a 27-year-old woman on the basis of a routine 1st trimester sonogram. Clinical examination revealed a voluminous uterus and a long, closed, very tonic cervix. Sulprostone was administered to aid cervical dilatation. An initial intramuscular injection of sulprostone caused uterine contractions without cervical modifications. 5 hours later an intravenous perfusion of sulprostone was started, during which significant contractions and cervical modifications were observed. An aspiration curettage was performed, in which numerous vesicles typical of the hydatidiform mole were evacuated. There was no need for further cervical dilatation and the curettage was rapid and nonhemorrhagic. The postoperative course was uneventful, and a test of beta hCG levels 6 weeks later was negative. The patient complained of pain during uterine contractions despite use of high doses of pethidine. The frequency of hydatidiform mole varies in different countries. It has been estimated at 1/85 in Indonesia and 1/2000 in the US. The clinical picture of hydatidiform mole includes vomiting often nonresponsive to treatment and metrorrhagia of varying volume, a large uterus for the gestational age, and often bilateral ovarian cysts. A vasculorenal syndrome may also begin at 13-16 weeks of amenorrhea. Beta hCG levels are high for the gestational age. Sonography reveals no embryonic structures. Biopsy shows a complete absence of embryo and amniotic sac. The karyotype is diploid and almost always XX. The mechanism is fertilization of an ovocyte whose nucleus is absent or inactive. The 2 chromosome sets are contributed by the father, a circumstance incompatible with embryonic development. Trophoblastic proliferation occurs without embryonic development. Hydatidiform moles may be transformed to invasive moles or chorioepithelioma. Treatment includes uterine evacuation by aspiration under sonographic control if possible. Many authors recommend oxytocin and antibiotic cover. The use of prostaglandin analogs to facilitate uterine evacuation is controversial, with some authors citing the increased risk of trophoblastic embolism. The mole should be histopathologically and cytogenetically studied, and postmolar follow-up is essential.
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PMID:[Use of sulprostone in the evacuation of molar pregnancies]. 206 88

Gemeprost vaginal suppositories (16,16-dimethyl-PGE1 methyl ester) were compared with intraamniotic Pgf2alpha in 20% saline after Dilapan tents for termination of 14-16 week pregnancies in 58 women. After randomization there were 44% multigravidae in the Gemeprost group and 58% in the Pgf2alpha-saline-Dilapan group; the Gemeprost group averaged 23.4 years, the Pgf2alpha group 26.2%. Gemeprost 1 mg vaginal pessaries were inserted at 3 hr intervals for a maximum of 5 doses. Pgf2alpha 20 mg in 40 ml 20% NaCl was injected intraamniotically under ultrasonic control immediately after Dilapan was inserted in the cervix. If abortion had not occurred within 24 hours, management by iv oxytocin, iv Pgf2alpha, intraamniotic Pgf2alpha or saline or both was at the physician's discretion, as was post-abortion treatment with oxytocin, ergometric or surgical evacuation of the placenta if not delivered within 2 hours. Successful abortion, defined as induction abortion intervals of 24 hours, occurred in 58% of the Gemeprost group and 90% of the PG-saline group, for mean induction-abortion intervals of 12.6 and 11.7 hours. 6 more Gemeprost patients aborted within 27.8 hours without additional treatment, while the last 2 patients to deliver took 42 and 50 hours, compared to a 32-hour maximum interval for PG-saline patients. Much of the difference in intervals was accounted for by primigravidas, who took 15.84 hours on average with Gemeprost, compared to 13.7 hours with PG-saline. Gastrointestinal side effects were more common in the Gemeprost group: diarrhea in 58% and vomiting in 62%, compared to 7% with diarrhea and 34% with vomiting in the PG-saline group. Retained placenta, hemorrhage 300 ml and pain requiring narcotics were similar in both series. The outcomes in terms of induction-abortion intervals were not significantly different. Gemeprost was considered the agent of choice, since it is not invasive, and avoids the risk of sudden collapse or death, intrauterine infection, saline intoxication or clotting disorders, which occur on rare occasions in Pgf2alpha- or saline-induced midtrimester abortions.
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PMID:Second-trimester termination with 16,16 dimethyl-PGE1-methyl ester (gemeprost), compared with a regimen that included intra-amniotic PGF2 alpha and hypertonic saline. 207 46

Uterine hyperactivity causing reduced local blood flow is quite prevalent among nulliparous women in their late teens. This pain called primary dysmenorrhea coincides with the onset of menstruation and stays a few hours to 1-2 days. The uterine agonist prostaglandin PGF2alpha and arginine vasopressin (VP) seem to be involved in dysmenorrhea. Pgf2alpha may induce pain by stimulating afferent nerve fibers. Generally common pain relievers treat dysmenorrhea, but in those instances when they do not, nonsteroid antiinflammatory drugs (NSAIDs) may do so (75% success rate). Yet NSAIDs may not be able to help because of the sizable time lag between ingestion and affecting pain. Moreover pain transpire very quickly and does not always last very long. Nevertheless clinical studies how promise for the NSAID ketoprofen. Plasma levels of ketoprofen reach their peak in 1 hour while it takes naproxen (the reference NSAID) about 2 hours to reach peak plasma levels. Oral contraceptives (OCs), especially those that are gestagen dominated, can also treat primary dysmenorrhea. OCs reduce the strong uterine contractions, blood flow, and sensitivity of the uterus to Pgf2alpha and VP. Calcium channel blocking agents and beta 2 adrenoceptor stimulating drugs may help when other treatments fail, but they have significant side effects. Moreover calcium channel blocking agents are not yet approved in Scandinavia. A double blind cross over comparative study with an intravenous oxytocin analogue shows good promise, but an oral preparation is not yet available. Secondary dysmenorrhea occurs most often in women 30 years old. A bodily condition, such as endometriosis or an IUD, is responsible for it. Many of these conditions stimulate the release of PGs so NSAIDs can generally relieve the pain. Ideally, to relieve suffering though, physicians should treat the condition.
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PMID:Modern treatment of dysmenorrhea. 209 35


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