Question: Why do we use Oxytocin?

Oxytocin (medication)






Oxytocin, sold under the brand name Pitocin among others, is a medication made from the peptide oxytocin.[3][4] As a medication, it is used to cause contraction of the uterus to start labor, increase the speed of labor, and to stop bleeding following delivery.[3] For this purpose, it is given by injection either into a muscle or into a vein.[3]

The use of oxytocin as a medication can result in excessive contraction of the uterus that can risk the health of the baby.[3] Common side effects in the mother include nausea and a slow heart rate.[3] Serious side effects include rupture of the uterus and with excessive dose, water intoxication.[3] Allergic reactions including anaphylaxis may also occur.[3]

Oxytocin was discovered in 1952.[5] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[6] As of 2014, the wholesale cost in the developing world is US$0.10 to 0.56 per dose.[7]
Medical uses
Labor induction: An intravenous infusion of oxytocin is used to induce labor and to support labor in case of slow childbirth if the oxytocin challenge test  fails. Whether a high dose is better than a standard dose for labor induction is unclear. It has largely replaced ergometrine as the principal agent to increase uterine tone in acute postpartum hemorrhage. Oxytocin is also used in veterinary medicine to facilitate birth and to stimulate milk release. The tocolytic agent atosiban (Tractocile) acts as an antagonist of oxytocin receptors; this drug is registered in many countries to suppress premature labor between 24 and 33 weeks of gestation. It has fewer side effects than drugs previously used for this purpose (ritodrine, salbutamol, and terbutaline).[8]
Help with breastfeeding: Oxytocin is sometimes prescribed for mothers to stimulate breast milk production to help with feeding their baby.[9] However, women receiving intranasal oxytocin daily before breastfeeding produced only slightly more milk after two days.[10]
Contraindications
Oxytocin injection (synthetic) is contraindicated in any of these conditions:[11]
Substantial cephalopelvic disproportion
Unfavorable fetal position or presentation (e.g., transverse lies) undeliverable without conversion before delivery
Obstetric emergencies where maternal or fetal risk-to benefit ratio favors surgery
Fetal distress when delivery is not imminent
Umbilical cord prolapse
Uterine activity fails to progress adequately
Hyperactive or hypertonic uterus
Vaginal delivery is contraindicated (e.g., invasive cervical carcinoma, active genital herpes infection, total placenta previa, vasa previa, cord presentation or prolapse)
Uterine or cervical scarring from previous cesarean section or major cervical or uterine (e.g., transfundal) surgery
Unengaged fetal head
History of hypersensitivity to oxytocin or any ingredient in the formulation
Side effects
Oxytocin is relatively safe when used at recommended doses, and side effects are uncommon.[12] These maternal events have been reported:[12]
Subarachnoid hemorrhage
Increased blood pressure
Cardiac arrhythmia including increased or decreased heart rate, and premature ventricular contraction
Impaired uterine blood flow
Pelvic hematoma
Afibrinogenemia
Anaphylaxis [3]
Nausea and vomiting
Increase fetal blood flow
Excessive dosage or long-term administration (over a period of 24 hours or longer) has been known to result in tetanic uterine contractions, uterine rupture, postpartum hemorrhage, and water intoxication, sometimes fatal.
During pregnancy, increased uterine motility has led to decreased heart rate, cardiac arrhythmia, seizures, brain damage, and death in the fetus or neonate.[12]
Certain learning and memory functions are impaired by centrally administered oxytocin.[13] Also, systemic oxytocin administration can impair memory retrieval in certain aversive memory tasks.[14] However, oxytocin does seem to facilitate learning and memory specifically for social information. Healthy males administered intranasal oxytocin show improved memory for human faces, in particular happy faces.[15][16]
Pharmacokinetics
Routes of administration

One IU of oxytocin is the equivalent of about 2μg or mcg of pure peptide.
Injection: Clinical doses of oxytocin are given by injection either into a muscle or into a vein to cause contraction of the uterus.[3] Very small amounts (< 1%) do appear to enter the central nervous system in humans when peripherally administered.[17] The compound has a half life of typically about 3 minutes in the blood when given intravenously.
Buccal: Oxytocin was delivered in buccal tablets, but this is not common practice any more.[18]
Under the tongue: Oxytocin is poorly absorbed sublingually.[19]
Nasal administration: Oxytocin is effectively distributed to the brain when administered intranasally via a nasal spray, after which it reliably crosses the blood–brain barrier and exhibits psychoactive effects in humans.[20][21] No serious adverse effects with short-term application of oxytocin with 18~40IU (36-80mcg) have been recorded.[22] Intranasal oxytocin has a central duration of at least 2.25hours and as long as 4hours.[1][2]
Oral: Oxytocin is destroyed in the gastrointestinal tract, so it is not active orally.
History
Its uterine-contracting properties were discovered by British pharmacologist Sir Henry Hallett Dale in 1906.[23] And its milk ejection property was described by Ott and Scott in 1910[24] and by Schafer and Mackenzie in 1911.[25]
Oxytocin became the first polypeptide hormone to be sequenced[26] or synthesized.[27][28] Du Vigneaud was awarded the Nobel Prize in 1955 for his work.[29]
Etymology
The word "oxytocin" was coined from the term oxytocic. Greek ὀξύς, oxys, and τόκος, tokos, meaning "quick birth").
Society and culture

Counterfeits
Oxytocin is marketed as a pheromone. Oxytocin in spray form is sold under the brands Attrakt and Connekt. It is not absorbed into the skin when used topically, but it may be inhaled in a manner similar to perfume applied to skin. Oxytocin sprays for insufflation are also sold, but often with little or no oxytocin at all.
In African countries, some oxytocin products were found to be counterfeit medications.[30][31]
Research
The trust-inducing property of oxytocin might help those with social anxiety and depression,[32] anxiety, fear, and social dysfunctions, such as generalized anxiety disorder, post-traumatic stress disorder, and social anxiety disorder, as well as autism and schizophrenia, among others.[33][34] However, in one meta-analysis only autism spectrum disorder showed a significant combined effect size.[35]
People using oxytocin show improved recognition for positive social cues over threatening social cues [36][37] and improved recognition of fear.[38] However, oxytocin has also the potential for being abused in confidence tricks.[39]
Autism: Oxytocin may play a role in autism and may be an effective treatment for autism's repetitive and affiliative behaviors.[40]
Relationship counseling: The use of oxytocin in relationship counseling for well-being has been suggested.[41]
See also
List of investigational anxiolytics
List of investigational sexual dysfunction drugs