Quick question regarding pitocin...

Specialties Ob/Gyn

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Hi there,

For years we have not refrigerated routinely vials of pit that we use in delivery or birthing rooms because they get used up so quickly. At various times we have refrigerated them if they were in packs until we used them or restocked rooms..There has never been a problem as far as I know.

Recently had some premixed pit in saline that is in our pxyis...It does not seem to work as well at all to the point where we have changed the bag and tubing and put our own pit in fresh IVs only to find that works much better. Recent conferences ( Murray) suggest that those premixed pit bags be refrigerated vs being in the pxyis. We can't get pharmacists to agree. Wondering what various policies are amongst all you people out there. Please feel free to share.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We don't use pre-mixed pitocin where I work, but it's being considered here and again. I would be interested in learning something here, too. I have NO idea if pre-mixed pitocin needs to be refrigerated or not! Anyone?

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We don't use pre-mixed pit either. Considering we only have one laboring patient at a time, it doesn't make much sense since I can inject 10 units of pit into 1000 ml of fluid in a few seconds.

I'll have to ask our pharmacist about refrigerating pre-mixed pit.

steph

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This pit is mixed in normal saline and double concentrated. I thought it was my imagination but since we have been using it we have had several inductions that last longer than usual with a speed up of labor as soon as we change over the bag and use the pit we already have on the floor. The pharmacy has a lot of pull here and we think there is a definite difference, at least in the batches we have been given, than the pit we normally put in the bag of LR, which is the solution we customarily use. I have no idea whether it is related to a refrigeration issue or not, but would certainly be interested to know if anyone else has had similar or different experiences..I bet people in hospitals with large numbers of laboring patients at a time could probably tell us more...Please, as Deb said, "Anyone"?

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My ohter "old nurse" issue is that I prefer to mix my own pit rather than hang something that someone else mixed...It took me awhile to get used to premixed mag sulfate too..Guess I am the old fashioned type!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I do not at all mind premixed solutions, esp when it comes to potassium and magnesium!!!! BUT if you are noticing a true problem w/the pitocin indx since this new procedure, you need to be documenting it and discussing it with your pharmacists!!! Good luck.

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We have shared it with them. Even called Brigham and Women's Pharmacy in Boston. Both disagree with the refrigeration fact and Michelle Murray's conference. We are only nurses after all. The goal is not to have them send us pitocin to the floor. I have no idea why. I imagine there is some sort of sweet deal with the drug company supplier. At my facility the pharmacy has a lot of power such as changing or substituting meds that docs write, at whim....But, we are writing down each instance...When I was an icu nurse and one who did straight delivery, I was used to mixing my own meds so it doesn't bother me at all..

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How can you not have straight pit on the floor? Don't you ever give it IM?

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Rarely but they think if they leave just a little bit on the floor we would be discouraged from mixing our own. I would use it to mix my own anyway at the rate the current batch is behaving. But, you are right, there should be some on the floor no matter what their intent...

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Yes, having straight pit on the floor is important. I do give it IM in the absence of an IV after birth, if the uterus is not firming up. I think it's a bad deal not to have it available.....you DO Have methergine and hemabate at the bedside for all deliveries, don't you? (I keep them in my pocket, even for csections) and put them back if not needed. You really need to talk to the manager about getting pharmacy to cooperate with you more on this. Alaska has a good point.

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I already said I agreed. We of course have methergine and hemabate available, but I don't keep them in my pocket as they do have to be refrigerated....

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We use "tool boxes" that have pitocin in them (along with suture, syringes, needles, etc) for each delivery. The toolbox is brought in the room when delivery is imminent and then taken back out and restocked when done. It's simple enough to put these meds (methergine and hemabate) in there, at the last minute, and put them back in fridge if you don't use use them. It works pretty well, no running for these things when the delivery is going on.

Hey, and No need to get touchy, lol, we are trying to help you out, is all.

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