Chapter 41
—posting due by July 14
Visit http://www.misoprostol.org/
This site states that use of Misoprostol could save women’s lives when used for obstetric and gynaecologic related problems. What condition may this drug treat? Briefly describe the drug’s actions (ie how does it work?)
Tuesday, July 17, 2007
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Misoprostol is approved to treat gastric ulcers resulting from chronic administration of nonsteroidal anti-inflammatory drugs (NSAIDS). The medication can be used in combination with another drug (mifepristone) to end a pregnancy (abortion).
Women who received Cytotec during clinical trials reported the following gynecological disorders: spotting (0.7%), cramps (0.6%), hypermenorrhea (0.5%), menstrual disorder (0.3%) and dysmenorrhea (0.1%). Postmenopausal vaginal bleeding may be related to Cytotec administration. If it occurs, diagnostic workup should be undertaken to rule out gynecological pathology.
Misoprostol is extensively absorbed, and undergoes rapid de-esterification to its free acid, which is responsible for its clinical activity and unlike the parent compound, is detectable in plasma. The alpha side chain undergoes beta oxidation and the beta side chain undergoes omega oxidation followed by reduction of the ketone to give prostaglandin F analogs.
Cytotec has been shown to produce uterine contractions that may endanger pregnancy. In studies in women undergoing elective termination of pregnancy during the first trimester, Cytotec caused partial or complete expulsion of the uterine contents in 11 % of the subjects and increased uterine bleeding in 41%.
http://www.rxlist.com/cgi/generic/misopro_ad.htm
http://www.misoprostol.org/
Misoprostol is commonly prescribed off-label to cause birth induction by uterine contractions and the ripening of the cervix. Misoprostol is highly effective and much less expensive than pitocin and cervidil, the FDA-approved drugs for medically necessary labor induction. Trial meta-analysis by the Cochrane Collaboration demonstrates no difference in efficacy or side effects between inductions undertaken with cervidil or misoprostol.
Misoprostol is a drug that is FDA-approved in the United States for the prevention of NSAID-induced gastric ulcers. It is also used to induce labor and as an abortifacient. A 1998 study found misoprostol to be helpful as a supplement to a vacuum pump (VED) in the treatment of erectile dysfunction, but not effective by itself.
The most commonly reported adverse effect of taking a misoprostol 200 µg tablet by mouth four times a day to reduce the risk of NSAID-induced gastric ulcers is diarrhea. In clinical trials, an average 13% of patients reported diarrhea, which was dose-related and usually developed early in the course of therapy and was usually self-limiting , but sometimes required discontinuation of misoprostol.
http://en.wikipedia.org/wiki/Misoprostol
http://www.misoprostol.org/
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a689009.html
-Misoprostol helps the stomach protect itself against acid damage. It also decreases the amount of acid produced by the stomach.
http://www.drugs.com/cons/Misoprostol.html
-First, an oral dose of mifepristone tablets is given by your health professional. Mifepristone causes the placenta to separate from the endometrium. It also softens the cervix and increases uterine contractions to allow the uterine contents to pass. For reference, see an illustration of the reproductive organs.
-Second, tablets of misoprostol are taken orally or inserted vaginally, usually within 48 hours of mifepristone. Misoprostol causes uterine contractions so that your body passes the uterine contents. This is an unlabeled use of misoprostol. Some clinics may have you stay for 4 hours after misoprostol is given, because if serious side effects occur, they usually occur in this time period and can then be treated. The pregnancy may end in the clinic or later at home. Some health professionals allow their patients to take misoprostol at home and then the pregnancy ends (like a miscarriage) at home
-Misoprostol is slightly more effective when taken vaginally than when taken orally. 2 Some studies show that vaginal misoprostol works more quickly and has fewer side effects than when taken orally.
http://health.yahoo.com/topic/women/medications/article/healthwise/tw1291
-Also, it may be used to induce labor contractions and some trails are being conducted for the treatment of erectile dysfunction.
http://en.wikipedia.org/wiki/Misoprostol
Misoprostol is used to induce labor by causing “uterine contractions” and thinning the line of the cervix. It is also used as an abortion agent. It’s taken and then 24-72 hours later the fetus is expulsed from the body and 92% of matter.
It’s mechanism of action is that it inhibits both basal and nocturnal gastric acid by acting on the parietal cell. It inhibits gastric acid secretion. It also prevents mucus bilayer disruption and reduces the backflow of H ions. It also protects the mucosal capacity to produce cells. Misoprostol lowers pepsin concentrations when under basal conditions.
Because of this action it could be used to treat ulcers.
http://en.wikipedia.org/wiki/Misoprostol
http://www.misoprostol.org/File/availability.php
http://gsm.about.com/compact/showmono.asp?cpnum=409&r=6078&monotype=full
Misoprostol is currently only approved by the Food and Drug Administration for the prevention and treatment of gastric ulcers resulting from chronic administration of nonsteroidal anti-inflammatory drugs (NSAIDS).
Misoprostol stimulates increased secretion of the protective mucus that lines the gastrointestinal tract and increases mucosal blood flow, thereby increasing mucosal integrity. It is sometimes co-prescribed with non-steroidal anti-inflammatory drugs to prevent their common adverse effect of gastric ulceration.
Misoprostol has been extensively studied in reproductive health, and is widely recommended for the treatment of missed and incomplete miscarriages, the induction of abortion, and cervical preparation before uterine instrumentation, induction of labor and postpartum hemorrhage prophylaxis and treatment. Misoprostol is also effective for preventing postpartum hemorrhage (PPH).
http://en.wikipedia.org/wiki/Misoprostol
http://www.misoprostol.org/File/news.php
Misoprostol (Cytotec) is indicated and approved for treatment of gastric ulcers. Misoprostol works by inhibiting gastric acid secretion, may protect gastric mucosa, and can increase bicarbonate mucos production. It is a prostaglandin E1 analog, and a gastric mucosa protectant. Misoprostol is readily metabolized into the free acid, which is the active form. In addition to being used for the treatment and prevention of gastric ulcers, it is also used for cervical ripening and induction of labor. Misoprostol has the ability to stimulate uterine contractions in late pregnancy and can cause uterine rupture in high doses. Obstetric and gynaecologic indications include cervical ripening, missed/incomplete miscarriages, induction of labor, and postpartum haemorrhage prophylaxis/treatment.
http://www.misoprostol.org/
www.adwia.com
Misoprostol - Prostaglandin
Misoprostol is Indicated in treating NSAID induced gastric ulcer complications, duodenal ulcers, ulcers unaffected by histamine antagonist.
Works by inhibiting gastric acid secretion, protecting gastric mucosa by increasing bicarbonate and mucous production, and decreases pepsin levels. It may also stimulate uterine contractions that may endanger pregnancy.
'99 edition of PDR Nurse's Handbook
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