Properties and Action of Misoprostol

Pharmacological effect

With antisecretory activity, Misoprostol is a synthetic analog of prostaglandin E.

By consuming tablets, the compound decreases hydrochloric acid discharge, enhances bicarbonate and mucus secretion while safeguarding internal organ cells. The durability of gastric mucosa is boosted considerably to evade erosive or ulcerative tissue damages; contributing towards better curating peptic ulcers. This therapeutic effect typically manifests 30 minutes post-ingestion and persists for roughly three hours.

Possible rewrites: – Recommended purposes of usage – Situations where it is appropriate to use – Conditions or circumstances suitable for utilization

The utilization of Misoprostol is advised for managing the following medical conditions:

The aim is to prevent the occurrence of gastric ulcers that may arise due to the intake of NSAIDs.

Managing a flare-up of duodenal ulcer.

Ulcer in the stomach.

It is recommended to use in conjunction with Mefiprostone for abortion during the initial phases (up to 42 days).

Could you explain its operational process?

The smooth muscles of the gastrointestinal tract are moderately stimulated by misoprostol. Additionally, it acts as a facilitator for contracting smooth muscle fibers in the myometrium and dilating the cervix.

As a result of the drug’s capacity to induce uterine contractions, dilation of its cervix is facilitated. The uterus becomes more tense which may trigger an abortion.

Prolactin, gonadotropins, thyroid stimulating hormone, growth hormone, thyroxine,cortisol , creatinine levels and platelet aggregation as well as pulmonary function and the cardiovascular system are not significantly affected by Misoprostol.

Contradictions

Pregnant women should not take Misoprostol due to its teratogenic impact, and it is solely employed for pregnancy termination. In the event that a woman using this medication becomes pregnant, she must discontinue its use immediately. Additionally, if there are any indications of an ectopic pregnancy in progress, Misoprostol usage should be avoided altogether.

Individuals may have an exaggerated response towards certain constituents present in the medication, such as other prostaglandins and their similar compounds.

Breastfeeding.

Individuals who are under the age of 18, including children and adolescents.

Possible rewrites: – Adverse reactions – Unintended consequences – Undesirable outcomes

Abdominal pain, dyspepsia, flatulence (with a prevalence of 2.9%), and gastrointestinal symptoms such as nausea/vomiting or diarrhea (11-40%) are commonly reported in relation to the digestive tract. Constipation is also an infrequent symptom (<1.1%).

The following symptoms may arise from the genitourinary system: irregular menstrual cycles, painful menstruation, excessive bleeding during periods and postmenopausal vaginal spotting. Other conditions include heavy period flow and abnormal uterine bleeding accompanied by lower abdominal pain caused by myometrial contractions.

Some possible rewrites: – Skin rash, itching, anaphylaxis and angioedema are all potential allergic reactions. – An individual who is experiencing allergies may exhibit symptoms such as skin irritations or rashes, intense itching sensations along the affected areas of their body. More serious cases could lead to life-threatening conditions like anaphylactic shock or angioedema. – Four different types of hypersensitivity responses known for causing adverse effects in people with allergic tendencies include; eruptions on the skin surface followed by irritation referred to as a rash (skin rash), constant scratching due to unbearable itchiness sensation(itching), swollen mucous membranes hindering breathing(Anaphylaxic) and sudden swellings(Angioderma).

Other adverse effects may include fluctuations in body weight, dizziness, headache (2.4%), asthenia, fatigue, hyperthermia and chills. Convulsions occur extremely rarely among women during pre- or postmenopausal periods.

Administration and Dosage

The administration of this medication is through oral intake with water. Individual dosage regimens will be determined based on the indications for use.

To prevent gastric ulcers from NSAIDs and treat erosive gastritis as well as peptic ulcer of the stomach and duodenum, take 200mcg two to four times a day (with the last dose before bedtime). The daily intake should be between 400-800 mcg. If you have poor tolerance to this medication, reduce your single dosage to 100mg. In case of renal failure, decrease your daily intake by half i.e.,50%.

Mifepristone in conjunction with abortion necessitates the prescription of 400 mg misoprostol after a period of 36-48 hours following its ingestion.

An excessive amount of a substance ingested or taken that can lead to harmful effects is known as overdose.

Possible outcomes of taking too much were recognized as follows:

Feeling sleepy and sluggish.

Shake.

Muscle spasms.

Difficulty breathing.

Pain in the abdomen.

Loose bowel movements.

High body temperature.

Heart palpitations.

Reducing the pressure.

Interacting with other medications/ drugs.

Consuming antacids results in a negligible drop in plasma misoprostolic acid levels. However, taking magnesium-containing antacids alongside it can exacerbate the diarrhea triggered by misoprostol.

Misoprostol’s level in the bloodstream is reduced due to accelerated metabolism caused by prolonged usage of rifampicin, isoniazid, anticonvulsants antidepressants, cimetidine, acetylsalicylic acid indomethacin and medications belonging to the phenobarbital group or smoking more than ten cigarettes per day.

You should cease taking acetylsalicylic acid and other NSAIDs within a week of consuming misoprostol.

Safety measures to take into consideration.

Misoprostol should always be used together with mifepristone to terminate an early pregnancy. Only a doctor can prescribe these drugs, and they must be administered in specialized medical facilities that regularly inspect the quality of Mifepristone and Misoprostol. These institutions must also have skilled medical personnel who can provide emergency surgical gynecological care as well as blood transfusions if needed.

Before prescribing misoprostol, it is important to inform the patient in detail about its action and potential side effects. Additionally, preventative measures for Rhesus conflict and other abortion-relating factors must be considered during drug usage.

In order to ensure safety, it is advised that the patient be monitored in a hospital for 4-6 hours prior to administering the medication. It’s crucial that prompt medical attention be given if there are any instances of excessive bleeding or unexpected complications during or after taking the drug. Typically, patients experience mild vaginal bleeding following administration; however, some women may encounter prolonged episodes.

In the case of an early pregnancy, Mifepristone can induce abortion; however, to maximize medical termination’s efficacy, Misoprostol tablets are also required. Within six hours of taking misoprostol, around 80% of women experience abortion; whereas in approximately 10% of cases it occurs within a week.

The medical institution requires the patient to have a follow-up examination 8-15 days after taking the medication. If there is an incomplete abortion or ongoing pregnancy, which can occur approximately 10-14 days post-mifepristone intake, vacuum aspiration must be performed and followed by histological analysis of the aspirate.

Conditions for storage

Store in a cool and dry location with temperatures below 25 ° C.

Life span on the shelf.

Two years