Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Cytotec
Active ingredient: Misoprostol
Available dosage forms: 100, 200 mcg
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Misoprostol general information
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Gastrointestinal hemorrhage was reported to be temporally linked to the use of citalopram and unwanted effects. Oral administration of the methylxanthine theophylline (chemically much like caffeine) can decrease a good number of episodes of apnea, but can further produce side effects for example palpitations and insomnia. Atypical antidepressants are really so named because they don’t fit into the normal drug classes described above. Mirtazapine also functions as an anti-nausea medication.
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Anxiety attacks are linked to the growing level of secretion of a certain enzyme known as within the blood. It’s now believed this vascular headache might be because of a primary neuronal dysfunction. Any imbalance among these various neurotransmitters is the primary source of depression.
Each individual differs,” he said, and it all is dependent on how your own body responds to the reduction in dosage. Medications might be adjusted to accomplish the best treatment outcomes. MAO inhibitors can only be obtained by prescription. Warm milk contains high rates of tryptophan, an all-natural sedative.
Many folks wish to know which is the greatest medication for healing anxiety. Additionally, This is among the most prescribed depression medicine which is used for curing clinical depression. The sort of surgery is essential for you may really depend on the severity of your own sleep apnea. Explore each of the possibilities with your personal doctor.
All kinds of depression medication need tapering down as a way to lessen the side effects which might be very serious. There are particular side-effects that accompany these drugs too, and this also is something one ought to be cautious about. It is important to understand that practically all of the antidepressant prescription drugs carry at least a few risk of potential unwanted side effects, and therefore, it is usually recommended to consider one of the all-natural cures instead. These are the hottest modes of anti depression medication and they don’t fall under some of the initial 3 types, thus they’re classified as atypical. After the very first treatment he did not require the pills in any way.
The more the individual smokes, more is the chance of contracting the illness. Otherwise, this could cause serious health concerns. Also it is crucial to understand that a lot of types of antidepressants are somewhat more probable to cause weight gain than otherwise. Likewise, they are also able to not be given to anybody using a history of liver disease. Furthermore, it contains vital nutrients that will restore their wellness.
Major depression is an intricate type of depression that might occur because of psychological, biological and social factors. It’s a behavioral disorder and it might happen to anybody in perfect nutritious conditions. This medication impacts the imbalanced neurotransmitters which cause depression. The symptom is employed to characterize the visible effects which are employed to identify the illness by the physicians.
Misoprostol (Misoprostol): instruction, and the use of a formula
Feature substance Misoprostol
A synthetic analog of PGE 1 . It consists of two diastereoisomers in a ratio of 1: 1.
The powder forming upon dilution with water, viscous liquid. Molecular weight 382,54.
Mode of action – gastroprotective, antiulcer, uterotoniziruyuschee stimulating generic activities.
It has antisecretory activity. Bind to receptors of PGE gastric parietal cells, inhibits basal, stimulated and nocturnal gastric acid secretion and hydrochloric acid, enhances the formation of bicarbonate and mucus, improves blood flow and exhibits cytoprotective action. It reduces basal (but not stimulated by histamine) production of pepsin. It improves the stability of the gastric mucosa and prevents the development of erosive – ulcerative lesions, promotes healing of peptic ulcers. In patients taking NSAIDs. reduces the incidence of gastric and duodenal ulcers, reduces the risk of ulcer bleeding. The action begins in 30 minutes and lasts for at least 3 – 6 h At a dose of 50 mcg effect is moderate and short, 200 mcg .; expressed.
Misoprostol has a weak stimulating effect on the smooth muscles of the gastrointestinal tract. It induces a contraction of smooth muscle fibers of the myometrium and cervical extension. The ability of misoprostol to encourage uterine contractions facilitates cervical ripening, increases the tone of the uterus and can cause miscarriage. Misoprostol has no clinically significant effect on prolactin levels of gonadotropins, thyrotropin, growth hormone, thyroxine, cortisol, creatinine, platelet aggregation, lung and heart function – vasculature.
Once inside quickly and completely absorbed. Simultaneous administration with food reduced the bioavailability (fatty foods significantly reduces the absorption without affecting its duration). The walls of the gastrointestinal tract and hepatic biotransformation to pharmacologically active metabolite of diester ; misoprostol acid. C max is misoprostol (6,08 & plusmn; 1,64) pg / ml, misoprostol acid ; (499 & plusmn; 15) pg / ml. T max ; (12 & plusmn; 3) minutes, the system circulates in the bloodstream related proteins form (approximately 90%). T 1/2 terminal is 20 – 40 min. Equilibrium concentration in plasma is achieved within 2 days, no accumulation is observed. 80% of the dose is excreted by the kidneys (64 – 73% in the first 24 hours) and the faeces (15%). If the kidney function can increase C max (almost 2 times) and elongated T 1/2 .
In elderly patients (over 64 years) an increase in AUC.
After a single oral administration of misoprostol metabolite ; misoprostol acid ; found in human milk. C max misoprostol acid in breast milk is reached in 1 hour and is 7.6 pg / mL when taking 200 mg of misoprostol and 20.9 pg / ml when taking 600 mg of misoprostol. misoprostol acid concentration in breast milk is reduced to 1 pg / ml in 5 hours after taking misoprostol.
Application of the substance Misoprostol
The erosion of the gastrointestinal tract. gastric ulcer and duodenal ulcer disease, erosive – ulcerative lesions of the gastrointestinal tract in the background drug therapy. including NSAID – gastropathy (prevention and treatment).
interrupt early pregnancy (up to 42 days of amenorrhea) ; only in combination with mifepristone.
Hypersensitivity, including to other prostaglandins and their analogs, breast-feeding, Children and Youth age (up to 18).
Restrictions on the use
Severe hepatic dysfunction, renal failure, hypotension, ischemic heart disease. cerebral blood flow, cerebral atherosclerosis, koronarokardioskleroz, epilepsy, enterocolitis, diarrhea, older age; endocrinopathies and endocrine diseases, including diabetes, adrenal dysfunction; hormone – dependent tumors; anemia; when applying for abortion ; the use of intrauterine contraceptive (before application is necessary to remove IUDs), the suspicion of an ectopic pregnancy.
Application of pregnancy and breastfeeding
When used as a gastroprotective agent . contraindicated in pregnancy (including the planning of pregnancy). In order to avoid pregnancy in women of reproductive age before treatment, you must first spend serum pregnancy test, which must be negative for 2 weeks before taking the drug. Treatment should be started no earlier than 2 – 3 days after the onset of menstruation. In should use reliable methods of contraception during the entire period of administration of misoprostol (if pregnancy occurs the woman informed of the potential threat to the fetus).
When used as a means of uterotoniziruyuschego can be used only for the purpose of termination of pregnancy, otherwise contraindicated in pregnancy.
Category effects on the fetus by FDA ; X.
The active metabolite of misoprostol ; misoprostol acid ; excreted into breast milk. Although reports about the development of public – any adverse side effects in children who are breastfed misoprostol is not registered, it is advisable to be careful in the appointment of misoprostol in this period.
Side effects of substance Misoprostol
From the digestive tract: abdominal pain, dyspepsia, flatulence (2.9%), nausea and / or vomiting, diarrhea (11 – 40%) and constipation (1.1%) .
With the genitourinary system: irregular menstruation, dysmenorrhea, hypermenorrhoea, postmenopausal vaginal bleeding, menorrhagia, metrorrhagia, pelvic pain associated with contractions of the myometrium.
Allergic reactions: skin rash, pruritus, anaphylactic reactions, angioedema.
Other: the change in body weight, dizziness, headache (2.4%), asthenia, fatigue, pyrexia, chills; It is extremely rare in women in pre – and postmenopausal ; cramps.
Eating, antacids, misoprostol acid is accompanied by a decrease in plasma concentrations (clinically insignificant). When combined with a magnesium-containing antacids may increase diarrhea caused by misoprostol. Admission for a long time of rifampicin, isoniazid, anticonvulsants, antidepressants, cimetidine, aspirin, indomethacin and phenobarbital drug group, smoking more than 10 cigarettes a day ; misoprostol stimulate the metabolism, reducing its levels in the blood serum.
Within 1 week after misoprostol should stop taking aspirin and other NSAIDs.
Phenomena overdose in humans has not been described. From tioksichnosti studies in animals, the clinical symptoms suggestive of an overdose of misoprostol may be drowsiness, confusion, tremors, convulsions, shortness of breath, abdominal pain, diarrhea, fever, palpitations, blood pressure reduction. bradycardia.
Treatment: symptomatic therapy. Hemodialysis is ineffective.
Dosing and Administration
Inside. Dosage is determined individually, depending on the evidence.
To prevent stomach ulcers caused by NSAIDs. and treatment of erosive gastritis and gastric ulcer and duodenal ulcer: 200 mg 2 – 4 times daily (last admission ; at bedtime); daily dose of ; 400 – 800 mcg. When poor tolerability of a single dose may be reduced to 100 mg. In renal insufficiency, the daily dose reduced by 50%.
To abortion (in combination with mifepristone): 36 – 48 hours after receiving mifepristone 400 mg administered misoprostol.
Precautions substance Misoprostol
In the application for the termination of early pregnancy misoprostol should be used only in combination with mifepristone. In combination with mifepristone medication should be used only by prescription and under medical supervision and only in specialized hospitals, with capacity to provide emergency surgical and gynecological transfusion care, and have appropriately trained medical staff.
The use of the drug requires prevention of Rhesus – conflict and other general activities related to abortion. Before the appointment of misoprostol patient must be informed in detail about the action and the possible side effects of the drug. The patient should be observed in a hospital for 4 – 6 hours before dosing. During and after the administration of the drug to the patient timely medical assistance in the event of massive bleeding or other complications should be provided. After drug administration in patients, usually there is a slight vaginal bleeding in some women ; very long. At a very early stage of pregnancy can have an abortion after mifepristone, but in this case it is also necessary pills of misoprostol for medical abortion optimization results. After administration of misoprostol in approximately 80% of women have an abortion takes place for 6 hours and approximately 10% of women ; for 1 week. The patient need to be retested in the same hospital at 8 – 15 days after ingestion. If necessary, it should be carried out or ultrasound to determine the level of human chorionic gonadotropin in serum. If you suspect incomplete abortion or continuation of the pregnancy is necessary to conduct a comprehensive medical examination in a timely manner. With incomplete abortion or ongoing pregnancy, estimated at 10 – 14 days after mifepristone, carefully carried out the vacuum – aspiration followed by histological examination of aspirate.
The drug as gastroprotectives should be discontinued in the event of diarrhea (mild diarrhea is not considered grounds for cancellation of treatment, drug overturned in severe diarrhea ; about 2% of cases), skin itching, bleeding from the vagina, lowering blood pressure and increasing the activity of transaminases .
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