Prostaglandin diarrhea with

Misoprostol (B) is a semisynthetic prostaglandin derivative with greater stability than natural prostaglandin, permitting absorption after oral administration. like locally released prostaglandins, it promotes mucus production and inhibits acid secretion. Additional systemic effects (frequent diarrhea risk of precipitating contractions of the Liillmann, Color Atlas of Pharmacology (... 

Misoprostol is a synthetic prostaglandin E2 analog that exogenously replaces prostaglandin stores. The minimum effective dose shown to inhibit acid secretion and promote mucosal defense is 400 meg/day. Misoprostol use is limited by a high frequency of bothersome gastrointestinal effects such as abdominal pain, flatulence, and diarrhea. In placebo-controlled studies diarrhea occurred with twice the frequency in the... 

As indicated earlier, COX-2 selective drugs may reduce the risk of toxicity to the stomach, kidneys, and other tissues because these drugs spare the production of normal or protective prostaglandins in these tissues.3 These drugs may cause other problems such as diarrhea, heartburn, gastrointestinal cramps, and an increased risk of upper respiratory tract infection. As indicated in Chapter 15, COX-2 drugs have also been associated with serious cardiovascular problems (heart attack, stroke), and these drugs should be avoided in people at risk for cardiac disease. 

Antiprogestins (eg, mifepristone) have been combined with an oral oxytocic prostaglandin (eg, misoprostol) to produce early abortion. This regimen is now available in the USA (see Chapter 39 Adrenocorticosteroids Adrenocortical Antagonists). The ease of use and the effectiveness of the combination have aroused considerable opposition in some quarters. The major toxicities are cramping pain and diarrhea. 

Side effects following intravaginally administered gemeprost are generally relatively mild, with systemic effects such as nausea and diarrhea reported. The effects of this drug on the fetus are not known, but once a prostaglandin has been used to initiate termination of pregnancy, if it is found to be unsuccessful, termination must be completed by another means. 

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