Prostaglandin Misoprostol

Arthrotec tablets contain the non-steroidal anti-inflammatory drug diclofenac and the prostaglandin misoprostol. The combination of the two active ingredients makes Arthrotec suitable in patients predisposed to gastrointestinal ulceration. Dulco-lax (bisacodyl) tablets act as a stimulant laxative. Voltarol Retard tablets contain the non-steroidal anti-inflammatory drug diclofenac. All... 

Roussel-UCLAF, 1982 (often in combination with a prostaglandin—Misoprostol)... 

Indometacin (Amuno ) provides a representative example ofthe fenac class. The search for better-tolerated drugs led inl974to diclofenac (Voltaren ). [ 184] This is weU-tolerated and nowadays available in a variety of application forms. For the prevention of gastrointestinal ulceration, a combination product with the prostaglandin misoprostol (Cytotec ) (cf. section 5.6, prostaglandins) has been developed. 

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... 

Cytotec containing misoprostol (prostaglandin analogue) may cause abnormal vaginal bleeding. 

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 (... 

NSAID with analgesic properties, and misoprostol, a Gl mucosal protective prostaglandin analog. 

Hypersensitivity to diclofenac or to misoprostol or other prostaglandins. Do not give to patients who have experienced asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. 

Misoprostol is a stable analog of prostaglandin Ei. It reduces acid secretion by inhibiting histamine-stimulated adenyl cyclase activity in the parietal cell. 

A. If the precipitant can be withdrawn then an-tisecretory treatment with a histamine H2 antagonist or proton pump inhibitor, or misoprostol (an antisecretory and mucosally protective prostaglandin) for a month may be enough to induce ulcer healing. 

Misoprostol (Cytotec) is a prostaglandin Ej analogue that is being evaluated as a cervical ripening agent. It also is used in the treatment and prevention of peptic ulcer disease (see Chapter 40). Clinical trials show that misoprostol is an effective agent for both cervical ripening and labor induction. It appears to be as effective as dinoprostone and is much less expensive. 

The answer is a. (Hardman, p 914.) Misoprostol is a prostaglandin analogue of PGE with an affinity for the gastric mucosa. It stimulates the secretion of mucus and bicarbonate, enhances cell proliferation, preserves the microcirculation, and stabilizes tissue lysosomes. Misoprostol is approved by the FDA for protection against the ulcerogenic action of NSAIDs (not because it antagonizes NSAIDs). 

The next major class of drugs for peptic ulcer disease is the mucoprotectants and other protective agents. Sucralfate (4.158) is a carbohydrate-based drug (chapter 8) which forms an impenetrable paste that adheres to the stomach lining defect, providing a protective barrier. Misoprostol (4.159) is a semisynthetic prostaglandin derivative that promotes mucus production. Carbenoxolone (4.160) has a mineralocorticoid-type action that also promotes mucus production. 

A major iimitation to the use of NSAIDs is gastrointestinal ulceration and bleeding, particularly in the stomach, due to suppression of protective gastric prostaglandins (PGs). NSAID-induced ulceration. The concomitant administration of the PGEl analogue, misoprostol, is more effective but is expensive and associated with an appreciable incidence of side effects, notably diarrhoea Renal adverse effects... 

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