Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Data from four double-blind studies of the treatment of patients with rheumatoid arthritis or osteoarthritis were combined. For 4 to 12 weeks, 747 patients received Arthrotec, a combination of 50 mg of diclofenac and 200 micrograms of misoprostol, and 754 patients received 50 mg of diclofenac; the drugs were given twice or three times daily. The five most commonly reported adverse events were abdominal pain by 23.2% of the diclofenac/misoprostol patients and 19.8% of the diclofenac patients; diarrhea by 19.9% and 11.3%; nausea by 11.8% and 6.5%; dyspepsia by 11.2% and 7.8%; and flatulence by 8.0% and 3.1%. Other adverse events, reported by similar proportions of both treatment groups, included headache, gastritis, dizziness, vomiting, and constipation. In the diclofenac/misoprostol-treated patients, the abdominal pain and diarrhea were rated mild in 30.6% and 24.3%, moderate in 49.1% and 51.4%, and severe in 20.2% and 24.3%. Serious adverse events occurred in eight of the diclofenac/misoprostol-treated patients and in 13 of the diclofenac-treated patients; 12.6% and 10.1%, respectively, were withdrawn from the study because of adverse events. Results of laboratory tests of hepatic and renal function were similar in the two treatment groups.
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PMID:Overall safety of Arthrotec. 143 22

One hundred sixty-two patients chronically ingesting ibuprofen, piroxicam, or naproxen for osteoarthritis, who had abdominal pain and an endoscopically proven gastric ulcer were evaluated for eight weeks in a randomized, double-blind trial comparing misoprostol (200 micrograms four times daily with meals and at bedtime) (N = 77) with placebo (N = 85). Patients discontinued their usual daily dose of antiarthritic medication throughout the study period, and an endoscopy was performed at four weeks and eight weeks (if necessary) to assess ulcer healing. Gastric ulcers were defined as circumscribed breaks in the gastric mucosa of 0.3 cm in diameter or greater. Misoprostol therapy significantly accelerated the rate of gastric ulcer healing compared to placebo (P = 0.033). The cumulative percent healed after four and eight weeks of therapy for misoprostol versus placebo were: 83% vs 61% at four weeks and 96% vs 90% at eight weeks (P = 0.0028 and P = 0.0977, respectively by lifetable analysis). Relief of abdominal pain did not differ significantly between the treatment groups. Misoprostol significantly accelerates the healing of ibuprofen-, piroxicam-, or naproxen-induced gastric ulcers.
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PMID:Treatment of nonsteroidal antiinflammatory drug-induced gastric ulcers with misoprostol. A double-blind multicenter study. 147 30

One hundred and thirty-seven consecutive outpatients with non-ulcer dyspepsia (NUD) and erosive prepyloric changes (EPC) were randomly allocated to double-blind treatment with 400-micrograms misoprostol tablets twice daily or placebo for 4 weeks. Misoprostol had a significant worsening effect on epigastric pain, nausea, meteorism, lower abdominal pain, and diarrhoea, as compared with placebo. The fact that symptoms in patients with NUD and EPC were exacerbated by an antisecretory dose of misoprostol indicates that the symptoms are largely unrelated to gastric acid.
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PMID:Misoprostol treatment exacerbates abdominal discomfort in patients with non-ulcer dyspepsia and erosive prepyloric changes. A double-blind, placebo-controlled, multicentre study. 212 24

Gastrointestinal symptoms have been the most frequently reported adverse experiences in the misoprostol (Cytotec) studies of both patients with peptic ulcer disease, and healthy subjects. There have been relatively few cardiovascular, genito-urinary, or other adverse effects. This is similar to the results of animal studies in which misoprostol had little, if any, effects on cardiovascular, central nervous, and endocrine systems. The predominant activity of misoprostol in the gastrointestinal tract, essential to its ulcer-healing activity, may also account in part for the association of misoprostol with gastrointestinal adverse experiences. Abnormal bowel movements were the most common complaint (9-13%) of patients in pivotal controlled studies. In patients taking misoprostol 200 micrograms four times daily, 7.1% had diarrhea, with less than 1% stopping therapy because of diarrhea. Abdominal pain in these patients was reported in an incidence of 12.8%, was mild, and only rarely resulted in stopping therapy. Other adverse reactions reported in these patients were nausea, headache, and dizziness. In pregnant women, undergoing a legal termination of pregnancy, it has been shown that misoprostol has a greater incidence of uterine bleeding, and partial or complete expulsion of uterine contents, than placebo. Misoprostol (Cytotec) has received government approval for marketing in 12 countries, since the first gave its approval in June, 1984. It has been launched in 6 of those markets to date, with an estimated 100,000 patients having taken the drug. No serious adverse experiences attributed to misoprostol have been reported, but mild adverse experiences have occurred. Those most frequently reported were gastrointestinal in nature, and included diarrhea, abdominal pain, and nausea.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Focus on misoprostol: review of worldwide safety data. 311 1

Non-steroidal anti-inflammatory drugs (NSAIDs) are an effective therapy for the management of arthritis, but their use is restricted by the risk of gastrointestinal complications from NSAID-induced ulceration. The elderly, in particular, are vulnerable to such damage and complications. Misoprostol is the only cytoprotective drug found to be effective in the prevention of both gastric and duodenal ulcers associated with NSAIDs. A fixed-combination of diclofenac 50 mg/misoprostol 200 micrograms has been evaluated for efficacy and safety in the treatment of arthritis. Pharmacokinetic studies of the fixed combination have found that no drug-drug interaction occurs between misoprostol and diclofenac after either single or multiple doses, and the bioavailability of misoprostol and diclofenac are comparable with that of misoprostol and diclofenac given alone. This fixed combination was found to be equivalent to other NSAIDs in the control of symptoms and other parameters of arthritis. The fixed combination was generally well tolerated, although the occurrence of abdominal pain and diarrhoea was slightly more frequent than with other NSAIDs. This contrasts with a 2- to 3-fold reduction in the rate of gastroduodenal damage with the fixed combination compared with the rate associated with other NSAIDs. These results indicate that the diclofenac 50 mg/misoprostol 200 micrograms combination should be considered in preference to other NSAIDs when treating patients at risk of ulcer complications.
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PMID:Efficacy and gastroduodenal safety of a fixed combination of diclofenac and misoprostol in the treatment of arthritis. 778 Jun 74

To assess the efficacy of misoprostol in the treatment of patients with severe chronic constipation, nine such patients were enrolled in a double-blind, randomized, crossover study of misoprostol (1200 micrograms/day) or placebo, that lasted three weeks. During this period each patient received the drug for one week and placebo for another with a week washout period in between. A colonic transit study, using radiopaque markers, was performed during each of the treatment weeks, while the number of stools and their total weight was recorded by each patient for the appropriate periods. Colonic transit time was significantly and consistently decreased by misoprostol compared to placebo [66 hr +/- 10.2 vs 109.4 hr +/- 8.1 (P = 0.0005)]. Misoprostol significantly increased the total stool weight per week [976.5 g +/- 288.8 vs 434.6 g +/- 190.5 (P = 0.001)] and also significantly increased the number of stools per week compared to placebo [6.5 +/- 1.3 vs 2.5 +/- 0.11 (P = 0.01)]. The incidence of abdominal pain was similar in both groups. We concluded that misoprostol, during a short trial period, proved effective in increasing the frequency and weight of bowel movements and decreasing colonic transit time in patients with severe chronic constipation. It may be used as a therapeutic measure to treat such patients.
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PMID:Misoprostol is effective treatment for patients with severe chronic constipation. 817 33

Twenty-five liver cirrhosis patients with endoscopically demonstrated gastro-duodenal mucosal damage (microhemorrhages, erosions, ulcers) were treated with misoprostol (prostaglandin E1) 400 mg/die. Eleven patients (44%) had abdominal pain and diarrhea and stopped treatment. Three months later, a new endoscopy was performed in the 11 patients that completed the study (3 patients were lost at follow up). Mucosal damage was stable in 5 patients (45%) and improved in 6 patients (55%), with complete absence of mucosal lesions in 2 patients (P = 0.027, Wilcoxon Ranks test). No case of worsening was observed and no patient had digestive bleeding during treatment. Digestive bleeding is a common complication of liver cirrhosis, originating in about 50% of cases from gastro-duodenal mucosal damage. Misoprostol suggests itself as a possible alternative therapy to the drugs usually utilized in these lesions (beta-blockers, H2-inhibitors), but individual intolerance is frequent and must be preliminary excluded.
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PMID:[The activity of misoprostol on the gastric and duodenal mucosal damage in patients with liver cirrhosis]. 825 66

A total of 1,456 patients were available for the All Patients Treated analysis of two large, randomized, double-blind, multicenter, controlled studies (Acid Suppression Trial: Ranitidine versus Omeprazole for NSAID-Associated Ulcer Treatment [ASTRONAUT] and Omeprazole versus Misoprostol for NSAID-Induced Ulcer Management [OMNIUM]). These studies examined the efficacies of omeprazole, 20 and 40 mg once daily (both studies), ranitidine, 150 mg twice daily (ASTRONAUT), and misoprostol, 200 microg four times daily (OMNIUM), for the healing of gastric ulcer, duodenal ulcer, or erosions, and the relief of dyspeptic symptoms. At entry, patients were receiving, and continued to receive, nonsteroidal anti-inflammatory drugs (NSAIDs), and had a gastric or duodenal ulcer, and/or >10 erosions in the stomach or duodenum at initial endoscopy. Patients were randomized to blinded treatment for 4/8 weeks until treatment success, which was defined as the healing of ulcer(s), <5 erosions at any site, and not more than mild dyspeptic symptoms. The proportions of patients reaching treatment success by 8 weeks were 77% with both doses of omeprazole, 63% with ranitidine, and 71% with misoprostol. In patients who initially had a gastric ulcer, more ulcers were healed at 8 weeks with omeprazole, 20 (83%) and 40 mg once daily (82%), than with ranitidine (64%) or misoprostol (74%). In patients who initially had a duodenal ulcer, 93% were healed at 8 weeks with omeprazole, 20 mg once daily, compared with 88% for omeprazole, 40 mg once daily, 79% for ranitidine, and 79% for misoprostol. Erosions healed slightly faster at 4 weeks with misoprostol, compared with the other regimens, but by 8 weeks most patients had <5 erosions per gastroduodenal region in each treatment group. Diarrhea and abdominal pain were more common in patients taking misoprostol, as were adverse events leading to withdrawal. Patients with duodenal ulcer or erosions at entry and the presence of Helicobacter pylori were good prognostic factors for overall treatment success. Using a model that included only patients with ulcers, those with smaller ulcers also had a higher likelihood of achieving treatment success. Against the background of these new data, omeprazole is the treatment of choice for healing NSAID-associated ulcers, on the basis of its efficacy and tolerability, and the optimal dose appears to be 20 mg once daily.
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PMID:New data on healing of nonsteroidal anti-inflammatory drug-associated ulcers and erosions. Omeprazole NSAID Steering Committee. 957 22

Surgical termination of pregnancy is of high risk for the woman's health and safe medical ways are required. The use of prostaglandins may substantially reduce this risk. The efficacy and safety of misoprostol as a medication for the termination of the second trimester pregnancies were studied. During a 15-month period ninety-eight healthy pregnant women (13-24 weeks) wishing to terminate their pregnancy due to medical reasons participated voluntarily in this study. Misoprostol was administered 400 microg per os and 400 microg vaginally. Dose was repeated every 6 hours until adequate contractions and cervical ripening were achieved. Outcome measures included successful termination rates, mean expulsion time and side effects of the medication. The efficacy of the method was as high as 91.8% (90/98 cases 95%, CI 86-97%). Mean expulsion time was 10.2 h (range 3-23.4 h) for primigravida and 9.2 h (range 2.5-22.2 h) for multigravida. In 9 cases (9.2%) placenta remnants and in 8 (8.2%) placenta retention were found. Most common side effect was shivering in 17.3% of cases, vomiting and nausea (10.2%), headache and dizziness (7.1%), abdominal pain (79.6%), while diarrhea was noticed in 4.1%. The high efficacy and low incidence of side effects make misoprostol a useful alternative method for medical termination of second trimester pregnancies.
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PMID:Use of misoprostol for the termination of second trimester pregnancies. 1178 46

Misoprostol is a synthetic prostaglandin E1 used during the first trimester of pregnancy as an adjacent to RU486 for medical termination of pregnancy. We present a case of a healthy 23-year-old woman who was admitted due to misoprostol overdose, used to induce an illegal abortion. Manifestations of toxicity included abdominal pain, vomiting, diarrhea and confusion. Treatment was supportive and included gastric lavage and administration of activated charcoal. Recovery was completed within a few hours, and the patient was scheduled for a dilatation and curettage the following day.
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PMID:Misoprostol overdose during the first trimester of pregnancy. 1522 78


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