Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A series of 100 consecutive patients seeking pregnancy termination in pregnancy weeks 7-20 were treated with a schedule of 20-mg vaginal suppositories containing prostaglandin E2 (PGE2); the schedule was being tested for its efficacy, specifically reduction of total dose and related side effects. 94 of the 100 patients were aborted within an arbitrary time span of 36 hours. Total drug dose ranged from 40-160 mg. 31 patients received augmentative intravenous oxytocin. Induction-abortion interval varied from 6-32.5 hours. Of the 97 successes, 76 were classified as complete abortions. No significant differences were noted in midtrimester groups based on increasing parity, although parous patients in gestation week 13-15 seemed to have the best results, based on average interval time. No sepsis or need for transfusion was encountered. Side effects were emesis (n-75), diarrhea (n=17), and drug fever (n=66); less frequent side effects included headache, breast tenderness, and vasomotor symptoms (n=13, 1, and 1, respectively). The midtrimester patient results compared favorably with results of studies using saline for abortifacient. The number of first trimester patients was too small to yield any conclusion.
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PMID:Vaginally administered prostaglandin E2 as a first and second trimester abortifacient. 111 58

The methods used presently for abortion of the attacks of migraine and cluster headache are not fully satisfactory which causes that the search for new therapies is continuing. Although the mechanism of migraine attacks remains unexplained, it is thought that an important role in it is played by serotonin receptors, vasodilation in certain regions and opening of arteriovenous communications in the head. Sumatriptan is an agonist of 5-HT1 -like receptors and exerts a selective vasoconstricting effect on the arteries of the head, particularly in the rami of the carotid artery. In 1988 the first reports appeared on the effectiveness of the drug in migraine attacks. In the following years extensive, multicentre and international studies of the drug were carried out on over 600 healthy volunteers and nearly 6000 patients with migraine. The studies demonstrated that Sumatriptan was effective in abortion of migraine attacks. After oral administration of 100 mg or subcutaneous injection of 6 mg in nearly 70% of cases the attack regressed or was greatly alleviated, similarly as other symptoms accompanying the headache such as photophobia, nausea, vomiting. Studies were undertaken also on the effectiveness of Sumatriptan in emergency treatment of cluster headache, and good results were again achieved. The tolerance of the drug is good, although in some cases side effects develop, usually transient and mild, among them tingling, feeling of pressure, heat or heaviness of the head or chest, taste change and burning sensation at the site of injection. Sumatriptan, similarly as all novel drugs, requires caution in its use, particularly in patients with coronary heart disease and hypertension, and also in old patients. As yet, the use of the drug in paediatric migraine or in pregnancy is not recommended.
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PMID:[Sumatriptan and its use in treatment of migraine and cluster headaches]. 133 66

Researchers analyzed data on 1572 18-44 year old women attending 1 of 10 institutions in 7 provinces and cities in China to examine the side effects of oral administration of 600 mg RU-486 followed by 1 mg of a prostaglandin (PG05) vaginal suppository and this combination's efficacy in terminating early pregnancy. Incomplete abortion occurred in 4.8% of the women; continuation of pregnancy, in 3.9%. 91.2% of the women experienced a complete abortion, which took an average of 2.4 days. Just 3.3% of the women experienced expulsion before insertion of the PG05 vaginal suppository. 81% expelled the fetal sac within 6 hours after PG05 insertion. 88% of women with complete abortion had bleeding on day 2 or 3 and bled on average 11.7 days. 24.5% experienced bleeding for more than 14 days; the bleeding was heavy for 47.4% of them. 1 women bled so profusely she required 2 blood transfusions. The leading side effects were nausea and vomiting (22.3%), abdominal pain (10.2%), headache and dizziness (4.1%), diarrhea (2.8%), and thirst (1.2%). 79.5-96.2% of subjects considered these side effects to be mild or moderate. The side effects persisted for 17-36 hours. None of the women experienced any serious complications that sometimes occur with intramuscularly injected prostaglandins. 92% of the women who experienced complete abortion considered this method to be at least good. The corresponding figure for the incomplete abortion and failed groups was 26.3% and 41.9%, respectively. The researchers concluded that this combination was effective and safe for termination of early pregnancy. They suggested that health workers counsel the women before treatment to increase tolerance of the mild to moderate side effects.
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PMID:Clinical trial on termination of early pregnancy with RU486 in combination with prostaglandin. 145 16

In addition to oral contraceptives (OCs), the morning-after pill, the minipill, and depot preparations also belong to hormonal contraceptives. The latter two contraceptives have not become established among young women because of inadequate cycle control. For postcoital contraception in Austria, Neogynon and Stediril-D, consisting of 0.05 mg of ethinyl estradiol (EE) + 0.25 mg of levonorgestrel, are used within 48 hours of unprotected intercourse. Lower dose OCs have considerably reduced the risks of side effects. Micropills are the optimal OCs with EE under 50 mcg combined with the new generation of gestagens. The beneficial effects include menstrual regularity and the prevention of anemia, ovarian cysts, and fibrocystic mastopathy. Nausea, headache, spotting, and weight gain do occur in individual cases, even among young people. The potential risk of thromboembolism is the most important, although arterial cardiovascular risk is minimal in young age. The probability of postpill amenorrhea is less than 1%. Micropills can be used by young diabetics provided the disease is not beyond 10 years' duration and there is no angiopathy. Acne, seborrhea, and hirsutism are beneficially influenced by a combination of 0.035 mg of EE with 2 mg of cyproterone acetate. The relative risk of endometrial and ovarian cancer are only about half as high among OC users as among nonusers. The risk of breast cancer in young OC users has not been conclusively explained. Regular colposcopy and cytology is recommended for young OC users to preclude the risk of malignancies of the genital tract. Sex education and the use of OCs that are the most suitable and effective for young people can reduce the number of unwanted pregnancies and abortion. The comparison of two 5-year periods in the 1970s and 1980s at the University Obstetrical-Gynecological Clinic in Graz showed that the incidence of births among women under 18 years of age decreased from 3.6% (778) to 1.6% (353).
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PMID:[Benefits and risks of hormonal contraception]. 146 64

Researchers analyzed data on 80 pregnant women seeking a 2nd trimester abortion due to fetal abnormalities at the Federico II Medical School at the University of Naples in Italy to determine the effectiveness and side effects of 2 different prostaglandin analogues and their ability to bring about cervical ripening and uterine contractions. 40 women received 1 mg Gemeprost every 3 hours up to 5 mg in vaginal suppository form while the other 40 women who tended to be primigravidae received an intramuscular injection of 500 mcg Sulprostone every 4 hours up to 2000 mcg. Sulprostone achieved an 85% success rate and Gemeprost achieved an 82.5% success rate. Complete abortion occurred more quickly for multigravidae patients than it did for primigravidae patients (in hours, 10.6 vs. 16.5 for Gemeprost, p.1; 9.83 vs. 15.65 for Sulprostone, p.01). There was no statistically significant difference between the 2 treatment groups, however. Side effects were more common among Sulprostone patients than among Gemeprost patients (40% vs. 22.5%). The most common side effects among Sulprostone patients were, in descending order, abdominal pain (75%), diarrhea (50%), and nausea (50%). For Gemeprost patients, they were abdominal pain (55.5%) and headache (44.4%). In terms of uterine contractility, Sulprostone brought about hypertone more quickly than did Gemeprost (in minutes, 18.32 vs. 36.75; range 10-30 vs. 25-50). Gemeprost treatment was more like physiological labor than was Sulprostone treatment. Both prostaglandin analogues produced similar histological and ultrastructural findings of cervical ripening. These results indicated that the women were better able to tolerate Gemeprost.
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PMID:Uterine motility and cervical ripening in second trimester elective abortion by two different PGE analogues. 179 Jun 8

Oral contraceptive (OCs) which are highly effective, simple to use, and reversible, are used by 50 million women globally. In Germany 37.1% of women used them in 1985. Recently their acceptance has declined because of the fear of side effects such as cancer, thrombophlebitis, and frigidity. Other negative factors are opposition of partner, religious views, inconvenience of daily intake, negative reports from the press, discussion by family physician, and anxiety about complications in the offspring. Psychological and psychosomatic side effects very from 1% to 56%. Most are psychovegetative symptoms: headache, sweating, heart disorders, gastrointestinal tract (GI) disorders, nausea, and sleep disturbance. Psychological symptoms include increased irritability, impulsiveness, affective lability, anxiety, depressive feelings, reduced libido, and sexual disorders. Unconscious and ambivalent feelings about wanting a child and problems with the partner can result in forgetting to take the pill. Inhibitions, shame, guilt, and repressed feelings about sexuality lead to a sense of victimization in the form of pregnancy. The Catholic Church holds the view that contraception and abortion are unnatural as enunciated in a 1968 encyclical on human life. Conflicts with the partner can be resolved by compromise and by medical counseling of both parties. True psychopathological disorders have to be distinguished from the psychological problems of healthy people. The soundness of the physician-patient relationship is essential for contraceptive counseling and for resolving such conflicts.
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PMID:[Psychosomatic aspects of oral contraception]. 179 82

From September 1982 to June 1987, all members (N = 513) of the Group Health Cooperative of Puget Sound, Seattle, Wash, who were prescribed isotretinoin for acne were observed throughout the first 4- to 5-month course of therapy for effectiveness and adverse effects. The highest rates of use were among male subjects aged 15 to 24 years. Excluding 47 subjects whose prescriptions were stopped because of noncompliance or who left the care of Group Health Cooperative physicians, 39 (8.4%) of the remaining 466 discontinued taking the drug because of the following adverse effects: mucous/skin/musculoskeletal effects (17); elevated triglyceride levels (eight); headaches (five); increased liver enzyme levels (three); amenorrhea (two); and other (four). One subject, excluded from the 466 because of noncompliance, became pregnant while using medication from a previous prescription and had a therapeutic abortion; she was not under the care of a physician at the time of pregnancy. Most subjects (97%) developed a mucocutaneous symptom, and 42% developed musculoskeletal symptoms. Moderate elevations in liver enzyme levels developed in six (1.8%) of 341 subjects with normal baseline values. Of 389 subjects with normal baseline triglyceride values (less than 2.25 mmol/L), nine (2.3%) developed moderate elevations (4.5 to 9.0 mmol/L), and one (0.3%) developed a severe elevation (greater than or equal to 9.0 mmol/L). Of 24 subjects with elevated baseline triglyceride levels, three (12.5%) developed moderate elevations. Of an additional 53 subjects whose baseline serum triglyceride levels were not determined, two developed elevations during therapy, one up to 13.4 mmol/L. Subjects who were overweight or had elevated baseline serum triglyceride values had an increased risk of developing elevations in triglyceride levels during therapy (odds ratio, 6.0; 95% confidence interval, 1.6 to 22.0; and odds ratio, 4.35; 95% confidence interval, 0.9 to 20.2, respectively). Acne was improved for at least 94.0% of subjects.
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PMID:An observational study of isotretinoin recipients treated for acne in a health maintenance organization. 182 96

Nursing management of second trimester abortion by PGE2 suppository after cervical dilatation with laminaria or Lamicel focuses on monitoring and treating side effects, managing pain, and supporting the patient emotionally. Mean abortion time by this method is 15-17 hours, within 24 hours in 80% of women. The side effects expected from PGs are nausea, vomiting, abdominal cramps, and diarrhea. Premedication with transdermal scopolamine, and ancillary methods such as giving ice chips, airing the room, keeping the patient clean are helpful. Acetaminophen is given orally or rectally for fever, headache, or chills. A beta-adrenergic tocolytic drug such as ritodrine HC1 is given if uterine contractions become tetanic, contractions 2-3 per minute or lasting longer than 6-90 seconds, detected by palpation. This drug must be used with caution in patients with asthma. Pain management in midtrimester abortion depends solely on the woman's comfort. Meperidine, morphine, epidural anesthesia with bupivacaine, lidocaine or morphine SO4, or patient-controlled anesthesia may be used. The nurse should monitor side effects such as hypotension, allergic responses, arrhythmias, and inability to void. Midtrimester abortion is often a stress-filled experience, since women may be ambivalent upon learning of fetal abnormalities. The women should be monitored after delivery to ensure that her uterus remains contracted, and assisted if surgical removal of retained products is necessary. Patients teaching for discharge, including medication to prevent lactation, is described. A care plan is suggested for assisting the family with bereavement, based on that used in case of stillbirth or neonatal deaths.
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PMID:Second-trimester termination of pregnancy: nursing care. 156 89

A case of tetanus occurring after induced abortion is reported. The patient gave a history of low grade fever with chill and rigors, headache, neck pain and Trismus. She subsequently developed respiratory distress. However, incorrect information from the patient resulted in the delay to locate and eradicate the source of infection. Early referral to an intensive care unit for ventilatory assistance was the most appropriate step to save the patient. Complications which occurred during the course of the disease were sometimes difficult to overcome. These complications were probably related to the duration of stay in the intensive care unit. Their incidence could be reduced by more meticulous patient care.
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PMID:Tetanus after induced abortion--a case report. 215 60

Abortion was attempted in 316 healthy women in early pregnancy within 7 weeks with the RU486 alone (600mg in a single oral dose) or in combination with a PG (15-dl-methyl-PGF2 alpha-methyl-ester) 1 mg suppository. The result of using RU 486 alone in 204 women was complete abortion 65.2%, incomplete 3.4% and continued pregnancy 31.4%. While RU486 and PG in 112 women resulted in complete abortion 87.5%, incomplete 8.9% and continued pregnancy 3.6%. The complete abortion rate of RU486 and PG was significantly higher than that of the RU486 alone (P less than 0.01). In RU486 and PG group, the measured mean blood loss after complete abortion (52.0 ml) was much less than in the RU486 alone (177.4ml). The main side-effects were nausea vomiting and headache. The RU486 and PG is an effective and safe agent for termination of early pregnancy. However, it should be used only under close medical supervision.
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PMID:[Termination of early pregnancy using RU 486 alone or in combination with prostaglandin. The RU 486 Collaboration Group]. 218 10


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