Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent research suggests that the action of prostaglandins on the pregnant uterus is more complex than that of oxytocin. Despite the fact that prostaglandins, like oxytocin, may fall short of the ideal, preliminary work makes it apparent that prostaglandins have attributes for induction of labor that will ultimately rank them as far superior to oxytocin. A 1st sign that prostaglandins might be more than just oxytocic agents came from the discovery of the effectiveness of prostaglandin F2alpha (PGF2alpha) and prostaglandin E2 (PGE2) in inducing mid-trimester abortion. For a long time it has been known that oxytocin seldom causes abortion of a normal pregnancy. Prostaglandins cause rapid dilatation of the cervix and expulsion of the conceptus despite a lesser degree of measurable uterine activity than that induced by oxytocin. Prostaglandins do something more, either to the quality of uterine contractions or to the cervix. A major problem associated with the pharmacological use of prostaglandins has been a high incidence of unpleasant side-effects when given by routes that are associated with substantial systemic uptake. In general, doses of prostaglandins that are oxytocic result in nausea, vomiting and diarrhea when administered by the intravenous, oral or intravaginal routes. The intra-amniotic and extra-ovular routes of administration for induction of mid-trimester abortion, as described by Doctors Karim and Hillier, are examples of the successful application of the principle that prostaglandins can be effective without side-effects when they are delivered close to the site of action. Prostaglandins appear particularly well suited to induction of labor in women with prolonged fetal death, anencephaly or hydatidiform mole.
 ...
PMID:Prostaglandins: current therapeutic status in obstetrics. 443 69

The present study was made to evaluate the efficiency of intraamiotically administered prostaglandin F2alpha upon unselected consecutive patients, hospitalized for legal abortion after the 12th week of pregnancy. In the first series, 178 cases were studied and in these the initial dose was related to the size of the uterus, i. e. 25 mg at 13 weeks, up to 40 mg at 24 weeks. A repeat injection of the same dose was required in 21% of the cases. Abortion occurred in 53% within 24 hours and in 81% within 48 hours. The mean abortion time was 32.3 hours. No failures occurred. In the second series, 73 patients were given an initial standardized dose of 40 mg irrespective of the size of the uterus. A repeat injection of 40 mg was given in 11%. Abortion occurred in 67% of the cases within 24 hours and in 80% within 48 hours. Four cases (5%) were failures. The mean time until expulsion of the fetus was 24.3 hours. Side effects in the form of vomiting and/or diarrhoea occurred about 2 times per patient in both series. In 20-30% a blood loss was sustained of more than 500 ml. Rupture of the cervix occurred in 3 cases. In both series multigravidae aborted faster than primigravidae. Early rupture of the membranes before the cervix was effaced caused very long abortion times in several cases.
 ...
PMID:Intraamniotic administration of prostaglandin F2alpha for therapeutic abortion. 453 96

This study determines the efficacy and incidence of side effects associated with intravaginal prostaglandin F2alpha (PGF2alpha). 20 healthy patients (16 to 30 years of age; 9-16 weeks gestational age) with no history of threatened abortion in the current pregnancy were studied. Baseline hematologic, metabolic, urinary, and hormonal studies were conducted. Transabdominal amniocentesis was performed in 7 patients. The uterus was observed for spontaneous contractility. Lactose tablets with 50 mg PGF2alpha (THAM salt) were administered vaginally. The intensity and frequency of uterine contractions in the 7 monitored patients determined the treatment regimen. Prostaglandin tablets were inserted at hourly intervals to maintain frequency of contractions at 5 per 10 minute time interval and/or intensity of contractions greater than an average of 40 mm Hg over a 10 minute-period. 13 patients whose uterine activity during the abortion process was assessed by clinical observation were given a similar time schedule. Blood studies were peformed 6 hours after the onset of therapy and immediately following abortion. Analgesia were used intramuscularly as antiemetic agents where necessary. Prepared questionnaires and personal interviews were completed at the 4-week clinic visit to determine patient acceptability of the method. 19 of 20 patients aborted, with 7 classified as complete and the remaining 12 requiring a uterine exploration and curettage for removal of retained placental fragments. Average induction-complete abortion interval was 17 hours and 50 minutes. There was no difference between multiparous and primiparous patients. In 1 patient who failed to abort with the prostaglandin tablet, administration of 900 mg PGF2alpha and hypertonic saline were used to facilitate abortion which occurred 24 hours later. Emesis occurred in 18 patients, diarrhea in 13, and fever in 11. Of 15 patients who agreed to an interview during the clinic visit, 14 stated they would choose the method again. Vaginal administration of PGs appears to exert effects by systemic, rather than by local mechanism. Although this method is effective, it has a high incidence of side effects and is associated with increased utilization of professional time.
 ...
PMID:Abortifacient efficacy of intravaginal prostaglandin F2 . 468 31

This paper reports on the 1st experiences with extraamniotic administration of prostaglandin F2alpha (PGF2alpha) in induced abortion. It was found that the average dose in 30 primigravidae and 32 multigravidae was approximately equal. The average time of application was 28 hours 30 minutes in the 1st group and 24 hours 40 minutes in the 2nd. In 11 cases, PG application was followed by oxytocin infusion. The method proved successful in 83.5%; partial success was achieved in 15% of the cases. As partial successes, those cases in which the cervical channel was not completely opened, the evacuation of the uterus with instruments was still achievable without difficulty. 1 failure was observed. The highest doses were needed between weeks 13-16 of pregnancy (the small numbers did not allow the computation of statistical significance). Side effects were remarkably low (e.g., nausea, vomiting, profuse perspiration). A temporary rise in temperature above 38 degrees Celsius was noted in 8 women. Compared with reports from the literature, the dose, number, and degree of side effects were lower than those found with intravenous administration. In contrast to other authors, we administered single doses up to 2000 mcg, at which time the application should be diminished. (author's)
 ...
PMID:[Initial experiences with prostaglandin F2 in induced abortion]. 471 51

An unnatural prostaglandin (PG) (prepared by biosynthesis using the method described by Vonkerman et al.) was used to terminate midtrimester pregnancy in 3 primiparous patients aged 21-24. The PG was administered intravenously using a Palmer slow infusion pump. The patients were monitored continuously with particular attention given to pulse, respiration, blood pressure, uterine contractions and cervical dilatation. All 3 cases successfully aborted. Effective infusion rate was similar to that of PGE1 and PGE2 (5-6 mcg/minute) and side effects were trivial (minimal skin flushing, vomiting, mild urticarial reaction). 2 of the patients aborted 8 and 22 hours after infusion stopped without being conscious of continuing uterine activity; the 3rd patient necessitated infusion on the 2nd day and exhibited increased response to the infusion; however, the PG supply was exhausted and syntocinon infusion facilitated the complete abortion. This study shows that this synthetic prostaglandin containing an uneven number of carbon atoms is pharmacologically active and can induce contractions in the intact human pregnant uterus.
 ...
PMID:The use of an "unnatural" prostaglandin in the termination of pregnancy. 555 13

This is a case report of a serious complication that occurred about 5 weeks after the insertion of an IUD. The patient, a 34 year old Caucasian woman, gravida 7, para 5 and abortions 2, was admitted to the hospital for chills, fever, abdominal pain, nausea, vomiting and diarrhoea which began 3 days prior to admission. Menstrual flow had begun 10 days earlier and had increased. Twenty-four hours before admission patient had become disoriented and confused. The Saf-T-Coil 33-S was removed from the uterus. Bacterial cultures were taken from the cervical canal. The uterus and adnexa were tender. There were no pelvic masses. Laboratory tests were not revealing. X-ray of the abdomen was compatible with paralytic ileus. The patient was treated for 3 days with intravenous antibiotics and other supportive measures. On the fourth day a duldo-centrisis yielded gross pus but smears and cultures showed no pathogenic organisms. A laparotomy was performed and a purulent fibrinoid exudate was found covering the uterus and adjacent intestines. No uterine perforation was present. Cultures from the cervix, bloodstream, urine and pus grew no pathogenic organisms. Other organs appeared normal. After a difficult convalescence, patient was discharged in the twenty-second day.
 ...
PMID:Severe peritonitis complicating an intrauterine contraceptive device. 556

In the etiology of premature labor prostaglandins fulfill a significant role. It is known that indomethacin is a strong inhibitor of prostaglandin synthesis. The effect of indomethacin on premature labor was studied in a prospective randomized double-blind study in 36 patients. Eighteen patients received indomethacin and eighteen received placebo. 200-300 mg of indomethacin was the total dosage in a 24 hours period. The activity of the uterus was monitored with a cardiotocograph. The mean duration of pregnancy and the mean birth weight in indomethacin group (36.4 weeks, 2833 g) were both significantly greater (p less than 0.001) than that in placebo group (31.2 weeks, 2028 g). In the indomethacin group 3 children weighted less than 2500 g compared with 14 in placebo group. In 15 of 18 indomethacin treated patients (83.3%) premature labor was arrested after indomethacin treatment compared with 4 of 18 in the placebo group (22.2%). The indomethacin group had a mean 1 minute APGAR score of 9.3 +/- 0.2 whereas the placebo group showed a score of 7.8 +/- 0.5 (p less than 0.01). Three infants died from respiratory distress syndrome; one in the indomethacin group (1810 g) and two in the placebo group (600 and 1450 g). Autopsies in the infants demonstrated a typical picture of pulmonary atelectasis and hyaline membranes. There was no evidence of premature closure of the ductus arteriosus or pulmonary hypertension. 2 mothers in the indomethacin group suffered minor discomfort i.e. nausea, vomiting and vertigo.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Further study of the inhibition of premature labor by indomethacin. Part II double-blind study. 637 98

A randomised controlled clinical trial compared ergometrine 0.25 mg, syntocinon 10 mg and normal saline injected intravenously during evacuation of the uterus after spontaneous abortion showed no difference between any drug with respect to uterine contraction, change in blood pressure, blood loss or postoperative vomiting.
 ...
PMID:Oxytocic drugs and anaesthesia. A controlled clinical trial of ergometrine, syntocinon and normal saline during evacuation of the uterus after spontaneous abortion. 638 11

This study evaluated the effectiveness of extraovular .1% ethacridine lactate alone and edacridine lactate plus spartein sulfate in midtrimester pregnancy termination. In the 60 cases where ethacridine lactate alone was administered, 50 cases aborted within 48 hours of instillation (83.3% success rate). Of these 50, 25 aborted within 24 hours (41.7%). Abortion was complete in 45 cases. The time of onset of uterine contractions ranged from 1 hour to 16.5 hours, with a mean 21-1/4 hours. The mean time of membrane rupture in the series was 23 hours and the induction-abortion interval averaged 27-1/4 hours. Side effects included vomiting (18.3%), shivering (16.6%), fever (3.3%), cervical injuries (6.6%), and excessive blood loss (1.7%). Blood loss until expulsion of the fetus averaged 54.1 ml, and blood loss up to 4 hours after abortion averaged 115.1 ml in cases of complete abortion and 219 ml in cases of incomplete abortion. In the 90 cases where both ethacridine lactate and spartein sulfate were used, 76 aborted within 48 hours (success rate 84.6%) and 40 aborted within 24 hours (44.4%). Abortion was complete in 75% of cases. The abortion-induction interval ranged from 4 hours to 47-3/4 hours, with a mean of 28-1/2 hours. These results, which are comparable to those obtained in other studies, indicate that extraovular ethacridine lactate alone appears to be a safe, efficient, and relatively inexpensive method of midtrimester abortion. Although there were fewer reports of side effects in the group that received spartein sulfate, use of this compound does not reduce the induction-abortion interval. The relatively low incidence of side effects such as vomiting and diarrhea, the antiseptic properties of ethacridine lactate, and the absence of serious complications such as rupture of the uterus and cervicovaginal fistula are advantages of the ethacridine lactate method that nullify the disadvantage of its slightly prolonged induction-abortion interval.
 ...
PMID:Termination of midtrimester pregnancies with extraovular 0.1% ethacridine lactate. Accurate method for estimation of blood loss. Role of spartein sulfate. 647 6

The case of small bowel incarcerated within the uterine cavity following a legal abortion is presented. The case, a 26-year old woman, gravida 5, para 4, was aborted with a rigid-type plastic suction cannula at 13 weeks after her last menstrual period. During the 1st hour after the procedure, the patient developed severe abdominal pain and vomiting. The uterus was felt to be 18 weeks in size, firm, and tender. Sonographic examination revealed multiple well-defined round cystic structures within the uterine cavity. At laparotomy, incarcerated and partially gangrenous small intestine was found in an intrauterine location. The perforation had occurred in the anterior fundal region, distant from the uterine scars from the case's 4 previous cesarian sections. This case illustrates a rare and serious complication of abortion and demonstrates the utility of sonography in postprocedure symptomatic patients. No other such cases have been reported in the literature.
 ...
PMID:Intrauterine incarcerated bowel following uterine perforation during an abortion: a case report. 665 Jun 37


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>