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)

In this study of 20 patients in the 13th-17th week of pregnancy abortion was induced with intrauterine, extraamniotic application of prostaglandins (PG) E2 or F2 in gel form. The gel composition was as follows: 4% tylose MH 300, 2% glycerine, 1% chlorhexidine digluconate, 83% sterile distilled water and 10% PG stock solution. Both PGE2 and PGF2 gels were used. Final concentration was 2.5 mg E2 or 2.5 mg F2 per g of gel. Gel was applied via transcervical, extraamniotic polyethylene catheter every 2-3 hours. Results: PGE2-gel was used in 14 cases. After 3-4 applications both fetus and placenta were expelled. Average dose used was 4.6 mg E2/patient. First contractions started in 30 minutes; induction to expulsion time was 11 hours 35 minutes. F2-gel given to 6 patients resulted in expulsion of the fetus in all cases but placenta needed removal by curettage in 4 patients. Average dose per patient was 17.7 mg of F2; first contractions in 30 minutes, average expulsion time 17 hours 38 minutes. With both PGs there were painful contractions which were controlled with a combination of pentazocine and Valium. PGE2 caused vomiting in 5 patients. No increased bleeding or postabortion infection occurred. Follow-up curettage was done in all patients to ensure removal of all tissues. Overall evaluation of the PG-gels was considered good. PG stability in gel form is good; during 8 months of preservation in sterile aluminum tubes at -25 degrees Celsius no decline in clinical effectiveness was noted. The gel application is less expensive than the slow-injection pump method.
 ...
PMID:[Induced abortion using prostaglandin E2 and F2alpha gel]. 447 6

The clinical advantages and disadvantages of intra amniotic administration of PGF2alpha in comparison with hypertonic saline has recently been summarized by the Prostaglandin Task Force within the World Health Organization Expanded program. The investigation comprised approximately 1,500 patients treated randomly with the two methods. The main advantage of the PG method was a significantly shorter induction-abortion interval and a lesser risk for serious complications and the significant disadvantage a slight increase in the mean frequency of minor complaints in terms of diarrhoea and vomiting. With PGF2alpha it seems difficult to obtain a "one shot" method to terminate second trimester pregnancy even with the intra-amniotic route of administration. The 15-methyl analogues seem more promising in this respect. The uterine response following administration of this compound is characterized by a more gradual initiation of uterine stimulation and a sustained effect, One intraamniotic injection of 2.5 mg 15-methyl-PGF2alpha induced abortion in nearly 100% of the cases and the incidence of side effects was low. Promising results with this compound have also been obtained following a single extra-amniotic instillation or by repeated intramuscular injections. Vaginal administration of 15-methyl PGF2alpha or its methyl ester can also be used for termination of pregnancy. Recently orally active PG analogues have become available for clinical testing. One of these compounds, 16,16-dimethyl-PGE2 may in some cases stimulate uterine contractility sufficiently to induce a second trimester abortion following repeated oral administration.
 ...
PMID:Induction of abortion by different prostaglandin analogues. 453 1

Abortion was induced in a series of 20 patients, in Basel, Switzerland, by administration of prostaglandin formulated in a gel. Patients aged 21-44 years old requesting medical termination of second trimester pregnancy were treated extraamniotically with a dose of prostaglandin; 14 patients received PGE2, and 6 received PGF2 alpha. The PGE2 dose ranged from 2.5-7.5 mg; the PGF2 alpha dose ranged from 15-22.5 mg. Mean induction-abortion intervals were 11 hours, 35 minutes for PGE2 and 17 hours, 38 minutes for PGF2 alpha. Placenta was expelled spontaneously in all 14 patients treated with PGE2; products were retained in 4 of 6 PGF2 alpha-treated patients. In PGE2 patients the average interval between expulsion of the fetus and the placenta was 2 hours; in the PGF2 alpha patients who successfully expelled the fetus, 1-2.7 hours were needed. Side effects included painful uterine contractions, vomiting, and temperature increases to 38 degrees centigrade. All patients were considered successfully induced.
 ...
PMID:Induction of abortion by the extra-amniotic administration of prostaglandin gels. 475 85

This study examines the efficacy of transabdominal intraamniotic injection of prostaglandins (PGs) in therapeutic abortions. Transabdominal amniocentesis was performed under local anesthesia (1% lignocaine) in 27 patients 14-22 weeks pregnant. Uterine activity was monitored. PGF2alpha 25 mg was given as a single intraamniotic injection in the 1st 14 cases. It was given in 3 doses at 24-hourly intervals for 3 successive days in 1 patient. PGE2 was given in 13 patients, 1 mg initially followed by 2 further 1 mg doses at 10-minute intervals. Intravenous oxytocin infusions were used where necessary, as was hysterotomy. Blood samples were collected in 10 patients before and at 4-6 hourly intervals following PGF2alpha administration until abortion occurred, and in 3 patients 40 hours prior to PG administration. A single 25 mg intraamniotic injection of PGF2alpha successfully terminated pregnancy in only 6 of 14 cases. Average-induction delivery interval was 19.52 hours. 6 other patients necessitated intravenous oxytocin infusions to stimulate effective uterine activity; average induction-abortion interval was 59 hours. 2 patients failed to abort, requiring hysterotomy. 7 of 12 vaginally delivered patients had incomplete abortion. Success rate was higher in PGE2-treated patients, with 11 of 13 patients aborting; average induction-delivery interval was 23 hours and 16 minutes. Side effects experienced included severe abdominal pain (for PGF2alpha), vomiting and mild pyrexia (38 degrees Celsius). No consistant change was observed in plasma steroid concentration until after delivery of fetus and placenta occurred. Transamniotic administration of PGE2 appears effective for therapeutic abortion, but not PGF2alpha.
 ...
PMID:Therapeutic abortion by intraamniotic injection of prostaglandins. 480 68

This study examines the efficacy of prostaglandins (PGs) as a postconceptional birth control method. Postconception refers to the period when early pregnancy is suspected but cannot be easily confirmed by clinical findings or by conventional laboratory tests. PG treatment was carried out on an outpatient basis in 80 volunteers a few days following the first missed menstruation (mean of 8 days). The microballoon technique was used to monitor uterine contractility in a limited number of cases. Pregnancy was diagnosed using parallel assays of gonadotropic activity in 2 radioimmunologic systems and by calculating indexes of discrimination. Methods of administration included 1) intravenous infusion of PGF2alpha at a constant rate of 68-78 mcg/minute for a period of 5 hours in 11 patients and 8 hours in 19 patients; 2) vaginal administration (n=30): a concentrated solution of PGF2alpha (50 mg/0.2 ml) or vaginal suppositories (50 mgPGF2alpha or 10-20 mg PGE2) was deposited into the posterior fornix of the vagina of 32 cases; and 3) intrauterine administration (n=18 cases): a single intrauterine injection of PGF2alpha (500 mcg) or 15(S)-15-methyl PGF2alpha (25-400 mcg) in 18 cases. The recorded pattern of contractility in 2 of intravenous PGF2alpha cases, 6 of vaginal administration group, and 3 of intrauterine 15-methyl-PGF2alpha instillation followed a similar course with rapid tone elevation and appearance of frequent small amplitude contractions. 29 of the 80 cases were found not to be pregnant at time of PG administration. During the treatment, 41% of nonpregnant and 70% of pregnant patients developed uterine bleeding. Duration of bleeding averaged 5 to 7 days, range 2 to 28 days. 2 cases required curettage for troublesome bleeding. In the intravenously infused group, 3 of 7 pregnancies were terminated after 5 hours, and 10 of 15 cases after 8 hours. In the vaginal administration group, unsatisfactory results were achieved and all treated cases continued their pregnancies. The intrauterine administration group was successful in 2 of 4 cases. Vomiting and diarrhea were the most distressing side effects of vaginal or intravenous administration. The study illustrates the difficulties of using PGs for postconceptional birth control.
 ...
PMID:Postconceptional fertility control by prostaglandins. 480 70

PGE2 (prostaglandin E2) had been successfully used in initiating labor in term pregnancies (Karim and Sharma, 1971). This study evaluates the safety and efficacy of prostaglandin for induction of labor in 23 patients (gestational length, 38-41 weeks; mean age, 27; age range, 17 to 40; parity 0 to 6). 20 received an oral PGE2 0.5 mg tablet hourly while 3 received an initial dose of 0.5 mg with 0.5 mg incremental increase hourly. 20 patients delivered vaginally liveborn infants without neonatal depression according to Apgar score and subsequent behavior in the nursery. 2 patients delivered by C-section and 1 was excluded from the study because of inadequate duration of treatment. Mean time to delivery was 5 hours, 47 minutes; mean drug dose, 2.53 mg. Mild transient emesis and diarrhea occurred in 2 patients, and emesis only in 1. Bishop induction score did not correlate with total dose of PGE2 used. Parity correlated negatively with dose necessary to achieve delivery (p0.05). The findings confirm the efficacy and safety of oral PGE, which provides an alternate drug and route for induction of labor. Oxytocin induction is briefly compared with prostaglandin induction.
 ...
PMID:Oral prostaglandin E2 for induction of labor. 482 94

This study evaluates the efficacy and safety of PGE2 (prostaglandin E2) tablets for induction of labor in term pregnancy (38 to 42 weeks). 47 women (21 nullipara and 26 multiparae; ages 19 to 29 for nulliparae and 21 to 39 for multiparae) were studied; all were clinically normal according to the criteria of Thiery et al (1971), had intact membranes and mean Bishop scores (Bishop, 1964) of 7 for the nulliparae and 6.6 for the multiparae. In the parous group, the number of previous births ranged from 1 to 5. An initial dose of 0.5 mg PGE2 (1 tablet) was given to all except 1 patient who was given a 0.25 mg PGE2 as a test dose. A second dose of PGE2 was given if after 60 minutes, the recorded myometrial activity was less than 150 Montevideo Units. Subsequent doses of PGE2 (0.5 to 2.0 mg) were given at approximately 2-hourly intervals. Fetal scalp blood sample was collected at full cervical dilatation. 31 patients had spontaneous delivery while 16 patients (11 nulliparae and 5 multiparae) had to have vacuum extraction. The infants were assessed biochemically and clinically by Apgar scores at 1 and 5 minutes. Induction was successful in all except in a 23-year old obese nulliparous female at 40 weeks gestation who had a Bishop score of 5. This patient was given oxytocin infusion 27 hours after the first dose of PGE2; the baby was born following an easy vacuum extraction. Maternal morbidity included 1 to 3 episodes of vomiting in 8 of 21 nulliparae and 3 of 26 parous patients; elevated blood pressure during labor in 2 normotensive parous patients; postpartum hemorrhage which was easily controlled in 1 nullipara; and retained placenta in 1. Test dose to delivery interval ranged from 2 hours and 37 minutes to 18 hours and 29 minutes for the nulliparae and from 1 hour and 57 minutes to 9 hours and 13 minutes for the parous patients. The infants were in satisfactory condition at birth.
 ...
PMID:Induction of labour with prostaglandin E2 tablets. 482 88

Clinical trials have demonstrated the use of prostaglandins as effective abortifacients. Continuous intravenous infusion of the drugs however has been associated with certain side effects at therapeutically effective doses, such as nausea, vomiting, diarrhea and a local erythematous reaction at the site of venepuncture. Higher doses result in more serious side effects such as vasovagal symptoms, pyrexia and tachycardia. Direct application of prostaglandins E2 or F2a into the uterine cavity has been shown to minimize the side effects. Appropriate doses of prostaglandins every one or 2 hours administered at the site of action between the fetal membrane and uterine wall (via the cervix) produce the strong and frequent uterine contractions necessary for the expulsion of the products of conception. A drawback of this method is the need for the uterine cavity to be continuously monitored as dosage is determined by the uterine response. Another effective method of terminating 1st and 2nd trimester pregnacy with minimal side effects is vaginal administration (into the posterior fornix) of 50 mg PGF2a or 20 mg PGE2 every 2 or 3 hours. Single injection of prostaglandins into the amniotic sac usually results in complete abortion. The method is simple but should be used only in pregnancies of over 12 weeks' gestation as the amniotic sac is inaccessible in the 1st trimester. The prostaglandin method, compared with other methods of abortion in the 1st trimester of pregnancy (e.g., suction or dilatation and curettage) is inferior in terms of time, expense and convenience. Incomplete abortion is quite common in the 1st trimester when prostaglandins are used. With respect to 2nd trimester methods (hypertonic saline and hysterotomy) however, prostaglandins given by intravaginal, intrauterine, or intraamniotic routes offer clear advantages.
 ...
PMID:Prostaglandins as abortifacients. 512 46

This paper describes the use of prostaglandins E2 and F2 alpha (PGE2, PGF2alpha) administered vaginally for 1st and 2nd trimester abortion and for labor induction at term. 45 patients (21 were nulliparous) aged 14-42 years with periods of amneorrhea ranging from 7-23 weeks were given PGF2alpha and PGE2 vaginal tablets to be inserted every 2-1/2 hours until abortion occurred. 30 patients received PGE2 (20 mg) and 15 received PGF2alpha (50 mg). All 45 women aborted, with 40 having complete abortion and 5 necessitating evacuation of retained products of conception. Average induction-abortion interval was 13 hours 15 minutes. Time to onset of regular rhythmic uterine activity was between 3-7 minutes. Vomiting occurred in 6 women (3 with PGF2alpha and 3 with PGE2) and diarrhea in 1 (PGF2alpha); maternal pulse and blood pressure were not affected, and blood loss was minimal. Average duration of hospital stay was 24 hours. No apparent complications were reported. Induction of labor at term using the vaginal tablets was attempted in 10 women with intact membranes. 5 women received PGE2 (2 mg) tablets and another 5 received PGF2alpha tablets every 2 hours until labor was established as judged by a cervical dilatation of 5-6 cm and adequate uterine contractions every 2-3 minutes. All the infants were born alive. There were no reported side effects. The vaginal administration of PGs for pregnancy termination is more acceptable and more practical than continuous intravenous infusion.
 ...
PMID:Therapeutic abortion and induction of labour by the intravaginal administration of prostaglandins E 2 and F 2- . 555 12

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


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