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

This study was undertaken to help formulate standardized dosage schedules of intraamniotic prostaglandin F2alpha (PGF2alpha) with respect to time to abort, completeness of abortion, and incidence and severity of side effects. The subjects were 100 healthy volunteer pregnant women (aged 14 to 42, gestational age 16 to 22 weeks) seeking abortion. 52 were nulliparous. There were 67 black patients and 33 whites. Blood studies and treatment urinalysis were performed. A test dose of 5 mg PGF2alpha (THAM salt) was given followed by saline to clear the catheter of the drug. Different protocols were formulated with respect to subsequent dosage. Oxytocics and laminaria were used where necessary. The first 10 patients (Group 1) were given a loading dose of 20 mg PGF2alpha and subsequent doses. There were 6 complete abortions and 4 incomplete abortions. Average time to abortion was 26 hours. Group 2 (n=10) was treated with an initial dose of 30 mg and another dose of 25 mg at 12 hours. There were 6 complete, 1 incomplete, and 3 failed abortions; average time to abortion was 25 hours. Group 3 (n=40) was given an initial dose of 30 mg, followed by 25 mg at hour 6, 30 mg at hours 18-24 and 25 mg at hours 24-30. There were 28 complete, 11 incomplete, and 1 failed abortion; average time to abortion was 21 hours. Group 4 (n=20) was given a large loading dose of 40 mg with no further therapy for 18-24 hours. There were 11 complete and 9 incomplete abortions; average time to abortion was 21 hours. Group 5 (n=20 gravidas) was treated with a loading dose of 40 mg followed by 20 mg in 6 hours and 40 mg after 24 hours. There were 14 complete, 5 incomplete, and 1 failed abortion. Overall, 65 patients aborted completely and 30 incompletely, giving a total of 95 successes in 100 patients. 40 had diarrhea and 8 had vomiting. There were no statistically significant linear regression between time to abort and patient age, parity, or gestational age. A comparison of nulliparous and parous patients in Group 5 showed a near significant difference in mean interval time to abort at p 0.05 level. A comparison of PGF2alpha with hypertonic saline shows little difference between the 2 methods with respect to proportion of complete abortion. 15-methyl analogues may reduce the high incidence of vomiting and diarrhea in the PGF2alpha method.
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PMID:Intra-amniotic prostaglandin F2 alpha to induce midtrimester abortion. 472 75

In order to evaluate luteolytic activity, prostaglandin F2alpha (PGF2alpha) was administered intravaginally to 7 women in doses ranging from 125 to 400 mg during the late luteal phase of the cycle. The women ranged in age from 22-28 years. The women, with a history of regular menstrual cycles, were studied during 3 menstrual cycles (2 control and 1 treatment). Cycles were monitored by basal body temperature and daily blood samples from day 10 of the cycle to the day of menses. 24 and 48 hours following treatment with prostaglandin F2alpha, each woman received 3000 and 6000 I.U. of human gonadotropin (HCG) intramuscularly. Although there was a transient decrease in 5 subjects, progesterone levels increased after the HCG. The length of the cycle was prolonged significantly in 5 of 7 subjects. Slight vaginal bleeding was noted in 2 subjects immediately following treatment. 2 women experienced severe vomiting and diarrhea. The chemical profile in all 7 patients was unaffected by PGF2alpha administration.
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PMID:The effect of vaginally administered prostaglandin F2alpha on corpus luteum function. 472 75

Clinical investigation was carried out into the coagulation and fibrinolytic systems in a series of patients undergoing intraamniotic instillation of dinoprost tromethamine (prostaglandin F2alpha, or PGF2alpha) for 2nd-trimester abortion. 20 healthy women, aged 14-27 years, were studied. The 1st 8 patients received PGF2alpha, 30 mg at hour 0 and 25 mg at hour 6 and again at hour 24 if needed. The last 12 patients received 30 mg at hour 0, and 25 mg at hour 8, 24, and 32 if necessary. The PGF2alpha used did not contain sodium chloride. 18 of the patients aborted in an average of 16 hours and 7 minutes; 2 required additional procedures. Some vomiting and 1 instance of fever but no other significant side effects were noted. Coagulation studies in these patients were normal. The prothrombin time, thrombin time, euglobulin lysis time, and plasminogen levels were normal and unchanged from the control blood value. Plasma fibrinogen concentration increased slightly 6 hours after the initial infusion of PGF2alpha. Red blood cell fragmentation was not observed at any time during labor, delivery, or the postpartum period. The increased white blood count was statistically significant but without clinical significance. Previous studies have shown that use of saline solution to achieve abortion causes alterations in the coagulation and fibrinolytic systems. This study with PGF2alpha showed no such effects.
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PMID:Abortion and coagulation by prostaglandin. Intra-amniotic dinoprost tromethamine effect on the coagulation and fibrinolytic systems. 474 Jun 10

132 physically health patients (aged 12-41 years; 12-21 weeks gestation) were given intraamniotic PGF2alpha (prostaglandin F2alpha) for induction of midtrimester abortion. Analgesic agents and antiemetics were administered intramuscularly as needed. The patients were grouped as follows: 1) Group A (n=48), those who were given an initial dose of 25 mg PGF2a, then as needed; 2) Group B (n=43), initial dose of 30 mg, 25 mg at hour 6-8, and 25 mg at hour 24; 3) Group C (n=17), initial dose of 40 mg, subsequent 40 mg if unaborted at hour 24; and 4) Group D (n=24), initial dose of 40 mg, 10-25 mg at hour 6-8, additional 20 mg if unaborted at hour 24. A 94.7% incidence of abortion was achieved. In Group A, 29 had complete abortion, 16 incomplete, and 3 failures. Group B had 32 complete abortions, 8 incomplete, and 3 failures. Group C had 9 complete, 7 incomplete, and 1 failure. Corresponding figures for Group D were 19, 5 and 0 respectively. Average time to abortion ranged from 13 hours 22 minutes to 25 hours 33 minutes. The primary side effects of PGF2a were gastrointestinal (vomiting, diarrhea). 70% of patients vomited and 13.6% became febrile. Serious complications included sepsis, systemic reaction to prostaglandin, and cervical laceration. Advantages of intraamniotic PGF2a include ease of administration; generally short injection-abortion time; and its ability to induce myometrial contractions regardless of gestational size. However, the safety, convenience, and acceptability of PGF2 are yet to be established. The following guidelines are suggested for minimizing complications: 1) a test dose of 2.5 mg should be administered slowly over at least 1 minute, 2) fever should not be attributed to drug reaction but considered as suggestive evidence of developing infection, 3) patients unaborted at hour 24 should be considered as high risk with respect to potential failure to abort, development of infection, or cervical laceration, and 4) cervical inspection should be performed, especially in the nulliparous patient with a later gestation and a long labor.
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PMID:Experience with intra-amniotic prostaglandin F2 alpha for abortion. 474 58

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.
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PMID:Prostaglandins as abortifacients. 512 46

The efficacy and acceptability of PGF2alpha (prostaglandin F2alpha) as an abortifacient has been examined during intravenous infusion in 15 obstetrically normal midtrimester patients. Infusions of up to 200 mcg/minute of PGF2alpha induced complete abortions in 3 and incomplete abortions in an additional 3 patients. 4 patients failed to abort. All patients experienced undesirable side effects, i.e., nausea, vomiting, and diarrhea, in various degrees. This form of therapy cannot be recommended for routine therapeutic use; however, current clinical studies complemented by model experiments in animals suggest that the efficacy and acceptability of PGF2alpha can be increased by topical, intrauterine administration. Preliminary deductions pertinent to the mechanism of the abortifacient effect of PGF2alpha have been made based on measurements of intraamniotic pressure, circulating estradiol-17 beta, and progesterone levels.
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PMID:The efficacy and acceptability of intravenously administered prostaglandin F as an abortifacient. 512 60

Prostaglandin F2 alpha was administered intravenous drip in 130 patients with missed, incomplete inevitable and septic abortion, intrauterine death and vesicular mole and for therapeutic termination of midtrimester pregnancies. In 84 patients (control group), no prophylactic antiemetic or antidiarrheal drugs were administered, while in 46 patients (study group), an antiemetic (prochlorperazine) and an antidiarrheal (diphenoxylate hydrochloride with atropine sulfate) drug were administered prophylactically before and during prostaglandin infusion. The incidence in vomiting and diarrhea was statistically much less in the study group (P less than 0.0005 for vomiting and P less than 0.005 for diarrhea). There was no statistically significant difference in the success rate of prostaglandin induction in the two groups.
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PMID:Prophylaxis against prostaglandin-induced gastrointestinal side effects. 612 32

The clinical characteristics and applicability of vaginal administration of a single suppository of (15S)-15-methyl prostaglandin F2alpha (PGF2alpha) methyl ester in postconceptional induction of menses was evaluated in 14 healthy women who were no more than 7 weeks pregnant and desired pregnancy termination. Each suppository contained 3.0 mg of 15S-15-methyl PGF2alpha methyl ester in a 2.2 gm base of Witepsol E-76-A. Blood samples were collected at 0, 4, 8, and 10 hours and again at the 14th day follow-up visit for analysis of serum chorionic gonadotropin (HCG) levels using the Beta subunit radioimmunoassay as described by Vaitukaitis et.al. and serum progesterone levels using the radioimmunoassay method of Kirton et.al. Pregnancy termination was successful in all but 1 patient. Vaginal bleeding persisted for at least 14 days in 8 cases; 2 of these patients necessitated curettage at 4 weeks and 9 weeks after the procedure. The failed case was an obese woman whose pregnancy persisted. HCG levels declined below the arbitrary limit of 1 I.U./ml within 2 weeks after therapy in 36% of the cases. Plasma progesterone levels declined below the baseline level of 5 ng/ml within 2 weeks. A wide range of values was observed at 4 and 8 hours. The 1 failure case had an initial value of 72 pg/ml at 4 and 8 hours; all cases with undetectable levels at 8 hours had initial values over 138 pg/ml. In patients with prolonged bleeding, serum HCG and progesterone showed a significantly slower decline than in patients with an uneventful abortion. Diarrhea occurred in 86% of the cases and vomiting in 36%. The study illustrates the effectiveness of administration of 1 vaginal suppository containing 3.0 mg of PGF2alpha methyl ester in 1st trimester abortion. However, the bleeding and gastrointestinal side effects associated with this method preclude its widespread use.
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PMID:Post-conceptional induction of menses with a single vaginal suppository of (15S)-15-methyl prostaglandin F2 alpha methyl ester. 625 75

To facilitate postoperative flatus, Prostaglandin F2 alpha (PGF2 alpha) was given intravenously to 23 patients who underwent urological operations. The patients were 14 males and 6 females aged from 20 to 77 years old. Patients with hypertension or cardiovascular disease were not included. Twelve operations were performed under general anesthesia, and 8 under epidural anesthesia. Thirteen operations were performed for the upper urinary tract or adrenal gland, and 5 were for the lower urinary tract. In 2 cases, the peritoneal cavity was opened and operations were performed on the intestines. PGF2 alpha 2000 micrograms was added to the postoperative drip infusion and administered in 2 to 3 hours. Until the first flatus was recognized, PGF2 alpha was given once a day in the same manner. Twenty-six patients, 10 of whom were given either vagostigmine or pantothen postoperatively, served as the control group. PGF2 alpha accelerated the postoperative flatus by 8.7 hours (mean) compared with the control group, but it was not significant. The onset of flatus was significantly promoted under epidural anesthesia. Gastrointestinal movement tended to be facilitated in the PGF2 alpha group after lower urinary tract surgery and in the patients over 50 years old. Three patients complained of severe abdominal pain as a side effect; and, injection of PGF2 alpha was stopped. In 7 patients, mild stomachache , vascular pain, nausea, vomiting or elevation of blood pressure were observed.
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PMID:[The effect of prostaglandin F2 alpha on the gastrointestinal movement after urological surgery]. 658 61

Changes in the external and internal cervical os after vaginal administration of a suppository containing 1 mg of 15-methyl prostaglandin F2alpha (PGF2alpha) were differentiated in this study of 19 pregnant women prior to a 1st trimester pregnancy termination. Mean age of the women was 20.6 +or- .99, mean parity was .68 +or- .2, and mean gravidity was 2.32 +or- .54. Pregnancies averaged 10 weeks duration. Cervical dilatation before administration averaged 6.89 +or- .45 mm in the external os and 3.37 +or- .43 in the internal os; compared to 10 +or- .44 mm in the external os and 8.05 +or- .57 mm in the internal os 3 hours after administration of suppositories. Mean additional dilatation prior to the procedure was 1.84 +or- .43 mm. 74% of the women experienced diarrhea, 37% had vomiting, 27% cramps, 21% nausea, 26% vaginal pain, and 26% bleeding prior to the procedure. The greater dilatation of the internal os found in the study is comparable to the behavior of the cervix in the uterus near term when lower segment changes often precede the dilatation of the external os.
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PMID:Internal and external cervical os dilation with vaginal 15-methyl prostaglandin F2 alpha. 684 41


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