Cebu Normal University College of Nursing Osmenia Blvd.
Cebu City 6000 NAS III – Pharmacology, Therapeutics and Diagnostics DRUG STUDY Name of Patient Diagnosis Doctor Drug Data Generic Name misoprostol Trade Name Cytotec Patients Dose pregnancies through nine weeks is the vaginal administrati on of 800µg of misoprostol Classi ficati on Thera peuti c Class: Endo crineMeta bolic Agent Phar macol ogic Class: Prost aglan din Mechanism of Action
Softens the cervix and stimulates uterine contractions.
Age Sex Date of Admission Indication Nonectopic pregnanc y of ≤ 63 days’ gestation For the treatment and preventio n of NSAIDinduced gastroduo denal ulcers.
Height Weight Body Build Adverse Reaction Body as a whole Aches/pains, asthenia, fatigue, fever, chills, rigors, weight changes Skin Rash, dermatitis, alopecia, pallor, breast pain Special senses Abnormal taste, abnormal vision, conjunctivitis, deafness, tinnitus, earache
Nursing Responsibilities – Drug is extensively absorbed and distributed Drug is deesterified to misoprostol acid, then to prostaglandin F analogs Excretion of drug: Renal 80%, Fecal15% Inform patient about drug’s mechanism of action and effect to the baby.
Confirmed or suspected ectopic pregnancy Allergy to misoprostol Presence of IUD Women with uterine infections, severe anemia, cardiovascular and cerebrovascular diseases, coagulopathy, and hypertension Drug interaction – Drug interaction studies between misoprostol and several nonsteroidal anti-inflammatory drugs showed no effect on the kinetics of ibuprofen or diclofenac, and a 20% decrease in aspirin AUC, not thought to be clinically significant. Studies also showed a lack of drug interaction with antipyrine and propranolol
Pharma cokineti cs Onset 8 minutes Peak 30 minutes
followed 24 hours later with the vaginal administrati on of a second 800µg dose of misoprostol (2 x 800µg) Availability and color 200 µg , 400 µg and 800 µg tablets, white
Duratio n 120 minutes Drug Half Life 20 to 40 minutes
Also indicated for the treatment of duodenal ulcers caused by Peptic Ulcer Disease (PUD).
when these drugs were given with misoprostol. Misoprostol given for 1 week had no effect on the steady state pharmacokinetics of diazepam when the two drugs were administered 2 hours apart.
Mean ± SD AUC(0-4) Tmax(mi (pg·hr/ml n) ) Fasting 811 ± 317 417 ± 14 ± 8 135 With Antacid 689 ± 315 349 ± 20 ± 14 108* With High Fat 303 ± 373 ± 64 ± 79* Breakfast 176* 111 * Comparisons with fasting results statistically significant, p < 0.05. Cmax(pg/ ml)
Respiratory Upper respiratory tract infection, bronchitis, bronchospasm, dyspnea, pneumonia, epistaxis Cardiovascular Chest pain, edema, diaphoresis, hypotension, hypertension, arrhythmia, phlebitis, increased cardiac enzymes, syncope, myocardial infarction (some fatal), thromboembolic events Gastrointestinal diarrhea and abdominal pain, nausea, flatulence, dyspepsia, vomiting and constipation, GI
Routes of administrati on Intravaginal
Monitor vital signs, compare with patient’s normal or previous readings. Take blood pressure when possible. Note patient’s individual physiological response to bleeding such as changes in menstruation, weakness, restlessness, and pallor. Monitor intake and output (I&O), and correlate with weight changes. Maintain bed rest. Schedule activities to provide undisturbed rest periods. Increase oral fluid intake to prevent occurrence UTI. Administer with food to prevent
bleeding, GI inflammation/inf ection, rectal disorder, abnormal hepatobiliary function, gingivitis, reflux, dysphagia, amylase increase Hypersensitivity Anaphylaxis Metabolic Glycosuria, gout, increased nitrogen, increased alkaline phosphatase Genitourinary Polyuria, dysuria, hematuria, urinary tract infection Nervous System/Psychiatr ic Anxiety, change in appetite, depression, drowsiness, dizziness, thirst, impotence, loss
GI upset. Advise against doing activities requiring mental alertness.
of libido, sweating increase, neuropathy, neurosis, confusion, headache Musculoskeletal Arthralgia, myalgia, muscle cramps, stiffness, back pain Blood/Coagulatio n Anemia, abnormal differential, thrombocytopeni a, purpura, ESR increased Source: http://www.medi cationabortion.c om/misoprostol/i ndex.html Sourc e http:/ /www .drug s.com /cons/ misop rostol .html Source: http://www. misoprostol .org/File/IJG O_pharm_T ang.pdf. Source: http://www.rx med.com/b.m ain/b2.pharm aceutical/b2. 1.monograph s/CPS%20Monogra phs/CPS%20(General %20Monogra phsSource: http://www.rxlist.com/cytotec-drug.htm#. Source: http://www.drugs .com/pro/misopr ostol.html. Source: http://en.wikipedia.org /wiki/Misoprostol.