dinoprost and Diarrhea

Topics: Apudoma; Diarrhea; Dinoprost; Fever; Fingers; Foot Diseases; Humans; Hypercalcemia; Hypotension; Paraneoplastic Syndromes; Polycythemia; Prostaglandins; Prostaglandins E; Prostaglandins F

Six patients with incurable malignancies were originally treated with vitamin E, 3200 IU/day for fourteen days, followed by the same dose of vitamin E daily plus LCV (20 mg/m2 i.v. bolus daily x 5) with 5FU (425 mg/m2 i.v. bolus immediately following LCV). The same schedule of LCV and 5FU was repeated 4 weeks later, then every 5 weeks indefinitely. When 3 of the first 6 had grade 3/4 toxicity, six more patients were treated on the identical drugs and schedule. Seven of twelve total patients had one or more grade 3/4 toxicities. Neutropenia, abdominal pain, and diarrhea were most common. No patient had a documented response, though seven patients did have stable disease. Though the combination of vitamin E and chemotherapy was toxic, this trial demonstrated maximal therapeutic doses of vitamin E can be combined with standard 5FU and LCV, without significantly increasing the side effects of the chemotherapy itself.

Topics: Abdominal Pain; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Diarrhea; Dinoprost; Dose-Response Relationship, Drug; F2-Isoprostanes; Female; Fluorouracil; Humans; Infusions, Intravenous; Leucovorin; Male; Middle Aged; Neoplasms; Neutropenia; Vitamin E

A multicentre randomized open clinical trial was conducted to compare the efficacy and side effects of two regimens of mifepristone with misoprostol, and mifepristone with PG05 for termination of early pregnancy (amenorrhoea < = 49 days). Six-hundred women in early pregnancy, who requested medical abortion were randomly allocated into 3 groups. In group 1 (n = 301), an initial dose of mifepristone 50 mg was given, followed by 25 mg every 12 hours up to a total dose of 150 mg mifepristone, plus a single oral dose of misoprostol 600 micrograms in the morning of the third day. In group 2 (n = 150), the same regimen of mifepristone was given, but dl-15-methyl PGF2 alpha (PG05) 1 mg vaginal suppository was inserted on the third day. In group 3 (n = 149), a single dose of mifepristone 200 mg was given and misoprostol 600 micrograms was used as in group 1. The complete abortion rate were 94.4%, 97.3%, and 94.6% for group 1, 2 and 3, respectively. 3.0, 2.0 and 2.7% of women had incomplete abortion, and 1.7, 0.7 and 2.0% of women in the 3 groups were treatment failures; in the remaining 1% in group 1 and 0.7% in group 3, treatment outcome could not be determined. There were no significant differences among the 3 groups. Lower abdominal pain was the main complaint which was reported by 82% of the subjects after PGs administration. The incidence of diarrhoea in PG05 group (38.7%) was significantly higher than that in the other two groups (21.6 and 20.1%) (P < 0.001), and so was vomiting. It was concluded that misoprostol, as an orally effective prostaglandin, in combination with mifepristone for induced abortion of early pregnancy was as effective as PG05 vaginal suppository. Besides, it has advantages of convenience of use, less side effects, easy storage and transfer, and low cost.

Topics: Abdominal Pain; Abortion, Induced; Administration, Oral; Adolescent; Adult; China; Diarrhea; Dinoprost; Dose-Response Relationship, Drug; Female; Humans; Mifepristone; Misoprostol; Pessaries; Pregnancy; Pregnancy Trimester, First; Uterine Hemorrhage

35 healthy women of 7-16 weeks gentation were treated with low-dose vaginal 15 methyl prostaglandin F2 alpha (PGF2alpha) for cervical dilatation. 15 patients (mean age, 24.6 +or- 5.5 years) were treated with a vaginal suppository containing 0.5 mg of the drug while 20 patients (mean age, 20.5 +or- 5.3 years) were treated with a 1.0 mg suppository. 2 time intervals, 3 and 6 hours, were studied. The internal diameter of the cervical canal at the internal os level was measured prior to PG treatment, after treatment, and again at the 2-week postabortion visit. Vacuum curettage abortions were performed with paracervical block anesthesia; intravenous sedation with low doses of diazepam and fentanyl was used as needed. The higher dose group appeared to have greater dilatation but the difference is of borderline statistical significance due to the small sample size. Treatment for 6 hours did not result in greater dilatation than treatment for 3 hours. The more advanced gestations exhibited a somewhat greater dilatation. In most cases, additional forcible dilatation was needed although it was usually easy to perform. 7% of the 0.5 mg group and 40% of the 1.0 mg group experienced vomiting. Diarrhea occurred in 40% of the 0.5 mg group and in 65% of the 1.0 mg group. There was a tendency for patients with the most vomiting and diarrhea to experience more cervical dilation with treatment. Complications included 2 cases of superficial tenaculum tears of the cervical mucosa and 1 case of transient generalized pruritus. Generally, the cervical dilatations were modest and not of sufficient benefit to offset the side effects in the patients. Perhaps a greater dose of the drug used for a 3-hour interval with antiemetic and antidiarrheal medication would produce adequate dilatation with no increase in side effects.

Topics: Abortion, Induced; Adult; Clinical Trials as Topic; Diarrhea; Dilatation and Curettage; Dinoprost; Female; Humans; Pregnancy; Premedication; Prostaglandins F; Suppositories; Time Factors; Vomiting

Topics: Abdominal Pain; Adult; Anaphylaxis; Angioedema; Anti-Asthmatic Agents; Biomarkers; Cromolyn Sodium; Diarrhea; Dinoprost; Female; Histamine Antagonists; Humans; Leukotriene E4; Male; Mast Cells; Mastocytosis; Middle Aged; Omalizumab; Prostaglandin D2; Treatment Outcome; Tryptases; Urticaria

Topics: Aggression; Animals; Diarrhea; Dinoprost; Grooming; Injections, Intravenous; Male; Molecular Structure; Morphine; Morphine Dependence; Motor Activity; Rats; Rats, Wistar; Substance Withdrawal Syndrome; Weight Loss

Prostaglandins cause diarrhea, and their production by the gut increases in diarrheal states. We studied the effects of PGF2 alpha and PGE2 on the electromyogram recorded from the cat colon in vitro to determine if these prostaglandins might produce electromyographic changes similar to those seen in diarrheal states. PGF2 alpha decreased slow wave frequency and uncoupled slow wave propagation in the proximal colon. It increased the frequency of migrating spike bursts. PGE2 had no effect on slow waves, but increased the frequency of the migrating spike burst. PGF2 alpha produced electromyographic changes similar to those recorded from the colon of cats with spontaneous diarrhea or after exposure to diarrhea-producing agents such as ricinoleate or quinidine. Some diarrhea-producing agents are likely to act by increasing prostaglandin production.

Topics: Animals; Cats; Colon; Diarrhea; Dinoprost; Dinoprostone; Electromyography; Female; Gastrointestinal Motility; In Vitro Techniques; Male

Clinical and biochemical effects of indomethacin were monitored in a patient with congenital chloride diarrhea (CCD) before and after 10 days of therapy. During indomethacin treatment, no clinical improvement could be achieved whereas hyperreninemia and hyperaldosteronism improved. Excretion rates of prostaglandin (PG) E2, PGF2 alpha, as well as PGE-M were found to be slightly raised and decreased during therapy with indomethacin. However, loss of electrolytes remained substantially unchanged. Prostaglandins, therefore, seem to play no important role in intestinal loss of electrolytes in CCD, and it is suggested that indomethacin is of no importance in the treatment of patients with CCD.

Topics: 18-Hydroxycorticosterone; Aldosterone; Chlorine; Diarrhea; Dinoprost; Dinoprostone; Humans; Indomethacin; Infant; Male; Potassium Chloride; Prostaglandins; Renin; Sodium Chloride; Water-Electrolyte Balance

To investigate whether prostaglandins (PGs) are involved in the mechanism of rotavirus diarrhea, PGE2 and PGF2 alpha concentrations in the plasma and stool of children (21 and 16, respectively) with rotavirus gastroenteritis were measured and compared with those of their respective controls. The effect of aspirin on the diarrhea was also studied in 14 patients with rotavirus gastroenteritis. The PGE2 and PGF2 alpha contents of both the plasma and the stool of patients with rotavirus gastroenteritis were significantly higher than in the plasma and stool of the control group. Furthermore, aspirin given by mouth caused the diarrhea to cease earlier. These results suggest that PGE2 and PGF2 alpha are involved as important mediators in the causative mechanism of rotavirus diarrhea.

Topics: Aspirin; Child; Child, Preschool; Diarrhea; Diarrhea, Infantile; Dinoprost; Dinoprostone; Feces; Female; Gastroenteritis; Humans; Infant; Male; Rotavirus Infections

Massive secretory diarrhea is associated with some villous adenomas. The mechanism of this secretion is unknown but the character of the diarrhea resembles that of cyclic nucleotide-mediated diarrheas. We have compared the cyclic nucleotide metabolism of a large secretory villous adenoma with a nonsecretory villous adenoma, a solid carcinoma and their normal mucosae. The adenylate cyclase, cyclic AMP content, and a cyclic AMP-dependent protein kinase ratios in the secretory tumor were increased as compared to these values in the nonsecretory tumors and normal mucosae, a situation similar to that seen with cholera toxin-induced diarrhea. Our data suggest that the massive diarrhea in our patient with a secretory villous adenoma may be related to increased adenylate cyclase activity.

Topics: Adenocarcinoma; Adenoma; Adenylyl Cyclases; Aged; Cyclic AMP; Diarrhea; Dinoprost; Dinoprostone; Female; Humans; Intestinal Mucosa; Intestinal Neoplasms; Male; Middle Aged; Nucleotides, Cyclic; Paraneoplastic Endocrine Syndromes; Prostaglandins E; Prostaglandins F; Protein Kinases; Sigmoid Neoplasms

A synthesis of 16-amino-derivatives of PGF2 alpha is reported. Introduction of an amino group into position 16 of PGF2 alpha has decreased the sensitivity of the compound to metabolic degradation. 16(S)-amino-PGF2 alpha methyl ester shows high abortifacient activity with reduced diarrhoeic side effect.

Topics: Abortifacient Agents; Abortifacient Agents, Nonsteroidal; Animals; Cricetinae; Diarrhea; Dinoprost; Female; Mice; Pregnancy; Prostaglandins F; Prostaglandins F, Synthetic; Rats

Topics: Animals; Body Weight; Diarrhea; Dinoprost; Dinoprostone; Inflammation; Intestinal Diseases; Male; Prostaglandins E; Prostaglandins F; Rats; Rats, Inbred Strains; Time Factors

15-methyl prostaglandin F2 alpha was administered by intramuscular injection to thirty patients to terminate pregnancy in the mid-trimester. Termination was considered successful if this occurred within 24 hours and this was so in twenty-seven cases (90%). There were no serious complications. prochlorperazine mesylate and diphenoxylate hydrochloride reduced the incidence and severity of vomiting and diarrhoea.

Topics: Abortifacient Agents; Abortifacient Agents, Nonsteroidal; Abortion, Therapeutic; Adolescent; Adult; Diarrhea; Dinoprost; Female; Humans; Injections, Intramuscular; Pregnancy; Pregnancy Trimester, Second; Prostaglandins F; Vomiting

Thirty-one mares of Quarter Horse and Thoroughbred breeding were utilized in two experiments to evaluate the efficacy of prostaglandin F2 alpha (PGF2 alpha) for induction of equine parturition and to monitor the effects of this treatment on viability of the resulting foals. Three of five mares given 5 mg PGF2 alpha (im) on day 338 of gestation foaled 19.6+/-8.2 hr postinjection. In the second experiment immediately following 3 daily injections of 10 mg estradiol cypionate (ECP) given on days 326, 327 and 328 of gestation, seven mares were infused (iv) with PGF2 alpha at the rate of 1.3 mg/hr for 24 hr or until parturition occurred. Four of the seven mares foaled in 8.8+/-1.8 hr after the start of infusion. Side effects including sweating, hypothermia, increased respiration rate and diarrhea were evident in both injected and infused mares, but effects were transient. Neither the injection, nor infusion route of administration of PGF2 alpha adversely affected the viability of foals. However, some mares induced to foal 12 days prior to expected parturition had foals with slightly weaker pasterns than those of control mares.

Topics: Animals; Body Temperature; Diarrhea; Dinoprost; Estradiol; Female; Horses; Labor, Induced; Pregnancy; Prostaglandins F; Sweating; Time Factors

Prostaglandins are mainly used in clinical medicine for midterm abortion and to terminate pregnancy. Systemic adverse reactions include nausea and vomiting, which occur in approximately half of the patients and, to a lesser extent, diarrhea. Although bronchospasm occurs infrequently, PGF2 should be avoided in asthmatics. Cardiorespiratory failure culminating in prolonged coma and death has been reported. Moreover, convulsions and EEG changes have been observed in a comparatively small number of cases.

Topics: Abortifacient Agents; Abortion, Induced; Bronchial Spasm; Diarrhea; Dinoprost; Dinoprostone; Female; Heart Arrest; Humans; Pregnancy; Prostaglandins; Prostaglandins E; Prostaglandins E, Synthetic; Prostaglandins F; Seizures; Vomiting

Increased prostaglandin synthesis has been implicated as a causative factor in the production of radiation induced enteritis. Seventeen patients selected to begin pelvic irradiation for treatment of gynecological cancer had plasma Prostaglandin E, Prostaglandin F, and 13, 14 dihydro 15 keto PGF2 alpha metabolite determined by radioimmunoassay, prior to initiation of radiotherapy, at weekly intervals during treatment and at six weeks following completion of radiotherapy. A total of 362 prostaglandin determinations were performed. Thirteen patients (76%) developed significant diarrhea consisting of three or more watery bowel movements per day. Nine patients (53%) had intermittent colicky pain and six patients (35%) had nausea and vomiting during treatment. Statistical evaluation revealed no significant elevation of plasma prostaglandins during radiotherapy.

Topics: Adult; Diarrhea; Dinoprost; Enteritis; Female; Genital Neoplasms, Female; Humans; Middle Aged; Prostaglandins E; Prostaglandins F; Radioimmunoassay; Radiotherapy; Radiotherapy Dosage

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.

Topics: Abortion, Induced; Antiemetics; Atropine; Diarrhea; Dinoprost; Diphenoxylate; Drug Combinations; Female; Humans; Isonipecotic Acids; Pregnancy; Prochlorperazine; Prostaglandins F; Vomiting

Severe intractable atonic postpartum hemorrhage can be treated by either uterine packing or surgical techniques. However, certain prostaglandins possess properties of potential value for the control of postpartum uterine atony. Two hundred fifty micrograms 15-methyl prostaglandin F2 alpha (15-methyl PGF2 alpha) was given intramuscularly to 16 subjects for whom a uterine pack of operative management was the only other alternative. Fifteen patients responded satisfactorily following a mean of 1.75 injections (437.5 microgram); only 1 patient required hysterectomy. The latter had a case of severe intrauterine infection. The incidence of side effects was very low. The use of intramuscularly administered 15-methyl PGF2 alpha in uncontrollable atonic postpartum hemorrhage appears to be a valuable lifesaving medical tool in critical cases.

Topics: Diarrhea; Dinoprost; Female; Humans; Hypertension; Injections, Intramuscular; Postpartum Hemorrhage; Pregnancy; Prostaglandins F, Synthetic; Uterine Contraction

A series of PGE2, 16,16-dimethyl-PGE2, and PGF2 alpha analogues modified at the carboxyl terminus with tetrazole, amide, acylurea, imide, and sulfonimide functionalities was evaluated for uterine stimulant, bronchodilator, hypotensive, gastric antisecretory, and diarrheal activity. These compounds were prepared by modification of the Corey prostaglandin synthesis utilizing as a key step condensation of known hemiacetals with the ylide derived from the requisite substituted phosphonium salts. Structure--activity relationships suggest that a proton at the C-1 position appears necessary for agonist activity and the acidity of this proton has a relatively greater influence on activity than pendant steric bulk. Noteworthy are the tissue-selective bronchodilator activity of N-acetyl-PGE2-carboxamide and the selectivity for uterine tissue of N-methanesulfonyl-PGE2-carboxamide, 2-decarboxy-2-(tetrazol-5-yl)-16,16-dimethyl-PGE2, N-acetyl-16,16-dimethyl-PGE2-carboxamide, and N-methanesulfonyl-16,16-dimethyl-PGE2-carboxamide.

Topics: Animals; Blood Pressure; Bronchodilator Agents; Diarrhea; Dogs; Female; Gastric Juice; Guinea Pigs; In Vitro Techniques; Male; Mice; Prostaglandins E, Synthetic; Prostaglandins F, Synthetic; Rats; Structure-Activity Relationship; Uterine Contraction

Topics: Animals; Chemical Phenomena; Chemistry; Diarrhea; Dinoprost; Female; Mice; Prostaglandins F, Synthetic; Rats; Uterine Contraction

The introduction of dinoprost tromethamine (Prostin F2 Alpha) as an abortifacient in the second trimester of pregnancy represents the first clinical use of a prostaglandin. Various synthetic analogues of the naturally occurring derivatives are being employed investigationally in the treatment of peptic ulcer, hypertension, asthma, and hypercalcemia. In the United States, dinoprost tromethamine is primarily administered intra-amniotically. Despite the fact that a substantial number of patients experience allergic reactions, hypertension, bronchospasm, nausea, vomiting, cramps, and diarrhea, the efficacy and relative safety of dinoprost tromethamine establish it as superior to intra-amniotic instillation of hypertonic saline. Cervical laceration, laceration or rupture of the lower uterine segment, retention of the placenta, and hemorrhage in part reflect the intensity of uterine contraction induced by dinoprost. Experience in administration improves the therapeutic response and diminishes adverse reactions.

Topics: Abortifacient Agents; Bronchial Spasm; Diarrhea; Dinoprost; Dose-Response Relationship, Drug; Drug Evaluation; Drug Hypersensitivity; Female; Humans; Hypertension; Injections; Muscle Contraction; Myometrium; Nausea; Pregnancy; Pregnancy Trimester, Second; Prostaglandins F; Vomiting