dinoprost and Vomiting

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

Peripheral plasma prostaglandins (PGs) were assayed in 10 cases of gynecologic malignancies. In addition, fluctuations of PG levels during chemotherapeutically-induced gastrointestinal toxicity as well as those caused by a bolus infusion of steroid hormone were investigated. As a result, the level of PGE2 in most cases of gynecologic malignancies was seen above or around the upper limit of that in healthy women. During chemotherapy, the levels of PGF2 alpha and thromboxane B2 (TxB2) increased significantly compared to baseline levels (P less than 0.05). A bolus infusion of steroid hormone did not bring about any noticeable change in any of the levels of PGF2 alpha, TxB2, PGE2 or 6K. It may be inferred from these findings that PGs are synthesized in tumor tissue itself and released into plasma. Also, the finding that the levels of peripheral plasma PGs increased during chemotherapy suggested that such an increase in PG release could be one of the factors causing gastrointestinal toxicity. Based on the fact that there were no changes in levels of peripheral plasma PGs due to the administration of steroid hormone, however, we failed to support the proposal that steroid hormone suppresses the release of PG.

Topics: 6-Ketoprostaglandin F1 alpha; Antineoplastic Combined Chemotherapy Protocols; Dinoprost; Dinoprostone; Female; Humans; Hydrocortisone; Nausea; Ovarian Neoplasms; Prostaglandins; Prostaglandins E; Prostaglandins F; Radioimmunoassay; Thromboxane B2; Uterine Neoplasms; Vomiting

By the application of the priming with 2.5 mg Minprostin F2 alpha a statistically provable dilatation of the cervix in comparison with another group can be achieved. But the priming does not yet effect the occurrence of early complications of the interruption in comparison with conventional methods. In is to be supposed that this method has got a protecting effect on the occurrence of latent late complications of the interruption. Because of the secondary effects of prostaglandins the indication for softening of the cervix should be applied to a very limited range of patients only.

Topics: Abortion, Induced; Adolescent; Adult; Cervix Uteri; Dinoprost; Female; Humans; Parity; Pregnancy; Prostaglandins F; Uterine Contraction; Uterine Hemorrhage; Vomiting

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

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

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

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