Medicine & USMLE

Misoprostol

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GI Drugs
  1. Ondansetron
  2. Sucralfate
  3. Docusate (Stool Softener)
  4. Bulk Forming Laxatives (Psyllium, Methylcellulose)
  5. Osmotic Laxatives (Lactulose, PEG)
  6. Stimulant Laxatives (Senna, Bisacodyl)
  7. Antidiarrheals (Loperamide, Diphenoxylate-Atropine)
  8. Bismuth Subsalicylate
  9. Antacids
  10. Proton Pump Inhibitors (PPIs)
  11. H2 Blockers
  12. Metoclopramide
  13. Misoprostol
  14. Orlistat
  15. Octreotide

Summary

Misoprostol is a medication used to prevent the formation of gastrointestinal ulcers. Clinically, it is commonly given to mitigate the ulcer-forming side effects of NSAIDs. It can also induce labor by causing cervical ripening and uterine contractions. Misoprostol’s uterotonic effects make it effective in treating postpartum hemorrhage, and expelling pregnancy tissue after a miscarriage or abortion. Unless being used to induce labor, misoprostol is teratogenic and should never be given to a pregnant woman.

Key Points

  • Misoprostol (Cytotec)
    • Mechanism
      • Prostaglandin E analog
      • Suppresses gastric acid secretion and increase protective mucus in the GI tract
    • Clinical Use
      • Ulcer Prevention
        • Prevents ulcers in patients taking NSAIDs or Aspirin; these drugs prevent prostaglandin formation to cause mucosal barrier degradation
        • Misoprostol replaces prostaglandins in the stomach to restore the mucosal lining
      • Labor induction
        • Misoprostol is a uterotonic medication, meaning it causes uterine contractions
        • Misoprostol helps with cervical ripening
        • May also be used to treat postpartum hemorrhage or expel pregnancy tissue after a miscarriage/abortion
    • Side Effects and Adverse Reactions
      • Teratogenic
        • Pregnancy category X
        • Educate women of childbearing age the importance of using reliable birth control
      • Do not take with antacids
        • Especially antacids containing magnesium
      • Diarrhea
      • Dehydration