Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Misoprostol is a synthetic (man-made) prostaglandin
that is used to reduce the risk of stomach ulcers in patients treated with
nonsteroidal antiinflammatory drugs (NSAIDs,
for example, aspirin, ibuprofen, etc.)
that are used for pain and various inflammatory conditions, for example,
arthritis. Misoprostol is used primarily in patients at high risk for
stomach ulcers when
treated with NSAIDs, for example, the elderly, patients with concomitant debilitating
diseases, and patients with a history of ulcers. Prostaglandins are chemicals
that are made within many organs of the body including the stomach. In the
stomach, prostaglandins are believed to protect the inner lining of the stomach
from the ulcer-producing effects of NSAIDs. Scientists now believe that NSAIDs
produce ulceration by preventing the production of prostaglandins in the
stomach. Synthetic prostaglandins such as misoprostol given orally "replace" the
prostaglandins whose production is inhibited by NSAIDs and have been shown to
protect the lining of the stomach from NSAID-induced ulcers. Misoprostol was
approved by the FDA in December 1988.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 100 and 200 mcg.
STORAGE: Tablets should be kept in a dry area with temperatures at or below
25 C (77 F)
PRESCRIBED FOR: Misoprostol is prescribed for the prevention of NSAID-induced
gastric ulcers in patients at high risk for ulceration when treated with NSAIDs.
Off-label (non-FDA approved) uses include fetal abortion, cervical ripening
procedure during delivery, duodenal and gastric ulcer, and postpartum
hemorrhage.
DOSING: The recommended adult oral dose for reducing the risk of
NSAID-induced gastric ulcers is 200 mcg four times daily with food. If this dose
cannot be tolerated, a dose of 100 mcg can be used.
DRUG INTERACTIONS: Misoprostol has no clinically important drug interactions.
PREGNANCY: Misoprostol should never be used during
pregnancy since it can
cause abortion, premature birth, or
birth defects. Uterine rupture has been
reported when misoprostol was administered to pregnant women to induce labor or
to induce abortion beyond the eighth week of pregnancy.
NURSING MOTHERS: It is not known if misoprostol is excreted in
human milk;
however it should not be administered to nursing mothers because it could cause
significant diarrhea in nursing infants.
SIDE EFFECTS: Common side effects include diarrhea and
abdominal pain.
Diarrhea is more common with higher doses and usually goes away with continued
administration. Rarely, profound and persistent diarrhea necessitates stopping
the drug. Less common side effects include
headache,
menstrual cramps,
nausea,
and flatulence.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
A peptic ulcer is an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to Helicobacter pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
What are nonsteroidal anti-inflammatory drugs (NSAIDs)?
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed medications for the inflammation of arthritis and other body tissues, such as in
tendinitis and bursitis. The are also used for minor aches and pain.
Examples of NSAIDs include:
aspirin,
indomethacin (Indocin),
ibuprofen (Motrin),
naproxen (Naprosyn),
piroxicam (Feldene),
nabumetone (Relafen), and
Celecoxib (Celebrex).
NSAIDs are available by prescription or without a prescription (over-the-counter). They are also ingredients in many over the counter medications used for
colds and minor aches and
pain. They are administered orally as capsules, tablets, liquids, or by
injection ketorolac
(Toradol). Although not included in this review, NSAIDs are also used as eye drops for eye inflammation (f...
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