Name of Student Nurse: Aika Grace G.

Espinosa Date: May 11, 2021

Level/ Block/Group: 2 BSN – 8 Hospital Area: PHINMA- Upang General Clinical Instructor: Carol Joy Paragas
Hospital (Labor and Delivery Room)

NAME OF DRUG MECHANISM CONTRAINDICATIONS SIDE ADVERSE NURSING

GENERIC NAME -Misoprostol -Contraindicated with The most CNS: headache. -Advise patient to
Misoprostol inhibits basal and history of allergy to common side avoid alcohol and foods
nocturnal gastric prostaglandins; pregnancy effects of GI: abdominal that may cause an
acid secretion (abortifacient; advise Cytotec pain, diarrhea, increase in GI irritation.
through a direct women of childbearing age include: constipation,
action on the in written and oral form of dyspepsia, -Inform patient that
parietal cell. use, have a negative serum -diarrhea flatulence, nausea, misoprostol will cause
BRAND NAME pregnancy test within 2 wk -stomach pain vomiting. spontaneous abortion.
Cytotec -Parietal cells prior to therapy, provide -nausea Women of childbearing
contain receptors contraceptives, and begin -upset GU: miscarriage, age must be informed
that have high therapy on the second or stomach menstrual of this effect through
affinity for third day of the next -gas disorders. verbal and written
prostaglandins of normal menstrual -vaginal information and must
CLASSIFICATION the E series. period);lactation bleeding or use contraception
Therapeutic Class: spotting throughout drug
Endocrine-Metabolic -Misoprostol can -heavy treatment. If pregnancy
Agent inhibit gastric acid menstrual is suspected, the
secretion flow and woman should stop
Pharmacologic secondary to menstrual taking misoprostol and
Class: Prostaglandin stimulation from cramps notify her health care
food, alcohol, professional
NSAIDs, Cytotec may immediately.
histamine, cause serious
pentagastrin, or side effects -If used with

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 INDICATION caffeine, and this including: mifepristone to
effect appears to terminate pregnancy,
-Cytotec be more -severe inform patient that
(misoprostol) is pronounced with ongoing vaginal bleeding and
indicated for increasing doses. stomach uterine cramping will
reducing the risk of H2-antagonists, discomfort or probably occur.
NSAID (nonsteroidal however, appear diarrhea Bleeding or spotting
anti-inflammatory to be more potent -feeling very occurs for an average
drugs, including than misoprostol thirsty or hot of 9–16 days, but may
aspirin)–induced in the ability to -unable to continue for more than
gastric ulcers in inhibit gastric acid urinate 30 days. Instruct
patients at high risk output, especially -heavy patient to report any
of complications at night. sweating and severe or unusual
from gastric ulcer, hot and dry cramping, bleeding, or
e.g., the elderly and -Misoprostol also skin pelvic pain that extends
patients with exerts a mucosal beyond the expected
concomitant protectant effect time periods.
debilitating disease, that may
as well as patients at contribute to its -Instruct patient to
high risk of effectiveness in report bothersome side
developing gastric treating ulcers. It effects, including
ulceration, such as has been severe or prolonged
patients with a suggested that the headache, menstrual
history of ulcer. cytoprotective irregularities, or GI
effect is problems (nausea,
-Cytotec has not secondary to diarrhea, vomiting,
been shown to mucus and constipation, heartburn,
reduce the risk of bicarbonate flatulence, abdominal
duodenal ulcers in secretion, pain).
patients taking prevention of
NSAIDs. Cytotec mucus bilayer
should be taken for disruption,
the duration of reduction of
NSAID therapy.

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 backflow of
-Cytotec has been hydrogen ions,
shown to reduce the regulation of
risk of gastric ulcers mucosal blood
in controlled studies flow, and
of 3 months' protection of the
duration. It had no mucosal capacity
effect, compared to to produce cells.
placebo, on
gastrointestinal pain -Misoprostol
or discomfort reduces pepsin
associated with concentrations
NSAID use. under basal
DOSAGE AND conditions;
FREQUENCY however,
NSAID-Induced histamine-
Ulcer (Adult) stimulated
Prophylaxis secretion is not
-200 mcg orally affected. Because
every 6 hours with prostaglandins can
food; may be affect many
decreased to 100 tissues, other
mcg every 6 hours if actions of
higher dose is not misoprostol have
tolerated; last dose to been identified.
be administered at
bedtime -Misoprostol may
Should take therapy increase the
for duration of frequency of
therapy uterine
contractions,
Geriatric which is
-To avoid possibility responsible for its

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 of diarrhea, dosing abortifacient
may be initiated at capability and
100 mcg every 6 ability to promote
hours and increased labor and cervical
by 100 mcg/day ripening.
every 3 days until
desired dose is -Increases in the
achieved amplitude and
frequency of
Stress Ulcer uterine
Prophylaxis (off- contractions
label) reduce cervical
-100-200 mcg orally tone, which
every 4-6 hours produces cervical
Induction of Labor dilation.
(off-label)
- In addition,
-25 mcg (1/4 of 100 misoprostol has
mcg oral tablet) been shown to
intravaginally improve renal
initially, then repeat function in renal
at intervals not to transplant patients
exceed every 3-6 treated with
hours cyclosporine and
-Not to be used in prednisone;
patients with misoprostol may
previous cesarean offset
delivery or major cyclosporine-
uterine surgery induced intrarenal
vasoconstriction.
Postpartum
Hemorrhage (off-
label)

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 -Prophylaxis: 600
mcg orally within 1
minute of delivery
-Treatment: 800
mcg orally once; use
caution if
prophylactic dose
already given and
adverse effects
present or
observed.Use only in
settings where
oxytocin not
available

Treatment of
Incomplete
Abortion (off-label)
-600 mcg buccally
(dissolved in the
mouth) once.

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