| 词条 | Misoprostol |
| 释义 |
| Watchedfields = changed | verifiedrevid = 456483721 | IUPAC_name = Methyl 7-((1R,2R,3R)-3-hydroxy-2-((S,E)-4-hydroxy-4-methyloct-1-enyl)-5-oxocyclopentyl)heptanoate | image = Misoprostol.svg | width = 200px | tradename = Cytotec, Misodel, other | Drugs.com = {{drugs.com|monograph|misoprostol}} | MedlinePlus = a689009 | pregnancy_AU = X | pregnancy_US = X | pregnancy_category = Used for terminating pregnancy | legal_AU = S4 | legal_CA = Rx-only | legal_UK = POM | legal_US = Rx-only | routes_of_administration = By mouth, vaginal, under the tongue | bioavailability = extensively absorbed | protein_bound = 80-90% (active metabolite, misoprostol acid) | metabolism = Liver (extensive to misoprostic acid) | elimination_half-life = 20–40 minutes | excretion = Urine (80%) | CAS_number_Ref = {{cascite|correct|??}} | CAS_number = 59122-46-2 | ATC_prefix = A02 | ATC_suffix = BB01 | ATC_supplemental = {{ATC|G02|AD06}} | PubChem = 5282381 | IUPHAR_ligand = 1936 | DrugBank_Ref = {{drugbankcite|correct|drugbank}} | DrugBank = DB00929 | ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}} | ChemSpiderID = 4445541 | UNII_Ref = {{fdacite|correct|FDA}} | UNII = 0E43V0BB57 | KEGG_Ref = {{keggcite|correct|kegg}} | KEGG = D00419 | ChEMBL_Ref = {{ebicite|correct|EBI}} | ChEMBL = 606 | C=22 | H=38 | O=5 | molecular_weight = 382.534 g/mol | smiles = CCCC[C@](C)(O)C/C=C/[C@H]1[C@H](O)CC(=O)[C@@H]1CCCCCCC(=O)OC | StdInChI_Ref = {{stdinchicite|correct|chemspider}} | StdInChI = 1S/C22H38O5/c1-4-5-14-22(2,26)15-10-12-18-17(19(23)16-20(18)24)11-8-6-7-9-13-21(25)27-3/h10,12,17-18,20,24,26H,4-9,11,13-16H2,1-3H3/b12-10+/t17-,18-,20-,22?/m1/s1 | StdInChIKey_Ref = {{stdinchicite|correct|chemspider}} | StdInChIKey = OJLOPKGSLYJEMD-URPKTTJQSA-N }}Misoprostol, sold under the brandname Cytotec among others, is a medication used to prevent and treat stomach ulcers, start labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus.[1][2] For abortions it is often used with mifepristone or methotrexate.[3] By itself, effectiveness for abortion is between 66% and 90%.[4] Misoprostol is taken by mouth when used to prevent gastric ulcers in persons on NSAIDs.[2] For labor induction or abortion, it is taken either in the cheek, under the tongue, or placed in the vagina.[3][5] Common side effects include diarrhea and abdominal pain.[2] It is pregnancy category X meaning that it is known to result in negative outcomes for the baby if taken during pregnancy.[2] In rare cases, uterine rupture may occur.[2] It is a prostaglandin analogue — specifically, a synthetic prostaglandin E1 (PGE1).[2] Misoprostol was developed in 1973.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] It is available as a generic medication.[2] The wholesale cost in the developing world is about 0.36 to 2.00 USD a dose.[8] A month's supply to treat stomach ulcers in the United States is between 100 and 200 USD.[9] The same costs between 30 and 55 EUR in Europe.[10] Medical usesUlcer preventionMisoprostol is used for the prevention of NSAID-induced gastric ulcers. It acts upon gastric parietal cells, inhibiting the secretion of gastric acid by G-protein coupled receptor-mediated inhibition of adenylate cyclase, which leads to decreased intracellular cyclic AMP levels and decreased proton pump activity at the apical surface of the parietal cell. Because other classes of drugs, especially H2-receptor antagonists and proton pump inhibitors, are more effective for the treatment of acute peptic ulcers, misoprostol is only indicated for use by people who are both taking NSAIDs and are at high risk for NSAID-induced ulcers, including the elderly and people with ulcer complications. Misoprostol is sometimes coprescribed with NSAIDs to prevent their common adverse effect of gastric ulceration (e.g. with diclofenac in Arthrotec). However, even in the treatment of NSAID-induced ulcers, omeprazole proved to be at least as effective as misoprostol,[11] but was significantly better tolerated, so misoprostol should not be considered a first-line treatment. Misoprostol-induced diarrhea and the need for multiple daily doses (typically four) are the main issues impairing compliance with therapy. Labor inductionMisoprostol is commonly used for labor induction. It causes uterine contractions and the ripening (effacement or thinning) of the cervix.[12] It can be less expensive than the other commonly used ripening agent, dinoprostone.[20] Oxytocin has long been used as the standard agent for labor induction, but does not work well when the cervix is not yet ripe. Misoprostol also may be used in conjunction with oxytocin.[13]Between 2002 and 2012, a misoprostol vaginal insert was studied, and was approved in the EU.[14][15] It was not approved for use in the USA, and the US FDA still considers cervical ripening and labor induction to be outside of the approved uses for misoprostol.[16] AbortionMisoprostol is used either alone or in conjunction with another medication (mifepristone or methotrexate) for medical abortions as an alternative to surgical abortion.[17] Medical abortion has the advantage of being less invasive, and more autonomous, self-directed, and discreet. It is preferable to some users because it feels more "natural," as the drugs induce a miscarriage.[18] It is also more easily accessible in places where abortion is illegal.[19] The World Health Organization provides clear guidelines on the use, benefits and risks of misoprostol for abortions.[20] Misoprostol is most effective when it is used with methotrexate or mifepristone (RU-486).[21] Misoprostol alone is less effective (typically 88% up to eight-weeks gestation). It is not inherently unsafe if medically supervised, but 1% of women will have heavy bleeding requiring medical attention, some women may have ectopic pregnancy, and the 12% of pregnancies that continue after misoprostol failure are more likely to have birth defects and are usually followed up with a more effective method of abortion.[22] Most large studies recommend a protocol for the use of misoprostol in combination with mifepristone.[23] Together they are effective in around 95% for early pregnancies.[24] Misoprostol alone may be more effective in earlier gestation.[25] WHO guidelines recommend for pregnancies up to 12 weeks to use 12 tablets of 200 mcg (micrograms). The woman should put 4 tablets of misoprostol under the tongue or far up the vagina and let them dissolve for 30 minutes. She should wait 3 hours and repeat with 4 pills under the tongue or in the vagina for 30 minutes. She should wait 3 hours and repeat once more.[21] It works in 90% after first attempt and, in case of failure, the attempt may be repeated after a minimum of 3 days. Misoprostol can also be used to dilate the cervix in preparation for a surgical abortion, particularly in the second trimester (either alone or in combination with laminaria stents). Failed miscarriageMisoprostol may be used to treat the mother in the case of fetal death which did not result in miscarriage. Further research is needed to establish a safe, effective protocol.[26] Misoprostol is regularly used in some Canadian hospitals for labour induction for fetal deaths early in pregnancy, and for termination of pregnancy for fetal anomalies. A low dose is used initially, then doubled for the remaining doses until delivery. In the case of a previous Caesarian section, however, lower doses are used. Postpartum bleedingMisoprostol is also used to prevent and treat post-partum bleeding. Orally administered misoprostol was marginally less effective than oxytocin.[27] The use of rectally administered misoprostol is optimal in cases of bleeding; it was shown to be associated with lower rates of side effects compared to other routes. Rectally administered misoprostol was reported in a variety of case reports and randomised controlled trials.[28][29] However, it is inexpensive and thermostable (thus does not require refrigeration like oxytocin), making it a cost-effective and valuable drug to use in the developing world.[30] A randomised control trial of misoprostol use found a 38% reduction in maternal deaths due to post partum haemorrhage in resource-poor communities.[31] Misoprostol is recommended due to its cost, effectiveness, stability, and low rate of side effects.[32] Oxytocin must also be given by injection, while misprostol can be given orally or rectally for this use, making it much more useful in areas where nurses and physicians are less available.[33] Adverse effectsThe most commonly reported adverse effect of taking a misoprostol by mouth for the prevention of stomach ulcers is diarrhea. In clinical trials, an average 13% of patients reported diarrhea, which was dose-related and usually developed early in the course of therapy (after 13 days) and was usually self-limiting (often resolving within 8 days), but sometimes (in 2% of patients) required discontinuation of misoprostol.[34] The next most commonly reported adverse effects of taking misoprostol by mouth for the prevention of gastric ulcers are: abdominal pain, nausea, flatulence, headache, dyspepsia, vomiting, and constipation, but none of these adverse effects occurred more often than when taking placebos.[34] In practice, fever is almost universal when multiple doses are given every 4 to 6 hours.{{Citation needed|reason=Strong claim is made with no citation or evidence. I could not easily find any source that concurred.|date=April 2016}} Misoprostol should not be taken by pregnant women with wanted pregnancies to reduce the risk of NSAID-induced gastric ulcers because it increases uterine tone and contractions in pregnancy, which may cause partial or complete abortions, and because its use in pregnancy has been associated with birth defects.[34][35] All cervical ripening and induction agents can cause uterine hyperstimulation, which can negatively affect the blood supply to the fetus and increases the risk of complications such as uterine rupture.[36] Concern has been raised that uterine hyperstimulation that occurs during a misoprostol-induced labor is more difficult to treat than hyperstimulation during labors induced by other drugs.[37] Because the complications are rare, it is difficult to determine if misoprostol causes a higher risk than do other cervical ripening agents. One estimate is that it would require around 61,000 people enrolled in randomized controlled trials to detect a difference in serious fetal complications and about 155,000 people to detect a difference in serious maternal complications.[38] PharmacologyMisoprostol, a prostaglandin analogue, binds to myometrial cells to cause strong myometrial contractions leading to expulsion of tissue. This agent also causes cervical ripening with softening and dilation of the cervix. Misoprostol binds to and stimulates prostaglandin EP2 receptors, prostaglandin EP3 receptor and prostaglandin EP4 receptor but not Prostaglandin EP1 receptor and therefore is expected to have a more restricted range of physiological and potentially toxic actions than prostaglandin E2 or other analogs which activate all four prostaglandin receptors.[39] Society and cultureA letter from Searle generated some controversy over the use of misoprostol in labor inductions.[40] The American College of Obstetricians and Gynecologists holds that substantial evidence supports the use of misoprostol for induction of labor, a position it reaffirmed in 2000 in response to the Searle letter.[41] Misoprostol is also on the WHO essential drug list for labor induction.[42] The largest medical malpractice award of nearly $70 million was awarded due to the use of misoprostol to induce labor in a California hospital.[43] A vaginal form of the medication is sold in the EU under the names Misodel and Mysodelle for use in labor induction. Black marketMisoprostol is used for self-induced abortions in Brazil, where black market prices exceed US$100 per dose. Illegal medically unsupervised misoprostol abortions in Brazil are associated with a lower complication rate than other forms of illegal self-induced abortion, but are still associated with a higher complication rate than legal, medically supervised surgical and medical abortions. Failed misoprostol abortions are associated with birth defects in some cases.[44][45][46][47][48] Low-income and immigrant populations in New York City have also been observed to use self-administered misoprostol to induce abortions, as this method is much cheaper than a surgical abortion (about $2 per dose).[49] The drug is readily available in Mexico.[50] Use of misoprostol has also increased in Texas in response to increased regulation of abortion providers.[51] References1. ^{{cite journal |vauthors=Rostom A, Dube C, Wells G, Tugwell P, Welch V, Jolicoeur E, McGowan J |title=Prevention of NSAID-induced gastroduodenal ulcers |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD002296 |year=2002 |pmid=12519573 |doi=10.1002/14651858.CD002296 }} 2. ^1 2 3 4 5 6 {{cite web|title=Misoprostol|url=https://www.drugs.com/monograph/misoprostol.html|publisher=The American Society of Health-System Pharmacists|accessdate=Feb 20, 2015|deadurl=no|archiveurl=https://web.archive.org/web/20150221072240/http://www.drugs.com/monograph/misoprostol.html|archivedate=2015-02-21|df=}} 3. ^1 {{cite journal|last1=Kulier|first1=R|last2=Kapp|first2=N|last3=Gülmezoglu|first3=AM|last4=Hofmeyr|first4=GJ|last5=Cheng|first5=L|last6=Campana|first6=A|title=Medical methods for first trimester abortion.|journal=The Cochrane Database of Systematic Reviews|date=9 November 2011|issue=11|pages=CD002855|pmid=22071804|doi=10.1002/14651858.CD002855.pub4}} 4. ^{{cite journal|last1=Bryant|first1=AG|last2=Regan|first2=E|last3=Stuart|first3=G|title=An overview of medical abortion for clinical practice.|journal=Obstetrical & Gynecological Survey|date=January 2014|volume=69|issue=1|pages=39–45|pmid=25102250|doi=10.1097/OGX.0000000000000017}} 5. ^{{cite journal|last1=Marret|first1=H|last2=Simon|first2=E|last3=Beucher|first3=G|last4=Dreyfus|first4=M|last5=Gaudineau|first5=A|last6=Vayssière|first6=C|last7=Lesavre|first7=M|last8=Pluchon|first8=M|last9=Winer|first9=N|last10=Fernandez|first10=H|last11=Aubert|first11=J|last12=Bejan-Angoulvant|first12=T|last13=Jonville-Bera|first13=AP|last14=Clouqueur|first14=E|last15=Houfflin-Debarge|first15=V|last16=Garrigue|first16=A|last17=Pierre|first17=F|last18=Collège national des gynécologues obstétriciens|first18=français|title=Overview and expert assessment of off-label use of misoprostol in obstetrics and gynaecology: review and report by the Collège national des gynécologues obstétriciens français.|journal=European Journal of Obstetrics, Gynecology, and Reproductive Biology|date=April 2015|volume=187|pages=80–4|pmid=25701235|doi=10.1016/j.ejogrb.2015.01.018}} 6. ^{{cite book|last1=Paul|first1=Maureen|title=Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care|date=2011|publisher=John Wiley & Sons|isbn=9781444358476|chapter-url=https://books.google.ca/books?id=iK7xrRr2p9sC&pg=RA1-PT161|chapter=Misoprostol}} 7. ^{{cite web|title=WHO Model List of Essential Medicines (19th List)|url=http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|work=World Health Organization|accessdate=8 December 2016|date=April 2015|deadurl=no|archiveurl=https://web.archive.org/web/20161213052708/http://www.who.int/medicines/publications/essentialmedicines/EML_2015_FINAL_amended_NOV2015.pdf?ua=1|archivedate=13 December 2016|df=}} 8. ^{{cite web|title=Misoprostol|url=http://mshpriceguide.org/en/single-drug-information/?DMFId=1154&searchYear=2014|website=International Drug Price Indicator Guide|accessdate=20 December 2015|deadurl=no|archiveurl=https://web.archive.org/web/20170510161038/http://mshpriceguide.org/en/single-drug-information/?DMFId=1154&searchYear=2014|archivedate=10 May 2017|df=}} 9. ^{{cite book|last1=Hamilton|first1=Richart|title=Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition|date=2015|publisher=Jones & Bartlett Learning|isbn=9781284057560|page=271}} 10. ^{{cite web|title=DocMorris - Cytotec 200 µg Tabletten |url=https://www.docmorris.de/cytotec-200-g-tabletten/01559347?sc=PKV |accessdate=20 May 2016 |date=6 May 2016 |deadurl=unfit |archiveurl=https://web.archive.org/web/20160506105240/https://www.docmorris.de/cytotec-200-g-tabletten/01559347?sc=PKV |archivedate=May 6, 2016 }} 11. ^{{cite journal | pmid = 9494149 | doi=10.1056/NEJM199803123381105 | volume=338 | issue=11 | title=Omeprazole compared with misoprostol for ulcers associated with nonsteroidal antiinflammatory drugs. Omeprazole versus Misoprostol for NSAID-induced Ulcer Management (OMNIUM) Study Group |date=March 1998 |vauthors=Hawkey CJ, Karrasch JA, Szczepañski L, etal | journal=N. Engl. J. Med. | pages=727–34}} 12. ^{{cite journal |doi=10.1056/NEJM200101043440107 |title=Misoprostol and Pregnancy |year=2001 |last1=Wood |first1=Alastair J. J. |last2=Goldberg |first2=Alisa B. |last3=Greenberg |first3=Mara B. |last4=Darney |first4=Philip D. |journal=New England Journal of Medicine |volume=344 |pages=38–47 |pmid=11136959 |issue=1}} 13. ^1 {{cite journal |doi=10.1016/S0091-2182(96)00138-3 |title=Methods of cervical ripening and labor induction |year=1997 |last1=Summers |first1=L |journal=Journal of Nurse-Midwifery |volume=42 |issue=2 |pages=71–85 |pmid=9107114}} 14. ^{{cite web|title=Ferring's removable misoprostol vaginal delivery system, approved for labour induction in European Decentralised Procedure|url=http://www.ferring.com/en/media/press-releases/2013/misodel-17oct13.aspx|publisher=Ferring|accessdate=26 November 2013|date=17 October 2013|deadurl=no|archiveurl=https://web.archive.org/web/20131203041216/http://www.ferring.com/en/media/press-releases/2013/misodel-17oct13.aspx|archivedate=3 December 2013|df=}} 15. ^{{cite web|last=Wing|first=Deborah|title=Misoprostol Vaginal Insert and Time to Vaginal Delivery: A Randomized Controlled Trial|url=http://journals.lww.com/greenjournal/Fulltext/2013/08000/Misoprostol_Vaginal_Insert_and_Time_to_Vaginal.4.aspx#|work=Obstetrics and gynaecology|publisher=Wolters Kluwer Health|accessdate=2014-05-26|deadurl=no|archiveurl=https://web.archive.org/web/20140527215714/http://journals.lww.com/greenjournal/Fulltext/2013/08000/Misoprostol_Vaginal_Insert_and_Time_to_Vaginal.4.aspx|archivedate=2014-05-27|df=}} 16. ^{{cite web|title=Safety Information, Cytotec (misoprostol) Tablets|url=https://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm330991.htm|publisher=FDA|accessdate=16 March 2017|date=11 December 2012|deadurl=no|archiveurl=https://web.archive.org/web/20170120123024/http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm330991.htm|archivedate=20 January 2017|df=}} 17. ^{{Cite web|title = WHO {{!}} Medical methods for first trimester abortion|url = http://apps.who.int/rhl/fertility/abortion/dgguide/en/|website = apps.who.int|access-date = 2016-02-04|deadurl = no|archiveurl = https://web.archive.org/web/20160214074838/http://apps.who.int/rhl/fertility/abortion/dgguide/en/|archivedate = 2016-02-14|df = }} 18. ^{{Cite journal|title = Knowledge and perceptions of medical abortion among potential users|journal = Family Planning Perspectives|date = 1995-10-01|issn = 0014-7354|pmid = 9104607|pages = 203–207|volume = 27|issue = 5|first = S. M.|last = Harvey|first2 = L. J.|last2 = Beckman|first3 = M. A.|last3 = Castle|first4 = F.|last4 = Coeytaux|doi=10.2307/2136276|jstor = 2136276}} 19. ^{{Cite news|title = The Dawn of the Post-Clinic Abortion|url = https://www.nytimes.com/2014/08/31/magazine/the-dawn-of-the-post-clinic-abortion.html|newspaper = The New York Times|date = 2014-08-28|access-date = 2016-02-04|issn = 0362-4331|first = Emily|last = Bazelon|deadurl = no|archiveurl = https://web.archive.org/web/20160302060713/http://www.nytimes.com/2014/08/31/magazine/the-dawn-of-the-post-clinic-abortion.html|archivedate = 2016-03-02|df = }} 20. ^{{cite web|title= Medical methods for first trimester abortion|publisher= The WHO Medical Reproductive Library|url= http://apps.who.int/rhl/fertility/abortion/dgguide/en/|accessdate= 2014-06-22|deadurl= no|archiveurl= https://web.archive.org/web/20140802174632/http://apps.who.int/rhl/fertility/abortion/dgguide/en/|archivedate= 2014-08-02|df= }} 21. ^1 {{Cite book|title=Safe abortion : technical and policy guidance for health systems|last=Organization.|first=World Health|isbn=9789241548434|edition=Second|location=Geneva|oclc=812323067|year = 2012}} 22. ^What is the "Mexican abortion pill" and how safe is it? {{webarchive|url=https://web.archive.org/web/20130730235702/http://drjengunter.wordpress.com/2013/07/27/what-is-the-mexican-abortion-pill-and-how-safe-is-it/ |date=2013-07-30 }} Jen Gunter, July 27, 2013 23. ^{{cite web|title=Annotated Bibliography on Misoprostol Alone for Early Abortion|publisher=Gynuity Health Projects|url=http://www.rhtp.org/news/publications/documents/Miso%20for%20Pregnancy%20Termination.Bibliography.pdf|accessdate=2006-08-22|deadurl=yes|archiveurl=https://web.archive.org/web/20070929071156/http://www.rhtp.org/news/publications/documents/Miso%20for%20Pregnancy%20Termination.Bibliography.pdf|archivedate=2007-09-29|df=}} 24. ^{{cite book|title=providing medical abortion in low-resource settings|date=2009|publisher=Gynuity Health Projects|page=4|edition=2|url=http://gynuity.org/downloads/clinguide_maguide2nd_edition_en.pdf|deadurl=no|archiveurl=https://web.archive.org/web/20160222095552/http://gynuity.org/downloads/clinguide_maguide2nd_edition_en.pdf|archivedate=2016-02-22|df=}} 25. ^{{cite web|title=Instructions for Use: Abortion Induction with Misoprostol in Pregnancies up to 9 Weeks LMP|publisher=Gynuity Health Projects|format=PDF|year=2003|url=http://www.rhtp.org/news/publications/documents/Miso%20for%20Pregnancy%20Termination.IFU.English.pdf#search=%22%20site%3Awww.rhtp.org%20misoprostol%20abortion%20success%20rate%22|accessdate=2006-08-24|deadurl=yes|archiveurl=https://web.archive.org/web/20070929071204/http://www.rhtp.org/news/publications/documents/Miso%20for%20Pregnancy%20Termination.IFU.English.pdf#search=%22%20site%3Awww.rhtp.org%20misoprostol%20abortion%20success%20rate%22|archivedate=2007-09-29|df=}} 26. ^{{cite journal |doi=10.1002/14651858.CD002253.pub3 |title=Medical treatment for early fetal death (less than 24 weeks) |journal=Cochrane Database of Systematic Reviews |year=2006 |last1=Neilson |first1=James P |last2=Hickey |first2=Martha |last3=Vazquez |first3=Juan C |editor1-last=Neilson |editor1-first=James P |pmid=16855990 |issue=3 |pages=CD002253}} 27. ^{{cite journal |doi=10.1016/S0029-7844(02)02371-2 |title=Systematic review of randomized controlled trials of misoprostol to prevent postpartum hemorrhage |year=2002 |last1=Villar |first1=J |journal=Obstetrics & Gynecology |volume=100 |issue=6 |pmid=12468178 |pages=1301–12 |last2=Gülmezoglu |first2=AM |last3=Hofmeyr |first3=GJ |last4=Forna |first4=F}} 28. ^{{cite journal |doi=10.1016/S0029-7844(98)00161-6 |title=Rectally administered misoprostol for the treatment of postpartum hemorrhage unresponsive to oxytocin and ergometrine: A descriptive study |year=1998 |last1=O'Brien |first1=P |journal=Obstetrics & Gynecology |volume=92 |issue=2 |pmid=9699753 |pages=212–4 |last2=El-Refaey |first2=H |last3=Gordon |first3=A |last4=Geary |first4=M |last5=Rodeck |first5=CH}} 29. ^{{cite journal |doi=10.1034/j.1600-0412.2001.080009835.x |title=A randomized study comparing rectally administered misoprostol versus Syntometrine combined with an oxytocin infusion for the cessation of primary post partum hemorrhage |year=2001 |last1=Lokugamage |first1=Amali U. |last2=Sullivan |first2=Keith R. |last3=Niculescu |first3=Iosif |last4=Tigere |first4=Patrick |last5=Onyangunga |first5=Felix |last6=Refaey |first6=Hazem El |last7=Moodley |first7=Jagidesa |last8=Rodeck |first8=Charles H. |journal=Acta Obstetricia et Gynecologica Scandinavica |volume=80 |issue=9 |pages=835–9 |pmid=11531635}} 30. ^{{cite journal |doi=10.1016/j.ijgo.2006.12.005 |title=Cost-effectiveness of misoprostol to control postpartum hemorrhage in low-resource settings |year=2007 |last1=Bradley |first1=S. E. K. |last2=Prata |first2=N. |last3=Young-Lin |first3=N. |last4=Bishai |first4=D.M. |journal=International Journal of Gynecology & Obstetrics |volume=97 |pmid=17316646 |pages=52–6 |issue=1}} 31. ^{{cite journal |doi=10.1016/S0140-6736(06)69522-6 |title=Oral misoprostol in preventing postpartum haemorrhage in resource-poor communities: A randomised controlled trial |year=2006 |last1=Derman |first1=Richard J |last2=Kodkany |first2=Bhalchandra S |last3=Goudar |first3=Shivaprasad S |last4=Geller |first4=Stacie E |last5=Naik |first5=Vijaya A |last6=Bellad |first6=MB |last7=Patted |first7=Shobhana S |last8=Patel |first8=Ashlesha |last9=Edlavitch |first9=Stanley A |last10=Hartwell |first10=Tyler |last11=Chakraborty |first11=Hrishikesh |last12=Moss |first12=Nancy |journal=The Lancet |volume=368 |issue=9543 |pmid=17027730 |pages=1248–53|display-authors=8 }} 32. ^{{cite book |first1=Harshad |last1=Sanghvi |first2=Mohammad |last2=Zulkarnain |first3=Gail Fraser |last3=Chanpong |editor1-first=Ann |editor1-last=Blouse |editor2-first=Dana |editor2-last=Lewison |year=2009 |title=Prevention of Postpartum Hemorrhage at Home Birth: A Program Implementation Guide |publisher=United States Agency for International Development |url=http://pdf.usaid.gov/pdf_docs/PNADX368.pdf |deadurl=no |archiveurl=https://web.archive.org/web/20131206122217/http://pdf.usaid.gov/pdf_docs/PNADX368.pdf |archivedate=2013-12-06 |df= }}{{page needed|date=September 2012}} 33. ^{{cite journal |doi=10.1093/heapol/czs068 |title=New hope: community-based misoprostol use to prevent postpartum haemorrhage|year=2012 |last1=Prata |first1=Ndola |last2=Passano |first2=Paige |last3=Bell |first3=Suzanne |last4=Rowen |first4=Tami |last5=Potts |first5=Malcolm |journal=Health Policy and Planning |volume= 28|issue= 4|pages=339–46|pmid=22879523}} 34. ^1 2 {{cite web |author=Pfizer |date=September 2006 |title=Cytotec US Prescribing Information |url=http://www.pfizer.com/pfizer/download/uspi_cytotec.pdf |accessdate=2007-03-15 |deadurl=yes |archiveurl=https://web.archive.org/web/20070216041437/http://www.pfizer.com/pfizer/download/uspi_cytotec.pdf |archivedate=2007-02-16 |df= }} 35. ^{{cite web |author=Pharmacia |date=July 2004 |title=Cytotec UK SPC (Summary of Product Characteristics) |url=http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=9352 |accessdate=2007-03-15 |deadurl=no |archiveurl=https://web.archive.org/web/20070928060833/http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=9352 |archivedate=2007-09-28 |df= }} 36. ^{{cite journal |doi=10.2146/ajhp050265.p2 |title=Drug therapy during labor and delivery, part 2 |year=2006 |last1=Briggs |first1=G. G. |journal=American Journal of Health-System Pharmacy |volume=63 |issue=12 |pages=1131–9 |pmid=16754739 |last2=Wan |first2=SR}} 37. ^{{harvnb|Wagner|2006}} 38. ^{{harvnb|Goldberg|Wing|2003}}, which cites::{{cite journal |doi=10.1097/00003081-200609000-00023 |title=Oral Misoprostol Administration for Labor Induction |year=2006 |last1=Weeks |first1=Andrew |last2=Alfirevic |first2=Zarko |journal=Clinical Obstetrics and Gynecology |volume=49 |issue=3 |pages=658–71 |pmid=16885670}} 39. ^{{cite journal | vauthors = Moreno JJ | title = Eicosanoid receptors: Targets for the treatment of disrupted intestinal epithelial homeostasis | journal = European Journal of Pharmacology | volume = 796 | issue = | pages = 7–19 | year = 2017 | pmid = 27940058 | doi = 10.1016/j.ejphar.2016.12.004 | url = }} 40. ^{{cite journal |doi=10.1016/S1526-9523(03)00087-4 |title=Induction of laborthe misoprostol controversy |year=2003 |last1=Goldberg |first1=A |last2=Wing |first2=D |journal=Journal of Midwifery & Women's Health |volume=48 |issue=4 |pmid=12867908 |ref=harv |pages=244–8}} 41. ^{{harvnb|Goldberg|Wing|2003}}, which cites::{{cite journal |author=American College of Obstetricians and Gynecologists |authorlink=American College of Obstetricians and Gynecologists |title=Induction of labor with misoprostol |journal=ACOG Committee Opinion No. 228 |location=Washington, DC |date=November 1999}}:{{cite journal |author=American College of Obstetricians and Gynecologists |authorlink=American College of Obstetricians and Gynecologists |title=Response to Searle's drug warning on misoprostol |journal=ACOG Committee Opinion No. 248 |location=Washington, DC |date=November 1999}} 42. ^{{cite web|title=WHO Essential drug list 2005 section 22.1 website|author=WHO|url=http://whqlibdoc.who.int/hq/2005/a87017_eng.pdf|accessdate=2006-12-06|deadurl=no|archiveurl=https://web.archive.org/web/20070212145830/http://whqlibdoc.who.int/hq/2005/a87017_eng.pdf|archivedate=2007-02-12|df=}} 43. ^{{cite web|title=Denver attorney receives 'Case of the Year' honor|url=http://www.lawweekonline.com/2012/05/david-woodruff-wins-case-of-the-year/|deadurl=no|archiveurl=https://web.archive.org/web/20131202231628/http://www.lawweekonline.com/2012/05/david-woodruff-wins-case-of-the-year/|archivedate=2013-12-02|df=}} 44. ^{{cite journal |doi=10.1016/0140-6736(93)91156-G |title=Misoprostol and illegal abortion in Rio de Janeiro, Brazil |year=1993 |last1=Costa |first1=S. H. |last2=Vessey |first2=M. P. |journal=The Lancet |volume=341 |issue=8855 |pmid=8098402 |pages=1258–61}} 45. ^{{cite journal |doi=10.1016/0010-7824(94)90084-1 |title=Misoprostol: The experience of women in Fortaleza, Brazil |year=1994 |last1=Coêlho |first1=Helena Lutéscia |last2=Teixeira |first2=Ana Cláudia |last3=De Fátima Cruz |first3=Maria |last4=Gonzaga |first4=Sandra Luzia |last5=Arrais |first5=Paulo Sérgio |last6=Luchini |first6=Laura |last7=La Vecchia |first7=Carlo |last8=Tognoni |first8=Gianni |journal=Contraception |volume=49 |issue=2 |pages=101–10 |pmid=8143449}} 46. ^{{cite journal |first1=Regina Maria |last1=Barbosa |first2=Margareth |last2=Arilha |year=1993 |title=The Brazilian Experience with Cytotec |journal=Studies in Family Planning |volume=24 |issue=4 |pages=236–40 |jstor=2939191 |doi=10.2307/2939191 |pmid=8212093}} 47. ^{{cite journal |doi=10.1136/bmj.309.6957.757a |title=Brazil investigates drug's possible link with birth defects |year=1994 |last1=Rocha |first1=J. |journal=BMJ |volume=309 |issue=6957 |pmid=7950553 |pages=757–8 |pmc=2540993}} 48. ^{{cite journal |doi=10.1002/ajmg.1320470113 |title=Limb deficiency with or without Möbius sequence in seven Brazilian children associated with misoprostol use in the first trimester of pregnancy |year=1993 |last1=Gonzalez |first1=Claudette Hajaj |last2=Vargas |first2=Fernando R. |last3=Perez |first3=Ana Beatriz Alvarez |last4=Kim |first4=Chong Ae |last5=Brunoni |first5=Decio |last6=Marques-Dias |first6=Maria Joaquina |last7=Leone |first7=Clea R. |last8=Neto |first8=Jordão Correa |last9=Llerena |first9=Juan C. |last10=De Almeida |first10=José Carlos Cabral |journal=American Journal of Medical Genetics |volume=47 |pages=59–64 |pmid=8368254 |issue=1|display-authors=8 }} 49. ^{{cite news |authorlink=John Leland (journalist) |author=John Leland |url=https://www.nytimes.com/2005/10/02/weekinreview/02leland.html |title=Abortion Might Outgrow Its Need for Roe v. Wade |newspaper=The New York Times |date=October 2, 2005 |accessdate=March 6, 2014 |deadurl=no |archiveurl=https://web.archive.org/web/20130518132249/http://www.nytimes.com/2005/10/02/weekinreview/02leland.html |archivedate=May 18, 2013 |df= }} 50. ^{{cite news|title=In Mexican Pill, a Texas Option for an Abortion|url=https://www.nytimes.com/2013/07/14/us/in-mexican-pill-a-texas-option-for-an-abortion.html|accessdate=July 14, 2013|newspaper=The New York Times|date=July 13, 2013|author=Erik Eckholm|deadurl=no|archiveurl=https://web.archive.org/web/20130714154112/http://www.nytimes.com/2013/07/14/us/in-mexican-pill-a-texas-option-for-an-abortion.html|archivedate=July 14, 2013|df=}} 51. ^{{ cite news |url=https://www.theatlantic.com/health/archive/2014/06/the-rise-of-the-diy-abortion-in-texas/373240/ |author=Erica Hellenstein |title=The Rise of the DIY Abortion in Texas |newspaper=The Atlantic |date=June 27, 2014 |deadurl=no |archiveurl=https://web.archive.org/web/20170302015432/https://www.theatlantic.com/health/archive/2014/06/the-rise-of-the-diy-abortion-in-texas/373240/ |archivedate=March 2, 2017 |df= }} External links
11 : Abortifacients|Gastroenterology|Gynaecology|Methods of abortion|Prostaglandins|Carboxylate esters|Alcohols|Ketones|Methyl esters|World Health Organization essential medicines|RTT |
| 随便看 |
|
开放百科全书收录14589846条英语、德语、日语等多语种百科知识，基本涵盖了大多数领域的百科知识，是一部内容自由、开放的电子版国际百科全书。