Review Topic
  • A 55-year-old man with a history of chronic NSAID use and recent hospitalization for a soft tissue infection presents to his primary care physician for diarrhea. His long-term medication list also includes ibuprofen, metoprolol, and most recently misoprostol given his long-term NSAID use. His physician is worried about C. difficile diarrhea, but the patient reports that this diarrhea started soon after starting misoprostol, which pre-dated his recent hospitalization and antibiotic use.
  • Drugs
    • misoprostol
  • Mechanism of action
    • misoprostol is a prostaglandin E1 (PGE1) analog, which strengthens the gastric mucous barrier and ↓ acid production
    • it also ↓ degree of fat malabsorption
  • Clinical use
    • non-steroidal anti-inflammatory drug (NSAIDs) -induced peptic ulcer prophylaxis
      • NSAIDs block PGE1 production
    • induction of labor
      • PGE1 ripens the cervix
  • Adverse effects
    • diarrhea
    • abdominal pain
    • abortive
      • contraindicated in women of childbearing age
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