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The Journal of Urology Jul 1995
Topics: Alprostadil; Erectile Dysfunction; Humans; Injections; Male; Pain; Penile Prosthesis; Penis
PubMed: 7776462
DOI: 10.1016/s0022-5347(01)67234-3 -
Canadian Journal of Gastroenterology =... Oct 2011Constipation is a common functional gastrointestinal disorder that affects patients of all ages. In 2007, a consensus group of 10 Canadian gastroenterologists developed... (Review)
Review
Constipation is a common functional gastrointestinal disorder that affects patients of all ages. In 2007, a consensus group of 10 Canadian gastroenterologists developed a set of recommendations pertaining to the management of chronic constipation and constipation dominant irritable bowel syndrome. Since then, tegaserod has been withdrawn from the Canadian market. A new, highly selective serotonin receptor subtype 4 agonist, prucalopride, has been examined in several large, randomized, placebo-controlled trials demonstrating its efficacy and safety in the management of patients with chronic constipation. Additional studies evaluating the use of stimulant laxatives, polyethylene glycol and probiotics in the management of chronic constipation have also been published. The present review summarizes the previous recommendations and new evidence supporting different treatment modalities - namely, diet and lifestyle, bulking agents, stool softeners, osmotic and stimulant laxatives, prucalopride and probiotics in the management of chronic constipation. A brief summary of lubiprostone and linaclotide is also presented. The quality of evidence is presented by adopting the Grading of Recommendations, Assessment, Development and Evaluation system. Finally, a management pyramid for patients with chronic constipation is proposed based on the quality of evidence, impact of each modality on constipation and on general health, and their availabilities in Canada.
Topics: Alprostadil; Benzofurans; Chloride Channels; Chronic Disease; Constipation; Feedback, Physiological; Gastrointestinal Motility; Humans; Laxatives; Life Style; Lubiprostone; Peptides
PubMed: 22114754
DOI: No ID Found -
BMJ (Clinical Research Ed.) Oct 2012
Review
Topics: Adult; Alprostadil; Constipation; Female; Humans; Laxatives; Lubiprostone; Male; Meta-Analysis as Topic; Peptides; Randomized Controlled Trials as Topic
PubMed: 23028096
DOI: 10.1136/bmj.e6168 -
Drugs 2006
Topics: Alprostadil; CLC-2 Chloride Channels; Cathartics; Chloride Channel Agonists; Chloride Channels; Constipation; Fatty Acids; Female; Humans; Intestinal Mucosa; Lubiprostone; Male
PubMed: 16706563
DOI: 10.2165/00003495-200666060-00017 -
Journal of Clinical Gastroenterology Apr 2007In January 2006 the Food and Drug Administration approved lubiprostone for the treatment of chronic constipation in men and women aged 18 and over. Lubiprostone is... (Review)
Review
In January 2006 the Food and Drug Administration approved lubiprostone for the treatment of chronic constipation in men and women aged 18 and over. Lubiprostone is categorized as a prostone, a bicyclic fatty acid metabolite of prostaglandin E1. Lubiprostone activates a specific chloride channel (ClC-2) in the gastrointestinal (GI) tract to enhance intestinal fluid secretion, which increases GI transit and improves symptoms of constipation. This article reviews the role of chloride channels in the GI tract, describes the structure, function, and pharmacokinetics of lubiprostone, and discusses clinically important data on this new medication.
Topics: Alprostadil; Cathartics; Chloride Channels; Chlorides; Chronic Disease; Constipation; Fatty Acids; Female; Gastrointestinal Transit; Humans; Lubiprostone; Male
PubMed: 17413599
DOI: 10.1097/01.mcg.0000225665.68920.df -
Journal of Psychosomatic Obstetrics and... Mar 2006This multi-center, randomized, placebo-controlled, crossover design study evaluated the effects of a topical alprostadil solution for the treatment of female sexual... (Randomized Controlled Trial)
Randomized Controlled Trial
This multi-center, randomized, placebo-controlled, crossover design study evaluated the effects of a topical alprostadil solution for the treatment of female sexual arousal disorder (FSAD). A total of 79 naturally or surgically post menopausal women with FSAD were treated with either 100 or 400 micrograms of alprostadil solution and placebo, delivered on separate clinic visits in random order. Study drug was applied to the external genitalia and was followed by 30 minutes of visual sexual stimulation. Study evaluations included investigator assessments of genital vasocongestion and patient assessments of physical and emotional sexual arousal, and sexual satisfaction. Genital vasocongestion in response to PGE1 was significantly greater than placebo (p < 0.0001) at each dose level and at all post dosing time points. Patient assessments of physical and emotional arousal and sexual satisfaction were significantly greater than placebo with the 400 mcg dose, but not with the 100 mcg dose of alprostadil. Topical alprostadil was well tolerated with no reports of significant systemic side effects. The most common adverse event was mild, transient genital burning typically < 1 minute duration. Other side effects were mild-moderate, resolving within two hours of application. These data suggest topical alprostadil should be further researched as a potentially appropriate on-demand therapeutic choice for women experiencing FSAD.
Topics: Administration, Topical; Adult; Aged; Alprostadil; Cross-Over Studies; Double-Blind Method; Drug Administration Schedule; Female; Humans; Middle Aged; Personal Satisfaction; Prospective Studies; Sexual Dysfunctions, Psychological; Time Factors; Vasodilator Agents
PubMed: 16752874
DOI: 10.1080/01674820500237973 -
Urologiia (Moscow, Russia : 1999) 2002Forty-four patients with erectile dysfunction (ED) aged 21-72 years aged 21-72 years (mean age 61 years) were examined and treated with sildenafil and alprostadil...
Forty-four patients with erectile dysfunction (ED) aged 21-72 years aged 21-72 years (mean age 61 years) were examined and treated with sildenafil and alprostadil monotherapy or combined therapy. ED was psychogenic in 9(20.5%), arterial in 12(27.2%), vein occlusive in 9(20.5%) and neurogenic in 14(31.8%) patients. Monotherapy was most effective in psychogenic ED (alprostadil--100%, sildenafil--88.9%), least effective in vein occlusive ED (alprostadil--33.3%, sildenafil--22.2%). Alprostadil was more effective in arterial and neurogenic ED (83.3 vs 66.7 and 78.6 vs 57.1%, respectively). Combination of the two drugs produced much high response: 100, 85.7 and 55.5% in arterial, neurogenic and vein occlusive ED, respectively. Thus, combined treatment with sildenafil and alprostadil is a method of choice in the treatment of ED in failure of monotherapy with these drugs or in vein occlusive ED. In the combined treatment dose of the drugs, number of side effects and cost of therapy are lower.
Topics: Adult; Aged; Alprostadil; Erectile Dysfunction; Humans; Male; Middle Aged; Piperazines; Purines; Sildenafil Citrate; Sulfones
PubMed: 12180059
DOI: No ID Found -
Digestive Diseases and Sciences Dec 2017
Topics: Alprostadil; Constipation; Humans; Lubiprostone; Nausea
PubMed: 28965302
DOI: 10.1007/s10620-017-4773-x -
Digestive Diseases and Sciences Feb 1986Misoprostol is an E1 prostaglandin analog. Most of the other synthetic prostaglandins that are being studied in advanced clinical trials for gastrointestinal diseases... (Clinical Trial)
Clinical Trial Review
Misoprostol is an E1 prostaglandin analog. Most of the other synthetic prostaglandins that are being studied in advanced clinical trials for gastrointestinal diseases are E2 derivatives. Misoprostol has shown a dose-related antisecretory effect that lasted 3-5.5 hr. In addition, animal studies have shown cytoprotective properties that are being confirmed in clinical studies. Ulcer-healing trials using four times daily dosing appear to parallel the antisecretory dose-response curve up to a dose of 200 micrograms qid. Evidence presented in this supplement suggests a further increase in healing-rate response at 300 micrograms misoprostol qid. The misoprostol healing rates obtained in duodenal ulcer and gastric ulcer therapy at 200 micrograms qid are not significantly different from those seen in the same studies with cimetidine at a dose of 300 mg qid. No significant rebound in recurrence has been observed during follow-up for 12 months after short-term 100- and 200-micrograms qid misoprostol treatment. The most frequent adverse effects are dose-related diarrhea and abdominal cramping, which are transient in most patients and have not caused a significant problem in clinical use. There is also a tropic effect on the pregnant uterus, which was observed in a special pharmacologic clinical study. No significant abnormalities have been detected in clinical laboratory tests or gastric biopsies. There have also been no adverse effects noted on blood pressure, pulse, platelets, the immune system, pulmonary function, gastrointestinal hormones, or the endocrine system. These previously discussed characteristics of misoprostol, and current data, suggest that this prostaglandin E1 derivative may be an important addition to the treatment of peptic ulcer disease.
Topics: Alprostadil; Anti-Ulcer Agents; Cimetidine; Clinical Trials as Topic; Diarrhea; Duodenal Ulcer; Female; Gastric Acid; Gastric Mucosa; Humans; Immune System; Misoprostol; Peptic Ulcer; Platelet Aggregation; Recurrence; Uterus
PubMed: 3080288
DOI: 10.1007/BF01309323 -
Clinical Pharmacy Sep 1989The pharmacology, pharmacokinetics, clinical efficacy, contraindications and precautions, adverse effects, dosage, and cost of misoprostol are reviewed. Misoprostol is a... (Review)
Review
The pharmacology, pharmacokinetics, clinical efficacy, contraindications and precautions, adverse effects, dosage, and cost of misoprostol are reviewed. Misoprostol is a synthetic analogue of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion and enhances mucosal resistance to injury. Misoprostol is extensively absorbed from the stomach and undergoes rapid de-esterification to its biologically active metabolite, misoprostol acid. The average absorption after an oral dose is 88%; peak plasma concentrations of misoprostol acid are achieved in less than 30 minutes. Clinical trials have demonstrated ulcer healing rates of approximately 60-80% in patients with duodenal ulcers who received misoprostol 800 micrograms daily for four weeks. Misoprostol was generally no more efficacious than conventional therapy with the H2-receptor antagonists cimetidine and ranitidine. The healing rate observed for gastric ulcers was less than that observed for duodenal ulcers. In trials involving healthy volunteers and patients with arthritis receiving aspirin, naproxen, tolmetin, ibuprofen, or piroxicam, misoprostol was consistently superior to placebo, cimetidine, and sucralfate in the prevention of nonsteroidal anti-inflammatory drug (NSAID)-induced gastropathy. The majority of these studies have been of short duration; however, long-term studies (up to three months) have corroborated superiority over placebo. Misoprostol is an abortifacient and is contraindicated in pregnant women and women of childbearing potential not using effective contraception. The most common adverse effect of misoprostol therapy is diarrhea, which is often mild and self-limiting and can be minimized by administration of misoprostol after meals and at bedtime. The cost (based on retail price) of four weeks of therapy with misoprostol is comparable to that of other antiulcer agents. Misoprostol has been shown to be an effective agent for the prevention of NSAID-induced gastric ulcers. However, there is no evidence that it offers any clinical advantage over H2-receptor antagonists for the treatment of gastric or duodenal ulcer disease.
Topics: Alprostadil; Anti-Ulcer Agents; Economics; Humans; Misoprostol
PubMed: 2507215
DOI: No ID Found