Oncology and Fibroids
Mifepristone is useful for Rx of? (AIPG 2011)
RU-486 OR MIFEPRISTONE
a. The first report of an anti-progestin, (often referred to as RU-486) or mifepristone; this drug is available for the termination of pregnancy.
c. Mifepristone is a derivative of the 19-norprogestin norethindrone containing a dimethyl-aminophenol substituent at the 11-position.
d. It effectively competes with both progesterone and glucocorticoids for binding to their respective receptors.
e. Mifepristone was initially thought to be a pure anti-progestin; this is its predominant activity in most situations, but it also has some agonist activity. Thus it is now considered a progesterone-receptor modulator (PRM) due to its context-dependent activity.
1. Criteria for medical management of ectopic pregnancy:
a. The gestational sac is not more than 3.5cm.
b. Serum LCG level net > 10,000 mIU/ml.
c. Fetal cardiac activity absent.
d. Patient can be followed up.
2. Drugs used are:
a. Methotrexate ± leucovorum
b. Prostaglandin F2 α (Misoprostol)
d. Hyperosmolar glucose