One case of severe allergic shock caused by misoprostol tablets

doi:10.19803/j.1672-8629.20240201

Abstract

Abstract: Objective To study one case of allergic shock caused by misoprostol tablets and the effects of different administration routes so as to provide references for safe use. Methods The clinical data of a 29-year-old patient with medical abortion due to 400 μg of misoprostol tablets sublingually was reviewed and the cause of allergic shock leading to cardiac arrest was analyzed. Medications were recommended after related literature was consulted. Results Allergic shock and cardiac arrest occurred in the patient who had received misoprostol tablets sublingually. The analysis of medications time of delivery pointed to severe adverse drug reactions (ADR). By analyzing relevant literature and cases, it was found that ADR might occur through different administration routes. Conclusion Misoprostol tablets may increase the risk of cardiac arrest, so clinical vigilance is required.

Key words: misoprostol, medical abortion, allergic shock, cardiac arrest, prostaglandin, adverse drug reactions

CLC Number:

R984
R994.11

JIANG Renjun, QIN Shuyong, WANG Yuan, LUO Sui. One case of severe allergic shock caused by misoprostol tablets[J]. Chinese Journal of Pharmacovigilance, 2024, 21(10): 1175-1177.

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https://zgywjj.magtechjournal.com/EN/Y2024/V21/I10/1175

References

[1] YUAN SS, WANG Y, FENG X, et al.Analysis of 688 cases of adverse drug reaction induced by misoprostol[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2021, 18(1): 68-71.
[2] Chinese Medical Association.The Chinese expert consensus on the standardized diagnosis and treatment of missed abortion in the second trimester of pregnancy[J]. Chinese Journal of Practical Gynecology and Obstetrics(中国实用妇科与产科杂志), 2021, 37(9): 928-932.
[3] BARTZ DA, BLUMENTHAL PD. First-trimester pregnancy termination: medication abortion[DB/OL]. (2024-02-21)[2024-05-10]. https://www.uptodate.cn/contents/zh-Hans/first-trimester-pregnancy-termination-medication-abortion.
[4] XIONG GH.Analysis of the clinical effect of Xinmupei combined with misoprostol in the treatment of postpartum hemorrhage[J]. Systems Medicine(系统医学), 2022, 7(1): 159-161.
[5] MAO W, WEN ZF.The prevention of NSAIDs-induced gastroduodenal ulcers-meta analysis[J]. The Journal of Evidence-Based Medicine(循证医学), 2004, 4(4): 220-223.
[6] BARTLEY J, BROWN A, ELTON R, et al.Double-blind randomized trial of mifepristone in combination with vaginal gemeprost or misoprostol for induction of abortion up to 63 days gestation[J]. Hum Reprod, 2001, 16: 2098.
[7] BÉNÉ J, ALARCON P, FAUCON M, et al. Anaphylactic shock after misoprostol in voluntary termination of pregnancy-a case report[J]. Eur J Obstet Gynecol Reprod Biol, 2014, 182: 260-261.
[8] YAN Z, YOU PL, ZHEN WL, et al.Side effect of mifepristone in combination with misoprostol for medical abortion[J]. Chinese Journal of Obstetrics and Gynecology(中华妇产科杂志), 2004, 39(1): 39-42.
[9] Chinese Medical Association.The Chinese expert consensus on the standardized diagnosis and treatment of missed abortion in the second trimester of pregnancy[J]. Chinese Journal of Practical Gynecology and Obstetrics(中国实用妇科与产科杂志), 2021, 37(9): 928.
[10] WHO. Abortion Care Guideline[EB/OL].[2022-03-08]. https://apps.who.int/iris/handle/10665/349316.
[11] ZHAO SD, LU ZP.Factors affecting the evaluation of individual ADR reports[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2012, 9(9): 553-555.
[12] XIAO HL, ZHAO HB.A case of anaphylactic shock induced by misoprostol[J]. Herald of Medicine(医药导报), 2001, 20(1): 63.
[13] LI XT, ZHAI SD, WANG Q, et al.Recommendations in guideline for emergency management of anaphylaxis[J]. Adverse Drug Reactions Journal(药物不良反应杂志), 2019, 21(2): 85-91.
[14] WANG JD, WANG HL.Interpretation of European academy of allergy and clinical immunology guideline: anaphylaxis (2021 update)[J]. Chinese Pediatric Emergency Medicine(中国小儿急救医学), 2022, 29(4): 260-265.
[15] XIANG L, WAN WL, QU ZH, et al.Recommendations for the diagnosis and treatment of anaphylaxis in Chinese children[J]. Chinese Journal of Applied Clinical Pediatrics(中华实用儿科临床杂志), 2021, 36(6): 410-415.
[16] LIN GF.Analysis of the effect of different administration routes of misoprostol before induced abortion[J]. Chin J Mod Drug Appl(中国现代药物应用), 2023, 17(10): 111-114.
[17] WANG YH.Effects of mifepristone combined with misoprostol on medical abortion in different administration routes[J]. Electronic Journal of Practical Gynecological Endocrinology(实用妇科内分泌杂志), 2022, 9(23): 41-43.
[18] CAI J, LUO YP.Clinical study on the application of misoprostol in the termination of 8-16 weeks of pregnancy by different administration routes[J]. Medical Innovation of China(中国医学创新), 2018, 15(10): 124-126.
[19] LIN WY.Clinical analysis of misoprostol in induction of abortion in late pregnancy[J]. Journal of Jiangxi University of Chinese Medicine(江西中医药大学学报), 2024, 36(1): 61-63.
[20] ZHONG YF, LIN CX.Evaluation on effect of intravaginal and sublingual administration of misoprostol in outpatient painless abortion[J]. China Prac Med(中国实用医药), 2023, 18(20): 112-115.
[21] GUAN SM, LIN ZR, WU B, et al.1463 adverse reactions of misoprostol tablets in Chongqing city[J]. Journal of Guangdong Medical University(广东医科大学学报), 2022, 40(1): 81-84.
[22] YANG CY, YANG L, ZENG LR, et al.Adverse reactions and safety of misoprostol tablets in different administration routes[J]. Strait Pharmaceutical Journal(海峡医药), 2020, 32(12): 251-252.