Medication Abortion

Question 1

Mifepristone (mifeprex)

Answer 1

Selective progesterone receptor modulator
antiprogesterone –> competitively inibits the actions of progesterone at the progesterone receptor side
decidual necrosis, cervical softening, increased uterine contractility, prostaglandin sensitivity

Question 2

Misoprostol (cytotec)

Answer 2

Prostaglandin Ei analogue
Cervical softening
Uterine contractions

Question 3

Medication abortion dosing

Answer 3

Mifepristone - 200mg orally (one dose)
Misoprostol - 800mcg buccally (put in both cheeks and dissolved) 24-48 hours after mifepristone dose
- take 2 200mcg tablets in each check (leave for 30 minutes to let fully dissolve)

Question 4

Counseling points

Answer 4

Bleeding - bleeding and cramping are expected
Contact - heavy bleeding, chills and any fever > or equal to 101 or 100.4 for more than 4 hours
Adverse effects - nausea, vomiting, diarrhea, headache, dizziness, hot flushes, chills
Pain- NSAIDs recommended, most severe ~2.5-4 hours after misoprostol