Buy Cytotec Online Australia
The active ingredient of Cytotec tablets is a synthesized analogue of prostaglandin E1 produced by the body. This molecule enhances the protective properties of the gastrointestinal mucosa by stimulating the production of mucus by glandular cells of the stomach. Cytotec should be used for ulcerative lesions of the duodenum with or without bleeding, ulcerative lesions of the stomach with or without bleeding.
1 tablet Cytotec contains misoprostol 0.2 mg. Additive components: MCC, aerosil, KMK sodium, hypromellose, castor oil.
The active ingredient of Cytotec tablets is a synthesized analogue of prostaglandin E1 produced by the body. This molecule enhances the protective properties of the gastrointestinal mucosa by stimulating the production of mucus by the glandular cells of the stomach, enhancing the natural secretion of bicarbonate molecules.
This increases the stability of the gastrointestinal mucosa, does not give aggressive ingredients from food, alcoholic beverages, therapeutic drugs harm the cells that form the gastrointestinal mucosa. Cytotec has the following effects:
- causes neutralization of the acid by enhancing the synthesis of bicarbonates;
- protects the walls of the stomach from aggressive molecules by increasing the production of mucus, improving its qualitative composition;
- improves blood supply to the gastrointestinal tract with stimulation of regenerative processes.
A molecule of misoprostol reduces the production of peptic molecules. The therapeutic effect starts 30 minutes after the use of the dosage form, lasts about 180 minutes. Misoprostol provokes a contraction of myometrium, increases the intensity of contractions.
Indications for use
Cytotec is appointed when:
- the need to use drugs NSAIDs;
- peptic ulcer of any localization;
- duodenal ulcers with or without bleeding;
- ulcerative lesions of the stomach with or without bleeding.
Mode of application
Cytotec tablet is taken orally. It is shown to use the dosage form directly with food, after eating and before going to bed. For the treatment of ulcerative injuries of the gastrointestinal tract, gastritis with erosions of the mucous membrane, the daily dose is 0.8 mg with its division into 2-4 doses.
In order to prevent the development of ulcerative lesions of the gastrointestinal tract, 0.4–0.8 mg / day is prescribed with a dose split of 2–4 doses. If necessary, treatment with drugs of the NSAID group is indicated to take Cytotec during the entire treatment. During the exacerbation of duodenal ulcers, the drug should be taken 1 month. After a month, endoscopy is done. If incomplete scarring is detected, the course is extended for another month.
The use of Cytotec tablets can be accompanied by:
- skin rashes;
- lower abdominal pain;
- bloody vaginal secretions;
- bouts of nausea;
- change in body weight;
- epigastric pain.
Cytotec is not assigned when:
- liver pathologies of a pronounced nature;
- acute form of renal failure;
- cerebral circulatory disorders;
- intestinal pathologies associated with inflammation;
- pregnancy planning;
- indications in pre-menopausal patients;
- indications at the feeding;
- misoprostol hypersensitivity;
- indications in patients under 17 years old.
Caution is needed when prescribing Cytotec tablets when:
- organic pathologies of cerebral vessels;
- acute disorders of peripheral circulation;
Cytotec tablets can provoke self-abortion. The use of misoprostol-containing drugs in pregnancy and suspicion of it is contraindicated.
The use of the drug in dosages that exceed therapeutic, may be accompanied by the following symptoms:
- epigastric pain;
- feverish state;
- slowing down the reaction rate;
- convulsive syndrome.
It is shown to carry out the therapy corresponding to the appeared symptomatology.
Adjustment of doses for gerontological patients is not carried out. For patients with diseases of the kidneys, liver and impaired function, standard dosing regimens are prescribed.
It is necessary to prescribe pregnancy tests for patients of childbearing age. Misoprostol is indicated to be administered several days after the onset of normal menstruation. It is shown to use reliable contraceptive methods for drug therapy Cytotec. This therapeutic agent may cause termination of pregnancy due to the stimulating effect on the tone of the uterus.
In appointing the drug to nursing mothers, a decision is made to stop lactation.
Peptic ulcer - Stomach cancer
Peptic ulcer (PUD) of the stomach is one of the most common pathologies among the diseases of the digestive system. According to various epidemiological data from WHO, peptic ulcer disease occurs in about 10-15% of the world's population. More than 3 million patients with peptic ulcer were diagnosed in the USA, and the prevalence of this disease is more than 5-10% of the population, continuing to increase annually.
Peptic ulcer disease is a polyetiological disease, but the discovery by scientists J.R. Warren, B. Marshal (1983) The role of Helicobacter pylori (Hp) in the development of peptic ulcer disease has led, since the early 80s, to a significant rethinking of the etiology and pathogenesis of this disease.
Helicobacter pylori is currently the main infectious agent leading to the development of peptic ulcer. According to its biological properties, Hp refers to microorganisms with an oxidative type of metabolism that produce enzymes: urease, catalase, oxidase, alkaline phosphatase, glutamine, aminopeptidase, DNA-ase, and cytotoxin that damage epithelial cells, forming an adhesive bacterial layer in them, thereby participating the development of ulcerative lesions of the stomach. Cytotoxin promotes the passage of bacteria into the extracellular space and the formation of colonies, thereby causing damage to the gastric mucosa. Urease causes cleavage of urea, which leads to the formation of carbon dioxide and ammonia, which neutralize hydrochloric acid and, being an important damage factor, affect both the mucus layer and the cells of the gastric epithelium, producing pro-inflammatory agents. In addition, Hp secrete surface proteins and platelet activating factor, which are inflammatory mediators, activate monocytes that carry receptors for IL-2 and produce oxygen free radicals, thereby contributing to the secretion of proteases, phospholipases that destroy the mucous gel, causing chronic inflammation and immune answer. This reduces the amount and viscosity of mucus, decreases the secretion of hydrochloric acid and pepsin up to achlorhydria, which contributes to the steady colonization of Hp, thereby causing the development of neoplastic processes in the wall of the stomach.
Under the influence of HP and activation of leukocytes, damage occurs to the vascular endothelium, impaired microcirculation and trophism of the gastric mucosa, which leads to the development of inflammatory, dystrophic and necrobiotic changes, determining the high frequency of recurrences of ulcers after their healing.
Recurrent and nonhealing forms of peptic ulcer with achlorhydria, kalezny ulcers, torpid course of the process of cicatrization of the ulcerative defect, polypous changes of the gastric mucosa, concomitant atrophic and dysplastic changes are referred to precancerous conditions. According to the recommendations of the WHO International Coordinating Committee on the Histological Classification of Precancerous Stomach Diseases (1978), the concept of dysplasia was introduced, which includes cell atypia, impaired differentiation and structure of the gastric mucosa.
With an unfavorable course of peptic ulcer associated with Hp and an active inflammatory process in the mucous membrane of the bile under the influence of environmental factors, harmful habits, genetic predisposition, proliferation processes are enhanced, leading to the development and progression of precancerous changes in the organ epithelium. According to a number of studies, damage to the cells of the mucous membrane of the bile causing metaplastic, dysplastic changes in the epithelium of the stomach is associated with autoimmune aggression induced by Hp. In the zones of intestinal metaplasia and glandular epithelium of the mucous membrane of the grouse with signs of dysplasia, intestinal antigens are detected. Thus, scientists believe that trophic disorders and dysplastic changes in the epithelium of the stomach are accompanied by intestinal antigenic rearrangement, therefore, in patients with peptic ulcer associated with Hp, these pathological disorders are often detected against the background of intestinal metaplasia.
Data on the frequency of malignancy of gastric ulcers are variable and contradictory: from 4.6–28% to 60%, which is explained by the difficulties in the differential diagnosis of peptic ulcer and primary ulcerative forms of cancer, encountered in 10–15% of all cases of gastric ulcers.
Stomach cancer is one of the most common forms of cancer and the second leading cause of cancer mortality worldwide. Approximately 700,000 to 900,000 new cases are diagnosed annually in the world. In the USA, gastric cancer ranks third in the structure of malignant diseases, and second in terms of mortality rates.
The incidence rates of gastric cancer all over the world are geographically different, and in developed countries there has been a decrease in the number of cases for several decades. Survival of patients with gastric cancer in the world varies within 15% when diagnosing the disease in the later stages and 65% in identifying the disease in the early stages.
According to epidemiological data from consensus experts, Maakhstrit-3, obtained in different countries, it is known that up to 95% of stomach cancers, 75-100% of chronic gastritis, more than 50-80% of gastric ulcers are associated with prolonged persistence of Hp in the gastric mucosa while in many countries, including the United States, the infection of this bacterium reaches 80% of the population.
In 1994, the International Agency for Research on Cancer included Hp in the list of carcinogens of the first group.
Population studies have shown that in individuals with positive serological tests for Hp, the risk of stomach cancer is increased from 2.8-6 to 25 times, while the proportion of cases of malignant diseases of the stomach associated with the presence of this bacterium is 42%. The lack of complete eradication of Hp, due to virulent strains of the bacteria, subsequently leads to the development of atrophy, metaplasia and malignant degeneration of the gastric epithelium. Atrophic changes of the gastric mucosa, mainly antral, fundus of the stomach with the development of pangastritis, atrophy of the glands, intestinal metaplasia, lead to the development of gastric cancer of the intestinal type. Morphological changes in the gastric mucosa progress in the process of activation of the nuclear protein Ki-67, CagA, VacA, which inhibits the proliferation of B-cells and SD8-cells of the anti-apoptotic Bcl-2 molecule and apoptosis, while bacterial arginases of γ-glutamyl transferase disrupt the normal functioning of T-cells , cause chemotaxis. CagA strains are more commonly detected in populations in developing countries and have oncogenic features. They enhance the proliferation of gastric epithelial cells, block endocytosis, activate tyrosine phosphorylation by tyrosine lipase “SARc and Abl” oncoproteins at various stages of Hp infection, disrupt membrane complexes, reduce the expression of the epidermal growth factor, inhibit VacA-induced apoptosis, provocate the inflammatory plate, suppress inflammatory expression of the epidermal growth factor, suppress VacA-induced apoptosis, provocate the inflammatory plate, suppress the inflammatory membrane. development of gastric adenocarcinoma. Such changes in the gastric mucosa in most cases are more often detected in young people with an individual predisposition, IL-genotype and lead to adenocarcinoma of the stomach intestinal or diffuse type, while both types are characterized by association with Hp infection. Hp, detected more than 90% in biopsy specimens of the gastric mucosa, stimulates a chronic inflammatory process, in some cases, an increased proliferation of extranodal lymphoid tissue, causing MALT lymphoma.
Gastric cancer is usually detected at a late stage and often surgical treatment of it is ineffective, therefore, in recent years, they are trying to detect precancerous changes in the gastric mucosa in the early stages using new and improved research methods.
Also, Hp eradication is being actively studied as a method to prevent the development of precancerous conditions and prevent gastric Cancer. There is evidence that Hp eradication is accompanied by a reverse development of morphological changes, such as atrophy, metaplasia, dysplasia, however, this information is contradictory and requires further study.
Diagnosis of precancerous changes of the gastric mucosa in peptic ulcer in the early stages includes fibrogastroduodenoscopy (FGDS), morphological examination, ultrasound diagnosis of the stomach, scintigraphic examination of the motor function of the stomach and serological methods. The increase in the number of cases of gastric cancer diagnosed at late stages dictates the need for patients with an “unfavorable course” of peptic ulcer diseases such studies as FGDS with compulsory multi-biopsy of the gastric mucosa with further morphological, biochemical, serological studies aimed at identifying an infectious agent, studying the extent and localization of atrophic, metaplastic, dysplastic or neoplastic changes in the epithelium of the stomach.
Modern FGDs method in combination with the method of insufflation of air into the stomach cavity for smoothing out folds makes it possible to assess the condition of the mucous membrane and, under visual control, take biopsy material from the bottom of the ulcer, its edges and the surrounding gastric mucosa, with tumor-like ulceration, rigidity of the stomach wall not inflated with air are symptoms of malignancy of a stomach ulcer. For early diagnosis of intestinal metaplasia in the gastric mucosa, chromogastroscopy using methylene blue can be used. Ultrasound examination of the stomach reveals the processes accompanied by thickening of the wall of the body as a result of edema, fibrosis, hemorrhage, and tumor. Also, blood tests of patients with ulcer are used for the main biochemical parameters - the level of lactate dehydrogenase and β2-macroglobulin, the determination of the level of serum gastrin, an increase in which indicates the presence of an infectious agent in the wall of the stomach and atrophic gastritis. The histological method, in addition to verification of the microbial seeding of the gastric mucosa, allows to evaluate its state of inflammation, atrophy, metaplasia or malignancy. Also, to detect Hp, a highly sensitive, specific method of hybridization of deoxyribonucleic acid (DNA) in paraffin sections, as well as HELPILL tests, is used. Immunological diagnostics allows to determine antibodies in the serum of patients using serological methods - agglutination reaction, indirect hemagglutination, precipitation using enzyme immunoassay (ELISA), as well as more specific and sensitive test using immune blot detect antibodies of classes IgM, IgG, IgA in serum to Hp antigens and secretory IgM, IgG in saliva and stomach contents, as well as pathogenicity of strains of bacteria with CagA status. Modern rapid tests using solid-phase ELISA in a few minutes allow for a qualitative assessment of the humoral immune response to the Hp antigen complex. Since 2000, a test system has been used to determine the concentration of Hp antigen in feces using quantitative ELISA, the FISH cytogenetic method, and the URINELISA Hp Antibodi test, based on solid-phase ELISA to determine the microbe in the urine of a patient with peptic ulcer. After deciphering the Hp genome, it became known that oncogenic are specific DNA segments of some strains of the microbe. The molecular method for identifying Hp strains using the polymerase chain reaction is based on identifying a fragment of various genes (cagA, ureC, vacA) of the microorganism in biopsy specimens of the gastric mucosa, plaque, saliva, coprofiltrate, and gastric juice.
Despite the positive effect of standard treatment of peptic ulcer disease, the incidence of recurrent, nonhealing, recurrent ulcers as the risk of pre-cancerous changes and stomach cancer in our time remains high. Effective, complex treatment of peptic ulcer with a concomitant unfavorable background should lead to the restoration of the immune status and integrity of the epithelial layer in the zone of the ulcerative defect in optimal terms, restoring the functions of glands, mucus, contributing to the complete eradication of Hp and ulceration.
The results of the study of the nature of the damaging effects on the mucous membrane of the stomach of Hp allow pathogenetically reasonable to include in the complex treatment of peptic ulcer metabolic drugs with reparative, angioprotective, cytoprotective, immunoprotective properties. Effective Hp eradication may reduce the risk of precancerous changes and gastric cancer. Considering this provision, the experts of Maakhstrit-3 state that the potential for cancer preservation in a global aspect is limited by existing methods and indicates the need to find alternative medicines and a large-scale treatment strategy for Peptic ulcer, to prevent the development of precancerous changes in the mucous membrane of the stomach with full elimination of bacteria as preventive measures malignant degeneration of the tissues of the stomach.