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Laurence A Levine - One of the best experts on this subject based on the ideXlab platform.
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treatment of cyclophosphamide induced hemorrhagic cystitis with intravesical Carboprost tromethamine
The Journal of Urology, 1993Co-Authors: Laurence A Levine, David F JarrardAbstract:We review our experience with 18 consecutive patients who received intravesical Carboprost tromethamine, an F2-alpha prostaglandin, for severe hemorrhagic cystitis following cyclophosphamide chemotherapy. Of the patients 16 were given cyclophosphamide for conditioning before bone marrow transplantation and 2 received the drug as cytotoxic therapy alone (dose range 3.6 to 15.8 gm.). All patients had severe gross hematuria that was refractory to forced diuresis and to continuous saline bladder irrigation. The intravesical prostaglandin therapy was initiated only after significant transfusion requirements (greater than 1 unit packed red blood cells per day) and/or numerous catheter manipulations for relief of clot retention. Eligible patients underwent complete clot evacuation followed by intravesical instillation of 0.4 to 1.0 mg.% Carboprost tromethamine for 2 hours 4 times per day, alternating with continuous saline bladder irrigation for 2 hours. Six patients attempted an alternate protocol of 0.8 to 1.0 mg.% Carboprost tromethamine given by continuous saline bladder irrigation. Complete resolution of gross hematuria occurred in 9 patients (50%). Eight patients had a partial response, with decreased transfusion requirements noted. However, complete resolution ultimately required an alternative therapy (for example formalin or urinary diversion). One patient (6%) failed to respond and required formalin therapy on day 4 of Carboprost tromethamine therapy. Decreased red blood cell transfusion requirements were noted during and after therapy when compared to pretreatment values. No changes in renal or bladder function were noted during the mean followup of 17 weeks (range 1 to 64 weeks). There were 3 cases of recurrent hematuria. Side effects were limited to bladder spasm in 14 of the 18 patients (78%), with no systemic complications. The results suggest that Carboprost tromethamine is a useful bedside therapy for hemorrhagic cystitis due to cyclophosphamide, and treatment appears to have minimal toxicity.
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prophylactic and therapeutic Carboprost tromethamine bladder irrigation in rats with cyclophosphamide induced hemorrhagic cystitis
The Journal of Urology, 1992Co-Authors: David M Kranc, Jae Kim, Francis H Straus, Laurence A LevineAbstract:Recently, prostaglandins have been shown to be effective agents for the treatment of cyclophosphamide-induced hemorrhagic cystitis. Among the prostaglandins studied is Carboprost tromethamine, a PGF2a analog. To determine the effectiveness of Carboprost tromethamine therapy on the urothelium, we induced hemorrhagic cystitis in 81 rats. These were divided into two treatment arms. One arm was treated prophylactically at the time of cyclophosphamide injection, and the other started treatment only after hemorrhagic cystitis was established. Animals were divided equally into groups receiving 0, 0.4, 0.8, and 1.6 mg.% Carboprost tromethamine in 0.9% normal saline by continuous bladder irrigation. All bladders were examined grossly for edema and hemorrhage, then histologically for mucosal ulceration, congestion, and perivascular hemorrhage. Results from the prophylactic arm, as compared to those for controls, revealed that all groups except those treated only with 0.9% normal saline had a lower incidence of hemorrhagic cystitis (p less than 0.05). In the established hemorrhagic cystitis arm, the group treated with 1.6 mg.% Carboprost tromethamine showed the best response (p less than 0.05), whereas the group treated with 0.9% normal saline showed the poorest response. This study reveals that hemorrhagic cystitis in the rat model may be prevented by prophylactic continuous bladder irrigation with Carboprost tromethamine, whereas established hemorrhagic cystitis may be treated effectively with intravesical instillation of Carboprost tromethamine. Although the mechanism of action of this prostaglandin on the urothelium is unknown, it appears grossly and histologically to decrease ulceration, perivascular hemorrhage, and congestion in the mucosa and submucosa.
Hailan Yang - One of the best experts on this subject based on the ideXlab platform.
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effect of Carboprost tromethamine injection combined with modified b lynch suture and Carboprost methylate suppositories in parturients with placenta previa
American Journal of Translational Research, 2021Co-Authors: Jianli Wang, Hailan YangAbstract:OBJECTIVE To investigate the clinical value of Carboprost tromethamine injection combined with modified B-lynch suture and Carboprost methylate suppositories in the treatment of placenta previa parturients with postpartum hemorrhage after cesarean section. METHODS A total of 102 parturients with placenta previa and postpartum hemorrhage after cesarean section in our hospital were selected as the study subjects, and they were divided into Group A (Carboprost tromethamine injection combined with modified B-lynch suture, n=35), Group B (Carboprost methylate suppositories, n=34), and Group C (Carboprost tromethamine injection, n=33) in accordance with a random number table. The amounts of hemorrhaging and clinical indices in the three groups were recorded, and the rescue effects were compared among the three groups. RESULTS The amount of hemorrhaging in Group A was significantly lower than that in Groups B and C during surgery and 24 h after surgery (P < 0.05). There were markedly improved clinical indices in Groups A, B and C, showing statistical significance (P < 0.05). There were statistically significant differences in hemostatic failure rate, hysterectomy, postoperative abdominal pain and puerperal infection between Groups A and B (P < 0.05). The intraoperative indices, postoperative infection, effective hemostasis rate and rate of advanced postpartum hemorrhage in Group A were remarkably higher than those in Groups B and C (P < 0.05), showing statistical significance (P < 0.05). There were statistically significant differences in blood oxygen saturation and pulse among the three groups before surgery and 2 h after surgery (P < 0.05). CONCLUSION Carboprost tromethamine injection combined with modified B-lynch suture and Carboprost methylate suppositories can reduce the amount of hemorrhaging and the risk of postoperative infection in placenta previa patients with postpartum hemorrhage after cesarean section.
L A Xiaolin - One of the best experts on this subject based on the ideXlab platform.
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clinical use of mifepristone and Carboprost methylate suppositories in painless induced abortion
Journal of Xinjiang Medical University, 2012Co-Authors: L A XiaolinAbstract:Objective To study the clinical effect of mifepristone and Carboprost methylate suppositories in painless induced abortion.Methods One thousand and twenty sixty cases of painless induced abortion that haven′t delivery through vaginal and pregnancy after cesarean section were randomly divided into three groups: mifepristone group:(n=450),before operation oral mifepristone 150 mg in two days;Carboprost methylate suppositories group(n=410),sixty-minter before operation placed Carboprost methylate suppositories 1 mg into vaginal;control group(n=300): before operation no drug was used.Then observe the degree of cervical dilator,the amount of bleeding,the length of operation and the side effect in three groups.Results The difference of the degree of cervical dilator,the amount of bleeding,the length of operation were significant in three groups(P0.05);mifepristone group compared with Carboprost methylate suppositories group,the degree of cervical dilator and side effect were no statistically significant(P0.05),but mifepristone group had less amount bleeding and shortly time of operation compare the Carboprost methylate suppositories group,the difference were statistically significant(P0.05).Conclusion Mifepristone and Carboprost methylate suppositories have same effect at cervical dilator in painless induced abortion,but Mifepristone is priority to Carboprost methylate suppositories at the reducing bleeding and shorten the length of operation and it is worthy of recommending for clinical application.
Zhengnian Ding - One of the best experts on this subject based on the ideXlab platform.
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efficacy of small dose of dexmedetomidine for prevention of adverse effects induced by Carboprost in patients undergoing caesarean section
Chinese Journal of Anesthesiology, 2014Co-Authors: Bo Gui, Xiuhong Jiang, Zhengnian DingAbstract:Objective To evaluate the efficacy of small dose of dexmedetomidine for prevention of the adverse effects caused by Carboprost in the patients undergoing caesarean section.Methods Forty parturients,of ASA physical status Ⅰ or Ⅱ,aged 26-30 yr,weighing 63-71 kg,scheduled for elective caesarean section under epidural anesthesia,were equally and randomly divided into control group (C group) or Carboprost group (D group) by using a random number table.After delivery of the fetus,all the patients received iv infusion of 20 U oxytocin and Carboprost 250 μg was injected into the myometrium simultaneously.In group D,after a loading dose of dexmedetomidine 0.1 μg/kg,dexmedetomidine was infused at a rate of 0.4 μg· kg-1 · h-1 starting from 1 min prior to Carboprost injection until the end of surgery,while the equal volume of normal saline was given in group C.Adverse effects such as dyspnea,facial flushing,nausea,vomiting,hypertension and tachycardia were recorded.The OAA/S scores and time for breastfeeding initiation were also recorded at the end of surgery and 2 h after surgery.Results Compared with group C,the incidence of dyspnea,facial flushing,nausea,vomiting,hypertension and tachycardia was significantly decreased in D group.There was no significant difference in OAA/S score and the time for breastfeeding initiation after surgery between the two groups.Conclusion Small-dose dexmedetomidine (loading dose 0.1 μg/kg,followed by infusion at 0.4 μg· kg-1 · h-1 until the end of surgery) infused before Carboprost administration is helpful in preventing the adverse gastrointestinal and cardiovascular reactions caused by Carboprost in the patients undergoing caesarean section. Key words: Dexmedetomidine ; Cesarean section ; Carboprost
David F Jarrard - One of the best experts on this subject based on the ideXlab platform.
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treatment of cyclophosphamide induced hemorrhagic cystitis with intravesical Carboprost tromethamine
The Journal of Urology, 1993Co-Authors: Laurence A Levine, David F JarrardAbstract:We review our experience with 18 consecutive patients who received intravesical Carboprost tromethamine, an F2-alpha prostaglandin, for severe hemorrhagic cystitis following cyclophosphamide chemotherapy. Of the patients 16 were given cyclophosphamide for conditioning before bone marrow transplantation and 2 received the drug as cytotoxic therapy alone (dose range 3.6 to 15.8 gm.). All patients had severe gross hematuria that was refractory to forced diuresis and to continuous saline bladder irrigation. The intravesical prostaglandin therapy was initiated only after significant transfusion requirements (greater than 1 unit packed red blood cells per day) and/or numerous catheter manipulations for relief of clot retention. Eligible patients underwent complete clot evacuation followed by intravesical instillation of 0.4 to 1.0 mg.% Carboprost tromethamine for 2 hours 4 times per day, alternating with continuous saline bladder irrigation for 2 hours. Six patients attempted an alternate protocol of 0.8 to 1.0 mg.% Carboprost tromethamine given by continuous saline bladder irrigation. Complete resolution of gross hematuria occurred in 9 patients (50%). Eight patients had a partial response, with decreased transfusion requirements noted. However, complete resolution ultimately required an alternative therapy (for example formalin or urinary diversion). One patient (6%) failed to respond and required formalin therapy on day 4 of Carboprost tromethamine therapy. Decreased red blood cell transfusion requirements were noted during and after therapy when compared to pretreatment values. No changes in renal or bladder function were noted during the mean followup of 17 weeks (range 1 to 64 weeks). There were 3 cases of recurrent hematuria. Side effects were limited to bladder spasm in 14 of the 18 patients (78%), with no systemic complications. The results suggest that Carboprost tromethamine is a useful bedside therapy for hemorrhagic cystitis due to cyclophosphamide, and treatment appears to have minimal toxicity.