Which of the following information is/are TRUE about Mifepristone?
I. It is commonly known as RU-486.
II. It is indicated for the medical termination of intrauterine pregnancy through 49 days' pregnancy.
III. The recommended dose is one (200 mg Mifepristone) as a single oral dose.
a. I only
b. I and II only
c. II and III only
d. II and III only
Answer: I and II are true. Mifepristone (Mifeprex) is a synthetic steroid with antiprogestational effects.
Mifepristone (Mifeprex) is indicated for the medical termination of intrauterine pregnancy through 49 days' pregnancy. For purposes of this treatment, pregnancy is dated from the first day of the last menstrual period in a presumed 28 day cycle with ovulation occurring at mid-cycle.
The duration of pregnancy may be determined from menstrual history and by clinical examination. Ultrasonographic scan should be used if the duration of pregnancy is uncertain, or if ectopic pregnancy is suspected.
Any intrauterine device ("IUD") should be removed before treatment with Mifepristone (Mifeprex) begins.
Patients taking Mifepristone (Mifeprex) must take 400 μg of Misoprostol two days after taking Mifepristone (Mifeprex) unless a complete abortion has already been confirmed before that time.
Day One: Mifeprex Administration
Patients must read the MEDICATION GUIDE and read and sign the PATIENT AGREEMENT before Mifeprex is administered.
Three 200 mg tablets (600 mg) of Mifeprex are taken in a single oral dose.
Day Three: Misoprostol Administration
The patient returns to the health care provider two days after ingesting Mifeprex. Unless abortion has occurred and has been confirmed by clinical examination or ultrasonographic scan, the patient takes two 200 μg tablets (400 μg) of misoprostol orally.
During the period immediately following the administration of Misoprostol, the patient may need medication for cramps or gastrointestinal symptoms.
The patient should be given instructions on what to do if significant discomfort, excessive vaginal bleeding or other adverse reactions occur and should be given a phone number to call if she has questions following the administration of the Misoprostol.
In addition, the name and phone number of the physician who will be handling emergencies should be provided to the patient.
Day 14: Post-Treatment Examination
Patients will return for a follow-up visit approximately 14 days after the administration of Mifeprex. This visit is very important to confirm by clinical examination or ultrasonographic scan that a complete termination of pregnancy has occurred.
Pregnancy termination by surgery is recommended in cases when Mifepristone (Mifeprex) and misoprostol fail to cause termination of intrauterine pregnancy
Serious and sometimes fatal infections and bleeding occur very rarely following spontaneous, surgical, and medical abortions, including following Mifepristone (Mifeprex) use.
Ensure that the patient knows whom to call and what to do, including going to an Emergency Room if none of the provided contacts are reachable, if she experiences sustained fever, severe abdominal pain, prolonged heavy bleeding, or syncope, or if she experiences abdominal pain or discomfort or general malaise (including weakness, nausea, vomiting or diarrhea) more than 24 hours after taking Misoprostol.
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