Instructions for medical abortion using mifepristone and misoprostol. Z – hypnotics, or high-precision remedies of “various calibers” for insomnia Blood pressure tablets starting with the letter z

This instruction is provided only for informational purposes and in no way encourages or encourages you to perform an abortion with pills yourself!

Please note Special attention! Before taking medications, consultation with a gynecologist is required!!!

Dosages of Mifepristone and Misoprostol

All dosages in our complex for MA are selected according to latest recommendations WHO (link to official World Health Organization recommendations for safe abortion).

For: Mifepristone – 200 mg

Our complex uses Ginestril (the brand name of the drug containing Mifepristone): 4 tablets of 50 mg.

For: Misoprostol – 400 mcg

Our kit uses Cytotec (the brand name of the drug containing Misoprostol): 2 tablets of 200 mcg.

Please note that the dosages indicated are current. only for our drugs from the world's leading manufacturers, the quality of which we guarantee!

For other manufacturers (China, Vietnam), the doses may increase significantly; we cannot in any way guarantee the success of the procedure with drugs not purchased from us, and we also do not comment on the numerous side effects and complications that arise after taking untested drugs.

IN Lately cases of attempts to use only one drug - Cytotec - in large doses to terminate a pregnancy have become more frequent.
Urgently NOT recommended do this!
Firstly, this is fraught with very serious complications.
Secondly, efficiency this method does not exceed 30-40% (in other words, in most cases it is Lost time and wasted money).
There is an official and very effective technique medical abortion. Don't ruin your own health!

Procedure for taking medications for Medical abortion

The drug administration procedure consists of two stages.

First stage. Taking Mifepristone

Before the procedure it is necessary be sure to do an ultrasound of the pelvic organs to determine the duration of pregnancy and the location of the fertilized egg (exclude ectopic pregnancy).

To begin the medical abortion procedure, the patient must take 200 mg of Mifepristone orally with water (at least 150 ml).

Most often, after taking the first drug (Mifepristone), a woman subjectively doesn't feel anything. THIS IS THE NORM! The main effect begins in the second stage - after taking Misoprostol.

And only in in some cases minor problems may begin bloody issues And aching pain lower abdomen. This is also normal, but much rarer.

Action of Mifepristone

Mifepristone is a progesterone blocker (this is the main hormone that maintains pregnancy). The main effect of the drug during medical abortion is to stop the development of pregnancy. Mifepristone also significantly increases the sensitivity of uterine cells to prostaglandins (in particular, Misoprostol).

Second phase. Taking Misoprostol

36-48 hours after taking Mifepristone, you must take the second drug from the complex - Misoprostol (Cytotec) in the following dose: 2 tablets of 200 mcg.

There are three ways to take Misoprostol:

  • place under the tongue (sublingual);
  • vaginally (deep in posterior arch vagina) and
  • buccally (place the tablet in the space between the cheek and gum).

The strength of the effect is the same for all methods, but we strongly recommend dissolving one tablet under the tongue first, and then a second one after 40-60 minutes. At the same time, the likelihood of vomiting is significantly reduced, and the duration of the effect increases.

Action of Misoprostol (Cytotec)

Misoprostol against the background of the action of Mifepristone stimulates the contractile activity of the uterus, which leads to cramping pain in the lower abdomen, as well as the appearance (much more often) or intensification (if it appeared at the first stage) of bloody discharge. Against the background of these processes, the fertilized egg is separated from the walls of the uterus and released through the genital tract.

After taking medications

Usually, over the next 3-5 days, spotting is observed (usually a little heavier than menstruation). Possible duration bleeding (with decreasing intensity) is 12-14 days.

After 10-14 days from the onset of bleeding, it is necessary to carry out a control ultrasonography pelvic organs. If bleeding continues, ultrasound should be delayed.

Briefly about the possible complications of medical abortion. Remedies

General symptoms

The following symptoms may occur during the use of Mifepristone and Misoprostol:

  • Dizziness;
  • Headache;
  • Nausea;
  • Vomit;
  • Feeling of discomfort;
  • Weakness;
  • Increase in body temperature to 37.5 degrees
  • Diarrhea.

Typically, these symptoms are mild and disappear without medical intervention.

If vomiting occurs within one hour after taking Mifepristone or Misoprostol, then you must take the corresponding drug in the same dose.

If the patient has severe early toxicosis pregnancy (vomiting of pregnant women), then before using the complex for medical abortion, it is necessary to administer Cerucal intramuscularly, 2.0 ml, after 30 minutes, take food (in a small volume), and then apply the drug.

Pain

Pain during medical abortion can be of varying intensity and depends on the duration of pregnancy (pain intensifies with increasing gestational age), as well as on the individual sensitivity threshold. Usually the pain is tolerable and does not require additional interventions. According to women, the pain is somewhat stronger than during menstruation.

The pain usually goes away within 1-3 days after the fertilized egg is released. To eliminate severe pain, it is possible to use antispasmodics, for example, No-shpu.

Please note that the use of non-steroidal anti-inflammatory drugs (NSAIDs) (most analgesics, for example Analgin, Paracetamol, Ketanov, Nimesulide, etc.) for pain relief is contraindicated, since they block the action of Misoprostol (!), thereby reducing the abortive effect of the complex. Read more about Pain with MA.

Bloody issues

Incomplete abortion

If detected this complication, then vacuum aspiration is necessary to evacuate the remnants of the fertilized egg. .

Rehabilitation after medical abortion

Abortion by medication completely eliminates mechanical damage uterus, but does not exclude the development of possible functional disorders as a result of hormonal stress. To prevent the development of such a pathology, all patients who have undergone medical termination of pregnancy are recommended to menstrual cycles take monophasic combination oral contraceptives(for example, Regulon). You need to start taking contraceptives from the fifth day from the start of menstrual-like discharge during a medical abortion.

This page describes how to use Mifepristone and Misoprostol (Cytotec) for medication interruption early pregnancy.

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In the conditions of modern city life and increased mental work, a person often experiences unbearable stress. And stress, physical inactivity, and the use of stimulants such as coffee, tobacco, and alcohol contribute to sleep disturbances. Most often for symptomatic therapy For insomnia disorders (this is what insomnia is called), a mild hypnotic is used, for example, plant origin.

A good sleeping pill must be effective and safe

But medical science does not stand still, and such drugs as, for example, peony tincture, Corvalol and Phytosedan are being replaced by new generation drugs that improve sleep. Moreover, they do not cause side effects characteristic of “classical” means. These drugs belong to the so-called Z - hypnotics. What is it and how to choose the most suitable sedative or sleeping pill?

What are Z - hypnotic (sleeping pills) drugs?

As you know, sleeping pills are called “hypnotics”, from the word “hypnosis”. By modern standards, it is necessary to begin treatment of insomnia disorders (that is, insomnia and difficulty falling asleep) with non-medicinal methods: changing the work and rest schedule, walking, going to bed on time, treating diseases that can provoke insomnia, for example, thyrotoxicosis or neurasthenia.

If these measures are not enough, then sedatives of plant origin. They are purchased freely, without prescriptions, and almost all have a mild sedative and hypnotic effect. IN in this case the weak effect is an advantage since the degree of sleep disturbance is small. In addition, they are not addictive, and these drugs have a low price.

Perhaps Valocordin has the most effective effect due to its phenobarbital content. It is the only barbiturate that can be purchased without a prescription as part of Valocordin (Corvalol).

Valocordin has a sedative effect

In the event that sleep disorders become so pronounced that they interfere with work and leading a normal lifestyle, then the prescription of “real” sleeping pills is required, which cannot be purchased without the appropriate prescriptions.

Such drugs previously included barbiturates (“Etaminal sodium”, “Barbamil”, “Veronal”), then they were replaced by benzodiazepine drugs, which were very actively used throughout the world in the 70s - 80s of the twentieth century. In the USA, for example, there was even a “benzodiazepine epidemic”: it was believed that such drugs not only improve sleep and bring harmony with oneself and the world around us, but are also an excellent stress preventative.

Time has shown that this is not so: benzodiazepine drugs, for example, nitrazepam (Radedorm) or Phenazepam, plunge a person into deep dream, but the next morning they leave you feeling exhausted. They also relax muscles (muscle relaxation), which can be dangerous when driving. Also, these drugs cause withdrawal syndrome: the patient becomes “addicted” to such drugs.

Therefore, the persistent search for such means that satisfied a very “capricious” list of requirements continued. For example, it is known that a good sleeping pill of the new generation should be as close to the ideal as possible. It should immediately induce sleep, cease its effect no later than an hour after waking up, maintain daytime alertness and performance, and not cause addiction or side effects. However, the drug should not be used as sedative medicine, do not affect memory and thinking.

And finally, at the end of the twentieth century, such drugs appeared, they were called Z - hypnotics. They are capable of very selectively influencing the structures of inhibitory GABAergic (inhibitory) receptors. Scientifically, these drugs are called “non-benzodiazepine benzodiazepine receptor agonists.” On the world pharmaceutical market representatives of this family began appearing in 1993.

The most prominent representatives of the family

By tradition, all Z-drugs have international generic name, which in Russian transcription begins with the letter “z”. Let's look at typical representatives of this class.

Zopiclone

Modern hypnotic drug of non-benzodiazepine structure

In the Russian Federation it is better known under the trade name “Imovan”. This is an easy and convenient sleeping pill that can be taken for 2 to 3 weeks without much fear. Falling asleep usually occurs (as with other drugs of this family) within 1 to 2 hours after administration. The sleep is even and calm, the morning awakening is quick, the daytime well-being is good. Single daily dose – 7.5 mg. In old age, it is recommended to reduce the dosage by half. In this case, the time to fall asleep may be extended by 1–2 hours, but the drug will have less effect on the liver, since Imovan is contraindicated in pronounced violations liver and kidney functions.

The cost of one package of “Imovan” (according to 2016 data) is, on average, 250 rubles for 20 tablets, for 3 weeks of use.

Zolpidem

Another of the Z-hypnotics is Zolpidem

The second drug of this family is better known as Hypnogen or Ivadal. This remedy (as well as other Z-hypnotics) should be taken within an hour immediately before bedtime, or even while lying in bed. It has a good therapeutic range: the initial dose is 5 mg, the maximum is 10 mg.

Has a significant drawback - high price. So, a similar number of tablets for 3 weeks of use will already cost over 2,500 rubles, that is, ten times higher than that of Imovan.

Zaleplon

This drug has beautiful musical trade names: "Andante" or "Sonata". This drug can be considered a really strong sleeping pill, but with its long-term use, a sharp withdrawal syndrome may develop, which will manifest itself in the form of persistent insomnia disorders. Therefore, this drug should be taken in short courses and in a minimal dosage.

However, an indisputable “plus” is the fact that after taking it, it is completely eliminated from the body within 1 – 2 hours, so daytime drowsiness never occurs while taking zaleplon.

Its recommended dose is the same as the maximum - 10 mg. It is recommended to take it a couple of hours after eating, but no later than an hour before bedtime. The ideal option is to go to bed two hours after dinner and take this medicine at night.

The active ingredient in Andante is zaleplon.

The cost of zaleplon preparations is on average 460 rubles, but only for 7 tablets.

Therefore, in terms of a weekly course we get:

  • zopiclone 12.5 rubles;
  • andante 460 rubles;
  • I gave 850 rubles.

It should be recalled that these drugs are sold by prescription only. Perhaps this is an unnecessary precaution (after all, these drugs are relatively safe), but this is how it should be done in relation to everyone sleeping pills. After all, before, when barbiturates were sold without prescriptions, their overdose often caused death, and they were used to commit suicide attempts and various crimes.

All Z-hypnotics are released strictly according to a doctor’s prescription

In conclusion, we note that in case of severe sleep disorders, these drugs should become the basis drug treatment, and zopiclone and zolpidem have an average effect over time, and zaleplon is a drug with an ultra-short, “spot” effect on insomnia.

The positive aspects of these remedies are the absence of breathing disturbances during sleep and the minimal risk of developing sleep apnea, as well as vigorous awakening and wellness during the day.

But still, the ideal treatment option for insomnia disorders should be considered modification of the patient’s lifestyle, and joint efforts should be made by both the patient and the doctor to normalize sleep physiological methods, leaving medications"in reserve".

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