Prostaglandin E2- (PGE2; Prostin®) and Prostaglandin E1 -
(PGE1;Cytotec®)are pharmacologic agents used in obstetrics
for cervical ripening and labor induction. Although the manufacturer's
drug information for the gel and the vaginal insert, PGE2 states that the drug
should be used with caution in patients with asthma or a history of asthma [1]
prostaglandin E2 (PGE2)
and prostaglandin PGE1appear to be bronchodilators [2-4] .
Towers and coworkers prospectively recorded all pregnancies that were
administered PGE2 gel or suppositories over an eleven year period. A total of 189
patients with a history of asthma or active asthma were exposed to prostaglandin
E2. None of the patients had any evidence of a clinical exacerbation of the
disease [5].
The drug information supplied with misoprostol (Cytotec
®) does not caution against the
use of misoprostol in patients with asthma or a history of asthma [6]
While all drug usage in patients with asthma should be monitored carefully
asthma does not appear to be an absolute contraindication for the use of
Prostaglandin E2 (PGE2) or Prostaglandin PGE1 .
However prostaglandin F2∝ is a potent bronchoconstrictor and
probably should not be used in pregnant patients with asthma[2]
REFERENCES
1. Physician's desk reference, 57th ed. Montvale (NJ): Thomson PDR; 2003. p.
1347-9
2. Dombrowski , M.P. Asthma and pregnancy.Obstet
Gynecol.2006 Sep;108(3 Pt 1):667-81. PMID: 16946229
3. Bianco MPS. Perspectives in the treatment of reversible airway obstruction.
Respiration 1986;50:131-6.
4. Wasiak W, Szmidt M. A six week double blind, placebo controlled, crossover
study of the effect of misoprostol in the treatment of aspirin sensitive asthma.
Thorax 1999;54:900-4.
5. Towers CV, Briggs GG, Rojas JA. The use of prostaglandin E2 in pregnant patients with asthma.
Am J Obstet Gynecol.2004 Jun;190(6):1777-80; discussion 1780.PMID: 15284797
6. Cytotec® package insert, 2006.
http://www.pfizer.com/pfizer/download/uspi_cytotec.pdf
Accessed 1/16/2007
