A woman undergoing medical abortion receives misoprostol 800 mcg orally instead of vaginally. Which adverse effect occurs distinctly more often with the oral route and is a major reason the route is less preferred?

• A Hypertension
• B Headache
• C Maculopapular rash
• D Diarrhoea ✓

Explanation

Misoprostol stimulates smooth muscle throughout the gastrointestinal tract. The oral and sublingual routes give higher peak serum concentrations of the active metabolite than the vaginal route, so abdominal cramping, nausea, and especially diarrhoea are markedly more frequent when the tablets are swallowed. Diarrhoea is the dose-limiting gastrointestinal side effect and a principal reason buccal, sublingual, and vaginal routes are preferred in abortion protocols. Headache, rash, and blood pressure changes are not recognised characteristic effects of misoprostol.

Reference: WHO Abortion Care Guideline, 2022 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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