Evaluation of cimetidine (tagamet). An antagonist of hydrochloric acid secretion.

Cimetidine, a potent H2-receptor antagonist, has been introduced for the treatment of various conditions associated with acid peptic digestion in the gastrointestinal tract. Preliminary results are encouraging. Adverse reactions do not appear to be substantial; however, the effect of long-term use has yet to be ascertained.

The prostaglandins.

The introduction of dinoprost tromethamine (Prostin F2 Alpha) as an abortifacient in the second trimester of pregnancy represents the first clinical use of a prostaglandin. Various synthetic analogues of the naturally occurring derivatives are being employed investigationally in the treatment of peptic ulcer, hypertension, asthma, and hypercalcemia. In the United States, dinoprost tromethamine is primarily administered intra-amniotically. Despite the fact that a substantial number of patients experience allergic reactions, hypertension, bronchospasm, nausea, vomiting, cramps, and diarrhea, the efficacy and relative safety of dinoprost tromethamine establish it as superior to intra-amniotic instillation of hypertonic saline. Cervical laceration, laceration or rupture of the lower uterine segment, retention of the placenta, and hemorrhage in part reflect the intensity of uterine contraction induced by dinoprost. Experience in administration improves the therapeutic response and diminishes adverse reactions.