The drug used in medical abortion is-

Raj. CHO - 2023

Obstetrics & Gynaecology

Easy

Appeared in: Raj. CHO - 2023

Explanation

Mifepristone is a synthetic steroid with potent anti-progestational (progesterone-blocking) activity.
It works by blocking progesterone receptors in the uterus. Since progesterone is essential for maintaining pregnancy, this action leads to the breakdown of the uterine lining and detachment of the embryo.
It is the standard drug for non-surgical, medical termination of early pregnancy (up to 9-10 weeks gestation).
For maximum efficacy (over 95%), it is used in a sequential regimen with a prostaglandin drug, typically Misoprostol, which causes uterine contractions to expel the pregnancy tissue.

Option B: Progesterone is a hormone that is essential for establishing and maintaining pregnancy. It prepares the uterus for implantation and supports the developing embryo.
Option C: Clomiphene is a fertility drug used to induce ovulation. Its purpose is to help a woman become pregnant, which is the opposite of medical abortion.
Option D: Loperamide is an anti-diarrheal medication that works by slowing down intestinal movement. It has no effect on the reproductive system or pregnancy.

Visual 1: Diagram - Illustrating the mechanism of Mifepristone. Show a progesterone molecule unable to bind to its receptor on the uterine wall because Mifepristone is blocking it, leading to the breakdown of the endometrium.
Visual 2: Flowchart - Depicting the two-step medical abortion process, showing 'Day 1: Take Mifepristone' leading to 'Pregnancy detaches', followed by 'Day 2-3: Take Misoprostol' leading to 'Uterus contracts and expels pregnancy'.

Clinical Relevance

Nursing practice connection: Knowing Pharmacology of drugs used for medical abortion helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's role in medical abortion includes comprehensive patient counseling about the procedure, what to expect (cramping, heavy bleeding, passing clots), managing side effects (pain, nausea), and the critical importance of the follow-up appointment.
Patient safety: The nurse must ensure the patient understands the signs of complications, such as excessive bleeding (soaking more than two maxi-pads per hour for two consecutive hours), severe pain not relieved by medication, fever, or foul-smelling discharge, and knows when to seek emergency care.
Legal and Ethical Context (India): Medical termination of pregnancy is legal in India under the MTP Act. Nurses must be aware of the legal gestational limits and documentation requirements.

How to Approach the Question

First, identify the core concept of the question: 'medical abortion'. This is a specific clinical procedure.
Second, analyze the function of each drug listed in the options in the context of pregnancy and reproduction.
Recall or deduce which drug is designed to terminate a pregnancy. Mifepristone is known as the 'abortion pill'.
Eliminate the other options by identifying their primary functions: Progesterone supports pregnancy, Clomiphene induces fertility, and Loperamide is unrelated (treats diarrhea).
This process of elimination based on pharmacological action confirms Mifepristone as the only logical answer.

Concept Tested & Keywords

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