Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of oral contraceptives (OCs) on drug therapy are related mainly to the inhibition of microsomal oxidation as well as the induction of enzymes involved in conjugation reactions. Since many drugs share these catabolic pathways, their pharmacodynamics will be affected by OCs. Notable interactions include an increased bioavailability of analgesics, tranquilizers, and tricyclic antidepressants. OCs increase the risk for hypertension, and pharmacokinetic interactions are to be expected when OCs are administered with antihypertensive drugs. Likewise, OCs affect lipid metabolism and thus modify the effects of atherogenic drugs; however, the different forms of hyperlipidemia show a heterogeneous response to OCs. Another particular concern is that the gestagen components of OCs may cause peripheral insulin resistance and may require dose adaption with antidiabetic treatments. Two common nonprescription drugs, theophylline and caffeine, show decreased clearance rates due to OCs. All share a common oxidation pathway involving cytochrome P-450 and P-448. However, cigarette smoking stimulates these enzymes, and the decreased clearance of theophylline and caffeine is usually not observed in smokers. The reports of effects of OCs and alcohol taken together are mixed, and no clinically relevant conclusions can be drawn. Most vitamin and mineral levels are influenced by OCs, but this is a concern only under conditions of deprived diet, when normal dietary adjustments are impossible. An important caveat of the many documented effects of OCs on the pharmacodynamics of other drugs is that, in most instances, these effects will be counterbalanced with kinetic changes and result in no clinical manifestation. Nevertheless, clinicians must be aware of possible adverse reactions, particularly in predisposed patients.
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PMID:Influence of oral contraceptives on drug therapy. 225 28

Contraindications to the use of estroprogestational agents must be critically and completely evaluated before any oral contraceptive (OC) prescription. Antecedents of cholestasis during pregnancy, jaundice, vascular lithiasis, hepato-cellular adenomas, or viral hepatitis are sure contradindications to OC use because of possible hepatic pathology, while antecedents of thromboembolic or cardiovascular accidents are contraindications because of the possible cardiovascular pathology. In the adolescent and premenopausal women any irregularities in the menstrual cycle would advise against OC prescription, just as any form of benign or malignant gynecological tumor would be a contraindication at any age. Prescription of OC is contraindicated in patients under treatment with several kinds of analgesics, anticoagulants, anticonvulsants, barbiturates, and tranquilizers, since such drugs usually interfere with the contraceptive action of OCs. Another absolute contraindication to OC treatment is pregnancy, even if it is not proven that OC treatment immediately before or during pregnancy can increase the risk of teratogenic effects. OCs can diminish the volume and duration of lactation in breastfeeding women; it is also possible that steroids and their metabolites can pass into maternal milk in minimal doses. The most important factors of risk are smoking, especially in women over 40, hypertension, hyperlipemia and diabetes, whether latent or real. It must be remembered, however, that risk of maternal mortality in Western Europe is 5-35/100,000 births, while risk of mortality because of OC treatment is only 3/100,000.
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PMID:[The contraindications of estroprogestagens]. 1227 52