Gene/Protein Disease Symptom Drug Enzyme Compound
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 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spironolactone (100 mg) for 25 days in each menstrual cycle was assessed over 6 months for treatment of hirsutism in 35 patients. Five patients withdrew due to either nausea or polymenorrhea. the latter problem was encountered in 16 patients. Of the 30 remaining patients, 17 had a significant reduction in hair growth as assessed by Ferriman and Gallwey hair scores (p less than 0.05). The only significant change in endocrine parameters was a reduction in serum testosterone (p less than 0.05). Treatment with spironolactone alone was inferior to our previous experience with the cyproterone acetate--estrogen combination.
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PMID:Spironolactone in the treatment of hirsutism. 373 47

Reductions in treatment time are attractive for patients and dialysis centers. However, there are concerns related to treatment adequacy and increased intradialytic symptoms. Treatment times were progressively reduced in 12 stable patients on standard 4-h acetate hemodialysis, solute clearances being increased proportionately, until the tolerance limit manifested by increased complications or 2.5 h of treatment was reached. Once shortened schedules (mean reduction approximately 31%) were achieved, a 2-month surveillance period was initiated, followed by 2 additional months of bicarbonate therapy, treatment time being unchanged. Rapid bicarbonate hemodialysis was associated with a significantly lower incidence of hypotension, nausea, and vomiting than rapid acetate or standard acetate therapies. Fluid removal was comparable with that of standard treatment, and serum chemistry levels remained stable. Based on the success of these studies treatment times have been reduced in greater than 200 patients with high-efficiency bicarbonate therapy for long-term evaluations.
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PMID:Rapid high-efficiency hemodialysis. 374 Nov 91

Drug companies have been at work throughout the 1960s, 1970s, and 1980s trying to reduce the steroid content of their oral contraceptives (OCs). Researchers have been successful in reducing steroid content while maintaining effectiveness, thereby making OCs safer. In the 1st half of the natural menstrual cycle, a woman secretes estrogen as the dominant steroid product. In the 2nd half, estrogen is the principal reproductive hormone. Estrogens inhibit ovulation, possibly by inhibiting implantation, altering ovum transplant, or in some way preventing corpus luteum function, which is necessary to maintain early pregnancies and the endometrium. There are still only 2 estrogens and 6 progestins on the market today. They are probably the most thoroughly studied chemical ever seen in the history of pharmacy or medicine. 1 of the estrogens, mestranol, is really a drug of the past. In the body, mestranol is converted to ethinyl estradiol, the other estrogen on the market. Consequently, there is no reason to use mestranol itself. Within the dose range of 50-100 mcg, there's little difference in contraceptive effect. Progestins are the other active ingredient in the combination OC. Their principal action is the thickening of the cervical mucus, which prevents sperm penetration. Also, with sufficient progesterone, ovulation is inhibited, but this happens in only 40% of those patients taking, for instance, the "mini-pill" (which consists of progesterone only). The progestins and the estrogens work in concert to make OCs a highly effective contraceptive method. Recent surveys conducted by the Centers for Disease Control and National Cancer Institute looked into the relative effectiveness of OCs. Nordette had a use effectiveness failure rate of 3.5; Ovral, 3.6. Loestrin 1/20 -- norethindrone acetate, 1 mg, and estinyl estradiol, 20 mcg -- shows a failure rate of 4.5. This indicates that the threshold for an effective dose of estinyl estradiol in OCs is 30 mcg. For 1 mini-pill, Ovrette, the failure rate is 9.5 -- much higher. Depo-Provera has a failure rate of 0.7. The primary complaint from women taking OCs is spotting and breakthrough bleeding during the cycle. 30-50% of women given OCs stop taking them within a year. OC side effects include nausea, fluid retention, breast tenderness, leukorrhea, hypomenorrhea, headaches, spotting around the face, hypertension, and visual changes. 1 of the risks of birth control pills may be cervical dysplasia -- changes in the cells of the cervix. The relative risk of cervical cancer with OCs after 5-9 years is approximately 1.8. Clinical cases of deep vein thrombosis number 1/1000 per year among nonusers of OCs. Among users, the rate is 3 times as high: 3/1000. The most serious potential adverse effect is myocardial infarction. Of the excess deaths attributed to OCs (23.3 total per 100,000 users), 22.7 are due to myocardial infarctions and hemorrhage. The discussion also briefly reviews other methods of contraception -- Depo-Provera, male contraceptives, implants, the diapragm, and IUDs.
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PMID:Prescription contraceptives: countering the risks. 405 Jun 70

Sequential oral contraceptive therapy was devised to inhibit ovulation by a potent estrogen alone. A progestational agent was added at the end of the course of therapy to prepare the endometrium for adequate withdrawal bleeding. The program consisted of giving 80 mug. of metranol daily for 15 days and then a combination of 80 mug. of mestranol and 2 mg. of chlormadinone acetate for five additional days. Such a regimen proved to be effective in 6070 patients carefully observed for 82,085 cycles of therapy at 25 medical centres.INCREASED CYCLE REGULARITY WAS NOTED: 98.1% of the cycles were 25 to 31 days long. In 80.1% of cycles, the withdrawal interval was two to five days in length. Duration of flow was four to six days in 85.3% of the therapeutic cycles. The amount of flow decreased as compared with pretreatment values. The incidence and severity of dysmenorrhea during sequential therapy were significantly lower than before treatment. Side effects, usually infrequent, diminished as therapy was continued; the average incidence of breakthrough bleeding was 1.9% and nausea was 2.9%. Extensive laboratory studies showed no consistent abnormalities. For oral contraception, sequential therapy has proved to be virtually 100% effective when taken as directed.
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PMID:Sequential therapy to achieve anovulatory cycles. 415 84

A combination of the estrogen quinestrol (3-cyclopentil ethynilestradiol ether) and the progestagen quingestanol (3-cyclopentilenol norethindrone acetate ether) was administered orally every 4 weeks to 256 healthy, mainly middle-class women for a total of 2610 cycles, and was found to be an effective contraceptive. Treatment was begun on the 2nd day of the cycle with a 2 mg dose of quinestrol. 2 mg of quinestrol and 2.5 mg of quingestanol was then given on the 22nd day and every 4 weeks thereafter. The subjects continued with their previous means of contraception during the days intervening between the dose of quinestrol and the combined dose. Patients were given thorough physicals at the beginning of the trial. Follow-up was done at 3 months and every 6 months thereafter. The average age was 28.1 years and the average number of pregnancies 3.6. The results given are for the 101 patients who completed 12 cycles of therapy. Bleeding occurred 6-14 days after ingestion and was of normal duration in 93% of the cycles. Length of the cycle was normal in 80% of the patients. Nausea, observed in 29% of the patients during the 1st cycles, was the most common side effect. Its frequency, however, had greatly diminished by the 4th cycle. 19% mentioned irregular bleeding during the 1st cycle, 26% during the 2nd, and 25% during the 3rd, but incidence greatly decreased by the 4th. No corporeal or cytological alterations were noted. Endometrial biopsies indicated by their lack of hyperplasias that the quinestrol did not accumulate.
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PMID:[Clinical study of an oral contraceptive, in a single monthly dose: quinestrol quingestanol]. 543 91

2 experimental contraceptive injection programs are reported. 1 method provides for administration of a combined long-acting estrogen-progestogen product once a month, the other uses a long acting progestogen alone once every 90 days. In the once-a-month injection program in Los Angeles 615 patients representing 871 admissions were studied; treatment data are for both 1st and all admissions. Age distribution was 21-25 years. Patients received 150 mg of progestogen/10 mg estrogen injection. 88.1% reported cycles of 22-30 days/on admission. Some results are: For 1st and all admissions average duration of flow was 6.6 days; for 1st admission group complaints consisted of breast tenderness, 46% dysmenorrhea, 61.8%, weakness or dizziness, 42.8%, local reaction to injection, 37.4%. For all admissions, complaints were: breast tenderness, 43.3%, dysmenorrhea, 59.6%, weakness, 40.2%, local reaction, 33%. Reasons for dropout for both groups included rigidity of protocol, about 52%, moved away, 4.5%, extraneous illness, 1.5%; 64.4% of all admissions discontinued treatment due to unrelated reasons. No pregnancies were reported. The once every 90 day injection of medroxyprogesterone acetate given in doses of 150 mg were given to 243 women, of whom 57% were aged 20-29. Some results are: 1) number of days of bleeding ranged from 6-20 days, 2) 4.6% reported nervousness, 3.4% nausea, 2.1% headaches, 3) main reasons for dropouts were moving away, 11.8%, bleeding, 4.6%, and 4) 1/3 resumed ovulation within 1/2 year. Both methods are found to be extremely effective.
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PMID:Present status of injectable contraceptives: results of seven-years study. 550 12

100 patients of a private gynecologic practice took Planovine (4 mg megestrol acetate 50 mcg ethinyl estradiol) for 1-26 cycles, starting in 1968. The group was composed of 17 nulliparas, 57 who had 1-3 abortions, 69 taking Planovine for various gynecologic indications, and 40 using contraception for the 1st time. The menstrual flow was usually the same, but diminished in 19 women, became more regular in 10 women, but intermenstrual bleeding occurred in 18 women during 1 to 7 cycles. 38 gynecologic disorders were improved. Side effects included nausea or stomach pain (15 cases), weight gain (27), weight loss (40), headache (5), and nervous complaints (11). Although 15 women initially had mild venous disorders such as swollen veins, heavy limbs, and varicosities, no further circulatory complications appeared. 19 representative endometrial biopsies are described.
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PMID:[Clinical study of Planovine in gynecologic practice]. 556 16

The contraceptive efficacy and menstrual abnormalities of long-acting medroxyprogesterone acetate, injected intramuscularly at doses of 150 mg. every 3 months for 1 year, were studied in 14 women (mean age 33 years, mean parity 4.6). No pregnancies were reported and there were no significant changes in weight or blood pressure. All Papanicolaou smears, taken initially and at 6 and 12 months, were normal and there were no reports of emotional instability, nausea, vomiting, or breast soreness. Results of endometrial biopsies, taken at 6,9, and 12 months are given. The occurrence of spotting and bleeding was erratic (spotting for as long as 20-38 days in a 3-month period), but both tended to decrease as the treatment continued. After cessation of therapy, most patients had 2 or 3 "normal menstrual periods," which biopsy proved to be from a proliferative endometrium. All patients had a secretory endometrium within 12 months after the last injection, or within 9 months after the effects of the last injection had presumably worn off. Disadvantages to MA include fear of injection, irregular bleeding and spotting, and prolonged anovulation after therapy discontinuation. The chief advantage is the infrequent need for injection; patients need to be concerned with birth control only 1 day every 3 months.
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PMID:Contraceptive and endometrial effects of medroxyprogesterone acetate. 577 97

The antiarrhythmic efficacy and safety of oral flecainide acetate and quinidine sulfate were compared in a double-blind, 16-center parallel trial involving 280 patients with chronic premature ventricular complexes (PVCs). Eighty-five percent of the flecainide patients had at least 80% suppression of PVCs, vs 57% of the quinidine patients (p less than 0.0001). Sixty-eight percent of the flecainide patients met the above criterion and also had complete suppression of couplets and beats of ventricular tachycardia, vs 33% of the quinidine patients (p less than 0.0001). PR and QRS intervals were prolonged by flecainide without clinical consequence, but they were not substantially affected by quinidine (p less than 0.0001). Quinidine prolonged JT (QT minus QRS) intervals significantly more than flecainide (p less than 0.05). Nineteen of 141 flecainide patients and 21 of 139 quinidine patients discontinued therapy because of side effects (p greater than 0.50). Flecainide side effects included dizziness, blurred vision, headache and nausea. Quinidine side effects included diarrhea, nausea, headache and dizziness. Flecainide was more effective than quinidine in suppressing chronic ventricular arrhythmias (especially complex forms), and thus is an important new antiarrhythmic agent.
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PMID:Flecainide versus quinidine for treatment of chronic ventricular arrhythmias. A multicenter clinical trial. 633 10

Ten women with essential hirsutism were treated for one year with cyclic administration of cyproterone acetate and ethinyl estradiol. Biochemical and clinical control took place after 1, 3, 6 and 12 months of treatment. In 4 patients great improvement of hirsutism was noted, but only after 6 months of therapy. In 4 patients there was some improvement, while 2 were resistant. Side effects included reduced libido in 4 cases, mental depression in 3, dry skin and itching in 4 and transient nausea in one, but never necessitated cessation or interruption of treatment. Several changes in endocrine function took place during treatment: testosterone secretion rate diminished together with the urinary excretion of 17-KS and 17-KGS, while the serum concentration of testosterone binding globulin increased. There was a reduction in the serum concentration of total endogenous estrogens and progesterone as well as LH. No changes in hepatic, renal or hematologic parameters were found except for a slight increase in plasma prothrombin time. Clinical outcome of therapy could not be correlated with a pretreatment endocrine "profile", nor with the changes that this therapy induced in endocrine function. It is concluded that the anti-androgenic effect is probably the most important in this drug regimen, but that reversibility of hirsutism may depend upon factors not directly related to androgen influence.
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PMID:The treatment of essential hirsutism in women with cyproterone acetate and ethinyl estradiol. Clinical and endocrine effects in 10 cases. 645 99


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