药妆：是药还是妆

近年来，受欧美、日本等发达国家的影响，到药店买“药妆”成为不少白领女性的最爱，她们认为“药妆”的天然成分更多、更安全，对皮肤的刺激性也更小。我国不少医药及化妆品企业也雄心勃勃进军“药妆”市场。     

药妆：是药还是妆

近年来,受欧美、日本等发达国家的影响,到药店买“药妆”成为不少白领女性的最爱,她们认为“药妆”的天然成分更多、更安全,对皮肤的刺激性也更小。我国不少医药及化妆品企业也雄心勃勃进军“药妆”市场。     

毛泽东忌药

我在毛泽东身边工作期间,他很少生病,不等于工作好做,有时甚至使我紧张为难. 一次,毛泽东牙床发炎,肿得厉害,已经化脓. 我说:"这次可是真病了,牙床化脓,淋巴肿大,你得吃药,吃抗生素." 毛泽东疼得直皱眉,却仍然在笑:"你们这些医生呀,就喜欢用药." "是呀,有病不用药怎么行?"     

炎夏慎用三类药

在正常情况下，人体在体温调节中枢作用下使机体保持一个恒定的温度，产热和散热处于动态平衡。而有些药物会抑制体内腺体的分泌功能，那样体内的热量就会排不出去，而导致中暑。     

情爱就是人间药

刚看到这个书名,心里是撇了一下嘴的.似乎已经成了一种时髦,穿衣、吃饭、工作、生活、感情都能被各路神棍写成一种修行.真的拿起来读完,还是不知道怎么修,也不知道如何行.无非是说了很多漂亮的空话,真遇到事儿,需要搞定的场合还是束手无策.这种修行还不如无.不过也记得倾城老早就写了《爱是一种修行》,这回是个延续,而且印象中的叶倾城是不弄玄虚的. 每位读者都能从她书中各取所需:有的人需要获取知识,于是贴着耳朵告诉你"顶着个婚姻的名义独自耗着,叫喝西北风".有的人需要享受美文从心中流过,那你可以随着她"从钢琴老师家出来,春夜正好,像件薄薄的黑绢衫子,亲密贴身.有路灯,把夜色稍微推开一段,是捋上去的袖管".有的人需要挑战智力,那么多倾城信箱,在你读下去之前,也可以试着先给出自己的答案.起码要占上其中一项才能看下去,这本书似乎已经占全.一本书怎么叫做好书?     

本性酷好谓之药

人的一生之中，总有一两样偏爱偏嗜的．像文王偏爱用菖蒲腌成的酸菜，曾暂偏爱羊枣、刘伶好酒、卢仝好茶、权长孺好爪，都是一种嗜好。癖嗜的东西，跟他性命相同，如果重病时能得到。都可以称为良药。     

催经止孕药Ru-486的临床药代动力学

应用高效液相色谱法(HPLC)研究了抗孕激素药,Ru-486的临床药代动力学。六名志愿受试者,一次口服Ru-486 50毫克后测得该药的药代动力学各项参数,血药半寿期t 1/2 33.0小时,一级消除速率常数Kel 0.021 hr~(-1),血药表观容积Vd 120.1 Liter,体内血药总廓清率Cl2.5 Liter/hr,药-时曲线下面积Auc 19825.1 ng/ml/hr。实验表明,服药后一小时血药浓度迅即达高峰,随后转入消除期,血浆药物浓度在消除相的头4～8小时消除较快,而后逐渐减慢,持续24小时,到48小时血药浓度已较低(0.15±0.07μg/ml)。     

情爱就是人间药

刚看到这个书名，心里是撇了一下嘴的。似乎已经成了一种时髦，穿衣、吃饭、工作、生活、感情都能被各路神棍写成一种修行。真的拿起来读完，还是不知道怎么修，也不知道如何行。无非是说了很多漂亮的空话，真遇到事儿，需要搞定的场合还是束手无策。这种修行还不如无。     

本性酷好谓之药

人的一生之中，总有一两样偏爱偏嗜的．像文王偏爱用菖蒲腌成的酸菜，曾暂偏爱羊枣、刘伶好酒、卢仝好茶、权长孺好爪，都是一种嗜好。癖嗜的东西，跟他性命相同，如果重病时能得到。都可以称为良药。     

左旋18-甲基炔诺酮经阴道给药的药代动力学和药效学研究

本文比较了左旋18-甲基炔诺酮(LNG)制剂Postinor单剂量(0.75mg)口服和阴道给药的药代动力学,并研究了这种制剂经阴道多次给药的药代动力学及对卵巢功能的影响。征集6例月经规则的健康育龄妇女。第一周期,每例对象每次于阴道深处放置一片Postinor,共8次,每2次间隔为48小时;第二周期,每例对象口服一片相同的LNG制剂,放免测定血清LNG、雌二醇和孕酮水平。结果表明在第一周期,除1例对象在中期有一较高的雌二醇峰以外,其余雌、孕激素水平均呈明显低平状态;口服和阴道放置相同的单剂量LNG以后血清LNG浓度时间曲线分别符合二室与一室开放模型。由此提示与口服相比,Postinor经阴道给药后吸收缓慢,且血清LNG峰值低,而消除过程则两种给药途径较为相似;Postinor经阴道给药可明显抑制排卵。     

A pharmacokinetic study with a low-dose oral contraceptive containing 20 microg ethinylestradiol plus 100 microg levonorgestrel.

This study investigated the pharmacokinetics of a dose-reduced oral contraceptive containing 20 microg ethinylestradiol (EE) + 100 microg levonorgestrel (LNG) in 18 young, healthy females. Serum levels of EE and LNG were determined after single and repeated daily oral administration over three treatment cycles, each consisting of 21 treatment days followed by a 7-day treatment-free period. Additionally, the time courses of sex hormone-binding globulin (SHBG), corticoid-binding globulin (CBG) and total and free testosterone serum levels were analyzed. Both active ingredients were rapidly absorbed and maximum concentrations in serum were reached between, on average, 1 and 2 h after single and multiple administrations, respectively. Concentrations of EE increased during repeated daily administration. An approximate two-fold accumulation was calculated based on the comparison of EE area under the curve (AUC) (0-24 h) values determined after the first and the last tablet administration within a treatment cycle. LNG serum concentrations also increased during repeated daily administration, reaching steady-state levels after about 11 days. Based on the comparison of AUC (0-24 h) values determined after the first and the last tablet administration, LNG accumulated approximately by a factor of 3 within a treatment cycle. Steady-state pharmacokinetics of LNG were similar at the end of the first and the third treatment cycles, indicating no further accumulation of LNG beyond a treatment cycle under long-term use of this combined oral contraceptive. The clearance and volume of distribution of LNG decreased and the terminal half-life increased after repeated daily administration, compared with single administration. These effects have also been reported for other LNG/EE combinations. SHBG serum concentrations increased during repeated daily intake by, on average, 1.5-1.6-fold, and for CBG, an average increase of 1.4-1.8-fold was found. Although free testosterone concentrations declined during repeated daily administration by about 40%, total testosterone remained relatively unchanged at a low level. In conclusion, the pharmacokinetics of EE and LNG determined in the present study were in good agreement with those previously reported for 30 microg EE + 150 microg LNG, taking the 33% dose reduction into account.     

A clinical study on the contraceptive effect of vaginal application of levonorgestrel]

50 healthy women aged 27-39 were screened and participated in an clinical study on the vaginal application of levonorgestrel (LNG) as a contraceptive. Among the 50 women, 27 had live births and 23 had abortions as the result of their last pregnancy within 5 years. They had regular menstruation for the past 3 months, and no disease of the liver, heart, or urinary system. 0.75 mg LNG tablets produced by Beijing Pharmaceutical Manufacturers were chosen for the study. All the participants were instructed to put one tablet into the upper end of vagina every other day from the seventh day of the menstrual cycle with 8 tablets per cycle. 258 cycles of pills were used by the 50 participants. 953 acts of sexual intercourse were recorded during the study with 3.69 per cycle on average. Even though pills were missed in 28 cycles, there was only 1 case of pregnancy. The pill use affected the duration of the menstrual cycle, with mean duration of 27.8 days + or - 4.1 days. Vaginal bleeding occurred in 13 cycles (4.06). Side effects including sickness, backache, breast pain, and increased vaginal secretion occurred only in 3.89% of the cycles, which was much lower than in oral administration. No vaginal infection occurred in any of the cases. 10 participants dropped out before the end of study, including 1 who became pregnant. 44 participants, including 4 drop-outs, wanted to continue with the method. Vaginal application of progesterone is a promising means of contraception. But, as the study has a small sample size and short duration, is further research to prove the advantage of vaginal application over oral administration in terms of effectiveness, side effects, longterm safety, an acceptability.     

Use of the novel combined contraceptive vaginal ring NuvaRing for ovulation inhibition

OBJECTIVE: To assess the effects of the combined contraceptive vaginal ring NuvaRing on ovarian function. DESIGN: Randomized, open-label, crossover study. SETTING: Clinical pharmacology unit. PARTICIPANT(S): Sixteen healthy female volunteers. INTERVENTION(S): Group 1: one cycle of combined oral contraceptive containing desogestrel (150 microg) and ethinyl estradiol (30 microg) (desogestrel/EE COC), followed by a NuvaRing treatment period. Group 2: NuvaRing treatment period followed by a cycle of desogestrel/EE COC. MAIN OUTCOME MEASURE(S): Follicular diameter, serum hormone concentrations (follicle-stimulating hormone, 17beta estradiol, luteinizing hormone, and progesterone), and endometrial thickness. RESULT(S): NuvaRing use for the recommended period of 3 weeks resulted in complete inhibition of ovulation, as assessed by vaginal ultrasound (follicular diameter) and by serum luteinizing hormone and progesterone concentrations. Inhibition of ovulation was maintained for an additional 2 weeks of NuvaRing use. Ovarian suppression between the groups was comparable. Furthermore, ovarian suppression after 3 weeks of NuvaRing use was comparable to that on day 21 of DGS/EE COC intake. NuvaRing was well tolerated. CONCLUSION(S): NuvaRing completely inhibited ovulation throughout the normal 3-week period and the extended period of use. Ovarian suppression was comparable to that with desogestrel/EE COC.     

The emergency contraceptive drug, levonorgestrel: a review of post-coital oral and peri-coital vaginal administration for prevention of pregnancy

The objective of our study was the evaluation and elucidation of levonorgestrel (LNG) as emergency contraception (EC) administered through oral and vaginal routes. Data regarding post-coital oral and peri-coital vaginal application of LNG were extracted from the literature through MEDLINE database service for years 2001-2010. It was found that a single dose of 1.5 mg LNG or two doses of 0.75 mg LNG 12 h apart were used for EC. Currently, LNG is also on trial for vaginal application as EC in Carraguard gel for 'dual protection'. The oral or vaginal dose of 1.5 mg LNG resulted in peak plasma concentration, C(max) 19.2 or 3.21 ng/ml, with shorter time, T(max) 1.4 or 6.6 h, and greater AUC, 152.7 or 52.5 ng.h/ml, with shorter half-life, 25 or 32 h, respectively. LNG EC inhibited mid-cycle LH surge and delayed or prevented ovulation when administered before ovulation. Mechanism of action of LNG EC appeared to inhibit or delay ovulation. The risk of pregnancy was 4.12%. A single dose of 1.5 mg LNG could reduce the pregnancy rate to 0.7%. Occurrence of ectopic pregnancy following failure of LNG EC was reported. This EC caused no serious adverse effects but was associated with menstrual disturbance. Although widely acceptable, the cost and short-supply to rural areas pose a barrier to access EC for the poor and rural-dwellers, respectively. It was concluded that unlike post-coital oral administration, peri-coital vaginal application of 1.5 mg LNG needs further study to be an alternative option for women to use it for prevention of pregnancy.     

The effect of oral contraceptive treatment on the serum concentration of dehydroisoandrosterone sulfate.

Dehydroisoandrosterone sulfate (DS), the major C19-steroid in the human circulation, was measured in serum obtained from blood samples collected daily (8 to 10 A.M.) throughout the menstrual cycles of eight normal, presumably ovulatory women and daily throughout the treatment cycles in four women taking an oral contraceptive (norethindrone, 1 mg., plus mestranol, 80 mcg.). The serum concentrations of DS in the ovulatory women ranged from 1,025 to 4,200 ng. per milliliter; mean, 2,062 +/- 137 ng. per milliliter (mean and standard error; n = 213). Serum DS concentrations during the follicular and luteal phases of the menstrual cycles of these women were similar. In women taking the oral contraceptive, the plasma DS concentrations ranged from 475 to 1,400 ng. per milliliter (mean, 895 +/- 83; n = 119). The 24 hour secretory pattern of DS was evaluated in one subject during a nontreatment cycle and again after 20 days of oral contraceptive treatment. In this subject, the mean serum DS level was 34 per cent lower during oral contraceptive treatment than the level before treatment. The decrease in the serum concentration of DS during oral contraceptive treatment likely results from a reduction in adrenal DS secretion since DS secretion by the normal human ovary is negligible and ovarian dehydroisoandrosterone secretion is small. Therefore, it is likely that the reduced serum DS levels in women taking oral contraceptives are the consequence of reduced adrenal secretion of DS resulting from reduced release of adrenocorticotropic hormone.     

Anti-Müllerian hormone levels during hormonal contraception in women with polycystic ovary syndrome

OBJECTIVE: The use of oral contraceptive (OC) pills alters the characteristic features of polycystic ovary syndrome (PCOS) complicating the diagnosis of this disease. Anti-Müllerian hormone (AMH) levels are high in PCOS patients and are stable throughout the menstrual cycle in healthy subjects. This study examined the influence of hormonal suppression with OC therapy on the serum AMH levels in women with PCOS and with normal menstrual cycles. STUDY DESIGN: Thirty women with PCOS and 15 women with normal menstrual cycles were enrolled in this prospective study. Serum was collected from the subjects during the early follicular phase of the menstrual cycle and after the sixth cycle of oral contraceptive therapy, and stored frozen until assayed. The effect of OC therapy on the serum AMH, estradiol (E(2)), luteinizing hormone (LH), follicle-stimulating hormone (FSH), free testosterone, total testosterone, and dehydroepiandrosterone sulfate (DHEA-S) levels was studied. In addition, ovarian volume and follicle count were assessed. RESULTS: The serum AMH levels in PCOS patients were significantly higher than in healthy women at baseline (+/-S.D.; 5.49+/-2.26 and 1.93+/-0.51 ng/ml, respectively; p=0.001). After six cycles of OC therapy, no significant changes in the AMH levels were observed in either the PCOS patients or normally cycling women. Ultrasound showed significant reductions in ovarian volume and follicle number and size at 6 months in both groups. CONCLUSION: Although significant reductions were observed in ovarian volume and follicle number, 6 months of contraceptive therapy did not change the serum AMH concentration in either group. AMH may be considered a new marker in PCOS patients who are already on contraceptive treatment.     

Current developments in hormonal contraception]

The development of hormonal oral contraceptives (OCs) hitherto has been characterized by the endeavor to reduce associated health risks as much as possible without reducing the contraceptive efficacy of menstrual cycle control. This has led to a gradual reduction of the estrogen dose in the OCs as well as to the development of ever more effective gestagens for ovulation inhibition and satisfactory menstrual cycle control. Combination preparations were developed with 30-35 mcg of ethinyl estradiol (EE) and high gestagen doses that guaranteed ovulation inhibition (30 mcg of gestodene, 60 mcg of norgestimate). A three-phase preparation with gestodene, which contains 30 mcg of EE and only 50 mcg of gestodene in the first week, massively suppresses the follicle maturation, more forcefully than an equivalent three-phase OC with levonorgestrel (LNG). In Germany since March 1992, there has been on the market an OC containing 20 mcg of EE and 1 mg of norethindrone acetate, with an effectiveness equal to that of higher-dose OCs. However, with this preparation the rate of spotting was still over 20% in the 12th menstrual cycle of use, hence it has not been accepted. In the coming years it is expected that further combination OCs with 20 mcg of EE and appropriate gestagen components will be introduced. In order to avoid the heavy burden on liver metabolism, various types depot gestagens such as implants (Norplant) or the vaginal ring (180 mcg of estradiol and 290 mcg of LNG) were developed as highly effective alternatives to OCs, however, their menstruation control is not satisfactory. Another implant, Capronor, releases 30-50 mcg of LNG over a period of 12-18 months. Parenterally applied highly effective contraceptive steroids (medroxyprogesterone acetate and norethindrone enanthate injected every 2-3 months) also seem to be able to alter hormone-dependent serum parameters in similar ways as OCs.     

左旋18-甲基炔诺酮两种产品的药代动力学比较

本文报告两种均含0.75mg左旋18-甲基炔诺酮(LNG)的事后片的药代动力学研究。每例对象服药后0～24小时的血清LNG浓度以放射免疫法进行测定;药—时曲线由微机以迭代法进行拟合,均符合二室开放模型。结果显示口服Postinor和国产片以后,血清LNG峰值,C_(max)分别为11.25±3.39(X±SD,下同)和5.89±1.72ng/ml(P<0.001);达峰时间T_(max)分别为1.9l±0.58 和3.08±1.24h,吸收半寿期T_(1/2a)分别是0.88±0.23和1.38±0.69h,服药后0～24h的药-时曲线下面积AUC_(0～24)分别为92.19±34.34和64.40±21.97ng/ml(P<0.05),两者亦均有明显差异。提示口服Postinor以后,LNG的吸收更迅速,更完全。然而服药后分布半寿期T_(1/2α)、消除半寿T_(1/2β)和总廓清率CL在统计学上无显著差异。故提示两种制剂经口服以后在体内的分布和消除过程较为相似。本文结果表明Postinor中LNG剂量可适当减少,而国产事后片若能改进制剂工艺,提高生物利用度也可适当减少剂量。     

The effect of oral contraceptives on assisted reproductive technology [corrected] cycles

PURPOSE OF REVIEW: To summarize the available data regarding the value of oral contraceptive pill addition in ovarian stimulation schemes used for in-vitro fertilization. RECENT FINDINGS: In agonists cycles, a decreased incidence of ovarian cyst formation is expected in patients pretreated with the oral contraceptive pill after gonadotropin-releasing hormone agonist administration compared to those treated according to a long follicular protocol. In antagonist cycles, oral contraceptive pill pretreatment appears to be feasible and has been used for programming cycle initiation. Solid evidence regarding its effect on the probability of pregnancy is, however, currently lacking. SUMMARY: The optimal use of oral contraceptive pretreatment as well as its effect on in-vitro fertilization outcome have not yet been fully explored. The effect of oral contraceptive pill pretreatment is worth further investigation in properly designed trials.