Oral contraceptives and

EthynodlolDia.ceta.te, Ethynodiol diacetate has been used alone, and in combination with an strogen, as an oral contraceptive and to treat disorders associated with progesterone deficiency (76). It may be crystallised from aqueous methanol (77) and is soluble in chloroform, ether, and ethanol sparingly soluble in fixed oils and insoluble in water (76). Extensive spectral and chromatographic data have been compiled (78). 

LynestrenoL Lynestrenol (73) has been used in oral contraceptives and to treat menstrual disorders. It is converted in vivo to its active metabohte norethindrone (102,103). It can be recrystallized from methanol, and is soluble in ethanol, ether, chloroform, and acetone, and insoluble in water (102). The crystal stmcture (104) and other spectral and analytical data have been reported for lynestrenol (62). 

L-Fohc acid is available as a crystalline dihydrate containing 8% water. Approximately 80% of the commercial production is consumed for feed enrichment in animal nutrition. FoHc acid is being offered by the pharmaceutical industry for therapeutic and prophylactic use (see Pharmaceuticals). Pharmacological doses of fohc acid are commonly used as a rescue dose during cancer chemotherapy, in women using oral contraceptives, and alcohoHcs. Several studies have provided evidence that multivitamins or foHc acid (0.8—4 mg/day) supplementation prevent the majority of neural tube defects (101). 

Areas of Continued Research. Research continues in many academic and pharmaceutical laboratories throughout the wodd with the objective of improving oral contraceptives and better understanding their pharmacological and clinical actions. 

Royal CoUege of General Practitioners, Oral Contraceptives and Health An Interim Report from the Oral Contraception Study, Pitman Medical, New York, 1974. 

Marchbanks PA, McDonald JA, Wilson HG et al (2002) Oral contraceptives and the risk of breast cancer. N Engl JMed 346 2025-2032... 

Drug Interactions Carbamazepine induces the hepatic metabolism of many drugs, including other antiepileptic drugs, antipsychotics, some antidepressants, oral contraceptives, and... 

Provide appropriate patient education regarding the use of oral contraceptives, and... 

TP, a 22 year-old woman, presents to your office for a routine gynecologic examination. She entered menarche at the age of 12. Her last menstrual period was 3 months ago. Her periods are often irregular and occur about every 2 to 3 months. She has had all normal Pap smears in the past and no history of sexually transmitted infections. She is currently in a monogamous relationship with a male partner. She has had a total of four sexual partners. She is not taking oral contraceptives and does not routinely use condoms. She has never been pregnant in the past, but she plans on starting a family in the near future. As you examine the patient, you note facial and chest acne, increased facial and abdominal hair, and obesity. 

A 22-year-old female college student with no remarkable medical history notes shortness of breath when she takes her daily 5-mile run, which has worsened progressively over the past 3 weeks. On review of systems, it is discovered that she has experienced intermittent sensations of chest tightness over the past 2 months that she ascribed to pollen allergies, and 3 days prior to presentation she experienced an episode of hemoptysis. Her only medication is oral contraceptives, and she reports no known drug allergies. A chest x-ray is remarkable for a 10 x 12 cm mediastinal mass. 

Dickinson BD, Altman RD, Nielsen NH, Sterling ML Council on Scientific Affairs, American Medical Association Drug interactions between oral contraceptives and antibiotics. Obstet Gynecol 2001 98 853-860. 

It induces the metabolism of oral contraceptives, and alternative contraception measures are required. 

Vandenbroucke JP, Rosing J, Bloemenkamp KW, Middeldorp S, Helmerhorst FM, Bouma BN, Rosendaal FR (2001) Oral contraceptives and the risk of venous thrombosis. N Engl J Med 344 1527-1535... 

Villard-Mackintosh and L., Vessey, M.P., Oral contraceptives and reproductive factors in multiple sclerosis incidence, Contraception, 47, 161, 1993. 

Kuukasjarvi, S., Eriksson, C.J.P., Koskela, E., Mappes, T., Nissinen, K. and Rantala, MJ. (2004) Attractiveness of women s body odors over the course of the menstrual cycle The role of oral contraceptives and receiver sex. Behav. Ecol. 15, 579-584. 

Some drugs, including oral contraceptives, and smoking tobacco, increase the body s demand for vitamins B, C and E. 

Theophylline is a narrow therapeutic index drug with significant difference in bioavailability following oral administration. The half-life of the drug is increased by heart failure, cirrhosis and viral infections, in elderly patients, and by certain drugs, such as cimetidine, ciprofloxacin, oral contraceptives and fluvoxamine. The half-life is decreased in smokers, chronic alcoholism, and by certain drugs, such as phenytoin, rifampicin and carbamazepine. 

Jick H, Walker AM, Watkins RN, et al. Oral contraceptives and breast cancer. Am J Epidemiol 1980 112 577. 

Oral contraceptives have also been reported to produce increases in sulfobromophthalein retention and other liver function tests, as well as in prothrombin time, clotting factors VII, VIII, IX, serum thyroxine, and protein-bound iodine (B8). In a group of 48 women the mean cholesterol value was 206 41 mg/100 ml while they were receiving a variety of oral contraceptives and 179 28 mg/100 ml when they were not receiving the drugs (W19). 

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