Cephradine and epicillin in body fluids of lactating and pregnant women.

The passage of two antibiotics, cephradine and epicillin, into the milk of 12 lactating women and the amniotic fluid of 48 pregnant women was investigated. All women were given a 500-mg capsule every six hours for at least two days prior to our taking multiple biologic samples from them. Constant levels of both antibiotics were reached in the milk of lactating women as well as in the amniotic fluid of mid-term and full-term pregnant women during the sample period. The ratio of drug concentrations in serum to that in milk was about 5.0 for each antibiotic. In the midtrimester women, the ratio of concentrations in serum to amniotic fluid of both antibiotics was approximately 1.0, suggesting the development of an equilibrium between these two compartments. This ratio was 0.2 for both drugs in the full-term women, demonstrating that the antibiotics concentrated in the amniotic fluid compartment.

Absorption and biotransformation of topically applied 8-(methylthio) cyclic AMP. Studies in dogs and humans.

8-(Methylthiocyclic AMP-35S was applied topically to the intact or abraded skin of dogs at a dose of about 2-5 mg/kg. In this species, an average of 7% of the dose was absorbed through the intact and 62% through abraded skin. Half-lives for radioactivity in plasma averaged 3-6 h. After the topical application of the drug to the intact skin of dogs, the average concentration in plasma of glucose, but not of insulin, was increased by as much as 21%; after application to abraded skin, glucose and insulin were increased, on average, by as much as 84 and 221%, respectively. 8-(methylthio)adenosine and two unidentified compounds were present as metabolites in the urine of dogs; some unchanged 8-(methylthio)cyclic AMP-35S was also excreted. 8-(methylthio)cyclic AMP-35S was also applied topically (25 mg; 0-32 mg/kg) to the intact and stripped skin of normal human subjects under conditions similar to those used for dogs. Three subjects with intact skin did not absorb any of the drug, whereas three subjects with stripped skin absorbed 0-5, 8-3, and 23-3% of the dose. The half-life of radioactivity in the plasma of the subject with the greatest absorption was 0-5 h during the first 2 h, and 11 h for the next 10 h. During the first 2 h, this same subject excreted unchanged drug and 8-(methylthio)adenosine in his urine. No changes in glucose or insulin concentrations in plasma were observed in any of the subjects nor was there any apparent irritation of the skin.

Fertility following termination of the once-a-month oral contraceptive.

PIP: The rate of fertility return as evidenced by conception after discontinuance, endometrial biopsies and return to menstruation was evaluated in 290 women who used the oral contraceptive quinestrol and quingestanol acetate once a month. 73% had their first menstrual flow 25-45 days after the last drug induced bleeding with a significant direct relationship of minimal influence between the duration of therapy and the time interval to menstruation. 104 of 111 women who desired a pregnancy conceived in an average of 7 months after their last treatment. There was no significant relationship between the duration of treatment, time to conceive or the autrome of the therapy. 72% of the 152 biopsies taken 14 days or less before the first regular menstruation showed a normal secretory endothelium with no correlation to duration of therapy.^ieng

Further experience with quingestanol acetate as a postcoital oral contraceptive.

PIP: The experiences of 4 clinical research groups, 1 each in Mexico, Peru, Chile, and Argentina, using quingestanol acetate as a postcoital oral contraceptive is described. 2702 patients accumulated 18,531 cycles of postcoital therapy. In Mexico with a 800 mcg dose, the pregnancy rate was .6. In Chile and Peru at a dose of 750 mcg, pregnancy rates were over 20. Differences in selection of patients may account for part of the difference.^ieng

Effect of contraception on lactation.

PIP: A study of the effects of IUD and hormonal contraceptives, both oral and injectable, on lactation is reported. The duration of lactation in 696 multiparous healthy women under contraceptive therapy was compared with the women's own previous duration of lactation when no contraception was used. In users of Lippes loop and injectable progestogens (in medroxyprogesterone acetate, DMPA) median duration of lactation (MDL) was significantly longer, even whem DMPA was injected immediately post partum, than in the controls. The MDL of Control Group B, which excluded those patients who had spontaneously stopped lactating within 30 days after delivery, was 5.3 months. The MDL in patients receiving DMPA 30 days after delivery was 9.3 months, and it was 6.7 months in those receiving DMPA immediately post partum. The MDL in patients with IUD was 7.7 months. When oral estrogen containing quinestrol and oral sequential steroidal contraceptives were given, MDL was significantly shorter than in control lactations. In the 2 groups of patients receiving the combination of quinestrol (Q1) and quingestronol acetate (Q2) orally, one a month, the MDL was 2.5 months respectively. The data indicate that compounds containing estrogens in the doses employed in this study should not be used as contraceptive therapy by nursing mothers.^ieng