Comparative bioavailability of a morphine suppository given rectally and in a colostomy.

In eight patients with a colostomy, plasma morphine levels were followed for 8 h after administration of 20 mg morphine chloride as a suppository, first rectally and after at least 48 h via the colostomy. The bioavailability after administration in the colostomy showed very great variation; the mean value compared to rectal bioavailability was only 43% (range 0.1-127%). In four patients the plasma concentrations of morphine after colostomy administration were lower at all times than after rectal administration, and in three only small amounts of morphine were detectable. One patient showed higher plasma concentrations after colostomy application than after rectal administration. It is concluded that administration of morphine suppositories in a colostomy cannot be recommended.

Comparative trial of the effects on glucose tolerance and lipoprotein metabolism of two new oral contraceptives containing gestoden and desogestrel.

The effects of two new low-dose oral contraceptives (triphasic ethinyl estradiol/gestoden and monophasic ethinyl estradiol/desogestrel) on glucose tolerance, plasma insulin response to glucose, fasting plasma cortisol, triglycerides (TG), total cholesterol (C), HDL-C, LDL-C, VLDL-C and sex hormone binding globulin (SHBG) were investigated in two groups of healthy women (n = 10). Investigations were performed prior to hormone ingestion and after treatment for 2 and 6 months. In both groups, fasting plasma levels of glucose and insulin as well as the areas below the glucose concentration curves were unchanged during treatment, whereas the insulin response to oral glucose was equally increased (p less than 0.05). Intake of both compounds was followed by similar increases in the levels of HDL-C (p less than 0.05) and in the HDL-C/total-C (p less than 0.05). A transient decrease in the levels of LDL-C was observed in both groups after two months. During intake of the gestoden-containing compound increases in VLDL-C and TG levels were registered after six months (p less than 0.05). Plasma levels of SHBG increased similarly in both groups (p less than 0.01). The study indicates, that intake of both hormonal compounds is free from adverse effects on glucose tolerance and lipoprotein metabolism known to be of clinical significance. No differences in the metabolic effects were found between the two compounds.