Drugs Archives - Page 2 of 2 - Protection of Conscience Project Library

Effect of mifepristone and levonorgestrel on expression of steroid receptors in the human Fallopian tube

A Christow, X Sun, K Gemzell-Danielsson

Abstract
It is likely that mifepristone or levonorgestrel in the future will find extended use for contraceptive purposes. It is therefore essential to characterize the modes of action of these compounds. To assess the effect on the human Fallopian tube, 24 women with regular menstrual cycles and proven fertility, admitted to the hospital for voluntary sterilization by laparoscopic technique, were randomly allocated to a control or one of two treatment groups. Treatments were given with either a single dose of 200 mg mifepristone or 0.75 mg levonorgestrel in two doses 12 h apart, on day LH2. Surgery was performed on day LH4 to LH6. Steroid receptor expression was analysed by immunohistochemistry, Western blot and RT-PCR. In the controls, there was a higher concentration of progesterone receptors in the stromal cells in the isthmic region than in those in the ampullar region. Treatment with mifepristone increased the progesterone receptor concentration in epithelial and stromal cells and increased the estrogen receptor concentration in epithelial cells. No effect on steroid receptor concentration was found following levonorgestrel. The contraceptive effect of post-ovulatory mifepristone has previously been considered to be dependent on an effect on the endometrium. However an effect on the Fallopian tube could contribute to alter the peri-implantation milieu influencing fertilization and embryo development.

Christow A, Sun X, Gemzell-Danielsson K. Effect of mifepristone and levonorgestrel on expression of steroid receptors in the human Fallopian tube. Mol Hum Reprod. 2002 April 01;8(4):333-340.

(Correspondence) Methotrexate and misoprostol used in abortions

Anthony T Kerigan

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
. . . methotrexate is contraindicated during pregnancy. If Wiebe and the University of British Columbia Ethics Committee have information on the safety of this drug during pregnancy perhaps they could share it with readers.

Kerigan AT. (Correspondence) Methotrexate and misoprostol used in abortions. Can Med Assoc J. 1994 Sep 01;151(5):518.

Conscientious objection and abortifacient drugs

D B Brushwood

Abstract
The legal right to assert a conscientious objection is reviewed, using as an example the dispensing of abortifacient drugs by pharmacists. The three areas of law that most significantly concern the right to assert a conscientious refusal are employment law, conscience clauses, and religious discrimination law. Each of these is reviewed, with descriptions of recent cases. It is concluded that employment law protects refusals that are consistent with public policy, but does not permit an employee’s personal policy to determine how a business will be run; that conscience clauses appear to provide protection for pharmacists who object to dispensing abortifacients, but that the precise meanings of critical words and phrases in some clauses need to be defined; and that even though laws of religious discrimination require that employers accommodate religious beliefs, they may not protect a pharmacist who objects to dispensing abortifacients if the accommodation becomes unreasonably burdensome.

Brushwood DB. Conscientious objection and abortifacient drugs. Clin Therapeutics. 1993 Jan-Feb;15(1):204-212.

(Correspondence) The CMA’s position on abortion

R Lee Isaacs

Extract
Well! The CMA has certainly done the “in” thing with its resolution on abortion. . . It has never been traditional or ethical to prescribe according to the demands of the patient, whether for narcotics or for euthanasia or for abortion. Minds can change, but death is final. The resolution portrays abandonment of principle, not leadership.

Isaacs RL. (Correspondence) The CMA’s position on abortion. Can Med Assoc J. 1988 Nov 15;139(10):929.

(Correspondence) The conscience clause

William Hardman

British Medical Journal, BMJ — British Medical Journal

Extract

Whilst agreeing in toto with your timely and forcible leader as regards the moral it indicates, yet do I take exception to certain statements therein contained. I object to the statement that it is petty sessional doings which have made Section ii of the Act-the conscience clause-a laughing- stock in so many parts of the country. The reason why it is not a laughing-stock in every part of the country is either because of the good sense or correct views of the inhabitants or because the antivaccinationists have neglected to disseminate their pernicious literature and to enforce their dangerous propaganda amongst these fortunate sections. . .

Hardman W. The conscience clause (Letter). Br Med J. 1899 January 14; 1(1985): 122