clomiphene – n. 氯米芬
ovarian failure – 卵巢功能衰竭
off-label use – 标示外使用
sterility – n. 不育症
vasomotor flushing – 血管舒张潮红
multiple pregnancies -- 多胎妊娠
oxytocin – n. 催产素
inertia – n. 乏力，无行动
uterine inertia – 子宫乏力
incomplete abortion – 不全流产
gravid uterus – 妊娠子宫
myoepithelium – n. 肌上皮
anaphylactic – a. （导致）过敏的
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Prototype Drugs 原型药
1. Clomiphene 氯米芬
Indications: Treatment of ovarian failure in patients with normal liver function and normal endogenous estrogens; off-label use; treatment of male sterility. 适应症：肝功能正常、内源性雌激素正常妇女卵巢功能衰竭的治疗；标示外使用；治疗男性不育
Actions: Binds to estrogen receptors, decreasing the number of available estrogen receptors, which gives the hypothalamus the false signal to increase FSH and LH secretion, leading to ovarian stimulation. 作用：与雌激素受体结合，减少可用的雌激素受体数量，从而给下丘脑一个错误信号，增加FSH和LH分泌，促进排卵。
Pharmacokinetics: 药物代谢动力学 Route Onset Peak Duration
PO 5-8 d Unknown 6 wk
途径 起效 达峰 持续
PO 5-8 d 未知 6 wk
T1/2: 5 days; metabolized in the liver and excreted in the urine.
半衰期：5天；代谢于肝，经肾排泄
Indications: To initiate or improve uterine contractions for early vaginal delivery; to stimulate or reinforce labor in selected cases of uterine inertia; to manage inevitable or incomplete abortion; for second-trimester abortion; to control postpartum bleeding or hemorrhage; to treat lactation deficiency.
Actions: Synthetic form stimulates the uterus, especially the gravid uterus; causes myoepithelium of the lacteal glands to contract, resulting in milk ejection in lactating women. 作用：合成剂型刺激子宫，特别是妊娠子宫；引起乳腺肌上皮收缩，导致授乳妇女排乳
Pharmacokinetics: 药物代谢动力学
Route Onset Peak Duration
IV Immediate Unknown 60 min
IM 3-5 min Unknown 2-3 h 途径起效达峰持续
IV 立即 未知 60 min
IM 3-5 min 未知 2-3 h
T1/2: 1 to 6 minutes; metabolized in the tissue and excreted in the urine. 半衰期：1-6 min；代谢于组织，经肾排出
Adverse Effects: Cardiac arrhythmias, hypertension, fetal bradycardia, nausea, vomiting, uterine rupture, pelvic hematoma, uterine hypertonicity, severe water intoxication, anaphylactic reaction.
1. Which of the following is a contraindication for use ofoxytocinto inducelabor?
A. Missed abortion
B. Placenta previa
C. Hyperbilirubinemia
D. Pregnancy past due date
2. A 28-year-old married woman seeks advice from the nurse in her company health office about oral contraceptives. The nurse should advise her that if she smokes:
A. Oral contraceptives can cause thrombophlebitis
B. Some oral contraceptives are safe, and others are not safe
C. Oral contraceptives can be used with other methods
D. Some oral contraceptives can be used without concern
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答案 Answer
1. B. Placenta previa Rationale: Use of oxytocin is contraindicated in the presence of placenta previa. Labor induction in this condition could be fatal to the fetus. Placenta previa is an indication for cesarean section. 2. A. Oral contraceptives can cause thrombophlebitis Rationale: Studies have shown that women who smoke at least a pack of cigarettes a day are more prone to cardiovascular problems such as thrombophlebitis.
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