Progesterone and estradiol in microspheres in an oil solution for use by intramuscular injection is marketed under the brand name Juvenum in Mexico. Progesterone and estradiol benzoate in an oil solution for use by intramuscular injection is marketed under the brand names Duogynon, Duoton Fort T P, Emmenovis, Gestrygen, Lutofolone, Menovis, Mestrolar, Metrigen Fuerte, Nomestrol, Phenokinon-F, Prodiol, Pro-Estramon-S, Proger F, Progestediol, and Vermagest and is available in Belize, Egypt, El Salvador, Ethiopia, Guatemala, Honduras, Italy, Lebanon, Malaysia, Mexico, Nicaragua, Taiwan, Thailand, and Turkey. Progesterone and estradiol hemisuccinate in an oil solution for use by intramuscular injection is marketed under the brand name Hosterona in Argentina. Progesterone and estrone for use by intramuscular injection is marketed under the brand name Synergon in Monaco. United States
As of November 2016, progesterone is available in the United States in the following formulations:
Oral: Capsules: Prometrium (100 mg, 200 mg, 300 mg)
Vaginal: Tablets: Endometrin (100 mg); Gels: Crinone (4%, 8%)
Intramuscular injection: Oil: Progesterone (50 mg/mL)A 25 mg/mL concentration of progesterone oil for intramuscular injection and a 38 mg/device progesterone intrauterine device (Progestasert) have been discontinued.An oral combination formulation of micronized progesterone and estradiol in oil-filled capsules (brand name Bijuva) is marketed in the United States for the treatment of menopausal symptoms and endometrial hyperplasia.Progesterone is also available in unregulated custom preparations from compounding pharmacies in the United States. In addition, transdermal progesterone is available over-the-counter in the United States, although the clinical efficacy of transdermal progesterone is controversial. Research
Progesterone was studied as a progestogen-only injectable contraceptive, but was never marketed.
Somatostatinomas are a tumor of the delta cells of the endocrine pancreas that produces somatostatin. Increased levels of somatostatin inhibit pancreatic hormones and gastrointestinal hormones. Thus, somatostatinomas are associated with mild diabetes mellitus (due to inhibition of insulin release), steatorrhoea and gallstones (due to inhibition of cholecystokinin release), and achlorhydria (due to inhibition of gastrin release). Somatostatinomas are commonly found in the head of pancreas. Only ten percent of somatostatinomas are functional tumours [9], and 60–70% of tumours are malignant. Nearly two-thirds of patients with malignant somatostatinomas will present with metastatic disease. Pathophysiology
In a normal subject, actions of somatostatin include:
In the anterior pituitary gland, the effects of somatostatin are:Inhibit the release of growth hormone, thus opposing the effects of growth hormone-releasing hormone (GHRH)
Inhibit the release of thyroid-stimulating hormone (TSH)Somatostatin suppresses the release of gastrointestinal hormonesGastrin
Cholecystokinin (CCK)
Secretin
Motilin
Vasoactive intestinal peptide (VIP)
Gastric inhibitory polypeptide (GIP)
EnteroglucagonLowers the rate of gastric emptying, and reduces smooth muscle contractions and blood flow within the intestine
Suppresses the release of pancreatic hormonesInhibits the release of insulin
Inhibits the release of glucagonSuppresses the exocrine secretory action of pancreas.This explains how abnormally elevated somatostatin can cause diabetes mellitus, by inhibiting insulin secretion, steatorrhoea by inhibiting cholecystokinin and secretin, gall stones by inhibiting cholecystokinin which normally induce gallbladder myocytes to contract, and hypochlorhydria caused by inhibiting gastrin, which normally stimulate acid secretion.Somatostatinomas are associated with calcium deposits called psammoma bodies.