In contrast to progesterone, OHPC is not metabolized by traditional steroid-transforming enzymes and instead is metabolized exclusively via oxidation at the caproate side chain by cytochrome P450 enzymes. As such, it is not thought to have the same tissue-specific activation and inactivation patterns that progesterone does nor the same non-genomic actions that progesterone and its metabolites possess.Further clinical research is anticipated to provide additional data to help clarify the issue of safety with OHPC. In any case, it has been recommended by the American College of Obstetricians and Gynecologists that pregnant women treated with OHPC receive counseling about its risks and benefits. Pharmacokinetics
Absorption
In animals, the bioavailability of OHPC with intramuscular injection is nearly 100%, but its oral bioavailability is very low at less than 3%. In women, 70 mg/day oral OHPC has similar endometrial potency as 70 mg/day oral OHPA and 2.5 mg/day oral medroxyprogesterone acetate, indicating that oral OHPC and OHPA have almost 30-fold lower potency than medroxyprogesterone acetate via oral administration. Studies on progestogenic endometrial changes with oral OHPC in women are mixed however, with one finding weak effects with 100 mg/day whereas another found that doses of 250 to 1,000 mg produced no effects. As a result of its low oral potency, OHPC has not been used by the oral route and has instead been administered by intramuscular injection.
Imaging in pulmonary gangrene shows multiple small cavities joining together to form a large cavity. Mycobacterial
Mycobacteria that can cause cavitations include Mycobacterium tuberculosis and nontuberculous mycobacteria, most commonly Mycobacterium avium complex. Primary tuberculosis is caused by the initial infection with Mycobacterium tuberculosis and rarely results in the formation of lung cavities. 90% of people with primary tuberculosis are able to contain the infection and enter a latent phase. Reactivation tuberculosis, which is caused by the reactivation of latent tuberculosis, results in lung cavities visible on X-ray 30 to 50% of the time. There are frequently multiple cavities, and they most commonly occur in the apical and posterior segments of the upper lobes or the superior segment of the lower lobes. Cavitary tuberculosis is associated with worse outcomes, a higher rate of treatment failure, more frequent relapse after treatment, and a higher risk of transmitting the disease to others. Even after successful treatment with anti-tuberculosis drugs, 20-50% of patients with cavitary tuberculosis have persistent cavities, which results in decreased lung function and increased risk of opportunistic infections by Aspergillus fumigatus and other fungal pathogens.Nontuberculous mycobacteria (NTM) are all mycobacterial species other than Mycobacteria tuberculosis (which causes tuberculosis) and Mycobacterium leprae (which causes leprosy). NTM are found everywhere in the environment but are most commonly found in soil and water. Lung disease is caused by inhaling or ingesting nontuberculous mycobacteria. Unlike tuberculosis, NTM infection is not transmitted from person to person.