Kari Laine

Citalopram in pregnancy and lactation.

Although citalopram has gained wide acceptance in the treatment of depression and anxiety disorders, its use during pregnancy and lactation has been poorly characterized. The aim of this study was to examine the efficacy and safety of citalopram in relation to concentrations of citalopram and its metabolites during pregnancy and lactation.

Pharmacokinetics of fluoxetine and norfluoxetine in pregnancy and lactation

The aim of this prospective clinical trial was to investigate the pharmacokinetics offluoxetine and its active metabolite, norfluoxetine, during pregnancy, delivery, and lactation in mothers and their infants.

Transfer of proinflammatory cytokines across term placenta.

OBJECTIVE: Increased concentrations of proinflammatory cytokines in amniotic fluid indicate the presence of intra-amniotic inflammation and increase the risk of preterm birth, cerebral palsy, and bronchopulmonary dysplasia. The purpose of this study was to find out if the proinflammatory cytokines, tumor necrosis factor alpha (TNF-&agr;), interleukin (IL)-1&bgr;, and IL-6, transfer across the placenta, and thereby determine whether intra-amniotic inflammatory response, measured from the amniotic fluid, is of maternal or fetal origin. METHODS: Nineteen placentas from healthy women undergoing elective cesarean delivery at term with intact membranes and without labor, were dually perfused ex vivo in an open circulation system for either 30 minutes or 2 hours. Tumor necrosis factor-&agr;, IL-1&bgr;, and IL-6 were added to maternal or fetal circulation in a concentration usually found in chorioamnionitis. As a reference, placentas without added cytokine were also perfused. The concentrations of cytokines were determined by enzyme immunoassays (enzyme-linked immunosorbent assay [ELISA]). RESULTS: After the addition of the cytokine to the arterial perfusate, the venous concentration on the same side of the placenta increased rapidly and reached a plateau at 10 minutes. No transfer of any cytokine in either direction was detected. Some endogenous release of IL-6 was observed in response to the perfusion. CONCLUSION: Proinflammatory cytokines do not cross normal term placenta. LEVEL OF EVIDENCE: II-1

Effect of Clopidogrel and Ticlopidine on Cytochrome P450 2B6 Activity as Measured by Bupropion Hydroxylation

Our objective was to study the effect of the antiplatelet agents clopidogrel and ticlopidine on bupropion (INN, amfebutamone) hydroxylation, a probe reaction for cytochrome P450 (CYP) 2B6 activity.

The transplacental transfer of the macrolide antibiotics erythromycin, roxithromycin and azithromycin

Objective To investigate the transplacental transfer of the macrolide antibiotics erythromycin, roxithromycin and azithromycin.

Functional role of P-glycoprotein in the human blood-placental barrier

In vitro and animal experiments suggest that P‐glycoprotein forms a functional barrier between maternal and fetal blood circulation in the placenta, thus protecting the fetus from exposure to xenobiotics during pregnancy. In this study we aimed to characterize the role of P‐glycoprotein in the blood‐placental barrier by use of dually perfused human placenta.

Effect of voriconazole on the pharmacokinetics and pharmacodynamics of intravenous and oral midazolam.

Our objective was to assess the effect of the antimycotic voriconazole on the pharmacokinetics and pharmacodynamics of oral and intravenous midazolam.

No sex-related differences but significant inhibition by oral contraceptives of CYP2C19 activity as measured by the probe drugs mephenytoin and omeprazole in healthy Swedish white subjects

Although it is known that the use of oral contraceptives inhibits oxidative drug metabolism, there is little information regarding their effect on CYP2C19 activity. Moreover, earlier reports suggest that there may be differences in CYP2C19 activity between men and women.

The influence of ants on the survival of mountain birches during an Oporinia autumnata (Lep., Geometridae) outbreak

SummaryThe present study reports the influence of ants on the survival of mountain birch (Betula pubescens ssp. tortuosa) during an Oporinia autumnata (Lep., Geometridae) outbreak. Undamaged “green islands” with a radius of 15–20 m were observed around Formica aquilonia mounds in a defoliated area in Finnish Lapland. The herbivore densities and grazing pressure were shown to be low within this radius. The foraging strategy of ants and their influence on birch growth are discussed.

SFINX—a drug-drug interaction database designed for clinical decision support systems

ObjectiveThe aim was to develop a drug-drug interaction database (SFINX) to be integrated into decision support systems or to be used in website solutions for clinical evaluation of interactions.MethodsKey elements such as substance properties and names, drug formulations, text structures and references were defined before development of the database. Standard operating procedures for literature searches, text writing rules and a classification system for clinical relevance and documentation level were determined. ATC codes, CAS numbers and country-specific codes for substances were identified and quality assured to ensure safe integration of SFINX into other data systems. Much effort was put into giving short and practical advice regarding clinically relevant drug-drug interactions.ResultsSFINX includes over 8,000 interaction pairs and is integrated into Swedish and Finnish computerised decision support systems. Over 31,000 physicians and pharmacists are receiving interaction alerts through SFINX. User feedback is collected for continuous improvement of the content.ConclusionSFINX is a potentially valuable tool delivering instant information on drug interactions during prescribing and dispensing.