I have tried many of them and they either aren't as simple or simply don't have the features. It's simple to use, the use of most of the features are around Stackoverflow, and it has a lot (and I mean a lot) of features. My favourite was being able to fill in Acro. Fields in PDFs ; ). Posted 1. 0/0. 4/2. Um, can someone write some documentation? IPDF is a free, open-source toolset developed by Orati Systems Ltd. As far i know by using itextsharp you can only print the text of a label (named here lblArticle), but you can't print the HTML attribute. Pearson Course Content. Pearson is the world leader in publishing, education and learning. Pearson Prentice Hall, along with our other respected imprints, provides. IText “XML Worker” allows developers to convert XML files to PDF documents in a programmer-friendly way. Check out iText; it is a pure Java PDF toolkit which has support for reading data from HTML. I used it recently in a project when I needed to pull content from our. You saved my bacon, as I was just about to look for something else, but didn't want to. In this post I'm going to talk about creating PDF documents in C#. I will primarily focus on the PdfSharp and MigraDoc libraries, which are free C# libraries. How to export gridview data to PDF using asp.net or Export gridview data to PDF using asp.net. How to create pdf in java using iText,iText image insertion in pdf, inserting table in itext pdf file, inserting list in itext pdf, new line in itext pdf chunk property. If you compare the changelogs for iText 5.5.6 with previous change log entries (for instance the one for iText 5.5.5), you immediately notice that we're using a.
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Download Google Chrome OS and Run it from a USB Drivemake- use- of- logologo- backgroundsearchsearch- startcloseemailbookmarkfacebookgooglepintereststumbleuponwhatsappamazonyoutubeyoutubelabel- rectangletriangle- longdown. Just a few days ago, Google announced the release of the Chrome OS source code. I even managed to put together my own Google Chrome OS download in the form of a complete Virtual. Box appliance. Designs are subject to change. All the other applications are simply links to webpages. Mail icon does indeed bring you to the Yahoo! Setting- up Unicode Coptic for Windows. Tuesday, June 1. 1, 2. Preparing Windows for Coptic Unicode. Preparing Windows for writing Coptic. Unicode requires mainly two steps: 1. Installing Unicode fonts with. Coptic glyphs. Get at least one Unicode font from this page and. Installing an appropriate. Keyboard. Install at least one keyboard of the following (of course you can install all, if you want to)Get and install the Coptic Keyboard defined by Logos Research Systems from this link. More information about. Keyboard can be found here. U2. 01. 2. zip from socrates. If you are used to the CS- Coptic encoding, you can try another keyboard I have. CS fonts. Though I would. Logos. The layout is shown below. If you would like to modify this layout or even create your own encoding. Microsoft Keyboard Layout Creator (MKLC) (free utility) and use my. Since Windows has no definition for the Coptic. Greek). Windows 7 seems to attach keymap the EN (English locale) by default. Converting CS Text files into Unicode. Name UTF-8 UTF-16 UTF-16BE UTF-16LE UTF-32 UTF-32BE UTF-32LE; Smallest code point: 0000: 0000: 0000: 0000: 0000: 0000: 0000: Largest code point: 10FFFF: 10FFFF: 10FFFF: 10FFFF: 10FFFF: 10FFFF: 10FFFF: Code unit size: 8 bits.Quick links: Converter I very simple, only for text files, swaps also. Converter II text files and clipboard, map is editable with. Excel. SIL Converter professional although free, also for MS Word. Converter II have written a small utility that will. Coptic text files into Unicode text file. In fact, before the Unicode was. ASCII or ISO8. 85. X standard for Coptic keymapping. Every. Coptic font had defined its own encoding. Few years ago, two active members of the. Remenkimi Group (Coptic Community) started. They have swapped all famous Coptic. Their standard along with 7 into. CS standard converted fonts can be downloaded at: The Coptic Orthodoxe Network. The converter I have written will convert text files written in this CS Standard into. Coptic Unicode. Currently UTF- 8 and UTF- 1. Simply start the tool, select. Unicode text. After that you can open the generated Unicode file with any editor. Unicode. Don't forget to select a Coptic Unicode font. Notice: Entering . In CS. the letter is typed BEFORE the Jinkim. In Unicode. one has to enter the combining mark AFTER entering the letter. The. converter takes care of this problem. Another important Note: Jinkim and. The Unicode Consortium. For example the Jinkim (which is ASCII 0x. CS) will be converted to U+0. D. The. complete Conversion table is available at this. Download CS Converter for Windows. Download theconversion Table as pdf- file. Download test. files: CS input test file and the. UTF- 8 output file. Converter II. There is another converter available at the Danacbe. Forum of the Coptic language. But the. mapping table is editable with Excel. Unicode Converter can convert multiple ansi/Unicode/non Unicode encoding documents between any encoding. Frequently Asked Questions (FAQ) and their answers for the alt.ascii-art Usenet newsgroup. Includes links to libraries, related webrings and IRC channels. Publicado no livro The Unicode Standard Characters-to-Unicode converter. This tool will convert special characters (such as CJK characters, special IPA characters, and other non-ASCII scripts) into Unicode decimal and hex code points, along with the. It also doesn't swap the combining diacritical. SIL Converter (MS Word)SIL International has published a collection of. Byte- based encodings and Unicode. The complete. package is called SIL- Converters and can be downloaded at: http: //scripts. After installing, you will need in. I have created. which defines the conversion rules between the CS encoding and Unicode. Just download. this file: cs. Start Microsoft Word, open a file that is encoded in one of the CS fonts, you can use. From the menu . Then a new window with the Tecmap. Choose the folder . Set up the location of the TECkit file . After that press the button . You can now. enter a user- friendly name, for example: . When you return back to the first window of the Converter. You can now convert the whole. Just experiment with this in cs font written sample doc- file, try to convert. Unicode. You shall get a file like this. Further you can export the file into ODF (Open Document Format) by using the. Sun ODF Plugin for Microsoft. Office. The odt- file can then be opened with Open. Office and the good thing is: In. Open. Office you can get an extension for spell checking Coptic. Supported formats are base. JSON, Java, C++, PHP, quoted- printable, URL. HTTP POST, XML, UTF- 8 and more. The encoder and decoder functions run in the browser. Java. Script) without any server- side communication. It is. possible to convert directly from one format to another. Base. 64 – The. Base. ASCII. It can also be used in. URI: s, encoding an image or similar directly as a. Since every 3 bytes of data are converted. Base. 64 format results in. JSON, Java. Script, Java, C, C++. PHP – The Wikipedia article on. Quoted- printable – The. UTF- 8 text into. ASCII. It is mostly used in email and. MIME. applications. This is sometimes added to. Q- encoding). e. g. It is sometimes. also known as WWW- form encoding. Some variations exist for handling. URL characters (=. UTF- 8 –. UTF- 8. Unicode. It is reasonably. Unicode character range (i. The result is 1. to 3 characters of output per input character. Source Code – The. Java. Script library used for the. Web/HTML to PDF API for Java. Provides access to the Pdfcrowd API from your Java applications. The file can be either an HTML document or a . Use - 1 for a single page PDF. The following variables are expanded. URL to convert.%p - The current page number.%n - Total number of pages. Footer. Url(Stringurl). Loads HTML code from the specified url and places it inside the page. See set. Footer. Html for the. See set. Footer. Html for the list of. See set. Footer. Html for the. Negative numbers. Programming Tutorials and Source Code Examples. Java XML HTML How to; JavaFX How to. Application convert's html link into PDF file format. Convert HTML to PDF in C# and VB.NET. Java PDF API to create PDF documents from scratch. Read, edit and convert PDF, XPS, EPUB, HTML, MHT, PCL, SVG, XSLFO, TEX. Source Code; Forums; Blogs; Downloads. Nick Afshartous illustrates a way to convert HTML content to PDF. JTidy is a Java port of the Tidy HTML. Example: . The default value is 0. Example: if set to . The default is true. Backgrounds(booleanvalue). Set value to false to disable printing backgrounds to the PDF. Convert HTML to PDF using PHP quick. Take a look at the piece of code bellow: Converting HTML to PDF. Reliable and secure HTML to PDF convertor. We've just added a Java example! This article specifies a simple Java code to convert any kind of. 72 responses to Java Code to Convert. The default is true. Html. Zoom(doublevalue). Set HTML zoom in percents. It determines the precision used for. HTML content. Despite its name, it does not zoom. HTML content. Higher values can improve glyph positioning and. PDF . The. default value is 2. See. also set. Pdf. Scaling. Factor(). The default. is utf- 8. This prevents search engines from indexing the. When a PDF has a user password, it. At most 3. 2 characters. Supplying an owner. PDF including changing the. At most 3. 2 characters. The default. is false. The default is. false. The default value is. You can easily convert any xml file to pdf with styles you need using itext in java. How to convert html file into pdf. Indeed Java script code for converting html file into pdf. Convert TEXT to PDF file using Java. A sample java code for Connection Pooling for JDBC connection. Requires the following CSS rule to be declared: body . The supported formats are. PNG and JPEG. The default offset. By default, the watermark is placed in the foreground. It is thrown when an error. Use get. Message() method to get the error message. If no units are specified, points are. Electrical Engineering Technology : : Welcome. Welcome to the Electrical Engineering Technology web site. We take great pride in our program and care about each. Site intended for girls that highlights opportunities in engineering careers in the United States. Includes links, profiles of women engineers, and interactive features. Humans and Robots Face Similar Walking Challenges Many people living with spinal cord injuries can regain mobility. However, they often reach a plateau in their recovery. There are billions of dollars of external scholarship money available to students of all qualifications, abilities, and interests. Organization that accredits US professional degree programs in architecture. Electrical Engineering Technology Welcome Page Today is. Welcome to the Electrical Engineering Technology web site. I hope that you are encouraged. Mechanism(s) of Support This funding opportunity announcement uses the T03 award mechanism. The PD/PI will be solely responsible for planning, directing, and. Catalog of Transportation Education, Training, and Workforce Development Programs and Resources August 2010. Download: catalog2010.pdf, 795 KB. You may also visit the other UT web sites and numerous links to. Engineering Technology and the electrical profession. We also welcome personal visits to our campus. About Marquette University . The university’s commitment to academic excellence is complemented by a grounding in the centuries- old Jesuit concept, cura personalis, which calls us to appreciate and respect the individual hopes, desires, aspirations, and concerns of all members of the Marquette community. In this spirit, this Bulletin has been created to guide you in planning your academic career and professional development. With its descriptions of academic majors and required courses, study abroad opportunities, services for students and policies, it is a resource to help you choose the path at Marquette that best suits you, fosters your growth, and prepares you for the challenges, rewards, leadership and service that await you when you complete your work here. Www Abet Org Accredited Programs Shtml Include FileUse it in the spirit of Father Jacques Marquette, the 1. Jesuit explorer for whom our university is named. Let his embrace of the unfamiliar, his openness to new opportunities, and his strong sense of purpose inspire you as you explore the offerings of this outstanding university. You have my prayers that our loving and gracious God will bless you in your academic work at Marquette. Michael R. Lovell, Ph. D. President. From the Provost. A Marquette education goes beyond the educational foundation your courses provide. Your time at Marquette will be more than an education. You will receive the guidance of faculty who are experts in their field and who truly believe in the teacher- scholar model, as well as leadership opportunities in service learning and student organizations. It will be an experience that we hope transforms you into men and women who seek answers to life’s deepest questions and contribute to solving the world’s most pressing problems. It describes the range of majors and courses Marquette offers, graduation requirements, academic policies and procedures, and experiential learning opportunities that exist both inside and outside of the classroom. I hope you will find it a helpful resource as you register for classes and plan ahead for future semesters. Our faculty and staff are here to help guide your growth intellectually, emotionally and spiritually during your time at Marquette. They are a valuable resource, and I encourage you to seek their advice and listen to their perspectives gleaned from years in their respective fields. Your time on campus offers you the opportunity to engage in meaningful dialogue and learn from this engagement and through the spirit of Ignatian reflection. The Marquette community is truly a family – one that extends beyond our campus community to the 1. We know that you will contribute your unique gifts to enrich the diversity of our campus community and will go out into the world and be men and women for others. Daniel J. Myers, Ph. D. Provost. History. Marquette began as a dream of the Most Rev. John Martin Henni the first Catholic bishop of Milwaukee, but it took a trip overseas to find an investor to make it a reality. Belgian businessman Guillaume Joseph De. Www Abet Org Accredited Programs Shtml RedirectAAMC Financing Your Medical Education. A series of programs to assist students in managing loans and preparing for future. Our global network of experts is the heart of ABET accreditation. By serving as team chairs and program evaluators, practicing professionals. The Cal Poly Pomona College of Engineering is the engineering college at California State Polytechnic University, Pomona (Cal Poly Pomona or Cal Poly) located in. Buey promised $1. Jacques Marquette, S. J., opened on Aug. Bishop Henni died just two days later, one might guess satisfied that his work was finished. Throughout the years, thousands of students have passed through Marquette's halls and classrooms, aspiring to achieve academic success and a spiritual foundation to last a lifetime. Marquette was founded in the rich tradition of the Society of Jesus, a Catholic religious order established in 1. St. The university is named after Rev. Jacques Marquette, S. J. Our mission, therefore, is the search for truth, the discovery and sharing of knowledge, the fostering of personal and professional excellence, the promotion of a life of faith, and the development of leadership expressed in service to others. All this we pursue for the greater glory of God and the common benefit of the human community. Excellence. Our students, whether traditional or non- traditional, undergraduate, graduate or professional, come to Marquette University to share our commitment to the pursuit of excellence in all things as a lifelong endeavor. They come to join a community whose members — faculty, staff, students, trustees, alumni and friends alike — believe that education must encompass the whole person: spiritual and moral as well as intellectual, the heart as well as the mind. And they come seeking the educational, professional and cultural advantages of a university located in the heart of the city. We, in turn, take seriously our responsibility to foster and support excellence in teaching and research, to keep a Marquette education accessible to a diverse population of students, and to offer personal attention and care to each member of the Marquette community. Faith. As a Catholic university, we are committed to the unfettered pursuit of truth under the mutually illuminating powers of human intelligence and Christian faith. Our Catholic identity is expressed in our choices of curricula, our sponsorship of programs and activities devoted to the cultivation of our religious character, our ecumenical outlook, and our support of Catholic beliefs and values. Precisely because Catholicism at its best seeks to be inclusive, we are open to all who share our mission and seek the truth about God and the world, and we are firmly committed to academic freedom as the necessary precondition for that search. We welcome and benefit enormously from the diversity of seekers within our ranks, even as we freely choose and celebrate our own Catholic identity. Leadership. As a Jesuit university, Marquette embodies the intellectual and religious traditions of the Society of Jesus. Through an academically rigorous, values- centered curriculum, our students receive a firm grounding in the liberal arts, preparation for work in a world of increasing complexity and diversity, and formation for life as ethical and informed leaders in their religious, cultural, professional and civic communities. They work with and learn from faculty who are true teacher- scholars, whose research not only advances the sum of human knowledge, but also informs their teaching, and whose commitment to students is fundamental to their intellectual and professional lives. Service. Through both our academic and co- curricular programs, Marquette strives to develop men and women who will dedicate their lives to the service of others, actively entering into the struggle for a more just society. We expect all members of the Marquette community, whatever their faith traditions, to give concrete expression to their beliefs by giving of themselves in service to those in need. Marquette University Guiding Values. Endorsed Dec. 8, 2. In accordance with the Catholic, Jesuit mission and vision of Marquette University, we hold that all people and things are created to praise, reverence and serve God in our community and throughout the world, and thus every aspect of the university’s lifeblood and work holds this principle and foundation as its beginning and end. Therefore, we will enact the following values and behaviors in our lives and our work to serve the greater glory of God: Pledge personal and holistic development of students as our primary institutional vocation. Pursue academic excellence and educate students who are men and women for and with others throughout the world. Embody a spirit of interdisciplinary curiosity, research, innovation, entrepreneurship and application to change and improve ourselves, our community and our world. Nurture an inclusive, diverse community that fosters new opportunities, partnerships, collaboration and vigorous yet respectful debate. Live as servant leaders with a commitment to the Jesuit tradition and Catholic social teaching for all people, beliefs and faith traditions. Create bold, ambitious plans enacted with agility, authentic accountability and a commitment to the greater good. Vision Statement. Marquette University aspires to be, and to be recognized, among the most innovative and accomplished Catholic and Jesuit universities in the world, promoting the greater glory of God and the well- being of humankind. We must reach beyond traditional academic boundaries and embrace new and collaborative methods of teaching, learning, research and service in an inclusive environment that supports all of our members in reaching their fullest potential. Marquette graduates will be problem- solvers and agents for change in a complex world so in the spirit of St. Ignatius and Jacques Marquette, they are ready in every way . Precisely because Catholicism at its best seeks to be inclusive, we are open to all who share our mission and seek the truth about God and the world. Through our admissions and employment policies and practices, our curricular and co- curricular offerings, and our welcoming and caring campus environment, Marquette seeks to become a more diverse and inclusive academic community dedicated to the promotion of justice. Our commitment to a diverse university community helps us to achieve excellence by promoting a culture of learning, appreciation and understanding. Each member of the Marquette community is charged to treat everyone with care and respect and to value and treasure differences. This call to action is integral to the tradition which we share. For more information please visit the Office of Diversity and Inclusion. Accreditation. An educational institution is only as strong as the level of excellence that it demands of itself as well as of its faculty and students. Marquette University is accredited by the Higher Learning Commission, a commission of the North Central Association of Colleges and Schools. Marquette University has set consistently high standards for itself that have resulted in accreditation and/or certification of its academic programs from these additional organizations and associations. These accreditations assure a student that Marquette is recognized and approved by select national and regional educational associations, societies and councils. Estrogens/Progestins, Transdermal (Combination Products) (Professional Patient Advice). Transdermal (Combination Products) Pronunciation: ES- troe- jenz proe- JES- tinz. Class: Estrogen and progestin combined. Trade Names. Climara Pro- Patch, transdermal estradiol 0. Combi. Patch- Patch, transdermal estradiol 0. Patch, transdermal estradiol 0. Low Dose Hormone Patch Less Risky for Stroke than Pills. Women taking low dose estrogen patches had the same risk of stroke as women not using hormone. Study: Different Hormone Therapy Formulations May Pose Different Risks for Heart Attack and Stroke. Although most studies that showed an increased risk wereof women taking estrogen as a pill, women using a patch or high-dose vaginal ring can also. Estradiol patch should not be used to prevent heart disease, heart attacks, strokes, or dementia. Estrogens have been shown to increase the risk of heart disease. Oral contraception pills and the patch or ring. Latest on What is Estrogen? When given through an estrogen patch, vaginal ring, or skin cream or gel (transdermal estrogen)., stroke, blood clots, or endometrial cancer. Something to discuss with your doctor. I have had a full stroke, but do wear an estrogen patch because the discomfort from just walking or sitting down was bad, let. Low-dose transdermal hormone replacement therapy does not appear to increase stroke risk compared with no HRT use. Pharmacology. Estrogens act to reduce the elevated levels of gonadotropins, luteinizing hormone, and follicle- stimulating hormone seen in postmenopausal women. Progestins counteract the proliferative effects of estrogens on the endometrium. Indications and Usage. Moderate to severe vasomotor symptoms associated with menopause; moderate to severe symptoms of vulvar and vaginal atrophy associated with menopause ( Combi. Patch only); hypoestrogenism due to hypogonadism, castration, or primary ovarian failure ( Combi. Patch only); prevention of postmenopausal osteoporosis ( Climara Pro only). Contraindications. Undiagnosed abnormal genital bleeding; known, suspected, or history of cancer of the breast; known or suspected estrogen- dependent neoplasia; active deep vein thrombosis, pulmonary embolism, or history of these conditions; active or recent (eg, within past year) arterial thromboembolic disease (eg, MI, stroke); liver dysfunction or disease; known or suspected pregnancy; hypersensitivity to any component of the product. Dosage and Administration. Adults. Transdermal. Climara Pro. Apply 1 patch to the lower abdomen; apply new patch once weekly. Combi. Patch. Apply 1 patch to the lower abdomen; apply new patch twice weekly. For continuous combined regimen, use regimen continuously. For continuous sequential regimen, use estradiol 0. Combi. Patch for days 1. General Advice. Application site should be a smooth (fold- free), clean, dry area of the skin on the lower abdomen. Do not apply on the waistline, to or near the breasts, or to areas where sitting could dislodge the patch. Ensure selected area is not oily, damaged, or irritated. Rotate application site, with an interval of at least 1 wk allowed between applications to the same site. If patch falls off, the same patch may be reapplied to another area of the lower abdomen. If necessary, a new patch may be applied and the original treatment schedule should be continued. A dose of estradiol 0. Storage/Stability. Climara Pro. Store between 5. After dispensing, store below 7. Monitor patient response; adjust the beta- blocker dose as needed. Corticosteroids (eg, prednisolone)Corticosteroid plasma concentrations may be elevated, increasing the pharmacologic effects and risk of toxicity. Monitor for signs of corticosteroid toxicity (cushingoid facies, weight gain, fluid retention); reduce the corticosteroid dose if necessary. Cyclosporine. Cyclosporine plasma concentrations may be elevated, increasing the pharmacologic effects and risk of toxicity (eg, nephrotoxicity). Monitor serum cyclosporine concentrations, as well as renal and liver function, for evidence of cyclosporine toxicity. Adjust the cyclosporine dose as needed. CYP3. A4 inducers (eg, barbiturates . John's wort)Coadministration may reduce plasma concentrations of estrogens, possibly resulting in a decrease in therapeutic effects and/or changes in the uterine bleeding profile. CYP3. A4 inhibitors (eg, azole antifungals . Monitor for estrogen- related adverse reactions. Felbamate, griseofulvin, penicillins (eg, ampicillin), pioglitazone, tetracyclines. These agents may decrease the pharmacologic effects of estrogen/progestin combinations. Hydantoins (eg, phenytoin)Hydantoins may decrease the pharmacologic effects of estrogen/progestin combinations. In addition, hydantoin concentrations may be altered. Adjust the hydantoin dose as needed. Lamotrigine. Lamotrigine plasma concentrations may be reduced, decreasing the pharmacologic effects. Adjust the lamotrigine dose as needed. Nevirapine. Nevirapine may decrease the pharmacologic effects of estrogen/progestin combinations. Coadministration is not recommended. Selegiline, tacrine, tacrolimus, tizanidine. Estrogen/progestin combinations may elevate the plasma concentrations of these agents, increasing the pharmacologic effects and risk of adverse reactions. Monitor closely; adjust the dose of these agents as needed. Theophyllines (eg, aminophylline)Theophylline plasma concentrations may be elevated, increasing the pharmacologic effects and risk of toxicity (eg, CV instability, nausea, seizures, vomiting). Monitor theophylline concentrations and the patient for signs of theophylline toxicity; adjust the theophylline dose as needed. Topiramate. Cl of estrogen from plasma is increased by topiramate at dosages greater than 2. Cl of progestin does not appear to be affected. Tranexamic acid. The risk of estrogen/progestin- related thrombotic events may be increased. Limit coadministration of tranexamic acid with an estrogen/progestin combination to patients with a strong medical need in whom the potential benefits outweigh the increased risk of a thrombotic event. Valproic acid. Valproic acid plasma concentrations may be reduced, decreasing the pharmacologic effects and increasing the risk of seizures. Monitor patient and valproic acid concentrations; adjust the valproic acid dose as needed. Laboratory Test Interactions. Impaired glucose tolerance. Decreased. Antithrombin III activity; levels of anti- factor Xa and antithrombin III activity; free hormone concentrations; LDL; response to metyrapone test; T 3 resin uptake. Increased. PTT, platelet aggregation time, and PT; platelet count; factors II, VII antigen, VIII antigen, VIII coagulation activity, IX, X, XII, VII- X complex, II- VII- X complex, and beta thromboglobulin; levels of fibrinogen and fibrinogen activity; plasminogen antigen and activity; thyroid- binding globulin (TBG) leading to increased circulating total thyroid hormone (as measured by protein- bound iodine, T 4 or T 3 ); corticosteroid binding globulin; sex hormone–binding globulin; angiotensinogen/renin substrate, alpha- 1 antitrypsin, ceruloplasmin; HDL, HDL 2 , and triglyceride levels. Adverse Reactions. Cardiovascular. Hypertension (3%); deep and superficial venous thrombosis, increase in BP, MI, pulmonary embolism, stroke, thrombophlebitis. CNSHeadache (2. 5%); depression (9%); insomnia (8%); dizziness (7%), nervousness (6%); chorea, dementia, exacerbation of epilepsy, irritability, migraine, mood disturbances. Dermatologic. Application- site reaction (4. EENTIntolerance of contact lenses, retinal vascular thrombosis. GIAbdominal pain, diarrhea (1. Genitourinary. Breast pain (4. PAP smear suspicious (8%) breast enlargement (7%); menorrhagia (5%); UTI (3%); breakthrough bleeding, breast cancer, breast tenderness, change in amount of cervical secretion, changes in cervical ectropion, changes in libido, changes in vaginal bleeding pattern and abnormal withdrawal bleeding or flow, endometrial cancer, endometrial hyperplasia, fibrocystic breast changes, galactorrhea, increase in size of uterine leiomyomata, nipple discharge, ovarian cancer, spotting, vaginal candidiasis. Hypersensitivity. Anaphylactoid/anaphylactic reactions. Metabolic- Nutritional. Edema (4%); hypocalcemia, increased triglycerides, reduced carbohydrate tolerance, weight decrease. Musculoskeletal. Arthralgia (6%); leg cramps. Respiratory. Rhinitis (2. Miscellaneous. Pain (1. Precautions. Warnings. Do not use estrogens and progestins for prevention of CV disease or dementia. The Women's Health Initiative study reported increased risks of MI, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women during 5 y of treatment with oral conjugated estrogens combined with medroxyprogesterone. In addition, increased risk of developing probable dementia in postmenopausal women 6. Because of these risks, prescribe estrogens with or without progestins at the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman. Monitor. Reevaluate patients as clinically appropriate (eg, 3- to 6- mo intervals) to determine if treatment is still necessary. Monitor BP at regular intervals; monitor blood glucose levels in patients with diabetes. For patients with hypothyroidism, monitor thyroid function. Pregnancy. Category X . There appears to little or no increased risk of birth defects in children born to women who have used estrogens and progestins in oral contraceptives inadvertently during early pregnancy. Lactation. Secreted in breast milk. Estrogens decrease the quantity and quality of breast milk. Children. Not indicated for use in children. Hepatic Function. Estrogens may be poorly metabolized in patients with hepatic impairment. Use with caution in patients with history of cholestatic jaundice associated with past estrogen use or pregnancy. Special Risk Patients. Use with caution in patients with asthma, diabetes mellitus, epilepsy, hepatic hemangiomas, migraine, porphyria, and SLE. Estrogens may exacerbate these conditions. Elevated BPSubstantial increases in BP have been attributed to idiosyncratic reactions to estrogens. Endometrial hyperplasia in women with intact uteri. Addition of a progestin for 1. Endometriosis. May be exacerbated. Fluid retention. Carefully monitor patients with conditions that might be influenced by fluid retention (eg, cardiac or renal dysfunction) because estrogen/progestin therapy may cause fluid retention. Gallbladder disease. The risk of gallbladder disease requiring surgery is increased 2- to 4- fold. Hypercalcemia. Estrogen administration may lead to severe hypercalcemia in patients with breast cancer and bone metastases. Hypertriglyceridemia. In patients with preexisting hypertriglyceridemia, estrogen therapy may be associated with elevations in plasma triglycerides, leading to pancreatitis. Consider discontinuation if pancreatitis occurs. Hypocalcemia. Use with caution in patients with severe hypocalcemia. Hypothyroidism. Estrogen use may lead to increased TBG levels. Monitor thyroid function in patients with hypothyroidism. |
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December 2016
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