作者  neo718 (美粧保養週年慶)                              看板  transgender 
 標題  Re: [醫療] 請問口服與針劑荷爾蒙？                                      
 時間  Mon Apr  5 21:17:33 2010                                               
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※ 引述《wuchien (chien)》之銘言：
: 大家好
: 我是想請問，
: 為什麼大部分FTM使用荷爾蒙是以針劑為主？
: MTF的荷爾蒙主要是用吃的？
: 有什麼考量或是什麼生物機轉的原因嗎？
: 謝謝。

  聲明:以下資訊不保證其正確性。詳情請洽詢你的主治醫師以求得較正確的訊息。
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  以前剛好有跟其他朋友及大型醫療藥局之藥師稍微討論過這件事，
  也搜尋找過一些相關文獻。我把當時所得到的結論提供上來給各位TS參考。

  首先是MTF的部分:

  MTF 施行HRT的Estrogens以及Anti-androgens的部分，醫師會採用口服為主。
  除了是因為此兩種成分若採用固體材質以口服進食方式，
  可以提供"時間週期較常，且穩定的Hormone濃度"。
  從(醫界)醫療方面的角度來看，這是較為理想及安全的做法。

  另一個原因是:採用針劑包裝的Hormone，會有"半衰期"的問題產生。
  所謂半衰期是指，該藥劑於施打之後，其在人體內的濃度會在一定的短暫時間之後，
  濃度劇烈下降，從而造成效果降低。針季雖然可以在施打初期，造成比口服藥劑
  還要高出許多的濃度比例，但是後續的持續性效果，卻不如口服來的穩定。

  另一個更顯著的原因是:因為通常使用針劑的MTF，使用習慣上多為自行施打。
  而由於其Hormone屬於高濃度油溶性質(非水溶性)。所以必須施打於人體肌肉組織上。
  若採用自行施打，而非由專業醫療人員施行，會有容易扎入血管內的疑慮。
  若是如此，這會造成相當大的危險。

  想像一下，如果人體的腦部微血管被油給堵塞了會怎樣?(輕則休克，重則有死亡之虞)
  就算是專業的醫護人士施打時，都還得先回抽確認沒扎到血管，才能完成注射。

  再來是FTM:

  FTM 之所以目前不採用口服，而以針劑為主，最大的原因是:androgen目前尚未開發
  出可供口服的固體材質包裝方式。(除了技術問題，某部分可能原因或許是成本考量)
  所以醫師對其FTM患者的HRT，才對都以採行針劑。

  至於半衰期的問題，因為藥商所開發出之液態的androgen針劑，其單位濃度的比例，
  還比液態的Estrogens針劑，濃度要低上許多。
  所以半衰期問題不若Estrogens針劑明顯。且因為單位濃度較低之關係，
  施打時的危險性，平均來說會較Estrogens針劑來的低。
  至於以後是否會有藥商開發口服包裝，目前實際上還不確定。
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本文一日後刪除

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※ 發信站: 批踢踢實業坊(ptt.cc)
推 piaon:為什麼要刪除@@
推 hoshiyomi:肌肉注射是在推之前要先抽看看有沒有血，沒血才能壓下去
→ neo718:要推之前,以及要抽出來前,都最好必須要檢查.
→ neo718:我印象中,以前與同校及它系同學在醫師實習時,校方跟院方
→ neo718:都會這樣提醒過.
推 swami:推推~~ 我一個護士友人也是教我要針下去之後要回抽 沒有血液
→ swami:才是針頭在肌肉內  而不是在血管裡
→ neo718:更正,在醫院實習時.
→ swami:如果藥商開發出FTM口服荷爾蒙  說不定FTM就不用挨針了
推 snowyangel65:不是退針喔～是推藥劑之前就要先回抽一下！確認是否
→ snowyangel65:有抽到血～有抽到血代表可能打到血管了，那時就要拔
→ snowyangel65:出針頭～再換個位置打，以避免將油性藥劑打入血管中
→ neo718:謝謝雪晴姐的補充.
※ 編輯: neo718          來自: 219.71.44.129        (04/05 22:10)
推 snowyangel65:這篇很值得參考～一日後刪除是否可以再考慮看看呢!?