GREEN BOOK 1 Trimoniums CIR EXPERT PANEL MEETING JUNE
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Antiseptics and Disinfectants for the Treatment Of
Verstraelen et al. BMC Infectious Diseases 2012, 12:148 http://www.biomedcentral.com/1471-2334/12/148 RESEARCH ARTICLE Open Access Antiseptics and disinfectants for the treatment of bacterial vaginosis: A systematic review Hans Verstraelen1*, Rita Verhelst2, Kristien Roelens1 and Marleen Temmerman1,2 Abstract Background: The study objective was to assess the available data on efficacy and tolerability of antiseptics and disinfectants in treating bacterial vaginosis (BV). Methods: A systematic search was conducted by consulting PubMed (1966-2010), CINAHL (1982-2010), IPA (1970- 2010), and the Cochrane CENTRAL databases. Clinical trials were searched for by the generic names of all antiseptics and disinfectants listed in the Anatomical Therapeutic Chemical (ATC) Classification System under the code D08A. Clinical trials were considered eligible if the efficacy of antiseptics and disinfectants in the treatment of BV was assessed in comparison to placebo or standard antibiotic treatment with metronidazole or clindamycin and if diagnosis of BV relied on standard criteria such as Amsel’s and Nugent’s criteria. Results: A total of 262 articles were found, of which 15 reports on clinical trials were assessed. Of these, four randomised controlled trials (RCTs) were withheld from analysis. Reasons for exclusion were primarily the lack of standard criteria to diagnose BV or to assess cure, and control treatment not involving placebo or standard antibiotic treatment. Risk of bias for the included studies was assessed with the Cochrane Collaboration’s tool for assessing risk of bias. Three studies showed non-inferiority of chlorhexidine and polyhexamethylene biguanide compared to metronidazole or clindamycin. One RCT found that a single vaginal douche with hydrogen peroxide was slightly, though significantly less effective than a single oral dose of metronidazole. -
Quaternary Ammonium Compounds
FACT SHEET: Quaternary Ammonium Compounds Quaternary ammonium compounds, also known as “quats” or “QACs,” include a number of chemicals used as sanitizers and disinfectants, including benzalkonium chloride, benzethonium chloride, cetalkonium chloride, cetrimide, cetrimonium bromide, cetylpyridinium chloride, glycidyl trimethyl, ammonium chloride, and stearalkonium chloride.[i] In general, quats cause toxic effects through all Mutagenicity routes of exposure including inhalation, Some quats have shown to be mutagenic and to ingestion, dermal application, and irrigation of damage animal DNA and DNA in human body cavities. Exposure to diluted solutions may lymphocytes at much lower levels than are result in mild irritation, while concentrated present in cleaning chemicals.[6] solutions are corrosive, causing burns to the skin and mucous Membranes. They can produce Antimicrobial Resistance systemic toxicity and can also cause allergic Genes have been discovered that mediate reactions.[2] resistance to quats. There has been an association of some of these genes with beta lactamase genes, Asthma and Allergies raising concern for a relationship between Of particular interest with regard to use as disinfectant resistance and antibiotic resistance.[7] disinfectants in the COVID-19 pandemic, quats increase the risk for asthma and allergic Reproductive Toxicity sensitization. Evidence from occupational Mice whose cages were cleaned with QACs had exposures shows increased risk of rhinitis and very low fertility rates. [8] Exposure to a common asthma -
Antimicrobial Activity of Cationic
ANTIMICROBIAL ACTIVITY OF CATIONIC ANTISEPTICS IN LAYER-BY-LAYER THIN FILM ASSEMBLIES A Thesis by CHARLENE MYRIAH DVORACEK Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE May 2009 Major Subject: Mechanical Engineering ANTIMICROBIAL ACTIVITY OF CATIONIC ANTISEPTICS IN LAYER-BY-LAYER THIN FILM ASSEMBLIES A Thesis by CHARLENE MYRIAH DVORACEK Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE Approved by: Chair of Committee, Jaime Grunlan Committee Members, Michael Benedik Xinghang Zhang Head of Department, Dennis O'Neal May 2009 Major Subject: Mechanical Engineering iii ABSTRACT Antimicrobial Activity of Cationic Antiseptics in Layer-by-Layer Thin Film Assemblies. (May 2009) Charlene Myriah Dvoracek, B.S., Rose-Hulman Institute of Technology Chair of Advisory Committee: Dr. Jaime Grunlan Layer-by-layer (LbL) assembly has proven to be a powerful technique for assembling thin films with a variety of properties including electrochromic, molecular sensing, oxygen barrier, and antimicrobial. LbL involves the deposition of alternating cationic and anionic ingredients from solution, utilizing the electrostatic charges to develop multilayer films. The present work incorporates cationic antimicrobial agents into the positively-charged layers of LbL assemblies. When these thin films are exposed to a humid environment, the antimicrobial molecules readily diffuse out and prevent bacterial growth. The influence of exposure time, testing temperature, secondary ingredients and number of bilayers on antimicrobial efficacy is evaluated here. Additionally, film growth and microstructure are analyzed to better understand the behavior of these films. -
Reseptregisteret 2013–2017 the Norwegian Prescription Database
LEGEMIDDELSTATISTIKK 2018:2 Reseptregisteret 2013–2017 Tema: Legemidler og eldre The Norwegian Prescription Database 2013–2017 Topic: Drug use in the elderly Reseptregisteret 2013–2017 Tema: Legemidler og eldre The Norwegian Prescription Database 2013–2017 Topic: Drug use in the elderly Christian Berg Hege Salvesen Blix Olaug Fenne Kari Furu Vidar Hjellvik Kari Jansdotter Husabø Irene Litleskare Marit Rønning Solveig Sakshaug Randi Selmer Anne-Johanne Søgaard Sissel Torheim Utgitt av Folkehelseinstituttet/Published by Norwegian Institute of Public Health Område for Helsedata og digitalisering Avdeling for Legemiddelstatistikk Juni 2018 Tittel/Title: Legemiddelstatistikk 2018:2 Reseptregisteret 2013–2017 / The Norwegian Prescription Database 2013–2017 Forfattere/Authors: Christian Berg, redaktør/editor Hege Salvesen Blix Olaug Fenne Kari Furu Vidar Hjellvik Kari Jansdotter Husabø Irene Litleskare Marit Rønning Solveig Sakshaug Randi Selmer Anne-Johanne Søgaard Sissel Torheim Acknowledgement: Julie D. W. Johansen (English text) Bestilling/Order: Rapporten kan lastes ned som pdf på Folkehelseinstituttets nettsider: www.fhi.no The report can be downloaded from www.fhi.no Grafisk design omslag: Fete Typer Ombrekking: Houston911 Kontaktinformasjon/Contact information: Folkehelseinstituttet/Norwegian Institute of Public Health Postboks 222 Skøyen N-0213 Oslo Tel: +47 21 07 70 00 ISSN: 1890-9647 ISBN: 978-82-8082-926-9 Sitering/Citation: Berg, C (red), Reseptregisteret 2013–2017 [The Norwegian Prescription Database 2013–2017] Legemiddelstatistikk 2018:2, Oslo, Norge: Folkehelseinstituttet, 2018. Tidligere utgaver / Previous editions: 2008: Reseptregisteret 2004–2007 / The Norwegian Prescription Database 2004–2007 2009: Legemiddelstatistikk 2009:2: Reseptregisteret 2004–2008 / The Norwegian Prescription Database 2004–2008 2010: Legemiddelstatistikk 2010:2: Reseptregisteret 2005–2009. Tema: Vanedannende legemidler / The Norwegian Prescription Database 2005–2009. -
Being Aware of Chlorhexidine Allergy
Being aware of chlorhexidine allergy If you have an immediate allergic reaction to chlorhexidine you may experience symptoms such as: x itching x skin rash (hives) x swelling x anaphylaxis. People who develop anaphylaxis to chlorhexidine may have experienced mild reactions, such as skin rash, to chlorhexidine before. Irritant contact dermatitis or allergic contact dermatitis Chlorhexidine can also cause irritant dermatitis. This is not a true allergic reaction. It is caused by chlorhexidine directly irritating skin and results in rough, dry and scaly Chlorhexidine is an antiseptic. Allergic reactions to skin, sometimes with weeping sores. chlorhexidine are rare but are becoming more common. Chlorhexidine is used in many products both in Chlorhexidine can also cause allergic contact hospitals and in the community. dermatitis. Symptoms look like irritant dermatitis, but the cause of the symptoms is delayed by 12-48 hours Why have I been given this factsheet? after contact with chlorhexidine. You have been given this brochure because you have had a reaction to a medication, a medical dressing Both irritant dermatitis and allergic contact dermatitis or antiseptic. This may or may not be caused by a caused by chlorhexidine are annoying but not chlorhexidine allergy. dangerous. It is important that you are aware of the possibility of an It is recommended that you avoid chlorhexidine if you allergy. experience these responses as some people have gone on to develop immediate allergic reaction to chlorhexidine. Allergic reactions to chlorhexidine Severe allergic reactions to chlorhexidine are rare, but How do I know which products contain they can be serious. Immediate allergic reactions can chlorhexidine? cause anaphlaxis (a very severe allergic reaction which can be life-threatening). -
ANNEX VI List of Preservatives Allowed for Use in Cosmetic Products
ANNEX VI List of preservatives allowed for use in cosmetic products ANNEX VI LIST OF PRESERVATIVES WHICH COSMETIC PRODUCTS MAY CONTAIN Preamble 1. Preservatives are substances which may be added to cosmetic products for the primary purpose of inhibiting the development of micro-organisms in such products. 2. The substances marked with the symbol (+) may also be added to cosmetic products in concentration other than those laid down in this ANNEX for other purposes apparent from the presentation of the products, e.g. as deodorants in soaps or as anti-dandruff agents in shampoos. 3. Other substances used in the formulation of cosmetic products may also have anti-microbial properties and thus help in the preservation of the products, as, for instance, many essential oils and some alcohols. These substances are not included in the ANNEX. 4. For the purposes of this list - “Salts” is taken to mean: salts of the cations sodium, potassium, calcium, magnesium, ammonium, and ethanolamines; salts of the anions chloride, bromide, sulphate, acetate. - “Esters” is taken to mean: esters of methyl, ethyl, propyl, isopropyl, butyl, isobutyl, phenyl. 5. All finished products containing formaldehyde or substances in this ANNEX and which release formaldehyde must be labelled with the warning “contains formaldehyde” where the concentration of formaldehyde in the finished product exceeds 0.05%. Revised as per August 2015 ASEAN Cosmetic Documents 1 Annex VI – Part 1 – List of preservatives allowed for use in cosmetic products ANNEX VI – PART 1 LIST OF PRESERVATIVES ALLOWED Reference Substance Maximum authorized Limitations and Conditions of use and Number concentration requirements warnings which must be printed on the label a b c d e 1 Benzoic acid (CAS No. -
Quaternary Ammonium Compounds
FT-619502 Quaternary ammonium compounds Products Description Name : BenzyldimethylhexadecylAmmoniu m Chloride Catalog Number : 619502, 100g 16-BAC ; Cetalkonium chloride; N-hexadecyl-N,N-dimethyl Benzenemethaminium, Chloride; cloruro de Structure : CAS: [122-18-9]; cetalconio; Chlorure de cetalkonium Benzyldimethylhexadecylammonium chloride; Benzyl n-hexadecyl Molecular Weight : MW= 396.1 dimethylammonium chloride; Cetol; Benzyldimethylhexadecylammonium chloride, hydrate; N-Hexadecyl- N,N-dimethylbenzenemethanaminium chloride; Alkyl C-16 Properties: Freely soluble benzyldimethyl ammonium chloride; pH : 6.0 - 8.5 (10% sol.) Corrosive Avoid shock and frictions S26-45-60-61 Storage: Room temperature (Z) Technical and Scientific Information General description and applications Quaternary ammonium compounds are any of a group of ammonium salts in which organic radicals have been substituted for all four hydrogens of the original ammonium cation. They has a central nitrogen atom which is joined to four organic radicals and one acid radical. The organic radicals may be alkyl, aryl, or aralkyl, and the nitrogen can be part of a ring system. They are prepared by treatment of an amine with an alkylating agent. They show a variety of physical, chemical, and biological properties and most compounds are soluble in water and strong electrolytes. Such compounds include: Benzalkonium Chloride ( CAS RN: 8001-54-5) Benzethonium Chloride CAS 121-54-0 Cetalkonium Chloride( CAS 122-18-9) Cetrimide ( CAS 8044-71-1) Cetrimonium Bromide ( CAS 57-09-0) Cetylpyridinium -
National OTC Medicines List
National OTC Medicines List ‐ DraŌ 01 DRAFT National OTC Medicines List Draft 01 Ministry of Public Health of Lebanon This list was prepared under the guidance of His Excellency Minister Waêl Abou Faour andDRAFT the supervision of the Director General Dr. Walid Ammar. Editors Rita KARAM, Pharm D. PhD. Myriam WATFA, Pharm D Ghassan HAMADEH, MD.CPE FOREWORD According to the French National Agency for Medicines and Health Products Safety (ANSM), Over-the-counter (OTC) drugs are medicines that are accessible to patients in pharmacies, based on criteria set to safeguard patients’ safety. Due to their therapeutic class, these medicines could be dispensed without physician’s intervention for diagnostic, treatment initiation or maintenance purposes. Moreover, their dosage, treatment period and Package Insert Leaflet should be suitable for OTC classification. The packaging size should be in accordance with the dosage and treatment period. According to ArticleDRAFT 43 of the Law No.367 issued in 1994 related to the pharmacy practice, and the amendment of Articles 46 and 47 by Law No.91 issued in 2010, pharmacists do not have the right to dispense any medicine that is not requested by a unified prescription, unless the medicine is mentioned in a list which is established by pharmacists and physicians’ syndicates. In this regard, the Ministry of Public Health (MoPH) developed the National OTC Medicines List, and presentedit in a scientific, objective, reliable, and accessible listing. The OTC List was developed by a team of pharmacists and physicians from the Ministry of Public Health (MoPH). In order to ensure a safe and effective self- medicationat the pharmacy level, several pharmaceutical categories (e.g. -
Safety Assessment Dhivacosmetics Dhiva Shampoo
Cosmetic Product Safety Report Product name: Dhiva Shampoo Company name: Dhiva Cosmetics Version: 1 Formula number: Date: October 2016 Part A: Cosmetic Product Safety Information The following information is gathered and managed in the Dhiva Cosmetics product database (the product information file, PIF) under the relevant section. 1. Quantitative and qualitative composition of the cosmetic product, Dhiva shampoo composition (see Appendix A – Quantitative and qualitative composition of the cosmetic product): 2. Physical/chemical characteristics and stability of the cosmetic product: Stability clearance (see Appendix B – Stability summary). 3. Claim support: (no claim on this product). 4. Microbiological quality: Microbiological clearance (see Appendix B – Stability summary). 5. Impurities, traces, information about the packaging material: Packaging clearance (see Appendix B – Stability summary). 6. Normal and reasonably foreseable use: Label specifications (see below 2. Labelled warnings and instructions of use). 7. Exposure to the cosmetic product: (see Appendix C – Exposure assessment) and assessment below 8. Exposure to the substances: MoS calculation (see Appendix D – Margin of Safety calculations). 9. Toxicological profile of the substances (see Appendix E - Toxicological profiles for ingredients). 10. Undesirable effects and serious undesirable effects: Data from reports on (serious) undesireable effects (see Part B: Cosmetic Product Safety Assessment). 11. Information on the cosmetic product: User Test (see Appendix F – User test). Part B: Cosmetic Product Safety Assessment 1. Assessment conclusion The cosmetic product Dhiva Shampoo can be assessed as safe for normal and reasonably foreseeable use in accordance with the European Cosmetics Regulation (EC) No 1223/2009. 2. Labelled warnings and instructions of use The following warnings and instructions of use are mentioned on the packaging material/label of the product: Instructions of use: Massage into wet hair until it lathers. -
Of 8 August 2014 Amending Annexes III, V and VI to Regulation (EC) No 1223/2009 of the European Parliament and the Council on Cosmetic Products
9.8.2014 EN Official Journal of the European Union L 238/3 COMMISSION REGULATION (EU) No 866/2014 of 8 August 2014 amending Annexes III, V and VI to Regulation (EC) No 1223/2009 of the European Parliament and the Council on cosmetic products (Text with EEA relevance) THE EUROPEAN COMMISSION, Having regard to the Treaty on the Functioning of the European Union, Having regard to Regulation (EC) No 1223/2009 of the European Parliament and of the Council of 30 November 2009 on cosmetic products (1), and in particular Article 31(2) thereof, Whereas: (1) The substances identified by the denominations alkyl (C12-22) trimethyl ammonium bromide and chloride are regu lated as preservatives under entry 44 of Annex V to Regulation (EC) No 1223/2009 with a maximum concentra tion of 0,1 %. (2) The Scientific Committee on Consumer Products (‘SCCP’), subsequently replaced by the Scientific Committee on Consumer Safety (‘SCCS’) pursuant to Commission Decision 2008/721/EC (2), evaluated the safety of alkyl (C16, C18, C22) trimethylammonium chloride (cetrimonium chloride, steartrimonium chloride and behentrimonium chloride) for other uses than as preservatives in 2005, 2007 and 2009. (3) The SCCS concluded in its opinion of 8 December 2009 (3) that, apart from the fact that quaternary ammonium derivative formulations have the potential to be skin irritants, especially when combinations of the concerned compounds are used, the use of cetrimonium chloride, steartrimonium chloride and behentrimonium chloride does not pose a risk to the health of the consumer in concentrations below certain limits, which are explicitly set out in the SCCS opinion. -
Ehealth DSI [Ehdsi V2.2.2-OR] Ehealth DSI – Master Value Set
MTC eHealth DSI [eHDSI v2.2.2-OR] eHealth DSI – Master Value Set Catalogue Responsible : eHDSI Solution Provider PublishDate : Wed Nov 08 16:16:10 CET 2017 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 1 of 490 MTC Table of Contents epSOSActiveIngredient 4 epSOSAdministrativeGender 148 epSOSAdverseEventType 149 epSOSAllergenNoDrugs 150 epSOSBloodGroup 155 epSOSBloodPressure 156 epSOSCodeNoMedication 157 epSOSCodeProb 158 epSOSConfidentiality 159 epSOSCountry 160 epSOSDisplayLabel 167 epSOSDocumentCode 170 epSOSDoseForm 171 epSOSHealthcareProfessionalRoles 184 epSOSIllnessesandDisorders 186 epSOSLanguage 448 epSOSMedicalDevices 458 epSOSNullFavor 461 epSOSPackage 462 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 2 of 490 MTC epSOSPersonalRelationship 464 epSOSPregnancyInformation 466 epSOSProcedures 467 epSOSReactionAllergy 470 epSOSResolutionOutcome 472 epSOSRoleClass 473 epSOSRouteofAdministration 474 epSOSSections 477 epSOSSeverity 478 epSOSSocialHistory 479 epSOSStatusCode 480 epSOSSubstitutionCode 481 epSOSTelecomAddress 482 epSOSTimingEvent 483 epSOSUnits 484 epSOSUnknownInformation 487 epSOSVaccine 488 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 3 of 490 MTC epSOSActiveIngredient epSOSActiveIngredient Value Set ID 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 TRANSLATIONS Code System ID Code System Version Concept Code Description (FSN) 2.16.840.1.113883.6.73 2017-01 A ALIMENTARY TRACT AND METABOLISM 2.16.840.1.113883.6.73 2017-01 -
List Item Cetrimide: Summary Report
The European Agency for the Evaluation of Medicinal Products Veterinary Medicines Evaluation Unit EMEA/MRL/073/96-FINAL March 1996 COMMITTEE FOR VETERINARY MEDICINAL PRODUCTS CETRIMIDE SUMMARY REPORT 1. Cetrimide (CAS 8044-71-1) is a quaternary ammonium antiseptic and surfactant. It consists mostly of trimethyltetradecylammonium bromide (CAS 1119-97-7; also known as tetradonium bromide) with smaller amounts of dodecyltrimethylammonium bromide (CAS 1119-94-4; also known as DTAB) and hexadecyltrimethylammonium bromide (CAS 57-09-0). The European Pharmacopoeia requires that cetrimide should contain at least 96% but no more than 101.0% alkyltrimethylammonium bromides. 2. Historically, the name cetrimide was used for a material consisting of predominantly hexadecyltrimethylammonium bromide, (CAS 57-09-0; also known as cetrimonium bromide, CTAB, and cetyltrimethylammonium bromide), together with smaller amounts of analogous alkyltrimethylammonium bromides. Some of the safety studies were carried out using this "cetrimide" rather than the cetrimide currently specified in the Europeam Pharmacopoeia. 3. In veterinary medicine, cetrimide is used as a topical antiseptic at concentrations of up to 2%. It is also used as an excipient in an injectable antibiotic formulation intended for use in cattle, sheep and pigs. When used as excipient, the concentration of cetrimide in the formulation is around 0.25 mg/ml, resulting in a dose of approximately 0.01 mg/kg bw of cetrimide in the target species. 4. In aqueous solution, cetrimide dissociates to a biologically-active cation and an inactive anion. Cetrimide is inactive towards bacterial spores, it is effective against some viruses and has variable anti-fungal activity. The cation is also responsible for the surfactant activity.