Mar. Biol. Ass. India, 1965, 8 (1): 28-56 EFFECTS OF
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Analgesia and Sedation in Hospitalized Children
Analgesia and Sedation in Hospitalized Children By Elizabeth J. Beckman, Pharm.D., BCPS, BCCCP, BCPPS Reviewed by Julie Pingel, Pharm.D., BCPPS; and Brent A. Hall, Pharm.D., BCPPS LEARNING OBJECTIVES 1. Evaluate analgesics and sedative agents on the basis of drug mechanism of action, pharmacokinetic principles, adverse drug reactions, and administration considerations. 2. Design an evidence-based analgesic and/or sedative treatment and monitoring plan for the hospitalized child who is postoperative, acutely ill, or in need of prolonged sedation. 3. Design an analgesic and sedation treatment and monitoring plan to minimize hyperalgesia and delirium and optimize neurodevelopmental outcomes in children. INTRODUCTION ABBREVIATIONS IN THIS CHAPTER Pain, anxiety, fear, distress, and agitation are often experienced by GABA γ-Aminobutyric acid children undergoing medical treatment. Contributory factors may ICP Intracranial pressure include separation from parents, unfamiliar surroundings, sleep dis- PAD Pain, agitation, and delirium turbance, and invasive procedures. Children receive analgesia and PCA Patient-controlled analgesia sedatives to promote comfort, create a safe environment for patient PICU Pediatric ICU and caregiver, and increase patient tolerance to medical interven- PRIS Propofol-related infusion tions such as intravenous access placement or synchrony with syndrome mechanical ventilation. However, using these agents is not without Table of other common abbreviations. risk. Many of the agents used for analgesia and sedation are con- sidered high alert by the Institute for Safe Medication Practices because of their potential to cause significant patient harm, given their adverse effects and the development of tolerance, dependence, and withdrawal symptoms. Added layers of complexity include the ontogeny of the pediatric patient, ongoing disease processes, and presence of organ failure, which may alter the pharmacokinetics and pharmacodynamics of these medications. -
(12) Patent Application Publication (10) Pub. No.: US 2006/0110428A1 De Juan Et Al
US 200601 10428A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2006/0110428A1 de Juan et al. (43) Pub. Date: May 25, 2006 (54) METHODS AND DEVICES FOR THE Publication Classification TREATMENT OF OCULAR CONDITIONS (51) Int. Cl. (76) Inventors: Eugene de Juan, LaCanada, CA (US); A6F 2/00 (2006.01) Signe E. Varner, Los Angeles, CA (52) U.S. Cl. .............................................................. 424/427 (US); Laurie R. Lawin, New Brighton, MN (US) (57) ABSTRACT Correspondence Address: Featured is a method for instilling one or more bioactive SCOTT PRIBNOW agents into ocular tissue within an eye of a patient for the Kagan Binder, PLLC treatment of an ocular condition, the method comprising Suite 200 concurrently using at least two of the following bioactive 221 Main Street North agent delivery methods (A)-(C): Stillwater, MN 55082 (US) (A) implanting a Sustained release delivery device com (21) Appl. No.: 11/175,850 prising one or more bioactive agents in a posterior region of the eye so that it delivers the one or more (22) Filed: Jul. 5, 2005 bioactive agents into the vitreous humor of the eye; (B) instilling (e.g., injecting or implanting) one or more Related U.S. Application Data bioactive agents Subretinally; and (60) Provisional application No. 60/585,236, filed on Jul. (C) instilling (e.g., injecting or delivering by ocular ion 2, 2004. Provisional application No. 60/669,701, filed tophoresis) one or more bioactive agents into the Vit on Apr. 8, 2005. reous humor of the eye. Patent Application Publication May 25, 2006 Sheet 1 of 22 US 2006/0110428A1 R 2 2 C.6 Fig. -
Synthesis, Physicochemical Characterization and Study of the Antimicrobial Activity of Chlorobutanol H
World Academy of Science, Engineering and Technology International Journal of Pharmacological and Pharmaceutical Sciences Vol:12, No:3, 2018 Synthesis, Physicochemical Characterization and Study of the Antimicrobial Activity of Chlorobutanol H. Nadia, G. Bahdja, S. Thili Malha, Y. Zahoua, D. Taoufik, B. Mourad, M. Marzouk, F. Z. Hadjadj Aoul, L. R. Mekacher I. INTRODUCTION Abstract—Introduction and objectives: Chlorobutanol is a raw XCIPIENTS play a vital role in the design, manufacture material, mainly used as an antiseptic and antimicrobial preservative and preservation of drugs. The addition of an in injectable and ophthalmic preparations. The main objective of our E study was the synthesis and evaluation of the antimicrobial activity of antimicrobial agents is of great interest in the case where the chlorobutanol hemihydrates. Material and methods: Chlorobutanol pharmaceutical preparations do not have adequate was synthesized according to the nucleophilic addition reaction of antimicrobial properties, (especially aqueous preparations), to chloroform to acetone, identified by an infrared absorption using prevent proliferation or limit microbial contamination [1], [2]. Spectrum One FTIR spectrometer, melting point, Scanning electron Chlorobutanol is a trihalogen alcohol with bacteriostatic and microscopy and colorimetric reactions. The dosage of Carvedilol fungistatic activity. The main objective of our work was to active substance was carried out by assaying the degradation products of chlorobutanol in a basic solution. The chlorobutanol obtained was obtain chlorobutanol hemihydrate by chemical synthesis, its subjected to bacteriological tests in order to study its antimicrobial purification and characterization as well as the study of its activity. The antibacterial activity was evaluated against strains such antimicrobial activity. as Escherichia coli (ATCC 25 922), Staphylococcus aureus (ATCC 25 923) and Pseudomonas aeroginosa (ATCC = American type II. -
)&F1y3x PHARMACEUTICAL APPENDIX to THE
)&f1y3X PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE )&f1y3X PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 3 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. Product CAS No. Product CAS No. ABAMECTIN 65195-55-3 ACTODIGIN 36983-69-4 ABANOQUIL 90402-40-7 ADAFENOXATE 82168-26-1 ABCIXIMAB 143653-53-6 ADAMEXINE 54785-02-3 ABECARNIL 111841-85-1 ADAPALENE 106685-40-9 ABITESARTAN 137882-98-5 ADAPROLOL 101479-70-3 ABLUKAST 96566-25-5 ADATANSERIN 127266-56-2 ABUNIDAZOLE 91017-58-2 ADEFOVIR 106941-25-7 ACADESINE 2627-69-2 ADELMIDROL 1675-66-7 ACAMPROSATE 77337-76-9 ADEMETIONINE 17176-17-9 ACAPRAZINE 55485-20-6 ADENOSINE PHOSPHATE 61-19-8 ACARBOSE 56180-94-0 ADIBENDAN 100510-33-6 ACEBROCHOL 514-50-1 ADICILLIN 525-94-0 ACEBURIC ACID 26976-72-7 ADIMOLOL 78459-19-5 ACEBUTOLOL 37517-30-9 ADINAZOLAM 37115-32-5 ACECAINIDE 32795-44-1 ADIPHENINE 64-95-9 ACECARBROMAL 77-66-7 ADIPIODONE 606-17-7 ACECLIDINE 827-61-2 ADITEREN 56066-19-4 ACECLOFENAC 89796-99-6 ADITOPRIM 56066-63-8 ACEDAPSONE 77-46-3 ADOSOPINE 88124-26-9 ACEDIASULFONE SODIUM 127-60-6 ADOZELESIN 110314-48-2 ACEDOBEN 556-08-1 ADRAFINIL 63547-13-7 ACEFLURANOL 80595-73-9 ADRENALONE -
Toxicological Review of Chloral Hydrate (CAS No. 302-17-0) (PDF)
EPA/635/R-00/006 TOXICOLOGICAL REVIEW OF CHLORAL HYDRATE (CAS No. 302-17-0) In Support of Summary Information on the Integrated Risk Information System (IRIS) August 2000 U.S. Environmental Protection Agency Washington, DC DISCLAIMER This document has been reviewed in accordance with U.S. Environmental Protection Agency policy and approved for publication. Mention of trade names or commercial products does not constitute endorsement or recommendation for use. Note: This document may undergo revisions in the future. The most up-to-date version will be made available electronically via the IRIS Home Page at http://www.epa.gov/iris. ii CONTENTS—TOXICOLOGICAL REVIEW for CHLORAL HYDRATE (CAS No. 302-17-0) FOREWORD .................................................................v AUTHORS, CONTRIBUTORS, AND REVIEWERS ................................ vi 1. INTRODUCTION ..........................................................1 2. CHEMICAL AND PHYSICAL INFORMATION RELEVANT TO ASSESSMENTS ..... 2 3. TOXICOKINETICS RELEVANT TO ASSESSMENTS ............................3 4. HAZARD IDENTIFICATION ................................................6 4.1. STUDIES IN HUMANS - EPIDEMIOLOGY AND CASE REPORTS .................................................6 4.2. PRECHRONIC AND CHRONIC STUDIES AND CANCER BIOASSAYS IN ANIMALS ................................8 4.2.1. Oral ..........................................................8 4.2.2. Inhalation .....................................................12 4.3. REPRODUCTIVE/DEVELOPMENTAL STUDIES ..........................13 -
Chloral Hydrate and Paraldehyde As Drugs of Addiction
Sept., 1932J CHLORAL HYDRATE DRUG HABIT : CHOPRA & SINGH CHOPRA 481 certain parts of the Punjab. This is not the outcome of the use of the drug in the treatment Original Articles of insomnia, but is due to entirely different causes. Until a few years ago in that province potable country-made spirits were allowed to CHLORAL HYDRATE AND PARALDE' be sold to retail dealers in bulk and the vendors HYDE AS DRUGS OF ADDICTION bottled the liquor themselves. Some of these ingenious people conceived the idea of diluting R. N. m.d. By CHOPRA, m.a., (Cantab.) the spirit and adding small quantities of chloral I.M.S. LIEUTENANT-COLONEL, hydrate to make up for the loss in its potency and which would result from dilution. The know- GURBAKHSH SINGH CHOPRA, m.b., b.s. ledge that the drug had hypnotic and narcotic was obtained from the (Drug Addiction Inquiry, Indian Research Fund effects undoubtedly Association) medical profession and compounders work- in It was further learnt that Series No. 15 ing dispensaries. the effects chloral hydrate in many Chloral produced by hydrate and paraldehyde belong to resemble those by alcohol, the of ways produced group drugs known as soporifics or especially when the latter is taken in large The chief use of hypnotics. this class of drugs quantities. When the two articles are taken is in the treatment of one insomnia, of the together they act in a manner synergistic to worst evils of modern times from which man- each other and in this way the effect of either kind can suffer. -
(12) United States Patent (10) Patent No.: US 6,264,917 B1 Klaveness Et Al
USOO6264,917B1 (12) United States Patent (10) Patent No.: US 6,264,917 B1 Klaveness et al. (45) Date of Patent: Jul. 24, 2001 (54) TARGETED ULTRASOUND CONTRAST 5,733,572 3/1998 Unger et al.. AGENTS 5,780,010 7/1998 Lanza et al. 5,846,517 12/1998 Unger .................................. 424/9.52 (75) Inventors: Jo Klaveness; Pál Rongved; Dagfinn 5,849,727 12/1998 Porter et al. ......................... 514/156 Lovhaug, all of Oslo (NO) 5,910,300 6/1999 Tournier et al. .................... 424/9.34 FOREIGN PATENT DOCUMENTS (73) Assignee: Nycomed Imaging AS, Oslo (NO) 2 145 SOS 4/1994 (CA). (*) Notice: Subject to any disclaimer, the term of this 19 626 530 1/1998 (DE). patent is extended or adjusted under 35 O 727 225 8/1996 (EP). U.S.C. 154(b) by 0 days. WO91/15244 10/1991 (WO). WO 93/20802 10/1993 (WO). WO 94/07539 4/1994 (WO). (21) Appl. No.: 08/958,993 WO 94/28873 12/1994 (WO). WO 94/28874 12/1994 (WO). (22) Filed: Oct. 28, 1997 WO95/03356 2/1995 (WO). WO95/03357 2/1995 (WO). Related U.S. Application Data WO95/07072 3/1995 (WO). (60) Provisional application No. 60/049.264, filed on Jun. 7, WO95/15118 6/1995 (WO). 1997, provisional application No. 60/049,265, filed on Jun. WO 96/39149 12/1996 (WO). 7, 1997, and provisional application No. 60/049.268, filed WO 96/40277 12/1996 (WO). on Jun. 7, 1997. WO 96/40285 12/1996 (WO). (30) Foreign Application Priority Data WO 96/41647 12/1996 (WO). -
Halogenated Ether, Alcohol, and Alkane Anesthetics Activate TASK-3 Tandem Pore Potassium Channels Likely Through a Common Mechanism S
Supplemental material to this article can be found at: http://molpharm.aspetjournals.org/content/suppl/2017/03/21/mol.117.108290.DC1 1521-0111/91/6/620–629$25.00 https://doi.org/10.1124/mol.117.108290 MOLECULAR PHARMACOLOGY Mol Pharmacol 91:620–629, June 2017 Copyright ª 2017 by The American Society for Pharmacology and Experimental Therapeutics Halogenated Ether, Alcohol, and Alkane Anesthetics Activate TASK-3 Tandem Pore Potassium Channels Likely through a Common Mechanism s Anita Luethy, James D. Boghosian, Rithu Srikantha, and Joseph F. Cotten Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts (A.L., J.D.B., and J.F.C.); Department of Anesthesia, Kantonsspital Aarau, Aarau, Switzerland (A.L.); Carver College of Medicine, University of Iowa, Iowa City, Iowa (R.S.) Received January 7, 2017; accepted March 20, 2017 Downloaded from ABSTRACT The TWIK-related acid-sensitive potassium channel 3 (TASK-3; hydrate (165% [161–176]) . 2,2-dichloro- . 2-chloro 2,2,2- KCNK9) tandem pore potassium channel function is activated by trifluoroethanol . ethanol. Similarly, carbon tetrabromide (296% halogenated anesthetics through binding at a putative anesthetic- [245–346]), carbon tetrachloride (180% [163–196]), and 1,1,1,3,3,3- binding cavity. To understand the pharmacologic requirements for hexafluoropropanol (200% [194–206]) activate TASK-3, whereas molpharm.aspetjournals.org TASK-3 activation, we studied the concentration–response of the larger carbon tetraiodide and a-chloralose inhibit. Clinical TASK-3 to several anesthetics (isoflurane, desflurane, sevoflurane, agents activate TASK-3 with the following rank order efficacy: halothane, a-chloralose, 2,2,2-trichloroethanol [TCE], and chloral halothane (207% [202–212]) . -
CAS No.) Screening Justification Is Public Comment Now Open? CAS No
EGLE Air Quality Division (AQD) Air Toxics Screening Level Justifications (Numerically by CAS No.) Screening Justification Is Public Comment Now Open? CAS No. Chemical Name Level & Responses Info E-Mail AQD Deadline None ad acid View View Not Open for Public Comment None amyl acetate (mixture) View View Not Open for Public Comment None atlox 848 View View Not Open for Public Comment None biosam tp-1.5 View View Not Open for Public Comment None calcium chloride View View Not Open for Public Comment None epoxy resin solution View View Not Open for Public Comment None heptamethyl-1-vinyl-1,7-dichlorotetrasilazane View View Not Open for Public Comment None n-butylglucamine View View Not Open for Public Comment None n-chloro-2,6-difluorobenzamide View View Not Open for Public Comment None trichloroethylene View View Not Open for Public Comment None triethylammonium suleptanate View View Not Open for Public Comment 50-00-0 formaldehyde View View Not Open for Public Comment 50-03-3 hydrocortisone acetate View View Not Open for Public Comment 50-21-5 lactic acid View View Not Open for Public Comment 50-28-2 estradiol View View Not Open for Public Comment 50-29-3 ddt View View Not Open for Public Comment 50-32-8 benzo(a)pyrene View View Not Open for Public Comment 51-28-5 2,4-dinitrophenol View View Not Open for Public Comment 53-36-1 methyl predisolone acetate View View Not Open for Public Comment 53-70-3 dibenz(a,h)anthracene View View Not Open for Public Comment 56-23-5 carbon tetrachloride View View Not Open for Public Comment 56-49-5 3-methylcholanthrene View View Not Open for Public Comment 56-55-3 benz(a)anthracene View View Not Open for Public Comment 56-81-5 glycerol View View Not Open for Public Comment 57-11-4 stearic acid View View Not Open for Public Comment Revised Monday, September 27, 2021 Page 1 of 51 EGLE Air Quality Division (AQD) Air Toxics Screening Level Justifications (Numerically by CAS No.) Screening Justification Is Public Comment Now Open? CAS No. -
Oral Chloral Hydrate Compare with Rectal Thiopental in Pediatric Procedural Sedation and Analgesia; a Randomized Clinical Trial
85 Emergency (2014); 2 (2): 85‐89 ORIGINAL RESEARCH Oral Chloral Hydrate Compare with Rectal Thiopental in Pediatric Procedural Sedation and Analgesia; a Randomized Clinical Trial Reza Azizkhani1, Soheila Kanani1*, Ali Sharifi2, Keihan Golshani1, Babak Masoumi1, Omid Ahmadi1 1. Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 2. Department of General Surgery, Isfahan University of Medical Sciences, Isfahan, Iran Abstract Introduction: The increasing use of diagnostic imaging in pediatric medicine has resulted in growing need for procedural sedation and analgesia (PSA) to minimize motion artifacts during procedures. The drug of choice in pediatric PSA was not introduced till now. The aim of the present study was comparison of oral chloral hydrate (OCH) and rectal sodium thiopental (RST) in pediatric PSA. Methods: In the present randomized clinical trial, 2‐6 years old pediatrics who referred for performing brain computed tomography scan was enrolled and were randomly divided in to two groups. OCH (50mg/kg) and RST (25mg/kg) were prescribed and a trained nurse recorded the time from drug prescription to receiving the con‐ scious sedation (onset of action), the total time period which the patient has the Ramsay score≥4 (duration of action), and adverse effect of agents. Mann‐Whitney U test and chi‐squared test, and Non‐parametric analysis of covariance (ANCOVA) were used for comparisons. Results: One hundred and forty children were entered to two groups of OCH and RST, randomly. The patients of two groups had similar age, sex, weight, and baseline vital signs except for diastolic blood pressure (p<0.001). The onset of action in OCH and RST groups were 24.5±6.1and 28.7±5.2 minutes, respectively (p<0.001). -
Guide to Extractables in Effluents from Ultipor® N66 and Posidyne® Filter
Validation Guide USTR 2521 Guide to Extractables in Effluents from Pall Ultipor ® N66 and Posidyne ® Filter Cartridges Contents 1. Introduction ........................................................................................................................3 2. Design and Manufacture of Pall N66 Pharmaceutical-rated (P-rated) Filters ................3 3. Principles of Extraction and the Non-Volatile Residue Test ............................................3 3.1 Factors Limiting Extraction ............................................................................................3 3.2 Defining Solvent Strength ..............................................................................................4 3.3 Materials of Construction of Ultipor N66 and Posidyne Filter Cartridges ........................5 3.4 Extractable Substances in Polymers Used in Pall Ultipor N66 and Posidyne Filter Cartridges ....................................................................................................5 4. Total Non-volatile Residues Extracted from Ultipor N66 and Posidyne Filters ..............6 4.1 Introduction ....................................................................................................................6 4.2 Summary of Method ......................................................................................................6 4.3 Results ..........................................................................................................................6 4.4 Conclusions ..................................................................................................................6 -
Chloral Hydrate Safety Issues
December 2016 www.nursingcenter.com Chloral Hydrate Safety Issues Chloral hydrate is a sedative-hypnotic that has been associated with serious adverse events in the pediatric population including dosing errors, over-sedation, and administration of the oral liquid by the intravenous (IV) route. In 2012, commercially available chloral hydrate products were discontinued and taken off the market. However, some ambulatory and hospital pharmacies are compounding an oral suspension of chloral hydrate for pediatric sedation in both inpatient and outpatient settings. Section 503A of the Federal Food, Drug and Cosmetic Act permits pharmacists to compound chloral hydrate to provide patient specific prescriptions in limited quantities. Compounded drugs are not approved by the US Food and Drug Administration (FDA), which means the FDA does not verify the safety or effectiveness of compounded drugs. One study found that compared to the commercial formulation, the compounded drug provided a shorter duration of sedation, more frequent need for an additional sedation agent, and frequent sedation failure. Over the last two years, there have been three reported cases of pediatric chloral hydrate overdoses and one death that occurred in the outpatient setting. Respiratory depression and arrest are two serious adverse events that can occur following chloral hydrate administration. Other risks associated with chloral hydrate use include: Resedation after discharge. Chloral hydrate can result in prolonged sedation or resedation with effects lasting longer than 24 hours in children of all ages, even if they appear to have cleared the sedation prior to discharge. Chloral hydrate is converted to trichloroethanol, which has a half-life of up to 66 hours in neonates, 28-40 hours in infants, 8-12 hours in children, and longer following an overdose.