Generic Sample Preparation Combined with High-Resolution Liquid Chromatography–Time-Of-Flight Mass Spectrometry for Unificatio

Total Page:16

File Type:pdf, Size:1020Kb

Generic Sample Preparation Combined with High-Resolution Liquid Chromatography–Time-Of-Flight Mass Spectrometry for Unificatio View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Wageningen University & Research Publications Anal Bioanal Chem (2010) 396:2583–2598 DOI 10.1007/s00216-010-3484-3 ORIGINAL PAPER Generic sample preparation combined with high-resolution liquid chromatography–time-of-flight mass spectrometry for unification of urine screening in doping-control laboratories R. J. B. Peters & J. E. Oosterink & A. A. M. Stolker & C. Georgakopoulos & M. W. F. Nielen Received: 18 August 2009 /Revised: 21 December 2009 /Accepted: 17 January 2010 /Published online: 16 February 2010 # The Author(s) 2010. This article is published with open access at Springerlink.com Abstract A unification of doping-control screening proce- using positive electrospray ionisation with the exception of the dures of prohibited small molecule substances—including thiazide diuretics for which the best sensitivity was obtained by stimulants, narcotics, steroids, β2-agonists and diuretics— using negative electrospray ionisation. The results show that, is highly urgent in order to free resources for new classes with the exception of clenhexyl, procaterol, and reproterol, all such as banned proteins. Conceptually this may be achieved compounds can be detected below the respective minimum by the use of a combination of one gas chromatography– required performance level and the results for linearity, time-of-flight mass spectrometry method and one liquid repeatability, within-lab reproducibility, and accuracy show chromatography–time-of-flight mass spectrometry method. that the method can be used for quantitative screening. If In this work a quantitative screening method using high- qualitative screening is sufficient the instrumental analysis may resolution liquid chromatography in combination with be limited to positive ionisation, because all analytes including accurate-mass time-of-flight mass spectrometry was devel- the thiazides can be detected at the respective minimum oped and validated for determination of glucocorticosteroids, required levels in the positive mode. The results show that the β2-agonists, thiazide diuretics, and narcotics and stimulants in application of accurate-mass time-of-flight mass spectrometry urine. To enable the simultaneous isolation of all the in combination with generic extraction and purification compounds of interest and the necessary purification of the procedures is suitable for unification and expansion of the resulting extracts, a generic extraction and hydrolysis proce- window of screening methods of doping laboratories. More- dure was combined with a solid-phase extraction modified for over, the full-scan accurate-mass data sets obtained still allow these groups of compounds. All 56 compounds are determined retrospective examination for emerging doping agents, without re-analyzing the samples. R. J. B. Peters (*) : J. E. Oosterink : A. A. M. Stolker : Keywords Doping control Validation M. W. F. Nielen High-resolution liquid chromatography . RIKILT- Institute of Food Safety, Wageningen UR, Accurate-mass time-of-flight mass spectrometry. Akkermaalsbos 2, P.O. Box 230, 6700 AE Wageningen, Quantitative screening . Retrospective data analysis The Netherlands e-mail: [email protected] C. Georgakopoulos Introduction Doping Control Laboratory of Athens, Olympic Athletic Center of Athens, Kifissias 37, The task of doping control laboratories is to screen for a wide 15123 Maroussi, Athens, Greece range of drugs currently included in the list of prohibited substances published by the World Anti-Doping Agency M. W. F. Nielen (WADA) [1]. Today, the cost-effectiveness of analytical Laboratory of Organic Chemistry, Wageningen University, Dreijenplein 8, procedures is becoming an important issue for all laborato- 6703 HB Wageningen, The Netherlands ries involved in doping control or residue analysis. A way to 2584 R.J.B. Peters et al. improve cost-effectiveness is to maximize the number of analysis of these compounds [17, 18]. Most corticosteroids analytes that may be determined in a single procedure, e.g. to are non-volatile, therefore excluding GC–MS analysis of use multi-compound techniques. However, most methods are urine samples unless lengthy derivatization or oxidation developed for the determination of specific prohibited com- procedures are used prior to GC–MS analysis. Generally, pounds or compound groups. Because resources are needed to LC–MS–MS with different ionization techniques has been determine new classes of doping compounds such as banned used [19–21]. In addition LC–TOFMS has been used for proteins, unification of doping control screening procedures toxicological drug screening of related compounds [22]and for prohibited small molecule substances—including stimu- specifically for doping agents in human urine [23]. The lants, narcotics, steroids, β2-agonists, and diuretics—is highly minimum required performance limit (MRPL) established urgent. Conceptually this may be achieved by the use of a for these compounds, at which all laboratories should be able combination of one gas chromatography–time-of-flight mass to perform [24], is 30 ng mL−1 in urine. The structures and spectrometry (GC–TOFMS) method and one liquid chroma- names of the 19 corticosteroids involved in this study are given tography time-of-flight mass spectrometry (LC–TOFMS) in Fig. 1. method. The aim of this study is to develop and validate a β2-Agonists act on the β2 adrenergic receptor, causing multi-compound LC–TOFMS method for compounds that are muscle relaxation resulting in a widening of the bronchial less suitable for GC–MS methods. Traditionally, capillary gas passages and blood vessels in the muscles, thereby chromatography combined with mass spectrometry (GC–MS) improving the performance of the athletes [25]. β2- has been used in doping analysis including laborious sample Agonists can be divided into short-acting and long-acting preparation for analytes or metabolites with a polar, non- groups with salbutamol and terbutaline as examples of the volatile, or thermolabile nature [2]. As an alternative, liquid first group and salmeterol and clenbuterol as examples of chromatography combined with mass spectrometry (LC–MS) the latter group. β2-Agonists, for example salbutamol, have may be used for those targeted molecules in urine that cannot become a concern in sports, because these drugs, when be covered by standard GC–MS methods. While LC used at high doses, can act as anabolic agents to promote combined with tandem mass spectrometry (LC–MS–MS) weight, mainly in the form of muscle [26]. As of 2006, has excellent sensitivity and selectivity for target analytes in WADA permits the use of selected β2-agonists (salbutamol, doping analysis [3–6], true multi-compound analyses salmeterol, terbutaline, and eformoterol) in athletic competi- requires a sensitive full-scan MS technique, for example tion only by asthmatic athletics. For salbutamol the threshold time-of-flight mass spectrometry (TOFMS) or Orbitrap mass value is 1000 ng mL−1 while for all other β2-agonists the spectrometry [7–9]. These analyzers provide high specificity MRPL is 100 ng mL−1. β2-Agonists in urine have been because of both high mass accuracy and high mass analysed using LC–MS–MS [27]andLC–TOFMS [23], but resolution and allow the reconstruction of highly selective also LC combined with Orbitrap mass spectrometry [28], in accurate mass chromatograms for a theoretically unlimited all cases after hydrolysis and liquid–liquid extraction of the number of compounds in complex matrices. Furthermore, sample. The structures and names of the 22 β2-agonists data can be acquired and reprocessed without any a priori involved in this validation study are given in Fig. 2. knowledge about the presence of specific compounds; that Diuretics increase the urine flow, thereby reducing body is, no analyte-specific information is required before injecting mass and potentially leading to the athlete’s classification in a sample and the presence of newly identified compounds can a lower weight class in some sports. Thiazide diuretics are be confirmed in previously analysed samples simply by also regarded as masking agents, because the increased reprocessing the data. The advantage of TOFMS can be urine flow and volume dilute possible residues of sports further improved by combining it with high-resolution LC doping and for these reasons all diuretics appear on the (HRLC) such as ultra performance LC (UPLC). Recent prohibited list, both in and out of competition with an research has shown that UPLC–TOFMS has significant MRPL of 250 ng mL−1. Diuretics have been determined as advantages concerning selectivity, sensitivity, and speed their methyl derivatives by GC–MS [29, 30] and by liquid [10–14]. This paper describes the development and valida- chromatography combined with tandem mass spectrometry tion of a quantitative screening method based on UPLC– (LC–MS–MS) [31–33]. The latter option does not require TOFMS for analysis of 56 restricted substances that are not derivatization and enables simplified sample preparation very suitable for detection with GC–MS methods, including because of to the compatibility of aqueous samples with the corticosteroids, β2-agonists, and diuretics. Corticosteroids analytical system. Figure 3 gives the structures and names affect the nervous system causing euphoria, alleviate pain, of the thiazide diuretics involved in this study. Narcotics and enhance the athlete’s ability to concentrate in endurance and stimulants can be misused in sports and
Recommended publications
  • 18 December 2020 – to Date)
    (18 December 2020 – to date) MEDICINES AND RELATED SUBSTANCES ACT 101 OF 1965 (Gazette No. 1171, Notice No. 1002 dated 7 July 1965. Commencement date: 1 April 1966 [Proc. No. 94, Gazette No. 1413] SCHEDULES Government Notice 935 in Government Gazette 31387 dated 5 September 2008. Commencement date: 5 September 2008. As amended by: Government Notice R1230 in Government Gazette 32838 dated 31 December 2009. Commencement date: 31 December 2009. Government Notice R227 in Government Gazette 35149 dated 15 March 2012. Commencement date: 15 March 2012. Government Notice R674 in Government Gazette 36827 dated 13 September 2013. Commencement date: 13 September 2013. Government Notice R690 in Government Gazette 36850 dated 20 September 2013. Commencement date: 20 September 2013. Government Notice R104 in Government Gazette 37318 dated 11 February 2014. Commencement date: 11 February 2014. Government Notice R352 in Government Gazette 37622 dated 8 May 2014. Commencement date: 8 May 2014. Government Notice R234 in Government Gazette 38586 dated 20 March 2015. Commencement date: 20 March 2015. Government Notice 254 in Government Gazette 39815 dated 15 March 2016. Commencement date: 15 March 2016. Government Notice 620 in Government Gazette 40041 dated 3 June 2016. Commencement date: 3 June 2016. Prepared by: Page 2 of 199 Government Notice 748 in Government Gazette 41009 dated 28 July 2017. Commencement date: 28 July 2017. Government Notice 1261 in Government Gazette 41256 dated 17 November 2017. Commencement date: 17 November 2017. Government Notice R1098 in Government Gazette 41971 dated 12 October 2018. Commencement date: 12 October 2018. Government Notice R1262 in Government Gazette 42052 dated 23 November 2018.
    [Show full text]
  • 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
    [Show full text]
  • Hexoprenaline: Β-Adrenoreceptor Selectivity in Isolated Tissues from the Guinea-Pig
    Clinical and Experimental Pharmacology and Physiology (1975) 2, 541-547. Hexoprenaline: p-adrenoreceptor selectivity in isolated tissues from the guinea-pig Stella R. O’Donnell and Janet C. Wanstall Department of Physiology, University of Queenstand, Brisbane, Australia (Received 12 March 1975; revision received 22 April 1975) SUMMARY 1. A catecholamine P-adrenoreceptor agonist, hexoprenaline, was examined in vitro on five guinea-pig tissues and its potency relative to isoprenaline (as 100) obtained. 2. Hexoprenaline clearly delineated between those tissues classified as containing P,-adrenoreceptors (trachea, hind limb blood vessels and uterus; relative potencies 219, 110 and 76 respectively) and those classified as containing P,-adrenoreceptors (atria and ileum; relative potencies 3.3 and 1.0 respectively). 3. Hexoprenaline differed from some previously studied noncatecholamine P-adrenoreceptor agonists in being only two-fold less potent, relative to isoprena- line, as a vasodilator in perfused hind limb than as a tracheal relaxant. Key words : j3-adrenoreceptors, blood vessels, bronchodilators, guinea-pig, hexo- prenaline, selectivity, trachea. INTRODUCTION In a previous study using in vitro preparations from the guinea-pig, O’Donnell & Wanstall (1974a) examined potential sympathomimetic bronchodilator compounds for their potency as tracheal relaxants (p,-adrenoreceptors), atrial stimulants (P,-adrenoreceptors) and vasodilators in the perfused hind limb (p2-adrenoreceptors). Some resorcinolamines showed selectivity for trachea compared with not only atria but also blood vessels. There is some evidence in dogs in vivo that other noncatecholamines, namely carbuterol (Wardell et al., 1974), and salbutamol and terbutaline (Wasserman & Levy, 1974), display similar select- ivity. If selectivity between respiratory and vascular smooth muscle represents selectivity at the p-adrenoreceptor level, it poses the question whether the P1/p2subclassification (Lands et al., 1967a; Lands, Luduena & Buzzo, 1967b) is too rigid.
    [Show full text]
  • Quick Screening of Priority Beta-Agonists in Urine Using Automated Turboflow™ - LC/Exactive Mass Spectrometry Thorsten Bernsmann, Peter Fuerst, Michal Godula
    Quick screening of priority beta-agonists in urine using automated TurboFlow™ - LC/Exactive mass spectrometry Thorsten Bernsmann, Peter Fuerst, Michal Godula To cite this version: Thorsten Bernsmann, Peter Fuerst, Michal Godula. Quick screening of priority beta-agonists in urine using automated TurboFlow™ - LC/Exactive mass spectrometry. Food Additives and Contaminants, 2011, 28 (10), pp.1352-1363. 10.1080/19440049.2011.619504. hal-00743048 HAL Id: hal-00743048 https://hal.archives-ouvertes.fr/hal-00743048 Submitted on 18 Oct 2012 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Food Additives and Contaminants This paper describes a method for the determination of priority β -agonists in urine based on a fully automated sample preparation procedure using the online TurboFlow™ chromatography clean -up step and determination on the Orbitrap™ mass analyzer technology. The principle of the method after enzymatic hydrolysis over night on a small column packed with a special stationary phase (TurboFlow™) while flushing away sample matrix and interfering compounds. Thereafter the analytes are transferred onto an analytical column and detected by id chromatography/high resolution mass spectrometry in full scan mode at a resolution of R=50,000 FWHM (full width at half maximum) and in HCD (Higher Energy Collisional Dissociation) scan mode at a resolving power of 10,000 FWHM.
    [Show full text]
  • Leaflet Bremax.Cdr
    Leaflet Bremax Syrup & Tabs. Size: 220 x 140mm Date: 10-07-2015, 27-06-2015 Ammara Commerial Printers (Pvt.) Ltd. Subacute Toxicity The maximum safe dose of tulobuterol was estimated to be 50 mg/kg in the rat. Chronic Toxicity In rats, the maximum safe dose of tulobuterol, orally, was 18 mg/kg/day for six months and 9 mg/kg/day for twelve months. In dogs, the non-toxic dose level was 50 mg/kg/day. CARCINOGENESIS, MUTAGENESIS AND IMPAIRMENT OF FERTILITY Carcinogenicity Potential tumorigenic effects of tulobuterol were evaluated in mice and rats by prolonged dietary administration in doses of 1, 3 and 9 mg/kg/day for two years. The Syrup highest dose used in these studies was greater than 100 times the recommended human dose (0.08 mg/kg/day). DESCRIPTION Mice Tulobuterol is a synthetic beta 2-agonist with potent and prolonged bronchodilator No abnormal clinical signs were detected and longevity was not affected. Food activity of the sympathomimetic amine class related structurally and consumption was not altered, but treated males gained less weight. Minor changes pharmacologically to epinephrine, isoproterenol, salbutamol (albuterol), in differential leukocytes were reported. metaproterenol, terbutaline, clorprenaline, carbuterol and procaterol. The incidence of uterine smooth muscle tumors (leiomyoma, leiomyosarcoma) in / Tulobuterol is an odorless and bitter tasting white crystalline powder. It is soluble in mice receiving the highest dose of tulobuterol (9 mg/kg/day) was not statistically methanol, water, acetic acid, ethanol, chloroform, and 1,2-dichloroethane, only significant. The tendency for these treated females to develop lymphoreticular slightly soluble in acetone, isopropanol and dioxane and practically insoluble in tumors was not greater than the background incidence in this strain of mice benzene, ether, cyclohexane and isopropylether.
    [Show full text]
  • BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available
    BMJ Open: first published as 10.1136/bmjopen-2018-027935 on 5 May 2019. Downloaded from BMJ Open is committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions. They should not be cited or distributed as the published version of this manuscript. BMJ Open is an open access journal and the full, final, typeset and author-corrected version of record of the manuscript is available on our site with no access controls, subscription charges or pay-per-view fees (http://bmjopen.bmj.com). If you have any questions on BMJ Open’s open peer review process please email [email protected] http://bmjopen.bmj.com/ on September 26, 2021 by guest. Protected copyright. BMJ Open BMJ Open: first published as 10.1136/bmjopen-2018-027935 on 5 May 2019. Downloaded from Treatment of stable chronic obstructive pulmonary disease: a protocol for a systematic review and evidence map Journal: BMJ Open ManuscriptFor ID peerbmjopen-2018-027935 review only Article Type: Protocol Date Submitted by the 15-Nov-2018 Author: Complete List of Authors: Dobler, Claudia; Mayo Clinic, Evidence-Based Practice Center, Robert D.
    [Show full text]
  • Anatomical Classification Guidelines V2021 EPHMRA ANATOMICAL CLASSIFICATION GUIDELINES 2021
    EPHMRA ANATOMICAL CLASSIFICATION GUIDELINES 2021 Anatomical Classification Guidelines V2021 "The Anatomical Classification of Pharmaceutical Products has been developed and maintained by the European Pharmaceutical Marketing Research Association (EphMRA) and is therefore the intellectual property of this Association. EphMRA's Classification Committee prepares the guidelines for this classification system and takes care for new entries, changes and improvements in consultation with the product's manufacturer. The contents of the Anatomical Classification of Pharmaceutical Products remain the copyright to EphMRA. Permission for use need not be sought and no fee is required. We would appreciate, however, the acknowledgement of EphMRA Copyright in publications etc. Users of this classification system should keep in mind that Pharmaceutical markets can be segmented according to numerous criteria." © EphMRA 2021 Anatomical Classification Guidelines V2021 CONTENTS PAGE INTRODUCTION A ALIMENTARY TRACT AND METABOLISM 1 B BLOOD AND BLOOD FORMING ORGANS 28 C CARDIOVASCULAR SYSTEM 36 D DERMATOLOGICALS 51 G GENITO-URINARY SYSTEM AND SEX HORMONES 58 H SYSTEMIC HORMONAL PREPARATIONS (EXCLUDING SEX HORMONES) 68 J GENERAL ANTI-INFECTIVES SYSTEMIC 72 K HOSPITAL SOLUTIONS 88 L ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS 96 M MUSCULO-SKELETAL SYSTEM 106 N NERVOUS SYSTEM 111 P PARASITOLOGY 122 R RESPIRATORY SYSTEM 124 S SENSORY ORGANS 136 T DIAGNOSTIC AGENTS 143 V VARIOUS 145 Anatomical Classification Guidelines V2021 INTRODUCTION The Anatomical Classification was initiated in 1971 by EphMRA. It has been developed jointly by Intellus/PBIRG and EphMRA. It is a subjective method of grouping certain pharmaceutical products and does not represent any particular market, as would be the case with any other classification system.
    [Show full text]
  • United States Patent (19) 11 Patent Number: 6,110,9749 9 Aberg Et Al
    USOO6110974A United States Patent (19) 11 Patent Number: 6,110,9749 9 Aberg et al. (45) Date of Patent: Aug. 29, 2000 54 METHODS OF ACCELERATING MUSCLE 52 U.S. Cl. .............................................................. 514/653 GROWTH AND IMPROVING FEED 58 Field of Search ............................................... 514/653 EFFICIENCY IN ANIMALS BY USING OPTICALLY PURE EUTOMERS OF 56) References Cited ADRENERGIC BETA-2 RECEPTOR AGONISTS, AND FOOD SUPPLEMENTS U.S. PATENT DOCUMENTS CONTAINING THE SAME 5,552,442 9/1996 Maltin ..................................... 514/620 5,708,036 1/1998 Pesterfield ............................... 514/653 75 Inventors: A. K. Gunnar Aberg, Sarasota, Fla.; Paul J. Fawcett, Dunedin, New Primary Examiner Kimberly Jordan Zealand Attorney, Agent, or Firm Nields, Lemack & Dingman 73 Assignee: Bridge Pharma, Inc., Sarasota, Fla. 57 ABSTRACT Method for improvingp 9. health, Survival and muscle growth9. 21 Appl. No.: 09/069,512 rate of animals, while reducing carcass fat and improving feed efficiency by administering an optically pure eutomer 22 Filed: Apr. 29, 1998 of an adrenergic beta-2 agonist. The invention is also Related U.S. Application Data directedagSh to food composiuOnSiti compriSIngising linethe adrenergicad 60 Provisional application No. 60/045,120, Apr. 30, 1997. (51) Int. Cl. .............................................. A61K 31/135 6 Claims, No Drawings 6,110,974 1 2 METHODS OF ACCELERATING MUSCLE the drugs and decreasing total drug residues in the body of GROWTH AND IMPROVING FEED the animal. The method has proved particularly useful in EFFICIENCY IN ANIMALS BY USING animals that have demonstrated a propensity for health OPTICALLY PURE EUTOMERS OF disorders, in which the health status and the Survival rate is ADRENERGIC BETA-2 RECEPTOR improved by eutomers of beta-2 agonists, and in animals that AGONISTS, AND FOOD SUPPLEMENTS have a muscular growth rate that needs to be improved and CONTAINING THE SAME in cases where improved feed efficiency is Sought.
    [Show full text]
  • EU Transition Strategy for Mdis
    EUROPEAN COMMUNITY STRATEGY FOR THE PHASEOUT OF CFCs IN METERED DOSE INHALERS A Communication from the European Commission to the Council and the European Parliament CONTENTS Chapter 1 Introduction Page 3 Chapter 2 Executive Summary Page 4 Chapter 3 CFCs and MDIs Page 6 Chapter 4 Patient Needs Page 9 Chapter 5 Developing Alternatives to CFC-containing MDIs Page 13 Chapter 6 Approval of new products and post-authorisation surveillance Page 18 Chapter 7 Phasing out CFCs Page 25 Chapter 8 Awareness raising Page 34 Chapter 9 Exports of MDIs from the EC Page 38 Chapter 10 CFC production Issues Page 40 Chapter 11 The Essential Use Process -Overview and Timetable Page 43 CHAPTER 1 INTRODUCTION 1.1 Decision IX/19 of the Parties to the Montreal Protocol requires Parties requesting essential use nominations for chlorofluorocarbons CFCs for metered-dose inhalers (MDIs) to present to the Ozone Secretariat an initial national or regional transition strategy if possible by 31 January 1998, and in any case by 31 January 1999. The European Community is a Party to the Montreal Protocol, and this document is its transition strategy prepared in accordance with decision IX/19 of the Parties. The European Community believes that a transition strategy is necessary to set out how the transition out of CFCs in MDIs is to be managed such that the CFCs can be phased out as quickly as possible without putting in jeopardy supplies of necessary medicines to patients in need. 1.2 The European Community, on behalf of the Member States, submits a joint request every year to the Parties for the continued use of CFCs to manufacture MDIs.
    [Show full text]
  • Stembook 2018.Pdf
    The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances FORMER DOCUMENT NUMBER: WHO/PHARM S/NOM 15 WHO/EMP/RHT/TSN/2018.1 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances. Geneva: World Health Organization; 2018 (WHO/EMP/RHT/TSN/2018.1). Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data.
    [Show full text]
  • Study Protocol and Statistical Analysis Plan
    ABCD TITLE PAGE Protocol for observational studies based on existing data Document Number: c02330001-03 BI Study Number: 1222.54 BI Investigational Olodaterol Product(s): Title: Cohort study of cardiovascular events in patients with chronic obstructive pulmonary disease initiating olodaterol or other long- acting beta2-agonists Protocol version 3.0 identifier: Date of last version of 14 Oct 2014 protocol: PASS: Yes EU PASS register Study not registered number: Active substance: Olodaterol Medicinal product: Striverdi, Respimat Product reference: BI 1744 Procedure number: Not applicable Marketing authorisation holder(s): Joint PASS: No Date: 28 October 2016 Page 1 of 69 Proprietary confidential information © 2016 Boehringer Ingelheim International GmbH or one or more of its affiliated companies. All rights reserved. This document may not - in full or in part - be passed on, reproduced, published or otherwise used without prior written permission Boehringer Ingelheim Page 2 of 69 Protocol for observational studies based on existing data BI Study Number 1222.54 c02330001-03 Proprietary confidential information © 2016 Boehringer Ingelheim International GmbH or one or more of its affiliated companies Additional Information Research question and Examine the risk of selected cardiac arrhythmias in patients objectives: with chronic obstructive pulmonary disease (COPD) exposed to olodaterol compared with the risk in patients exposed to other long-acting beta2-agonists (LABAs) Examine the risk of acute myocardial infarction (AMI) and other serious
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 8.426,475 B2 Weidner Et Al
    USOO8426475B2 (12) United States Patent (10) Patent No.: US 8.426,475 B2 Weidner et al. (45) Date of Patent: Apr. 23, 2013 (54) TREATMENT OF CONNECTIVE TISSUE W W 28:8: A: 2.38 DISEASES OF THE SKN WO WO 2006/027579 A2 3, 2006 (75) Inventors: Morten Sloth Weidner, Virum (DK); OTHER PUBLICATIONS Hans Christian Wulf, Epsergaerde (DK) Pullen, Jr., R.; “Managing Subacute cutaneous lupus erythematosus' (73) Assignee: Astion Development A/S, Copenhagen Dermatology Nursing, Dec. 2001, pp. 1-3. O (DK) Freitas et al. "Chronic cutaneous Lupus erythematosus: Sudy of 290 patients'. An bras Dermatol, Rio de Janeiro, 2003, vol. 78(6), pp. 703-771.* (*) Notice: Subject to any disclaimer, the term of this Patent Abstract of Japan, 07258067 A, Oct. 9, 1995. patent is extended or adjusted under 35 Patent Abstracts of Japan, 07304647 A, Nov. 21, 1995. U.S.C. 154(b) by 1273 days. Patent Abstracts of Japan, 09 110674 A. Apr. 28, 1997. Patent Abstracts of Japan, 630 10716 A, Jan. 19, 1988. (21) Appl. No.: 11/402,255 Dawn Baramki BSN et al., “Modulation of T-cell function by (R)- and (S)-isomers of albuterol: Anti-inflammatory influences of (R)- (22) Filed: Apr. 12, 2006 isomers are negated in the presence of the (S)-isomers'. J. Allergy Clin. Immunol. 2002, 109(3):449-454. (65) Prior Publication Data Peter J. Barnes, “Effect of beta-agonists on inflammatory cells'. J. Allergy Clin. Immunol. 1999, 104(2 Pt 2):510-517. US 2006/0235048A1 Oct. 19, 2006 Richard Kalish et al., “Sensitization of mice to topically applied drugs: albuterol, chlorpheniramine, clonidine and nadolol.
    [Show full text]