List of Generic Medications
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New Developments in Prokinetic Therapy for Gastric Motility Disorders
REVIEW published: 24 August 2021 doi: 10.3389/fphar.2021.711500 New Developments in Prokinetic Therapy for Gastric Motility Disorders Michael Camilleri* and Jessica Atieh Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States Prokinetic agents amplify and coordinate the gastrointestinal muscular contractions to facilitate the transit of intra-luminal content. Following the institution of dietary recommendations, prokinetics are the first medications whose goal is to improve gastric emptying and relieve symptoms of gastroparesis. The recommended use of metoclopramide, the only currently approved medication for gastroparesis in the United States, is for a duration of less than 3 months, due to the risk of reversible or irreversible extrapyramidal tremors. Domperidone, a dopamine D2 receptor antagonist, is available for prescription through the FDA’s program for Expanded Access to Investigational Drugs. Macrolides are used off label and are associated with tachyphylaxis and variable duration of efficacy. Aprepitant relieves some symptoms of gastroparesis. There are newer agents in the pipeline targeting diverse gastric (fundic, antral and pyloric) motor functions, including novel serotonergic 5-HT4 agonists, dopaminergic D2/3 antagonists, neurokinin NK1 antagonists, and ghrelin agonist. Novel Edited by: targets with potential to improve gastric motor functions include the pylorus, macrophage/ Jan Tack, inflammatory function, oxidative -
Prokinetics and Ghrelin for the Management of Cancer Cachexia Syndrome
85 Review Article Prokinetics and ghrelin for the management of cancer cachexia syndrome Jimi S. Malik, Sriram Yennurajalingam Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Contributions: (I) Conception and design: All authors; (II) Administrative support: S Yennurajalingam; (III) Provision of study materials or patients: S Yennurajalingam; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Sriram Yennurajalingam, MD. Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1414, Houston, TX 77030, USA. Email: [email protected]. Abstract: Cancer cachexia (CC) is one of the most distressing syndromes for both patients and their families. CC can have an impact on patient reported quality of life and overall survival. It is often associated with symptoms such as fatigue, depressed mood, early satiety, and anorexia. Prokinetic agents have been found to improve chronic nausea and early satiety associated with CC. Among the prokinetic agents, metoclopramide is one of the best studied medications. The role of the other prokinetic agents, such as domperidone, erythromycin, haloperidol, levosulpiride, tegaserod, cisapride, mosapride, renzapride, and prucalopride is unclear for use in cachectic cancer patients due to their side effect profile and limited efficacy studies in cancer patients. There has been an increased interest in the use of ghrelin-receptor agonists for the treatment of CC. Anamorelin HCl is a highly selective, novel ghrelin receptor agonist. -
Therapeutic Class Overview Irritable Bowel Syndrome Agents
Therapeutic Class Overview Irritable Bowel Syndrome Agents Therapeutic Class Overview/Summary: This review will focus on agents used for the treatment of Irritable Bowel Syndrome (IBS).1-5 IBS is a gastrointestinal syndrome characterized primarily by non-specific chronic abdominal pain, usually described as a cramp-like sensation, and abnormal bowel habits, either constipation or diarrhea, in which there is no organic cause. Other common gastrointestinal symptoms may include gastroesophageal reflux, dysphagia, early satiety, intermittent dyspepsia and nausea. Patients may also experience a wide range of non-gastrointestinal symptoms. Some notable examples include sexual dysfunction, dysmenorrhea, dyspareunia, increased urinary frequency/urgency and fibromyalgia-like symptoms.6 IBS is defined by one of four subtypes. IBS with constipation (IBS-C) is the presence of hard or lumpy stools with ≥25% of bowel movements and loose or watery stools with <25% of bowel movements. When IBS is associated with diarrhea (IBS-D) loose or watery stools are present with ≥25% of bowel movements and hard or lumpy stools are present with <25% of bowel movements. Mixed IBS (IBS-M) is defined as the presence of hard or lumpy stools with ≥25% and loose or water stools with ≥25% of bowel movements. Final subtype, or unsubtyped, is all other cases of IBS that do not fall into the other classes. Pharmacological therapy for IBS depends on subtype.7 While several over-the-counter or off-label prescription agents are used for the treatment of IBS, there are currently only two agents approved by the Food and Drug Administration (FDA) for the treatment of IBS-C and three agents approved by the FDA for IBS-D. -
Prophylactic Antiemetic Therapy with Ondansetron, Granisetron and Metoclopramide in Patients Undergoing Laparoscopic Cholecystectomy Under GA
JK SCIENCE ORIGINAL ARTICLE Prophylactic Antiemetic Therapy with Ondansetron, Granisetron and Metoclopramide in Patients Undergoing Laparoscopic Cholecystectomy Under GA Vishal Gupta, Renu Wakhloo, Anjali Mehta, Satya Dev Gupta Abstract The aim of the present study was to compare the antiemetic effect of intravenous Granisetron, Ondansetron & Metoclopramide in a randomized blinded study for prophylaxis of post operative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy under general anaesthesia. 60 patients (ASA I & II) undergoing laparoscopic cholecystectomy under general anaesthesia were randomly allocated into three equal groups (n=20). Emetic episodes in first 24 hours were recorded and compared in different study groups. Results were analyzed. Minimal emetic episodes were observed in early post-operative period (1-12hrs) in patients who had received intravenous granisetron in comparison to ondansetron and metoclopramide. However, after 12 hours emesis free periods were statistically insignificant between group A and B while patients in group C had no antiemetic effect. Keywords Post Operative Nausea and Vomiting (PONV), Granisetron, Ondensetron, Metoclopramide Introduction The most common and distressing symptoms, which vascular anastomoses and increased intracranial follow anaesthesia and surgery, are pain and emesis. The pressure(4). The anaesthetic consequences are aspiration syndrome of nausea, retching and vomiting is known as pneumonitis and discomfort in recovery. For institutions 'sickness' and each part of it can be distinguished as a there is increased financial burden because of increased separate entity (1). PONV (post operative nausea and nursing care, delayed discharge from Phase I and II vomiting) has been characterized as big 'little problem(2) recovery units and unexpected admissions. Hence, and has been a common complication for both in patients prophylactic antiemetic therapy is needed for all these and out patients undergoing virtually all types of surgical patients. -
International Journal of Medicine and Pharmaceutical Research
Wayal Sunil Anil et al, IJMPR, 2019, 7(6): 180-183 CODEN (USA): IJCPNH | ISSN: 2321-2624 International Journal of Medicine and Pharmaceutical Research Journal Home Page: www.pharmaresearchlibrary.com/ijmpr R E S E A R C H A R T I C L E Formulation and In-vitro Evaluation of Alosetron Oral Thin Films Wayal Sunil Anil1, G.S. Valluri2, Gampa Vijay Kumar3 Department of Pharmacy, KGR Institute of Technology and Management, Rampally, Kesara, Medchal, Telangana, India. A B S T R A C T Alosetron, is a 5-HT3 antagonist used for the management of severe diarrhea-predominant irritable bowel syndrome. In present study oral thin films of Alosetron were developed to have a faster on set of action. The oralthin films were developed by using polymers Guar gum, Pullulan and PVP K30.Oral thin films were prepared by employing solvent casting method. Propylene glycol was selected as permeation enhancer and plasticizer. Drug excipient compatibility studies were carried out by using FTIR, and it was observed that there were no interactions. Formulations were prepared with the varying concentrations polymers ranging from F1-F9, and all the formulations were evaluated for various physical parameters Physical appearance, Weight variation, Thickness, Folding endurance, Tensile strength, Drug content, Moisture uptake, Moisture content and all the results were found to be were found to be within the pharmacopeial limits, in-vitro drug release studies by using USP dissolution Apparatus Type II. Among all the 9 formulations F4 formulation which contain Pullulan 10mg and shown 97.06% cumulative drug release within 30 min. -
Comprehensive Pgx Report for 1 / 31 Examples of Different Levels of Evidence for Pgx Snps
Comprehensive PGx report for PERSONAL DETAILS Advanced Diagnostics Laboratory LLC CLIA:31D2149403 Phone: Fax: PATIENT DOB Address: 1030 North Kings Highway Suite 304 Cherry Hill, NJ 08034 GENDER FEMALE Website: http://advanceddiagnosticslaboratory.com/ SPECIMEN TYPE Oral Fluid LABORATORY INFORMATION ORDERING PHYSICIAN ACCESSION NUMBER 100344 FACILITY COLLECTION DATE 08/10/2020 RECEIVED DATE 08/14/2020 REPORT GENERATED 09/08/2020 LABORATORY DIRECTOR Dr. Jeanine Chiaffarano Current Patient Medication Clonidine (Catapres, Kapvay) The personalized pharmacogenomics profile of this patient reveals intermediate CYP2D6-mediated metabolism, extensive CYP1A2-mediated metabolism, and extensive CYP3A5-mediated metabolism. For further details, please find supporting evidence in this report or on websites such as www.pharmgkb.org or www.fda.gov. Losartan (Cozaar) The personalized pharmacogenomics profile of this patient reveals extensive CYP2C9-mediated metabolism, extensive CYP3A4-mediated metabolism, and extensive CYP3A5-mediated metabolism. For further details, please find supporting evidence in this report or on websites such as www.pharmgkb.org or www.fda.gov. Diltiazem (Cardizem, Tiazac) The personalized pharmacogenomics profile of this patient reveals extensive CYP3A4-mediated metabolism, intermediate CYP2C19-mediated metabolism, and extensive CYP3A5- mediated metabolism. For further details, please find supporting evidence in this report or on websites such as www.pharmgkb.org or www.fda.gov. Labetalol (Normodyne, Trandate) The personalized pharmacogenomics profile of this patient reveals intermediate CYP2D6-mediated metabolism, and intermediate CYP2C19-mediated metabolism. For further details, please find supporting evidence in this report or on websites such as www.pharmgkb.org or www.fda.gov. Mycophenolate mofetil (Myfortic, CellCept) The personalized pharmacogenomics profile of this patient reveals extensive CYP3A4-mediated metabolism, extensive CYP3A5-mediated metabolism, and extensive CYP2C8-mediated metabolism. -
Classification of Medicinal Drugs and Driving: Co-Ordination and Synthesis Report
Project No. TREN-05-FP6TR-S07.61320-518404-DRUID DRUID Driving under the Influence of Drugs, Alcohol and Medicines Integrated Project 1.6. Sustainable Development, Global Change and Ecosystem 1.6.2: Sustainable Surface Transport 6th Framework Programme Deliverable 4.4.1 Classification of medicinal drugs and driving: Co-ordination and synthesis report. Due date of deliverable: 21.07.2011 Actual submission date: 21.07.2011 Revision date: 21.07.2011 Start date of project: 15.10.2006 Duration: 48 months Organisation name of lead contractor for this deliverable: UVA Revision 0.0 Project co-funded by the European Commission within the Sixth Framework Programme (2002-2006) Dissemination Level PU Public PP Restricted to other programme participants (including the Commission x Services) RE Restricted to a group specified by the consortium (including the Commission Services) CO Confidential, only for members of the consortium (including the Commission Services) DRUID 6th Framework Programme Deliverable D.4.4.1 Classification of medicinal drugs and driving: Co-ordination and synthesis report. Page 1 of 243 Classification of medicinal drugs and driving: Co-ordination and synthesis report. Authors Trinidad Gómez-Talegón, Inmaculada Fierro, M. Carmen Del Río, F. Javier Álvarez (UVa, University of Valladolid, Spain) Partners - Silvia Ravera, Susana Monteiro, Han de Gier (RUGPha, University of Groningen, the Netherlands) - Gertrude Van der Linden, Sara-Ann Legrand, Kristof Pil, Alain Verstraete (UGent, Ghent University, Belgium) - Michel Mallaret, Charles Mercier-Guyon, Isabelle Mercier-Guyon (UGren, University of Grenoble, Centre Regional de Pharmacovigilance, France) - Katerina Touliou (CERT-HIT, Centre for Research and Technology Hellas, Greece) - Michael Hei βing (BASt, Bundesanstalt für Straßenwesen, Germany). -
CAS Number Index
2334 CAS Number Index CAS # Page Name CAS # Page Name CAS # Page Name 50-00-0 905 Formaldehyde 56-81-5 967 Glycerol 61-90-5 1135 Leucine 50-02-2 596 Dexamethasone 56-85-9 963 Glutamine 62-44-2 1640 Phenacetin 50-06-6 1654 Phenobarbital 57-00-1 514 Creatine 62-46-4 1166 α-Lipoic acid 50-11-3 1288 Metharbital 57-22-7 2229 Vincristine 62-53-3 131 Aniline 50-12-4 1245 Mephenytoin 57-24-9 1950 Strychnine 62-73-7 626 Dichlorvos 50-23-7 1017 Hydrocortisone 57-27-2 1428 Morphine 63-05-8 127 Androstenedione 50-24-8 1739 Prednisolone 57-41-0 1672 Phenytoin 63-25-2 335 Carbaryl 50-29-3 569 DDT 57-42-1 1239 Meperidine 63-75-2 142 Arecoline 50-33-9 1666 Phenylbutazone 57-43-2 108 Amobarbital 64-04-0 1648 Phenethylamine 50-34-0 1770 Propantheline bromide 57-44-3 191 Barbital 64-13-1 1308 p-Methoxyamphetamine 50-35-1 2054 Thalidomide 57-47-6 1683 Physostigmine 64-17-5 784 Ethanol 50-36-2 497 Cocaine 57-53-4 1249 Meprobamate 64-18-6 909 Formic acid 50-37-3 1197 Lysergic acid diethylamide 57-55-6 1782 Propylene glycol 64-77-7 2104 Tolbutamide 50-44-2 1253 6-Mercaptopurine 57-66-9 1751 Probenecid 64-86-8 506 Colchicine 50-47-5 589 Desipramine 57-74-9 398 Chlordane 65-23-6 1802 Pyridoxine 50-48-6 103 Amitriptyline 57-92-1 1947 Streptomycin 65-29-2 931 Gallamine 50-49-7 1053 Imipramine 57-94-3 2179 Tubocurarine chloride 65-45-2 1888 Salicylamide 50-52-2 2071 Thioridazine 57-96-5 1966 Sulfinpyrazone 65-49-6 98 p-Aminosalicylic acid 50-53-3 426 Chlorpromazine 58-00-4 138 Apomorphine 66-76-2 632 Dicumarol 50-55-5 1841 Reserpine 58-05-9 1136 Leucovorin 66-79-5 -
5-HT3 Receptor Antagonists in Neurologic and Neuropsychiatric Disorders: the Iceberg Still Lies Beneath the Surface
1521-0081/71/3/383–412$35.00 https://doi.org/10.1124/pr.118.015487 PHARMACOLOGICAL REVIEWS Pharmacol Rev 71:383–412, July 2019 Copyright © 2019 by The Author(s) This is an open access article distributed under the CC BY-NC Attribution 4.0 International license. ASSOCIATE EDITOR: JEFFREY M. WITKIN 5-HT3 Receptor Antagonists in Neurologic and Neuropsychiatric Disorders: The Iceberg Still Lies beneath the Surface Gohar Fakhfouri,1 Reza Rahimian,1 Jonas Dyhrfjeld-Johnsen, Mohammad Reza Zirak, and Jean-Martin Beaulieu Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Laval University, Quebec, Quebec, Canada (G.F., R.R.); Sensorion SA, Montpellier, France (J.D.-J.); Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran (M.R.Z.); and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada (J.-M.B.) Abstract. ....................................................................................384 I. Introduction. ..............................................................................384 II. 5-HT3 Receptor Structure, Distribution, and Ligands.........................................384 A. 5-HT3 Receptor Agonists .................................................................385 B. 5-HT3 Receptor Antagonists. ............................................................385 Downloaded from 1. 5-HT3 Receptor Competitive Antagonists..............................................385 2. 5-HT3 Receptor -
IBS Treatment
TREATMENTS OF IBS Douglas A. Drossman, MD Co-Director UNC Center for Functional GI & Motility Disorders INTRODUCTION In recent years, there has been increased interest by physicians and the pharmaceutical industry regarding newer treatments for IBS. Before discussing these new treatments, it is important to consider the overall management strategy in IBS. This is necessary because patients with IBS exhibit a wide spectrum of symptoms of varying frequencies and degrees of severity. There is no one ideal treatment for IBS, and the newer medications may work best for only a subset of patients having this disorder. Therefore, the clinician must first apply certain general management approaches and, following this, treatment choices will depend on the nature (i.e., predominant diarrhea, constipation, or bloating, etc.) and severity (mild, moderate, severe) of the symptoms. The symptoms of IBS may have any of several underlying causes. These can include: (a) abnormal motility (uncoordinated or excessive contractions that can lead to diarrhea, constipation, bloating) (b) visceral hypersensitivity (lower pain threshold of the nerves that can produce abdominal discomfort or pain) resulting from the abnormal motility, stress or infection (c) dysfunction of the brain's ability to regulate these visceral (intestinal) activities. Treatments will vary depending on which of these possibilities are occurring. In general, milder symptoms relate primarily to abnormal motility, often in response to food, activity or stress, and/or visceral hypersensitivity. They are commonly treated symptomatically with pharmacological agents directed at the gut. However, more severe symptoms often relate to dysfunction of the brain-gut regulatory system with associated psychosocial effects, and psychological or behavioral treatments and antidepressants are frequently helpful. -
Gastroparesis: 2014
GASTROINTESTINAL MOTILITY AND FUNCTIONAL BOWEL DISORDERS, SERIES #1 Richard W. McCallum, MD, FACP, FRACP (Aust), FACG Status of Pharmacologic Management of Gastroparesis: 2014 Richard W. McCallum Joseph Sunny, Jr. Gastroparesis is characterized by delayed gastric emptying without mechanical obstruction of the gastric outlet or small intestine. The main etiologies are diabetes, idiopathic and post- gastric and esophageal surgical settings. The management of gastroparesis is challenging due to a limited number of medications and patients often have symptoms, which are refractory to available medications. This article reviews current treatment options for gastroparesis including adverse events and limitations as well as future directions in pharmacologic research. INTRODUCTION astroparesis is a syndrome characterized by documented gastroparesis are increasing.2 Physicians delayed emptying of gastric contents without have both medical and surgical approaches for these Gmechanical obstruction of the stomach, pylorus or patients (See Figure 1). Medical therapy includes both small bowel. Patients can present with nausea, vomiting, prokinetics and antiemetics (See Table 1 and Table 2). postprandial fullness, early satiety, pressure, fullness The gastroparesis population will grow as diabetes and abdominal distension. In addition, abdominal pain increases and new therapies will be required. What located in the epigastrium, and distinguished from the do we know about the size of the gastroparetic term discomfort, is increasingly being recognized population? According to a study from the Mayo Clinic as an important symptom. The main etiologies of group surveying Olmsted County in Minnesota, the gastroparesis are diabetes, idiopathic, and post gastric risk of gastroparesis in Type 1 diabetes mellitus was and esophageal surgeries.1 Hospitalizations from significantly greater than for Type 2. -
A Four-Country Comparison of Healthcare Systems, Implementation
Neurogastroenterology & Motility Neurogastroenterol Motil (2014) 26, 1368–1385 doi: 10.1111/nmo.12402 REVIEW ARTICLE A four-country comparison of healthcare systems, implementation of diagnostic criteria, and treatment availability for functional gastrointestinal disorders A report of the Rome Foundation Working Team on cross-cultural, multinational research M. SCHMULSON,* E. CORAZZIARI,† U. C. GHOSHAL,‡ S.-J. MYUNG,§ C. D. GERSON,¶ E. M. M. QUIGLEY,** K.-A. GWEE†† & A. D. SPERBER‡‡ *Laboratorio de Hıgado, Pancreas y Motilidad (HIPAM)-Department of Experimental Medicine, Faculty of Medicine-Universidad Nacional Autonoma de Mexico (UNAM). Hospital General de Mexico, Mexico City, Mexico †Gastroenterologia A, Department of Internal Medicine and Medical Specialties, University La Sapienza, Rome, Italy ‡Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, India §Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea ¶Division of Gastroenterology, Mount Sinai School of Medicine, New York, NY, USA **Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, TX, USA ††Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ‡‡Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Key Messages • This report identified seven key issues related to healthcare provision that may impact how patients with FGIDs are investigated, diagnosed and managed. • Variations in healthcare provision around the world in patients with FGIDs have not been reviewed. • We compared four countries that are geographically and culturally diverse, and exhibit differences in the healthcare coverage provided to their population: Italy, South Korea, India and Mexico. • Since there is a paucity of publications relating to the issues covered in this report, some of the findings are based on the authors’ personal perspectives, press reports and other published sources.