DOCSLIB.ORG

The Perugia Consensus on Nausea and Vomiting: Chemotherapy-Induced Delayed Emesis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Perugia Consensus on Nausea and Vomiting: Chemotherapy-Induced Delayed Emesis The Perugia Consensus On Nausea And Vomiting: Chemotherapy- Induced Delayed Emesis Matti Aapro, MD Objectives 1. Briefly describe the mechanisms of CT induced delayed emesis 2. Efficacy of standard therapy in delayed emesis 3. Efficacy of new drugs in delayed emesis 4. MASCC recommendations 2004 Delayed emesis has two components: early delayed and late delayed, which probably have different physiological basis. The early phase still has a serotonin mediated component, the late phase seems more driven by substance P/neurokinin-1. Cytotoxic agents induce various types of delayed emesis. Steroids, dopamine recpetor antagonists and serotonin3 ( 5-HT3) receptor antagonists are proven to be efficacious in preventing delayed emesis. Neurokinin-1 recpetor antagonists have added value. The MASCC Perugia 2004 consensus recommendations in this rea will be presented. DELAYED EMESIS: AFTER ACUTE AND MODERATELY EMETOGENIC CHEMOTHERAPY Matti S. Aapro on behalf of the PERUGIA Writing Committee Paul J Hesketh; Ian Olver; Enzo Ballatori; Sussanne Börjeson; Jim Koeller; Mark Kris; Fausto Roila David Warr; Rebecca A. Clark; Maurizio Tonato ; Richard J Gralla, Lawrence H. Einhorn; Jorn Herrstedt Delayed emesis is a complex phenomenon with various physiologic determinants. It is dependent on the type of emetogenic agent. Most studies have centered on delayed emesis caused by cisplatin based chemotherapy, and the Perugia consensus will establish the respective roles of dexamethasone ( the best studied corticosteroid ), dopamine and 5HT3 receptor antagonists, as well as NK1 receptor antagonists. Excellent control of the acute phase is mandatory. Data on the incidence as well as on the efficacy of antiemetic prophylaxis against delayed emesis induced by moderately emetogenic chemotherapy (MEC ) are scanty. An overview of the literature has been done that showed the efficacy of dexamethasone in two of three randomized trials in MEC. Its optimal dose and duration of administration has not been defined. Instead, only one of four randomized studies showed a statistically significant efficacy of 5-HT3 antagonists (MEC). Finally, only weak evidences have been published on the efficacy of dopamine receptor antagonists. These data will be updated after ASCO 2004 and published by MASCC in its official Journal Supportive Care in Oncology REFERENCES up to Early 2004 1. Kris, MG, Gralla RJ, Clark RA, Tyson LB, O’Connell JP, Wertheim MS, Kelsen DP: Incidence, course, and severity of delayed nausea and vomiting following the administration of high-dose cisplatin. J Clin Oncol 10: 1379-1384, 1985. 2. Roila F, Boschetti E, Tonato M, et al: Predictive factors of delayed emesis in cisplatin-treated patients and antiemetic activity and tolerability of metoclopramide or dexamethasone. Am J Clin Oncol 14: 238-242, 1991. 3. Louvet C, Lorange A, Letendre F, et al: Acute and delayed emesis after cisplatin- based regimen: Description and prevention. Oncology 48: 392-396, 1991. 4. Italian Group for Antiemetic Research: Cisplatin-induced delayed emesis: Prognostic factors during three subsequent cycles. Ann Oncol 5: 585-589, 1994. 5. Roila F, Donati D, Tamberi S, Margutti G: Delayed emesis: incidence, pattern, prognostic factors and optimal treatment. Support Care Cancer 10: 88-95, 2002. 6. Gralla RJ, Itri LM, Pisko SE, Squillante AE, Kelsen DP, Braun DW, Bordin LA, Braun TJ, Young CW: Antiemetic efficacy of high-dose metoclopramide: randomized trials with placebo and prochlorperazine in patients with chemotherapy- induced nausea and vomiting. N Engl J Med 16: 905-909, 1981. 7. Rudd JA, Jordan CC, Naylor RJ: Profiles of emetic action of cisplatin in the ferret: a potential model of acute and delayed emesis. Eur J Pharmacol 262: R1-R2, 1994. 8. Milano S, Blower P, Romain D, Grelot L: The piglet as a suitable animal model for studying the delayed phase of cisplatin-induced emesis. J Pharmcol Exp Ther 274: 951-961, 1995. 9. Kris MG, Roila F, De Mulder PHM, Marty M: Delayed emesis following anticancer chemotherapy. Support Care Cancer 6: 228-232, 1998. 10. Hesketh PJ, Van Belle S, Aapro M, Tattersall FD, Naylor RJ, Hargreaves R, Carides AD, Evans JK, Horgan KJ: Differential involvement of neurotransmitters through the time course of cisplatin-induced emesis as revealed by therapy with specific receptor antagonists. Eur J Cancer 8: 1074-1080, 2003. 11. Kris MG, Gralla RJ, Tyson LB, Clark RA, Cirrincione C, Groshen S: Controlling delayed vomiting: Double-blind, randomized trial comparing placebo, dexamethasone alone, and metoclopramide plus dexamethasone in patients receiving cisplatin. J Clin Oncol 7: 108-114, 1989. 12. Roila F, Boschetti E, Tonato M, Basurto C, Bracarda S, Picciafuoco M, Patoia L, Santi E, Penza O, Ballatori E, delFavero A: Predictive factors of delayed emesis in cisplatin-treated patients and antiemetic activity and tolerability of metoclopramide or dexamethasone. J Clin Oncol 14: 238-242, 1991. 13. Passalacqua R, Cocconi G, Bella M, Monici L, Michiara M, Bandini N, Bacchi M: Double-blind, randomized trial for the control of delayed emesis in patients receiving cisplatin: Comparison of placebo vs. adrenocorticotropic hormone (ACTH). Ann Oncol 6: 481-485, 1992. 14. Passalacqua R, Cocconi G, Caminiti C, Silingardi V, Bella MA, Bichisao E, Michiara M, Malavasi V, Donati D, DiCostanzo F, Rocca A, DiSarra S, Scaglione F, Fraschini F: Double-blind, multicenter, randomized trial to compare the effect of two doses of adrenocorticotropic hormone versus placebo in controlling delayed emesis after high- dose cisplatin in adult patients with cancer. J Clin Oncol 15: 2467-2473, 1997. 15. Gandara DR, Harvey WH, Monaghan GG, Perez EA, Hesketh PJ: Delayed emesis following high-dose cisplatin: A double-blind randomized comparative trial of ondansetron (GR 38032F) versus placebo. Eur J Cancer 29A: (Suppl 1) 35-38, 1993. 16. Smyth J: Delayed emesis after high-dose cisplatin-The residual problem. Proceedings of the Satellite Symposium to the XVII Congress of the European Society for Medical Oncology. Lyon, France, 1992, pp: 24-26. 17. Navari RM, Madajewicz S, Anderson N, Tchekmedyian NS, Whaley W, Garewal H, Beck TM, Chang AY, Greenberg B, Caldwell KC, Huffman DH, Gould JR, Carron G, Ossi M, Anderson EM: Oral ondansetron for the control of cisplatin-induced delayed emesis: A large, multicenter, double-blind, randomized comparative trial of ondansetron versus placebo. J Clin Oncol 13: 2408-2416, 1995. 18. Olver I, Paska W, Depierre A, Seitz JF, Stewart DJ, Goedhals L, McQuade B, McRae J, Wilkinson JR: A multicentre, double-blind study comparing placebo, ondansetron and ondansetron plus dexamethasone for the control of cisplatin-induced delayed emesis. Ann Oncol 9: 945-952, 1996. 19. Cocquyt V, VanBelle S, Reinhardt RR, Decramer MLA, O’Brien M, Schellens JHM, Borms M, Verbeke L, VanAelst F, DeSmet M, Carides AD, Eldridge K, Gertz BJ: Comparison of L-758,298, a prodrug for the selective neurokinin-1 antagonist, L- 754,030, with ondansetron for the prevention of cisplatin-induced emesis. Eur J Cancer 37: 835-842, 2001. 20. Navari RM, Reinhardt RR, Gralla RJ, Kris MG, Hesketh PJ, Khojasteh A, Kindler H, Grote TH, Pendergrass K, Grunberg SM, Carides AD, Gertz BJ: Reduction of cisplatin-induced emesis by a selective neurokinin-1-receptor antagonist. New England Journal of Medicine 340: 190-195, 1999. 21. Campos D, Pereira JR, Reinhardt RR, Carracedo C, Poli S, Vogel C, Martinez- Cedillo J, Erazo A, Wittreich J, Eriksson LO, Carides AD, Gertz BJ: Prevention of cisplatin-induced emesis by the oral neurokinin-1 antagonist, MK-869, in combination with granisetron and dexamethasone or with dexamethasone alone. J Clin Oncol 19: 1759-1767, 2001. 22. VanBelle S, Lichinitser MR, Navari RM, Garin AM, Decramer ML, Riviere A, Thant M, Brestan E, Bui B, Eldridge K, DeSmet M, Michiels N, Reinhardt RR, Carides AD, Evans JK, Gertz BJ: Prevention of cisplatin-induced acute and delayed emesis by the selective neurokinin-1 antagonists, L-758,298 and MK-869. American Cancer Society 94: 3032-3041, 2002. 23. Hesketh PJ, Gralla RJ, Webb RT, Ueno W, DelPrete S, Bachinsky ME, Dirlam NL, Stack CB, Silberman SL: Randomized phase II study of the neurokinin 1 receptor antagonist CJ-11,974 in the control of cisplatin-induced emesis. J Clin Oncol 17: 338-343, 1999. 24. Moreno I, Rosell R, Abad A, Barnadas A, Carles J, Ribelles N, Solano V, Font A: Comparison of three protracted antiemetic regimens for the control of delayed emesis in cisplatin-treated patients. Eur J Cancer 28A: 1344-1347, 1992. 25. Shinkai T, Saijo N, Eguchi K, Sasaki Y, Tamura T, Fujiwara Y, Mae M, Fukuda M, Ohe Y, Sasaki S, Nakagawa K, Minato K, Hong WS, Suemasu K: Control of cisplatin-induced delayed emesis with metoclopramide and dexamethasone: A randomized controlled trial. J Clin Oncol 19: 40-44, 1989. 26. Italian Group for Antiemetic Research: Ondansetron versus metoclopramide, both combined with dexamethasone, in the prevention of cisplatin-induced delayed emesis. J Clin Oncol 15: 124-130, 1997. 27. Matsui K, Fukuoka M, Takada M, Kusunoki Y, Yana T, Tamura K, Yoshida T, Iida K, Hirashima T, Tsukada H, Ushijima S, Miyawaki H, Masuda N: Randomized trial for the prevention of delayed emesis in patients receiving high-dose cisplatin. Br J Cancer 2: 217-221, 1996. 28. Italian Multicenter study Group: A double-blind randomized study comparing intramuscular (i.m.) granisetron with i.m. granisetron plus dexamethasone in the prevention of delayed emesis induced by cisplatin. Anticancer drugs 5: 465-470, 1999. 29. Gridelli C, Ianniello GP, Ambrosini G, et al: Multicentre, double-blind, randomized trial comparing ondansetron versus ondansetron plus dexamethasone in the prophylaxis of cisplatin-induced delayed emesis. Int J Oncol 10: 395-400, 1997. 30. Latreille J, Pater J, Johnston D, Laberge F, Stewart D, Rusthoven J, Hoskins P, Findlay B, McMurtie E, Yelle L, Williams C, Walde D, Ernst S, Dhaliwal H, Warr D, Shepherd F, Mee D, Nishimura L, Osoba D, Zee B: Use of dexamethasone and granisetron in the control of delayed emesis for patients who receive highly emetogenic chemotherapy.
Load more

Recommended publications
  • Table S1: Sensitivity, Specificity, PPV, NPV, and F1 Score of NLP Vs. ICD for Identification of Symptoms for (A) Biome Developm
    Table S1: Sensitivity, specificity, PPV, NPV, and F1 score of NLP vs. ICD for identification of symptoms for (A) BioMe development cohort; (B) BioMe validation cohort; (C) MIMIC-III; (D) 1 year of notes from patients in BioMe calculated using manual chart review. A) Fatigue Nausea and/or vomiting Anxiety Depression NLP (95% ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P CI) 0.99 (0.93- 0.59 (0.43- <0.00 0.25 (0.12- <0.00 <0.00 0.54 (0.33- Sensitivity 0.99 (0.9 – 1) 0.98 (0.88 -1) 0.3 (0.15-0.5) 0.85 (0.65-96) 0.02 1) 0.73) 1 0.42) 1 1 0.73) 0.57 (0.29- 0.9 (0.68- Specificity 0.89 (0.4-1) 0.75 (0.19-1) 0.68 0.97 (0.77-1) 0.03 0.98 (0.83-1) 0.22 0.81 (0.53-0.9) 0.96 (0.79-1) 0.06 0.82) 0.99) 0.99 (0.92- 0.86 (0.71- 0.94 (0.79- 0.79 (0.59- PPV 0.96 (0.82-1) 0.3 0.95 (0.66-1) 0.02 0.95 (0.66-1) 0.16 0.93 (0.68-1) 0.12 1) 0.95) 0.99) 0.92) 0.13 (0.03- <0.00 0.49 (0.33- <0.00 0.66 (0.48- NPV 0.89 (0.4-1) 0.007 0.94 (0.63-1) 0.34 (0.2-0.51) 0.97 (0.81-1) 0.86 (0.6-0.95) 0.04 0.35) 1 0.65) 1 0.81) <0.00 <0.00 <0.00 F1 Score 0.99 0.83 0.88 0.57 0.95 0.63 0.82 0.79 0.002 1 1 1 Itching Cramp Pain NLP (95% ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P CI) 0.98 (0.86- 0.24 (0.09- <0.00 0.09 (0.01- <0.00 0.52 (0.37- <0.00 Sensitivity 0.98 (0.85-1) 0.99 (0.93-1) 1) 0.45) 1 0.29) 1 0.66) 1 0.89 (0.72- 0.5 (0.37- Specificity 0.96 (0.8-1) 0.98 (0.86-1) 0.68 0.98 (0.88-1) 0.18 0.5 (0-1) 1 0.98) 0.66) 0.88 (0.69- PPV 0.96 (0.8-1) 0.8 (0.54-1) 0.32 0.8 (0.16-1) 0.22 0.99 (0.93-1) 0.98 (0.87-1) NA* 0.97) 0.98 (0.85- 0.57 (0.41- <0.00 0.58 (0.43- <0.00 NPV 0.98 (0.86-1) 0.5 (0-1) 0.02 (0-0.08) NA* 1) 0.72) 1 0.72) 1 <0.00 <0.00 <0.00 F1 Score 0.97 0.56 0.91 0.28 0.99 0.68 1 1 1 *Denotes 95% confidence intervals and P values that could not be calculated due to insufficient cells in 2x2 tables.
    [Show full text]
  • List of Union Reference Dates A
    Active substance name (INN) EU DLP BfArM / BAH DLP yearly PSUR 6-month-PSUR yearly PSUR bis DLP (List of Union PSUR Submission Reference Dates and Frequency (List of Union Frequency of Reference Dates and submission of Periodic Frequency of submission of Safety Update Reports, Periodic Safety Update 30 Nov. 2012) Reports, 30 Nov.
    [Show full text]
  • Pharmacy and Poisons (Third and Fourth Schedule Amendment) Order 2017
    Q UO N T FA R U T A F E BERMUDA PHARMACY AND POISONS (THIRD AND FOURTH SCHEDULE AMENDMENT) ORDER 2017 BR 111 / 2017 The Minister responsible for health, in exercise of the power conferred by section 48A(1) of the Pharmacy and Poisons Act 1979, makes the following Order: Citation 1 This Order may be cited as the Pharmacy and Poisons (Third and Fourth Schedule Amendment) Order 2017. Repeals and replaces the Third and Fourth Schedule of the Pharmacy and Poisons Act 1979 2 The Third and Fourth Schedules to the Pharmacy and Poisons Act 1979 are repealed and replaced with— “THIRD SCHEDULE (Sections 25(6); 27(1))) DRUGS OBTAINABLE ONLY ON PRESCRIPTION EXCEPT WHERE SPECIFIED IN THE FOURTH SCHEDULE (PART I AND PART II) Note: The following annotations used in this Schedule have the following meanings: md (maximum dose) i.e. the maximum quantity of the substance contained in the amount of a medicinal product which is recommended to be taken or administered at any one time. 1 PHARMACY AND POISONS (THIRD AND FOURTH SCHEDULE AMENDMENT) ORDER 2017 mdd (maximum daily dose) i.e. the maximum quantity of the substance that is contained in the amount of a medicinal product which is recommended to be taken or administered in any period of 24 hours. mg milligram ms (maximum strength) i.e. either or, if so specified, both of the following: (a) the maximum quantity of the substance by weight or volume that is contained in the dosage unit of a medicinal product; or (b) the maximum percentage of the substance contained in a medicinal product calculated in terms of w/w, w/v, v/w, or v/v, as appropriate.
    [Show full text]
  • Pharmacy and Poisons Act 1979
    Q UO N T FA R U T A F E BERMUDA PHARMACY AND POISONS ACT 1979 1979 : 26 TABLE OF CONTENTS PART I PRELIMINARY 1 Short title 2 Interpretation PART II THE PHARMACY COUNCIL 3 The Pharmacy Council 4 Membership of the Council 4A Functions of the Council 4B Protection from personal liability 4C Annual Report 5 Proceedings of the Council, etc PART III REGISTRATION OF PHARMACISTS 6 Offence to practise pharmacy if not registered 7 Registration as a pharmacist 7A Re-registration as non-practising member 7AA Period of validity of registration 8 Code of Conduct 9 Pharmacy Profession Complaints Committee 10 Investigation of complaint by Committee 10A Inquiry into complaint by Council 10B Inquiry by Council of its own initiative 11 Surrender of registration 12 Restoration of name to register 1 PHARMACY AND POISONS ACT 1979 13 Proof of registration 14 Appeals 14A Fees 14B Amendment of Seventh Schedule 15 Regulations for this part PART IV REGISTRATION OF PHARMACIES 16 Register of pharmacies 17 Registration of premises as registered pharmacies 18 Unfit premises: new applications 19 Unfit premises: registered pharmacies 20 Appeals 21 When certificates of unfitness take effect 22 Regulations for this Part PART V CONTROL OF PRESCRIPTIONS AND IMPORTATION 23 Prescriptions to be in a certain form 23A Validity of a prescription 24 Supply by registered pharmacist of equivalent medicines 25 Restrictions on the importation of medicines 26 Declaration relating to imported medicines [repealed] PART VI CONTROL OF DRUGS 27 Certain substances to be sold on prescription
    [Show full text]
  • Quality Issues in Caring for Older People
    Doctoral Thesis - Tesis Doctoral Quality issues in caring for older people: • Appropriateness of transition from long-term care facilities to acute hospital care • Potentially inappropriate medication: development of a European list Anna Renom Guiteras Prof. Gabriele Meyer Prof. Ramón Miralles Basseda Martin Luther University Halle-Wittenberg Universitat Autònoma de Barcelona Halle (Saale) & Barcelona, Catalonia University of Witten/Herdecke Spain Witten Germany Programa de doctorat en Medicina Departament de Medicina, Facultat de Medicina Universitat Autònoma de Barcelona Barcelona, 2015 13 Contents 15 1. Introduction • Research context • Background of the research topics • Pesetaio of the ailes 23 2. Summary and discussion of the results 31 3. Conclusions 37 4. References 47 5. Articles • Article 1: Renom-Guiteras A, Uhrenfeldt L, Meyer G, Mann E. Assessment tools for determining appropriateness of admission to acute care of persons transferred from long-term care facilities: a systematic review. BMC Geriatr. 2014;14:80 • Article 2: Renom-Guiteras A, Meyer G, Thürmann PA. The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol. 2015;71(7):861-75 77 6. Annexes • Annex 1.1 (article 1) - Additional file 1: Studies dealing with assessment tools for determining appropriateness of hospital admissions among residents of LTC facilities. • Annex 1.2 (article 1) - Additional file 2: Characteristics of the assessment tools for determining appropriateness of hospital admissions among residents of LTC facilities. • Annex 2.1 (article 2) - Appendix 1: Complete EU(7)-PIM list • Annex 2.2 (article 2) - Appendix 2: Questionable Potentially Inappropriate Medications (Questionable PIM): results of the Delphi survey.
    [Show full text]
  • Metoclopramide: an Antiemetic in Chemotherapy Induced Nausea and Vomiting
    Central Journal of Drug Design and Research Bringing Excellence in Open Access Mini Review *Corresponding author Jørn Herrstedt, Department of Oncology, Odense University Hospital, DK-5000, Odense C, Denmark, Tel: Metoclopramide: An Antiemetic 45-6541-3634; Email: Submitted: 13 January 2017 Accepted: 16 March 2017 in Chemotherapy Induced Published: 17 March 2017 ISSN: 2379-089X Nausea and Vomiting Copyright © 2017 Herrstedt et al. 1 2 Signe Ladegaard Harder and Jørn Herrstedt * OPEN ACCESS 1Department of Oncology, Odense University Hospital, Denmark 2Department of Oncology, Odense University Hospital and the University of Southern Keywords Denmark, Denmark • Metoclopramide • Chemotherapy Abstract • Nausea • Vomiting Chemotherapy induced nausea and vomiting (CINV) are two of the most • Emesis feared adverse events experienced by cancer patients undergoing chemotherapy. Metoclopramide was derived from procainamide in the 1950s and one of the first drugs investigated in the prophylaxis of nausea and vomiting induced by chemotherapy. The breakthrough came in 1981 with the recognition that high-dose metoclopramide was effective and tolerable in the prevention of cisplatin-induced nausea and vomiting. A combination of high- dose metoclopramide and a corticosteroid was the standard antiemetic recommendation until the serotonin (5-HT)3-receptor antagonists, ondansetron, granisetron, tropisetron and dolasetron became available in the beginning of the 1990s. The development of these highly selective (5-HT)3-receptor antagonists with a superior effect and a preferable tolerability profile has limited the use of metoclopramide to be prescribed as a rescue antiemetic, when guideline recommended antiemetic therapy fails. ABBREVIATIONS The emetic risk of chemotherapy is divided in high emetic risk (risk of vomiting 0-24 hours after chemotherapy > 90%), CINV: Chemotherapy-Induced Nausea and Vomiting; moderate emetic risk (30-90%), low emetic risk (10-30%) and MCP: Metoclopramide; NK -Receptor Antagonist: Neurokinin 1 minimal emetic risk (< 10%).
    [Show full text]
  • The Handbook of Cannabis Therapeutics: from Bench to Bedside
    Handbook of Cannabis Therapeutics From Bench to Bedside 9780789030979 Handbook of Cannabis Therapeutics From Bench to Bedside Size: 212 x 152mm Spine size: 26 mm Color pages: Binding: Paperback THE HAWORTH PRESS® Haworth Series in Integrative Healing Ethan Russo Editor The Last Sorcerer: Echoes of the Rainforest by Ethan Russo Professionalism and Ethics in Complementary and Alternative Medicine by John Crellin and Fernando Ania Cannabis and Cannabinoids: Pharmacology, Toxicology, and Therapeutic Potential by Franjo Grotenhermen and Ethan Russo Modern Psychology and Ancient Wisdom: Psychological Healing Practices from the World’s Religious Traditions edited by Sharon G. Mijares Complementary and Alternative Medicine: Clinic Design by Robert A. Roush Herbal Voices: American Herbalism Through the Words of American Herbalists by Anne K. Dougherty The Healing Power of Chinese Herbs and Medicinal Recipes by Joseph P. Hou and Youyu Jin Alternative Therapies in the Treatment of Brain Injury and Neurobehavioral Disorders: A Practical Guide edited by Gregory J. Murrey Handbook of Cannabis Therapeutics: From Bench to Bedside edited by Ethan B. Russo and Franjo Grotenhermen Handbook of Cannabis Therapeutics From Bench to Bedside Ethan B. Russo, MD Franjo Grotenhermen, MD Editors Routledge Taylor &. Francis Croup NEW YORK AND LONDON First Published by The Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580. Transferred to Digital Printing 2010 by Routledge 270 Madison Ave, New York NY 10016 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN For more information on this book or to order, visit http://www.haworthpress.com/store/product.asp?sku=5741 or call 1-800-HAWORTH (800-429-6784) in the United States and Canada or (607) 722-5857 outside the United States and Canada or contact [email protected] © 2006 by The Haworth Press, Inc.
    [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]
  • Changes Highlighted Final Version Date of Issue: 23Rd December 2015
    EPHMRA ANATOMICAL CLASSIFICATION GUIDELINES 2016 Section A Changed Classes/Guidelines: Changes Highlighted Final Version Date of issue: 23rd December 2015 1 A2B ANTIULCERANTS R1997r2 016 Combinations of specific antiulcerants with anti-infectives against Helicobacter pylori are classified according to the anti-ulcerant substance. For example, proton pump inhibitors in combination with these anti-infectives are classified in A2B2. A2B1 H2 antagonists R2002 Includes, for example, cimetidine, famotidine, nizatidine, ranitidine, roxatidine. Combinations of low dose H2 antagonists with antacids are classified with antacids in A2A6. A2B2 Acid Proton pump inhibitors R2003r2 016 Includes esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole. A2B3 Prostaglandin antiulcerants Includes misoprostol, enprostil. A2B4 Bismuth antiulcerants Includes combinations with antacids. A2B9 All other antiulcerants R2002r2 016 Includes all other products specifically stated to be antiulcerants even when containing antispasmodics (see A3). Combinations of low dose H2 antagonists with antacids are classified with antacids in A2A6. Included are, eg carbenoxolone, gefarnate, pirenzepine, proglumide, sucralfate and sofalcone. Herbal combinations are classified in A2C. In Japan, Korea and Taiwan only, sulpiride and other psycholeptics indicated for ulcer use are also included in this group, whilst in all other countries, these compounds are classified in N5A9. Products containing rebamipide for gastric mucosal protection are classified here. Products containing rebamipide and indicated for dry eye are classified in S1K9. A2C OTHER STOMACH DISORDER PREPARATIONS R1994 Includes herbal preparations and also plain alginic acid. Combinations of antacids with alginic acid are in A2A1. 2 A4 ANTIEMETICS AND ANTINAUSEANTS A4A ANTIEMETICS AND ANTINAUSEANTS R1996 Products indicated for vertigo and Meniere's disease are classified in N7C. Gastroprokinetics are classified in A3F.
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2017/0143734 A1 DE COLLE Et Al
    US 20170143734A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2017/0143734 A1 DE COLLE et al. (43) Pub. Date: May 25, 2017 (54) PRODRUGS OF METOPMAZINE Publication Classification (51) Int. Cl. (71) Applicant: Neurogastrx, Inc., Campbell, CA (US) A6II 3/545 (2006.01) A6IR 9/00 (2006.01) (72) Inventors: Cyril DE COLLE, Campbell, CA A 6LX 9/70 (2006.01) (US); Pankaj PASRICHA, Ellicott C07D 417/06 (2006.01) City, MD (US); David WUSTROW, A63L/98 (2006.01) Los Gatos, CA (US) (52) U.S. Cl. (21) Appl. No.: 15/320,724 CPC ........ A6IK3I/5415 (2013.01); C07D 417/06 (2013.01); A61K 31/198 (2013.01); A61 K (22) PCT Fed: Jun. 23, 2015 9/7023 (2013.01); A61K 9/006 (2013.01) (86) PCT No.: PCT/US 15/37258 (57) ABSTRACT S 371 (c)(1), Provided herein are methods, compounds, compositions, and kits for the treatment of an enteric nervous system (2) Date: Dec. 20, 2016 disorder. Such methods may comprise administering to a Subject an effective amount of a phenothiazine compound, a peripherally restricted dopamine decarboxylase inhibitor, Related U.S. Application Data and/or a peripherally restricted dopamine D2 receptor (60) Provisional application No. 62/016.235, filed on Jun. antagonist that does not substantially inhibit hERG chan 24, 2014. nels. Patent Application Publication May 25, 2017. Sheet 1 of 2 US 2017/O143734 A1 Repeated measures one-way ANOVA data 2 5 2 O 1 5 1 O FIGURE 1 Patent Application Publication May 25, 2017. Sheet 2 of 2 US 2017/O143734 A1 Solid Gastric Emptying (%) QCcodoG |- ODCON,COLO<!--(NI<- G2Cco ||||||| IIIIII FIGURE 2 US 2017/O 143734 A1 May 25, 2017 PRODRUGS OF METOPMAZINE The safety concerns relate to (1) unwanted cardiac side effects caused by, e.g., interaction of the agents with ion CROSS-REFERENCE channels involved in cardiac action potentials, and (2) unwanted motor dysfunction caused by the actions of the 0001.
    [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]
  • Niperotidine Hydrochloride
    Metopimazine/Nizatidine 1751 ataxia, confusion, disorientation, dizziness, euphoria, dysphoria, little effect on the metabolism of other drugs. However, hallucinations, psychosis, depression, headache, decreased con- like other H2-antagonists its effects on gastric pH may centration, blurred vision, sleep disturbances, decreased coordi- O affect the absorption of some other drugs. nation, and tremors. Adverse cardiovascular reactions including -O N+ hypotension, orthostatic hypotension, and tachycardia have oc- curred. Gastrointestinal disturbances, decreased appetite, and ab- HN Pharmacokinetics dominal pain have also been reported. Nizatidine is readily and almost completely absorbed O HN Precautions S from the gastrointestinal tract. The bioavailability of Nabilone is extensively metabolised and largely excreted in bile, O CH3 nizatidine after oral doses exceeds 70% and may be and therefore is not recommended in patients with severe hepatic O N slightly increased by the presence of food. It is widely impairment. It should be used with caution in patients with a his- CH3 distributed and is about 35% bound to plasma proteins. tory of psychiatric disorders or depression, or those with hyper- tension or heart disease. (niperotidine) The elimination half-life of nizatidine is 1 to 2 hours Because of the possibility of CNS depression, patients should be and is prolonged in renal impairment. Nizatidine is warned not to drive or operate machinery. Profile partly metabolised in the liver: nizatidine N-2-oxide, Niperotidine hydrochloride is a histamine H2-receptor antagonist nizatidine S-oxide, and N-2-monodesmethylnizatidine The possibility of dependence similar to that of cannabis should with general properties similar to those of cimetidine (p.1716). be borne in mind.
    [Show full text]