DOCSLIB.ORG

Development of a Novel Biodegradable Drug Polymer for the Modification of Inflammatory Response

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Development of a Novel Biodegradable Drug Polymer for the Modification of Inflammatory Response DEVELOPMENT OF A NOVEL BIODEGRADABLE DRUG POLYMER FOR THE MODIFICATION OF INFLAMMATORY RESPONSE by Sara Khor A thesis submitted in conformity with the requirements for the degree of MASTER OF APPLIED SCIENCE Graduate Department of Institute of Biomaterials and Biomedical Engineering University of Toronto © Copyright by Sara Khor (2008) DEVELOPMENT OF A NOVEL BIODEGRADABLE DRUG POLYMER FOR THE MODIFICATION OF INFLAMMATORY RESPONSE MASTER OF APPLIED SCIENCE, 2008 Sara Khor Institute of Biomaterials and Biomedical Engineering University of Toronto ABSTRACT The first objective of this thesis was to assess the feasibility of designing a “smart” degradable polymer that can release anti-inflammatory drugs in response to inflammatory- related enzymes. The drug polymer was synthesized using diisocyanates, poly(caprolactone) diols, and oxaceprol (OC) biomonomers. Biodegradation studies demonstrated that the trimethylhexamethylene diisocyanate-based drug polymer responded to an inflammatory enzyme to release more OC, while a 1, 12-diisocyanatododecane analog demonstrated minimal drug release. The drug delivery response was believed to be a direct function of the molecular structure and distribution of the hard segment. The second objective of this thesis was to elucidate the anti-inflammatory mechanisms of OC by investigating its effects on cytokine-induced monocytic-cells adhesion in human umbilical vein endothelial cells (HUVECs) in vitro. Results showed that OC had no direct effect on the monocyte-endothelium adhesion, suggesting that OC may mediate inflammation by mechanisms other than those suggested by the literature. ii ACKNOWLEDGEMENTS First and foremost, Professor Paul Santerre, your guidance, support and unfailing patience throughout the highs and lows of this thesis and the preparation of this document have made this thesis possible. I would not have been able to pull through many difficult times without your organized leadership and optimism. To Dr. Frank LaRonde: it has been an honor working with you on this project. Your quality as a scientist has been inspirational, and your friendship and advice (anytime, anywhere) have made these two years truly memorable and enjoyable. I would also like to thank my Masters committee for their constructive criticisms throughout this thesis. This project would not have been possible without the assistance of many individuals. Many thanks to the Interface Biologics team for your wonderful support throughout this project. Thanks to Dr. Fan Gu, Dr. Peng Chen for your help with synthesis and chemical analysis, as well as the warm support. To Dr. David Courtman and Dr. Effat Rezaei: you made cell work so fun and feasible. Thank you so much for your guidance with all the HUVEC work. I am also grateful to Mr. Frank Gibbs for his help in DSC studies; Dr Jian Wang for his assistance in SEM analysis and Dr Alex Young for Mass Spectrometry analysis. Many thanks to Dr. Santerre lab team: Meilin, for your extensive knowledge in chemistry and your lovely surprises to keep me positive; Kuihua, for all the help and care, without you nothing would be possible; Hung, Patrick, JP, Ekanki, Soroor, Yi and many others whose friendships and support made these two years a lovely experience. And thank you, my dearest friends, Ellwood, Jean, Darrell, Onil, James, Cheri, Daniel and many others, for reminding me that life is so wondrously beautiful; and my dear family, for loving, believing and supporting me unconditionally since the very first day. iii TABLE OF CONTENTS ABSTRACT ........................................................................................................................... II ACKNOWLEDGEMENTS .................................................................................................III TABLE OF CONTENTS .....................................................................................................IV LIST OF FIGURES...........................................................................................................VIII LIST OF TABLES...............................................................................................................XV CHAPTER 1 INTRODUCTION........................................................................................... 1 1.1 BACKGROUND.................................................................................................................. 1 1.2 HYPOTHESIS..................................................................................................................... 2 1.3 THESIS OUTLINE .............................................................................................................. 3 REFERENCE .......................................................................................................................4 CHAPTER 2 LITERATURE REVIEW............................................................................... 5 2.1 POLYURETHANE CHEMISTRY, SYNTHESIS AND CHARACTERISTICS.................................. 5 2.1.1 Polyurethane Chemistry .......................................................................................... 5 2.1.2 The synthesis of polyurethane.................................................................................. 7 2.1.3 Polyurethane Degradation ...................................................................................... 9 2.2 POLYMERIC DRUG DELIVERY ........................................................................................ 12 2.2.1 Controlled Drug Delivery...................................................................................... 12 2.3 POLYMER-BASED DRUG DELIVERY SYSTEMS.................................................................. 13 2.3.1 Diffusion-based systems......................................................................................... 15 2.3.2 Water penetration-based systems .......................................................................... 18 2.3.3 Polymeric drug conjugates.................................................................................... 20 2.3.4 Responsive delivery systems .................................................................................. 23 2.4 MEDICAL DEVICE RELATED INFLAMMATION AND INFLAMMATORY DISEASES.............. 25 2.4.1 Inflammation Responses and Repair ..................................................................... 26 2.4.2 Biomaterials, Tissue Engineering and Regeneration ............................................ 28 2.4.3 Inflammatory Diseases .......................................................................................... 29 2.4.4 Anti-inflammatory Medications............................................................................. 30 REFERENCE ..................................................................................................................... 33 CHAPTER 3 SYNTHESIS AND CHARACTERIZATION OF A NOVEL ANTI- iv INFLAMMATORY DRUG POLYMER USING OXACEPROL ................................... 43 ABSTRACT ........................................................................................................................... 43 INTRODUCTION .................................................................................................................... 44 3.2 MATERIALS AND METHODS ........................................................................................... 48 3.2.1 Drug Biomonomer Synthesis ................................................................................. 48 3.2.2 Drug Polymer Synthesis ........................................................................................ 52 3.2.3 Characterization of Biomonomer and Polymer..................................................... 53 3.2.4 Biodegradation studies .......................................................................................... 56 3.2.5 High Performance Liquid Chromatography ......................................................... 58 3.2.6 Scanning electron microscopy (SEM) ................................................................... 60 3.2.7 Statistical Analysis................................................................................................. 60 3.3 RESULTS ........................................................................................................................ 60 3.3.1 Biomonomer synthesis and characterization......................................................... 60 3.3.2 Polymer synthesis and characterization................................................................ 64 3.3.3 Degradation Profile and Degradation Products................................................... 68 3.3.5 SEM .......................................................................................................................74 3.4 DISCUSSION ................................................................................................................... 76 3.5 CONCLUSION.................................................................................................................. 86 3.6 ACKNOWLEDGEMENTS................................................................................................... 87 REFERENCE ..................................................................................................................... 88 CHAPTER 4 INTERACTION OF OXACEPROL ON TNF-ALPHA-INDUCED U937 MONOCYTE ADHESION ON HUMAN UMBILICAL VASCULAR ENDOTHELIAL CELLS ................................................................................................................................... 93 ABSTRACT
Load more

Recommended publications
  • 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]
  • (12) United States Patent (10) Patent No.: US 9,005,660 B2 Tygesen Et Al
    USOO9005660B2 (12) United States Patent (10) Patent No.: US 9,005,660 B2 Tygesen et al. (45) Date of Patent: Apr. 14, 2015 (54) IMMEDIATE RELEASE COMPOSITION 4,873,080 A 10, 1989 Bricklet al. RESISTANT TO ABUSEBY INTAKE OF 4,892,742 A 1, 1990 Shah 4,898,733. A 2f1990 DePrince et al. ALCOHOL 5,019,396 A 5/1991 Ayer et al. 5,068,112 A 11/1991 Samejima et al. (75) Inventors: Peter Holm Tygesen, Smoerum (DK); 5,082,655 A 1/1992 Snipes et al. Jan Martin Oevergaard, Frederikssund 5,102,668 A 4, 1992 Eichel et al. 5,213,808 A 5/1993 Bar Shalom et al. (DK); Joakim Oestman, Lomma (SE) 5,266,331 A 11/1993 Oshlack et al. 5,281,420 A 1/1994 Kelmet al. (73) Assignee: Egalet Ltd., London (GB) 5,352.455 A 10, 1994 Robertson 5,411,745 A 5/1995 Oshlack et al. (*) Notice: Subject to any disclaimer, the term of this 5,419,917 A 5/1995 Chen et al. patent is extended or adjusted under 35 5,422,123 A 6/1995 Conte et al. U.S.C. 154(b) by 473 days. 5,460,826 A 10, 1995 Merrill et al. 5,478,577 A 12/1995 Sackler et al. 5,508,042 A 4/1996 OShlack et al. (21) Appl. No.: 12/701.248 5,520,931 A 5/1996 Persson et al. 5,529,787 A 6/1996 Merrill et al. (22) Filed: Feb. 5, 2010 5,549,912 A 8, 1996 OShlack et al.
    [Show full text]
  • Oxaceprol Monotherapy Versus Oxaceprol and Glucosamine Combination Therapy for Knee Osteoarthritis
    Original Article ISSN (Print) : 2454-8952 International Journal of Medical and Dental Sciences, Vol 9(2), DOI: 10.18311/ijmds/2020/24871, July 2020 ISSN (Online) : 2320-1118 Oxaceprol Monotherapy versus Oxaceprol and Glucosamine Combination Therapy for Knee Osteoarthritis Vijay Kumar1, Sanjeev Sareen2, Shrey Bhatia3* 1Professor and Head, Department of Pharmacology, Government Medical College, Patiala – 147001, Punjab, India 2Associate Professor, Department of Orthopaedics, Government Medical College, Patiala – 147001, Punjab, India 3Junior Resident, Department of Pharmacology, Government Medical College, Patiala – 147001, Punjab, India; [email protected] Abstract Introduction: Osteoarthritis (OA) is the commonest form of arthritis which presents with joint pain and functional limitations. Oxaceprol, a derivative of hydroxyproline, inhibits leukocyte migration into the joints thus inhibiting Proline in chondrocytes. Aims and Objective: Glucosamineinflammatory combination process. Oxaceprol therapy also in patients increases diagnosed availability with of Knee Glucosamine Osteoarthritis and improving (KOA). Materials uptake ofand Glucosamine Methods: Thisand To demonstrate efficacy of Oxaceprol Monotherapy versus Oxaceprol and randomly received either Oxaceprol 600mg OD for 4 weeks, or combination of Oxaceprol 600mg OD and Glucosamine was an open labelled, parallel group, Randomized Controlled Trial where 40 adults age ≥50 years diagnosed with KOA visual analogue scale (VAS) recording from baseline to 4 weeks of treatment. Results: Our study showed that both Oxaceprol monotherapySulphate 1500mg (group OD A, for n=20), 4 weeks. and GlucosamineThe patients pluswere Oxaceprol analysed ascombination per the differences therapy (group between B, n=20) WOMAC improved scale scores, joint pain, and stiffness, and functionality as shown by analysing WOMAC scores before, and after 4 weeks of treatment.
    [Show full text]
  • La. ADMINISTRATION of DAMAN & DIU OFFICE of the HEAD of OFFICE/HEALTH OFFICER GOVERNMENT HOSPITAL, DIU (362 520)
    iiv utsr T;3Tvr V ifta UTrTT Farf% T 3r d (Z9't 3r-4c Tom) WT 4114C414, i TWt 3TF9c1I i, i la-362520. ir. ii3r41/ii T/1(2)/1 -20/2016-2017/301. fka* :- 02/08/2016. *-fr Wr3W) SMi T i ' i 'i11 * AT * ialft r Citct']^1 q T-^r&T (iriq+rf1 379ciis), ,1"d q, F71Ftq * , , U)' UM 79 M-401 3rt9'Trci, t a 4 111AIREF, Tc 'lr1 Lrd *U u hC iit rl *t 3TiV i f^lv ft &M WiiW W04cii3T1icn1b cr $1cci1/3rrqpV^ft34 i1 http_//daman.nprocure.com qi 3i- T fWf T 3Trr 9 I f1T 7W www. daman.nic.in qi 3ft < 6 t I WA i41j1f4 #f WT fur 3T ;5r7 T Tft (ftwfg fir N1i Ic i * Tr ) (3i,i1 ) 2. 3. 4. 01. iii T1Zp Fszi Er11 r Lrcr iri^rtl T. 4,50,000/- T. 2,000/- 3rF^-T1 cam, i a ' fv "'A iii V r c iff *+ is1$d 3T1- T T 1 f t ZR 4,A 3i3 c S WE# *t 3rfc r M ft :- 23/08/2016 41 12.00 Wi1 ^W. 3 i r a - l T 3 1 f r i tc I .,i V 9 1 t *r 3i1 err :- 23/08/2016 ;E^t 13.00 a4 -TW. Ar r ft 3ird-c i:T i)W# *t itrr :- 1 mm T3Tr t 23/ 08/2016 ;E^t 16.00 W4. f l ih1 -sir ift cr if s u1Tq 4 www.nprocure.com W{ 3rfc'IJR arilzrr T iRm i vf^ff v i i t m e1Jrr I vi^w ft ftDqpj AiTq i f! S # 1 fPjf^r # Fi Ti Tf f f + Tr i TVIU I f'df i S r &A.
    [Show full text]
  • Diclofenac in the Treatment of Pain in Patients with Rheumatic Diseases
    Review paper Reumatologia 2018; 56, 3: 174–183 DOI: https://doi.org/10.5114/reum.2018.76816 Diclofenac in the treatment of pain in patients with rheumatic diseases Justyna Kołodziejska, Michał Kołodziejczyk Department of Pharmaceutical Technology, Chair of Applied Pharmacy, Medical University of Lodz, Poland Abstract Diclofenac, a phenylacetic acid derivative, is a drug demonstrating high efficacy after oral adminis- tration in the treatment of pain and physical disability in rheumatic diseases. In view of the adverse effects associated with using diclofenac, it is necessary to consider all known drug safety informa- tion before the drug is selected for therapy and the dosage regimen is set for individual patients. Selecting an oral dosage form with specific properties determined by excipients is a method to im- prove the availability of the drug substance and, at the same time, minimize adverse drug reactions. An alternative to tablet or capsule dosage forms is diclofenac application to the skin. The proven efficacy of this method is further improved through the use of transdermal penetration enhancers and vehicle ingredients which provide dosage forms with specific physical properties. Key words: diclofenac, efficacy, adverse effects, dosage form technology. Introduction on the market also exhibit technological differences (dosage form modifications). Intense pharmacological Diseases of the musculo-skeletal system affect 70% and formulation research is currently being conducted of the population over the age of 50 years. Pain caused to obtain more effective and safer products [2]. by rheumatic diseases decreases or resolves during re- NSAIDs are effective in multiple indications. In rheu- mission-inducing treatment. Drugs used in the therapy matology, they are used in the treatment of a range of of rheumatic diseases usually have a late onset of ac- diseases including rheumatoid arthritis, lupus erythe- tion.
    [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 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] BMJ Open Pediatric drug utilization in the Western Pacific region: Australia, Japan, South Korea, Hong Kong and Taiwan Journal: BMJ Open ManuscriptFor ID peerbmjopen-2019-032426 review only Article Type: Research Date Submitted by the 27-Jun-2019 Author: Complete List of Authors: Brauer, Ruth; University College London, Research Department of Practice and Policy, School of Pharmacy Wong, Ian; University College London, Research Department of Practice and Policy, School of Pharmacy; University of Hong Kong, Centre for Safe Medication Practice and Research, Department
    [Show full text]
  • Vr Meds Ex01 3B 0825S Coding Manual Supplement Page 1
    vr_meds_ex01_3b_0825s Coding Manual Supplement MEDNAME OTHER_CODE ATC_CODE SYSTEM THER_GP PHRM_GP CHEM_GP SODIUM FLUORIDE A12CD01 A01AA01 A A01 A01A A01AA SODIUM MONOFLUOROPHOSPHATE A12CD02 A01AA02 A A01 A01A A01AA HYDROGEN PEROXIDE D08AX01 A01AB02 A A01 A01A A01AB HYDROGEN PEROXIDE S02AA06 A01AB02 A A01 A01A A01AB CHLORHEXIDINE B05CA02 A01AB03 A A01 A01A A01AB CHLORHEXIDINE D08AC02 A01AB03 A A01 A01A A01AB CHLORHEXIDINE D09AA12 A01AB03 A A01 A01A A01AB CHLORHEXIDINE R02AA05 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S01AX09 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S02AA09 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S03AA04 A01AB03 A A01 A01A A01AB AMPHOTERICIN B A07AA07 A01AB04 A A01 A01A A01AB AMPHOTERICIN B G01AA03 A01AB04 A A01 A01A A01AB AMPHOTERICIN B J02AA01 A01AB04 A A01 A01A A01AB POLYNOXYLIN D01AE05 A01AB05 A A01 A01A A01AB OXYQUINOLINE D08AH03 A01AB07 A A01 A01A A01AB OXYQUINOLINE G01AC30 A01AB07 A A01 A01A A01AB OXYQUINOLINE R02AA14 A01AB07 A A01 A01A A01AB NEOMYCIN A07AA01 A01AB08 A A01 A01A A01AB NEOMYCIN B05CA09 A01AB08 A A01 A01A A01AB NEOMYCIN D06AX04 A01AB08 A A01 A01A A01AB NEOMYCIN J01GB05 A01AB08 A A01 A01A A01AB NEOMYCIN R02AB01 A01AB08 A A01 A01A A01AB NEOMYCIN S01AA03 A01AB08 A A01 A01A A01AB NEOMYCIN S02AA07 A01AB08 A A01 A01A A01AB NEOMYCIN S03AA01 A01AB08 A A01 A01A A01AB MICONAZOLE A07AC01 A01AB09 A A01 A01A A01AB MICONAZOLE D01AC02 A01AB09 A A01 A01A A01AB MICONAZOLE G01AF04 A01AB09 A A01 A01A A01AB MICONAZOLE J02AB01 A01AB09 A A01 A01A A01AB MICONAZOLE S02AA13 A01AB09 A A01 A01A A01AB NATAMYCIN A07AA03 A01AB10 A A01
    [Show full text]
  • Attachment 9.Pdf
    Kyowa Hakko U.S.A., Inc. Dated: February 14, 2003 N-Acetyl-L-Hydroxyproline New Dietary Ingredient Notification Reference No. 9 ? Clin Rheumatol (2000) 19:99-104 0 2000 Clinical Rheulnatology Clinical Rheumatology Original Article Oxaceprol is a Well-Tolerated Therapy for Osteoarthritis with Efficacy Equivalent to Diclofenac G. Herrmann’, D. Steeger’, M. Klasser*, J. Wirbitzky’, M. Fiirst4, R. Venbrocks’, H. Rohde6, D. Jungmiche17, H. D. Hildebrandt’, M. J. Parnham9, W. Gimbell’ and H. Dirschedl’ ‘BayerischesRotes Kreuz, Orthop&discheKlinik Lindenlohe,Schwandorf; ‘Gesellschaft fur wissenschaftlicheDatenverarbeitung + Didaktik mbH, MiihlheimiMain; 3Kurpark-Klinik,Bad Schussenried;4Schlo13park-Kliniken, Bad Waldsee;‘ Orthopgdische Uniklinik am Rudolf-Elle-Krankenhaus,Eisenberg; 6Fachklinikfiir Orthopadieund Rheumatologie,Oberstdorf; 7Fachklinik fir Orthopadie,Bad Dfiben; ‘Klinik am Homberg,Bad Wildungen;“ PamhamAdvisory Services,Bonn; and “ChephasaarGmbH, St Ingbert, Germany Abstract: The therapeutic equivalence and safety of was statistically significant (p = 0.04106) for the number treatment for 21 days with 400 mg t.i.d. oxaceprol (n = of these adverse events. Oxaceprol is therapeutically 132) and 50 mg t.i.d. diclofenac (n = 131) were assessed equivalent to diclofenac, but better tolerated than in a multicentre, randomised, double-blind study of a diclofenac in the treatment of osteoarthritis. mixed population of patients with osteoarthritis of the knee and/or hip. In a per-protocol analysis of efficacy, Keywords: Diclofenac; Lequesne index; Osteoarthritis; the mean Lequesne index decreasedby 2.5 points in the Oxaceprol; Pain oxaceprol group (n = 109) and by 2.8 points in the diclofenac group (n = 109). The 95% confidence interval for the end-point difference revealed therapeutic equivalence. This was confirmed by assessments (visual analogue scale) of pain at rest, weight-bearing pain, pain on standing and pain on movement, all of Introduction which decreased to a similar extent under both treatments.
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2005/0249806A1 Proehl Et Al
    US 2005O249806A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2005/0249806A1 Proehl et al. (43) Pub. Date: Nov. 10, 2005 (54) COMBINATION OF PROTON PUMP Related U.S. Application Data INHIBITOR, BUFFERING AGENT, AND NONSTEROIDAL ANTI-NFLAMMATORY (60) Provisional application No. 60/543,636, filed on Feb. DRUG 10, 2004. (75) Inventors: Gerald T. Proehl, San Diego, CA (US); Publication Classification Kay Olmstead, San Diego, CA (US); Warren Hall, Del Mar, CA (US) (51) Int. Cl." ....................... A61K 9/48; A61K 31/4439; A61K 9/20 Correspondence Address: (52) U.S. Cl. ............................................ 424/464; 514/338 WILSON SONS IN GOODRICH & ROSAT (57) ABSTRACT 650 PAGE MILL ROAD Pharmaceutical compositions comprising a proton pump PALO ALTO, CA 94304-1050 (US) inhibitor, one or more buffering agent and a nonsteroidal ASSignee: Santarus, Inc. anti-inflammatory drug are described. Methods are (73) described for treating gastric acid related disorders and Appl. No.: 11/051,260 treating inflammatory disorders, using pharmaceutical com (21) positions comprising a proton pump inhibitor, a buffering (22) Filed: Feb. 4, 2005 agent, and a nonsteroidal anti-inflammatory drug. US 2005/0249806 A1 Nov. 10, 2005 COMBINATION OF PROTON PUMP INHIBITOR, of the Stomach by raising the Stomach pH. See, e.g., U.S. BUFFERING AGENT, AND NONSTEROIDAL Pat. Nos. 5,840,737; 6,489,346; and 6,645,998. ANTI-NFLAMMATORY DRUG 0007 Proton pump inhibitors are typically prescribed for Short-term treatment of active duodenal ulcers, gastrointes CROSS REFERENCE TO RELATED tinal ulcers, gastroesophageal reflux disease (GERD), Severe APPLICATIONS erosive esophagitis, poorly responsive Symptomatic GERD, 0001.
    [Show full text]
  • A Abacavir Abacavirum Abakaviiri Abagovomab Abagovomabum
    A abacavir abacavirum abakaviiri abagovomab abagovomabum abagovomabi abamectin abamectinum abamektiini abametapir abametapirum abametapiiri abanoquil abanoquilum abanokiili abaperidone abaperidonum abaperidoni abarelix abarelixum abareliksi abatacept abataceptum abatasepti abciximab abciximabum absiksimabi abecarnil abecarnilum abekarniili abediterol abediterolum abediteroli abetimus abetimusum abetimuusi abexinostat abexinostatum abeksinostaatti abicipar pegol abiciparum pegolum abisipaaripegoli abiraterone abirateronum abirateroni abitesartan abitesartanum abitesartaani ablukast ablukastum ablukasti abrilumab abrilumabum abrilumabi abrineurin abrineurinum abrineuriini abunidazol abunidazolum abunidatsoli acadesine acadesinum akadesiini acamprosate acamprosatum akamprosaatti acarbose acarbosum akarboosi acebrochol acebrocholum asebrokoli aceburic acid acidum aceburicum asebuurihappo acebutolol acebutololum asebutololi acecainide acecainidum asekainidi acecarbromal acecarbromalum asekarbromaali aceclidine aceclidinum aseklidiini aceclofenac aceclofenacum aseklofenaakki acedapsone acedapsonum asedapsoni acediasulfone sodium acediasulfonum natricum asediasulfoninatrium acefluranol acefluranolum asefluranoli acefurtiamine acefurtiaminum asefurtiamiini acefylline clofibrol acefyllinum clofibrolum asefylliiniklofibroli acefylline piperazine acefyllinum piperazinum asefylliinipiperatsiini aceglatone aceglatonum aseglatoni aceglutamide aceglutamidum aseglutamidi acemannan acemannanum asemannaani acemetacin acemetacinum asemetasiini aceneuramic
    [Show full text]
  • (CD-P-PH/PHO) Report Classification/Justifica
    COMMITTEE OF EXPERTS ON THE CLASSIFICATION OF MEDICINES AS REGARDS THEIR SUPPLY (CD-P-PH/PHO) Report classification/justification of - Medicines belonging to the ATC group M01 (Antiinflammatory and antirheumatic products) Table of Contents Page INTRODUCTION 6 DISCLAIMER 8 GLOSSARY OF TERMS USED IN THIS DOCUMENT 9 ACTIVE SUBSTANCES Phenylbutazone (ATC: M01AA01) 11 Mofebutazone (ATC: M01AA02) 17 Oxyphenbutazone (ATC: M01AA03) 18 Clofezone (ATC: M01AA05) 19 Kebuzone (ATC: M01AA06) 20 Indometacin (ATC: M01AB01) 21 Sulindac (ATC: M01AB02) 25 Tolmetin (ATC: M01AB03) 30 Zomepirac (ATC: M01AB04) 33 Diclofenac (ATC: M01AB05) 34 Alclofenac (ATC: M01AB06) 39 Bumadizone (ATC: M01AB07) 40 Etodolac (ATC: M01AB08) 41 Lonazolac (ATC: M01AB09) 45 Fentiazac (ATC: M01AB10) 46 Acemetacin (ATC: M01AB11) 48 Difenpiramide (ATC: M01AB12) 53 Oxametacin (ATC: M01AB13) 54 Proglumetacin (ATC: M01AB14) 55 Ketorolac (ATC: M01AB15) 57 Aceclofenac (ATC: M01AB16) 63 Bufexamac (ATC: M01AB17) 67 2 Indometacin, Combinations (ATC: M01AB51) 68 Diclofenac, Combinations (ATC: M01AB55) 69 Piroxicam (ATC: M01AC01) 73 Tenoxicam (ATC: M01AC02) 77 Droxicam (ATC: M01AC04) 82 Lornoxicam (ATC: M01AC05) 83 Meloxicam (ATC: M01AC06) 87 Meloxicam, Combinations (ATC: M01AC56) 91 Ibuprofen (ATC: M01AE01) 92 Naproxen (ATC: M01AE02) 98 Ketoprofen (ATC: M01AE03) 104 Fenoprofen (ATC: M01AE04) 109 Fenbufen (ATC: M01AE05) 112 Benoxaprofen (ATC: M01AE06) 113 Suprofen (ATC: M01AE07) 114 Pirprofen (ATC: M01AE08) 115 Flurbiprofen (ATC: M01AE09) 116 Indoprofen (ATC: M01AE10) 120 Tiaprofenic Acid (ATC:
    [Show full text]
  • Obesity Invites Osteo-Arthritis in Young Women Weight Reduction Be the Main Stay of Management! a Case Study
    5 ISSN: 2687-816X DOI: 10.33552/GJOR.2021.03.000565 Global Journal of Orthopedics Research Research Article Copyright © All rights are reserved by S Tejesh Obesity Invites Osteo-Arthritis in Young Women Weight Reduction be the Main Stay of Management! A Case Study S Tejesh1* and Suresh Kishanrao2 1 S Tejesh MPH, School of Public Health & Environmental Sciences, Karnataka state rural development and panchayat raj university Gadag, India 2 Suresh Kishanrao, Public Health Consultant and Vissiting Professor, MPH, School of Public Health & Environmental Sciences, KSRDPRU, Gadag, India *Corresponding author: S Tejesh, MPH, School of Public Health & Environmental Received Date: July 26, 2021 Sciences, Karnataka state rural development and panchayat raj university Gadag, India. Published Date: August 18, 2021 Abstract Knee osteoarthritis (OA), also known as degenerative joint disease of the knee, is typically the result of wear and tear and progressive loss of articular cartilage. Age, weight and gender are the predisposing risk factors and symptoms are swelling, pain and stiffness at knee joint. We here present a case of 43-year-old housewife reported with pain, swelling and stiffness at right knee on 5 May 2021 was taken to nearby orthopedician. After physical examination and radiological investigation, she was diagnosed with knee osteoarthritis. He treated her with some analgesics and anti-inflammatory drugs and suggested to take physical therapy and counselled for weight reduction. In a follow up visit she had reduced her weight byBackground 3 kgs in a month’s time and was doing fine. We infer that weight of an individual plays an important role in the incidence of knee osteoarthritis.
    [Show full text]