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Comparison of Norepinephrine and Cafedrine/Theodrenaline Regimens for Maintaining Maternal Blood Pressure During
IBIMA Publishing Obstetrics & Gynecology: An International Journal http://www.ibimapublishing.com/journals/GYNE/gyne.html Vol. 2015 (2015), Article ID 714966, 12 pages DOI: 10.5171/2015.714966 Research Article Comparison of Norepinephrine and Cafedrine/Theodrenaline Regimens for Maintaining Maternal Blood Pressure during Spinal Anaesthesia for Caesarean Section Hoyme, M.1, Scheungraber, C.2, Reinhart, K.3 and Schummer, W.3 1Department of Internal Medicine I (Cardiology, Angiology, Pneumology) Friedrich Schiller University, Jena, Germany 2Departments of Obstetrics and Gynecology, Friedrich Schiller University, Jena, Germany 3Clinic of Anaesthesiology and Intensive Care Medicine, Friedrich Schiller University, Jena, Germany Correspondence should be addressed to: Schummer, W.; [email protected] Received date: 9 January 2014; Accepted date: 4 April 2014; Published date: 26 August 2015 Academic Editor: Dan Benhamou Copyright © 2015. Hoyme, M., Scheungraber, C., Reinhart, K. and Schummer, W. Distributed under Creative Commons CC-BY 4.0 Abstract Common phenomena of spinal anaesthesia for caesarean sections are hypotension and cardiovascular depression, both of which require immediate action. Akrinor® (theodrenaline and cafedrine), a sympathomimetic agent commonly used in Germany for such cases, was phased out with little notice at the end of 2005. Phenylephrine was not and is not an approved drug. Norepinephrine became the first-line drug. The outcome in neonates delivered by elective caesarean section under spinal anaesthesia was studied. At our university hospital, all elective caesarean sections under spinal anaesthesia from 2005 and 2006 were analysed regarding hypotension and the vasopressor administered. If maternal arterial pressure decreased by more than 20% of baseline, patients in 2005 received Akrinor®; patients in 2006 received norepinephrine. -
Hypotension After Spinal Anesthesia for Cesarean
REVIEW CURRENT OPINION Hypotension after spinal anesthesia for cesarean section: how to approach the iatrogenic sympathectomy Christina Massotha, Lisa To¨pelb, and Manuel Wenkb Purpose of review Hypotension during cesarean section remains a frequent complication of spinal anesthesia and is associated with adverse maternal and fetal events. Recent findings Despite ongoing research, no single measure for sufficient treatment of spinal-induced hypotension was 05/25/2020 on BhDMf5ePHKbH4TTImqenVDezntqwKeJGjCYTUOBBz0EyVSh+WquM7uJo3U//pWTO by http://journals.lww.com/co-anesthesiology from Downloaded Downloaded identified so far. Current literature discusses the efficacy of low-dose spinal anesthesia, timing and solutions for adequate fluid therapy and various vasopressor regimens. Present guidelines favor the use of from phenylephrine over ephedrine because of decreased umbilical cord pH values, while norepinephrine is http://journals.lww.com/co-anesthesiology discussed as a probable superior alternative with regard to maternal bradycardia, although supporting data is limited. Alternative pharmacological approaches, such as 5HT3-receptor antagonists and physical methods may be taken into consideration to further improve hemodynamic stability. Summary Current evidence favors a combined approach of low-dose spinal anesthesia, adequate fluid therapy and vasopressor support to address maternal spinal-induced hypotension. As none of the available vasopressors by is associated with relevantly impaired maternal and fetal outcomes, none of them should -
The National Drugs List
^ ^ ^ ^ ^[ ^ The National Drugs List Of Syrian Arab Republic Sexth Edition 2006 ! " # "$ % &'() " # * +$, -. / & 0 /+12 3 4" 5 "$ . "$ 67"5,) 0 " /! !2 4? @ % 88 9 3: " # "$ ;+<=2 – G# H H2 I) – 6( – 65 : A B C "5 : , D )* . J!* HK"3 H"$ T ) 4 B K<) +$ LMA N O 3 4P<B &Q / RS ) H< C4VH /430 / 1988 V W* < C A GQ ") 4V / 1000 / C4VH /820 / 2001 V XX K<# C ,V /500 / 1992 V "!X V /946 / 2004 V Z < C V /914 / 2003 V ) < ] +$, [2 / ,) @# @ S%Q2 J"= [ &<\ @ +$ LMA 1 O \ . S X '( ^ & M_ `AB @ &' 3 4" + @ V= 4 )\ " : N " # "$ 6 ) G" 3Q + a C G /<"B d3: C K7 e , fM 4 Q b"$ " < $\ c"7: 5) G . HHH3Q J # Hg ' V"h 6< G* H5 !" # $%" & $' ,* ( )* + 2 ا اوا ادو +% 5 j 2 i1 6 B J' 6<X " 6"[ i2 "$ "< * i3 10 6 i4 11 6! ^ i5 13 6<X "!# * i6 15 7 G!, 6 - k 24"$d dl ?K V *4V h 63[46 ' i8 19 Adl 20 "( 2 i9 20 G Q) 6 i10 20 a 6 m[, 6 i11 21 ?K V $n i12 21 "% * i13 23 b+ 6 i14 23 oe C * i15 24 !, 2 6\ i16 25 C V pq * i17 26 ( S 6) 1, ++ &"r i19 3 +% 27 G 6 ""% i19 28 ^ Ks 2 i20 31 % Ks 2 i21 32 s * i22 35 " " * i23 37 "$ * i24 38 6" i25 39 V t h Gu* v!* 2 i26 39 ( 2 i27 40 B w< Ks 2 i28 40 d C &"r i29 42 "' 6 i30 42 " * i31 42 ":< * i32 5 ./ 0" -33 4 : ANAESTHETICS $ 1 2 -1 :GENERAL ANAESTHETICS AND OXYGEN 4 $1 2 2- ATRACURIUM BESYLATE DROPERIDOL ETHER FENTANYL HALOTHANE ISOFLURANE KETAMINE HCL NITROUS OXIDE OXYGEN PROPOFOL REMIFENTANIL SEVOFLURANE SUFENTANIL THIOPENTAL :LOCAL ANAESTHETICS !67$1 2 -5 AMYLEINE HCL=AMYLOCAINE ARTICAINE BENZOCAINE BUPIVACAINE CINCHOCAINE LIDOCAINE MEPIVACAINE OXETHAZAINE PRAMOXINE PRILOCAINE PREOPERATIVE MEDICATION & SEDATION FOR 9*: ;< " 2 -8 : : SHORT -TERM PROCEDURES ATROPINE DIAZEPAM INJ. -
ESPGHAN/European Society for Pediatric Infectious Diseases
CLINICAL GUIDELINES European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases Evidence-Based Guidelines for the Management of Acute Gastroenteritis in Children in Europe: Update 2014 ÃAlfredo Guarino (Coordinator), yShai Ashkenazi, zDominique Gendrel, ÃAndrea Lo Vecchio, yRaanan Shamir, and §Hania Szajewska ABSTRACT Results: Gastroenteritis severity is linked to etiology, and rotavirus is the most Objectives: These guidelines update and extend evidence-based indications severe infectious agent and is frequently associated with dehydration. for the management of children with acute gastroenteritis in Europe. Dehydration reflects severity and should be monitored by established score Methods: The guideline development group formulated questions, systems. Investigations are generally not needed. Oral rehydration with identified data, and formulated recommendations. The latter were graded hypoosmolar solution is the major treatment and should start as soon as with the Muir Gray system and, in parallel, with the Grading of possible. Breast-feeding should not be interrupted. Regular feeding should Recommendations, Assessment, Development and Evaluations system. continue with no dietary changes including milk. Data suggest that in the hospital setting, in non–breast-fed infants and young children, lactose-free feeds can be considered in the management of gastroenteritis. Active therapy Received March 17, 2014; accepted March 19, 2014. may reduce the duration and severity of diarrhea. Effective interventions From the ÃDepartment of Translational Medical Science, Section of include administration of specific probiotics such as Lactobacillus GG or Pediatrics, University of Naples Federico II, Naples, Italy, the Saccharomyces boulardii, diosmectite or racecadotril. Anti-infectious drugs ySchneider Children’s Medical Center, Tel-Aviv University, Tel-Aviv, should be given in exceptional cases. -
Specifications of Approved Drug Compound Library
Annexure-I : Specifications of Approved drug compound library The compounds should be structurally diverse, medicinally active, and cell permeable Compounds should have rich documentation with structure, Target, Activity and IC50 should be known Compounds which are supplied should have been validated by NMR and HPLC to ensure high purity Each compound should be supplied as 10mM solution in DMSO and at least 100µl of each compound should be supplied. Compounds should be supplied in screw capped vial arranged as 96 well plate format. -
Appendix on Tariff Elimination Schedule for Mercosur
Trade part of the EU-Mercosur Association Agreement Without Prejudice Disclaimer: In view of the Commission's transparency policy, the Commission is publishing the texts of the Trade Part of the Agreement following the agreement in principle announced on 28 June 2019. The texts are published for information purposes only and may undergo further modifications including as a result of the process of legal revision. However, in view of the growing public interest in the negotiations, the texts are published at this stage of the negotiations for information purposes. These texts are without prejudice to the final outcome of the agreement between the EU and Mercosur. The texts will be final upon signature. The agreement will become binding on the Parties under international law only after completion by each Party of its internal legal procedures necessary for the entry into force of the Agreement (or its provisional application). AR applied BR applied PY applied UY applied Mercosur Final NCM Description Comments tariff tariff tariff tariff Offer 01012100 Pure-bred horses 0 0 0 0 0 01012900 Lives horses, except pure-bred breeding 2 2 2 2 0 01013000 Asses, pure-bred breeding 4 4 4 4 4 01019000 Asses, except pure-bred breeding 4 4 4 4 4 01022110 Purebred breeding cattle, pregnant or lactating 0 0 0 0 0 01022190 Other pure-bred cattle, for breeding 0 0 0 0 0 01022911 Other bovine animals for breeding,pregnant or lactating 2 2 2 2 0 01022919 Other bovine animals for breeding 2 2 2 2 4 01022990 Other live catlle 2 2 2 2 0 01023110 Pure-bred breeding buffalo, pregnant or lactating 0 0 0 0 0 01023190 Other pure-bred breeding buffalo 0 0 0 0 0 01023911 Other buffalo for breeding, ex. -
Tonsillopharyngitis - Acute (1 of 10)
Tonsillopharyngitis - Acute (1 of 10) 1 Patient presents w/ sore throat 2 EVALUATION Yes EXPERT Are there signs of REFERRAL complication? No 3 4 EVALUATION Is Group A Beta-hemolytic Yes DIAGNOSIS Streptococcus (GABHS) • Rapid antigen detection test infection suspected? (RADT) • roat culture No TREATMENT EVALUATION No A Supportive management Is GABHS confi rmed? B Pharmacological therapy (Non-GABHS) Yes 5 TREATMENT A EVALUATE RESPONSEMIMS Supportive management TO THERAPY C Pharmacological therapy • Antibiotics Poor/No Good D Surgery, if recurrent or complicated response response REASSESS PATIENT COMPLETE THERAPY & REVIEW THE DIAGNOSIS© Not all products are available or approved for above use in all countries. Specifi c prescribing information may be found in the latest MIMS. B269 © MIMS Pediatrics 2020 Tonsillopharyngitis - Acute (2 of 10) 1 ACUTE TONSILLOPHARYNGITIS • Infl ammation of the tonsils & pharynx • Etiologies include bacterial (group A β-hemolytic streptococcus, Haemophilus infl uenzae, Fusobacterium sp, etc) & viral (infl uenza, adenovirus, coronavirus, rhinovirus, etc) pathogens • Sore throat is the most common presenting symptom in older children TONSILLOPHARYNGITIS 2 EVALUATION FOR COMPLICATIONS • Patients w/ sore throat may have deep neck infections including epiglottitis, peritonsillar or retropharyngeal abscess • Examine for signs of upper airway obstruction Signs & Symptoms of Sore roat w/ Complications • Trismus • Inability to swallow liquids • Increased salivation or drooling • Peritonsillar edema • Deviation of uvula -
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. -
Pharmaceutical Manufacturing Formulations Liquid Products V () L UME Sarfaraz K
HANDBOOK OF Pharmaceutical Manufacturing Formulations Liquid Products V () L UME Sarfaraz K. Niazi CRC PRESS Boca Raton London New York Washington, D.C. Table of Contents PART I Regulatory and Manufacturing Guidance 1 Chapter 1 Current Good Manufacturing Practice Considerations in Liquid Manufacturing 3 I. Introduction 3 II. Facilities 3 III. Equipment 3 IV. Raw Materials 4 V. Compounding 4 VI. Microbiological Quality 4 VII. Oral Suspensions 5 VIII. Product Specifications 5 IX. Process Validation 5 X. Stability 5 XI. Packaging 6 Chapter 2 Stability Testing of New Drug Substances and Products 7 I. Introduction 7 II. Drug Substance 7 A. General Case 8 B. Drug Substances Intended for Storage in a Refrigerator 8 C. Drag Substances Intended for Storage in a Freezer 8 D. Drug Substances Intended for Storage below -20°C 9 HI. Drag Product 10 A. General Case •' B. Drag Products Packaged in Impermeable Containers 11 C. Drag Products Packaged in Semipermeable Containers 11 D. Drag Products Intended for Storage in a Refrigerator 12 E. Drag Products Intended for Storage in a Freezer 13 F. Drag Products Intended for Storage below -20"C 13 IV Glossary 14 References 1() Chapter 3 Container Closure Systems '7 I. Introduction '7 A. Definitions '7 B. Current Good Manufacturing Practice, the Consumer Product Safety Commission, and Requirements on Containers and Closures 17 C. Additional Considerations 17 II. Qualification and Quality Control of Packaging Components 18 A. Description 21 B. Information about Suitability 21 C. Stability Data (Packaging Concerns) 22 D. Inhalation Drag Products 23 E. Injection and Ophthalmic Drag Products 23 F. -
Genl:VE 1970 © World Health Organization 1970
Nathan B. Eddy, Hans Friebel, Klaus-Jiirgen Hahn & Hans Halbach WORLD HEALTH ORGANIZATION ORGANISATION .MONDIALE DE LA SANT~ GENl:VE 1970 © World Health Organization 1970 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. Nevertheless governmental agencies or learned and professional societies may reproduce data or excerpts or illustrations from them without requesting an authorization from the World Health Organization. For rights of reproduction or translation of WHO publications in toto, application should be made to the Division of Editorial and Reference Services, World Health Organization, Geneva, Switzerland. The World Health Organization welcomes such applications. Authors alone are responsible for views expressed in signed articles. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Director-General of the World Health Organization concerning the legal status of any country or territory or of its authorities, or concerning the delimitation of its frontiers. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. © Organisation mondiale de la Sante 1970 Les publications de l'Organisation mondiale de la Sante beneficient de la protection prevue par les dispositions du Protocole n° 2 de la Convention universelle pour la Protection du Droit d'Auteur. Les institutions gouvernementales et les societes savantes ou professionnelles peuvent, toutefois, reproduire des donnees, des extraits ou des illustrations provenant de ces publications, sans en demander l'autorisation a l'Organisation mondiale de la Sante. Pour toute reproduction ou traduction integrate, une autorisation doit etre demandee a la Division des Services d'Edition et de Documentation, Organisation mondiale de la Sante, Geneve, Suisse. -
Chewable Lozenge Formulation
Umashankar M S et al. Int. Res. J. Pharm. 2016, 7 (4) INTERNATIONAL RESEARCH JOURNAL OF PHARMACY www.irjponline.com ISSN 2230 – 8407 Review Article CHEWABLE LOZENGE FORMULATION- A REVIEW Umashankar M S *, Dinesh S R, Rini R, Lakshmi K S, Damodharan N SRM College of Pharmacy, SRM University, Kattankulathur, India *Corresponding Author Email: [email protected] Article Received on: 11/02/16 Revised on: 13/03/16 Approved for publication: 28/03/16 DOI: 10.7897/2230-8407.07432 ABSTRACT Development of lozenges dated back to 20thcentury and is still remain popular among the consumer and hence it has continued commercial production. Lozenges are palatable solid unit dosage form administrated in the oral cavity. They meant to be dissolved in mouth or pharynx for its local or systemic effect. Lozenge tablets provide several advantages as pharmaceutical formulations however with some disadvantages. Lozenge as a dosage form can be adopted for drug delivery across buccal route, labial route, gingival route and sublingual route. Multiple drugs can also be incorporated in them for chronic illness treatments. Lozenge enables loading of wide range of active ingredients for oral systemic delivery of drugs. Lozenges are available as over the counter medications in the form of caramel based soft lozenges, hard candy lozenges and compressed tablet lozenges containing drugs for sore throat, mouth infection and as mouth fresheners. The rationale behind the use of medicated lozenges as one of the most favored dosage form for the delivery of antitussive drugs. This review focuses various aspects of lozenge formulation providing an insight to the formulation scientist on novel application of lozenge drug delivery system. -
Phosphodiesterase (PDE)
Phosphodiesterase (PDE) Phosphodiesterase (PDE) is any enzyme that breaks a phosphodiester bond. Usually, people speaking of phosphodiesterase are referring to cyclic nucleotide phosphodiesterases, which have great clinical significance and are described below. However, there are many other families of phosphodiesterases, including phospholipases C and D, autotaxin, sphingomyelin phosphodiesterase, DNases, RNases, and restriction endonucleases, as well as numerous less-well-characterized small-molecule phosphodiesterases. The cyclic nucleotide phosphodiesterases comprise a group of enzymes that degrade the phosphodiester bond in the second messenger molecules cAMP and cGMP. They regulate the localization, duration, and amplitude of cyclic nucleotide signaling within subcellular domains. PDEs are therefore important regulators ofsignal transduction mediated by these second messenger molecules. www.MedChemExpress.com 1 Phosphodiesterase (PDE) Inhibitors, Activators & Modulators (+)-Medioresinol Di-O-β-D-glucopyranoside (R)-(-)-Rolipram Cat. No.: HY-N8209 ((R)-Rolipram; (-)-Rolipram) Cat. No.: HY-16900A (+)-Medioresinol Di-O-β-D-glucopyranoside is a (R)-(-)-Rolipram is the R-enantiomer of Rolipram. lignan glucoside with strong inhibitory activity Rolipram is a selective inhibitor of of 3', 5'-cyclic monophosphate (cyclic AMP) phosphodiesterases PDE4 with IC50 of 3 nM, 130 nM phosphodiesterase. and 240 nM for PDE4A, PDE4B, and PDE4D, respectively. Purity: >98% Purity: 99.91% Clinical Data: No Development Reported Clinical Data: No Development Reported Size: 1 mg, 5 mg Size: 10 mM × 1 mL, 10 mg, 50 mg (R)-DNMDP (S)-(+)-Rolipram Cat. No.: HY-122751 ((+)-Rolipram; (S)-Rolipram) Cat. No.: HY-B0392 (R)-DNMDP is a potent and selective cancer cell (S)-(+)-Rolipram ((+)-Rolipram) is a cyclic cytotoxic agent. (R)-DNMDP, the R-form of DNMDP, AMP(cAMP)-specific phosphodiesterase (PDE) binds PDE3A directly.