DOCSLIB.ORG

Neuromuscular Blockers/Alcuronium Chloride 1901 27

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Neuromuscular Blockers/Alcuronium Chloride 1901 27 Neuromuscular Blockers/Alcuronium Chloride 1901 27. Gin T, et al. Plasma catecholamines and neonatal condition after hyaline membrane disease but did appear to speed recov- area near the site of the injury, but such localised tetanus is induction of anaesthesia with propofol or thiopentone at caesar- ean section. Br J Anaesth 1993; 70: 311–116. ery of lung function. rare and can progress to the generalised form. The aetiology of intraventricular haemorrhage remains Treatment aims to destroy the causative organism and/or obscure but there is a well recognised association with ges- neutralise any unbound toxin in the body, to control rigid- Intensive care tational age;12 less mature neonates are more susceptible ity and muscle spasms, and to control autonomic dysfunc- The use of neuromuscular blockers in patients requiring and the incidence decreases sharply after 30 weeks’ gesta- tion. For the antibacterial treatment and prevention of mechanical ventilation as part of intensive care has been 1-3 4 tion. There appears to be an association between fluctuat- tetanus and neutralisation of tetanospasmin, see p.196. Af- discussed in a number of reviews and guidelines. Neu- ing cerebral blood-flow velocity in the first day of life and ter antibacterial therapy the mainstay of treatment of rigid- romuscular blockers are used to provide additional relaxa- subsequent development of intraventricular haemor- ity and spasms is sedation with benzodiazepines such as tion and facilitate ventilatory support in patients who fail rhage.13 Respiratory paralysis from the first day of life un- diazepam or midazolam; they may also reduce patient anx- to respond to sedation alone. It is important to ensure that til 72 hours of age has been reported14 to stabilise both cer- iety. Opioid analgesics can be added to treatment to pro- such patients are adequately sedated and relatively pain ebral and arterial blood-flow velocity and to produce a vide analgesia and additional sedation; in addition, fenta- free before these drugs are used. Patients who are consid- decrease in the incidence and severity of intraventricular nyl, morphine, and sufentanil may control autonomic ered most likely to benefit are those with spontaneous res- haemorrhage in infants with respiratory distress syndrome. overactivity. Antiepileptics, particularly phenobarbital, piration that is counterproductive to mechanical ventila- However, respiratory paralysis has also been reported to may also provide additional sedation. Chlorpromazine is tion. Patients with little inherent respiratory muscle have no effect on the development of intraventricular sometimes used with benzodiazepines to minimise rigidity activity are less likely to obtain an improvement in oxy- haemorrhage.9,10 and muscle spasms. Sedation with propofol may also con- genation. Neuromuscular blockers may also improve con- The use of neuromuscular blockers in the newborn is not trol spasms and rigidity without the need for an additional trol of intracranial pressure in patients with intracranial hy- without complications. Multiple joint contractures, possi- relaxant; however, mechanical ventilation is required. pertension, including prevention of rises in intracranial bly potentiated by use of aminoglycosides or phenobarbi- Centrally acting muscle relaxants have also been tried to pressure associated with routine tracheobronchial suction. tal, have been reported15,16 in infants given pancuronium, control muscle spasms. Baclofen has been given by the in- Pancuronium has been widely used as a neuromuscular and regular passive limb movements should be performed trathecal route, but its therapeutic range in severe tetanus blocker in intensive care because of its tendency to in- during paralysis. Marked oedema, severe disturbances of may be very narrow and deep coma and loss of spontane- crease arterial pressure and the majority of patients requir- fluid balance, renal failure and death have been reported in ous respiration has been reported. Dantrolene has also ing a neuromuscular blocker can be adequately managed 2 neonates.17 Hypoxaemia may develop after induction of been reported to be effective. When muscle spasms are se- with pancuronium; however, its long duration of action paralysis unless a significant increase in ventilator support vere or interfere with respiration, competitive neuromuscu- may be a problem in some circumstances, and its vagolytic is made;9,13,18 hypotension may also occur.19 Drugs such lar blockers have been used in addition to benzodiazepine activity can also produce tachycardia. Vecuronium, atracu- as pancuronium which are metabolised in the liver and ex- sedation, to control spasms and to induce therapeutic pa- rium, and cisatracurium have relatively few cardiovascular creted in the urine have a prolonged action in premature ralysis so mechanical ventilation can be initiated. effects, but there has been some concern over the ability of infants.7 As with adults (see above), continuous use of Control of autonomic overactivity may be achieved with the atracurium metabolite laudanosine to accumulate in neuromuscular blockers in neonates has been associated sedation; benzodiazepines, antiepileptics, and opioid the CNS (see Biotransformation, under Pharmacokinetics, with prolonged neuromuscular block on withdrawal.20 analgesics have all been used (see above). Beta blockers p.1905). Atracurium and cisatracurium may also be more 1. Coursin DB, et al. Muscle relaxants in critical care. Curr Opin such as propranolol have also been used; however, they are suitable in patients with hepatic or renal impairment as Anaesthesiol 1993; 6: 341–6. no longer recommended because of the potential for their metabolism does not lead to the accumulation of ac- 2. Elliot JM, Bion JF. The use of neuromuscular blocking drugs in intensive care practice. Acta Anaesthesiol Scand 1995; 39 (sup- severe cardiovascular effects. Labetalol has both alpha- tive metabolites. Other neuromuscular blockers that have pl 106): 70–82. and beta-blocking activity but offers no advantage over been used in intensive care include doxacurium, pipecuro- 3. Lewis KS, Rothenberg DM. Neuromuscular blockade in the in- propranolol. More recently, esmolol, a short-acting beta nium, and rocuronium. tensive care unit. Am J Health-Syst Pharm 1999; 56: 72–5. 4. Murray MJ, et al. Clinical practice guidelines for sustained neu- blocker, has been used. Magnesium sulfate has been found Close monitoring of neuromuscular blockade is recom- romuscular blockade in the adult critically ill patient. Am J to minimise autonomic disturbance in ventilated patients mended since the pharmacodynamics and pharmacokinet- Health-Syst Pharm 2002; 59: 179–95. and controls spasms in non-ventilated patients, but there is 5. Fischer JR, Baer RK. Acute myopathy associated with com- ics of neuromuscular blockers may be altered in patients in bined use of corticosteroids and neuromuscular blocking agents. need for further investigation. Electrolyte disturbance is intensive care;1-4 this should also allow the lowest effec- Ann Pharmacother 1996; 30: 1437–45. corrected with calcium and magnesium salts. tive neuromuscular blocking dose to be used, and reduce 6. Watling SM, Dasta JF. Prolonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents: a re- References. adverse events. Prolonged neuromuscular blockade has view of the literature. Crit Care Med 1994; 22: 884–93. 1. Attygalle D, Karalliedde L. Unforgettable tetanus. Eur J Anaes- been related to dosage. 7. Levene MI, Quinn MW. Use of sedatives and muscle relaxants thesiol 1997; 14: 122–33. in newborn babies receiving mechanical ventilation. Arch Dis 2. Ernst ME, et al. Tetanus: pathophysiology and management. Ann Other factors that may potentiate neuromuscular blockade Child 1992; 67: 870–3. Pharmacother 1997; 31: 1507–13. include drug interactions, electrolyte imbalance, hypother- 8. Cools F, Offringa M. Neuromuscular paralysis for newborn in- 3. Farrar JJ, et al. Tetanus. J Neurol Neurosurg Psychiatry 2000; mia, or changes in acid–base balance.1,3 Conversely, dos- fants receiving mechanical ventilation. Available in The Co- 69: 292–301. chrane Database of Systematic Reviews; Issue 2. Chichester: 4. Cook TM, et al. Tetanus: a review of the literature. Br J Anaesth age requirements may be increased in patients with burns John Wiley; 2005 (accessed 20/10/05). 2001; 87: 477–87. or in those receiving prolonged therapy. Tachyphylaxis has 9. Greenough A, et al. Pancuronium prevents pneumothoraces in 5. Edlich RF, et al. Management and prevention of tetanus. J Long occurred with some neuromuscular blockers, but may re- ventilated premature babies who actively expire against positive Term Eff Med Implants 2003; 13: 139–54. pressure inflation. Lancet 1984; i: 1–3. solve on switching to another blocker. 6. Okoromah CN, Lesi FE. Diazepam for treating tetanus. Availa- 10. Cooke RWI, Rennie JM. Pancuronium and pneumothorax. Lan- ble in The Cochrane Database of Systematic Reviews; Issue 1. Prolonged neuromuscular blockade has been associated cet 1984; i: 286–7. Chichester: John Wiley; 2004 (accessed 18/05/06). 11. Pollitzer MJ, et al. Pancuronium during mechanical ventilation with adverse effects and should be avoided when possible. speeds recovery of lungs of infants with hyaline membrane dis- Recovery after withdrawal of prolonged treatment may be ease. Lancet 1981; i: 346–8. longer than pharmacologically predicted due to the accu- 12. Miall-Allen VM, et al. Blood pressure fluctuation and intraven-
Load more

Recommended publications
  • 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]
  • Veterinary Anaesthesia (Tenth Edition)
    W. B. Saunders An imprint of Harcourt Publishers Limited © Harcourt Publishers Limited 2001 is a registered trademark of Harcourt Publishers Limited The right of L.W. Hall, K.W. Clarke and C.M. Trim to be identified as the authors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers (Harcourt Publishers Limited, Harcourt Place, 32 Jamestown Road, London NW1 7BY), or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency Limited, 90 Tottenham Court Road, London W1P 0LP. First edition published in 1941 by J.G. Wright Second edition 1947 (J.G. Wright) Third edition 1948 (J.G. Wright) Fourth edition 1957 (J.G. Wright) Fifth edition 1961 (J.G. Wright and L.W. Hall) Sixth edition 1966 (L.W. Hall) Seventh edition 1971 (L.W. Hall), reprinted 1974 and 1976 Eighth edition 1983 (L.W. Hall and K.W. Clarke), reprinted 1985 and 1989 Ninth edition 1991 (L.W. Hall and K.W. Clarke) ISBN 0 7020 2035 4 Cataloguing in Publication Data: Catalogue records for this book are available from the British Library and the US Library of Congress. Note: Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The authors and the publishers have taken care to ensure that the information given in this text is accurate and up to date.
    [Show full text]
  • Muscle Relaxants
    Muscle relaxants ●cause relaxation of striated (voluntary skeletal) musculature (in contrast to spasmolytics which relax unstriped musculature) Classification of myorelaxants 1. Neuromuscular blocking drugs ●periferial (direct) myorelaxants: interact with acetylcholine nicotinic (N) receptors of skeletal musculature a) stabilizing myorelaxants – N-receptors antagonists b) depolarizing myorelaxants – N-receptors agonists ●continuous N-receptors stimulation depolarization of cells functional antagonism: further leading of impulses imposible, no muscle contraction c) indirect myorelaxants: botulinum toxin ●irreversibly inhibits acetycholine releasing 2. Central muscle relaxants ●acts in CNS ●structurally heterogenic group ●compounds with various mechanisms of action Stabilizing myorelaxants ●N-receptors antagonists in skeletal muscle cells ●usage: surgical operative measures (often as a part of some form of anaesthesia) ●structures derived from curare alkaloids Curare: arrow poison of South American Indians ●preparation from various plants ●contained a complex mixture of alkaloids Curare classification: according to preparation and package in which it was shipped to Europe 1. Tubocurare: in hollow bamboo rods 2. Calebase curare: in bottle-shaped cucurbits (gourds, calabashes - from plants of genus Strychnos) 3. Pot curare: in ceramic vessels Structural types: 1. Benzyltetrahydroisoquinolines: tubocurarine (from tubocurare) atracurium besylate (synthetic) mivacurium besylate (synthetic) etc. 2. Indole derivatives: toxiferine C alcuronium chloride 3. Steroids with basic substituents: vecuronium bromide pancuronium bromide rocuronium bromide 1. Benzyltetrahydroisoquinolines H3C O H C O O CH3 3 H3C H + H3C H C O O H3C N O 3 OH H C 3 O O H3C H H H + CH + N 3 O O N OH O CH3 N CH3 O O O H3C O CH3 O CH3 tubocurarine atracurium ●used as besylate Tracrium ® inj.
    [Show full text]
  • EUROPEAN PHARMACOPOEIA 10.0 Index 1. General Notices
    EUROPEAN PHARMACOPOEIA 10.0 Index 1. General notices......................................................................... 3 2.2.66. Detection and measurement of radioactivity........... 119 2.1. Apparatus ............................................................................. 15 2.2.7. Optical rotation................................................................ 26 2.1.1. Droppers ........................................................................... 15 2.2.8. Viscosity ............................................................................ 27 2.1.2. Comparative table of porosity of sintered-glass filters.. 15 2.2.9. Capillary viscometer method ......................................... 27 2.1.3. Ultraviolet ray lamps for analytical purposes............... 15 2.3. Identification...................................................................... 129 2.1.4. Sieves ................................................................................. 16 2.3.1. Identification reactions of ions and functional 2.1.5. Tubes for comparative tests ............................................ 17 groups ...................................................................................... 129 2.1.6. Gas detector tubes............................................................ 17 2.3.2. Identification of fatty oils by thin-layer 2.2. Physical and physico-chemical methods.......................... 21 chromatography...................................................................... 132 2.2.1. Clarity and degree of opalescence of
    [Show full text]
  • Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DIX to the HTSUS—Continued
    20558 Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DEPARMENT OF THE TREASURY Services, U.S. Customs Service, 1301 TABLE 1.ÐPHARMACEUTICAL APPEN- Constitution Avenue NW, Washington, DIX TO THE HTSUSÐContinued Customs Service D.C. 20229 at (202) 927±1060. CAS No. Pharmaceutical [T.D. 95±33] Dated: April 14, 1995. 52±78±8 ..................... NORETHANDROLONE. A. W. Tennant, 52±86±8 ..................... HALOPERIDOL. Pharmaceutical Tables 1 and 3 of the Director, Office of Laboratories and Scientific 52±88±0 ..................... ATROPINE METHONITRATE. HTSUS 52±90±4 ..................... CYSTEINE. Services. 53±03±2 ..................... PREDNISONE. 53±06±5 ..................... CORTISONE. AGENCY: Customs Service, Department TABLE 1.ÐPHARMACEUTICAL 53±10±1 ..................... HYDROXYDIONE SODIUM SUCCI- of the Treasury. NATE. APPENDIX TO THE HTSUS 53±16±7 ..................... ESTRONE. ACTION: Listing of the products found in 53±18±9 ..................... BIETASERPINE. Table 1 and Table 3 of the CAS No. Pharmaceutical 53±19±0 ..................... MITOTANE. 53±31±6 ..................... MEDIBAZINE. Pharmaceutical Appendix to the N/A ............................. ACTAGARDIN. 53±33±8 ..................... PARAMETHASONE. Harmonized Tariff Schedule of the N/A ............................. ARDACIN. 53±34±9 ..................... FLUPREDNISOLONE. N/A ............................. BICIROMAB. 53±39±4 ..................... OXANDROLONE. United States of America in Chemical N/A ............................. CELUCLORAL. 53±43±0
    [Show full text]
  • Jämförelse Av Olika Övervakningstekniker För Monitorering Av Neuromuskulär Blockad Vid Ögonkirurgi Applicerbarhet Av Elektromyograf Tetragraph (Senzime) På Hund
    Fakulteten för veterinärmedicin och husdjursvetenskap Jämförelse av olika övervakningstekniker för monitorering av neuromuskulär blockad vid ögonkirurgi Applicerbarhet av elektromyograf TetraGraph (Senzime) på hund A comparative study of different techniques for monitoring of neuromuscular blockade during ophthalmology surgery Application of electromyograph TetraGraph (Senzime) in dogs Jonathan Sverud Uppsala 2020 Examensarbete 30 hp inom Veterinärprogrammet Jämförelse av olika övervakningstekniker för monitorering av neuromuskulär blockad vid ögonkirurgi Applicerbarhet av elektromyograf TetraGraph (Senzime) på hund A comparative study of different techniques for monitoring of neuromuscular blockade during ophthalmology surgery Application of electromyograph TetraGraph (Senzime) in dogs Jonathan Sverud Handledare: Görel Nyman, institutionen för kliniska vetenskaper Biträdande handledare: Lena Ström & Desiree Ferrari, institutionen för kliniska vetenskaper Examinator: Patricia Hedenqvist, institutionen för kliniska vetenskaper Examensarbete i veterinärmedicin Omfattning: 30 hp Nivå och fördjupning: Avancerad nivå, A2E Kurskod: EX0869 Kursansvarig institution: Institutionen för kliniska vetenskaper Utgivningsort: Uppsala Utgivningsår: 2020 Elektronisk publicering: https://stud.epsilon.slu.se Omslagsillustration: fotografiet taget av Desiree Ferrari Nyckelord: anestesi, övervakning, neuromuskulär blockad, acceleromyografi, elektromyografi, mekanomyografi, hund Key words: anaesthesia, monitor, neuromuscular blockade, acceleromyogaphy, electromyography,
    [Show full text]
  • Stembook 2018.Pdf
    The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances FORMER DOCUMENT NUMBER: WHO/PHARM S/NOM 15 WHO/EMP/RHT/TSN/2018.1 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances. Geneva: World Health Organization; 2018 (WHO/EMP/RHT/TSN/2018.1). Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data.
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 7,199,151 B2 Shashoua Et Al
    US007 1991.51B2 (12) United States Patent (10) Patent No.: US 7,199,151 B2 Shashoua et al. (45) Date of Patent: *Apr. 3, 2007 (54) DHA-PHARMACEUTICAL AGENT 4,692,441 A 9, 1987 Alexander et al. CONUGATES OF TAXANES 4,704,393 A 11/1987 Wakabayashi et al. 4,729,989 A 3, 1988 Alexander (75) Inventors: Victor E. Shashoua, Brookline, MA 4,788,063 A 11/1988 Fisher et al. (US); Charles E. Swindell, Merion, PA is: A RE s al (US); Nigel L. Webb, Bryn Mawr, PA 4s68161. A 9, 1989 Roberts (US); Matthews O. Bradley, 4.902,505 A 2/1990 Pardridge et al. Laytonsville, MD (US) 4,933,324. A 6/1990 Shashoua 4,939,174 A 7, 1990 Shashoua (73) Assignee: Luitpold Pharmaceuticals, Inc., 4,943,579 A 7, 1990 Vishnuvajala et al. Shirley, NY (US) 4,968,672 A 1 1/1990 Jacobson et al. 5,059,699 A 10/1991 Kingston et al. (*) Notice: Subject to any disclaimer, the term of this 5,068,224. A 11/1991 Fryklund et al. patent is extended or adjusted under 35 5, 112,596 A 5/1992 Malfroy-Camine U.S.C. 154(b) by 81 days. 5, 112,863 A 5/1992 Hashimoto et al. 5,116,624 A 5/1992 Horrobin et al. This patent is Subject to a terminal dis- 5, 120,760 A 6/1992 Horrobin claimer. 5,141,958 A 8, 1992 Crozier-Willi et al. 5,169,762 A 12/1992 Grey et al. (21) Appl. No.: 10/618,884 5,169,764 A 12/1992 Shooter et al.
    [Show full text]
  • RH DH HC HP 1 1.01 Ketamine Injection 50Mg/Ml Thiopentone
    GUYANA EDL 2009-2010 Product Dose Form Strength RH DH HC HP 1 Anaesthetics 1.01 General Anaesthetics and oxygen 1.01.01 Intravenous Ketamine Injection 50mg/ml Pdr. for Thiopentone Sodium 0.5g injection Propofol Injection 10mg/ml 1.01.02 Inhalation Halothane Vol. liquid Soda lime Pellet Nitrous oxide Gas Complementary Drugs Enflurane Vol. liquid 1.02 Local Anaesthetics Bupivacaine Injection 0.50% 0.5% in dextrose Bupivacaine (spinal) heavy Injection 7.5% Ethyl chloride Spray Lidocaine Spray 10% Lidocaine (hydrochloride) Injection 1%, 2% Lidocaine (hydrochloride), Injection 5%/2ml spinal heavy Lidocaine hydrochloride + Injection 2% + 1:80 000 epinephrine (den.) Preoperative Medication and Sedation for Short-Term Procedures 1.03 Midazolam Injection 5mg/ml Diazepam Tablet 5mg 2 Analgesics, Antipyretics, Nonsteroidal Anti-Inflammatory Drugs (NSAID); Drugs 2.01 Non-Opioids Acetylsalicylic acid Tablet 500mg Diclofenac sodium Injection 25mg/ml * Diclofenac sodium Tablet 25mg, 75mg Diclofenac sodium Suppositories 50 mg Ibuprofen Tablet 200, 400 mg 60 mg, Paracetamol Suppositories 120mg Paracetamol Tablet 500mg Paracetamol Syrup 120mg/5ml Complementary Drugs Metamizole sodium Injection 500 mg/ml 2.02 Opioid Analgesics Codeine Tablet 30mg Co-codamol Tablet 30 mg+ 500 mg (codeine+ paracetamol) Morphine Injection 10mg/ml Morphine Oral Sol. 10mg/5ml Morphine Tablet 10mg Morphine SR (10a) Tablet 30mg Complementary Drugs Fentanyl (10a) Injection 0.5mg/10 ml Methadone Injection 10 mg/ml Methadone Tablet 5mg 50mg/ml, Pethidine
    [Show full text]
  • Harmonized Tariff Schedule of the United States (2004) -- Supplement 1 Annotated for Statistical Reporting Purposes
    Harmonized Tariff Schedule of the United States (2004) -- Supplement 1 Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE Harmonized Tariff Schedule of the United States (2004) -- Supplement 1 Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 2 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. Product CAS No. Product CAS No. ABACAVIR 136470-78-5 ACEXAMIC ACID 57-08-9 ABAFUNGIN 129639-79-8 ACICLOVIR 59277-89-3 ABAMECTIN 65195-55-3 ACIFRAN 72420-38-3 ABANOQUIL 90402-40-7 ACIPIMOX 51037-30-0 ABARELIX 183552-38-7 ACITAZANOLAST 114607-46-4 ABCIXIMAB 143653-53-6 ACITEMATE 101197-99-3 ABECARNIL 111841-85-1 ACITRETIN 55079-83-9 ABIRATERONE 154229-19-3 ACIVICIN 42228-92-2 ABITESARTAN 137882-98-5 ACLANTATE 39633-62-0 ABLUKAST 96566-25-5 ACLARUBICIN 57576-44-0 ABUNIDAZOLE 91017-58-2 ACLATONIUM NAPADISILATE 55077-30-0 ACADESINE 2627-69-2 ACODAZOLE 79152-85-5 ACAMPROSATE 77337-76-9 ACONIAZIDE 13410-86-1 ACAPRAZINE 55485-20-6 ACOXATRINE 748-44-7 ACARBOSE 56180-94-0 ACREOZAST 123548-56-1 ACEBROCHOL 514-50-1 ACRIDOREX 47487-22-9 ACEBURIC ACID 26976-72-7
    [Show full text]
  • Muscle Relaxants
    Muscle relaxants ●cause relaxation of striated (voluntary skeletal) musculature (in contrast to spasmolytics which relax unstriped musculature) Classification of myorelaxants 1. Neuromuscular blocking drugs = periferial (direct) myorelaxants ●interact with acetylcholine nicotinic (N) receptors of skeletal musculature a) stabilizing myorelaxants – N-receptors antagonists b) depolarizing myorelaxants – N-receptors agonists ●continuous N-receptors stimulation ⇒ depolarization of cells ⇒ functional antagonism: further leading of impulses imposible, no muscle contraction c) indirect myorelaxants: botulin ●irreversibly inhibits acetycholine releasing 2. Central muscle relaxants ●acts in CNS ●structurally heterogenic group ●compounds with various mechanisms of action Stabilizing myorelaxants ●N-receptors antagonists in skeletal muscle cells ●usage: surgical operative measures (often as a part of some form of anaesthesia) ●structures derived from curare alkaloids Curare: arrow poison of South American Indians ●preparation from various plants ●contained a complex mixture of alkaloids Curare classification: according to preparation and package in which it was shipped to Europe 1. Tubocurare: in hollow bamboo rods 2. Calebase curare: in bottle-shaped cucurbits (gourds, calabashes - from plants of genus Strychnos) 3. Pot curare: in ceramic vessels Structural types: 1. Benzyltetrahydroisoquinolines: tubocurarine (from tubocurare) atracurium besylate (synthetic) mivacurium besylate (synthetic) etc. 2. Indole derivatives: toxiferine C alcuronium chloride 3. Steroids with basic substituents: vecuronium bromide pancuronium bromide rocuronium bromide 1. Benzyltetrahydroisoquinolines H3C O H C O O CH3 3 H3C H + H3C H C O O H3C N O 3 OH H C 3 O O H3C H H H + CH + N 3 O O N O OH CH3 N CH3 O O O H3C O CH3 O CH3 tubocurarine atracurium ●used as besylate Tracrium ® inj.
    [Show full text]
  • ICCB-L Plate (10 Mm / 3.33 Mm) ICCB-L Well Vendor ID Chemical Name
    ICCB-L Plate ICCB-L Therapeutic Absorption Protein FDA Additional info Additional info Vendor_ID Chemical_Name CAS number Therapeutic class Target type Target names (10 mM / 3.33 mM) Well effect tissue binding approved type detail Pharmacological 3712 / 3716 A03 Prestw-1 Azaguanine-8 134-58-7 Oncology Antineoplastic tool 3712 / 3716 A05 Prestw-2 Allantoin 97-59-6 Dermatology Antipsoriatic Carbonic 3712 / 3716 A07 Prestw-3 Acetazolamide 59-66-5 Metabolism Anticonvulsant Enzyme Carbonic anhydrase GI tract Yes anhydrase Potential Plasmatic New therapeutic 3712 / 3716 A09 Prestw-4 Metformin hydrochloride 1115-70-4 Endocrinology Anorectic GI tract Yes anticancer proteins use agent Chemical Plasmatic classification Quaternary 3712 / 3716 A11 Prestw-5 Atracurium besylate 64228-81-5 Neuromuscular Curarizing Yes proteins (according ATC ammonium code) 3712 / 3716 A13 Prestw-6 Isoflupredone acetate 338-98-7 Endocrinology Anti-inflammatory Therapeutic Amiloride-sensitive classification Potassium- 3712 / 3716 A15 Prestw-7 Amiloride hydrochloride dihydrate 17440-83-4 Metabolism Antihypertensive LGIC GI tract Yes sodium channel, ENaC (according ATC sparing agent code) 3712 / 3716 A17 Prestw-8 Amprolium hydrochloride 137-88-2 Infectiology Anticoccidial Veterinary use Poultry Therapeutic Solute carrier family 12 Plasmatic classification Low-ceiling 3712 / 3716 A19 Prestw-9 Hydrochlorothiazide 58-93-5 Metabolism Antihypertensive Carrier GI tract Yes member 3 proteins (according ATC diuretic code) Chemical classification 3712 / 3716 A21 Prestw-10 Sulfaguanidine
    [Show full text]