In-Silico Analysis of Potential Interaction of Drugs and the SARS-Cov-2 Spike Protein
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Cross-Linking of Alpha 2-Plasmin Inhibitor to Fibrin by Fibrin- Stabilizing Factor
Cross-linking of alpha 2-plasmin inhibitor to fibrin by fibrin- stabilizing factor. Y Sakata, N Aoki J Clin Invest. 1980;65(2):290-297. https://doi.org/10.1172/JCI109671. Research Article The concentration of alpha 2-plasmin inhibitor in blood plasma is higher than that in serum obtained from the blood clotted in the presence of calcium ions, but is the same as that in serum obtained in the absence of calcium ions. Radiolabeled alpha2-plasmin inhibitor was covalently bound to fibrin only when calcium ions were present at the time of clotting of plasma or fibrinogen. Whereas, when batroxobin, a snake venom enzyme that lacks the ability to activate fibrin- stabilizing factor, was used for clotting fibrinogen, the binding was not observed. When fibrin-stablizing, factor-deficient plasma was clotted, the specific binding of alpha 2-plasmin inhibitor to fibrin did not occur even in the presence of calcium ions and the concentration of alpha 2-plasmin inhibitor in serum was the same as that in plasma. Monodansyl cadaverine, a fluorescent substrate of the fibrin-stablizing factor, was incorporated into alpha 2-plasmin inhibitor by activated fibrin-stablizing factor. All these findings indicate that alpha 2-plasmin inhibitor is cross-linked to fibrin by activated fibrin-stabilizing factor when blood is clotted. Analysis of alpha 2-plasmin inhibitor-incorporated fibrin by sodium dodecyl sulfate gel electrophoresis showed that the inhibitor was mainly cross-linked to polymerized alpha-chains of cross-linked fibrin. Cross-linking of alpha 2-plasmin inhibitor to fibrin renders fibrin clot less susceptible to fibrinolysis by plasmin. -
Tavalisse™ (Fostamatinib) (Oral) Document Number: IC-0361 Last Review Date: 02/02/2021 Date of Origin: 06/01/2018 Dates Reviewed: 06/2018, 02/2019, 02/2020, 02/2021
Tavalisse™ (fostamatinib) (Oral) Document Number: IC-0361 Last Review Date: 02/02/2021 Date of Origin: 06/01/2018 Dates Reviewed: 06/2018, 02/2019, 02/2020, 02/2021 I. Length of Authorization Coverage is provided for six months and may be renewed. II. Dosing Limits A. Quantity Limit (max daily dose) [NDC Unit]: 100 mg tablets – 2 tablets per day 150 mg tablets – 2 tablets per day B. Max Units (per dose and over time) [HCPCS Unit]: 300 mg daily III. Initial Approval Criteria 1,2 Coverage is provided in the following conditions: Patient is at least 18 years of age; AND Universal Criteria 1 Patient is not receiving a thrombopoietin receptor agonist or mimetic (e.g., romiplostim, eltrombopag, lusutrombopag, avatrombopag, etc.); AND Laboratory values are current (i.e., drawn within the previous 28 days); AND Fostamatinib is not being used to attempt to normalize platelet count; AND Patient will avoid concomitant therapy with any of the following: o Coadministration with strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole, ketoconazole, etc.), or if therapy is unavoidable, the patient will be monitored closely for adverse reaction and/or dose modifications will be implemented; AND o Coadministration with strong CYP3A inducers (e.g., rifampin, carbamazepine, St. John’s Wort, etc.); AND Chronic Immune Thrombocytopenia (ITP) † 1-5 Patient has had persistent/chronic ITP for at least 3 months; AND Proprietary & Confidential © 2021 Magellan Health, Inc. Patient has previously failed any of the following treatments for ITP: Patient has failed previous therapy with corticosteroids (i.e., patient had no response to at least a 3-month trial or is corticosteroid-dependent); OR Patient has failed previous therapy with immunoglobulins; OR Patient has had a splenectomy; OR Patient has failed previous therapy with a thrombopoietin receptor agonist; AND The patient is at increased risk for bleeding as indicated by platelet count of less than 30 × 109/L (30,000/mm³) † FDA Approved Indication(s) IV. -
United States Patent (19) 11 Patent Number: 6,019,993 Bal (45) Date of Patent: Feb
USOO6O19993A United States Patent (19) 11 Patent Number: 6,019,993 Bal (45) Date of Patent: Feb. 1, 2000 54) VIRUS-INACTIVATED 2-COMPONENT 56) References Cited FIBRIN GLUE FOREIGN PATENT DOCUMENTS 75 Inventor: Frederic Bal, Vienna, Austria O 116 263 1/1986 European Pat. Off.. O 339 607 4/1989 European Pat. Off.. 73 Assignee: Omrix Biopharmaceuticals S.A., O 534 178 3/1993 European Pat. Off.. Brussels, Belgium 2 201993 1/1972 Germany. 2 102 811 2/1983 United Kingdom. 21 Appl. No.: 08/530,167 PCTUS85O1695 9/1985 WIPO. PCTCH920.0036 2/1992 WIPO. 22 PCT Filed: Mar. 27, 1994 PCT/SE92/ 00441 6/1992 WIPO. 86 PCT No.: PCT/EP94/00966 PCTEP9301797 7/1993 WIPO. S371 Date: Nov.30, 1995 Primary Examiner-Carlos Azpuru Attorney, Agent, or Firm-Jacobson, Price, Holman, & S 102(e) Date: Nov.30, 1995 Stern, PLLC 87 PCT Pub. No.: WO94/22503 57 ABSTRACT PCT Pub. Date: Oct. 13, 1994 A two-component fibrin glue for human application includes 30 Foreign Application Priority Data a) a component A containing i) a virus-inactivated and concentrated cryoprecipitate that contains fibrinogen, and ii) Mar. 30, 1993 EP European Pat. Off. .............. 93105298 traneXamic acid or a pharmaceutically acceptable Salt, 51 Int. Cl." A61F 2/06; A61K 35/14 thereof, and b) component B containing a proteolytic 52 U s C - - - - - - - - - - - - - - - - - - - - - - - - - - -424/426. 530,380, 530/381: enzyme that, upon combination with component A, cleaves, O X O -- O - - - s 530(383. 530ass Specifically, fibrinogen present in the cryoprecipitate of 58) Field of Search 424/426,530,380 component A, thereby, effecting a fibrin polymer. -
Safety and Efficacy of Prothrombin Complex Concentrate As First-Line
Cappabianca et al. Critical Care (2016) 20:5 DOI 10.1186/s13054-015-1172-6 RESEARCH Open Access Safety and efficacy of prothrombin complex concentrate as first-line treatment in bleeding after cardiac surgery Giangiuseppe Cappabianca1†, Giovanni Mariscalco2*† , Fausto Biancari3, Daniele Maselli4, Francesca Papesso1, Marzia Cottini1, Sandro Crosta5, Simona Banescu5, Aamer B. Ahmed6 and Cesare Beghi1 Abstract Background: Bleeding after cardiac surgery requiring surgical reexploration and blood component transfusion is associated with increased morbidity and mortality. Although prothrombin complex concentrate (PCC) has been used satisfactorily in bleeding disorders, studies on its efficacy and safety after cardiopulmonary bypass are limited. Methods: Between January 2005 and December 2013, 3454 consecutive cardiac surgery patients were included in an observational study aimed at investigating the efficacy and safety of PCC as first-line coagulopathy treatment as a replacement for fresh frozen plasma (FFP). Starting in January 2012, PCC was introduced as solely first-line treatment for bleeding following cardiac surgery. Results: After one-to-one propensity score–matched analysis, 225 pairs of patients receiving PCC (median dose 1500 IU) and FFP (median dose 2 U) were included. The use of PCC was associated with significantly decreased 24-h post-operative blood loss (836 ± 1226 vs. 935 ± 583 ml, p < 0.0001). Propensity score–adjusted multivariate analysis showed that PCC was associated with significantly lower risk of red blood cell (RBC) transfusions (odds ratio [OR] 0.50; 95 % confidence interval [CI] 0.31–0.80), decreased amount of RBC units (β unstandardised coefficient −1.42, 95 % CI −2.06 to −0.77) and decreased risk of transfusion of more than 2 RBC units (OR 0.53, 95 % CI 0.38–0.73). -
Blood Modifier Agents Policy #: Rx.01.208
Pharmacy Policy Bulletin Title: Blood Modifier Agents Policy #: Rx.01.208 Application of pharmacy policy is determined by benefits and contracts. Benefits may vary based on product line, group, or contract. Some medications may be subject to precertification, age, quantity, or formulary restrictions (ie limits on non-preferred drugs). Individual member benefits must be verified. This pharmacy policy document describes the status of pharmaceutical information and/or technology at the time the document was developed. Since that time, new information relating to drug efficacy, interactions, contraindications, dosage, administration routes, safety, or FDA approval may have changed. This Pharmacy Policy will be regularly updated as scientific and medical literature becomes available. This information may include new FDA-approved indications, withdrawals, or other FDA alerts. This type of information is relevant not only when considering whether this policy should be updated, but also when applying it to current requests for coverage. Members are advised to use participating pharmacies in order to receive the highest level of benefits. Intent: The intent of this policy is to communicate the medical necessity criteria for eltrombopag olamine (Promacta®), fostamatinib disodium (Tavalisse™), avatrombopag (Doptelet®), lusutrombopag (Mulpleta®) as provided under the member's prescription drug benefit. Description: Idiopathic thrombocytopenia purpura (ITP): ITP is an immune disorder in which the blood doesn't clot normally. ITP can cause excessive bruising and bleeding and can be characterized as an unusually low level of platelets, or thrombocytes, in the blood results in ITP. Thrombocytopenia in patients with hepatitis C: Thrombocytopenia can occur in patients with chronic hepatitis C virus (HCV) infection. -
A Study on Ulinastatin in Preventing Post ERCP Pancreatitis
International Journal of Advances in Medicine Vedamanickam R et al. Int J Adv Med. 2017 Dec;4(6):1528-1531 http://www.ijmedicine.com pISSN 2349-3925 | eISSN 2349-3933 DOI: http://dx.doi.org/10.18203/2349-3933.ijam20175083 Original Research Article A study on ulinastatin in preventing post ERCP pancreatitis R. Vedamanickam1, Vinoth Kumar2*, Hariprasad2 1Department of Medicine, 2Department of Gasto and Hepatology , SREE Balaji Medical College and Hospital, Chrompet, Chennai, Tamil Nadu, India Received: 19 September 2017 Accepted: 25 October 2017 *Correspondence: Dr. Vinothkumar, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Pancreatitis remains the major complication of endoscopic retrograde cholangiopancreatography (ERCP), and hyperenzymemia after ERCP is common. Ulinastatin, a protease inhibitor, has proved effective in the treatment of acute pancreatitis. The aim of this study was to assess the efficacy of ulinastatin, compare to placebo study to assess the incidence of complication due to ERCPP procedure. Methods: In this study a randomized placebo controlled trial, patients undergoing the first ERCP was randomizing to receive ulinastatin one lakh units (or) placebo by intravenous infusion one hour before ERCP for ten minutes duration. Clinical evaluation, serum amylase, ware analysed before the procedure 4 hours and 24 hours after the procedure. Results: Total of 46 patients were enrolled (23 in ulinastatin and 23 in placebo group). -
Antiproteases in Preventing Post-ERCP Acute Pancreatitis
JOP. J Pancreas (Online) 2007; 8(4 Suppl.):509-517. ROUND TABLE Antiproteases in Preventing Post-ERCP Acute Pancreatitis Takeshi Tsujino, Takao Kawabe, Masao Omata Department of Gastroenterology, Faculty of Medicine, University of Tokyo. Tokyo, Japan Summary there is no other randomized, placebo- controlled trial on ulinastatin under way. Pancreatitis remains the most common and Large scale randomized controlled trials potentially fatal complication following revealed that both the long-term infusion of ERCP. Various pharmacological agents have gabexate and the short-term administration of been used in an attempt to prevent post-ERCP ulinastatin may reduce pancreatic injury, but pancreatitis, but most randomized controlled these studies involve patients at average risk trials have failed to demonstrate their of developing post-ERCP pancreatitis. efficacy. Antiproteases, which have been Additional research is needed to confirm the clinically used to manage acute pancreatitis, preventive efficacy of these antiproteases in would theoretically reduce pancreatic injury patients at a high risk of developing post- after ERCP because activation of proteolytic ERCP pancreatitis. enzymes is considered to play an important role in the pathogenesis of post-ERCP pancreatitis. Gabexate and ulinastatin have Introduction recently been evaluated regarding their efficacy in preventing post-ERCP ERCP is widely performed for the diagnosis pancreatitis. Long-term (12 hours) infusion of and management of various pancreaticobiliary gabexate significantly decreased the incidence diseases. Early complications after ERCP of post-ERCP pancreatitis; however, no include acute pancreatitis, bleeding, prophylactic effect was observed for short- perforation, and infection (cholangitis and term infusion (2.5 and 6.5 hours). These cholecystitis) [1, 2]. Of these ERCP-related results may be due to the short-life of complications, pancreatitis remains the most gabexate (55 seconds). -
Characterisation, Classification and Conformational Variability Of
Characterisation, Classification and Conformational Variability of Organic Enzyme Cofactors Julia D. Fischer European Bioinformatics Institute Clare Hall College University of Cambridge A thesis submitted for the degree of Doctor of Philosophy 11 April 2011 This dissertation is the result of my own work and includes nothing which is the outcome of work done in collaboration except where specifically indicated in the text. This dissertation does not exceed the word limit of 60,000 words. Acknowledgements I would like to thank all the members of the Thornton research group for their constant interest in my work, their continuous willingness to answer my academic questions, and for their company during my time at the EBI. This includes Saumya Kumar, Sergio Martinez Cuesta, Matthias Ziehm, Dr. Daniela Wieser, Dr. Xun Li, Dr. Irene Pa- patheodorou, Dr. Pedro Ballester, Dr. Abdullah Kahraman, Dr. Rafael Najmanovich, Dr. Tjaart de Beer, Dr. Syed Asad Rahman, Dr. Nicholas Furnham, Dr. Roman Laskowski and Dr. Gemma Holli- day. Special thanks to Asad for allowing me to use early development versions of his SMSD software and for help and advice with the KEGG API installation, to Roman for knowing where to find all kinds of data, to Dani for help with R scripts, to Nick for letting me use his E.C. tree program, to Tjaart for python advice and especially to Gemma for her constant advice and feedback on my work in all aspects, in particular the chemistry side. Most importantly, I would like to thank Prof. Janet Thornton for giving me the chance to work on this project, for all the time she spent in meetings with me and reading my work, for sharing her seemingly limitless knowledge and enthusiasm about the fascinating world of enzymes, and for being such an experienced and motivational advisor. -
Alternatives and Adjuncts to Blood Transfusion
Joint United Kingdom (UK) Blood Transfusion and Tissue PDF Generated JPAC Transplantation Services Professional Advisory Committee 02/10/2021 03:05 Transfusion Handbook Update 6: Alternatives and adjuncts to blood transfusion http://www.transfusionguidelines.org/transfusion-handbook-update/6-alternatives-and-adjuncts-to-blood-transfusion 6: Alternatives and adjuncts to blood transfusion Essentials Transfusion alternatives were mostly developed to reduce blood use in surgery but have much wider application. They are most effective when used in combination and as part of a comprehensive patient blood management programme. Predeposit autologous blood donation before surgery is of uncertain benefit and now has very restricted indications in the UK. Intraoperative cell salvage (ICS) is effective (and may be life-saving) in elective or emergency high blood loss surgery and management of major haemorrhage. Postoperative cell salvage (PCS) and reinfusion can reduce blood use in joint replacement and scoliosis surgery. ICS and PCS are usually acceptable to Jehovah’s Witnesses. Tranexamic acid (antifibrinolytic) is inexpensive, safe and reduces mortality in traumatic haemorrhage. It reduces bleeding and transfusion in many surgical procedures and may be effective in obstetric and gastrointestinal haemorrhage. Off-label use of recombinant activated Factor VII (rFVIIa) for haemorrhage does not reduce mortality and can cause serious thromboembolic complications. Erythropoiesis stimulating agents (ESAs), such as erythropoietin, are standard therapy in renal anaemia and can support blood conservation in some cancer chemotherapy patients and autologous blood donation programmes. They may also be effective in selected patients with myelodysplasia. ESAs may cause hypertension and thromboembolic problems. Careful monitoring is required to keep the haematocrit below 35%. -
Farmaatsia- Terminoloogia Teine, Täiendatud Trükk
Farmaatsia- terminoloogia Teine, täiendatud trükk Graanulid Suspensioon Lahus Emulsioon Pillid Pulber Salv Kreem Aerosool Plaaster Sprei Pastill Tampoon Oblaat Emulsioon Kontsentraat Silmageel Tablett Haavapulk Ninatilgad Kapsel Lakukivi Inhalaator Farmaatsia- terminoloogia Teine, täiendatud trükk Tartu 2019 Koostajad: Toivo Hinrikus, Karin Kogermann, Ott Laius, Signe Leito, Ain Raal, Andres Soosaar, Triin Teppor, Daisy Volmer Keeletoimetaja: Tiina Kuusk Kirjastanud: Ravimiamet Nooruse 1, 50411 Tartu Telefon: +372 737 4140 Faks: +372 737 4142 E-post: [email protected] Esimene trükk 2010 Teine, täiendatud trükk 2019 Raamat on leitav Ravimiameti veebilehelt: www.ravimiamet.ee/farmaatsiaterminoloogia Väljaande refereerimisel või tsiteerimisel palume viidata allikale. ISBN 978-9949-9697-3-9 Sisukord Farmaatsiaterminoloogia Eestis..........................................................................................5 Üldised farmaatsiaalased terminid ...................................................................................10 Euroopa farmakopöa ......................................................................................................... 21 Euroopa farmakopöa sõnastik ..........................................................................................24 Standardterminid ..............................................................................................................29 Ravimvormid .....................................................................................................................29 -
New Drug Evaluation Monograph Template
© Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 | Fax 503-947-2596 Drug Class Review: Thrombocytopenia Date of Review: January 2019 End Date of Literature Search: 11/05/2018 Purpose for Class Review: Treatments for thrombocytopenia are being reviewed for the first time, prompted by the recent approval of three new drugs; avatrombopag (Doptelet®), fostamatinib (Tavalisse™) and lusutrombopag (Mulpleta®). Research Questions: 1. What is the evidence for efficacy and harms of thrombocytopenia treatments (avatrombopag, eltrombopag, lusutrombopag, fostamatinib, and romiplostim)? 2. Is there any comparative evidence for therapies for thrombocytopenia pertaining to important outcomes such as mortality, bleeding rates, and platelet transfusions? 3. Is there any comparative evidence based on the harms outcomes of thrombocytopenia treatments? 4. Are there subpopulations of patients for which specific thrombocytopenia therapies may be more effective or associated with less harm? Conclusions: Three guidelines, six randomized clinical trials and five high-quality systematic reviews and meta-analyses met inclusion criteria for this review. There was insufficient direct comparative evidence between different therapies to treat thrombocytopenia. A majority of trials were small and of short duration. Guidelines recommend corticosteroids and intravenous immunoglobulin (IVIg) as first-line therapy for most adults with idiopathic thrombocytopenia (ITP). Thrombopoietin receptor agonists (TPOs) and the tyrosine kinase inhibitor, fostamatinib, are recommended as second-line treatments after failure of at least one other treatment.1–3 Avatrombopag and lusutrombopag are only approved for short-term use before procedures in patients with chronic liver failure. -
EC-PSI: Associating Enzyme Commission Numbers with Pfam Domains
bioRxiv preprint doi: https://doi.org/10.1101/022343; this version posted July 10, 2015. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. EC-PSI: Associating Enzyme Commission Numbers with Pfam Domains Seyed Ziaeddin ALBORZI1;2, Marie-Dominique DEVIGNES3 and David W. RITCHIE2 1 Universite´ de Lorraine, LORIA, UMR 7503, Vandœuvre-les-Nancy,` F-54506, France 2 INRIA, Villers-les-Nancy,` F-54600, France 3 CNRS, LORIA, UMR 7503, Vandœuvre-les-Nancy,` F-54506, France Corresponding Author: [email protected] Abstract With the growing number of protein structures in the protein data bank (PDB), there is a need to annotate these structures at the domain level in order to relate protein structure to protein function. Thanks to the SIFTS database, many PDB chains are now cross-referenced with Pfam domains and enzyme commission (EC) numbers. However, these annotations do not include any explicit relationship between individual Pfam domains and EC numbers. This article presents a novel statistical training-based method called EC-PSI that can automatically infer high confi- dence associations between EC numbers and Pfam domains directly from EC-chain associations from SIFTS and from EC-sequence associations from the SwissProt, and TrEMBL databases. By collecting and integrating these existing EC-chain/sequence annotations, our approach is able to infer a total of 8,329 direct EC-Pfam associations with an overall F-measure of 0.819 with respect to the manually curated InterPro database, which we treat here as a “gold standard” reference dataset.