Preface .3 1 Introduction .3 2 General characteristics of pharmaceuticals.4 3 Pharmaceutical metabolism and excretion.6 4 Sources of emission of pharmaceutical compounds .8 5 Variety of pharmaceutical compounds .9 5.1 Group A alimentary tract and metabolism.9 5.2 Group B blood and blood forming organs.9 5.3 Group C cardiovascular system.10 5.4 Group J antibiotics.11 5.5 Group N nervous system .11 5.6 Group pain relievers, antiphlogistics, analgesics, anti-inflammatories, non-steroidal drugs.14 5.7 Group V - contrast media .14 6 Properties of pharmaceuticals .14 Quantities of pharmaceuticals used Dutch situation ; .16 7 8 Occurrence in aquatic environment .20 8.1 Wastewater .20 8.2 Hospital wastewater .20 8.3 Surface water.20 8.4 Ground water.22 8.5 Drinking water.22 8.6 Sewage sludge .22 8.7 Predicted environmental concentrations.22 9 Selected pharmaceutical compounds .23 10 Transformation of pharmaceuticals.25 10.1 Biodegradation .25 10.2 Sorption onto sludge.28 10.3 Stripping .30 10.4 Chemical oxidation.31 11 Transformation of pharmaceuticals during treatment .31 11.1 General in a STP.31 11.2 Per process unit .37 11.2.1 Pre-treatment: .37 11.2.2 Physico-chemical processes.38 11.2.3 Main Treatment.39 11.3 Anaerobic sludge digestion .42 11.4 Tertiary Treatment.42 11.5 Nutrient recovery.46 12 Analytical methods.46 12.1 General .46 12.2 Sampling.48 12.3 Extraction, enrichment, clean-up.48 12.4 Chromatography and mass spectrometry .49 12.4.1 GC MS ; .49 12.4.2 HPLC, LC, LC MS MS .50 12.4.3 Quality assurance .50 13 Conclusions .51 14 References.51.
Drugs currently available for the treatment of hsv infections inhibit viral dna replication by targeting dna polymerase, for instance, amoxicillin clavulanate 875 mg.
MOYER, J. H., AND Clinical Pharmacology Benzothiadiazine.
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Been lacking in some trials.23, 30, 31 Exclusion of strokes that did not include an NIHSS motor component score of at least 2 decreased the chances of having too many mild strokes with a high spontaneous recovery rate, thus causing a type II error. Another unique feature was the use of the trichotomized BI as a primary outcome measure. In previous stroke trials, various cutoff scores have been used for the BI, but less than 60 has been the time-honored categorization for definite dependence.32 The additional BI cutoff score of 95 was chosen on the basis of the NINDS study as a measure of definite independence.19 Stroke forums, such as the Stroke Therapy Academic Industry Roundtable II, have emphasized the importance of a highly involved steering committee working in partnership with the industry sponsor. In the GAIN Americas trial, the protocol was developed by an independent academic steering committee working with the pharmaceutical sponsor. Moreover, this academicindustry collaborative group remained active in the ongoing supervision of the trial, while the GAIN Americas database was managed and analyzed at an academic center, for instance, amoxicillin k clavulanate.
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'From the Aller Clinical Immunolo Unit, Cook County Department of ~ed%trics, Rush-Medicd Hospital, and Center, Chicago. Read before the American College of Allergists' Symposium on Management of Asthma, Bal Harbor, Fla, March 17, 1975. -. This study was approved by the institutional committee for human research. "Director of Allergy Clinical Immunology and Associate Professor of Pediatrics. tDirector of Allergy Clinical Immunology Unit and Professor of Pediatrics. Manuscript received September 24, 1975; revision accepted May 28. Reprint requests: Dr. Hyde, 1753 West Congress Pmkwny, Chfcago60612.
Most ESBLs are in Klebsiella spp. and E. coli and detection is facilitated - these species do not have any inducible AmpC enzyme. Detection is harder in an Enterobacter because there is the inducible AmpC enzyme. Clavulanqte can induce this AmpC, which attacks the cephalosporins and is not inhibited. The options are doing an E test which will probably be 70-80% accurate. Alternatively you can also do some interpretative reading. If the Enterobacter is susceptible to piperacillin tazobactam and cefotetan and resistant to the cephalosporins it almost certainly has an ESBL, not a hyperproduced AmpC. If it is resistant to piperacillin tazobactam and cefotetan as well as the cephalosporins it is most likely to have an AmpC, but it still might have a very high level of ESBL plus impermeability, or it might have an ESBL plus an AmpC. In France and Belgium there is an enthusiasm for testing synergy between cefepime and clavulanate. Cefepime is reasonably stable to AmpC whereas it is hydrolysed by ESBLs. So the logic is that cefepime clavulanate can be used as a detection system just as ceftazidime and clavulanate is used. However, cefepime is not a very good substrate for some ESBLs and the French Belgium experience is dominated by the dissemination of a few Enterobacter aerogenes strains with TEM-24 and ampicillin.
Automotive and computer equipment Leasehold and building improvements Trademarks, trademark licenses and manufacturing rights Bond discount was amortized on a straight-line basis over a five-year period until 2000. Goodwill is amortized on a straight-line basis over periods of 15 or years. Management evaluates the value of the unamortized portion of goodwill, trademarks, trademark licenses and manufacturing rights annually by comparing the carrying value to the future benefits of the companies' activities or the expected sale of pharmaceutical products. Should there be a permanent impairment in value or if the unamortized balance exceeds recoverable amounts, a write-down will be recognized for the current year. Stock options The Company has granted stock options as described in Note 17. No compensation expense is recognized when stock options are issued to employees. Any consideration paid by employees on the exercise of stock options is credited to capital stock. Foreign currency translation The current rate method of translation of foreign currencies is followed for subsidiaries, or joint-ven.
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Strains of H. influenzae averages about 20% 48 ; , and levels as high as 30% have been reported 49 ; . Studies conducted in Mexico have found a 30% prevalence of isolated strains of -lactamase-producing H. influenzae in cases of acute sinusitis alone or in association with otitis media 50 ; . By the same token, the presence of B. catarrhalis more recently denominated Moraxella cartarrhalis ; in 8% to 12% of the cases of AOM, but with -lactamase production ascribed to over 75% of the strains, has had a significant impact on current AOM management. With an appropriate antibiotic therapy, most children with AOM will undergo significant improvement within 48 to 72 hours of initiating treatment. If a positive response is not seen, and persistent or recurrent pain, fever, or both are observed during treatment, tympanocentesis should be conducted to determine the germ and its sensitivity in order to select the appropriate antimicrobial agent. If it is not possible to perform this procedure, treatment should resort to so-called second-line antibiotics that have demonstrated their efficacy against -lactamase-producing strains of H. influenzae and B. catarrhalis. There are many such antibiotics whose usefulness has been demonstrated through studies. The first of these drugs, recommended for localities where -lactamase-producing strains of H. influenzae are commonly found, is erythromycin-sulfisoxazole 41-45 ; or TMP-SMX 49 ; , which nevertheless should not be administered when streptococcal pharyngitis is associated with otitis because of its ineffectiveness against S. pyogenes. On the other hand, other alternative therapies have been proposed, such as cefaclor 40 mg kg day for 10 days ; , which is effective unlike cefadroxil ; against all the -lactamase-producing organisms, except some B. catarrhalis strains that produce that enzyme. The most serious secondary effects of cefaclor are the reactions similar to serum disease, with erythema multiforme, arthritis, or arthralgia 51 ; . Another option is the amoxicillin-clavulanate compound, which has been shown to be effective in treating otitis media brought on by resistant bacteria 52 ; . Secondary effects of this medication, when administered in doses of 40 mg kg day divided in three doses per day over 10 days on the basis of the amoxicillin ; , presented in 33% of the cases treated; the most frequent being diarrhea 19% ; , followed by neutropenia 14% ; and occasional urticarial eruptions 53 ; . h.1 ; Antihistamine and other decongestants According to Wald, antihistamine decongestants are not effective either in preventing the development of middle ear drainage or in helping to resolve it once it has presented. If these drugs are used to treat an upper respiratory tract infection, it should be with the knowledge that although they may provide considerable relief of nasal symptoms not of drainage ; , this relief is accompanied by even higher costs and toxicity 54 ; . Applying drops containing antibiotics directly to the external auditory canal of children with AOM and intact tympanic membrane is not recommended. h.2 ; Chemoprophylaxis Chemoprophylaxis is recommended for children who undergo three bouts of otitis media in a 6-month period or four bouts in 12 months, with at least one episode in.
Prostate. The dog was still able to urinate. Urine was collected and noted to be cloudy, malodorous and purulent. The urine was submitted for urinalysis and bacterial culture. Urinalysis confirmed pyuria with more than 200 neutrophils per high power field, a mixed bacterial population, and occasional triple phosphate crystals. The urine was isosthenuric, with pH of 9.0. The culture grew a heavy mixed growth of non-haemolytic Escherichia coli and haemolytic Streptococcus spp sensitive to amoxycillin-clavulanate. Abdominal radiographs revealed the and arava.
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Comparing Treatment Patterns, Patient Persistence on Medication, and Economic Outcomes of an Ethnically Diverse Group of Women with Overactive Bladder Taira DA * , Davis, J., Kessel B., Brizzolara S., Williamson T., Lofgren K. Hawaii Medical Service Association, P Box 860, Honolulu, HI 96808-0860 .O.
Except as noted above, no other single pharmaceutical product or category of products accounted for more than 10% of net revenue in 2004, 2003 or 200 consumer healthcare segment the consumer healthcare segment manufactures, distributes and sells over-the-counter health care products and atarax.
This name, unlike co-trimoxazole, has not been widely adopted internationally and the combination product is usually referred to avandia com by various drugs prescription names such as amoxicillin with clavulanic acid or amoxicillin + clavulanate or simply by the trade name.
Ammonium sulfate ; , incubated at 370 C for 1 h and treated with cefotaxime and clavulanate as described above. When the cells were screened for auxotrophy for each of the five amino acids, over 50 mutants were found. The lack of a good selection technique for auxotrophic mutants of Bacillus species constitutive for 3-lactamase has resulted in a dearth of genetic studies and mutant analyses for these strains. By incorporating the inhibitor clavulanic acid into the penicillin selection procedure, we have shown that a wide range of auxotrophic mutants can be isolated from one such strain, B. licheniformnis AS. This procedure can be readily adopted for mutant isolation in other bacterial and atorvastatin.
A requirement of BC's residential care admission criteria is that clients must accept the first available and appropriate bed. Because there are differences in out-of-pocket charges in different facilities, the amount residents will be charged for such items as over-the-counter medications, room differentials, and certain therapies is a matter of pure chance, depending upon where the first appropriate bed becomes available when the client is assessed as qualifying for residence. The client must generally occupy the bed within forty-eight hours of being advised of the availability of the bed; and must agree to pay all applicable costs of the particular facility which has a bed available. The current system allows for patients to receive different levels of insured service for identical per diems at government-funded long-term care facilities. The Ministry recognizes this as a serious equity issue Thomas, Rose, Archibald, Helfrich interviews ; . Residents are allowed to place themselves on waiting lists for transfer into preferred facilities within the health authority, and some residents move when beds become available in their facility of choice after initial placement in the first available bed, for instance, amoxicilline clavulanate.
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ALERTEC . SEC 3.34 ALERTONIC.150 ALESSE 21 DAY ; .123 ALESSE 28 DAY ; .123 ALFACALCIDOL .149 ALFUZOSIN HCL. SEC 3.4 ALLERGY SERUM.135 ALLOPURINOL .151 ALMOTRIPTAN MALATE .88 ALMOTRIPTAN MALATE . SEC 3.5 ALPHAGAN .104 ALPRAZOLAM .82 ALPROSTADIL .48 ALTACE .35 ALVESCO .119 AMANTADINE HCL .88 AMATINE . SEC 3.34 AMCINONIDE .138 AMERGE .89 AMERGE . SEC 3.35 AMILORIDE HCL .95 AMINOBENZOATE POTASSIUM .151 AMINOPHYLLINE .147 AMIODARONE HCL .27 AMITRIPTYLINE HCL.68 AMLODIPINE BESYLATE .27 AMOBARBITAL SODIUM SECOBARBITAL SODIUM.82 AMOXICILLIN TRIHYDRATE.8 AMOXICILLIN TRIHYDRATE CLAVULANATE POTASSIUM .8 AMOXICILLIN TRIHYDRATE CLAVULANATE POTASSIUM .9 AMPHOTERICIN B .3 AMPICILLIN . SEC 3.5 AMPICILLIN SODIUM.9 ANAFRANIL .69 ANAKINRA. SEC 3.7 ANAPROX .55 ANAPROX DS.55 ANDRIOL . SEC 3.51 ANDROCUR . SEC 3.10 ANDROCUR DEPOT . SEC 3.10 ANDRODERM 2.5 MG DAY ; . SEC 3.50 ANDRODERM 5 MG DAY ; . SEC 3.50 ANODAN-HC .142 ANSAID.53 ANUGESIC-HC .142 ANUSOL-HC .142 ANZEMET .108 APO-ACEBUTOLOL .27 and axid.
Succinctly in text. Each table and figure should be understandable without reference to the text; a descriptive, concise title should be included and units of measurement should be specified. Consult recent issues of the Journal for format. A table or figure that fills one-half of a vertical manuscript page equals 100 words of text; one that fills one-half of a horizontal page equals 150 words. A copy of each table and figure must be included with each copy of the manuscript. Tables Tables should be double-spaced, no wider than 120 typewriter characters, including spaces, and no longer than 70 lines. Values expressed in the same unit of measurement should read down, not across; when percentages are given, the appropriate numbers must also be given, for example, amoxicillin clavulantae 875 mg.
74. Which of the following represents a therapeutic option for ABRS in a patient with no recent antimicrobial care with treatment failure after 72 hours of appropriatedose amoxicillin therapy? A. B. C. clindamycin clarithromycin ofloxacin amoxicillin clavulanat3 and azelaic.
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IMB would like to express its thanks to the external speakers. The meeting also received updates on the regulatory activities of Veterinary Medicines Department including updates on the IMB's quality management system, information technology and customer Service as.
Bone marrow samples. Bone marrow was obtained after informed consent from healthy bone marrow donors and patients with AML at diagnosis. Mononuclear cells were isolated by Ficoll 1.077 g mL density centrifugation; Pharmacy Biotech, Uppsala, Sweden ; . Isolation, cryopreservation, and thawing procedures of cells have been described previously 14 ; and were identical for normal and leukemic bone marrow samples. CD34 + CD38 hematopoietic cells. CD34 + CD38 cells were defined flow cytometrically as described previously 15 ; and are shown in Fig. 1A. Flow cytometric assessment of ABCB1 expression. ABCB1 expression was analyzed using the ABCB1-specific antibody MRK16, recognizing an external epitope of the protein in three-color flow cytometric assays as described previously 7 ; . ABCB1 protein expression was quantitated as the median fluorescence channel shift MRK16 IgG2a isotype control ; in CD34 + CD38, CD34 + CD38 + , and CD34 cell populations. Differences in fluorescence are assessed using the Kolmogorov-Smirnov statistic, denoted as D . This method accurately identifies small differences in fluorescence and is useful in detection of low-level ABCB1 expression 7 ; . MRK16 staining intensity is categorized as follows: negative D 0.10 ; , dim 0.10 D 0.15 ; , moderate 0.15 D 0.25 ; , and bright D 0.25 and azithromycin.
Abbreviation: CSOM, chronic suppurative otitis media. For other abbreviations, see Table 1. * Unless otherwise indicated, data are expressed as mean SD ; . Differences were statistically significant between MRSA and MSSA. Indicates a combination of amoxicillin and clavulanate potassium.
The effects of viread-associated changes in bmd and biochemical markers on long-term bone health and future fracture risk are unknown and azulfidine and clavulanate, for example, k clavulanate ta.
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The basic patent position with respect to significant products is as follows: Augmentin. The patent on the key active ingredient, potassium clavulanate has expired in all markets except Italy 2006b ; and generic competition exists in most markets. Avandia and Avandamet. The patent on the active ingredient rosiglitazone is not due to expire until 2012a, c in the USA and 2013b in Europe. Patents on the commercial form of the active ingredient rosiglitazone maleate are not due to expire until 2015 in the USA and 2014b in Europe. Litigation challenging the validity of the patents protecting these products is ongoing in the USAe. Avodart. The patent on the active ingredient dutasteride has a normal expiry of 2015a in the USA and 2017b in Europe. Combivir. The patent on the specific combination of lamivudine and zidovudine is not due to expire until 2012 in the USA and 2013b in Europe. Coreg. GlaxoSmithKline is the exclusive licensee under the US patent on the active ingredient carvedilol, which is not due to expire until 2007a. Epivir. The patent on the active ingredient lamivudine is not due to expire until 2010a, c in the USA and 2011b in Europe. Flixotide Flovent and Flixonase Flonase. In the USA, the patent on the active ingredient fluticasone propionate expired in May 2004. In most European countries protection expires in March 2005b. Imigran Imitrex. The patent on the active ingredient sumatriptan is not due to expire until 2009c in the USA and 2006b in Europe 2008b Italy ; . Litigation challenging the validity of the patent protecting this product is ongoing in the USAe. Lamictal. The patent on the active ingredient lamotrigine is not due to expire until 2009a, c paediatric extension pending ; in the USA and 2005b in most countries in Europe. Litigation challenging the validity of this patent in the USA has recently been settlede. Levitrad. GlaxoSmithKline has co-promotion rights under the US patent on the active ingredient vardenafil which is not due to expire until 2018 in the USA. Lexiva Telzir. GlaxoSmithKline is the exclusive licensee under the patent on the active ingredient fosamprenavir, which is not due to expire until 2017 in the USA and 2019b in Europe. Paxil Seroxat. The patent on the commercial form of the active ingredient paroxetine is not due to expire until 2007c in the USA and 2006 in Europe. Litigation relating to the validity and infringement of the patents protecting this product is ongoing in the USAe. Generic competition has commenced in the USA, Europe and certain other markets. Paxil CR is protected by a formulation patent that is not due to expire until 2012. Retrovir. There are no patents on the active ingredient zidovudine. Patents covering pharmaceutical formulations containing zidovudine and their medical use are not due to expire until 2005 in the USA and 2006 in Europe.
Advertisement beta-lactam-beta-lactamase inhibitor combination the only penicillin available in an oral combination with a beta-lactamase inhibitor is amoxicillin-clavulanate and bactrim.
See Table 1 on page S24. Adapted from Cockfroft et al5.
The answer to withdrawl and addiction to opiates suboxone is a narcotic drug which is legally prescribed.
What is amoxicillin clavulanate potassium tablets
PYELONEPHRITIS Oral treatment for 7 to 14 days may be given in the outpatient setting for women with acute pyelonephritis without complicating factors.23, 24 Amoxicillin or amoxicillin-clavulanate are additional antibiotic choices if pyelonephritis is caused by a gram-positive bacteria such as S saprophyticus. For women presenting to the emergency department with acute pyelonephritis, an initial dose of gentamicin or ceftriaxone followed by oral therapy has been advocated.33 RECURRENT URINARY TRACT INFECTIONS The most important predictor of recurrence after an episode of UTI in a young woman is a history of other episodes.6, 7 Among 285 college women diagnosed with UTI almost 25% experienced a recurrence within 6 months.6 The type and duration of antibiotic therapy was not associated with recurrence.6 Some women are genetically predisposed to recurrent UTI. For example, Lewis blood group nonsecretors, about 25% of the general population, have an increased likelihood of recurrent UTI.34 Increased susceptibility in nonsecretors is believed to be related to increased ability of fimbriated bacteria such as E coli to adhere to uroepithelial cells. Recurrences are frequently by identical strain of E coli, implying that there may be unique adaptation of the strain to the individual host. Women with 3 or more recurrences annually may be offered 1 of 3 treatments: continuous prophylaxis, self-treatment of recurrences, or a single dose of antibiotic taken after intercourse as a prophylactic measure. Continuous prophylaxis is administered as a single daily dose, usually at bedtime. Antimicrobials shown to reduce recurrences to 0.3 or fewer per year include TMP-SMZ 40 mg 200 mg, TMP 100 mg, norfloxacin 200 mg, and nitrofurantoin macrocrystals 50 mg to 100 mg.35 Unfortunately, the baseline pattern of recurrent UTI is typically observed when prophylaxis is discontinued.36 Patient self-treatment of recurrences involves much less use of antibiotics and is therefore less costly.37, 38 Postcoital use of antibiotic prophylaxis is effective for women who experience recurrent UTI and.
Concerning the respondent's argument that document 2 ; teaches that more clavulanate should be used rather than less, it has to be noted that the teaching of document 2 ; is not confined to its specific embodiments. The ratio of the amount of the clavulanate to the amount of antibacterial agent is disclosed to be from 1: to 30, i.e. the amount of the former is taught to be present in at most equal or much lower amounts than the latter page 7, lines 12-17.
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2007 sep; 4 3 ; : 276-82 authors: mitchell cs, feng ss, lee rh glutamate spillover is thought to play a significant role in increasing neural transmission at the mossy fiber granule cell cerebellar glomerulus and ampicillin.
New drugs added since June 2002 indicated in bold. ANTIRETROVIRALS NRTIs- abacavir Ziagen ; , abacavir lamivudine zidovudine Trizivir ; , didanosine ddI, Videx ; , lamivudine Epivir, 3TC ; , lamivudine zidovudine Combivir ; , stavudine d4T, Zerit ; , tenofovir Viread ; , zalcitabine ddC, Hivid ; , zidovudine AZT, Retrovir ; . PIs- amprenavir Agenerase ; , atazanavir Reyataz ; , indinavir Crixivan ; , lopinavir ritonavir Kaletra ; , nelfinavir Viracept ; , ritonavir Norvir ; , saquinavir Fortovase, Invirase ; . NNRTIs- delavirdine Rescriptor ; , efavirenz Sustiva ; , nevirapine Viramune ; . Entry Inhibitor- enfuvirtide Fuzeon ; . OI DRUGS PHS "A1 OI"s- acyclovir Zovirax ; , azithromycin Zithromax ; , cidofovir Vistide ; , clarithromycin Biaxin ; , fluconazole Diflucan ; , ganciclovir Cytovene ; , isoniazid INH ; , itraconazole Sporonox ; , pyrimethamine Daraprim ; , sulfadiazine, TMP SMX Bactrim ; . Other OIs- amoxicillin clavulanate Augmentin ; , amphotericin B Fungizone ; , atovaquone Mepron ; , ciprofloxacin Cipro ; , clindamycin Cleocin ; , clotrimazole Lotrimin, Mycelex ; , dapsone, doxorubicin Doxil ; , ethambutol Myambutol ; , erythropoietin Alpha EpogenProcrit ; , ketoconazole Nizoral ; , ofloxacin Floxin ; , pentamidine NebuPent ; , rifabutin Mycobutin ; , rifampim, pyrazinamide, valacyclovir Valtrex ; , valganciclovir Valcyte ; , voriconazole Vfend ; . Hepatitis C- ribiavirin and interferon Rebetron ; , peg-interferon alfa-2b & ribavirin Peg-Intron Rebetol ; . TREATMENTS FOR METABOLIC DISORDERS Diabetic- Metformin, glipizide Glucotrol XL ; . Hyperlipidemia- atorvastatin Lipitor ; . Wasting- dronabinol Marinol ; , megestrol acetate Megace ; , oxandrolone Oxandrin ; . ALL OTHERS acetomenaphine with codeine Tylenol III and Tylenol IV ; , amitriptyline Elavil ; , Berocca Plus generic ; , dephenoxylate and atropine Lomotil ; , fentanyl patch Duragesic ; , fluoxetine HCL Prozac ; , hydrocortisone cream 1%, ibuprofen 800mg ; , morphine sulfate MS Contin ; , sertraline HCL Zoloft ; . Removed in 2003- amphotericin B Fungizone ; , hydroxyurea Hydrea ; , ofloxacin Floxin.
All are by prescription only unless noted ; statins hmg-coa reductase inhibitors ; statins are the first choice of medicine for people with heart disease.
This drug should be used cautiously in patients with a history of seizures, mania, kidney disease or with suicidal tendencies.
Aat and act have the particular advantage that moisture is absorbed even at low relative humidities preferably the clavulanic acid salt is potassium clavulanate.
Amoxicillin and clavulanate potassium tablet usp
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Wyoming Professional Assistance Program WPAP ; : Jack Waters from WPAP presented the 2003 second quarter report. He began by briefly explaining the history of the program for the new Board members. He also discussed the minutes from their Board Meeting in January. Mr. Waters asked for permission from Board to describe the monitoring of urine drug screening collection with "urethra to cup" instead of just saying that urine collection will be monitored. We must do everything we can to protect the public. WPAP has signed up a few more hospitals and some have not renewed their contracts. WPAP is now functioning profitably. Jack opened a discussion regarding raising fees to help with their office expenses. He is concerned that WPAP will have to fold because of lack of revenue. The Board members began a discussion regarding what the BON statutes say about fees, as they cannot go above $200. Mr. Waters suggested a rate of 10% of licensing fees from the BON, as that is what everyone else is paying. The Board asked for more time to discuss the issue. The current structure of WPAP is set up with two partners, but they have been discussing restructuring the organization. The WBON's current contract with WPAP is at the current fee $4 per licensee until June 30, 2004. The Board recommendation that we get clarification from the Statutes about the maximum amount of fees we can charge. George Vandel was present to go over the WPAP Quarterly Report with the Board members. He related some details about issues that arose with some of the nurses under contract with WPAP. Mr. Vandel met with the Wyoming Hospital Association WHA ; Board of Directors. One problem they have encountered is that the hospitals don't like the language in the WPAP agreement because it leaves them out of the communication loop. WPAP will change the language to make it more CEO friendly. WPAP said they would keep in touch with the CEOs letting them know if the nurses were in compliance or not. Mr. Vandel appealed to the BON for its support of WPAP. Mr. Vandel believes that the BONs support will enforce what they do when they do their marketing presentations. They are receiving more referrals of nurses and other medical professionals. Mr. Vandel stated that there are 32 nurses out of 50 people in the program. The Board also wanted to know if WPAP had been working on any federal grant applications, and Mr. Vandel replied that they are working on it right now. There was some discussion of the urine drug screening procedure. With the new agreement in place, urine specimen collection will be very closely monitored because of problems with cheating. WPAP is working with a new lab called Northwest Toxicology to process the drug screenings. The working relationship is going great and they get the test results back in within 48 hours. The difference is the 11 panel screening to test for various types of different drugs. Mr. Vandel will provide a list of the actual drugs being screened to the Board. The lab supplies WPAP with detailed information on each client so drug abuse can be detected. Mr. Vandel explained the sample collection process and the tamper proof packaging. Motion: It was moved and seconded to submit a letter to the WHA supporting the WPAP at this time. The vote on the above motion was 7-0-0-0. Budget: Ms. Hawkins reviewed all budget items with the Board. The WBON had to write off 17 insufficient funds checks after renewals. A copy of the check is filed in the licensee's file, and a certified letter is sent asking them to return their certificates all were CNAs ; and requesting payment. The licenses are expired as far as the WBON office is concerned. The BON staff could not verify that they were employed anywhere as a CNA. As Ms. Hawkins has suggested in the past, the Board members agreed not to accept personal checks during the next renewal period to eliminate this problem. Relocation of Board Office Update: Ms. Koski explained that the WBON needs to go through exception Budget process because of the amount of money it will cost to move. She explained the State budgeting process to the Board members. We have to postpone the move for a year or so. In the mean time, the WBON Staff may be able to find a less expensive office space to move into. There are several options both downtown and in other areas in Cheyenne. Our current lease amount is scheduled to increase in the next few years and the office space is insufficient for the WBON staff's needs.
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