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He ADA announces the availability of the Henry Becton Innovation Award, funded by Becton Dickinson. The award is for $50, 000 per year for two years. This pilot and feasibility grant is designed to support novel hypotheses that may lack preliminary data, but offer considerable promise for the cure, prevention, or treatment of diabetes. Applications in the following research areas will be accepted: 1. Use of medical informatics in direct patient therapy 2. Advanced methods of insulin delivery 3. Community-based care I Role of allied health professionals I Care of kids with type 2 diabetes Eligible award candidates must have a faculty appointment as of July 1, 2004. All candidates must be citizens or permanent residents of the United States. The deadline is January 15, 2004, for July 1, 2004, funding. Interested applicants should complete the Henry Becton Innovation Award application, located at : diabetes professional research opportunities . L 15, for example, information on diazepam!
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Clonidin vs. diazepam in the Treatment of Alcohol Withdrawal Syndrome Vilma Lazarova, Psychiatric hospital 'Skopje', Alchohol addiction - ward, Sidska 20 - 3 1, 1060 Skopje, Macedonia M. Jakovcevska-Kujundziska, V. Filovska, M. Vulovska.
Despite all the discussions about self care at policy level, two-thirds of GP consultations still end with a prescription being written. Few doctors take time to ask patients what they have done for themselves or explain what they should do next time they have the same problem. As pharmacists take on more of the prescribing role the risk is that we shift dependency on the GP to dependency on the pharmacist. That isn't what expanding self care is about. There is a risk that including self care as a level of care in the NHS could reinforce the belief that the NHS is really the first port of call and the answer to all health needs. In his blueprint for the future of the NHS, Derek Wanless explained clearly that if the NHS is to survive, the focus has to change and everyone needs to be fully engaged in managing their health. The.
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Combative patients Administer Midazolam at an initial dose of 2-4 mg IV IM IN. A subsequent dose of 2 mg IV IM IN may be given after 5 minutes if adequate sedation is not achieved and provided systolic BP 100 mmHg. The patient's respiratory rate and effort should be monitored for respiratory depression. Maximum of 2 doses. OR Administer diazepam at an initial dose of 5 - 10 mg IV IM. A subsequent dose of 5-10 mg IV IM may be given after 5 minutes if adequate sedation is not achieved and provided systolic BP 100 mmHg. The patient's respiratory rate and effort should be monitored for respiratory depression. Maximum of 2 doses. Contact BHP if further doses are required. b ; Intubated patients The intravenous route is preferred for intubated patients. Administer midazolam at an initial dose of 2-4 mg IV IM IN. Subsequent doses of 2 mg IV IM IN may be given after 5 minutes if adequate sedation is not achieved and provided systolic BP 100 mmHg. The patient's respiratory rate and effort should be monitored to avoid respiratory depression. Maximum of 2 doses OR Administer diazepam at an initial dose of 5 -10 mg IV IM. Subsequent doses of 5-10 mg IV IM may be given after 5 minutes if adequate sedation is not achieved and provided systolic BP 100 mmHg. The patient's respiratory rate and effort should be monitored to avoid respiratory depression. Maximum of 2 doses total c ; Procedural sedation patients The intravenous route is preferred for patients requiring procedural sedation. Administer midazolam at an initial dose of 2-4 mg IV. Subsequent doses of 2 mg IV may be given after 5 minutes if adequate sedation is not achieved and provided systolic BP 100 mmHg. The patient's respiratory rate and effort should be monitored to avoid respiratory depression. Maximum of 2 doses.
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Table 1. Comparison of demographic and clinical characteristics between patients who recovered and patients who died.
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Groups of drugs: barbiturates, such as phenobarbital and secobarbital Seconal nonbarbiturate sedatives, such as methaqualone, over-thecounter sleeping aids, chloral hydrate, and tranquilizers; and benzodiazepines, such as diazepam Valium ; , alprazolam Xanax ; , flunitrazepam Rohypnol ; , clonazepam Klonopin or Rivotril ; , flurazepam Dalmane ; , lorazepam Ativan ; , and chlordiazepoxide Librium and Librax ; . Rohypnol is discussed separately in the Club Drugs section of this report. The 2004 secondary school survey reported lifetime use of downers decreased from 7.1 percent in 2002 to 5.9 percent in 2004. Past-year use decreased from 3.4 percent in 2002 to 2.6 percent in 2004. The 2000 adult survey reported lifetime use of downers at 6.9 percent and past-month use at 0.6 percent; in 1996, lifetime use was 6.2 percent and past-month use was 0.3 percent. The difference in past-year use between 1996 and 2000 1 percent to 1.8 percent ; was statistically significant. About 1 percent of the clients entering treatment in 2004 had a primary problem with barbiturates, sedatives, or tranquilizers. These clients were the most likely to be female; only 36 percent were male. They were also likely to be highly impaired, based on their ASI scores see Exhibit 29 ; . Alprazolam, clonazepam, and diazepam are among the 15 most commonly identified substances and effexor.
Table II presents the data concerning the subcellular distribution of the vitamin D-dependent CaBP in the chick duodenum as evaluated by radioimmunoassay. By far the highest concentration of CaBP is in the soluble or cytosol fraction of the cell. The cytosol CaBP in nanograms per milligram of protein was 82 times higher than in the crude nuclear and mitochondrial pellets which had the second highest CaBP concentration. In addition, 96% of the total CaBP of the whole homogenate was recovered in the cytosol. Only very low levels!
BRUNEAU et al. times, and his diagnosis changed to undifferentiated schizophrenia. He became more agitated and aggressive, and he was incoherent, with complete loss of insight. The choreiform movement disorder worsened, with abnormal balance problems and parkinsonian features. An electromyography EMG ; performed in 1989 showed an axonal polyneuropathy. Lab tests always revealed hematological abnormalities and an increased level of hepatic enzymes. Mr. B was further treated with loxapine, chlorpromazine, haloperidol, flupenthixol, and fluphenazine with lithium. His treatment was changed to pimozide after a neurologist suspected that symptoms were indicative of spinocerebellar degeneration. In 1998, Mr. B was hospitalized for agitation, sleep problems, and urinary incontinence. Due to elevated levels of CK, neuroleptic malignant syndrome was suspected. Subsequently, all neuroleptic medication was withdrawn, and he was treated with dantrolene and diazepam. After resolution, a treatment with clozapine and valproic acid was introduced. In February 1999, a new consulting neurologist suspected neuroacanthocytosis and referred the patient to our clinic for diagnosis confirmation. In retrospect, we wondered if Mr. B's psychiatric illness was the first presentation of his neuroacanthocytosis or if the two illnesses schizophrenia and neuroacanthocytosis ; were coincidental in the same patient. In the second case, Mr. S, a 39-year-old man, had a family history that was positive for undetermined psychiatric illnesses. He had two paternal uncles, three paternal aunts, and a paternal grandmother who all suffered from some form of psychiatric illness. Additionally, his father was diagnosed with schizophrenia and suffered from movement disorders. Mr. S, who never worked or married, was described as having a schizoid personality type since youth. When he was 17 years old, a psychiatrist suspected that he was schizophrenic. He wasn't hospitalized for psychiatric problems until he was 35 years old, in 1995. Reasons for hospital admittance included paranoid ideas, agitation, visual and auditive hallucinations, and an incoherent thought disorder. While drug abuse was ruled out, he was diagnosed with paranoid schizophrenia and treated with fluphenazine, perphenazine, chlorpromazine, risperidone, and anticholinergics and placed in a supervised home. Mr. S began experiencing movement disorders in 1994. He was described as clumsy, and he had difficulty walking as well as eating, due to an imbalance and involuntary movement of the tongue, respectively. A diagnosis of neuroacanthocytosis was confirmed in January 1998 following a consultation at our neurogenetic clinic at the Montreal General Hospital. A neurological exam showed that Mr. S had dysarthria, generalized choreiform movements, dystonia of the left leg, postural tremor of the arms, and a diminished sense of vibration. One neurologist suspected executive, attention, and memory dysfunction as well as lack of judgment. However, the neurologist's suppositions were never validated by formal neuropsychological assessment. In July 1999, Mr. S was hospitalized for paranoia and suicidal ideas. He also contracted gambling debts, which was unusual for him. His gambling was considered a possible sign of neuropsychiatric pathology. Mr. S was further treated with haloperidol and olanzapine; still, his behavioral problems were so difficult to manage that he was eventually placed in a nursing home. Germane to Mr. S's case study is that out of his five siblings, one sister was also affected with neuroacanthocytosis. In his sister's case, the disease presented at age 34, with choreiform movement, personality change with disinhibition, impulsivity, and emotional lability. These behavioral manifestations required psychiatric consultation, and she was treated with haloperidol to control the movement disorder and elocon.
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Table 1.1. Levels of Substantiation in Evidence-Based Medicinea Level-ofEvidence Categoryb 1.
Venlafaxine had no effect on the pharmacokinetics of diazepam or its active metabolite, desmethyldiazepam and flonase.
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Figure 2. Left ; EEG of patient 4 comatose ; revealing continuous ongoing seizure activity constituted by synchronous high voltage epileptiform discharges with brief periods of Xattening. Right ; Focal sharp waves localised in the left centro-parietal area and vertex after the injection of 10 mg of diazepam.
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ONG, et al.\ LORAZEPAM AND DIAZEPAM IN CAESAREAN SECTION.
Tory models ; have on patterns of ATS-related risk. The association between subculture and ATS abuse is most pronounced among youth. Ethnicity, socioeconomic status, sexual orientation, musical preference, and the high school attended geographical and environmental determinants ; all influence youths' access to and choice of ATSs 8 ; . American street youths, ravers, truck drivers, and motorcycle groups all function in different sociocultural niches, each with its own shared space, identifiable leaders, shared rituals, and adherence to specific codes of behavior. Homosexual or gay communities, for example, can be found in every major city in the United States and in most other major cities of the world. These communities have social, commercial, and political functions. In the United States the communities have gay businesses, bars, athletic centers and gyms, social service centers, phone-sex lines, computer bulletin boards, and churches that are easily accessible and that may serve as locations for ATS acquisition or use 8 ; . It estimated that 10 000 gay men in Los Angeles use methamphetamine regularly, maintaining social networks that facilitate their drug use practices and activities associated with their gay identity 19 ; . Another important aspect of ATS use in the United States is the abuse of additional drugs, most often alcohol and marijuana. Furr and colleagues 20 ; reported a strong relationship between daily alcohol intoxication and smoking "ice." According to the NIDA Community Epidemiology Working Group 7, 9, 10 ; , marijuana is the most common "secondary drug" in San Diego, Chicago, and Houston. Alcohol is the preferred secondary drug in San Francisco and Boston. In Miami, cocaine is the most common secondary drug, and heroin is the most common "tertiary drug." In Chicago and elsewhere, stimulant users may inject a combination of methylphenidate Ritalin ; and heroin. Street outreach workers in the city of New Orleans, Louisiana, report that ecstasy is injected with cocaine and nalbuphine Nubain ; , a synthetic narcotic analgesic similar to morphine. Other reports mention frequent mixing of ecstasy with other drugs: LSD "candy flipping" ; , psychotropic mushrooms "flower flipping" ; , and heroin "H-bomb" ; . Some bisexual or gay men use ecstasy in combination with isobutyl nitrate "poppers" ; during sexual activity, which increases the heart rate, blood flow, and sexual excitement and also allows for relaxation of the anus without loss of erection. Among amphetamine users who want to soften the euphoric "high" coming from amphetamine and to allow for sleep, a variety of relaxants are often subsequently employed 21 ; . These can include diazepam, temazepam, and dextromethor and fosamax.
This applies to the individual isomers cis and trans ; that are components of the existing mixture. See examples 27 to 34 the Annex. An example is nelfinavir and its active metabolite M8. When an active metabolite of an existing product is registered with the health authority in its own right, it is possible that a full set of new safety and efficacy data will be required, similar to that which was generated for the parent compound. There are cases where an active metabolite has been registered for a different indication to that of the parent drug for example, the primary indication for temazepam, an active metabolite of diazepam, is as a hypnotic whereas the primary indication for diaz4pam itself is anxiety ; . Some examples are the following: enalapril is converted by esterase to the active enalaprilat; valaciclovir is converted by esterase to the active aciclovir; levodopa is converted by DOPA decarboxylase to the active dopamine; fosamprenavir calcium is a pro-drug of the protease inhibitor and antiretroviral drug amprenavir. In some cases, the prodrug might have benefits in terms of being more readily administered than the active compound. In the UK, for instance, it was held that sales of hetacillin, an acetone adduct of ampicillin which was immediately hydrolyzed in the body to ampicillin, infringed the ampicillin patent, because it was "ampicillin in disguise" Grubb 1999 ; , p. 211 ; . See, e.g. Grubb 1999 ; , p. 212-213. The decision however, did not invalidate the patent to the active metabolite when produced other than by metabolism. Another conflict arose with regard to a Bristol Myers patent over the monohydrate form of cephalosporin, which is metabolized in the body from a semi-hydrate form developed by Zenith. See, e.g., Soto Vzquez, Crdenas y Espinosa, Parra Cervantes y Cassaigne Hernndez 2001 ; , p. 54. See examples 35 to 40 the Annex. The medical profession is not an industry, as stated in a landmark decision by the German Federal Supreme Court in Operation for baldness 38 BGHZ 313, 1968 GRUR 142 ; . See, e.g. Thomas 2003 ; , p. 850. See Thomas 2003 ; , p. 870. : jpo.go.jp tetuzuki e t tokkyo e Guidelines PartVII-3 . : european-patent-office legal gui lines e c iv well known example of a `second indication' patent relates to sildenafil citrate. Another example is zidovudine, developed as an anticancer drug and then covered by patent as a HIV drug. As required by the Vienna Convention on the Law of the Treaties. EPO Board of Appeal, 10 November 1986, Case number: EP80104029. T 0289 84 - 3.3.1, Application number.
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Martin BR. The THC receptor and its antagonists. In: Nahas GG, Burks TF, eds. Drug Abuse in the Decade of the Brain. Amsterdam: IOS press; 1997: 139-144. Duffy A, Milin R, Case Study: Withdrawal Syndrome in Adolescent Chronic Cannabis Users. J. Am. Acad Child Adolesc Psychiatry. 1996; 35: 1618-21. Wu T C, et al. Pulmonary hazards of smoking marijuana as compared with tobacco. NEJM. 1988; 318: 347-351.
Tables 1, 2 ; . When functional indexes of CL-1 cells reached their peaks on the 7th day, the albumin synthesis, urea synthesis and diazepam transformation of CL-1 in microcarrier culture were 39.8, 41.6 and 33.3 times over those in common culture on the 5th day.
These Harris Interactive survey results show that substantial numbers of the public do not have confidence that it is adequately protected when it comes to drug safety. It is also evident that the entities people identify as most responsible for ensuring drug safety have a long way to go to win the public's trust. People have little confidence that they will do all they can to protect the public from adverse reactions to prescription medications. This is particularly true for the two entities considered to be most responsible for drug safety, the FDA and pharmaceutical companies and diflucan.
1978; 61: 165 Mitchell AA, Louik C, Lacouture P, et al: Risks to children from computed tomographic scan premedication. JAMA 1982; 247: 2385 Morselli PL, Principi N, Tognoni G, et al: Xiazepam elimination in premature and full term infants, and children. J Perinat Med 1973; 1: 133 SR: Late complications in passively addicted inin Rementeria JL ed ; : Drug Abuse in Pregnancy and the Neonate. St Louis, CV Mosby, 1977, p 116 Schiff D, Chan G, Stern L: Fixed drug combinations and the displacement of bilirubin from albumin. Pediatrics 1971; 48: 139 Nathenson G, Cohen MI, Litt IF, et al: The effect of maternal heroin addiction on neonatal jaundice. J Pediatr 1972; 81: 899 Bekeris L, Baker C, Fenton J, et al: Propylene glycol as a cause of an elevated serum osmolality. J Clin Pathol 1979; 72: 633 Glasgow AM, Boeckx RL, Miller MK, et al: Vehicle to hyperosmolality in neonates: Propylene glycol in parenteral multivitamins. Pediatr Res 1983; 17: 149A Jarvik ME: Drugs used in the treatment of psychiatric disorders, in Goodman LS, Gilman A eds ; : The Pharmacological Basis of Therapeutics, ed 4. New York, Macmillan Co, 1970, p 156 Finnegan LP, Mitros TF, Hopkins LE: Management of neonatal narcotic abstinence utilizing a phenobarbital loading dose method. Nati Inst Drug Abuse Res Monogr Ser Kandall fants.
Hyperhidrosis include: Infections such as tuberculosis, which characteristically causes night sweats Malignancies eg, Hodgkin disease ; Metabolic diseases and disorders, including thyrotoxicosis, diabetes, hypoglycemia, gout, pheochromocytoma, and pituitary disease Menopause Severe physiologic stress such as shock, pain, or drug withdrawal, which may cause release of acetylcholine at sympathetic eccrine nerve endings Many prescribed drugs. Venlafaxine, an antidepressant, inhibits the reuptake of serotonin and norepinephrine. Excess sweating occurs in as many as 12% of all patients receiving venlafaxine or other selective serotonin reuptake inhibitors. Tricyclic antidepressants also can induce excess sweating despite their anticholinergic action. Treatment of generalized hyperhidrosis Benzodiazepines, such as diazepam, may have an ameliorating effect for patients whose hyperhidrosis is related to specific anxietyproducing events such as a speaking engagement or a school dance. Systemic anticholinergics may be helpful, but the dosages required to reduce sweating also cause side effects such as xerostomia, mydriasis, cycloplegia, and bowel and bladder dysfunction, and most patients with hyperhidrosis cannot tolerate them for long. However, the anticholinergic oxybutynin Ditropan ; is useful in the relatively rare syndrome of episodic hyperhidrosis with hypothermia. Another anticholinergic, benztropine Cogentin ; , is useful for treating venlafaxine-induced hyperhidrosis. Clonidine, a centrally acting adrenergic agonist, has been found to be useful in treating hyperhidrosis due to tricyclic antidepressants and menopause. s LOCALIZED HYPERHIDROSIS The most common form of localized hyperhidrosis is focal hyperhidrosis, which is localized to the palms, soles, axillae, or face. Focal hyperhidrosis affects an estimated 7.8 million Americans. It may be inherited.
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For the dialysis period to ensure stability of the analytes through the dialysis process. For analysis of ketoconazole, terfenadine 25 g ; was added as internal standard. Acetonitrile 100 l ; was added to precipitate microsomal protein. Mixtures were centrifuged for 10 min. Twenty-five microliters of the supernatant was injected for HPLC analysis. For analysis of fluconazole, the dialysate and calibration standards with phenacetin 0.5 g ; as internal standard were alkalinized with 150 l of 1 NaOH and extracted twice with 2 ml of ethyl acetate. The organic extract was evaporated to dryness and reconstituted with 250 l of mobile phase. Fifty microliters was injected for HPLC analysis. For fluvoxamine, norfluoxetine, ritonavir, and hydroxyitraconazole, dialyzed microsomal samples were diluted with buffer, and buffer samples were diluted with microsomes to ensure an identical matrix for each sample, at a given microsomal protein concentration. The volume of retentate or dialysate used in analysis was varied according to the microsomal protein concentration. This was necessary to ensure that the detector responses in the liquid chromatography mass spectrometry assay were in the linear range for all samples. For fluvoxamine and norfluoxetine samples, microsomal proteins were precipitated using two volumes of acetonitrile containing the internal standard 150 pmol ml fluvoxamine for norfluoxetine samples, and 250 pmol ml norfluoxetine for fluvoxamine samples ; followed by centrifugation, and supernatants were injected on the column for liquid chromatography mass spectrometry analysis. For ritonavir and hydroxyitraconazole samples, ketoconazole 10 ng in methanol ; was added as an internal standard followed by extraction with 3 ml of methyl t-butyl ether. The extracts were evaporated N2, 35C ; and reconstituted in 0.025 ml of HPLC mobile phase. Due to poor recovery from the dialysis system, equilibrium dialysis studies of itraconazole could not be performed. HPLC Conditions: Analysis of Ketoconazole and Fluconazole. The analytical column was 30 cm in length containing C18 Bondapak 10- m particle size ; . The mobile phase for ketoconazole was 50 mM NH4H2PO4 CH3CN CH3OH 55: 40: 5 ; at a flow rate of 1.5 ml min. The ultraviolet absorbance detector was set at 206 nm. The retention times for ketoconazole and terfenadine were approximately 13 and 19.5 min, respectively. For fluconazole analysis, the mobile phase was methanol 10 mM sodium acetate 40: 60 ; at a flow rate of 1.0 ml min, and UV detection was at 261 nm. The retention times for fluconazole and phenacetin were approximately 8 and 12.5 min, respectively. HPLC-Mass Spectrometry Conditions: Analysis of Hydroxyitraconazole, Fluoxetine, Fluvoxamine, and Ritonavir. Samples were injected onto a Phenomenex Luna C18 column 2.0 50 mm, 5 m ; equilibrated in 20 mM acetic acid pH adjusted to 4 with NH4OH ; containing 23% CH3CN at a flow rate of 0.5 ml min. The system consisted of a CTC PAL autosampler CTC Analytics, Carrboro, NC ; , model 1100 quaternary gradient pump and solvent degasser Agilent, Palo Alto, CA ; , and an API100 mass spectrometer PE Sciex, Thornhill, ON, Cananda ; fitted with a TurboIonspray interface. The initial mobile phase conditions were maintained for 1 min followed by a linear gradient to 77% CH3CN at 6 min and held for 3 min. The flow was split approximately 50: into the mass spectrometer. The mass spectrometer was operated in the positive ion mode with an orifice voltage of 20 V and a source temperature of 400C. The monitored ions and their respective retention times Rt ; were m z 296 norfluoxetine, Rt 4.0 min m z 319 fluvoxamine, Rt 3.7 min m z 531 ketoconazole, Rt 4.4 min m z 721 hydroxyitraconazole, Rt 6.1 min and m z 721 ritonavir, Rt 6.1 min ; . Data Analysis. At each microsomal protein concentration, rates of formation of temazepam from diazepam with inhibitor present were expressed as a fraction Rv ; of the control velocity without inhibitor, as follows: Rv Reaction velocity with inhibitor present Reaction velocity without inhibitor 1.
Summary The aim of the present study was to explore the possibility of anxiolytic activity of Trans-01, a polyherbal preparation, in mice. Swiss albino mice weighing between 18-24 g were used. The standard anxiolytic, diazepam 1 mg kg ; , and the test drug, Trans-01 powder 100, 200 and 400 mg kg ; were selected and suspended in water for administration orally. In the study the vehicle and the drugs were given daily for 10 days with the last dose one hour prior to the experiments elevated plus maze and open field tests ; . Administration 200 and 400 mg kg ; of trans-01 increased the number of entries, the time spent in open arms of elevated plus maze model. Similarly, in open field paradigm higher doses of the test drug increased the crossings, rearing and grooming. Pretreatment with Flumazenil, the benzodiazepine antagonist completely reversed the effect produce by Trans-01 400 mg kg ; in the EPM.These changes are similar to those induced by the standard anxiolytic diazepam. The lower dose of Trans-01 100 mg kg ; , however did not show any significant effect in the parameters tested. Thus it can be concluded that Trans-01exhibited anxiolytic-like activity in the models used and it may be partly acting through the GABA receptors as it is evident from the blockade of its action by flumazenil. Keywords: Anxiolytic; Polyherbal formulation; Elevated Plus Maze; Open field.
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