The products and structure of the markets barr's acquisition of pliva would reduce the number of current or future competing generic suppliers in the following three pharmaceutical products: trazodone hydrochloride tablets, triamterene hctz tablets and nimodipine soft-gel capsules.
Figure 1. cAMP hydrolysis in MDCK is directed by PDE3 and PDE4. A ; PDE activity in MDCK cells. PDE3 or PDE4 activity in extract of MDCK cells was determined as basal cAMP-PDE inhibitable by 3 lM lixazinone a PDE3 inhibitor ; or 3 lM rolipram a PDE4 inhibitor ; . B ; Effect of PDE inhibitors on intracellular cAMP content. Quiescent MDCK cells were treated with 10 lM potent adenylate cyclase agonist forskolin FSK ; , 10 lM lixazinone Lix ; , or 10 lM rolipram Rp ; for 60 mins. cAMP content was measured using RIA. C ; Effect of PDE inhibitors on PKA activation. Quiescent MDCK cells were treated with 10 lM FSK, 10 lM Lix, or 10 lM Rp, PKA activation was assessed by a transfection-based in vivo kinase assay. Values represent means 6 SE n 0.05 vs. control.
Has your use of DRUG ; caused problems with other people, such as with farnily members, friends, or -people at work?" "Did you ever get into-physical fights or bad arguments about your hg use?" ; "Did you keep on using DRUG ; anyway?" "Over what period of time?.
158: Nurs Times. 1990 Nov 7-13; 86 45 ; : 36-8. Making sense of . hydrocolloid dressings. Thomas S. PMID: 2235619 [PubMed - indexed for MEDLINE] 159: Arch Surg. 1990 Sep; 125 9 ; : 1136-9. Occlusive dressings. Does dressing type influence the growth of common bacterial pathogens? Marshall DA, Mertz PM, Eaglstein WH. Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Fla. We studied the effect of different occlusive dressings and of air exposure on the growth of four pathogenic bacteria in wounds. Partial-thickness wounds on domestic pigs were inoculated with Staphylococcus aureus, Clostridium!
Within acceptable ranges 10% ; with one exception in the 3.0-mg kg-day target group on May 5, 1998 15.8% ; . The stock solution was prepared at least once, but the exact number of times was not reported. Stability of solutions was assumed based on determinations by AFRL HEST for the 90-day bioassay, as discussed in Section 5.2.3. On arrival, Spraque-Dawley rats were assigned randomly to individual housing, and consecutive order was used to assign the P1 generation rats to cohabitation one male rat per female rat ; . The cohabitation period lasted a maximum of 14 days. Females with spermatozoa observed in a vaginal smear or with a copulatory plug observed in situ were considered to be at GD0 and assigned to individual housing. Estrous cycling was evaluated daily by examination of vaginal cytology beginning 21 days before the scheduled cohabitation period and continuing until GD0. The rats were observed for viability at least twice each day of the study and daily for clinical signs. Body weights were recorded weekly during acclimation, on the first day of dosage, weekly thereafter, and at scheduled sacrifice. Feed consumption and water consumption values were recorded at least three times per week. Females were evaluated for duration of gestation GD0 to the day the first pup was delivered ; . Day 1 of lactation LD1, post-partum ; was defined as the day of birth and was the first day on which all pups in a litter were weighed individually. Maternal behavior was observed on LD1, 4, 7, 14, and 21. Rats that did not deliver a litter were sacrificed on GD25 and examined for pregnancy status. Each litter was evaluated for litter size live and dead pups versus live pups only ; and pup viability at least twice each day of the 21-day post-partum period, and pups were counted daily. Deviations from expected nursing behavior also were recorded. All F1-generation rats were weaned at the same age based on observed growth and viability at LD21, unless required to be extended to LD28. At the end of the 21-day post-partum period, all surviving P1 rats were sacrificed. Gross necropsy was performed on all animals, and all gross lesions were examined histologically. Organ weights were obtained for the thyroid, adrenal glands, brain, epididymides, heart, kidneys, liver, ovaries, pituitary, prostate, seminal vesicles, spleen, and testes. The thyroids and parathyroids were submitted for histopathological examination. Histopathology of other organs was performed for the control and high-dose groups. Blood was collected for determination of hormone levels T3, T4, and TSH ; . Portions of the epididymides were used either for evaluation of sperm count or motility. The left testis was homogenized after weighing for analysis of spermatid concentration spermatids per gram of tissue ; . January 16, 2002 5-84 DRAFT-DO NOT QUOTE OR CITE.
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Reagents and drugs. Nifedipine, nimodipine, d-verapamil, l-verapamil, d l-verapamil, flunarizine, amiloride, methoxyverapamil, nimodipine metabolite, l-BAY K 8644, dBAY K 8644, and -conotoxin were purchased from Research Biochemicals International Natick, MA ; . Poly-L-lysine PLL ; , EDTA, and 2-deoxyglucose 2-DG ; were obtained from Sigma Chemical St. Louis, MO ; . Cell lines. PC-12 cells were obtained from American Type Culture Collection ATCC ; and cultured in Dulbecco's modiAJP-Cell Physiol VOL.
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However the rate from week 60 to week 150 was significantly better in the etidronate group 54 vs 6 per 100 patient-years; p 0.023 ; . In a multicentre study, 423 women with postmenopausal osteoporosis were randomised to receive double blind treatment with phosphate 1g or placebo twice daily for 3 days, etidronate 400mg or placebo daily for 14 days and calcium 500mg daily for the remainder of the 91 day treatment cycle [11]. The study was originally designed for two years, extended to three years as a double blind protocol and then to a fourth and fifth year as an open label study. The primary study endpoints were progression of spinal bone loss and decrease in incidence of vertebral fractures. During the three years of double-blind treatment, spinal bone density increased significantly in the groups that received etidronate with or without phosphate mean increase 5.08 0.61% ; with most of the increase occurring in the first two years. There was no significant change in spinal density in those treated with placebo. At the end of three years, vertebral fractures were reported in 14.3% of patients 8.6 fractures per 100 patient years ; treated with etidronate and 17.4% of patients 11.7 fractures per 100 patient years ; not treated with etidronate. This difference was not statistically significant. However, patients who received both phosphate and etidronate had lower fracture rates than those who received placebo and placebo 11.2% vs 21.7%; p 0.05 ; . The open label phase, where all patients received cyclical etidronate treatment, showed that increases in vertebral bone mass and low vertebral fracture rates were maintained [12, 13]. Recently, the results of seven continuous years of therapy have been published[ 14]. One hundred and ninety three patients who completed 5 years of the study continued into a double blind study. The primary efficacy endpoint in this phase of the study was the mean percent change in lumbar spine bone mineral density BMD ; from baseline to weeks 52 and 104. One hundred and sixty six patients 86% ; completed the study. The groups receiving cyclical etidronate during this period had statistically significant gains in spinal BMD increase of 1.8% and 2.2% in 7 and 4 year groups respectively; p 0.05 ; . Miller's study showed that etidronate prevented fractures in those women with low spinal BMD but the fracture rate was too low to demonstrate a significant effect in the entire group. Randomised, comparative trials Wimalawansa compared the efficacy of oestrogen with or without etidronate in a four year, prospective, randomised study of 58 early postmenopausal women [15]. Patients received either hormone replacement therapy HRT ; and calcium n 15 ; , intermittent cyclical etidronate ICE ; and calcium n 14 ; , HRT, ICE and HRT n 15 ; or calcium alone n 14 ; .The primary study endpoints were change in bone mineral density and development of bone mineralisation defects. The increases in spinal and femoral bone mineral density at four years were 6.78 1.11% and 4.01 0.96% HRT plus calcium 6.79 1.31% and 1.20 0.72% etidronate and calcium 10.9 1.68% and 7.25 1.59% HRT plus etidronate plus calcium and 3.81 0.98% and 4.96 1.15% calcium alone ; . The change in bone mineral density was significantly statistically different in patients receiving combination HRT and etidronate therapy compared with either alone. Patients receiving oestrogen and calcium had a significantly greater improvement in femoral bone density than those treated with etidronate and calcium. Histomorphometric measures found that three patients treated with etidronate and calcium had signs of osteomalacia while patients treated with oestrogen with or without etidronate ; had normal histomorphology. Wimalawansa conducted a further randomised four year prospective study of 72 postmenopausal women to determine whether there is an added beneficial effect on BMD when HRT is combined with cyclical etidronate in patients with established osteoporosis [16]. Patients received either HRT and calcium Vitamin D n 18 ; , intermittent cyclical etidronate and calcium Vitamin D n 18 ; , HRT and etidronate plus calcium Vitamin D n 18 ; , calcium Vitamin D alone. Patients in the combined therapy group had an increase in spine BMD of 10.4% 0.8 at year 4, and this was a significant increase in comparison with those treated with HRT or etidronate alone p 0.05 ; . Hip BMD increased by 7.3% in the combined group. The group treated with calcium and vitamin D lost 2.5% p 0.05 ; and 4.4% p 0.01 ; of BMD in the vertebrae and femora respectively after 4 years and nateglinide.
T, N, P ; , most appear to be insensitive to antagonism by calcium channel blockade 1 ; . The `first generation' calcium channel blockers are represented by structurally dissimilar drugs: verapamil, diltiazem and nifedipine. Most of the `second generation' agents fall into the dihydropyridine class felodipine, amlodipine, nicardipine, nimodipine ; and have been developed to increase vascular selectivity while minimizing the cardiac depressant properties associated with this class of drugs. Calcium channel blockers can also be classified by their different pharmacological properties Table 2 ; . Although similarities in their pharmacological profiles exist, the relative potencies of these activities may vary with each drug, thereby resulting in potentially different clinical effects. Calcium ions play a fundamental role in the activation of cells, particularly in neu99.
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Younger than 10: * Syrup 4 8 12 Tablets 4 Extended release tablets 4 17 14 Syrup 0 2 Tablets 1 4 8 Extended release tablets 1 13 10 * One patient who switched from syrup to extended release tablets is excluded from results. Three patients not taking study medication at 12-week assessment due to discontinuation or interruption of treatment ; are excluded from results.
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References 1. 2. 3. Alborch, E., Salom, J.B. and Torregrosa, G. 1995 ; Calcium channels in cerebral arteries. Pharmacol. Ther. 68 1 ; , 1-34. Beckman, J.S. 1991 ; The double-edged role of nitric oxide in brain function and superoxidemediated injury. J. Dev. Physiol. 15 1 ; , 53-59. Bossu, J.L., Elhamdani, A., Feltz, A., Tanzi, F., Aunis, D. and Thierse, D. 1992 ; Voltage-gated Ca entry in isolated bovine capillary endothelial cells: evidence of a new type of BAY K 8644sensitive channel. Pflugers Arch. 420 2 ; , 200-207. Cohen, Z., Bonvento, G., Lacombe, P. and Hamel, E. 1996 ; Serotonin in the regulation of brain microcirculation. Prog. Neurobiol. 50 4 ; , 335-62. Cohen, Z., Bouchelet, I., Olivier, A., Villemure, J.G., Ball, R., Stanimirovic, D.B. and Hamel, E. 1999 ; Multiple microvascular and astroglial 5-hydroxytryptamine receptor subtypes in human brain: molecular and pharmacologic characterization. J. Cereb. Blood Flow Metab. 19 8 ; , 90817. De Jong, G.I., de Weerd, H., Schuurman, T., Traber, J. and Luiten, P.G.M. 1990a ; Microvascular changes in aged rat forebrain. Effects of chronic nimodipine treatment. Neurobiol. Aging 11 4 ; , 381-389. De Jong, G.I., Horvath, E. and Luiten, P.G.M. 1990b ; Effects of early onset of nimodipine treatment on microvascular integrity in the aging rat brain. Stroke 21 12 Suppl ; , IV113-611. De Jong, G.I., Jansen, A.S.P., Horvath, E., Gispen, W.H. and Luiten, P.G.M. 1992a ; Nimodipine effects on cerebral microvessels and sciatic nerve in aging rats. Neurobiol. Aging 13 1 ; , 7381. De Jong, G.I., Traber, J. and Luiten, P.G.M. 1992b ; Formation of cerebrovascular anomalies in the ageing rat is delayed by chronic nimodipine application. Mech. Ageing Dev. 64 3 ; , 255272 and nicotine.
Summary This material contains an active pharmaceutical ingredient that has been tested, and which may be very toxic to aquatic organisms if released directly to the environment. Consult the MSDS of the active ingredient for specific information about potential environmental effects. Appropriate precautions should be taken to limit release of this mixture to the environment. Local regulations and procedures should be consulted prior to environmental release. Specific information on the active pharmaceutical ingredient is provided below. ECOTOXICITY Aquatic Activated Sludge Respiration No toxicity to sludge microorganisms was observed for the active pharmaceutical ingredient in this mixture, but the upper range of the test was limited by the low water solubility of the compound. 0.27 mg L, 3 Hours, Residential sludge IC50: Microtox is a general toxicity test which utilizes a sensitive marine photo bacteria as the test species. This material contains an active pharmaceutical ingredient that is toxic to these microorganisms. EC50: 0.36 mg L, 15 Minutes No toxicity to algae was observed for the active pharmaceutical ingredient in this mixture, but the upper range of the test was limited by the low water solubility of the compound. 50 mg L, 72 Hours, Selenastrum capricornutum, IC50: green algae This material contains an active pharmaceutical ingredient that is very toxic to daphnids. EC50: 0.024 mg L, 48 Hours, Daphnia magna, Static test NOEL: Terrestrial Earthworm 0.017 mg L, 48 Hours, Daphnia magna, Static test.
Fig. 2. Serial changes in plasma norepinephrine, ANF and cyclic GMP in controls, with chronic rapid pacing, with chronic pacing and concomitant ACE inhibition and chronic rapid pacing with concomitant AT1 Ang-II receptor blockade. top panel ; Plasma norepinephrine significantly increased from baseline values in the rapid pacing only group P .05 ; and appeared to plateau with longer durations of pacing. Plasma norepinephrine concentrations were significantly lower with ACE inhibition or with AT1 Ang-II receptor blockade when compared with rapid pacing only values P .05 ; . middle panel ; Plasma levels of ANF were significantly increased after 1 week of rapid pacing P .05 ; and remained elevated for the entire 4-week pacing protocol. With concomitant ACE inhibition or AT1 Ang-II receptor blockade, plasma ANF values were somewhat variable during the pacing protocol. ANF was increased from baseline values after 2 and 4 weeks of pacing in both the ACE inhibition and AT1 Ang-II receptor blockade groups P .05 ; . After 4 weeks of pacing, plasma ANF were lower in both drug treatment groups than with pacing alone values P .05 ; bottom panel ; Plasma cyclic GMP levels increased after 1 week in the rapid pacing only group P .05 ; and remained elevated for the remainder of the rapid pacing protocol. In contrast, there was no significant increase in plasma cyclic GMP levels with either concomitant ACE inhibition or AT1 Ang-II receptor blockade during the pacing period P .50 and nortriptyline.
Normotensive rats when compared to a 40 weeks old normotensive group. On the other hand microvascular BMT and fibrosis markedly increased in 60 weeks old hypertensive animals compared to 40 weeks old SHR-SP rats. Based on this finding, it may be concluded that hypertension accelerates capillary damage in the brain. Our results also indicate that chronic nifedipine or nimodipine treatment can prevent the progression of capillary wall damage in the rat cerebral cortex. It is known that dihydropyridines decrease blood pressure by binding to L-type calcium channels on vascular smooth muscle cells and inhibit vascular contractility Katz et al., 1985; Fleckenstein and Fleckenstein-Grun, 1988; Alborch et al., 1995 ; , which, in turn, gives rise to vasodilatation and reduced vascular resistance Van Zwieten and Pfaffendorf, 1993 ; . However, the two drugs have selective effects: varying doses of nifedipine have been shown to consistently decrease blood pressure while nimodipine action on tension appeared to be concentration dependent Grabowski and Johansson, 1985; Freedman and Waters, 1987; Scriabine and van den Kerckhoff, 1988; Liu et al., 1989; Frohlich, 1991 ; . At the dose used in the present study, only nifedipine, but not nimodipine decreased SBP. Although both compounds improved the condition of cerebral capillaries in a similar fashion, only the nifedipinemediated microvascular protection correlated with decreasing SBP while nimodipine action was independent of pressure. Thus, the processes underlying the protective effect of the two drugs on cortical capillaries must be based on more than just lowering blood pressure. The location of L-type calcium channels in the microvascular domain, which are the principal targets of nimodipine and nifedipine, may offer further explanations for the different protective mechanisms of the two drugs. The primary building blocks of capillaries are the endothelial cells, which seem not to be endowed with L-type channels, although the occurrence of the L-type channels on the endothelium is a matter of conflicting evidence. Preparations of isolated bovine vessels or rat pulmonary artery indicated either the presence Bossu et al., 1992; Murphy et al., 1994 ; or the absence Harrison et al., 1991 ; of L-type calcium channels on endothelial cells but a generally promoted concept claims the latter conclusion Alborch et al., 1995 ; . Accepting the lack of L-type channels on the endothelial surface, it is doubtful that nifedipine or nimodipine can directly act on the endothelium. Nifedipine was described to block cellular calcium influx by binding to L-type calcium channels on peripheral vascular smooth muscle. By doing so, nifedipine attenuates the contractility of these vascular elements, which leads to decreased blood pressure Katz et al., 1985; Fleckenstein and Fleckenstein-Grun, 1988; Alborch et al., 1995 ; . Thus, it seems attractive to reason that vascular protection in our nifedipine treated animals was achieved by reducing SBP, which assumption would agree with the correlation found between the.
Although found helpful nearly a decade ago for uncomplicated mania, nimodipine may have particular benefits for those diagnostic subclasses of bipolar disorder most resistant to therapy, e, g and pamelor.
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100-second baseline measurement and five 20-second periods of flicker stimulation, followed by an 80-second observation period. The five stimulation periods were then averaged. The rectangular luminance flicker operated at 12.5 Hz at a wavelength of 530 to 600 nm. The baseline-corrected flicker response bFR ; was defined as the difference between the peak dilatation and subsequent constriction after flicker stimulation minus the fluctuation of the baseline. The BP was measured at 1-minute intervals during the examination. RESULTS: In 26 subjects with normal BP, flicker light induced a bFR of + 6.4% + - 2.7%. The bFR decreased nonsignificantly in healthy subjects with increasing age y 8.48-0.048x; r 0.26 ; . The baseline diameter did not influence the amplitude of the flicker response over a range of 70 to 140 measuring units. The hypertensive patients reacted with a bFR of + 2.2% + - 2.5% P 0.001 ; . Four hitherto healthy subjects with elevated BP during the examination were excluded from analysis. CONCLUSIONS: A significant correlation of age and bFR was not found in the small sample examined. Untreated arterial hypertension appeared to be associated with a reduced flicker response. The value of such functional vessel properties in the screening of vasosclerosis and in diagnostics in arterial hypertension should be examined in further studies.
Outcomes were not defined as spasm related or not but there was a significant reduction in the overall rate of infarction and severely disabling neurological outcome at 3 months: nimodipine placebo 278 276 199 * 169 24 16 * 0444 - good and moderate vs severe and dead * p 001 - severe disability * p 056 - death a dose ranging study comparing 30, 60 and 90 mg doses found a generally low rate of spasm related neurological deficits but no significant relation of response to dose and pimozide and nimodipine.
ABSTRACT In the present study, the effects on intracellular calcium concentration [Ca2 ]i ; oscillations of the blockade of ether-a-gogo-related gene ERG ; K channels and of Ca2 influx through store-operated channels SOC ; activated by [Ca2 ]i store depletion have been studied in GH3 cells by means of a combination of single-cell fura-2 microfluorimetry and whole-cell mode of the patch-clamp technique. Nanomolar concentrations 130 nM ; of the piperidinic second-generation antihistamines terfenadine and astemizole and of the class III antiarrhythmic methanesulfonanilide dofetilide, by blocking ERG K channels, increased the frequency and the amplitude of [Ca2 ]i oscillations in resting oscillating GH3 cells. These compounds also induced the appearance of an oscillatory pattern of [Ca2 ]i in a subpopulation of nonoscillating GH3 cells. The effects of ERG K channel blockade on [Ca2 ]i oscillations appeared to be due to the activation of L-type Ca2 channels, because they were prevented by 300 nM nimodipine. By contrast, the piperazinic second-generation antihistamine cetirizine 0.0130 M ; , which served as a negative control, failed to affect ERG K channels and did not interfere with [Ca2 ]i oscillations in GH3.
The test drug nimodipine or placebo ; was initially administered through a nasogastric tube or orally in a dose of 30 mg every 6 hours for a period of 3 weeks and orinase.
To ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities, the facility must, if necessary, assist the resident -1. In making appointments, and 2. By arranging for transportation to and from the office of a practitioner specializing in the treatment of vision or hearing impairment or the office of a professional specializing in the provision of vision or hearing assistive devices. Intent 483.25 b ; The intent of this regulation is to require a facility to assist residents in gaining access to vision and hearing services by making appointments and arranging for transportation, and assistance with the use of any devices needed to maintain vision and hearing. Interpretive Guidelines 483.25 b ; This corresponds to MDS, sections C and O; MDS 2.0 sections C, D, and P when specified for use by the State. Assistive devices to maintain vision include glasses, contact lenses, and magnifying glasses. Assistive devices to maintain hearing include hearing aids. This requirement does not mean that the facility must provide refractions, glasses, contact lenses, conduct comprehensive audiological evaluations although screening is a part of the required assessment in 483.20 b or provide hearing aids. The facility's responsibility is to assist residents and their families in locating and utilizing any available resources e.g., Medicare or Medicaid program payment, local health organizations offering items and services which are available free to the community ; for the provision of the services the resident needs. This includes making appointments and arranging transportation to obtain needed services.
Reference: 1. Minutes of the New Zealand Medicines Adverse Reactions Committee meeting, 6 Sept 2000. Available from URL: : medsafe.govt.nz 2. `Dear Healthcare Professional' letter from Apotex Inc, Canada.
And heinz affolter 1 division of gastruenlerology, graduate hospital and graduate school of medicine, university of, pennsylvania, philadelphia, pa.
The key to customer satisfaction is making sure that they understand what they are buying before they buy it. When people do not understand they will leave as soon as they can, and they will complain about the product. 6.3 Life cycle These products will start slowly and catch on when people see the results. Because these are both longer-term products, the "demonstration effect" will take longer and slow the pace of growth. Once these products catch on, people will recognize the benefits of insurance and will want to move to additional products. This has happened in several countries and would be likely also to occur in Indonesia. Though these products are likely to remain staple products for insurers, clients will soon push for health coverage, property insurance, and some level of livestock and crop insurance. This is a common evolution. Starting people with a good solid life product, or in this case two products, is a good way for everyone to understand how to manage this market.
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