From the Divisions of Nuclear Medicine K.K.S., WED. ; , Interventional Radiology I.F.H. ; , and Pediatric Nephrology R.S.F. ; , Shands Hospital and the University of Florida College of Medicine, Box J-374, JHMHC, Gainesville, FL 32610. Received February 17, 1993; revision requested March 18; revision received August 6; accepted August 17. Address reprint requests to WED. 0 RSNA, 1994.

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What Medications are Available? There are a number of medications that are frequently used for individuals with autism to address certain behaviors or symptoms. Some have studies to support their use, while others do not. Examples of some symptoms and the psychotropic medications prescribed for them by Luke Y. Tsai, MD, Medication Treatment of Autism Spectrum Disorder in New Millennium. Contact ASA-Greater Georgia Chapter for a reprint of the article The article contains specific suggestions on when and when not to prescribe each of the above listed medications. Psychotropic Medications should be used to treat target symptoms only. 1. Short attention, impulsive behavior, ADHD, disturbance of motility Clonidine Catapres ; , guanfacine Tenex ; , imipramine Tofranil ; , haloperidol Haldol ; , risperidone Risperdal ; , naltrexone ReVia ; , Ritalin, Concerta timed release Ritalin ; , dextroamphetamine Dexedrine or Adderall ; 2. Resistance to change, repetitive thoughts, perseverative talking, repetitive, ritualistic or compulsive behaviors, abnormal attachments, and ObsessiveCompulsive Disorder Clomipramine Anafranil ; , fluoxetine Prozac ; , sertraline Zoloft ; , paroxetine Paxil ; , Celexa, Luvox 3. Stereotyped movements or behaviors, motor and or vocal tics, or Gilles de la Tourette Syndrome Haldol, pimozide Orap ; , Risperdal, Catapres, Prozac, or combination of Haldol or Orap with Prozac 4. Excessive fear, worry, anxiety or Generalized Anxiety Buspirone BuSpar ; , Prozac, Zoloft, Luvox, Paxil 5. Irritability, labile mood, frequent crying or laughing spells, sleep disturbances, Major Depressive Disorder Tricyclic antidepressants such as desipramine Norpramin ; or other serotonin reuptake blocker such as Prozac, Zoloft, Luvox, Celexa, Paxil, or Effexor, Lithium, or divalproex Depokote ; 6. Self-Injurious Behaviors Naltrexone Used in combination with Therapy, such as Communication Therapy ; , a drug undergoing research, binds to brain cells, preventing endorphins from binding and activating their normal response. Trazodone Desyrel ; or Prozac are options 7. Aggressive Behaviors Haldol, Risperdal, Desyrel, carbamazepine Tegretal ; , Depakote, Lithium, Inderxl 8. Unusual sleeping pattern Melatonin, antihistamines such as diphenhydramine Benadryl ; and hydroxyzine Atarax ; or clonidine. Antidepressants such as Tofranil or Desyrel, or hypnotics such as zolpidem Ambient ; 21.
Rogers v. Tufts Health Plan of New England, Inc and ketoconazole. Most cases in the pharmaceutical industry, either a commercially successful radical innovation ZRIrMS., which was introduced when the scientific and medical principles on which it depended were not completely elucidated and offered a robust and versatile model for imitation, or a radical process innovation, which made possible the discovery or development of numerous drugs in one or more therapeutic categories. Examples of the first case include: cortisone ZCORTONE, Merck, 1948. in corticosteroids, barbital ZVERONAL, Bayer, 1903. in barbiturate hypnotics; propranolol, the first beta adrenergic blocker ZINDERAL, ICI, 1964. in antihypertensives; chlorpromazine ZLARGACTIL, Rhone Poulenc, 1952. in tranquilizers; chlordiazepoxide ZLIBRIUM, Roche, 1960., in anxiolytics. ZFor more examples, see Table 3. Examples of the second case include: the chemical processes for the isolation and purification of alkaloids, which led to the development of many drugs for a score of therapeutic uses, such as morphine, quinine, papaverine, codeine, noscapine, etc.; the process of screening soil samples for the identification of fungal metabolites with antibacterial properties and the process of deep aerobic fermentation, which made possible the industrial production of penicillin and the discovery of a score of antibiotics, such as streptomycin, tetracycline, chloramphenicol, erythromycin, etc., which have nothing in common in terms of structure or composition. Fermentation processes for the production of 6-aminopenicillanic acid and 7-aminocephalosporanic acid made possible the manufacture of a wide range of semisynthetic penicillins and cephalosporins. The processes for recombinant DNA and cell fusion opened the biotechnology era for the pharmaceutical industry and led to biosynthetic proteins, such as human insulin and growth hormone, antineoplastic drugs and diagnostics. It should be noted that there are many commercially successful RIs that cannot be imitated for technological reasons as was the case of vitamins, centrally acting antihypertensives, e.g., methyl DOPA ZALDOMET, Merck, 1961., clonidine ZCATAPRESS, Boehringer, 1966., and antineoplastic drugs, e.g., tamoxifen ZNOLVADEX, ICI, 1971. and cisplatin ZPLATINOL, Bristol, 1978. Thus, the technology of an industrial sector or subsector advances by both paradigms and by innovations unrelated to.

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HYDROCORTISONE. Description and cases, p. 409. HYDROMORPHONE HYDROCHLORIDE. Description and cases, p. 410. HYDROMOX. See RESERPINE. HYDROPRES. ' See RESERPINE. HYDROXYPROGESTERONE CAF'ROATE. Description and cases, p. 412. HYDROXYZHVE. Description and cases, p. 413. HYPAQUE$ HYPAQUE-60; HYPAQUE SODIUM. See SODIUM DIATRIZOATE. HYPOGLYCEMIC AGENTS. Acetohexamide. Chlorpropamide. Diabeta. Diabinese. Dymelor. Glipizide. Glucotrol. Glyburide. Glynase. Micronase. HYPRHO-D. See Rho D ; IMMUNE GLOBULIN HUMAN ; . I IBUPROFEN. Description and cases, p. 419. ILOSONE. See ERYTHROMYCIN ESTOLATE. IMIPRAMINE HYDROCHLORIDE. Description and cases, p. 420. IMITREX. See SUMATRIPTAN. IMOVAX See RABIES VACCINE. IMORAN. See AZATHIOPRINE. INDERAL. See PROPRANOLOL HYDROCHLORIDE. INDERIDE. See PROPRANOLOL HYDROCHLORIDE. 1026 and lansoprazole. ILETIN II REGULAR PORK ; .50 ILOPAN INJECTION .72 imipramine HCl.28 IMITREX .24 immune globulin.56 IMOGAM RABIES-HT.56 IMOVAX RABIES VACCINE .58 INAMRINONE .32 indapamide .34 INDERAL .30 INDERAL LA .30 INDOCIN .26 INDOCIN I.V.26 indomethacin .26 INFANRIX .59 INFERGEN .57 INFLAMASE MILD.63 INFUMORPH .23 INNOHEP .31 INNOPRAN XL.30 INPERSOL W 4.25% DEXTROSE.43 INSPRA.33 INSULIN SYRINGE .51 INTAL .68 INTEGRILIN .33 intralipid .72 INTROL .65 INTRON A .58 INVANZ .14 INVERSINE.32 INVIRASE .14 IODOFLEX .40 IODOPEN .21 IODOSORB .40 IONOSOL B W DEXTROSE 5%.71 IONOSOL MB IN 5% DEXTROSE .71 IONOSOL MB W DEXTROSE 5% .71 IONOSOL T W DEXTROSE 5% .71 IOPIDINE.64 ipecac .54 IPOL .57 ipratropium bromide.47 IRESSA .20 IRRIGATING SOLUTION G .69 ISMOTIC.31 ISOLYTE E .71 ISOLYTE E W DEXTROSE.71 ISOLYTE G W DEXTROSE .71 ISOLYTE H W DEXTROSE .71 ISOLYTE M W DEXTROSE.71 ISOLYTE P W DEXTROSE.71 isolyte r w dextrose.71 ISOLYTE S .71 ISOLYTE S W DEXTROSE.71.
INTRODUCTION Hydrophilic matrices containing swellable polymers are referred to as hydrogel matrices, swellable controlledrelease systems or hydrophilic matrix tablets. A number of polymers have been investigated to develop in situ gelforming systems, due to the ability of these hydrogels to release an entrapped drug in aqueous medium and to regulate the release of such drug by control of swelling and cross-linking 1, 2, 3 ; . These systems draw attention in the search for improved patient compliance and decreased incidence of adverse drug reactions. Under ideal conditions, a sustained-release formulation maintains therapeutic blood level of a drug for a specific period of time. Oral controlled-release dosage forms have been developed and studied to restrict these systems to specific regions of the gastrointestinal tract as well as to improve the pharmacological activity and to reduce toxic effects 4 ; . One method of fabricating controlled-release formulations is by the incorporation of the drug in a matrix containing a hydrophilic, rate-controlling polymer 5, 6 ; . Hydroxypropylmethylcellulose HPMC ; is the polymer most widely used as the gel-forming agent in the formulation of solid, liquid, semisolid and even controlled-release dosage forms. Water penetration, polymer swelling, drug dissolution, drug diffusion and matrix erosion from these dosage forms are controlled by the hydration of HPMC, which forms a gel barrier through which the drug diffuses 7, 8 ; . The adjustment of the polymer concentration, the viscosity grade and the addition of different types and levels of excipients to the HPMC matrix can modify the drug release rate. The importance of the diffusion layer for a swollen HPMC matrix was illustrated in a mathematical model 9 ; . In addition, the influence of technological variables on drug release from HPMC matrices was reviewed by Vazquez et al 10 ; Vyas et al reported the influence of high viscosity grade of HPMC on the drug release from matrix tablets 11 and levofloxacin.

63 Europe Germany and Italy ; was between 2% and 17% CV coefficient of variation ; for either parameter. The CV for PCF ranged from 2% to 16% for all observers at all sites, whereas the CV for CEM ranged from 5% to 17%. Female operators appeared to have lower CVs and there appeared to be some degree of learning in that the CV tended to fall over time for the same observer. The CV for PCF for most technicians at each study site was 10% and is significantly less than the quoted CVs for the bleeding time. The higher CV for CEM has been determined to be at least partially because of the efficiency of pipetting and sample mixing. These deficiencies are being addressed by modification of the RM2 to include an automated mixing step. As noted previously for platelet aggregation studies, the platelet function is stable at room temperature for a minimum of 46 h. When compared to aggregation studies however, PCF is a much hardier parameter. Samples of whole blood were held at room temperature for up to 16 Each day, the samples were assayed for platelet aggregations and PCF. Platelet aggregations were dramatically decreased at 24 h and completely absent at 48 h. PCF persisted in all samples for at least 10 d, and in two samples, PCF was detectable far beyond what is reported to be the total life-span of platelets. This finding was unexpected and may indicate that the life-span of platelet outside of the body is longer than 10 d. The mechanism of normal platelet senescence within the body is incompletely known. Even the final place of platelet removal has not been firmly established. We have clearly shown that PCF is absent when platelets are not in the sample. The finding of prolonged extracorporeal platelet activity may mean that once they are removed from the body, platelets can be held for significantly longer periods than the current limit of 4 d. Prolonged platelet storage would require adequate suppression of bacterial contamination and growth, but could significantly expand the available supply of platelets without requiring additional donors. It should be, for example, inderzl without prescription.
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