Pabianickie Zaklady Farmaceutyczne "POLFA" Adamed Sp. z o.o. Pierre Fabre Medicament Pierre Fabre Medicament Pierre Fabre Medicament.
Dear village health worker--whoever and wherever you are, whether you have a title or official position, or are simply someone, like myself, with an interest in the wellbeing of others--make good use of this book. It is for you and for everyone. But remember, the most important part of health care you will not find in this book or any other. The key to good health lies within you and your people, in the care, the concern, and appreciation you have for each other. If you want to see your community be healthy, build on these, because side effects of procardia.
P17 SURGICAL OUTCOME OF TRABECULOTOMY AB EXTERNO WITH GONIOTOMY FOR CHRONIC OPEN ANGLE GLAUCOMA Kazuhiko Mori, Yoko Ikeda, Toru Ikushima, Kojiro Imai, Shigeta Naruse, Yukako Hozono, Takeshi Ishibashi, Shigeru Kinoshita Dept. Ophthalmol Kyoto Pref. Univ. of Med., Japan PURPOSES To evaluate the safety and efficacy of trabeculotomy ab externo with goniotomy in the management of chronic open angle glaucoma. METHODS Twenty eyes of 20 patients with medical uncontrollable chronic open angle glaucoma, including primary open angle glaucoma n 10 ; , steroid glaucoma n 4 ; , and pseudo exfoliation syndrome n 6 ; , were enrolled to this study at the Glaucoma Clinic in Kyoto Prefectural University of Medicine. Written informed consents were obtained before the surgery for all patients. Surgical procedures were as follows; 1 ; a 4 x square deep scleral flap with 4 5 thickness was excised towards the corneal limbus. 2 ; Outer wall of Schlemm's canal was dissected and trabeculotomy probes were inserted into the canal. 3 ; Viscoelastic material Healon, Pfizer Ophthalmics ; were injected into the anterior chamber. 4 ; Swan-Jacob gonioprism Ocular Instruments, inc. ; was placed on the surface of the cornea and probes were confirmed to be inserted in Schlemm's canal. 5 ; Goniotomy was performed with MVR 20G V-lance, Alcon Surgical ; or Microsurgical Needle Blade Sharpoint ; toward the trabeculotomy probe. 6 ; Trabeculotomy was completed with rotating into the anterior chamber. Mean follow up period was 5.5 5.4 months. RESULTS This procedure allowed the Schlemm's canal to open into the anterior chamber with less complications, such as Descemet's membrane detachment or cyclodialysis, because the position of Schlemm's canal can be confirmed by the metallic refraction of the probe, compared with conventional goniotomy or trabeculotomy alone. Blood reflux was observed in all cases during the operation. Linear clefts at trabecular meshwork showed the ruptures of the inner wall of Schlemm's canal by the post operative gonioscopy. Although some patients showed a short-term spike of intraocular pressure IOP ; rise, IOP was well-controlled between 16 to 19 mmHg after one month. CONCLUSIONS Trabeculotomy ab externo with goniotomy is a safe and effective procedure which has several advantages such as 1 ; easy to confirm that the probes are correctly inserted to Schlemm's canal, 2 ; less complications caused by rotating the probes, 3 ; less invasive to the collector channels. However, there are some minor disadvantages such as 1 ; the viscoelastics are necessary, 2 ; needs some technical learning with gonioprism.
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IMS Health, the global healthcare information company, reported drug sales of US$351 billion through retail pharmacies in 13 key markets in the period from March 2004 through to February 2005. This figure, largely referable to sales of patent-protected drugs, represented growth of 6% on sales for the previous period. A similar level of growth has been experienced by the US$49.9 billion world market for gastrointestinal products, for example, what is procardia used for.
Experiences. All side effects reported during PROCARDIA XL Extended Release Tablet therapy were tabulated independent of their causal relation to medication. The most common side effect reported with PROCARDIA XL was edema which was dose related and ranged in frequency from approximately 10% to about 30% at the highest dose studied 180 mg ; . Other common adverse experiences reported in placebo-controlled trials include: Adverse Effect Headache Fatigue Dizziness Constipation Nausea PROCARDIA XL % ; N 707 ; 15.8 5.9 4.1 Placebo % ; N 266 ; 9.8 4.1 4.5 Of these, only edema and headache were more common in PROCARDIA XL patients than placebo patients. The following adverse reactions occurred with an incidence of less than 3.0%. With the exception of leg cramps, the incidence of these side effects was similar to that of placebo alone. Body as a Whole Systemic: asthenia, flushing, pain Cardiovascular: palpitations Central Nervous System: insomnia, nervousness, paresthesia, somnolence Dermatologic: pruritus, rash Gastrointestinal: abdominal pain, diarrhea, dry mouth, dyspepsia, flatulence Musculoskeletal: arthralgia, leg cramps Respiratory: chest pain nonspecific ; , dyspnea Urogenital: impotence, polyuria Other adverse reactions were reported sporadically with an incidence of 1.0% or less. These include: Body as a Whole Systemic: face edema, fever, hot flashes, malaise, periorbital edema, rigors Cardiovascular: arrhythmia, hypotension, increased angina, tachycardia, syncope Central Nervous System: anxiety, ataxia, decreased libido, depression, hypertonia, hypoesthesia, migraine, paroniria, tremor, vertigo Dermatologic: alopecia, increased sweating, urticaria, purpura Gastrointestinal: eructation, gastroesophageal reflux, gum hyperplasia, melena, vomiting, weight increase Musculoskeletal: back pain, gout, myalgias Respiratory: coughing, epistaxis, upper respiratory tract infection, respiratory disorder, sinusitis Special Senses: abnormal lacrimation, abnormal vision, taste perversion, tinnitus Urogenital Reproductive: breast pain, dysuria, hematuria, nocturia.
VTE develops as a result of multiple interacting risk factors.80 The classic predisposing factors of hypercoagulation, venous stasis, and vascular damage are present in every pregnancy and postpartum.81 Hypercoagulability of pregnancy results from an increased concentration of procoagulant factors II, VII, X, and fibrin, combined with decreased activity of the endogenous anticoagulant, protein S.81 Stasis results, from increased venous distension, and obstruction of the inferior vena cava by the gravid uterus. Reduction in venous flow is evident by 13 weeks gestation, reaches a nadir at 36 weeks, and returns to non-pregnant levels approximately six weeks postpartum.76 Pelvic vascular damage may occur from the trauma of vaginal or cesarean delivery.81 Table 7 lists additional risk factors for VTE in pregnancy. Overall, the risk of VTE is five to six times higher for a pregnant woman than a non-pregnant woman of the same age.76 and promethazine.
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Received 10th February 2004. Accepted for publication in final form 11th May 2004. From the Department of Dermatology and Venereology, College of Medicine, University of Baghdad, Baghdad, Iraq. Address correspondence and reprint requests to Prof. Makram Al-Waiz, Department of Dermatology and Venereology, College of Medicine, University of Baghdad, PO Box 61369, Postal Code 12114, Medical Collection Post Office, Bab Al-Mua'dham, Baghdad, Iraq. Fax. + 964 1 ; 4250243. E-mail: makram552000 yahoo and propoxyphene, for instance, side effects of procardia.
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Limitations We did not measure any clinical outcomes associated with these changes in drug utilization and reduction in the average price cost per prescription ; . We therefore could not assess the effects of our drug cost and utilization outcomes on total medical care outcomes. However, 4 times during the year, the medical staff was informally queried as to whether they felt there was any change in office visits or patient satisfaction because of these prescription drug interventions. Each time, the staff indicated that they perceived no change in office visit volume or patient satisfaction. This suggests that service-humanistic outcomes were not adversely affected by this drug cost reduction program. Use of national data for comparative purposes was useful but less desirable than cost and utilization data obtained from a control medical ; group operating without clinical pharmacist intervention. The national data source also used different metrics in the 2 measurement years. Another potential limitation, perhaps small, was the different calendar periods used for data collection in the Novartis reports, October 1 to September 30, while the medical group collected data in a calendar year. We also did not calculate or have access to summary demographic information for the managed care organization members assigned to the medical group. It is therefore not possible to either extrapolate our findings to other groups of MCO members or to riskadjust our own enrolled population, which declined in total numbers by 13.4% from 14, 005 to 12, 218 ; in 1998 and by an additional 8.3% in 1999 from 12, 218 to 11, 119 ; . We also did not have the ability to use a control group of members within this medical group due to the open communication and fairly advanced degree of electronic networking among practicing physicians. The absence of a control group limits our ability to attribute precisely the observed change in average cost per prescription to the clinical pharmacist intervention. However, other potential confounders such as a change in drug benefit design appear to be minimized. The observed reduction in the average cost per prescription occurred despite the conclusion of the drug-risk contract period 2 months prior to the end of the study period. Left to other researchers is a comparison of the relative effectiveness of a clinical pharmacist employed by the medical group compared with academic detailing performed by clinical pharmacists employed by the health plan or PBM. A number of other alternative intervention models are possible to permit daily interaction of a clinical pharmacist with prescribers to foster optimum working relationships and identify ways to tailor messages to individual prescribers and the needs of a given medical group. ss Conclusions The PMPY expenditures for drug therapy for health plan members assigned to this primary care medical group increased by only 1.7% after rising by 29.8% the previous year. The PMPY and
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Chest or epigastric discomfort lasting minutes to hours not seconds or days May radiate to neck, jaw, shoulder, inner arm or elbow May be associated with diaphoresis, nausea, vomiting, SOB , weakness or lightheadedness May be brought on by exertion or stress. Relieved by rest or nitroglycerine. May have PMH of bypass surgery, angioplasty, angina, heart attack or myocardial infarction. Medications commonly include, but not limited to: nitrates nitroglycerin, Nitrostat, Isordil, nitro patches, Imdur ; , calcium channel blockers Norvasc, nifedipine, Procardia, Adalat, diltiazem, Dilacor, Cardizem ; , beta blockers propranolol, Inderal, metoprolol, Lopressor, Toprolol, atenolol, sotalol Betapace ; , Coreg ; or statins Mevacor, Lipitor, Zocor, Pravachol, Lescol, Rosuvastatin, Crestor ; Typical presentation anterior, lateral or inferior ; : Chest pressure, ache, band, heaviness, crush or "elephant on the chest" Lasting minutes to hours not seconds or days May radiate to left arm or jaw Typical presentation inferior ; : Epigastric distress, pain or "indigestion" Atypical presentations may include no discomfort.
Manufacturing and availability information: Tolazoline hydrochloride Priscoline hydrochloride; mfg: Ciba Pharmaceutical Co, Summit, NJ Pentoxifylline Trental; mfg: Hoechst-Roussel Pharmaceuticals, Somerville, NJ Nifedipine Procardia; mfg: Pfizer Inc, New York, NY Phenoxybenzamine hydrochloride Dibenzyline; mfg: SmithKline Beecham, Philadelphia, Pa pHisoHex hexachloraphene detergent cleanser; mfg: Sinofi Winthrop Pharmaceuticals, New York, NY Betadine povidone-iodine; mfg: Purdue Frederick, Norwalk, Conn Hibiclens chlorhexidine gluconate; mfg: Stuart Pharmaceuticals, Wilmington, Del ; . Not often used; listed in AHFS Drug Information. Bethesda, Md: American Society of Health-System Pharmacists, American Hospital Formulary Service; 1999. The solution is made fresh by the hospital pharmacy on request. Moyer 's solution was developed by Moyer for burn care at St Louis University School of Medicine, Department of Surgery, St Louis, Mo. It is good for superficial infection in frostbite too, and it also lessens pain. FCI: freezing cold injury Sources: 1 ; Salini Z, Wolverson M, Herbold D, Vas W, Salini A. Treatment of frostbite with IV streptokinase: An experimental study in rabbits. AJR J Roentgenol. 1987; 149 Oct ; : 773776. 2 ; Tuomey J. An open label pilot study to evaluate the efficacy and safety of intra-arterial tissue plasminogen activators TPA ; in the treatment of severe frostbite. Minneapolis, Minn: Trauma Center, Henepin County Medical Center; December 1989. Letter. 3 ; Zdeblick T, Field G, Shaffer J. Treatment of experimental frostbite with urokinase. J Hand Surg Am. 1988; 13A 6 ; : 948953. 4 ; Mills WJ. Frostbite: A discussion of the problem and a review of an Alaskan experience. Alaska Med. 1973; 15 2 ; : 31, 32 and
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Channel blockers CCBs ; are another drug class in the battle against hypertension. These drugs slow the absorption rate of calcium, relaxing blood vessels and lowering blood pressure. CCB brands include Procardia, Adalat, Calan, Plendil, Tiazac, and Norvasc. Grapefruit juice affects the liver's ability to metabolize CCBs. After taking a CCB, wait at least four hours before drinking grapefruit juice. Also, if you are 60 or older, you may experience more fatigue, flushing, heartburn, or and
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Vasoconstriction at least four new avenues are being explored: i ; 5-HT1D receptor agonists; ii ; 5-ht1F receptor agonists; iii ; 5-HT7 receptor antagonists; and iv ; blockade of receptors for CGRP and substance P. 5-HT1D Receptor Agonists A series of isochroman-6-carboxamide derivatives, including PNU-109291, have been described as highly selective 5-HT1D receptor agonists pKi values: 5.2 and 9.0 at 5-HT1B and 5-HT1D receptor, respectively ; [61] see Table 1 ; . PNU-109291 is devoid of carotid vasoconstrictor effect in the anaesthetised cat, but potently inhibits dural plasma extravasation in the guinea-pig [61]. Moreover, these 5-HT1D receptor agonists do not produce vasoconstriction in in vivo canine external and internal carotid bed [100] ; or in vitro cerebral arteries; [101] ; preparations. More recently, it has been shown that PNU-142633 is ineffective in patients with migraine [17]. Clearly, inhibition of dural plasma extravasation by itself is not predictive of antimigraine activity. 5-ht1F Receptor Agonists Two potent 5-ht1F receptor agonists, LY344864 pKi values: 6.3, 6.2 and 8.2 at 5-HT1B, 5-HT1D and 5-ht1F.
Conclusions: in addition to other traditional predictors, adrb2 haplotype may have a significant effect on risk for heart transplant death in hf patients who receive contemporary hf pharmacotherapy.
18 ii ; The person may not be eligible for parole except in accordance 19 with 4-305 of the Correctional Services Article. 20 g ; 1 ; this subsection, "drug kingpin" means a person who occupies a 21 position of an organizer, supervisor, financier, or manager as a coconspirator in a 22 conspiracy to manufacture, distribute, dispense, bring into, or transport in the State 23 controlled dangerous substances. 24 2 ; A drug kingpin who conspires to manufacture, distribute, dispense, 25 bring into, or transport in the State controlled dangerous substances in one or more of 26 the amounts described under subsection f ; of this section is guilty of a felony and on 27 conviction is subject to: 28 i ; Imprisonment for not less than 20 nor more than 40 years 29 without the possibility of parole, and it is mandatory on the court to impose no less 30 than 20 years' imprisonment, no part of which may be suspended; and 31 ii ; A fine of not more than $1, 000, 000!
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The company's contribution to the Bangalore Research Institute includes a $10 million capital investment in new laboratories, and a minimum of $5 million a year from 2001 to 2005 to support TB research. AstraZeneca is the only pharmaceutical company with a research program of this kind in India. More than 60 scientists recruited from leading research institutions around the world work at the new laboratories. The Bangalore scientists work closely with AstraZeneca's infection research center in Boston. Backed by advanced technologies such as microbial genomics, AstraZeneca's scientists in Bangalore are focused on developing improved diagnostic tests and discovering new therapies that are more effective against increasing numbers of persistent organisms and resistant bacteria. AstraZeneca and the International Federation of the Red Cross and Red Crescent societies supported by the national Red Cross societies of the U.K., U.S., Sweden and Spain ; also have joined forces in the fight against TB. The company has committed more than $450, 000 over the next three years to help the charities and
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1. Identification--Acute viral illness of 1 4 weeks duration. Onset is gradual, with malaise, fever, headache, sore throat, cough, nausea, vomiting, diarrhea, myalgia and chest and abdominal pain; fever is persistent or spikes intermittently. Inflammation and exudation of the pharynx and conjunctivae are common. About 80% of human infections are mild or asymptomatic; the remaining cases have severe multisystem disease. Disease is more severe in pregnancy; fetal loss occurs in more than 80% of cases. In severe cases, hypotension or shock, pleural effusion, hemorrhage, seizures, encephalopathy and oedema of the face and neck are frequent, often with albuminuria and hemoconcentration. Early lymphopenia may be followed by late neutrophilia. Platelet counts are moderately depressed, but platelet function is abnormal. Transient alopecia and ataxia may occur during convalescence, and eighth cranial nerve deafness occurs in 25% of patients, of whom only half recover some function after 13 months. The overall case-fatality rate is about 1%, up to 15% among hospitalized cases and even higher in some epidemics. The rate is particularly high among women in the third trimester of pregnancy and fetuses. AST levels above 150 and high viraemia are of poor prognosis. Inapparent infections, diagnosed serologically, are common in endemic areas. Diagnosis is through IgM antibody capture and antigen detection ELISA ; or detection of the viral genome by PCR; isolation of virus from blood, urine or throat washings; and IgG seroconversion by ELISA or IFA. Laboratory specimens must be handled with extreme care including BSL-4 containment, if available. Heating serum at 60C 140F ; for 1 hour will largely inactivate the virus, and the serum can then be used to measure heat-stable substances such as electrolytes, blood urea nitrogen or creatinine. 2. Infectious agent--Lassa virus, an arenavirus, serologically related to lymphocytic choriomeningitis, Machupo, Juni Guanarito and Sabia n, viruses. 3. Occurrence--Endemic in Guinea, Liberia, regions of Nigeria, and Sierra Leone. Serologically related viruses of lesser virulence for laboratory hosts in Mozambique and Zimbabwe have not yet been associated with human infection or disease. 4. Reservoir--Wild rodents; in western Africa, the multimammate mouse of the Mastomys species complex. 5. Mode of transmission--Primarily through aerosol or direct contact with excreta of infected rodents deposited on surfaces such as floors and beds or in food and water. Laboratory infections occur, especially in the hospital environment, through inoculation with contaminated needles.
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