I. Introduction J. Fischer and R. Ganellin ; II. Optimising Drug Therapy by Analogs pp 60 ; Janos Fischer ; Subchapters: Statins S. Kerpel-Fronius and J. Fischer ; 28 ; ACE-inhibitors S. Alfldi and J. Fischer 20 ; AT1-antagonists C. Farsang and J. Fischer ; 20 ; Calcium channel blockers G. Gaviraghi ; 16 ; Case Study: Lacidipine G. Gaviraghi ; Beta-blocking agents P. Erhardt, L. Matos ; Case Study: Esmolol P. Erhardt ; Organic nitrates L. Dezsi ; # H2 antagonists R. Ganellin ; 19 ; Proton-pump inhibitors P. Lindberg and E. Carlsson ; Case Study: Pntoprazole J. Senn-Bilfinger ; Coxibs K.D. Rainsford.
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For some patients, intermittent or on-demand therapy with a PPI may be more appropriate, equally satisfactory, and less expensive than maintenance therapy. Talley et al. randomly assigned 721 patients who had achieved complete heartburn relief with short-term PPI therapy to on-demand esomeprazole, 20 mg or 40 mg, or placebo maximum one dose per day ; for six months.24 Compared with placebo, signifiRelative to Omeprazole cantly fewer patients discontinued treatment with Two weeks on-demand esomeprazole. The higher dose of Lansoprazole esomeprazole provided no additional benefit over the lower dose. Four weeks In another study, Bytzer et al. found that onLansoprazole demand therapy with rabeprazole 10 mg daily Pantorpazole was highly effective in the maintenance treatment Rabeprazole of nonerosive reflux disease.25.
Once arrived, our crew apparently found people no sicker than they'd been in Negesu the time we went there. Perhaps the sickest ones had already died. Tonight Chris, who has been on break, arrived back from Addis on a Save the Children truck. Eileen and I, Daniel my translator ; , Ali Mussa, the TB patient, and others are going to Addis tomorrow. This will be my break for four to five days and Eileen will be going to Greece for a month. I supposedly will have to drive the Land Rover back to Geweha. One problem is I don't have an international driver's license here yet due to snarled red tape. I've had a license in the USAsince age sixteen, however. ; Supposedly CRDA is working on it. JULY 10, 1985 WEDNESDAY This morning Eileen, Ali Mussa and his mother, Teshoma one of our near-sighted employees going to Addis for doctor's exam for glasses ; , Daniel, Haile Ministry of Health health assistant ; , Omar camp guard ; and his son with TB and large liver and spleen, and I, all piled into the Land Rover to go to Addis.On the way we dropped five sheets of corrugated iron at Zuti and I looked around their feeding center. It is smaller than ours but has similarities. Then I squeezed into the front seat with Ali Mussa who rode beside me, on my lap, or in front of me all the way to Addis, because pantoprazole indications.
The decrease in domestic and international income from continuing operations before taxes in 2003 compared to 2002 is due primarily to several non-cash charges associated with purchase accounting; an increase in merger-related costs incurred in connection with our acquisition of Pharmacia; and the provisions for two legacy Warner-Lambert legal matters. The provision for taxes on income from continuing operations before minority interests and the cumulative effect of change in accounting principles consists of the following.
233-239 7 ; publisher: bentham science publishers previous article next article view table of contents key: - free content - new content - subscribed content - free trial content abstract: currently the treatment of alzheimer' s disease ad ; and mild cognitive impairment mci ; is largely unrealised, with no preventive or curative therapies and
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Description: These pharmaceutical company intelligence reports provide a full review of the company's activities together with five-year sales forecasts for its key products. The company's financial performance is covered in-depth, from its latest results to a complete analysis of its latest full fiscal year and an outlook for the future. A section on company strategy covers mergers, acquisitions and divestitures, key agreements, products and R&D. An overview of key products and R&D is followed by a comprehensive review of the company's product portfolio and research and development pipeline by therapeutic area. In addition, supplementary appendices provide more in-depth information on financials, agreements and corporate events. "Wyeth is one of the world's largest research-based pharmaceutical and healthcare products companies and is a leader in the discovery, development, manufacturing and marketing of pharmaceuticals, biotechnology products, vaccines, non-prescription medicines and animal health products. Wyeth currently operates in over 145 countries worldwide. Current Growth Drivers Wyeth markets a broad range of pharmaceutical products, treating a variety of indications within the following therapeutic areas: Neuroscience, Gastroenterology, Vaccines, Women's Healthcare, Musculoskeletal, Anti-inectives, Haemophilia and Immunology. Among these products, four have achieved sales in excess of US$1 billion: In 2005, Effexor venlafaxine ; was the company's top selling product. Effexor is a structurally novel antidepressant with dual serotonin and norepinephrine reuptake inhibitory activity. Effexor works by increasing levels of two brain chemicals, serotonin and norepinephrine, whereas many other antidepressants raise levels of serotonin alone. Effexor is due to lose patent protection in 2007, and this will lead to a gradual fall in sales. In terms of year-on-year sales growth, Enbrel etanercept ; was Wyeth's top product in 2005, recording a 59.4 per cent increase in sales from the previous year. During this period of growth, Enbrel achieved sales of over US$1 billion for the first time. Enbrel is a recombinant version of the soluble human p75 TNF receptor, and consequently is indicated for several musculoskeletal and anti -inflammatory conditions. Wyeth is a world leader in the development and commercialisation of vaccines. Prevnar, a 7-valent glycoconjugate vaccine diphtheria CRM197 protein ; against Streptococcus pneumoniae systemic diseases, is Wyeth's current signature vaccine product. It has been adopted into the child vaccination programmes of the US, Canada and the UK and in 2005, achieved double-digit sales growth. However, patent protection is expected to expire in 2007, leading to falling sales. Altana successfully developed and brought to market Protonix pantoprazole ; , a proton pump inhibitor, in 1994. Since then, Altana has extensively licensed-out the product, with Wyeth securing co-marketing rights in the US, the world's largest pharmaceutical market. Wyeth has managed to generate strong sales in the US, and in 2005, Wyeth's share of US sales exceeded US$1.5 billion. Pipeline Analysis Wyeth believes it has one the most exciting late-stage new product pipelines in the industry and plans to file at least two products from this pipeline per year. During 2005, Wyeth entered 12 new compounds into formal development for the fifth year in a row, for a total of 60 new compounds in the past 60 months. Consequently, the company has assembled a varied pipeline, containing compounds treating a range of indications and in various stages of development. Among these, the following stand out as potential growth drivers: Desvenlafaxine succinate is a novel serotonin norepinephrine reuptake inhibitor, which is being developed as a follow-up compound to Effexor. In addition to desvenlafaxine succinate, bapineuzumab formerly AAB-001 ; is one the leading projects in the Neuroscience pipeline. Bapineuzumab is a humanised antibody that targets amyloid beta in the treatment of Alzheimer's disease. It is being developed with Elan as an immunotherapy.
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Acid-related disorders encompass a wide variety of diagnoses, including the extremely prevalent gastroesophageal reflux disease GERD ; , which affects an estimated 25 million Americans, 1 duodenal and gastric ulceration, stressrelated mucosal disease, and acute upper gastrointestinal bleeding, a common medical emergency resulting in approximately 300, 000 hospitalizations annually.2 During the last three decades, the management of these disorders has been revolutionized by the introduction of histamine-2 receptor antagonists H2RAs ; and proton pump inhibitors PPIs ; . Five available delayed-release PPIs include omeprazole Prilosec, AstraZeneca ; , lansoprazole Prevacid, TAP ; , pantoprazole Protonix, Wyeth ; , esomeprazole magnesium Nexium, AstraZeneca ; , and rabeprazole Aciphex , Eisai Janssen ; . These drugs are highly effective, irreversible inhibitors of H + ATPase, the final step in gastric acid secretion. Although these agents form the therapeutic cornerstone of management for a variety of acid-related disorders, there is still room for improvement in our armamentarium. For example, all PPI compounds are weak bases that are acidlabile and are rapidly degraded, usually within minutes, in the acidic environment of the stomach. Until the recent introduction of immediate-release omeprazole.
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Table 12 shows the numerical results obtained for lansoprazole refinement study, and four minimum energy conformations were found. The corresponding optimized structures for each of them are in Figure 11. Angles and energy results are presented in Table 13. There is no X-ray structure reported for this molecule. However, as in the cases of omeprazole and pantoprazole, conformations B and C are optical isomers, as can be seen from the comparison made in Figure 12.
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These include: some of the other medicines used to treat seizures such as phenobarbitone, phenytoin, carbamazepine and valproic acid propranolol and calcium antagonists such as felodipine and verapamil, which are medicines used to treat heart problems and high blood pressure diuretic medicines, also called fluid or water tablets diazepam, a medicine used to help you sleep or calm you down some medicines used to treat depression, including imipramine, amitriptyline, clomipramine and citalopram progesterone, which is often used in hormone replacement therapy hrt ; for the menopause and in oral contraceptives see below ; cyclophosphamide, a medicine used to treat some types of cancer and to suppress the immune system some medicines used to treat stomach ulcers, including omeprazole, lansoprazole and pantoprazole st john's wort, which is found in many medicines that you can buy without a prescription in a pharmacy, health food shop or supermarket proguanil, a medicine used to treat malaria the above medicines may be affected by trileptal or they may affect how well it works.
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Sales of altana' s ulcer drug pantoprazole rose 5 percent to 382 million euros, making up almost 40 percent of revenu - bloomberg upper gastrointestinal bleeding in the icu aug 23, 2006 he was transfused with 2 units of blood and was started on intravenous pantoprazole 80 mg rapid infusion and 8 mg hour constant infusion ; - medscape subscription ; atlana says sues schwarz over ulcer drug aug 9, 2006 research ; have sued rival schwarz pharma srzg : quote, profile, research ; , alleging patent infringement on ulcer drug protonix, or pantoprazole, altana said and
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WARNINGS AND PRECAUTIONS General In the presence of any alarm symptom e.g. significant unintentional weight loss, recurrent vomiting, dysphagia, haematemesis, anaemia, or melaena ; and when gastric ulcer is suspected, the possibility of malignancy should be excluded before therapy with PANTO IV pantoprazole sodium for injection ; is instituted since treatment with pantoprazole sodium may alleviate symptoms and delay diagnosis. Further investigation should be considered if symptoms persist despite adequate treatment. As with any other intravenous product containing edetate disodium the salt form of EDTA ; , which is a potent chelator of metal ions including zinc, zinc supplementation should be considered in patients treated with PANTO IV who are prone to zinc deficiency. Caution should be used when other EDTA containing products are also co-administered intravenously. Carcinogenesis and Mutagenesis Effects of long-term treatment include hypergastrinemia, possible enterochromaffin-like ECL ; cell hyperplasia and carcinoid formation in the stomach, adenomas and carcinomas in the liver and neoplastic changes in the thyroid. In the rat, the mechanism leading to the formation of gastric carcinoids is considered to be due to the elevated gastrin level occurring during chronic treatment. Similar observations have also been made after administration of other acid secretion inhibitors. For further details, see TOXICOLOGY ; . Short-term and long-term treatment with pantoprazole sodium in a limited number of patients up to 6 years have not resulted in any significant pathological changes in gastric oxyntic exocrine cells. Hepatic Biliary Pancreatic The daily dose in patients with severe liver disease should, as a rule, not exceed 20 mg pantoprazole. In severe hepatically impaired patients with Zollinger-Ellison syndrome, doses of pantoprazole should be adjusted according to acid output measurements, and kept at a minimum effective dose. See ACTION & CLINICAL PHARMACOLOGY, Special Populations & Conditions. Renal The daily dose used in renal insufficient patients, as a rule, should not exceed the recommended dosage regimens. See ACTION & CLINICAL PHARMACOLOGY, Special Populations & Conditions.
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Moayyedi P, Soo S, Deeks J, Forman D, Innes M, Mason J and Delaney B. Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia. British Medical Journal 2000; 321: 659-664. Forman D, Bazzoli F, Bennett C, Broutet N, Calvet-Calvo X, Chiba N, Deeks J, Fallone C, Fischbach L, Gisbert J, Harris A, Hunt R, Kuipers E, Lahaie R, Laheij R, Megraud F, Miseiwicz F, Moayyedi P, Oderda G, Palli D, Savarino V, Unge P. Therapies for the eradication of Helicobacter pylori Protocol for a Cochrane Review ; . In: The Cochrane Library, Issue 4, 2000. Oxford: Update Software. Axon ATR, Moayyedi P, Sahay P. Whom, how and when to test for H. pylori infection. In: Helicobacter pylori: Basic mechanisms to clinical cure. Eds. Hunt RH, Tytgat GNJ.Kluwer Academic Publishers, Dordrecht 1996; 269-285. Loy CT, Irwig LM, Katelaris PH, Talley NJ. Do commercial serology kits for Helicobacter pylori infection differ in accuracy? J Gastroenterol 1996; 91: 1138-44. Roberts AP, Childs S, Rubin G, de Wit NJ. Tests for Helicobacter pylori infection: a critical appraisal from primary care. Family Practice 2000; 17 suppl 2 ; : S12-S20. Wilcox, M.H., Dent, T.H., Hunter, J.O., Gray, J.J., Brown, D.F., Wight, D.G., Wraight EP Accuracy of serology for the diagnosis of Helicobacter pylori infection--a comparison of eight kits. Journal of Clinical Pathology 1996; 49, 373-376. Cutler AF. Havstad S. Ma CK. Blaser MJ. Perez-Perez GI. Schubert TT. Accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection. Gastroenterology 1995; 109: 136-41. Moayyedi P, Carter AM, Catto A, Heppell RM, Grant PJ, Axon ATR. Validation of a rapid whole blood tests for the diagnosis of Helicobacter pylori infection. British Medical Journal, 1997; 314: 119 Stone MA. Mayberry JF. Wicks AC. Livsey SA. Stevens M. Swann RA. Robinson RJ. Near patient testing for Helicobacter pylori: a detailed evaluation of the Cortecs Helisal Rapid Blood test. European Journal of Gastroenterology & Hepatology. 1997; 9: 257-60. Moayyedi P. Tompkins DS. Axon AT. Salivary antibodies to Helicobacter pylori: screening dyspeptic patients before endoscopy. [Letter] Lancet 1994 344: 1016-7. Atherton, J.C, Spiller, R.C. The urea breath test for Helicobacter pylori. Gut 1994; 35, 723-725. Vakil N. Review article: the cost of diagnosing Helicobacter pylori infection. Alimentary Pharmacology & Therapeutics 2001 15 Suppl 1: 10-5. Moayyedi P, Axon ATR. The usefulness of likelihood ratios in the diagnosis of dyspepsia and gastro-esophageal reflux disease. J Gastroenterol 1999; 94: 3122-3125. Unge P. Antimicrobial Treatment of H. pylori Infection - a Polled Efficacy Analysis of Eradication Therapies. Eur J Surg 1998; 582: 16-26. Fock KM. Chelvam P. Lim SG. Triple therapy in the eradication of Helicobacter pylori in patients with duodenal ulcer disease: results of a multicentre study in South-East Asia. South-East Asia Multicenter Study Group. Alimentary Pharmacology & Therapeutics 2000 14: 225-31. Katelaris PH. Adamthwaite D. Midolo P. Yeomans ND. Davidson G. Lambert J. Randomized trial of omeprazole and metronidazole with amoxycillin or clarithromycin for Helicobacter pylori eradication, in a region of high primary metronidazole resistance: the HERO study. Alimentary Pharmacology & Therapeutics 2000; 14: 751-8. Lind T, Veldhuyzen van Zanten SJO, Unge P, et al. Eradication of Helicobacter pylori using one week triple therapies combining omeprazole with two antimicrobials. The MACH1 Study. Helicobacter 1996; 1: 138-144. Misiewicz JJ. Harris AW. Bardhan KD. Levi S. O'Morain C. Cooper BT. Kerr GD. Dixon MF. Langworthy H. Piper D. One week triple therapy for Helicobacter pylori: a multicentre comparative study. Lansoprazole Helicobacter Study Group. Gut 1997; 41: 735-9. Gisbert JP, Gonzalez L, Calvet X, et al. Helicobacter pylori eradication: proton pump inhibitor vs ranitidine bismuth plus two antibiotics for 1 week a meta-analysis of efficacy. Aliment Pharmacol Ther 2000; 14: 1141 Labenz J. Beker JA. Dekker CP. Farley A. Klor HU. Jonsson A. Doubling the omeprazole dose 40 mg b.d. vs. 20 mg b.d. ; in dual therapy with amoxycillin increases the cure rate of Helicobacter pylori infection in duodenal ulcer patients. Alimentary Pharmacology & Therapeutics 1997; 11: 515-22. Vallve M, Vergara M, Gisbert J P, et al. Single vs a double dose of a proton pump inhibitor in triple therapy for Helicobacter pylori eradication: a metaanalysis. Aliment Pharmacol Ther 2002; 16: 1149-1156. Lamouliatte H. Perie F. Joubert-Collin M. Treatment of Helicobacter pylori infection with lansoprazole 30 mg or 60 mg combined with two antibiotics for duodenal ulcers. Gastroenterologie Clinique et Biologique 2000; 24: 495-500. Catalano F. Branciforte G. Catanzaro R. Bentivegna C. Cipolla R. Nuciforo G. Brogna A. Comparative treatment of Helicobacter pylori-positive duodenal ulcer using pantoprazole at low and high doses versus omeprazole in triple therapy. Helicobacter 1999; 4: 178-84. Lamouliatte H. Samoyeau R. De Mascarel A. Megraud F. Double vs. single dose of pantoprazole in combination with clarithromycin and amoxycillin for 7 days, in eradication of Helicobacter pylori in patients with non-ulcer dyspepsia. Alimentary Pharmacology & Therapeutics 1999; 13: 1523-30. Sieg A. Sellinger M. Schlauch D. Horner M. Fuchs W. Short-term triple therapy with lansoprazole 30 mg or 60 mg, amoxycillin and clarithromycin to eradicate Helicobacter pylori. Alimentary Pharmacology & Therapeutics 1999; 13: 865-8. Di Mario F, Buda A, Dal Bo' N. Different lanzoprazole dosages in H. pylori therapy: : a prospective multicentre study comparing 30mg b.i.d versus 15mg b.i.d. Gut, 1997: suppl 3; A209. Buda A, Dal Bo' N, Kusstatscher S, et al. Different lanzoprazole dosages in Helicobacter pylori eradication therapy: a prospective multicentre study comparing 30mg b.i.d versus 15mg b.i.d. Gastroenterology 1999; 120: A92.
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With respect to recordkeeping he said the standards in 1996-97 were somewhat different from those in current times. The reason was that prior to 1997, before accreditation of general practice was put in place, there was no real "bar" for standards of medical records, although there were guidelines from the RACGP about record-keeping, disseminated amongst the members of the College. However at that time doctors were not required to be Fellows of the College to work in general practice and thus non-College members might not have been familiar with those guidelines. When accreditation of general practice commenced in 1997, there were more stringent requirements with respect to record-keeping, to which practices had to adhere in order to be accredited.
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| Pantoprazole side effectsTable III. Total number and percentage of centromere-negative CN ; and centromere-positive CN ; micronuclei MN ; Group Controls C1 T-1 C2 T-1 C3 T-1 C4 T-1 C5 T-1 Mean in controls T-1 C1 medium C2 medium C3 medium C4 medium C5 medium Mean in controls T-1.
Table 3 ; 20 ; . Uptake was generally lower than cx pected; this trend was statistically significant p 0.05 ; for all three regions at 48 hr postinjection. The resultsofthe gradingof['31IJMIBGin the general.
Figure 1. Flow diagram of the first- and second-line treatment of H. pylori infection in the present study. Abbreviations: OAM omeprazole, amoxicillin, metronidazole; PAM pantoprazole, amoxicillin, metronidazole; RBAAz ranitidine bismuth citrate, amoxicillin, azithromycin; Az azithromycin; C clarithromycin. In the second-line treatment, azithromycin and clarithromycin were used in combination with omeprazole or pantopraazole and amoxicillin.
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Inhibition of acid secretion by the proton pump.4, 5 Some minor differences exist among the PPIs with respect to their mechanisms of action within the parietal cell. For example, rabeprazole forms a partially reversible bond with the proton pump, 5 whereas pwntoprazole preferentially binds avidly to an additional acid-inhibiting cysteine residue located deep within the membrane, 4 which greatly impairs the reversibility of binding and prolongs duration of action. The clinical significance of these differences is unknown. Because PPIs inhibit only actively secreting proton pumps, they should be administered when the maximum number of pumps is activated. Accordingly, patients should be instructed to take these medications about 30 minutes before a major meal, not at bedtime.4 Ideally, meals should be high in protein and low in fat to maximize stimulation of secretion pump activity ; and, hence, drug efficacy. The suppression of gastric acid secretion associated with the IV administration of PPIs is rapid and profound. When these agents are administered orally, the onset of activity of the first dose is slower than that of antacids or H2RAs. However, with repeated dosing and a long duration of action, no significant start-up delay is observed. For instance, in healthy volunteers, an initial oral dose of pantoprazole 40 mg inhibited acid secretion by an average of 51% within 2.5 hours.6 After seven days of once-daily dosing, however, acid secretion was inhibited by an average of 85% around the clock in most subjects. In contrast to H2RAs, there is no evidence of the development of pharmacological tolerance to PPIs in terms of their ability to raise gastric pH. This was shown in an early doubleblind, crossover study by Merki and Wilder-Smith.7 In this study, 12 healthy subjects each received individually titrated 72-hour IV infusions of omeprazole, ranitidine Zantac, GlaxoSmithKline ; , or placebo, during which time gastric pH and dosing requirements were monitored. Whereas omeprazole consistently maintained a gastric pH above 4, the investigators recorded marked and statistically significant P .001 ; tolerance to the antisecretory effect of ranitidine infusion. The pharmacokinetic profiles of the PPIs are summarized in Table 2. Despite the relatively short elimination half-lives of these products, their minimally irreversible binding to the proton pump allows for a long duration of acid suppression and once-daily dosing in most patients.
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Also receive an electriqal discharge from tended to be equally curious about a fa- and other animals, " he says."We believt its own cell. Onlywhen both cells are talk- miliar object and a new one. it's highly likely that it plays a similar role ing at once does the NIraoe receptor turn The altered mice grow up looking and in humans." on. It then permits calcium ions to flow acting just like ordinary mice, with no evEven so, Tsien has no plan to try tin. into the host cell, which somehow-no idence of seizures convulsions, or accord- kering with human genes-nor could he one knows the details yet-makes the cell ing to Tsien. That's critical. The NIraoe re- under current ethical guidelines. Drugs easier to furn ott rr" * t'time around. This ceptor shows up throughout the brain, that can boost the action of the xner phenomenon, known aslong-term poten- and though calcium is crucial to learning molecule, however, are not only ethica tiation, is believed to be but already being con. g "Princeton the essenceof one tytrle T templated. tt memory, formation. of has applied for a us r NMDCs role inlearnpatent for this gen, ' z tr ing and memory isn't t YOne sign of an improved memonf is the mouse's preference the same thing when sible to manipulate a for snuffing a newly introduced obiect over one it has already been exposed to we talk about learning higher cognitive function like learning and and memory, too much of it can lead to in a rodent and learning in a human. memory by changing a single molecule? cell death. That's what happens during a Tsien concedesthat using the emo most scientistswould havelooked atyou as stroke: when brain cells are deprived of tive word intelligence in the paper was if you were crazy." oxygen, they releasehuge amounts of glu- sure to generate controversy. "We realll Yet that's just what Tsien & Co. did, tamate, which overstimulates nearby don't mean to suggest, " explains, "thal he focusing not just on the NMDAreceptor NMDAreceptors and kills their host cells. human intelligence is the sameas anima but , on a particular' component of it. Nature may have designed Nnzs-based intelligence. But I would argue that probCalled NR2B, it's very active in young an- receptcirsto taper off in adult brains for a lem solving is clearly part of intelligence, imals which happen to be good at learn- reason. Sorne scientistsfear that the al- and learning and memory are crucial tc ing ; , lessactivein adults who aren't ; , and tered mice may be prone to strokes."You problem solving.And these mice are betis found mostly in the forebrain and hipmight worry about what happens when ter learners, with better memories, than pocampus where explicit, long-term theseanimalsget old, " saysneuroscientist other mice." memories are formed ; . The researchers Larry Squire of the University of CaliforBut Tsien doesn't claim that he and spliced the gene that creates Nnzs into nia, San Diego. his colleagueshave found the unique gethe oNe of ordinary mouse embryos to Premature cell death isn't the only netic key to intelligence or even to memcreatethe strain theycalled Doogie.Then possible complication. Stanford's Robert ory. "It's likely that brain plasticity in"This is they ran the mice through a seriesof stan- Malenka has shown that the NMDA recep- volvesmany molecules, "he says. dardized tests-sort of a rodent ser. In tor is involved in sensitizing the brain to just one of them." On the other hand, he one, the mice were given a paw'shock drugs like cocaine, heroin and ampheta- asserts-and his critics would not diswhile in. a box; after a few rounds, they mines, and others are investigating its role agree-that "intelligence doesarise out ol showed signs of fear from just being in in triggering chronic pain-two more in- biology, at least in part." How much rethe box, having learned that a shock was dications that it may not be wise to try to mains the great question. Whatever the likely to follow. They learned in similar fool Mother Nature. answer, little Doogie surely representsan fashion to be afraid wllen a bell soundIt will be a while before such dangers important step in unraveling what role ed-a variation on Pavlov's dog experi- arise, though, and-as cancerresearchers our genes play in constructing not jusl ments. In each case, the Doogieslearned have discoveredall too often-it isn't even memory but all the other attributes of the faster than normal mice. The same hap- certain that what works in mice will work human mind. And clearly he won't be the pened with a novel-object test: after be- in people. Tsien and his colleaguesbe- last. -With reportin$ coming familiar with two plastic toys, the lieve it's not unreasonableto think it will. by David Bjerklie and Alice ParklNew York, "The NMDA Doogies would show special interest receptor in humans is nearly t. Madeleine NashlChicaeo and DickThompsont when one was replaced; normal mice identical to the receptorin mice, rats, cats Washington 56.
1. Reite ML, Nagel KE, Ruddy JR. The Evaluation and Management of Sleep Disorders. Washington, DC: American Psychiatric Press; 1990 2. American Sleep Disorders Association. Thorpy MJ, ed. The International Classification of Sleep Disorders: Diagnosis and Coding Manual. Lawrence, Kansas: Allen Press; 1990 3. Kryger MH, Roth T, Dement WC. Principles and Practice of Sleep Medicine. 2nd ed. Philadelphia, Pa: WB Saunders; 1994 4. Wysowski DK, Baum C. Outpatient use of prescription sedative-hypnotic drugs in the United States, 1970 thought 1989. Arch Intern Med 1991; 151: 17791783 Sateia MJ, Doghramji K, Hauri PJ, et al. Evaluation of chronic insomnia. Sleep 2000; 23: 243314 Mitler MM. Nonselective and selective benzodiazepine receptor agonists: where are we today? Sleep 2000; 23 suppl 1 ; : S39S47 7. Aldrich MS. Automobile accidents in patients with sleep disorders. Sleep 1989; 12: 487494 Ray WA, Griffen MR, Downey W. Benzodiazepines of long and short elimination half-life and the risk of hip fracture. JAMA 1989; 262: 33033307 Doghramji K. The need for flexibility in dosing hypnotic agents. Sleep 2000; 23 suppl 1 ; : S16S20 10. Greenblatt DJ. Benzodiazepine hypnotics: sorting the pharmacodynamic facts. J Clin Psychiatry 1991; 52 9, suppl ; : 410 11. Pagel JF. The treatment of insomnia. Fam Phys 1994; 49: 14171422.
These statements are for informational purposes only. They are not medical advice. Medical decisions should be made only under the private and personal guidance of licensed professionals. Nor does Verist guarantee the accuracy nor completeness of this information. It is intended as a resource, not a definitive reference, for example, pantoprazole fda.
Conclusion: in elderly patients, pantoprazole and rabeprazole were significantly more effective than omeprazole in healing esophagitis and than omeprazole or lansoprazole in improving symptoms.
Nexium Tab 20mg Nexium Tab 40mg Lansoprazole Cap 30mg E C Gran ; Lansoprazole Cap 15mg E C Gran ; Lansoprazole Gran Sach 30mg Zoton Cap 30mg E C Gran ; Zoton Cap 15mg E C Gran ; Zoton Gran For Susp Sach 30mg Omeprazole Cap E C 20mg Omeprazole Cap E C 40mg Omeprazole Cap E C 10mg Omeprazole Tab Disper 10mg E C Pellets ; Omeprazole Tab Disper 20mg E C Pellets ; Omeprazole Tab Disper 40mg E C Pellets ; Omeprazole Tab 10mg Omeprazole Tab 20mg Losec Cap E C 20mg Losec Cap E C 40mg Losec Cap E C 10mg Losec MUPS Tab Disper 10mg E C Pellets ; Losec MUPS Tab Disper 20mg E C Pellets ; Pantoprazole Tab E C 40mg Pantoprazole Tab E C 20mg Protium Tab E C 40mg Protium Tab E C 20mg Rabeprazole Sod Tab E C 10mg Rabeprazole Sod Tab E C 20mg Pariet Tab E C 10mg Pariet Tab E C 20mg Co-Danthramer Susp 25mg 200mg 5ml S F Co-Danthramer Susp 75mg 1g 5ml S F Co-Danthramer Cap 25mg 200mg Co-Danthramer Cap Strong 37.5mg 500mg Ailax Susp 25mg 200mg 5ml S F Bisacodyl Tab E C 5mg Bisacodyl Suppos 5mg.
To specific patients. g. Coordination with the directors of local hospitals emergency departments. ON-LINE MEDICAL CONTROL - refers to direct radio and or phone communication between pre-hospital care personnel and hospital emergency departments which are staffed 24 hours a day by qualified emergency physicians. Emergency physicians should be familiar with ACLS and ATLS recommendations and be familiar with the pre-hospital care protocols and the capabilities of local EMS providers. On-line medical control may override written protocols when appropriate; such as: a. Directing medical care for patients within pre-hospital care providers scope of practice. b. Routing patients to appropriate hospital destination considering the number of patients, patient needs pediatric, psychiatric, obstetric, trauma ; or hospital availability of specialty beds, operating rooms or imaging procedures. PROCEDURE FOR OBTAINING ON-LINE MEDICAL CONTROL a. First Responders and EMTs will follow the appropriate standing orders for pre-hospital care. If uncertain of protocol or treatment, contact the emergency physician at the receiving hospital for on-line medical control. b. In situations where the patient's condition is judged to be critical or serious, and especially when there are multiple critically ill or injured patients, early notification of the receiving hospital is mandatory. This will allow proper allocation of medical resources and timely preparation for definitive care. c. All requests by EMS personnel for medical guidance will be accommodated promptly and reflect an attitude of joint responsibility and cooperation. The on-line emergency physician shall issue treatment and transport instructions based on an objective analysis of the patient's needs and the hospital's capability and proximity. No effort shall be made to obtain institutional or commercial advantage through the use of such transport instructions and hospital assignments. When an emergency department at one hospital is acting as agent for another hospital, information regarding the patients shall be communicated to the receiving hospital in an accurate and timely manner. The transmission of information regarding patient's identity, condition, and treatment shall otherwise remain strictly confidential. d. All emergency departments and pre-hospital care providers operating under the protocols of these standing orders shall maintain radio communication equipment which meets the standards of the Oregon State Health Division. All first response units will have Med Net 1 155.340 ; frequency and all transport capable vehicles will have both Med Net 1 and Med Net 2 155.400 ; frequencies. e. Any difficulties or problems that arise within the medical control system shall be communicated to the supervising physicians for clarification or resolution.
Stent, noncoronary, temporary, with delivery system Infusion pump, nonprogrammable, temporary implantable ; Catheter, suprapubic cystoscopic Catheter, occlusion Introducer sheath, other than guiding, intracardiac electrophysiological, laser Catheter, electrophysiology, diagnostic ablation, other than 3D or vector mapping, cool-tip Repair device, urinary, incontinence, without sling graft Brachytherapy source, cesium-131, per source Brachytherapy source, high-activity, Iodine-125, greater than 1.01 mCi NIST ; , per source Brachytherapy source, high-activity, Paladium-103, greater than 2.2 mCi NIST ; , per source Brachytherapy linear source, paladium 103, per 1 mm Brachytherapy source, ytterbium-169, per source Magnetic resonance angiography with contrast, abdomen Magnetic resonance angiography without contrast, abdomen Magnetic resonance angiography without contrast followed by with contrast, abdomen Magnetic resonance imaging with contrast, breast; unilateral Magnetic resonance imaging without contrast, breast; unilateral Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral Magnetic resonance imaging with contrast, breast; bilateral Magnetic resonance imaging without contrast, breast; bilateral Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral Magnetic resonance angiography with contrast, chest excluding myocardium ; Magnetic resonance angiography without contrast, chest excluding myocardium ; Magnetic resonance angiography without contrast followed by with contrast, chest excluding myocardium ; Magnetic resonance angiography with contrast, lower extremity Magnetic resonance angiography without contrast, lower extremity Magnetic resonance angiography without contrast followed by with contrast, lower extremity Magnetic resonance angiography with contrast, pelvis Magnetic resonance angiography without contrast, pelvis Magnetic resonance angiography without contrast followed by with contrast, pelvis Intravenous infusion for therapy diagnosis; initiation of prolonged infusion more than eight hours ; , requiring use of portable or implantable pump Palivizumab-RSV-IgM, per 50 mg Injection, pantoprazole sodium, per vial Injection, argatroban, per 5 mg Injection, idursulfase, 1 mg Injection, ranibizumab, 0.5 mg Injection, alglucosidase alfa, 10 mg Injection, panitumumab, 10 mg Microporous collagen tube of nonhuman origin, per centimeter length Acellular dermal tissue matrix of nonhuman origin, per square centimeter Do not report C9351 in conjunction with J7345 ; Unclassified drugs or biologicals Creations of thermal anal lesions by radiofrequency energy Dynamic infrared blood perfusion imaging DIRI ; Endoscopic full-thickness plication in the gastric cardia using endoscopic plication system EPS includes endoscopy Placement of endorectal intracavitary applicator for high intensity brachytherapy Placement and removal if performed ; of applicator into breast for radiation therapy Insertion of implants into the soft palate; minimum of three implants.
Pantolup protium , pantoprazole , protonix ; used for the short-term treatment of erosive esophagitis, a severe form of gastroesophageal reflux disease gerd ; or heartburn.
Fig 4. Photomicrograph of cross-section ed capillaries from a 180-d ay-old normal hamster heart papillary muscle ; . Paraffin -emb ed ded 3- m s ection s tain ed with Mas son trich rome.
36468 36469 36470 Cite 30 SR 737 ; Single or multiple injections of sclerosing solutions, spider veins telangiectasia limb or trunk Face Injection of sclerosing solution; single vein Multiple veins, same leg Therapeutic apheresis, plasma and or cell exchange Insertion of implantable intravenous infusion pump Penile revascularization, artery Penile venous occlusive procedure Bone marrow transplant , allogenic Bone marrow transplant, autologous Bone marrow or blood-derived peripheral stem cell transplantation; allogeneic donor lymphocyte infusions Uvulectomy, excision of uvula Palatopharyngoplasty e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty ; Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass roux-en-y Laparoscopy, gastric bypass including small intestine Gastroplasty, vertical-banded, for morbid obesity Gastroplasty, other than vertical-banded, for morbid obesity Gastric restrictive procedure, with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoleostomy 50 to 100 cm common channel ; to limit absorption biliopancreatic diversion with duodenal switch ; Gastric restrictive procedure, with gastric bypass for morbid obesity with short limb less than 100 cm ; Roux-en-Y gastroenterostomy Gastric restriction procedure, with gastric bypass for morbid obesity Revision of gastric restriction procedure for morbid obesity separate procedure ; Revision of gastroduodenal anastomosis with reconstruction; without vagotomy With vagotomy Revision of gastrojejunal anastomosis gastrojejunostomy ; with reconstruction; without vagotomy With vagotomy Intestinal allotransplantation; from cadaver donor Intestinal allotransplantation; from living donor Liver transplant, with or without recipient hepatectomy Liver allotransplantation, heterotoxic, partial or whole, from cadaver or living donor any age Cholecystectomy with transduodenal sphincterotomy or sphincteroplasty, Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islets Transplantation of pancreatic allograft Endoscopic injection of implant material into submucosal tissues of the urethra Transurethral balloon dilation of prostatic urethra, any method Circumcision, using clamp or other device, newborn Circumcision, surgical excision other than clamp, device or dorsal slit, newborn Insertion of penile prosthesis; non-inflatable, semi-rigid. Inflatable, self contained Insertion of inflatable penile prosthesis Insertion of testicular prosthesis Total abdominal hysterectomy with or without removal of tubes and ovaries Total abdominal hysterectomy with or without removal of tubes and ovaries, with colpourethrocystopexy Supracervical hysterectomy with or without removal of tubes and ovaries Total abdominal hysterectomy including partial vaginectomy, with or without removal of tubes and ovaries Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy, with or without removal of tubes and ovaries Vaginal hysterectomy, uterus 250 grams or less Vaginal hysterectomy, uterus 250 grams or less, with removal of tubes and or ovaries Vaginal hysterectomy, uterus 250 grams or less, with removal of tubes and or ovaries with repair of enterocele Vaginal hysterectomy, uterus 250 grams or less, with colpo-urethrocystoplexy Vaginal hysterectomy, uterus 250 grams or less, with repair of enterocele Vaginal hysterectomy, with total or partial vaginectomy State Register, TUESDAY 3 January 2006 Page 737.
