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超高效液相色谱-串联质谱法同时检测地龙药材中4种黄曲霉毒素含量及阳性结果确证

超高效液相色谱-串联质谱法同时检测地龙药材中4种黄曲霉毒素含量及阳性结果确证

分析测试经验介绍 (104 ~ 109)超高效液相色谱-串联质谱法同时检测地龙药材中4种黄曲霉毒素含量及阳性结果确证郭 晶1,张 进1,李文君1,李正刚2(1. 通化市食品药品检验所,吉林 通化 134000;2. 四平市食品药品检验所,吉林 四平 136000)摘要:建立超高效液相色谱-串联质谱法同时测定地龙药材中黄曲霉毒素B 1、B 2、G 1、G 2的含量,并对阳性结果进行确证. 样品经70%甲醇提取、免疫亲和柱净化、超高效液相色谱柱分离、三重四极杆质谱检测,并采用离子峰度比进行阳性结果确证. 结果表明,4种黄曲霉毒素的线性关系良好(r >0.999 5),回收率在91.2%~95.6%范围内.黄曲霉毒素B 1、B 2、G 1、G 2的检出限分别为0.10、0.038、0.11、0.038 µg/kg. 方法专属性好,灵敏度高,准确性好,可以进行最终阳性检出的判定. 15批地龙药材中6批黄曲霉毒素确证阳性检出, 证明地龙药材较易被黄曲霉毒素污染.关键词:地龙;超高效液相色谱-串联质谱;黄曲霉毒素;阳性结果确证中图分类号:O657. 63 文献标志码:B 文章编号:1006-3757(2024)02-0104-06DOI :10.16495/j.1006-3757.2024.02.005Simultaneous Determination of Four Aflatoxins in Pheretima by Ultra Performance Liquid Chromatography Tandem Mass Spectrometry andConfirmation of Positive ResultsGUO Jing 1, ZHANG Jin 1, LI Wenjun 1, LI Zhenggang2(1. Tonghua Institute for Food and Drug Control , Tonghua 134000, Jilin China ;2. Siping Institute for Food andDrug Control , Siping 136000, Jilin China )Abstract :A method for simultaneous determination of aflatoxins B 1, B 2, G 1, and G 2 in pheretima was been established by ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS), and the positive results was confirmed. The samples were extracted by 70% methanol, purified by a immunoaffinity columns, separated by UPLC-MS/MS, detected by triple quadrupole mass spectrometry, and confirmed by ion peak ratio. The results showed that the linear relationship of the four aflatoxins were good (r >0.999 5), and the recoveries ranged from 91.2% to 95.6%. The limits of detection for aflatoxin B 1, B 2, G 1, and G 2 were 0.10, 0.038, 0.11, 0.038 µg/kg, respectively. The method has a good specificity, high sensitivity, good accuracy, and can be used to determine the final positive detection. Aflatoxin were positively detected in 6 out of 15 batches of pheretima , which proved that the Pheretima were more susceptible to contamination by aflatoxins.Key words :Pheretima ;UPLC-MS/MS ;aflatoxin ;confirmation of positive results收稿日期:2024−01−10; 修订日期:2024−03−05.基金项目:吉林省中药材标准及中药饮片炮制规范(项目编号:JLPZGF-2020-052)作者简介:郭晶(1979−),女,副主任药师,研究方向为药品质量标准通信作者:李正刚(1982−),男,硕士,医药工程师,研究方向为中药质量标准,E-mail :*****************.第 30 卷第 2 期分析测试技术与仪器Volume 30 Number 22024年3月ANALYSIS AND TESTING TECHNOLOGY AND INSTRUMENTS Mar. 2024黄曲霉毒素(aflatoxins, AF)是一种毒性极强的剧毒物质,被各个国家的癌症研究机构列为Ⅰ类致癌物. 黄曲霉毒素主要是由黄曲霉、寄生曲霉产生的次生代谢产物,是一组化学结构类似的化合物[1-2],主要包括AFB1、AFB2、AFG1、AFG2,多存在于土壤、动植物、各种坚果中[3],在湿热环境下出现黄曲霉毒素污染的概率最高. 黄曲霉毒素的危害性在于对人及动物肝脏组织的慢性毒性作用,长期积累可导致肝癌甚至死亡[4-5]. 各国药典均对黄曲霉毒素在中药材或中草药中的限量作了规定,如《欧洲药典》规定AFB1、AFB2、AFG1、AFG2总量在中草药中的限量不得高于4 µg/kg,《美国药典》规定AFB1、AFB2、AFG1、AFG2总量在中草药中的限量不得高于20µg/kg,《中华人民共和国药典》规定其总量在中药材中的限量不得高于10 µg/kg[6].地龙药材标准收载在《中华人民共和国药典》2020版一部[7]. 采收时需要及时剖开腹部,除去内脏和泥沙. 由于地龙生长在土壤环境中,故其被AF污染的风险较大. 目前AF测定的方法主要有液相色谱-柱后碘衍生化法或光化学衍生化法-荧光检测器以及酶联免疫法,但以上方法均存在假阳性的误判可能性,当超出标准限值时均需要采用质谱检测器进行阳性确证[8]. 本研究采用超高效液相色谱-串联质谱法(UPLC-MS/MS)同时测定不同产地多批次地龙药材中AFB1、AFB2、AFG1、AFG2的含量,并对阳性结果进行确证,从而准确的判定检出情况,为地龙药材中AF污染情况提供参考.1 试验部分1.1 仪器和试剂BT125D型电子天平(北京赛多利斯仪器天平有限公司),TDL-5-A型离心机(上海安亭科学仪器厂),AB SCIEX QTRAP® 5500型超高效液相色谱-三重四极杆质谱(美国AB SCIEX公司). 超高压液相色谱柱(岛津科技有限公司),免疫亲和柱(青岛普瑞邦生物工程有限公司,规格:3 mL,批号:2J1J24-4).AF混合对照品溶液:AFB1、AFB2、AFG1、AFG2标示质量浓度分别为1.04、0.38、1.08、0.38µg/mL,批号:610001-202006,来源于中国食品药品检定研究院. 氯化钠和醋酸铵(国药集团化学试剂有限公司,分析纯),甲醇和乙腈(Flsher Scientific,色谱纯),纯化水为自制.本次收集到不同产地和批次的地龙药材共15批,基本信息如表1所列.表 1 地龙药材样品基本信息Table 1 Basic informations of Pheretima samples药材编号样品名称产地DL1广地龙海南文昌DL2广地龙广东肇庆DL3广地龙广东韶关DL4广地龙广东韶关DL5广地龙广西玉林DL6广地龙广西北海DL7沪地龙湖北襄阳DL8沪地龙河南濮阳DL9沪地龙河南安阳DL10沪地龙浙江嘉兴DL11沪地龙河南焦作DL12沪地龙浙江金华DL13沪地龙江西赣州DL14沪地龙江西九江DL15沪地龙江西宜春1.2 仪器工作条件1.2.1 色谱条件色谱柱:Shim-pack XR-ODS,3.0 mm×75 mm (1.8 µm);以10 mmol/L醋酸铵溶液为流动相A,甲醇为流动相B;柱温:25 ℃;流速:0.3 mL/min. 按表2中的程序进行梯度洗脱.表 2 梯度洗脱程序Table 2 Gradient elution procedure时间/min流动相A/%流动相B/%0~4.565~1535~854.5~615~085~1006~6.50~65100~356.5~1065351.2.2 质谱条件离子源:电喷雾离子源(ESI源);监测模式:正离子扫描下的多反应监测模式(MRM);喷雾压强:0.21 MPa;干燥气流速:8 L/min;干燥气温度:550 ℃;毛细管电压:5 500 V;三重四极杆离子对及相关电压参数设定如表3所列.第 2 期郭晶,等:超高效液相色谱-串联质谱法同时检测地龙药材中4种黄曲霉毒素含量及阳性结果确证1051.3 标准曲线绘制分别精密量取AF混合对照品溶液100、50、25µL于10 mL容量瓶中,用甲醇稀释至刻度,摇匀,即得标准曲线溶液1、2、3. 分别精密量取1 mL标准曲线溶液2、0.1 mL标准曲线溶液1于10 mL容量瓶中,用甲醇稀释至刻度,摇匀,即得标准曲线溶液4、5. 精密量取1 mL标准曲线溶液4于10 mL 容量瓶中,用甲醇稀释至刻度,摇匀,即得标准曲线溶液6.1.4 供试品溶液制备取供试品粉末约15 g(过四号筛网),精密称定,置于均质瓶中,加入氯化钠3 g、70%甲醇溶液75 mL,12 000 r/min高速搅拌2 min,4 500 r/min离心5 min,取上清液15.0 mL,置于50 mL量瓶中,用水稀释至刻度,摇匀,4 500 r/min离心10 min,取续滤液20.0 mL. 通过免疫亲合柱,流速3 mL/min,用20 mL水洗脱,洗脱液弃去,使空气进入免疫亲合柱,将水挤出,再用适量甲醇洗脱,收集洗脱液,置于2 mL量瓶中,加甲醇稀释至刻度,摇匀,用微孔滤膜(0.22 µm)滤过,取续滤液,即得.2 结果与讨论2.1 免疫亲和柱技术和质谱测定法的优势免疫亲和柱技术是利用抗原、抗体之间高度特异性结合对目标物进行净化富集的一种实验技术,预置在柱体内的特异性抗体选择性结合样本中的待测物,杂质不被结合流出柱外,柱上结合的目标物再被洗脱液洗脱,从而实现目标物的高效净化和浓缩[9].质谱法是使待测化合物产生气态离子,再按质荷比(m/z)将离子分离、检测的分析方法,检测限可达10−15~10−12 mol数量级. 相比较液相色谱法,测试样品需要的量较少,其检测灵敏度也大幅度提高,且其较好的专属性可以作为液相色谱检出情况的进一步确证,大大降低误判阳性检出的情况[10-13]. 2.2 线性范围和检出限分别精密吸取1.3项下系列混合对照品溶液5µL,注入液相色谱仪,测定峰面积,以进样质量浓度(ng/mL)为横坐标,峰面积为纵坐标,绘制标准曲线.结果如表4所列,4种黄曲霉毒素的线性关系良好(r>0.999 5).取不含AF的样品15 g,加入0.15 mL标准曲线溶液1,余下操作同1.4项下供试品溶液制备,1.2项下仪器工作条件测定,以信噪比(S/N)为3作为4种黄曲霉毒素的检出限(limit of detection,LOD),结果如表4所列,AFB1、AFB2、AFG1、AFG2的LOD分别为0.10、0.038、0.11、0.038 µg/kg,表明方法灵敏度较高.表 4 回归方程、线性范围和检出限Table 4 Regression equations, linear ranges and limits of detection组分名称回归方程r线性范围/(ng/mL)LOD/(µg/kg)S/N AFB1y=33 600x –1 3600.999 90.104~10.4000.10 4.5AFB2y=30 900x – 4 8800.999 80.038~3.8000.038 3.1AFG1y=26 150x – 6 3400.999 80.108~10.8000.11 4.2AFG2y=21 200x + 2 9200.999 80.038~3.8000.038 3.32.3 精密度考察取5 µL 1.3项下标准曲线溶液1,在1.2项下仪器条件及测定方法下分别连续进样6次,测定各组分的色谱峰面积. 测试结果:AFB1、AFB2、AFG1、表 3 质谱条件Table 3 Conditions of mass spectrometer序号组分名称母离子/(m/z)子离子/(m/z)碎裂电压/V碰撞能量/eV1AFB1313.1285.1*16034241.0207512AFB2315.1287.1*18937259.1200393AFG1329.1243.1*16338311.1180314AFG2331.1313.1*18535245.118842注:*定量离子对106分析测试技术与仪器第 30 卷AFG2色谱峰面积相对标准偏差(RSD)分别为1.3%、2.2%、1.8%和2.2%,表明仪器的精密度良好.2.4 稳定性试验取1.3项下标准曲线溶液1,分别于0、4、8、16、18、24 h 按1.2项下仪器条件进样5 µL,记录所测各组分峰面积. 测试结果:AFB1、AFB2、AFG1、AFG2色谱峰面积RSD分别为2.6%、2.2%、2.5%和2.3%,结果表明在24 h内测定结果稳定.2.5 重复性和回收率试验由于15批次地龙药材中仅部分检出AFB1、AFB2,故在加标回收试验中进行方法的重复性考察.称取不含AF的地龙药材(编号:DL1)粉末约15 g,各6份,分别精密加入AF混合对照品溶液75 µL,其余操作同2.1.2项下供试品溶液制备,按2.2项下条件分别测定各组分的色谱峰面积,结果如表5所列. 由表5可见,AFB1、AFB2、AFG1、AFG2的平均回收率分别为95.6%、93.4%、93.2%、91.2%,加标测定值的RSD分别为1.9%、2.0%、1.7%和2.6%,表明该方法的回收率满足要求,方法的重复性良好.2.6 样品测定取15批次地龙药材,按照1.4项下方法制备供试品溶液,1.2项下仪器条件进行测定,结果如表6所列,结果表明在6批地龙样品中检测出AFB1和AFB2,质谱总离子流图如图1所示.表 6 样品测定结果Table 6 Determination results of samples/(µg/kg)样品编号AFB1质量分数AFB2质量分数AFG1质量分数AFG2质量分数总质量分数DL1/////DL2/////DL3/////DL4 6.80.53//7.33 DL5/////DL6/////DL77.80.35//8.15 DL8 6.50.31// 6.81 DL9 4.30.24// 4.54 DL10/////DL11/////DL12/////DL13 3.10.43// 3.53 DL14 2.50.31// 2.81 DL15/////注:“/”:未检出2.7 阳性结果确证中药组成成分相较于西药组成成分复杂多样,三重四极杆质谱是以母离子及子离子组成的离子对进行检测,由于样品基质成分的复杂性,单个离子对出现干扰的情况在试验过程中偶有发生. 然而一个化合物在质谱检测器的离子源中被固定碰撞电压击碎产生的多个碎片离子之间具有相对固定的比例,故采用离子对峰面积的比值进行比较更具有专属性,UPLC-MS/MS法通常采用离子峰度比对结果进一步确证阳性检出,即:如果样品检出色谱峰的保留时间与对照品一致,并且在扣除背景后的表 5 方法的重复性和回收率试验结果Table 5 Experimental results of repeatability andrecovery of method添加质量分数加入质量/ng实测质量/ng回收率/%平均回收率/%RSD/%AFB1 (5 µg/kg)78.0074.2195.1495.6 1.9 78.0073.1193.7378.0075.5396.8378.0076.5298.1078.0072.9993.5878.0075.2396.45AFB2 (2 µg/kg)28.5026.1291.6593.4 2.0 28.5025.2390.7728.5026.7893.9628.5027.0194.7728.5027.3295.8628.5026.5593.16AFG1 (5 µg/kg)81.0077.4495.6093.2 1.7 81.0075.2692.9181.0075.3693.0481.0074.8292.3781.0076.3594.2681.0073.7891.09AFG2 (2 µg/kg)28.5025.1591.0591.2 2.6 28.5026.2292.0028.5025.4789.3728.5025.1188.1128.5027.0194.7728.5026.2892.21第 2 期郭晶,等:超高效液相色谱-串联质谱法同时检测地龙药材中4种黄曲霉毒素含量及阳性结果确证107质谱图中,所选择的监测离子对均出现,而且所选择的监测离子对峰面积比与对照品的监测离子对峰面积比一致,则可判定样品中存在该真菌毒素.经计算本试验检出的6批阳性样品的离子峰度比AFB 1分别为75.3%、75.2%、75.1%、75.3%、75.2%、75.1%,相对平均偏差均小于0.2%. AFB 2分别为85.0%、85.1%、85.1%、85.2%、85.3%、85.0%,相对平均偏差均小于0.2%. 均在允许偏差±20%内,确证样品阳性检出.3 结论由多批次样品检验情况可以初步得出,地龙药材中黄曲霉毒素的污染主要为黄曲霉毒素B 1和B 2.地龙药材在产地初加工过程中需去除泥沙,而泥沙为黄曲霉毒素污染的重要来源,如果泥沙去除不净、保存不当、遇湿热环境,则黄曲霉毒素含量容易超标[14-17]. 因此地龙药材的黄曲霉毒素监测检验非常必要[18-21]. 试验结果表明,UPLC-MS/MS 法操作简便、专属性好、灵敏度高、重复性好,能够对地龙药材的阳性结果作出准确判定,故将在中药材的黄曲霉毒素污染检测中发挥重要作用.参考文献:刘丽娜, 李海亮, 李耀磊, 等. 中药真菌毒素质量控制概况、限量标准制定及有关问题的思考[J ]. 中草药,2023,54(19):6197-6207. [LIU Lina, LI Hailiang, LI Yaolei, et al. Overview on quality control of mycotox-ins in traditional Chinese medicine, limit requirements and discussion on related issues [J ]. Chinese Tradition-al and Herbal Drugs ,2023,54 (19):6197-6207.][ 1 ]沈立, 汤燕, 陈铁柱, 等. 固相萃取液质联用测定川产道地药材黄精、麦冬中10种真菌毒素[J ]. 药物分析杂志,2023,43(8):1369-1380. [SHEN Li, TANG[ 2 ]Yan, CHEN Tiezhu, et al. Determination of 10 my-cotoxins in Polygonati Rhizoma and Ophiopogonis Radix as a genuine regional drug of Sichuan by solid-phase extraction coupled with LC-MS/MS [J ]. Chinese Journal of Pharmaceutical Analysis ,2023,43 (8):1369-1380.]徐晓艳, 王宇, 王梦瑶, 等. 中药材中真菌毒素的检测与脱毒研究进展[J ]. 中草药,2024,55(2):657-669.[XU Xiaoyan, WANG Yu, WANG Mengyao, et al.Research progress on detection and detoxification of mycotoxins in Chinese medicinal materials [J ].Chinese Traditional and Herbal Drugs ,2024,55 (2):657-669.][ 3 ]李正刚, 程焱, 王丹彧, 等. 地龙药材中黄曲霉毒素B 1、B 2、G 1、G 2的含量检测[J ]. 化学工程师,2023,37(8):34-37. [LI Zhenggang, CHENG Yan, WANG Danyu, et al. Detection of aflatoxins B 1、B 2、G 1、G 2 in Pheretima materials [J ]. Chemical Engineer ,2023,37(8):34-37.][ 4 ]莫紫梅. 黄曲霉毒素B 1降解产物及其安全性评价研究进展[J/OL ]. 中国油脂, 2023:1-12[2024-02-29].https:///10.19902/ki.zgyz.1003-7969.230329. [MO Zimei. Research progress on degrada-tion products of aflatoxin B 1 and its safety evaluation [J/OL ]. China Oils and Fats, 2023:1-12[2024-02-29]. https:///10.19902/ki.zgyz.1003-7969.230329.][ 5 ]孙艳杰, 李正刚, 赵磊, 等. 制貂肾中黄曲霉毒素的测定方法研究及暴露风险评估[J ]. 中国药物评价,2023,40(3):249-252. [SUN Yanjie, LI Zhenggang,ZHAO Lei, et al. Determination method of aflatoxin in processed mustela and risk assessment [J ]. Chinese Journal of Drug Evaluation ,2023,40 (3):249-252.][ 6 ]国家药典委员会. 中华人民共和国药典(一部)[S ].北京: 中国医药科技出版社, 2020: 127.[ 7 ]许晓辉, 李晨曦, 吴福祥, 等. QuEChERS-分散固相萃取-液质联用法快速测定地龙中黄曲霉毒素[J ].分析测试技术与仪器,2021,27(1):18-23. [XU[ 8 ]1×1042×1043×104(a)(b)4×1045×1046×1047×104t /minI n t e n s i t y /c p sI n t e n s i t y /c p st /min1×1042×1043×1044×1045×1046×104AFB 2AFB 1AFG 2AFB 2AFB 1AFG 1图1 样品测定图谱(a )对照品质谱总离子流图,(b )样品质谱总离子流图Fig. 1 Total ion flow diagrams of samples108分析测试技术与仪器第 30 卷Xiaohui, LI Chenxi, WU Fuxiang, et al. QuEChERS-dispersed solid phase extraction-ultra performance li-quid chromatography-tandem mass spectrometry for rapid determination of aflatoxin in pheretima [J ]. Ana-lysis and Testing Technology and Instruments ,2021,27 (1):18-23.]马彧, 李正刚, 程焱, 等. 超声萃取-免疫亲和柱净化-柱后光化学衍生高效液相色谱法同时测定蜂房药材中4种黄曲霉毒素[J ]. 化学分析计量,2023,32(2):20-23, 56. [MA Yu, LI Zhenggang, CHENG Yan, et al. Simultaneous determination of four aflatox-ins in Nidus Vespae by ultrasonic extraction-immun-oaffinity column purification-post column photochem-ical derivatization HPLC [J ]. Chemical Analysis and Meterage ,2023,32 (2):20-23, 56.][ 9 ]龚敏, 陈明亮, 金鹏, 等. QuEChERS 结合UPLC-MS/MS 测定水产品中4种黄曲霉毒素及其裂解规律研究[J ]. 热带农业科学,2023,43(10):35-40.[GONG Min, CHEN Mingliang, JIN Peng, et al. De-termination of four aflatoxins in aquatic product by QuEChERS combine UPLC-MS/MS method and study on fragmentation pathway [J ]. Chinese Journal of Tropical Agriculture ,2023,43 (10):35-40.][ 10 ]袁正宁, 李梁子涵, 王艳敏, 等. 黄曲霉毒素对肝脏和脾脏的毒理作用研究[J ]. 中国畜禽种业,2023,19(4):91-95. [YUAN Zhengning, LI Liangzihan,WANG Yanmin, et al. Toxicological effects of aflatoxin on liver and spleen [J ]. The Chinese Live-stock and Poultry Breeding ,2023,19 (4):91-95.][ 11 ]何洁, 余婷婷, 梁松, 等. 高通量高效快速净化方法结合UPLC-MS/MS 测定粮食中黄曲霉毒素[J/OL ]. 中国测试, 2023:1-12 [2024-02-29]. https:///kcms/detail/51.1714.TB.20230421.1514.008.html.[HE Jie, YU Tingting, LIANG Song, et al. Determina-tion of aflatoxins in grains using the high-throughput high efficient flow-through clean-up method and ultra-high performance liquid chromatography tandem mass spectrometry [J/OL ]. China Measurement & Test,2023:1-12 [2024-02-29]. https:///kcms/de-tail/51.1714.TB.20230421.1514.008.html.][ 12 ]李正刚, 谢秋红, 邵大志, 等. 高效液相色谱-荧光检测法同时测定人参归脾丸中4种黄曲霉毒素[J ]. 中国卫生工程学, 2022, 21(5):714-716. [LI Zhenggang,XIE Qiuhong, SHAO Dazhi, et al. Simultaneous de-termination of content of four Aflatoxins Ginseng spleen-invigorating bolus by HPLC-FLD [J ]. Chinese Journal of Public Health Engineering, 2022, 21(5):714-716.][ 13 ]陈莉. 超高效液相色谱串联三重四极杆质谱法同时测定舒眠胶囊(片)中4种黄曲霉毒素含量[J ]. 中国药业,2022,31(22):77-80. [CHEN Li. Simultaneous[ 14 ]determination of four aflatoxins in Shumian capsules(tablets) by UPLC-QQQ/MS [J ]. China Phar-maceuticals ,2022,31 (22):77-80.]夏仕青, 李晓慧, 吴桃丽. 超高效液相色谱-串联质谱法测定辣椒粉中4种黄曲霉毒素的含量[J ]. 微量元素与健康研究,2023,40(1):57-60. [XIA Shiqing, LI Xiaohui, WU Taoli. Determination of four aflatoxins in Chili Powder by UPLC-MS/MS [J ]. Studies of Trace Elements and Health ,2023,40 (1):57-60.][ 15 ]淦露. 黄曲霉毒素检测技术研究进展[J ]. 现代食品,2022,28(15):114-117. [GAN Lu. Research progress of aflatoxin detection technology [J ]. Modern Food ,2022,28 (15):114-117.][ 16 ]杨昊, 公丕学, 王骏, 等. 基于石墨烯净化的超高效液相色谱串联质谱快速测定乳制品中黄曲霉毒素[J ].中国食品卫生杂志,2023,35(3):396-402. [YANG Hao, GONG Pixue, WANG Jun, et al. Fast determina-tion of aflatoxin in dairy products by ultra-high per-formance liquid chromatography-tandem mass spec-trometry based on purification of graphene [J ].Chinese Journal of Food Hygiene ,2023,35 (3):396-402.][ 17 ]赵飞. QuEChERS 结合超高效液相色谱-三重四极杆质谱法测定坚果中黄曲霉毒素[J ]. 当代化工,2022,51(3):752-756. [ZHAO Fei. Determination of aflatoxins in nuts by QuEChERS coupled with ultra-li-quid chromatography-mass spectrometry [J ]. Contem-porary Chemical Industry ,2022,51 (3):752-756.][ 18 ]谭丽盈. 超高效液相色谱-串联质谱法同时测定醋延胡索药材中4种黄曲霉毒素[J ]. 化学分析计量,2021,30(10):27-32. [TAN Liying. Simultaneous de-termination of four kinds of aflatoxins in vinegar cory-dalis by UPLC-MS/MS [J ]. Chemical Analysis and Meterage ,2021,30 (10):27-32.][ 19 ]周颖, 祝清岚, 马临科, 等. 免疫亲和柱净化-柱后光化学衍生-高效液相色谱法检测蜚蠊中的黄曲霉毒素[J ]. 中国药物评价,2020,37(5):358-361.[ZHOU Ying, ZHU Qinglan, MA Linke, et al. De-termination of aflatoxins in periplaneta Americana by immunoaffinity column and high performance liquid chromatography coupled with post-column photo-chemical derivatization [J ]. Chinese Journal of Drug Evaluation ,2020,37 (5):358-361.][ 20 ]刘宁, 王萌萌, 金红宇, 等. 高效液相色谱-柱后光化学衍生法测定参苓白术散中黄曲霉毒素G 2、G 1、B 2、B 1[J ]. 中国药事,2012,26(5):442-445. [LIU Ning,WANG Mengmeng, JIN Hongyu, et al. Determination of aflatoxin G 2, G 1, B 2, B 1 in Shenling Baizhu Powder by HPLC with post column photochemical derivatiza-tion [J ]. Chinese Pharmaceutical Affairs ,2012,26 (5):442-445.][ 21 ]第 2 期郭晶,等:超高效液相色谱-串联质谱法同时检测地龙药材中4种黄曲霉毒素含量及阳性结果确证109。

Healthy Blue SC会员手册说明书

Healthy Blue SC会员手册说明书

December 2019BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections.To report fraud, call our confidential Fraud Hotline at 877-725-2702. You may also call the South Carolina Department of Health and Human ************************************************************.BSCPEC-1596-19 December 2019This is an update about information in the provider manual. For access to the latest manual, go online to .Quarterly pharmacy formulary change noticeWe reviewed and approved the formulary changes listed in the table below at the second quarter Pharmacy and Therapeutics Committee meeting.What does this mean to me?• Effective February 1, 2020, preferred and non-preferred formulary changes will apply. • Effective February 1, 2020, utilization management (UM) edits requirements will apply. • This notice applies to all Healthy Connections members.Effective for all patients on February 1, 2020Therapeutic class DrugRevised status Potential alternativesORALANTIHISTAMINESDIPHENHYDRAMINE 6.25MGSOLUTIONLORATADINE 5MG CHEWABLETABLETPREFERREDN/AORALANTIHISTAMINESED CHLORPED 2MG/ML LIQUID SILPHEN COUG 12.5/5ML SYRUP CLEMASTINE 2.68MG TABLET NON-PREFERRED CHLORPHENIRAMINE4MG TABLETSED CHLORPED JR SYRUPDIPHENHYDRAMINE12.5/5MLLIQUIDCLEMASTINE 1.34 MG OTCORAL NSAIDS(GENERIC)FENOPROFEN 200MG CAPSULE FENOPROFEN 400MG CAPSULE FENOPROFEN 600MG TABLET MEFENAM ACID 250MG CAPSULE NAPROXEN SOD 375MG CR TABLET NAPROXEN SOD 500MG CR TABLETPREFERRED N/A ORAL NSAIDS(BRAND) EC-NAPROSYN 375MG TABLET EC-NAPROSYN 500MG TABLET ADVIL CHILD 100/5ML SUSPENSION NON-PREFERRED GENERIC NAPROXENTABLETSIBUPROFEN 100/5 ML SUSPENSIONTOPICAL NSAIDSDICLOFENAC GEL 1% PREFERREDWITH PAN/A TOPICALANESTHETICS(OTC)PAIN RELIEF ROLL-ON LIQUIDLIDOCAINE 4% PLUS CREAMALOE/LIDOCAINE 0.5% GELREGENECARE 2% GELPREFERRED N/ALIDODOSE 3% GELREGENECARE SPRAYALOCANE 4% GELAFTERBURN 2.5% GELXOLIDO 2% CREAM BURN RELIEF 0.5% AEROSAL ASPERCREME 4% SPRAYLIDOCAINE 3% CREAMLIDOCAINE 4% CREAMLIDOCAINE 5% CREAMAFTERSUN 0.5% GELLIDOCAINE 4% PADTOPICAL ANESTHETICS(RX)LIDOCAINE 3% CREAMLIDOCAINE 5% OINTMENT NON-PREFERREDOTC LIDOCAINEPRODUCTSRX LIDOCAINE5% PATCH(PA REQUIRED)MISCELLANEOUS ANTICONVULSANTSPREGABALIN 25MG CAPSULEPREGABALIN 50MG CAPSULEPREGABALIN 75MG CAPSULEPREGABALIN 100MG CAPSULEPREGABALIN 150MG CAPSULEPREGABALIN 200MG CAPSULEPREGABALIN 225MG CAPSULEPREGABALIN 300MG CAPSULEPREGABALIN SOL 20MG/MLPREFERREDWITH NO PRIORAUTHORIZATION(PA)N/AATOPICDERMATITIS PIMECROLIMUS 1% CREAMPREFERREDWITH STEPTHERAPY (ST)N/AFIBRATESFENOFIBRATE 130MG CAPSULEFENOFIBRATE 145MG TABLETFENOFIBRIC 35MG TABLETFENOFIBRIC 105MG TABLETFENOFIBRIC 135MG DR CAPSULENON-PREFERREDWITH STFENOFIBRATE134MG, 160MG, 200MG,43MG, 48MG,54 MG,67 MGFENOFIBRIC ACID 45 MGALCOHOL SWABS (MANUFACTURERS) GLOBAL DIABETICRITE AID NON-PREFERREDMANUFACTURERSBD DIABETESDYNAREXHEALTH MARTULTIMEDALCOHOL SWABS (MANUFACTURERS) BD DIABETESDYNAREXHEALTH MARTULTIMEDPREFERRED N/AIRON SUPPLEMENTS (GENERIC OTC)IRON 45MG TABLETSLOW-RELEASE FE 45MG TABLETHEMAX TABLETGENTLE IRON 28MG CAPSULEHIGH POTENCY FE 27MG TABLETNU-IRON 150 150MG CAPSULEABATRON AF TABLETSLOW IRON 50MG TABLETPREFERRED N/AFERGON 27MG TABLETIRON SUPPLEMENTS(BRAND OTC)FOLITAB 500 TABLET IRON 28MG TABLETFERROUS GLUC 324MG TABLETEZFE 200MG CAPSULEFERROUS GLUC TAB 324MGFERROUS SULF 324MG EC TABLETFERRETTS 325MG TABLETFERREX 150MG CAPSULEFERREX 28 MIS FERREX 150 PLUS CAPSULE FERREX 150 FORTE PL CAPSULECHEWABLE IRONPEDIATRIC IRON CHEWABLEFERROUS SUL 220/5ML LIQUIDFERROUS SULF 300/5ML SYRUPFEOSOL 200MG TABLETSLOW RELEASE FE 143MG CRTABLETNON- PREFERRED OTC GENERIC IRONSUPPLEMENTSRX PRODUCTS:HEMATOGEN FA CAPSULEHEMETAB TABLETMULTIGEN TABLETMULTIGEN PLS TABLETMULTIGEN FOLICTABLETFERRAPLUS 90 TABLETTARON FORTE CAPSULEFOLIVANE-F CAPSULEFOLIVANE-PLS CAPSULECENTRATEX CAPSULEIRON SUPPLEMENTS(PRESCRIPTIONSTRENGTH)IFEREX 150 FORTE CAPSULE HEMATOGEN CAPSULE HEMATOGEN FORTE CAPSULE TRICON CAPSULE MYFERON 150 FORTE CAPSULE FERROCITE PLUS TABLET FEROCON CAPSULE PUREVIT DUA FE PLUS CAPSULE HEMATINIC PL VIT/MIN TABLET HEMATINIC/FA TABLET POLY-IRON 150 FORT CAPSULE CORVITA 150 TABLET TRIGELS-F FORTE CAPSULE TL ICON CAPSULE SE-TAN PLUS CAPSULE NON- PREFERRED OTC GENERIC IRON SUPPLEMENTSRX PRODUCTS:HEMATOGEN FA CAPSULE HEMETAB TABLET MULTIGEN TABLET MULTIGEN PLS TABLET MULTIGEN FOLIC TABLET FERRAPLUS 90 TABLETTARON FORTE CAPSULE FOLIVANE-F CAPSULEFOLIVANE-PLS CAPSULE CENTRATEX CAPSULEUM edits — effective for all members no later than February 1, 2020 No changes in preferred/non-preferred status revision or addition to UM edit onlyANDROGENS*JATENZO CAPSULE ADD ST WITH QUANTITY LIMITS (QL)58 MG AND 198 MG QL: 4 PER DAY 237 MG QL: 2 PER DAY ANTICONVULSANTSNAYZILAM SPRAY 5MG ADD PA WITH QLQL: 50 MG PER 30 DAYS ANTICONVULSANTSOXTELLAR XR 150 MGOXTELLAR XR 600 MGREVISED QL LIMIT:150 MG: 3 TABLETS PER DAY 600 MG: 4 TABLETS PER DAYANTINEOPLASTICAGENTSPIQRAY 200 MG TABLETSPIQRAY 250 MG TABLETSPIQRAY 300 MG TABLETSADD PA WITH QL QL: 1 CARTON PER 28 DAYS ANTINEOPLASTICAGENTSXPOVIO PAK 60MGXPOVIO PAK 80MGXPOVIO PAK 100MGADD QL 1 CARTON PER 28 DAYSANTINEOPLASTICAGENTSNUBEQA 300MG TABLET ADD QL 4 TABLETS PER DAY ANTINEOPLASTICAGENTS TURALIO CAP 200MG ADD QL 4 TABLETS PER DAY ANTINEOPLASTICAGENTS PIQRAY 200MG TAB DOSE PIQRAY 300MG TAB DOSE PIQRAY 250MG TAB DOSE REVISE QL1 CARTON PER 28 DAYS CHOLESTEROLAGENTS EZALLOR SPRINKLE 5 MG CAP EZALLOR SPRINKLE 10 MG CAP EZALLOR SPRINKLE 20 MG CAP EZALLOR SPRINKLE 40 MG CAP ADD PA AND QLQL: 1 TABLET PER DAY COPD AGENTS DUAKLIR 400/12 INHALER ADD ST AND QLQL: 1 INHALER PER 30 DAYSCYSTIC FIBROSISAGENTSKALYDECO PAK 25MG ADD QL2 PACKETS PER DAYCYSTIC FIBROSISAGENTSORKAMBI GRANULES ADD QL2 PACKETS PER DAY HIVDOVATO TABLET EDURANT 25 MG TABLET DELSTRIGO TABLET COMPLERA TABLET ODEFSEY TABLET JULUCA TABLET ADD PA FOR NEW STARTS AND ADD QLQL: 1 PER DAY HIVINTELENCE TABLET ADD PA FOR NEW STARTS AND ADD QLQL:200 MG- 2 TABLETS PER DAY 400 MG- 4 TABLETS PER DAY 25 MG – 16 TABLETS PER DAYHIVATRIPLA TABLET BIKTARVY TABLET CIMDUO TABLET DESCOVY TABLETEMTRIVA 200 MG CAPSULE EPIVIR 300 MG TABLET EPZICOM TABLET EVOTAZ TABLET GENVOYA TABLET PIFELTRO 100 MG TABLET PREZCOBIX TABLET PREZISTA 800 MG TABLET REYATAZ 300 MG CAPSULESTRIBILD TABLET SUSTIVA 600 MG TABLETSYMFI TABLET SYMFI LO TABLET SYMTUZA TABLET TRIUMEQ TABLET TRUVADA TABLET TYBOST 150 MG TABLET VIDEX EC 400 MG CAPSULE VIDEX EC 250 MG CAPSULE VIRAMUNE XR 400 MG TABLETADD QL 1 PER DAYTEMIXYS TABLETHIVREYATAZ 200 MG CAPSULE REYATAZ 150 MG CAPSULE VIDEX EC 200 MG CAPSULE ZERIT 40 MG CAPSULE ZERIT 30 MG CAPSULE COMBIVIR TABLET DUTREBIS TABLET EPIVIR 150 MG TABLET ISENTRESS HD 600 MG TABLET PREZISTA 600 MG TABLET RETROVIR 300 MG TABLET SELZENTRY 75 MG TABLET TIVICAY 10 MG, 25 MG AND 50 MGTABLETTRIZIVIR TABLETVIRAMUNE 200 MG TABLET ZIAGEN 300 MG TABLET ADD QL 2 PER DAYHIV ISENTRESS 100 MG GRANULE PACKET FOR SUSPENSION ADD QL2 PACKETS PER DAYHIVVIDEX EC 125 MG CAPSULE VIRAMUNE XR 100MG TABLET ADD QL 3 PER DAYHIVAPTIVUS 250 MG CAPSULE INVIRASE 500 MG TABLET ISENTRESS 400 MG TABLET KALETRA 200 MG-50 MG TABLETLEXIVA 700 MG TABLET SELZENTRY 300 MG TABLET SELZENTRY 150 MG TABLET SUSTIVA 200 MG CAPSULE VIRACEPT 625 MG TABLET ZERIT 20 MG CAPSULE ZERIT 15 MG CAPSULEADD QL 4 PER DAYHIVREYATAZ 50 MG POWDER FORSUSPENSIONADD QL5 PACKETS PER DAYHIVCRIXIVAN 400 MG CAPSULE PREZISTA 150 MG TABLET RESCRIPTOR 200 MG TABLET RETROVIR 100 MG CAPSULE ISENTRESS 100 MG CHEWABLEADD QL 6 PER DAY HIV SELZENTRY 25 MG TABLET ADD QL 8 PER DAY HIV TROGARZO 150MG/ML VIAL ADD QL8 VIALS PER 28 DAYSHIVINVIRASE 200 MG CAPSULE KALETRA 100 MG-25 MG TABLETPREZISTA 75 MG TABLET VIRACEPT 250 MG TABLET ADD QL 10 PER DAY HIVCRIXIVAN 200 MG CAPSULE NORVIR 100 MG TABLET NORVIR 100 MG CAPSULEADD QL 12 PER DAYNORVIR 100 MG ORAL POWDERPACKETRESCRIPTOR 100 MG TABLET SUSTIVA 50 MG CAPSULEHIV APTIVUS 100 MG/ML SOLUTION ADD QL 13 ML PER DAYHIV PREZISTA 100 MG/ML SUSPENSION ADD QL 14 ML PER DAY HIV KALETRA 400 MG-100 MG/5 MLORAL SOLUTIONNORVIR 80 MG/ML ORAL SOLUTION ADD QL 16 ML PER DAY HIV ISENTRESS 25 MG CHEWABLE ADD QL24 TABLETS PER DAYHIV EMTRIVA 10 MG/ML SOLUTION ADD QL 29 ML PER DAYHIVEPIVIR 10 MG/ML ORAL SOLUTION ZIAGEN 20 MG/ML SOLUTION ADD QL 32 ML PER DAY HIVVIDEX 4 GM PEDIATRIC ORALSOLUTIONVIDEX 2 GM PEDIATRIC ORALSOLUTIONVIRAMUNE 50 MG/5 MLSUSPENSION ADD QL 40 ML PER DAY HIV VIRACEPT 50 MG/G POWDERADD QL 53 GM PER DAYHIV FUZEON 90 MG VIAL ADD QL60 VIALS PER 30 DAYSHIV LEXIVA 50 MG/ML SUSPENSION ADD QL 60 ML PER DAYHIV SELZENTRY 20 MG/ML ORALSOLUTION ADD QL 62 ML PER DAYHIV RETROVIR 10 MG/ML SYRUP ADD QL 64 ML PER DAYHIVZERIT 1 MG/ML SOLUTION ADD QL 80 ML PER DAY IRRITABLE BOWEL SYNDROME (IBS)AGENTSZELNORM 6MG TABLET ADD PA AND QL QL 2 TABLETS PER DAY LAMBERT-EATON MYASTHENIC SYNDROME AGENTSRUZURGI 10MG TABLET ADD PA AND QL QL 10 TABLETS PER DAYNARCOTIC ANTAGONISTS SUBLOCADE 100/0.5 INJECTION SUBLOCADE 300/1.5 INJECTION REMOVE PANARCOTIC ANTAGONISTS VIVITROL 380MG INEJCTION REMOVE PA AND ADD QL QL 1 VIAL PER 28 DAYSNARCOTIC ANTAGONISTS ZUBSOLV 2.9-0.71 SUB REVISE QL QL 5 PER DAY ORAL DIABETICAGENTS*QTERNMET XR TABLETADD ST AND QLQL:5 MG/5 MG/1000 MG, 10 MG/5 MG/1000 MG:1 TABLET PER DAY2.5 MG/2.5 MG/1000 MG, 5 MG/2.5 MG/10000MG: 2 TABLETS PER DAYORAL DIABETICAGENTS QTERN 5-5MG TABLET ADD QL1 TABLET 28 DAYSINJECTABLE DIABETIC AGENTSOZEMPIC 2/1.5ML INJECTION ADD QL 1 PER 28 DAYSPRENATAL VITAMINS DUET DHADUET DHA BALANCEDNESTABS ABC NESTABS DHA OBTREX DHA SELECT-OB+DHATHERANATAL COMPLETEVITAFOL FE+ VITAFOL-OB+DHABAL-CARE DHA ESSENTIAL ADD QL 2 PER DAYPRENATAL VITAMINS CITRANATAL B-CALMADD QL 3 PER DAYTOPICAL ANTIPRURITICS DOXEPIN HCL 5% CREAM,ZONALON 5% CREAM, PRUDOXIN5% CREAM ADD PA AND QLQL 1 TUBE PER FILL; 1 FILL PER 3 MONTHSTOPICAL ANESTHETIC COMBINATIONSLIDOCAINE/PRILOCAINE CREAMREVISE QL30 GM PER 30 DAYS* Clinical edits will be put in place as these new drugs to come market.What action do I need to take?Please review these changes and work with your Healthy Connections members to transition them to formulary alternatives. If you determine preferred formulary alternatives are notclinically appropriate for specific members, you will need to obtain prior authorization (PA) to continue coverage beyond the applicable effective date.What if I need assistance?We recognize the unique aspects of member cases. If your Healthy Connections member cannot be converted to a formulary alternative for medical reasons, call our Pharmacy department at 866-902-1689 and follow the voice prompts for pharmacy PA.You can find the Preferred Drug List on our website at > Providers > Pharmacy Information. If you need assistance with any other item, contact the Customer Care Center at 866-757-8286.。

富马酸福莫特罗吸入溶液说明书

富马酸福莫特罗吸入溶液说明书

HIGHLIGHTS OF PRESCRIBING INFORMATIONThese highlights do not include all the information needed to use PERFOROMIST safely and effectively. See full prescribing information for PERFOROMIST.These highlights do not include all the information needed to use PERFOROMIST Inhalation Solution safely and effectively. See full prescribing information for PERFOROMIST Inhalation Solution. PERFOROMIST® (formoterol fumarate) Inhalation SolutionInitial U.S. Approval: 2001WARNING: ASTHMA-RELATED DEATHSee full prescribing information for complete boxed warning• Long-acting beta2-adrenergic agonists (LABA) increase the risk of asthma-related death. (5.1)• A placebo-controlled study with another long-acting beta2-adrenergic agonist (salmeterol) showed an increase in asthma-related deaths in patients receiving salmeterol. (5.1)• The finding of an increased risk of asthma-related death with salmeterol is considered a class effect of LABA, including formoterol, the active ingredient in PERFOROMIST. The safety and efficacy of PERFOROMIST in patients with asthma have not been established. All LABA, including PERFOROMIST, are contraindicated in patients with asthma without use of a long-term asthma control medication. (4, 5.1)INDICATIONS AND USAGEPERFOROMIST Inhalation Solution is a long-acting beta2-adrenergic agonist (beta2-agonist) indicated for:• Long-term, twice daily (morning and evening) administration in the maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. (1.1)Important limitations of use:• PERFOROMIST Inhalation Solution is not indicated to treat acute deteriorations of chronic obstructive pulmonary disease. (1.2, 5.2)• PERFOROMIST Inhalation Solution is not indicated to treat asthma. (1.2)DOSAGE AND ADMINISTRATIONFor oral inhalation only.• One 20 mcg/2 mL vial every 12 hours (2)• For use with a standard jet nebulizer (with a facemask or mouthpiece) connected to an air compressor (2)DOSAGE FORMS AND STRENGTHSInhalation Solution (unit dose vial for nebulization); 20 mcg/2 mL solution (3)CONTRAINDICATIONS• All LABA, including PERFOROMIST, are contraindicated in patients with asthma without use of a long-term asthma control medication. (4)WARNINGS AND PRECAUTIONS• Do not initiate PERFOROMIST Inhalation Solution in acutely deteriorating patients. (5.2)• Do not use for relief of acute symptoms. Concomitant short-acting beta2 agonists can be used as needed for acute relief. (5.2)• Do not exceed the recommended dose. Excessive use of PERFOROMIST Inhalation Solution, or use in conjunction with other medications containing long-acting beta2-agonists, can result in clinically significant cardiovascular effects, and may be fatal. (5.3, 5.5)• Life-threatening paradoxical bronchospasm can occur. Discontinue PERFOROMIST Inhalation Solution immediately. (5.4)• Use with caution in patients with cardiovascular or convulsive disorders, thyrotoxicosis, or with sensitivity to sympathomimetic drugs. (5.6, 5.7)ADVERSE REACTIONSMost common adverse reactions (>2% and more common than placebo)are diarrhea, nausea, nasopharyngitis, dry mouth, vomiting, dizziness, and insomnia (6.2)To report SUSPECTED ADVERSE REACTIONS, contact Dey Pharma, L.P. at 1-800-429-7751 or FDA at 1-800-FDA-1088 or / medwatch.To report SUSPECTED ADVERSE REACTIONS, contact Dey Pharma, LP at or FDA at 1-800-FDA-1088 or /medwatchDRUG INTERACTIONS• Other adrenergic drugs may potentiate effect. Use with caution. (5.3, 7.1) • Xanthine derivatives, steroids, diuretics, or non-potassium sparing diuretics may potentiate hypokalemia or ECG changes. Use with caution. (5.7, 7.2, 7.3)• MAO inhibitors, tricyclic antidepressants and drugs that prolong QTc interval may potentiate effect on the cardiovascular system. Use with extreme caution. (7.4)• Beta-blockers may decrease effectiveness. Use with caution and only when medically necessary. (7.5)See 17 for PATIENT COUNSELING INFORMATION and the FDA-approved Medication GuideRevised: 05/2010FULL PRESCRIBING INFORMATION: CONTENTS *WARNING: ASTHMA-RELATED DEATH1 INDICATIONS AND USAGE1.1 Maintenance Treatment of COPD1.2 Important Limitations of Use2 DOSAGE AND ADMINISTRATION3 DOSAGE FORMS AND STRENGTHS4 CONTRAINDICATIONS5 WARNINGS AND PRECAUTIONS5.1 Asthma-Related Deaths5.2 Deterioration of Disease and Acute Episodes5.3 Excessive Use and Use with Other Long-Acting Beta2-Agonists5.4 Paradoxical Bronchospasm5.5 Cardiovascular Effects5.6 Coexisting Conditions5.7 Hypokalemia and Hyperglycemia5.8 Immediate Hypersensitivity Reactions6 ADVERSE REACTIONS6.1 Beta2-Agonist Adverse Reaction Profile6.2 Clinical Trials Experience6.3 Postmarketing Experience7 DRUG INTERACTIONS7.1 Adrenergic Drugs7.2 Xanthine Derivatives, Steroids, or Diuretics7.3 Non-potassium Sparing Diuretics7.4 MAO Inhibitors, Tricyclic Antidepressants, QTc Prolonging Drugs7.5 Beta-blockers8 USE IN SPECIFIC POPULATIONS8.1 Pregnancy8.2 Labor and Delivery8.3 Nursing Mothers8.4 Pediatric Use8.5 Geriatric Use10 OVERDOSAGE11 DESCRIPTION12 CLINICAL PHARMACOLOGY12.1 Mechanism of Action12.2 Pharmacodynamics12.3 Pharmacokinetics13 NONCLINICAL TOXICOLOGY13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility13.2 Animal Pharmacology14 CLINICAL STUDIES14.1 Adult COPD Trial16 HOW SUPPLIED/STORAGE AND HANDLING17 PATIENT COUNSELING INFORMATION* Sections or subsections omitted from the full prescribing information are not listedFULL PRESCRIBING INFORMATIONWARNING: ASTHMA-RELATED DEATHLong-acting beta2-adrenergic agonists (LABA) increase the risk of asthma-related death. Data from a large placebo-controlled US study that compared the safety of another long-acting beta2-adrenergic agonist (salmeterol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol is considered a class effect of LABA, including formoterol, the active ingredient in PERFOROMIST Inhalation Solution. The safety and efficacy of PERFOROMIST in patients with asthma have not been established. All LABA, including PERFOROMIST, are contraindicated in patients with asthma without use of a long-term asthma control medication [see CONTRAINDICATION (4), WARNINGS AND PRECAUTIONS (5.1)].1 INDICATIONS AND USAGE1.1 Maintenance Treatment of COPDPERFOROMIST (formoterol fumarate) Inhalation Solution is indicated for the long-term, twice daily (morning and evening) administration in the maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.1.2 Important Limitations of UsePERFOROMIST Inhalation Solution is not indicated to treat acute deteriorations of chronic obstructive pulmonary disease [see WARNINGS AND PRECAUTIONS (5.2)].PERFOROMIST Inhalation Solution is not indicated to treat asthma. The safety and effectiveness of PERFOROMIST Inhalation Solution in asthma have not been established.2 DOSAGE AND ADMINISTRATIONThe recommended dose of PERFOROMIST (formoterol fumarate) Inhalation Solution is one 20 mcg unit-dose vial administered twice daily (morning and evening) by nebulization. A total daily dose greater than 40 mcg is not recommended. PERFOROMIST Inhalation Solution should be administered by the orally inhaled route via a standard jet nebulizer connected toan air compressor. The safety and efficacy of PERFOROMIST Inhalation Solution have been established in clinical trials when administered using the PARI-LC Plus® nebulizer (with a facemask or mouthpiece) and the PRONEB® Ultra compressor. The safety and efficacy of PERFOROMIST Inhalation Solution delivered from non-compressor based nebulizer systems have not been established.PERFOROMIST Inhalation Solution should always be stored in the foil pouch, and only removed IMMEDIATELY BEFORE USE. Contents of any partially used container should be discarded.If the recommended maintenance treatment regimen fails to provide the usual response, medical advice should be sought immediately, as this is often a sign of destabilization of COPD. Under these circumstances, the therapeutic regimen should be re-evaluated and additional therapeutic options should be considered.The drug compatibility (physical and chemical), efficacy, and safety of PERFOROMIST Inhalation Solution when mixed with other drugs in a nebulizer have not been established.3 DOSAGE FORMS AND STRENGTHSPERFOROMIST (formoterol fumarate) Inhalation Solution is supplied as a sterile solution for nebulization in low-density polyethylene unit-dose vials. Each vial contains formoterol fumarate dihydrate, USP equivalent to 20 mcg/2 mL of formoterol fumarate.4 CONTRAINDICATIONSAll LABA, including PERFOROMIST, are contraindicated in patients with asthma without use of a long-term asthma control medication. [see WARNINGS and PRECAUTIONS (5.1)].5 WARNINGS AND PRECAUTIONS5.1 Asthma-Related Deaths[See BOXED WARNING]Data from a large placebo-controlled study in asthma patients showed that long-acting beta2-adrenergic agonists may increase the risk of asthma-related death. Data are not available to determine whether the rate of death in patients with COPD is increased by long- acting beta2-adrenergic agonists.A 28-week, placebo-controlled US study comparing the safety of salmeterol with placebo, each added to usual asthma therapy, showed an increase in asthma-related deaths in patients receiving salmeterol (13/13,176 in patients treated with salmeterol vs.3/13,179 in patients treated with placebo; RR 4.37, 95% CI 1.25, 15.34). The increased risk of asthma-related death is considereda class effect of the long-acting beta2-adrenergic agonists, including PERFOROMIST Inhalation Solution. No study adequateto determine whether the rate of asthma related death is increased in patients treated with PERFOROMIST Inhalation Solutionhas been conducted. The safety and efficacy of PERFOROMIST in patients with asthma have not been established. All LABA, including PERFOROMIST, are contraindicated in patients with asthma without use of a long-term asthma control medication. [see CONTRAINDICATIONS (4)].Clinical studies with formoterol fumarate administered as a dry powder inhaler suggested a higher incidence of serious asthma exacerbations in patients who received formoterol than in those who received placebo. The sizes of these studies were not adequate to precisely quantify the differences in serious asthma exacerbation rates between treatment groups.5.2 Deterioration of Disease and Acute EpisodesPERFOROMIST Inhalation Solution should not be initiated in patients with acutely deteriorating COPD, which may be a life-threatening condition. PERFOROMIST Inhalation Solution has not been studied in patients with acutely deteriorating COPD. The use of PERFOROMIST Inhalation Solution in this setting is inappropriate.PERFOROMIST Inhalation Solution should not be used for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. PERFOROMIST Inhalation Solution has not been studied in the relief of acute symptoms and extra doses should not be used for that purpose. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.When beginning PERFOROMIST Inhalation Solution, patients who have been taking inhaled, short-acting beta2-agonists on a regular basis (e.g., four times a day) should be instructed to discontinue the regular use of these drugs and use them only for symptomatic relief of acute respiratory symptoms. When prescribing PERFOROMIST Inhalation Solution, the healthcare provider should also prescribe an inhaled, short-acting beta2-agonist and instruct the patient how it should be used. Increasing inhaled beta2-agonist useis a signal of deteriorating disease for which prompt medical attention is indicated. COPD may deteriorate acutely over a periodof hours or chronically over several days or longer. If PERFOROMIST Inhalation Solution no longer controls the symptoms of bronchoconstriction, or the patient’s inhaled, short-acting beta2-agonist becomes less effective or the patient needs more inhalation of short-acting beta2-agonist than usual, these may be markers of deterioration of disease. In this setting, a re-evaluation of the patient and the COPD treatment regimen should be undertaken at once. Increasing the daily dosage of PERFOROMIST Inhalation Solution beyond the recommended 20 mcg twice daily dose is not appropriate in this situation.5.3 Excessive Use and Use with Other Long-Acting Beta2-AgonistsAs with other inhaled beta2-adrenergic drugs, PERFOROMIST Inhalation Solution should not be used more often, at higherdoses than recommended, or in conjunction with other medications containing long-acting beta2-agonists, as an overdose may result. Clinically significant cardiovascular effects and fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs.5.4 Paradoxical BronchospasmAs with other inhaled beta2-agonists, PERFOROMIST Inhalation Solution can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs, PERFOROMIST Inhalation Solution should be discontinued immediately and alternative therapy instituted.5.5 Cardiovascular EffectsPERFOROMIST Inhalation Solution, like other beta2-agonists, can produce a clinically significant cardiovascular effect in some patients as measured by increases in pulse rate, systolic and/or diastolic blood pressure, and/or symptoms. If such effects occur, PERFOROMIST Inhalation Solution may need to be discontinued. In addition, beta-agonists have been reported to produce ECG changes, such as flattening of the T wave, prolongation of the QTc interval, and ST segment depression. The clinical significance of these findings is unknown. Therefore, PERFOROMIST Inhalation Solution, like other sympathomimetic amines, should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension.5.6 Coexisting ConditionsPERFOROMIST Inhalation Solution, like other sympathomimetic amines, should be used with caution in patients with convulsive disorders or thyrotoxicosis, and in patients who are unusually responsive to sympathomimetic amines. Doses of the related beta2 agonist albuterol, when administered intravenously, have been reported to aggravate preexisting diabetes mellitus and ketoacidosis.5.7 Hypokalemia and HyperglycemiaBeta-agonist medications may produce significant hypokalemia in some patients, possibly through intracellular shunting, which has the potential to produce adverse cardiovascular effects [see CLINICAL PHARMACOLOGY (12.2)]. The decrease in serum potassium is usually transient, not requiring supplementation. Beta-agonist medications may produce transient hyperglycemia in some patients. Clinically significant changes in serum potassium and blood glucose were infrequent during clinical studies with long-term administration of PERFOROMIST Inhalation Solution at the recommended dose.5.8 Immediate Hypersensitivity ReactionsImmediate hypersensitivity reactions may occur after administration of PERFOROMIST Inhalation Solution, as demonstrated by cases of anaphylactic reactions, urticaria, angiodema, rash, and bronchospasm.6 ADVERSE REACTIONSLong acting beta2-adrenergic agonists such as formoterol increase the risk of asthma-related death [See BOXED WARNING and WARNINGS AND PRECAUTIONS (5.1)].6.1 Beta2-Agonist Adverse Reaction ProfileAdverse reactions to PERFOROMIST Inhalation Solution are expected to be similar in nature to other beta2-adrenergic receptor agonists including: angina, hypertension or hypotension, tachycardia, arrhythmias, nervousness, headache, tremor, dry mouth, muscle cramps, palpitations, nausea, dizziness, fatigue, malaise, insomnia, hypokalemia, hyperglycemia, and metabolic acidosis.6.2 Clinical Trials ExperienceBecause clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.Adults with COPDThe data described below reflect exposure to PERFOROMIST Inhalation Solution 20 mcg twice daily by oral inhalation in 586 patients, including 232 exposed for 6 months and 155 exposed for at least 1 year. PERFOROMIST Inhalation Solution was studied in a 12-week, placebo-and active-controlled trial (123 subjects treated with PERFOROMIST Inhalation Solution) and a 52-week, active-controlled trial (463 subjects treated with PERFOROMIST Inhalation Solution). Patients were mostly Caucasians (88%) between40-90 years old (mean, 64 years old) and had COPD, with a mean FEV1 of 1.33 L. Patients with significant concurrent cardiac and other medical diseases were excluded from the trials.Table 1 shows adverse reactions from the 12-week, double-blind, placebo-controlled trial where the frequency was greater than or equal to 2% in the PERFOROMIST Inhalation Solution group and where the rate in the PERFOROMIST Inhalation Solution group exceeded the rate in the placebo group. In this trial, the frequency of patients experiencing cardiovascular adverse events was 4.1% for PERFOROMIST Inhalation Solution and 4.4% for placebo. There were no frequently occurring specific cardiovascular adverse events for PERFOROMIST Inhalation Solution (frequency greater than or equal to 1% and greater than placebo). The rate of COPD exacerbations was 4.1% for PERFOROMIST Inhalation Solution and 7.9% for placebo.TABLE 1Number of patients with adverse reactions in the 12-week multiple-dose controlled clinical trial Adverse Reaction PERFOROMIST PlaceboInhalationSolution20 mcgn (%) n (%) Total Patients 123 (100) 114 (100)Diarrhea 6 (4.9) 4 (3.5)Nausea 6 (4.9) 3 (2.6) Nasopharyngitis 4 (3.3) 2 (1.8)Dry Mouth 4 (3.3) 2 (1.8)Vomiting 3 (2.4) 2 (1.8)Dizziness 3 (2.4) 1 (0.9)Insomnia 3 (2.4) 0 0 Patients treated with PERFOROMIST Inhalation Solution 20 mcg twice daily in the 52-week open-label trial did not experience an increase in specific clinically significant adverse events above the number expected based on the medical condition and age of the patients.6.3 Postmarketing ExperienceThe following adverse reactions have been reported during post-approval use of PERFOROMIST. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.Anaphylactic reactions, urticaria, angioedema (presenting as face, lip, tongue, eye, pharyngeal, or mouth edema), rash, and bronchospasm.7 DRUG INTERACTIONS7.1 Adrenergic DrugsIf additional adrenergic drugs are to be administered by any route, they should be used with caution because the sympathetic effects of formoterol may be potentiated [see WARNINGS AND PRECAUTIONS (5.3, 5.5, 5.6, 5.7)].7.2 Xanthine Derivatives, Steroids, or DiureticsConcomitant treatment with xanthine derivatives, steroids, or diuretics may potentiate any hypokalemic effect of adrenergic agonists [see WARNINGS AND PRECAUTIONS (5.7)].7.3 Non-potassium Sparing DiureticsThe ECG changes and/or hypokalemia that may result from the administration of non-potassium sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. Although the clinical significance of these effects is not known, caution is advised in the co-administration of beta-agonists with non-potassium sparing diuretics.7.4 MAO Inhibitors, Tricyclic Antidepressants, QTc Prolonging DrugsFormoterol, as with other beta2-agonists, should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors, tricyclic antidepressants, or drugs known to prolong the QTc interval because the effect of adrenergic agonists on the cardiovascular system may be potentiated by these agents. Drugs that are known to prolong the QTc interval have an increased risk of ventricular arrhythmias.7.5 Beta-blockersBeta-adrenergic receptor antagonists (beta-blockers) and formoterol may inhibit the effect of each other when administered concurrently. Beta-blockers not only block the therapeutic effects of beta-agonists, but may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g., as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.8 USE IN SPECIFIC POPULATIONS8.1 PregnancyTeratogenic Effects: Pregnancy Category CFormoterol fumarate administered throughout organogenesis did not cause malformations in rats or rabbits following oral administration. However, formoterol fumarate was found to be teratogenic in rats and rabbits in other testing laboratories. When given to rats throughout organogenesis, oral doses of 0.2 mg/kg (approximately 40 times the maximum recommended daily inhalation dose in humans on a mg/m2 basis) and above delayed ossification of the fetus, and doses of 6 mg/kg (approximately 1200 times the maximum recommended daily inhalation dose in humans on a mg/m2 basis) and above decreased fetal weight. Formoterol fumarate has been shown to cause stillbirth and neonatal mortality at oral doses of 6 mg/kg and above in rats receiving the drug during thelate stage of pregnancy. These effects, however, were not produced at a dose of 0.2 mg/kg. Because there are no adequate and well-controlled studies in pregnant women, PERFOROMIST Inhalation Solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Women should be advised to contact their physician if they become pregnant while taking PERFOROMIST Inhalation Solution.8.2 Labor and DeliveryThere are no adequate and well-controlled human studies that have investigated the effects of PERFOROMIST Inhalation Solution during labor and delivery.Because beta-agonists may potentially interfere with uterine contractility, PERFOROMIST Inhalation Solution should be used during labor only if the potential benefit justifies the potential risk.8.3 Nursing MothersIn reproductive studies in rats, formoterol was excreted in the milk. It is not known whether formoterol is excreted in human milk, but because many drugs are excreted in human milk, caution should be exercised if PERFOROMIST Inhalation Solution is administered to nursing women. There are no well-controlled human studies of the use of PERFOROMIST Inhalation Solution in nursing mothers. Women should be advised to contact their physician if they are nursing while taking PERFOROMIST Inhalation Solution.8.4 Pediatric UsePERFOROMIST Inhalation Solution is not indicated for use in children. The safety and effectiveness of PERFOROMIST Inhalation Solution in pediatric patients have not been established. The pharmacokinetics of formoterol fumarate has not been studied in pediatric patients.8.5 Geriatric UseOf the 586 subjects who received PERFOROMIST Inhalation Solution in clinical studies, 284 were 65 years and over, while 89 were 75 years and over. Of the 123 subjects who received PERFOROMIST Inhalation Solution in the 12-week safety and efficacy trial,48 (39%) were 65 years of age or older. No overall differences in safety or effectiveness were observed between these subjects and younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger adult patients, but greater sensitivity of some older individuals cannot be ruled out.The pharmacokinetics of PERFOROMIST Inhalation Solution has not been studied in elderly subjects.10 OVERDOSAGEThe expected signs and symptoms with overdosage of PERFOROMIST Inhalation Solution are those of excessive beta-adrenergic stimulation and/or occurrence or exaggeration of any of the signs and symptoms listed under ADVERSE REACTIONS. Signs and symptoms may include angina, hypertension or hypotension, tachycardia with rates up to 200 beats/min, arrhythmias, nervousness, headache, tremor, seizures, muscle cramps, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, insomnia, hyperglycemia, hypokalemia, and metabolic acidosis. As with all inhaled sympathomimetic medications, cardiac arrest and even death may be associated with an overdose of PERFOROMIST Inhalation Solution.Treatment of overdosage consists of discontinuation of PERFOROMIST Inhalation Solution together with institution of appropriate symptomatic and/or supportive therapy. The judicious use of a cardioselective beta-receptor blocker may be considered, bearingin mind that such medication can produce bronchospasm. There is insufficient evidence to determine if dialysis is beneficial for overdosage of PERFOROMIST Inhalation Solution. Cardiac monitoring is recommended in cases of overdosage.The minimum lethal inhalation dose of formoterol fumarate in rats is 156 mg/kg (approximately 32,000 times the maximum recommended daily inhalation dose in humans on a mg/m2 basis). The median lethal oral doses in Chinese hamsters, rats, and mice provide even higher multiples of the maximum recommended daily inhalation dose in humans.For additional information about overdose treatment, call a poison control center (1-800-222-1222).11 DESCRIPTIONPERFOROMIST (formoterol fumarate) Inhalation Solution is supplied as 2 mL of formoterol fumarate inhalation solution packaged in a 2.5 mL single-use low-density polyethylene vial and overwrapped in a foil pouch. Each vial contains 2 mL of a clear, colorless solution composed of formoterol fumarate dihydrate, USP equivalent to 20 mcg of formoterol fumarate in an isotonic, sterile aqueous solution containing sodium chloride, pH adjusted to 5.0 with citric acid and sodium citrate.The active component of PERFOROMIST Inhalation Solution is formoterol fumarate dihydrate, USP, a racemate. Formoterol fumarate dihydrate is a beta2-adrenergic bronchodilator. Its chemical name is (±)-2-hydroxy-5-[(1RS)-1-hydroxy-2-[[(1RS)-2-(4­methoxyphenyl)-1-methylethyl]-amino]ethyl]formanilide fumarate dihydrate; its structural formula is:Formoterol fumarate dihydrate, USP has a molecular weight of 840.92 and its empirical formula is (C19H24N2O4)2•C4H4O4•2H2O. Formoterol fumarate dihydrate, USP is a white to yellowish crystalline powder, which is freely soluble in glacial acetic acid, soluble in methanol, sparingly soluble in ethanol and isopropanol, slightly soluble in water, and practically insoluble in acetone, ethyl acetate, and diethyl ether.PERFOROMIST Inhalation Solution does not require dilution prior to administration by nebulization. Like all other nebulized treatments, the amount delivered to the lungs will depend on patient factors and the nebulization system used and its performance. Using the PARI-LC Plus® nebulizer (with a facemask or mouthpiece) connected to a PRONEB® Ultra compressor under in vitro conditions, the mean delivered dose from the mouthpiece was approximately 7.3 mcg (37% of label claim). The mean nebulizerflow rate was 4 LPM and the nebulization time was 9 minutes. PERFOROMIST Inhalation Solution should be administered from a standard jet nebulizer at adequate flow rates via a facemask or mouthpiece.12 CLINICAL PHARMACOLOGY12.1 Mechanism of ActionFormoterol fumarate is a long-acting, beta2-adrenergic receptor agonist (beta2-agonist). Inhaled formoterol fumarate acts locally in the lung as a bronchodilator. In vitro studies have shown that formoterol has more than 200-fold greater agonist activity at beta2-receptors than at beta1-receptors. Although beta2-receptors are the predominant adrenergic receptors in bronchial smooth muscle and beta1 receptors are the predominant receptors in the heart, there are also beta2-receptors in the human heart comprising 10% to 50% of the total beta-adrenergic receptors. The precise function of these receptors has not been established, but they raise the possibility that even highly selective beta2-agonists may have cardiac effects.The pharmacologic effects of beta2-adrenoceptor agonist drugs, including formoterol, are at least in part attributable to stimulationof intracellular adenyl cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3', 5'-adenosine monophosphate (cyclic AMP). Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.In vitro tests show that formoterol is an inhibitor of the release of mast cell mediators, such as histamine and leukotrienes, fromthe human lung. Formoterol also inhibits histamine-induced plasma albumin extravasation in anesthetized guinea pigs and inhibits allergen-induced eosinophil influx in dogs with airway hyper-responsiveness. The relevance of these in vitro and animal findings to humans with COPD is unknown.12.2 PharmacodynamicsSystemic Safety and Pharmacokinetic / Pharmacodynamic RelationshipsThe major adverse effects of inhaled beta2-agonists occur as a result of excessive activation of the systemic beta-adrenergic receptors. The most common adverse effects in adults include skeletal muscle tremor and cramps, insomnia, tachycardia, decreases in plasma potassium, and increases in plasma glucose.Changes in serum potassium and serum glucose were evaluated in 12 COPD patients following inhalation of single doses of PERFOROMIST Inhalation Solution containing 10, 20 and 244 mcg of formoterol fumarate (calculated on an anhydrous basis) in a crossover study. At 1 hour after treatment with formoterol fumarate inhalation solution, mean (± standard deviation) serum glucose rose 26 ± 30, 29 ± 28, and 38 ± 44 mg/dL, respectively, and was not significantly different from baseline or trough level at 24 hours post-dose. At 1 hour after dosing with formoterol fumarate inhalation solution 244 mcg, serum potassium fell by 0.68 ± 0.4 mEq/L, and was not different from baseline or trough level at 24 hours post-dose.。

CAS1177-87-3_Dexamethasone acetate_参考说明脉铂

CAS1177-87-3_Dexamethasone acetate_参考说明脉铂
CAS
1、Dexamethasone-17-acetate物理参数:
常用名
醋酸地塞米松
英文名
Dexamethasone-17-acetate
CAS号
1177-87-3
分子量
434.498
密度
1.3±0.1 g/cm3
沸点
579.4±50.0 °C at 760 mmHg
分子式
C24H31FO6
熔点
238-240 °C(lit.)
CAS
包装
纯度
MedBio
MED12666
Pasireotide Acetate
Pasireotide Acetate
396091-76-2
5mg
≥98%
品牌
货号
中文名称
英文名称
CAS
包装
纯度
MedBio
MED13287
16,16-Dimethyl Prostaglandin E2
16,16-Dimethyl Prostaglandin E2
闪点
304.2±30.1 °C
2、Dexamethasone-17-acetate技术资料:
体外研究
地塞米松调节几种转录因子,包括激活蛋白-1,核因子-AT和核因子-κB,导致激活和抑制参与炎症反应的关键基因[1]。地塞米松有效抑制A549细胞释放粒细胞-巨噬细胞集落刺激因子(GM-CSF),EC50为2.2 nM。发现地塞米松(EC50 = 36nM)诱导β2受体的转录与糖皮质激素受体(GR)DNA结合相关,并且发生在比GM-CSF释放抑制高10-100倍的浓度。地塞米松(IC50 = 0.5 nM)抑制3×κB(NF-κB,IκBα和I-κBβ),这与抑制GM-CSF释放有关[2]。

达格列净联合二甲双胍治疗2_型糖尿病的效果观察

达格列净联合二甲双胍治疗2_型糖尿病的效果观察

·药物与临床·糖尿病新世界 2023年9月DOI:10.16658/ki.1672-4062.2023.18.085达格列净联合二甲双胍治疗2型糖尿病的效果观察卢红艳1,21.广宁县人民医院呼吸科,广东肇庆526300;2.广宁县人民医院内分泌科,广东肇庆526300[摘要]目的探讨对2型糖尿病患者采用达格列净+二甲双胍药物完成治疗后获得临床效果。

方法选取2020年10月—2021年10月广宁县人民医院100例2型糖尿病患者,按照随机数字表法分为常规组和研究组,各50例。

常规组采用格列齐特缓释片+二甲双胍缓释片治疗,研究组采用达格列净+二甲双胍缓释片治疗。

比较两组患者治疗结果。

结果研究组治疗总有效率(98.00%)高于常规组(84.00%),差异有统计学意义(χ2= 5.983,P<0.05)。

治疗后,研究组三酰甘油、低密度脂蛋白、总胆固醇以及体质指数均低于常规组,差异有统计学意义(P<0.05)。

治疗后,研究组空腹血糖、糖化血红蛋白、餐后2 h血糖水平均低于常规组,差异有统计学意义(P<0.05)。

结论达格列净+二甲双胍缓释片联合应用,可显著提高患者治疗效果,显著改善血脂水平以及体质量,有效降低血糖水平,促进2型糖尿病患者总体预后水平改善。

[关键词] 2型糖尿病;达格列净;二甲双胍缓释片;格列齐特缓释片;治疗总有效率;血脂指标;体质指数;血糖指标[中图分类号] R47 [文献标识码] A [文章编号] 1672-4062(2023)09(b)-0085-04Efficacy of Dapagliflozin Combined with Metformin in the Treatment of Type 2 Diabetes MellitusLU Hongyan1,21. Department of Respiratory, Guangning County People's Hospital, Zhaoqing, Guangdong Province, 526300 China;2. Department of Endocrinology, Guangning County People's Hospital, Zhaoqing, Guangdong Province, 526300 China[Abstract] Objective To investigate the clinical effect of dapagliflozin plus metformin in patients with type 2 diabe‐tes. Methods 100 patients with type 2 diabetes in Guangning County People's Hospital from October 2020 to October 2021 were selected and divided into routine group and study group according to random number table, with 50 casesin each group. The routine group was treated with gliclazide sustained-release tablets and metformin sustained-release tablets, while the study group was treated with daggliflozin and metformin sustained-release tablets. Compared the treatment results of two groups of patients. Results The total effective rate of the study group (98.00%) was higher than that of the routine group (84.00%), the difference was statistically significant (χ2=5.983, P<0.05). After treat‐ment, the levels of triglycerides, low-density lipoprotein, total cholesterol, and body mass index in the study group were lower than those in the routine group, the difference was statistically significant (P<0.05). After treatment, the fasting blood glucose, glycated hemoglobin, and 2-hour postprandial blood glucose levels in the study group were sig‐nificantly lower than those in the routine group, the difference was statistically significant (P<0.05). Conclusion The combined application of dapagliflozin and metformin sustained-release tablets can significantly improve the therapeu‐tic effect of patients, significantly improve the level of blood lipid and body mass, effectively reduce the level of blood glucose, and promote the improvement of the overall prognosis of patients with type 2 diabetes.[Key words] Type 2 diabetes; Dapagliflozin; Metformin sustained-release tablets; Gliclazide sustained release tab‐lets; Total effective rate of treatment; Blood lipid index; Body mass index; Blood glucose index[作者简介]卢红艳(1982-),女,本科,副主任医师,研究方向为内分泌。

罗米司亭及艾曲波帕药品说明书

罗米司亭及艾曲波帕药品说明书

根据病人的病情选择:1.确定什么原因引起的血小板减少,至少要找到疾病的诱因。

免疫系统?骨髓造血系统?分泌(激素)?2.若不能找到诱因,一定要使用该两种药品,先用6周,看看效果,查血小板计数,是否继续使用,再做评估。

罗米司亭【商品名】Nplate【药品名称】罗米司亭/ romiplostim【适应症】治疗脾切除和脾未切除慢性免疫性血小板减少性紫癜(ITP)成人患者的血小板生成药。

【用法用量】(1)初始剂量1μg/kg每周1次皮下注射。

(2)因为需要减低出血的风险,通过增量1μg/kg调整每周剂量以达到和维持血小板计数50 × 109/L.(3)最大剂量不要超过每周10μg/kg。

如血小板计数达>400×109/L不要给药。

(4)如在最大剂量4周后血小板计数不增加中断Nplate。

(5)在配制期间不要震荡;避光保护配制好的Nplate; 24小时给配制好的Nplate。

(6)注射容积可能非常小。

使用刻度0.01 mL的注射器。

(7)遗弃单次使用小瓶中未使用部份。

【注意事项】(1)Nplate增加骨髓网硬蛋白(reticulin)沉积的风险;临床研究未除外网硬蛋白和其它纤维沉积导致有血细胞减少的骨髓纤维化的可能性。

监查外周血骨髓纤维化征象。

(2)中止Nplate可能导致血小板减少比Nplate治疗前更坏。

Nplate中止后监查全血细胞计数(CBCs),包括血小板计数至少2周。

(3)过量Nplate可能增加血小板计数至产生血栓形成/栓塞并发症的水平。

(4)如随Nplate初期反应后血小板计数严重减低评估患者中和抗体的形成。

(5)Nplate可能增加血液学恶性病的风险,尤其是有骨髓增生异常综合征患者。

(6)每周监查CBCs,包括血小板计数和外周血涂片,直至达到稳定的Nplate 剂量。

其后,至少每月监查CBCs,包括血小板计数和外周血涂片。

(7)只能通过受限制的分配计划,称为Nplate NEXUS(了解和支持Nplate专家和患者网络)计划,才能获得Nplate。

Exherin trifluoroacetate_1135237-88-5_DataSheet_MedChemExpress

Exherin trifluoroacetate_1135237-88-5_DataSheet_MedChemExpress

10 mM in water
Mechanisms: Pathways:Others; Target:Others Biological Activity: Exherin (ADH-1) trifluoroacetate is a small, cyclic pentapeptide vascular-targeting agent with potential antineoplastic and antiangiogenic activities; selectively and competitively binds to and blocks N-cadherin. IC50 value: Target: N-cadherin blocker ADH-1 selectively and competitively binds to and blocks N-cadherin, which may result in disruption of tumor vasculature, inhibition of tumor cell growth, and the induction of tumor cell and endothelial cell apoptosis. Ncadherin, a cell- surface transmembrane glycoprotein of the cadherin superfamily of proteins involved in calcium-mediated cell-cell adhesion and signaling mechanisms; may be upregulated in some aggressive tumors and the endothelial cells and pericytes of some tumor blood vessels....

左甲状腺素钠片剂药品说明书(英文)

左甲状腺素钠片剂药品说明书(英文)

Revised: September 2000 (3rd version of new form)Standard Commodity Classification No. of Japan872431THYRADIN -S Tablets 25THYRADIN -S Tablets 50THYRADIN -S Tablets 100<Levothyroxine Sodium>Powerful drug, designated drug and presctiption-only drugCaution: Use only pursuant to the prescription or direction of a physician,etc.Storage2550100Approval No.21000AMZ0017000021000AMZ0021900021000AMZ00171000 The product should be storedin a light-resistant container at room temperature.Date of listing in the NHIreimbursement priceJuly 1998November 1965July 2000Expiration date Date of initial marketing inJapanSeptember 1998July 1998September 2000Date of latest reevaluation March 1978Do not use after theexpiration date indicated onthe package.CONTRAINDICATIONS (THYRADIN-S Tabletsare contraindicated in the following patients.)Patients with fresh myocardial infarction [Due to increasein basal metabolism, cardiac load may increase, and thecondition of patients may be deteriorated.]DESCRIPTIONposition and dosage formTHYRADIN-S Tablets 25:Each tablet contains 25 µg of levothyroxine sodium (TheJapanese Pharmacopoeia: dried material). Light red plaintablet (scored).THYRADIN-S Tablets 50:Each tablet contains 50 µg of levothyroxine sodium (TheJapanese Pharmacopoeia: dried material). White plaintablet (scored).THYRADIN-S Tablets 100:Each tablet contains 100 µg of levothyroxine sodium (TheJapanese Pharmacopoeia: dried material). Yellow tablet.2.Product descriptionBrand name THYRADIN-STablets 25THYRADIN-STablets 50THYRADIN-STablets 100AppearanceDiameter 6.5 mm 6.5 mm 6.5 mmThickness 2.4 mm 2.4 mm 2.4 mmWeight100 mg100 mg100 mgIdentificationcodeTZ214TZ224TZ234INDICATIONSMyxedema, cretinism, hypothyroidism (primary or pituitary)and goiter.DOSAGE AND ADMINISTRATIONUsually for adults, administer orally 25-400 µg aslevothyroxine sodium once daily. Generally in many cases, 25-100 µg is administered as a starting dose, and 100-400 µg isadministered for maintenance therapy. The dose may beincreased or decreased according to age and symptoms.PRECAUTIONS1.Careful Administration (THYRADIN-S Tablets shouldbe administered with care in the following patients.)(1)Patients with severe cardiovascular disorders such asangina pectoris, old myocardial infarction,arteriosclerosis and hypertension[Since the condition of patients may deteriorate due tothe cardiac load induced by an increase in basalmetabolism, the administration should be initiated witha small amount, and the dose should be graduallyincreased by taking longer time than usual. Maintenancedosage should be kept at minimum.](2)Patients with adrenal cortical insufficiency or pituitaryinsufficiency[Since adrenal crisis with the symptoms of shock, etc.,may be induced, the drug should be administered afteradequate treatment for adreanal cortical insufficiency(administration of adreno-cortical hormones).](3)Patients with diabetes mellitus[Since the condition of control of blood glucose may bechanged, sufficient care should be taken when the drugis administered.] (refer to "Drug Interactions")(4)Elderly patients (refer to "Use in the Elderly")2.Important PrecautionsTo patients with hypothyroidism and myxedema, theadministration should be initiated with a small amount, and the dose shall be gradually increased up to themaintenance dosage with sufficient observation.3.Drug Interactions[Precautions for coadministration] (THYRADIN-STablets should be administered with care whencoadministered with the following drugs.)Drugs Signs, Symptoms andTreatment Mechanism and Risk FactorsCoumarin-type anticoagulant1) (warfarin potassium, etc.)Since the drug may increasethe action of coumarin-type anticoagulants, in case of coadminitsration, specialattention should be paidsuch as by measuringprothrombin time, etc., andby adjusting the dose ofanticoagulants, etc.It is considered thatthyroid hormonesmay promote thecatabolism ofVitamin K-dependentanticoagulantfactors.Sympathomimetic drugs (epinephrine, norepinephrine, drugs containing ephedrine or methylephedrine)The drug may increase theaction of sympathomimeticdrugs. Since the risk ofcoronary failure mayincrease when the drugs arecoadministered to thepatients with coronaryartery diseases, specialattention should be paid incase of coadiministration.It is considered thatthyroid hormonesmay increase thesensitivity ofreceptors forcatecholamines.Cardiac grycosides (digoxin, digitoxin, etc.)Since it is reported thatserum digoxinconcentration decreases athyperthyroid condition andincreases at hypothyroidcondition, larger amount(under hyperthyroidcondition) or smalleramount (under hypothyroidcondition) of cardiacglycosides than usual maybe required. In case ofcoadministration, specialattention should be paid(e.g., with monitoring bloodIt is considered thatthe absorption rate,distribution volume,hepatic metabolism,renal excretion rate,etc., of cardiacglycosides may beattributable to thephenomenon.concentration of cardiacglycosides).Hypoglycemicagents(insulinpreparations,sulfonyl ureapreparations)In the patients to whomhypoglycemic agents areadministered, the drug-Smay change the conditionof control of blood glucose.In case of coadministration,the drugs should beadministered carefully byobserving the blood glucoselevel and the condition ofpatients, and by adjustingthe doses of drugs.It is considered thatthe drug may affectwhole glucosemetabolism andchange glucoselevel.Colestyramine2),ironpreparations3),antacidscontainingalminum4,5)Since the absorption of thedrug may be retarded orreduced bycoadministration, sufficientcare should be taken suchas providing sufficient doseinterval of the drug in caseof coadministration.It is considered thatthe drugs bind to thedrug in thegastrointestinal tractand suppress theabsorption of thedrug.Phenitoinpreparations6)Since phenitoin maydecrease the bloodconcentration of the drug,sufficient care should betaken such as increasing thedose of the drug in case ofcoadministration.It is considered thatphenitoin maypromote thecatabolism ofthyroid hormones.4.Adverse ReactionsPost-marketing surveirances that will clarify the incidenceof adverse reactions have not been performed.(THYRADIN-S Tablets are not classified as the drugswhich are subject to reexamination.)(1)Clinically significant adverse reactions (incidenceunknown)Angina pectoris may occur. In such case, overdosagemay be considered, and, appropriate measures, such asreduction of dose, discontinuation, etc., should betaken.(2)Clinically significant adverse reactions (by similardrugs) (incidence unknown)1)The occurrence of shock in the treatment with similardrug (liothyronine sodium) has been reported.2)The occurrence of congestive heart failure in thetreatment with similar drug (liothyronine sodium) hasbeen reported. In such case, overdosage may beconsidered, and, appropriate measures, such asreduction of dose, discontinuation, etc., should betaken.(3)Other adverse reactionsIncidence unknownHypersensitivity†1)Symptoms of hypersensitivityHepatic†2)Hepatic dysfunctions (fever, malaise, abnormalfindings in hepatic function test, etc.)Cardiovascular†3)Palpitation, increase in pulse rate, arrhythmiaPsychoneurologic†3)Tremor, insomnia, headache, dizziness, diaphoresis, psychoneurologic symptoms such as nervousness, excitement, anxiety, psychosis, etc.Gastrointestinal†3)Anorexia, vomiting, diarrheaOthers†3)Muscle pain, menstrual disturbance, weight decrease, weakness, hot flushes of skin[Note]†1)In such cases, the treatment with the drug should be discontinued.†2)In such cases, appropriate measures, such as reduction of dose, discontinuation, etc., should be taken.†3)In such case, overdosage may be considered, and, appropriate measures, such as reduction of dose,discontinuation, etc., should be taken.e in the ElderlyTo elderly patients, the administration of THYRADIN-STablets should be initiated with a small amount andperformed carefully such as by prolonging administration interval, etc., under close observation of patients.[Since elderly patients may have reduced renal function, the administration of THYRADIN-S Tablets may induceangina pectoris due to cardiac load by increased basalmetabolism.]6.OverdosageSymptoms: Refer to "Adverse Reactions."Measures: In case of overdosage, treatments such as inhibition of absorption of THYRADIN-S Tablets fromgastrointestinal tract (e.g., induction of vomiting,gastrolavage, administration of cholestylamine andactivated carbon, etc., in accordance with situation) orsymptomatic treatments (oxygen supplement formaintenance of ventilation, administration of β-blockerssuch as propranolol for sympathetic irritation,administration of cardiac glycosides against congestiveheart failure, treatment for fever, hypoglycosism andhumoral loss, etc.) should be performed.7.Precautions concerning UseAt dispensing drugsFor drugs that are dispensed in a press-through package(PTP), instruct the patient to remove the drug from thepackage prior to use. (It has been reported that, if the PTP sheet is swallowed, the sharp corners of the sheet maypuncture the esophageal mucosa, resulting in severecomplications such as mediastinitis.)CLINICAL STUDIESWhen THYRADIN-S Tablets were administered to 8 patients with primary hypothyroidism initiating with a dose of 50µg/day and continuously administered with increasing the dose by 50 µg/day of each in every 2 weeks, T3, rT3, T4 levels in blood are as shown in the following table, and the ratio (rT3/T3) increased in accordance with the increase in dose.PHARMACOLOGY1.Levothyroxine sodium enhances oxygen consumption ofthe tissues and increases basal metabolism (Patients withhypothyroidism8,9), Rats10-12)).2.Levothyroxine sodium promotes growth but suppresses it ata high dose (Rats12,13))3.Levothyroxine sodium promotes protein anabolism butinduces protein catabolism at a high dose (Patients withhypothyroidism14), Rats15,16)).4.Levothyroxine sodium decreases lipids, especially,cholesterol (Patients with hypothyroidism9), Rats17),Dogs18)).5.Levothyroxine sodium promotes glycogenolysis in the liver(Rats19)).6.Levothyroxine sodium increases excretion of water andelectrolytes (Patients with hypothyroidism, Healthyadults20)).PHYSICOCHEMISTRYNonproprietary name:Levothyroxine sodium (JAN)Chemical name:Monosodium O-(4-hydroxy-3,5-diiodophenyl)-3,5-diiodo-L-tyrosinate hydrate*Molecular formula:C15H10I4NNaO4 x H2OStructural formula:Molecular weight:798.86 (anhydrous)Description:Levothyroxine sodium occurs as a pale yellowish white to light yellow-brown powder. It is odorless. It is slightlysoluble in ethanol, and practically insoluble in water and in ether. It dissolves in sodium hydroxide. It is graduallycolored by light.PACKAGINGTHYRADIN-S Tablets 25:Boxes of 100 tablets (10 tab. × 10)Boxes of 500 tablets (10 tab. × 50)Bottles of 500 tabletsTHYRADIN-S Tablets 50:Boxes of 100 tablets (10 tab. × 10)Boxes of 500 tablets (10 tab. × 50)Bottles of 500 tabletsBoxes of 1,000 tablets (10 tab. × 100)THYRADIN-S Tablets 100:Boxes of 100 tablets (10 tab. × 10)Boxes of 500 tablets (10 tab. × 50)Bottles of 500 tabletsREFERENCES1)Hansten, P.D.: Drug Intel. Clin. Pharm., 14, 331, 1980.2)Northcutt, R.C., et al.: J. Am. Med. Assoc., 208, 1857,1969.3)Campbell, N.R.C., et al.: Ann. Intern. Med., 117, 1010,1992.4)Sherman, S.I., et al.: Am. J. Med., 96, 531, 1994.5)Liel, Y., et al.: ibid., 97, 363, 1994.6)Blackshear, J.L., et al.: Ann. Intern. Med., 99, 341, 1983.7)Nihei, N., et al.: Igaku no Ayumi (J. Clinical andExperimental Medicine), 104, 100, 1978.8)Burack, R., et al.: J. Pharmacol. Exptl. Therap., 176, 212,1971.9)Hart, F.D., et al.: Brit. Med. J., 1, 512, 1950.10)Barker, S.B., et al.: Proc. Soc. Exptl. Biol. Med., 83, 500,1953.11)Tata, J.R., et al.: Biochem. J., 86, 408, 1963.12)Hsieh, A.C.L.: J. Endocrinol., 26, 55, 1963.13)Tapp, E.: J. Bone & Joint Surg., 48, 526, 1966.14)Rawson, R.W., et al.: Am. J. Med. Sci., 226, 405, 1953.15)Farthing, C.P., et al.: J. Endocrinol., 21, 83, 1960.16)Michels, R., et al.: Science, 140, 1417, 1963.17)Ellefson, R.D., et al.: Endocrinol., 71, 425, 1962.18)Grande, F., et al.: J. Nutr., 94, 60, 1968.19)Sokoloff, L., et al.: J. Biol. Chem., 236, 795, 1961.20)Byrom, F.B.: Clin. Sci., 1, 273, 1933.REQUEST FOR LITERATURE SHOULD BE MADE TO:Medical Service DepartmentTeikoku Hormone Mfg. Co., Ltd.5-1, Akasaka 2-chome, Minato-ku, Tokyo, 107-8522 Japan. INFORMATION ON LONG-TERM ADMINISTRATIONThe product may be dispensed by prescription for 90 days at one time in accordance with Notification No.73, issued on March 17, 2000 by the Ministry of Health and Welfare of Japan.Manufactured by:Teikoku Hormone Mfg.Co., Ltd.5-1, Akasaka 2-chome, Minato-ku, Tokyo, 107-8522 Japan。

老年脓毒症患者血清氨基末端脑钠肽前体升高的影响因素分析

老年脓毒症患者血清氨基末端脑钠肽前体升高的影响因素分析

论著DOI:10.16662/ki.1674-0742.2023.17.001老年脓毒症患者血清氨基末端脑钠肽前体升高的影响因素分析李程锦,石松菁,陈湘平,陈凤朱福建医科大学教学医院福建省老年医院重症医学科,福建福州350000[摘要]目的探讨影响老年脓毒症患者NT-proBNP升高的影响因素。

方法采用回顾性研究分析2017年10月—2019年12月福建省老年医院收治的老年脓毒症患者114例的临床资料。

根据患者确诊入院时的血清NT-proBNP水平是否升高,将其分为观察组(NT-proBNP升高)60例和对照组(NT-proBNP正常)54例。

收集患者的人口学特征以及既往病史、BMI、是否有脓毒性休克及SOFA评分、APACHE Ⅱ评分等。

入院时采集患者外周静脉血,送检血清肌酐、NT-proBNP、心肌损伤标志物、炎症指标、心肌抑制因子、心肌自身免疫抗体等指标。

以单因素和多因素分析老年脓毒症患者NT-proBNP的影响因素。

结果与对照组比较,观察组的脓毒性休克占比、SOFA评分、APACHEⅡ评分、CK-MB、cTnI、PCT、CRP、IL-1β、TNF-α、β1-AAB、M2-AA显著较高,Ccr水平更低,差异有统计学意义(P<0.05)。

Logistic多因素回归分析结果表明老年脓毒症患者NT-proBNP水平的独立影响因素为PCT、IL-1β、BMI、Ccr(P<0.05)。

结论老年脓毒症患者NT-proBNP的升高与BMI、PCT、IL-1β、Ccr指标相关,上述指标是老年脓毒症患者NT-proBNP升高的影响因素,但这些发现需要样本量更大的前瞻性研究进一步验证。

[关键词]脓毒症;氨基末端脑钠肽前体;炎症因子;心肌损伤标志物;心肌自身免疫抗体[中图分类号]R5 [文献标识码]A [文章编号]1674-0742(2023)06(b)-0001-07Analysis of Factors Affecting Elevated Serum Amino-terminal Brain Natri⁃uretic Peptide Precursors in Elderly Patients with SepsisLI Chengjin, SHI Songjing, CHEN Xiangping, CHEN FengzhuDepartment of Critical Care Medicine, Fujian Provincial Geriatric Hospital, Fujian Medical University Teaching Hos⁃pital, Fuzhou, Fujian Province, 350000 China[Abstract] Objective To investigate the influencing factors affecting the elevation of NT-proBNP in elderly patients with sepsis. Methods A retrospective study was used to analyze the clinical data of 114 cases of geriatric sepsis pa⁃tients admitted to Fujian Provincial Geriatric Hospital from October 2017 to December 2019. The patients were di⁃vided into 60 cases in the observation group (elevated NT-proBNP) and 54 cases in the control group (normal NT-proBNP) according to whether their serum NT-proBNP levels were elevated at the time of confirmed admission. The patients' demographic characteristics as well as past medical history, BMI, presence of septic shock and SOFA score and APACHE Ⅱ score were collected. Peripheral venous blood was collected from patients on admission and sent for serum creatinine, NT-proBNP, myocardial injury markers, inflammatory indexes, myocardial inhibitory factors, and myocardial autoimmune antibodies. Analyzed the influencing factors of NT proBNP levels in elderly sepsis patients us⁃ing single and multiple factors. Results Compared with the control group, septic shock percentage, SOFA score, APACHEⅡ score, CK-MB, cTnI, PCT, CRP, IL-1β, TNF-α, β1-AAB, and M2-AA in the observation group were significantly higher, Ccr levels was lower, the difference was statistically significant (P<0.05). Logistic multi-factor re⁃[基金项目]福建省卫生计生科研人才培养项目青年科研课题(2017/2/19)。

英语药品说明书的翻译

英语药品说明书的翻译

英语药品说明书的翻译英语药品说明书由以下12项内容组成,大多数英语药品说明书结构基本相同。

1. Pakage Insert (Insert) 说明书2. Drug Name (Medicine) 药品名称3. Description 性状4. Action 作用5. Indication 适应症6. Contraindications 禁忌症7. Precaution 注意事项8. Side Effects 副作用9. Dosage and Administration 剂量和用法10. Dacking 包装11.Expiry 失效期12. Manufactring Date (Manu.date)出厂日期13.Reference 参考文献药品名称一、英语药品说明书一般用商品名,由生产厂家向该国政府有关部门申请注册正式名称,受该国政府法律保护,在药品名称的右上角有个○R的符号,意思是已经申请注册的法定名称,不可随意改变名称。

○R=Recive在药品之后有时Issued to(for) the Medical profession only短语,意:仅供医界参考。

例:Mobic ○R Issued to(for) the medical prfession.二、译法:分四种译法1. 音译:按英语读音用相应的汉字译出例:Mobic 莫比可Rifampicin 利福平2. 意译:按药品名称各组成部份的英语意义译成汉语例:Streptomycine 是由Strepto和mycine组成,其中Strepto(链球状),mycine(霉素),则按英语意思,译成:链霉素。

因此必须掌握大量前、后缀,才以准确翻译,此种译法多数是抗生素类药物。

Nitroglycerine 由Nitro(硝基)+glycerin(甘油)组成,则意为硝酸甘油Aminophylline由Amino+phylline 译:氨茶碱3. 音意并译:按英语药名组成,前面部份按音译,后面部份按意译。

885060-09-3_ARRY 520_ trifluoroacetate_技术参数_MedBio

885060-09-3_ARRY 520_ trifluoroacetate_技术参数_MedBio
3、同类产品列表:
品牌
货号
中文名称
英文名称
CAS
包装
纯度
MedBio
MED11497
THZ1
THZ1
1604810-83-4
10mM (in 1mL DMSO)
≥98%
品牌
货号
中文名称
英文名称
CAS
包装
纯度
MedBio
MED11555
Arcyriaflavin A
Arcyriaflavin A
118458-54-1
100mg
≥98%
品牌
货号
中文名称
英文名称
CAS
包装
纯度
MedBio
MED11571
3MB-PP1
3MB-PP1
956025-83-5
10mg
≥98%
品牌
货号
中文名称
英文名称
CAS
包装
纯度
MedBio
MED11428
Angiotensin (1-7)
Angiotensin (1-7)
51833-78-4
885060-09-3
1、产品物理参数:
常用名
ARRY-520
英文名
ARRY-520
CAS号
885060-09-3
分子量
420.476
密度
1.3±0.1 g/cm3
沸点
511.3±60.0 °C at 760 mmHg
分子式
C20H22F2N4O2S
熔点
无资料
闪点
263.0±32.9 °C
2、技术资料:
英文名称
CAS
包装

阿斯利康公司埃索美拉唑钠最新原版英文说明书

阿斯利康公司埃索美拉唑钠最新原版英文说明书

HIGHLIGHTS OF PRESCRIBING INFORMATION •Hypomagnesemia has been reported rarely with prolonged treatmentThese highlights do not include all the information needed to use NEXIUM I.V. safely and effectively. See full prescribing information for NEXIUM I.V.NEXIUM® I.V. (esomeprazole sodium) for Injection, for intravenous use Initial US Approval: 2005---------------------------RECENT MAJOR CHANGES-----------------------­Warnings and Precautions, Interaction with Clopidogrel (5.4) 10/2012 Warnings and Precautions, Clostridium difficile associated 09/2012 diarrhea (5.3)Warnings and Precautions, Concomitant use of NEXIUMwith Methotrexate (5.9) 01/2012-------------------------INDICATIONS AND USAGE--------------------------­NEXIUM I.V. is a proton pump inhibitor indicated for the treatment of Gastroesophageal Reflux Disease (GERD) with erosive esophagitis (EE) in adults and pediatric patients greater than one month of age, when oral therapy is not possible or appropriate. (1.1)-----------------------DOSAGE AND ADMINISTRATION-------------------­GERD – with Erosive Esophagitis• Adults: Dose is either 20 mg or 40 mg esomeprazole given once daily by intravenous injection (no less than 3 minutes) or intravenous infusion(10 minutes to 30 minutes). (2.1)• Pediatric: Give the following doses once daily as an intravenous infusion over 10 minutes to 30 minutes• 1 year to 17 years: (2.1)o Body weight less than 55 kg: 10 mgo Body weight 55 kg or greater: 20 mg• 1 month to less than 1 year of age: 0.5 mg/kg (2.1)---------------------DOSAGE FORMS AND STRENGTHS------------------­NEXIUM I.V. for Injection is supplied as a freeze-dried powder containing 20 mg or 40 mg of esomeprazole per single-use vial. (3)----------------------------CONTRAINDICATIONS-----------------------------­Patients with known hypersensitivity to any component of the formulation or to substituted benzimidazoles (angioedema and anaphylaxis have occurred).(4)-----------------------WARNINGS AND PRECAUTIONS--------------------­• Symptomatic response to therapy with NEXIUM does not preclude the presence of gastric malignancy. (5.1)• Atrophic gastritis has been noted with long-term omeprazole therapy.(5.2)• PPI therapy may be associated with increased risk of Clostridium difficile associated diarrhea. (5.3)• Avoid concomitant use of NEXIUM I.V. with clopidogrel. (5.4)• Bone Fracture: Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine. (5.5)with PPIs (5.6)• Avoid concomitant use of NEXIUM with St John’s Wort or rifampin due to the potential reduction in esomeprazole levels (5.7, 7.2)• Interactions with diagnostic investigations for Neuroendocrine Tumors: Increases in intragastric pH may result in hypergastrinemia and enterochromaffin-like cell hyperplasia and increased chromogranin A levels which may interfere with diagnostic investigations for neuroendocrine tumors. (5.8, 12.2)-----------------------------ADVERSE REACTIONS----------------------------­Most common adverse reactions (≥1%):• Headache, flatulence, nausea, abdominal pain, injection site reaction, diarrhea, dry mouth, dizziness/vertigo, constipation and pruritus (6.1)To report SUSPECTED ADVERSE REACTIONS, contact AstraZeneca at 1-800-236-9933 or FDA at 1-800-FDA-1088 or /medwatch. ---------------------------------DRUG INTERACTIONS------------------------­• NEXIUM I.V. inhibits gastric acid secretion and may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (e.g. ketoconazole, iron salts, erlotinib, and digoxin).Patients treated with NEXIUM and digoxin may need to be monitored for digoxin toxicity. (7)• Patients treated with proton pump inhibitors and warfarin concomitantly may need to be monitored for increases in INR and prothrombin time.(7)• NEXIUM I.V. may reduce the plasma levels of atazanavir, nelfinavir, and saquinavir. (7)• Concomitant treatment with a combined inhibitor of CYP2C19 and CYP3A4, such as voriconazole, may result in more than doubling of the esomeprazole exposure. (7)• May increase systemic exposure of cilostazol and an active metabolite.Consider dose reduction (7)• Clopidogrel: NEXIUM I.V. decreases exposure to the active metabolite of clopidogrel. (7)• Tacrolimus: NEXIUM may increase serum levels of tacrolimus (7.2)• Methotrexate: NEXIUM may increase serum levels of methotrexate(7.3)------------------------USE IN SPECIFIC POPULATIONS-------------------­• Pregnancy: Based on animal data, may cause fetal harm. Limited human data. (8.1)• Nursing Mothers: Caution should be exercised when administered to a nursing woman. (8.3)• Hepatic Insufficiency: For patients with severe liver impairment (Child Pugh Class C), a dose of 20 mg of NEXIUM should not be exceeded. (2,8.6, 12.3)See 17 for PATIENT COUNSELING INFORMATIONRevised: 10/2012_______________________________________________________________________________FULL PRESCRIBING INFORMATION: CONTENTS* 1 INDICATIONS AND USAGE1.1 Treatment of Gastroesophageal Reflux Disease (GERD) withErosive Esophagitis2 DOSAGE AND ADMINISTRATION2.1 GERD with Erosive Esophagitis2.2 Preparations for Use and Administration3 DOSAGE FORMS AND STRENGTHS4 CONTRAINDICATIONS5 WARNINGS AND PRECAUTIONS5.1 Risk of Concomitant Gastric Malignancy5.2 Atrophic Gastritis5.3. Clostridium difficile associated diarrhea5.4 Interaction with Clopidogrel5.5 Bone Fracture5.6 Hypomagnesemia5.7 Concomitant use of NEXIUM with St John's Wort or Rifampin5.8 Interactions with Investigations for Neuroendocrine Tumors5.9 Concomitant use of NEXIUM with Methotrexate6 ADVERSE REACTIONS6.1 Clinical Trials Experience with Intravenous NEXIUM6.2 Clinical Trials Experience with Oral NEXIUM6.3 Postmarketing Experience7 DRUG INTERACTIONS7.1 Interactions With Investigations of Neuroendocrine Tumors7.2 Tacrolimus7.3 Methotrexate8 USE IN SPECIFIC POPULATIONS8.1 Pregnancy8.3 Nursing Mothers8.4 Pediatric Use8.5 Geriatric Use8.6 Hepatic Impairment10 OVERDOSAGE11 DESCRIPTION12 CLINICAL PHARMACOLOGY12.1 Mechanism of Action12.2 Pharmacodynamics12.3 Pharmacokinetics12.4 Microbiology13 NONCLINICAL TOXICOLOGY13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility14 CLINICAL STUDIES14.1 Acid Suppression in Gastroesophageal Reflux Disease(GERD)16 HOW SUPPLIED/STORAGE AND HANDLING17 PATIENT COUNSELING INFORMATION*Sections or subsections omitted from the full prescribing information are not listed.________________________________________________________________________2 FULL PRESCRIBING INFORMATION1. INDICATIONS AND USAGE1.1 Treatment of Gastroesophageal Reflux Disease(GERD) with Erosive EsophagitisNEXIUM I.V. for Injection is indicated for the short-termtreatment of GERD with erosive esophagitis in adults andpediatric patients 1 month to 17 years, inclusively as analternative to oral therapy when oral NEXIUM is not possibleor appropriate.DOSAGE AND ADMINISTRATIONNEXIUM I.V. for Injection should not be administeredconcomitantly with any other medications through the sameintravenous site and or tubing. The intravenous line shouldalways be flushed with either 0.9% Sodium ChlorideInjection, USP, Lactated Ringer’s Injection, USP or 5%Dextrose Injection, USP both prior to and after administrationof NEXIUM I.V. for Injection.The admixture should be stored at room temperature up to30°C (86°F) and should be administered within the designatedtime period as listed in the Table 1 below. No refrigeration isrequired.Table 1Diluent Administer within:0.9% Sodium Chloride 12 hoursInjection, USPLactated Ringer’sInjection, USP12 hours5% Dextrose 6 hoursInjection, USPParenteral drug products should be inspected visually forparticulate matter and discoloration prior to administration,whenever solution and container permit.As soon as oral therapy is possible or appropriate, intravenoustherapy with NEXIUM I.V. for Injection should bediscontinued and the therapy should be continued orally.Special PopulationsHepatic Insufficiency: No dosage adjustment is necessary inpatients with mild to moderate liver impairment (Child PughClasses A and B). For patients with severe liver impairment(Child Pugh Class C), a dose of 20 mg of NEXIUM shouldnot be exceeded [see Use in Specific Populations (8.6) andClinical Pharmacology, Pharmacokinetics (12.3)].2.1 GERD with Erosive EsophagitisAdultsThe recommended adult dose is either 20 mg or 40 mgesomeprazole given once daily by intravenous injection (noless than 3 minutes) or intravenous infusion (10 minutes to30 minutes).Safety and efficacy of NEXIUM I.V. for Injection as atreatment of GERD patients with erosive esophagitis for morethan 10 days have not been demonstrated.PediatricThe recommended doses for children ages 1 month to 17years, inclusive, are provided below. Dose should be infusedover 10 minutes to 30 minutes.1 year to 17 years:Body weight less than 55 kg: 10 mgBody weight 55 kg or greater: 20 mg1 month to less than 1 year of age: 0.5 mg/kg2.2 Preparations for Use and AdministrationAdultsIntravenous Injection (20 mg or 40 mg vial) over no less than3 minutesThe freeze-dried powder should be reconstituted with5 mL of 0.9% Sodium Chloride Injection, USP.Withdraw 5 mL of the reconstituted solution andadminister an intravenous injection over no less than 3minutes.Intravenous Infusion (20 mg or 40 mg) over 10 minutes to 30 minutesA solution for intravenous infusion is prepared by firstreconstituting the contents of one vial with 5 mL of 0.9% Sodium Chloride Injection, USP, Lactated Ringer’s Injection, USP or 5% Dextrose Injection, USP and further diluting the resulting solution to a final volume of 50 mL.The solution (admixture) should be administered as an intravenous infusion over a period of 10 minutes to 30 minutes.The reconstituted solution should be stored at room temperature up to 30°C (86°F) and administered within 12 hours after reconstitution. No refrigeration is required. Pediatric PopulationIntravenous Infusion over 10 minutes to 30 minutes (0.5mg/kg) for patients ages 1 month to less than 1 year of ageA solution for intravenous infusion is prepared by firstreconstituting the contents of one vial with 5 mL of 0.9%Sodium Chloride Injection, USP and further diluting theresulting solution to a final volume of 50 mL. Theresultant concentration after diluting to a final volume of50 mL is as follows:40 mg vial: 0.8 mg/mL20 mg vial: 0.4 mg/mLWithdraw appropriate amount of volume for desired dose(0.5 mg/kg) and administer as an intravenous infusion over10 minutes to 30 minutesIntravenous Infusion (10 mg and 20 mg) over 10 minutes to 30 minutes for Pediatric Patients, ages 1 year to 17 years of age40 mg vialA solution for intravenous infusion is prepared by firstreconstituting the contents of one vial with 5 mL of 0.9%Sodium Chloride Injection, USP and further diluting theresulting solution to a final volume of 50 mL. Theresultant concentration after diluting to a final volume of50 mL is 0.8 mg/mL.20 mg dose: Withdraw 25 mL of the final solution andadminister as an intravenous infusion over 10 minutes to30 minutes10 mg dose: Withdraw 12.5 mL of the final solution andadminister as an intravenous infusion over 10 minutes to30 minutes20 mg vialA solution for intravenous infusion is prepared by firstreconstituting the contents of one vial with 5 mL of 0.9%Sodium Chloride Injection, USP and further diluting theresulting solution to a final volume of 50 ml. The resultantconcentration after diluting to a final volume of 50 mL is0.4 mg/mL.20 mg dose: Administer the final solution (50 mL) as anintravenous infusion over 10 minutes to 30 minutes10 mg dose: Withdraw 25 mL of the final solution andadminister as an intravenous infusion over 10 minutes to30 minutes3 DOSAGE FORMS AND STRENGTHSNEXIUM I.V. for Injection is supplied as a freeze-dried whiteto off-white powder containing 20 mg or 40 mg ofesomeprazole per single-use vial.4 CONTRAINDICATIONSPatients with known hypersensitivity to any component of theformulation or to substituted benzimidazoles (angioedema andanaphylaxis have occurred).5 WARNINGS AND PRECAUTIONS5.1 Risk of Concomitant Gastric MalignancySymptomatic response to therapy with NEXIUM does notpreclude the presence of gastric malignancy.5.2 Atrophic GastritisAtrophic gastritis has been noted occasionally in gastriccorpus biopsies from patients treated long-term withomeprazole, of which esomeprazole is an enantiomer.5.3 Clostridium difficile associated diarrheaPublished observational studies suggest that PPI therapy likeNEXIUM may be associated with an increased risk ofClostridium difficile associated diarrhea, especially inhospitalized patients. This diagnosis should be considered fordiarrhea that does not improve [see Adverse Reactions (6.2)].5.4 5.5 5.6 5.7 Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Interactions with ClopidogrelAvoid concomitant use of NEXIUM I.V. with clopidogrel. Clopidogrel is a prodrug. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. The metabolism of clopidogrel to its active metabolite can be impaired by use with concomitant medications, such as esomeprazole, that inhibit CYP2C19 activity. Concomitant use of clopidogrel with 40 mg esomeprazole reduces the pharmacological activity of clopidogrel. When using NEXIUM I.V. consider alternative anti-platelet therapy. [see Drug Interactions (7 and Pharmacokinetics (12.3)]Bone FractureSeveral published observational studies suggest that proton pump inhibitor (PPI) therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine. The risk of fracture was increased in patients who received high-dose, defined as multiple daily doses, and long-term PPI therapy (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Patients at risk for osteoporosis-related fractures should be managed according to established treatment guidelines. [see Dosage and Administration (2) and Adverse Reactions (6.3)] HypomagnesemiaHypomagnesemia, symptomatic and asymptomatic, has been reported rarely in patients treated with PPIs for at least three months, in most cases after a year of therapy. Serious adverse events include tetany, arrhythmias, and seizures. In most patients, treatment of hypomagnesemia required magnesium replacement and discontinuation of the PPI.For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically. [See Adverse Reactions (6.3)]Concomitant use of NEXIUM with St John’s Wort or RifampinDrugs which induce CYP2C19 or CYP3A4 (such as St John’s Wort or rifampin) can substantially decrease esomeprazole concentrations [see Drug Interactions (7)]. Avoid concomitant use of NEXIUM with St John’s Wort or rifampin.5.8 5.96 6.1 Interactions with Investigations for Neuroendocrine TumorsSerum chromogranin A (CgA) levels increase secondary to drug-induced decreases in gastric acidity. The increased CgA level may cause false positive results in diagnostic investigations for neuroendocrine tumors. Providers should temporarily stop esomeprazole treatment before assessing CgA levels and consider repeating the test if initial CgA levels are high. If serial tests are performed (e.g. for monitoring), the same commercial laboratory should be used for testing, as reference ranges between tests may vary.Concomitant use of NEXIUM with Methotrexate Literature suggests that concomitant use of PPIs with methotrexate (primarily at high dose; see methotrexate prescribing information) may elevate and prolong serum levels of methotrexate and/or its metabolite, possibly leading to methotrexate toxicities. In high-dose methotrexate administration a temporary withdrawal of the PPI may be considered in some patients. [see Drug Interactions (7.3)] ADVERSE REACTIONSClinical Trials Experience with Intravenous NEXIUM Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.AdultsThe safety of intravenous esomeprazole is based on results from clinical trials conducted in three different populations including patients having symptomatic GERD with or without a history of erosive esophagitis (n=199), patients with erosive esophagitis (n=160), and healthy subjects (n=204). Adverse experiences occurring in >1% of patients treated with intravenous esomeprazole (n=359) in trials are listed below by body system:Symptomatic GERD and Erosive Esophagitis TrialsThe data described below reflect exposure to NEXIUM I.V for Injection in 359 patients. NEXIUM I.V. for Injection was studied only in actively-controlled trials. The population was 18 to 77 years of age; 45% Male, 52% Caucasian, 17% Black, 3% Asian, 28% Other, and had either erosive reflux esophagitis (44%) or GERD (56%). Most patients received doses of either 20 or 40 mg either as an infusion or an injection.Table 2Adverse reactions occurring at an incidence≥ 1% in the NEXIUM I.V. group% of patientsEsomeprazoleIntravenous Adverse Reactions (n=359)Headache 10.9Flatulence 10.3Nausea 6.4Abdominal pain 5.8Diarrhea 3.9Mouth dry 3.9Dizziness/vertigo 2.8Constipation 2.5Injection site reaction 1.7Pruritus 1.1Intravenous treatment with esomeprazole 20 and 40 mgadministered as an injection or as an infusion was found tohave a safety profile similar to that of oral administration ofesomeprazole.PediatricIn a randomized, open-label, multi-national study to evaluatethe pharmacokinetics of repeated intravenous doses of oncedaily esomeprazole, esomeprazole was well tolerated inpediatric patients 1 month to 17 years old, inclusive. Thesafety results are consistent with the known safety profile ofesomeprazole and no unexpected safety signals wereidentified. [See Clinical Pharmacology (12.3)]6.2 Clinical Trials Experience with Oral NEXIUMAdultThe safety of oral NEXIUM was evaluated in over 15,000patients (aged 18 to 84 years) in clinical trials worldwideincluding over 8,500 patients in the United States and over6,500 patients in Europe and Canada. Over 2,900 patientswere treated in long-term studies for up to 6-12 months. Ingeneral, NEXIUM was well tolerated in both short and long-term clinical trials.The safety in the treatment of healing of erosive esophagitiswas assessed in four randomized comparative clinical trials,which included 1,240 patients on NEXIUM 20 mg, 2,434patients on NEXIUM 40 mg, and 3,008 patients onomeprazole 20 mg daily. The most frequently occurringadverse events (≥1%) in all three groups were headache (5.5, 5.0, and 3.8, respectively) and diarrhea (no difference among the three groups). Nausea, flatulence, abdominal pain, constipation, and dry mouth occurred at similar rates among patients taking NEXIUM or omeprazole.Additional adverse events that were reported as possibly or probably related to NEXIUM with an incidence <1% are listed below by body system:Body as a Whole: abdomen enlarged, allergic reaction, asthenia, back pain, chest pain, chest pain substernal, facial edema, peripheral edema, hot flushes, fatigue, fever, flu-like disorder, generalized edema, leg edema, malaise, pain, rigors; Cardiovascular: flushing, hypertension, tachycardia; Endocrine: goiter; Gastrointestinal: bowel irregularity, constipation aggravated, dyspepsia, dysphagia, dysplasia GI, epigastric pain, eructation, esophageal disorder, frequent stools, gastroenteritis, GI hemorrhage, GI symptoms not otherwise specified, hiccup, melena, mouth disorder, pharynx disorder, rectal disorder, serum gastrin increased, tongue disorder, tongue edema, ulcerative stomatitis, vomiting; Hearing: earache, tinnitus; Hematologic: anemia, anemia hypochromic, cervical lymphadenopathy, epistaxis, leukocytosis, leukopenia, thrombocytopenia; Hepatic: bilirubinemia, hepatic function abnormal, SGOT increased, SGPT increased; Infections and Infestations: Clostridium difficile associated diarrhea; Metabolic/Nutritional: glycosuria, hyperuricemia, hyponatremia, increased alkaline phosphatase, thirst, vitamin B12 deficiency, weight increase, weight decrease; Musculoskeletal: arthralgia, arthritis aggravated, arthropathy, cramps, fibromyalgia syndrome, hernia, polymyalgia rheumatica; Nervous System/Psychiatric: anorexia, apathy, appetite increased, confusion, depression aggravated, dizziness, hypertonia, nervousness, hypoesthesia, impotence, insomnia, migraine, migraine aggravated, paresthesia, sleep disorder, somnolence, tremor, vertigo, visual field defect; Reproductive: dysmenorrhea, menstrual disorder, vaginitis; Respiratory: asthma aggravated, coughing, dyspnea, larynx edema, pharyngitis, rhinitis, sinusitis; Skin and Appendages: acne, angioedema, dermatitis, pruritus, pruritus ani, rash, rash erythematous, rash maculo-papular, skin inflammation, sweating increased, urticaria; Special Senses: otitis media, parosmia, taste loss, taste perversion; Urogenital: abnormal urine, albuminuria, cystitis, dysuria, fungal infection, hematuria, micturition frequency, moniliasis, genital moniliasis, polyuria; Visual: conjunctivitis, vision abnormal.Endoscopic findings that were reported as adverse eventsinclude: duodenitis, esophagitis, esophageal stricture,esophageal ulceration, esophageal varices, gastric ulcer,gastritis, hernia, benign polyps or nodules, Barrett’sesophagus, and mucosal discoloration.The incidence of treatment-related adverse events during 6­month maintenance treatment was similar to placebo. Therewere no differences in types of related adverse events seenduring maintenance treatment up to 12 months compared toshort-term treatment.Two placebo-controlled studies were conducted in 710patients for the treatment of symptomatic gastroesophagealreflux disease. The most common adverse events that werereported as possibly or probably related to NEXIUM werediarrhea (4.3%), headache (3.8%), and abdominal pain (3.8%).The following potentially clinically significant laboratorychanges in clinical trials, irrespective of relationship toNEXIUM, were reported in ≤ 1% of patients: increasedcreatinine, uric acid, total bilirubin, alkaline phosphatase,ALT, AST, hemoglobin, white blood cell count, platelets,serum gastrin, potassium, sodium, thyroxine and thyroidstimulating hormone [see Clinical Pharmacology, EndocrineEffects (12.2) for further information on thyroid effects].Decreases were seen in hemoglobin, white blood cellcount,platelets, potassium, sodium, and thyroxine.PediatricThe safety of oral NEXIUM was evaluated in 316 pediatricand adolescent patients aged 1 to 17 years in four clinicaltrials for the treatment of symptomatic GERD [see ClinicalStudies (14.2)]. In 109 pediatric patients aged 1 to 11 years,the most frequently reported (at least 1%) treatment-relatedadverse reactions in these patients were diarrhea (2.8%),headache (1.9%) and somnolence (1.9%). In 149 pediatricpatients aged 12 to 17 years the most frequently reported (atleast 2%) treatment-related adverse reactions in these patientswere headache (8.1%), abdominal pain (2.7%), diarrhea (2%),and nausea (2%). No new safety concerns were identified inpediatric patients.6.3 Postmarketing ExperienceThe following adverse reactions have been identified duringpost-approval use of NEXIUM. Because these reactions arereported voluntarily from a population of uncertain size, it isnot always possible to reliably estimate their frequency orestablish a causal relationship to drug exposure.Postmarketing Reports -There have been spontaneous reportsof adverse events with postmarketing use of esomeprazole.These reports occurred rarely and are listed below by bodysystem:Blood And Lymphatic System Disorders: agranulocytosis,pancytopenia; Eye Disorders: blurred vision; GastrointestinalDisorders: pancreatitis; stomatitis; microscopic colitis;Hepatobiliary Disorders: hepatic failure, hepatitis with orwithout jaundice; Immune System Disorders: anaphylacticreaction/shock; Infections and Infestations: GI candidiasis;Metabolism and nutritional disorders: hypomagnesemia;Musculoskeletal And Connective Tissue Disorders: muscularweakness, myalgia, bone fracture; Nervous System Disorders:hepatic encephalopathy, taste disturbance; PsychiatricDisorders: aggression, agitation, depression, hallucination;Renal and Urinary Disorders: interstitial nephritis;Reproductive System and Breast Disorders: gynecomastia;Respiratory, Thoracic and Mediastinal Disorders:bronchospasm; Skin and Subcutaneous Tissue Disorders:alopecia, erythema multiforme, hyperhidrosis, photosensitivity, Stevens-Johnson syndrome, toxic epidermalnecrolysis (TEN, some fatal).Other adverse events not observed with NEXIUM, butoccurring with omeprazole can be found in the omeprazolepackage insert, ADVERSE REACTIONS section.7 DRUG INTERACTIONSEsomeprazole is extensively metabolized in the liver byCYP2C19 and CYP3A4.In vitro and in vivo studies have shown that esomeprazole isnot likely to inhibit CYPs 1A2, 2A6, 2C9, 2D6, 2E1 and 3A4.No clinically relevant interactions with drugs metabolized bythese CYP enzymes would be expected. Drug interactionstudies have shown that esomeprazole does not have anyclinically significant interactions with phenytoin, warfarin,quinidine, clarithromycin or amoxicillin. Post-marketingreports of changes in prothrombin measures have beenreceived among patients on concomitant warfarin andesomeprazole therapy. Increases in INR and prothrombin timemay lead to abnormal bleeding and even death. Patientstreated with proton pump inhibitors and warfarinconcomitantly may need to be monitored for increases in INRand prothrombin time.Esomeprazole may potentially interfere with CYP2C19, themajor esomeprazole metabolizing enzyme. Coadministrationof esomeprazole 30 mg and diazepam, a CYP2C19 substrate,resulted in a 45% decrease in clearance of diazepam. Increased plasma levels of diazepam were observed 12 hours after dosing and onwards. However, at that time, the plasma levels of diazepam were below the therapeutic interval, and thus this interaction is unlikely to be of clinical relevance. ClopidogrelClopidogrel is metabolized to its active metabolite in part by CYP2C19. Concomitant use of esomeprazole 40 mg results in reduced plasma concentrations of the active metabolite of clopidogrel and a reduction in platelet inhibition. Avoid concomitant administration of NEXIUM I.V. with clopidogrel. When using NEXIUM I.V., consider use of alternative anti-platelet [see Pharmacokinetics (12.3)]. Omeprazole acts as an inhibitor of CYP 2C19. Omeprazole, given in doses of 40 mg daily for one week to 20 healthy subjects in cross-over study, increased C max and AUC of cilostazol by 18% and 26%, respectively. C max and AUC of one of its active metabolites, 3,4-dihydro-cilostazol, which has 4-7 times the activity of cilostazol, were increased by 29% and 69%, respectively. Co-administration of cilostazol with esomeprazole is expected to increase concentrations of cilostazol and its above mentioned active metabolite. Therefore, a dose reduction of cilostazol from 100 mg twice daily to 50 mg twice daily should be considered. Concomitant administration of esomeprazole and a combined inhibitor of CYP2C19 and CYP3A4, such as voriconazole, may result in more than doubling of the esomeprazole exposure. Dose adjustment of esomeprazole is not normally required for the recommended doses. However, in patients who may require higher doses, dose adjustment may be considered.Drugs known to induce CYP2C19 or CYP3A4 (such as rifampin) may lead to decreased esomeprazole serum levels. Omeprazole, of which esomeprazole is an enantiomer, has been reported to interact with St. John’s wort, an inducer of CYP3A4. In a cross-over study in 12 healthy male subjects, St John’s wort (300 mg three times daily for 14 days) significantly decreased the systemic exposure of omeprazole in CYP2C19 poor metabolizers (C max and AUC decreased by37.5% and 37.9%, respectively) and extensive metabolizers(C max and AUC decreased by 49.6% and 43.9%, respectively). Avoid concomitant use of St. John’s Wort or rifampin with NEXIUM.。

恩格列净联合二甲双胍治疗2_型糖尿病肥胖患者的疗效分析

恩格列净联合二甲双胍治疗2_型糖尿病肥胖患者的疗效分析

· 药物与临床 ·糖尿病新世界 2024年1月糖尿病新世界 DIABETES NEW WORLD恩格列净联合二甲双胍治疗2型糖尿病肥胖患者的疗效分析赵雪华,钟雅丽,俞梅芳漳州市医院药学部,福建漳州 363000[摘要] 目的 分析恩格列净联合二甲双胍治疗2型糖尿病肥胖患者的疗效。

方法 回顾性分析2021年9月—2022年9月漳州市医院收治的80例2型糖尿病肥胖患者,根据治疗方式不同分为两组,各40例,对照组行二甲双胍单一药物治疗,观察组行恩格列净联合二甲双胍治疗,对比两组患者血糖水平、体质指数变化情况。

结果 治疗后,观察组血糖水平低于对照组,差异有统计学意义(P <0.05)。

治疗后,观察组的体质指数低于对照组,差异有统计学意义(P <0.05)。

结论 2型糖尿病肥胖患者采取恩格列净联合二甲双胍治疗可有效降低血糖水平和体质指数。

[关键词] 恩格列净;二甲双胍;2型糖尿病;肥胖;体质指数[中图分类号] R9 [文献标识码] A [文章编号] 1672-4062(2024)01(a )-0084-03Efficacy of Empagliflozin Combined with Metformin in the Treatment ofObese Patients with Type 2 DiabetesZHAO Xuehua, ZHONG Yali, YU MeifangDepartment of Pharmacy, Zhangzhou Hospital, Zhangzhou, Fujian Province, 363000 China[Abstract ] Objective To analyze the efficacy of Empagliflozin combined with metformin in the treatment of obese pa⁃tients with type 2 diabetes. Methods A retrospective analysis was performed on 80 obese patients with type 2 diabetes treated in Zhangzhou Hospital from September 2021 to September 2022. The patients were divided into two groups ac⁃cording to different treatment methods, with 40 cases in each group. The control group was treated with metformin alone, and the observation group was treated with empaglifozin combined with metformin. The changes in blood glu⁃cose levels and body mass index in the two groups of patients were compared. Results After treatment, the blood glu⁃cose level of the observation group was lower than that of the control group, and the difference was statistically signifi⁃cant (P <0.05). After treatment, the body mass index of the observation group was lower than that of the control group,and the difference was statistically significant (P <0.05). Conclusion Empagliflozin combined with metformin can ef⁃fectively reduce blood glucose levels and body mass index in obese patients with type 2 diabetes.[Key words ] Empagliflozin; Metformin; Type 2 diabetes; Obesity; Body mass index流行病学调查显示,我国糖尿病患病率在12%,其中2型糖尿病患者占比>90%[1],而超重或肥胖者在2型糖尿病患者中的比例高达60%[2]。

欧洲药典7.5版

欧洲药典7.5版
EUROPEAN PHARMACOPOEIA 7.5
INDEX
To aid users the index includes a reference to the supplement in which the latest version of a text can be found. For example : Amikacin sulfate...............................................7.5-4579 means the monograph Amikacin sulfate can be found on page 4579 of Supplement 7.5. Note that where no reference to a supplement is made, the text can be found in the principal volume.
English index ........................................................................ 4707
Latin index ................................................................................. 4739
EUROPEAN PHARMACOPபைடு நூலகம்EIA 7.5
Index
Numerics 1. General notices ................................................................... 7.5-4453 2.1.1. Droppers...................

腾讯AI助手 - 产品说明书

腾讯AI助手 - 产品说明书

TRIS Acetate-EDTA buffer, 10×concentrateDNase and RNase, none detected, BioReagent, suitable for electrophoresis Catalog Number T4038Store at Room Temperature Synonym: TAE bufferProduct DescriptionTRIS Acetate-EDTA (TAE) buffer is a powder blend packaged in sealed foiled pouches that produces a 10×concentrate of TAE (0.4 M Tris acetate and 10 mM EDTA, pH 8.3), when dissolved with the indicated amount of water. A suitable size container must be separately obtained.TRIS Acetate-EDTA buffer is suitable for gel electrophoresis after dilution to the workingconcentration. This product has been analyzed for the absence of nucleases.Tris-Acetate-EDTA (TAE) running buffer is a commonly used buffer for DNA agarose gel electrophoresis, and isespecially useful in preparative work.1Compared to Tris-Borate-EDTA (TBE) and Tris-Phosphate-EDTA (TPE) buffers, double-stranded DNA tends to run faster in TAE. However, because TAE has the lowest buffering capacity of the three buffers, the buffering capacity can become exhausted during extended electrophoresis. Buffer circulation or replacement can remedy this situation.The 1×TAE buffer is used both in the agarose gel and as a running buffer. Applied voltages of <5 V/cm (the distance between the electrodes of the unit) arerecommended for maximum resolution.2TAE buffer has been utilized in agarose gel electrophoresis of RNA.3,4A study of free DNA solution mobility in TAE at various buffer concentrations, in the presence and absence ofadded NaCl, has been reported.5The use of TAE buffer in a denaturing gradient gel electrophoresis method for broad-range mutation analysis has been described.6Precautions and DisclaimerThis product is for R&D use only, not for drug,household, or other uses. Please consult the Safety Data Sheet for information regarding hazards and safe handling practices.References1.Ogden, R.C., and Adams, D.A., Electrophoresis inagarose and acrylamide gels. Methods Enzymol.,152, 61-87 (1987).2.Molecular Cloning: A Laboratory Manual, 3rd ed.,Sambrook, J., and Russell, D.W., CSHL Press (Cold Spring Harbor, NY: 2001), pp. 5.8, 5.76, A1.16.3.Loening, U.E., The fractionation of high-molecular-weight ribonucleic acid by polyacrylamide-gelelectrophoresis. Biochem. J.,102, 251-257 (1967).4.Masters, D.B. et al., High sensitivity quantificationof RNA from gels and autoradiograms withaffordable optical scanning. Biotechniques,12(6), 902-906, 908-911 (1992).5.Stellwagen, E., and Stellwagen, N.C., The freesolution mobility of DNA in Tris-acetate-EDTAbuffers of different concentrations, with and without added NaCl. Electrophoresis,23(12), 1935-1941 (2002).6.Hayes, V.M. et al., Improvements in gelcomposition and electrophoretic conditions for broad-range mutation analysis by denaturing gradient gel electrophoresis. Nucleic Acids Res., 27(20), e29 (1999).VNC,GCY,RXR,MAM 01/15-1©2015 Sigma-Aldrich Co. LLC. All rights reserved. SIGMA-ALDRICH is a trademark of Sigma-Aldrich Co. LLC, registered in the US and other countries. Sigma brand products are sold through Sigma-Aldrich, Inc. Purchaser must determine the suitability of the product(s) for theirparticular use. Additional terms and conditions may apply. Please see product information on the Sigma-Aldrich website at and/or on the reverse side of the invoice or packing slip.。

国际非专利药品名称(INN)词干表

国际非专利药品名称(INN)词干表

国际非专利药品名称(INN)词干表药名词干中文译名药物类别药名举例-abine (见-arabine, -citabine)-他滨抗肿瘤药,阿拉伯糖苷衍生物Capecitabine 卡培他滨-ac-酸抗感染药,异丁芬酸衍生物Diclofenac 双氯芬酸-acetam (见-racetam)-西坦酰胺型益智药,吡拉西坦衍生物Piracetam 吡拉西坦-actide-克肽类促皮质激素合成多肽Alsactide 阿沙克肽-adol或-adol--多止痛药Tramadol 曲马多-adom-多止痛药,替氟多类衍生物Tifluadom 替氟多-afenone-非农(酮)抗心律失常药物,普罗帕酮衍生物Propafenone 普罗帕酮-afil-非血管扩张药Sildenafil 西地那非-aj--义抗心律失常药物,阿义马林衍生物detajmium bitartrate 重酒石酸地他义铵-al-醛醛类从第14次报告的一般原则中删除-aldrate-铝抗酸药,铝盐Magaldrate 镁加铝-alol (见-olol)-洛尔与-olols相关的芳香环-CH-CH2-NH-R醇Medroxalol 美沙洛尔-alox (见-ox)-铝抗酸药,铝衍生物Sucralox 羟糖铝-amab (见-mab)-单抗大鼠源单克隆抗体-amivir (见-vir)-米韦神经氨酸酶抑制剂Oseltamivir 奥塞米韦-ampanel-帕奈AMPA受体阻滞药Becampanel 贝坎帕奈andr雄类固醇,雄激素Androstanolone雄诺龙-anib-尼血管生成抑制药Semaxanib 司马沙尼-anide-尼特利尿药,吡咯他尼类衍生物Besunide 贝舒尼特-anserin-色林5-羟色胺拮抗药Adatanserin 阿达色林-antel-太尔寄生虫药Amidantel 阿米太尔-antrone-蒽醌抗肿瘤药物,蒽醌衍生物Mitoxantrone 米托蒽醌-apine (见-pine)-氮平(平)抗精神病药Clozapine 氯氮平-(ar)abine-拉滨抗肿瘤药,阿拉伯糖苷衍生物Fludarabine 氟达拉滨-arit-(扎)利消炎镇痛药Lobenzarit 氯苯扎利-arol-香豆素抗凝血药,双香豆素衍生物Dicoumarol 双香豆素-arone-隆(酮)抗心律失常药物Amiodarone 胺碘酮-arotene-罗汀芳维A酸衍生物Bexarotene 贝沙罗汀arte-(青)蒿-抗疟药,青蒿素衍生物Artemether 蒿甲醚-ase-酶酶Alglucerase 阿糖脑苷酶-ast-司特镇咳平喘药、抗过敏药Acitazanolast 阿扎司特-(a)steride (见-ster-)-雄胺抗肿瘤药,睾酮还原酶抑制Finasteride 非那雄胺剂-astine-斯汀抗组胺药Acrivastine 阿伐斯汀-azam (见-azepam)-占安定药,地西泮衍生物Razobazam 雷唑巴占-azenil-西尼苯二氮受体拮抗剂/激动剂Flumazenil 氟马西尼(苯二氮卓类衍生物)-azepam-西泮安定药,地西泮衍生物Clonazepam 氯硝西泮-azepide-西匹(派特)胆囊收缩素受体拮抗剂Devazepide 地伐西匹-azocine-佐辛麻醉拮抗剂/激动剂,6,7-二Anazocine 阿那佐辛苯吗啡衍生物-azolam (见-azepam)-唑仑安定药,地西泮衍生物Alprazolam 阿普唑仑-azoline-唑啉抗组胺药或局部血管收缩药,Antazoline 安他唑啉安他唑啉衍生物-azone (见-buzone)-宗(腙或消炎镇痛药Nifenazone 尼芬那宗酮)-azosin-唑嗪降压药物,哌唑嗪衍生物Doxazosin 多沙唑嗪-bactam-巴坦β内酰胺酶抑制剂Sulbactam 舒巴坦-bamate-氨酯镇静剂,丙二醇和戊二醇衍Cyclarbamate 环拉氨酯生物barb -比妥安眠药,巴比妥酸衍生物Phenobarbital 苯巴比妥-begron-勃隆β3-肾上腺素受体激动剂Ritobegron 利托勃隆-benakin (见-kin)-白介素白介素I β类似物或衍生物Mobenakin 莫贝白介素-bendan (见-dan)-本旦强心药Adibendan 阿地本旦-bendazole-苯达唑寄生虫药,噻苯达唑类衍生Albendazole 阿苯达唑物-bermin (见-ermin)-柏明血管内皮生长因子类药Telbermin 替柏明-bersat-博沙抗惊厥药,苯甲酰胺-苯吡喃Carabersat 卡拉博沙衍生物-betasol (见pred)-他索泼尼松和泼尼松龙衍生物Clobetasol 氯倍他索bol-勃合成代谢类固醇Bolandiol 勃雄二醇-bradine-雷定减缓心率药Cilobradine 西洛雷定-brate (见-fibrate)-贝特降血脂药Beclobrate 苄氯贝特-bufen-布芬非甾体类消炎药,芳基丁酸衍生物Fenbufen 芬布芬-bulin-布林抗肿瘤药物;有丝分裂抑制剂,微管蛋白粘合剂Batabulin 巴他布林-butazone (见-buzone)-布宗消炎镇痛药,保泰松类衍生物Mofebutazone 莫非布宗-buzone-布宗消炎镇痛药,保泰松类衍生物Feclobuzone 苯氯布宗-caine-卡因局部麻醉药Benzocaine 苯佐卡因-cain--卡-I类抗心律失常药物,普鲁卡因和利多卡因衍生物Acecainide 乙酰卡尼calci骨化醇维生素D类似物/衍生物Alfacalcidol 阿法骨化醇-carbef-头孢抗生素,碳头孢烯类衍生物Loracarbef 氯碳头孢-carnil (见-azenil)-卡尔苯二氮受体拮抗剂/激动剂(咔啉衍生物)Abecarnil 阿贝卡尔-castat (见-stat)-卡司他多巴胺β-羟化酶抑制剂Nepicastat 奈匹司他-cavir (见-vir)-卡韦碳环核苷类抗病毒药Abacavir 阿巴卡韦cef-头孢-抗生素类药,头孢孢子酸衍生物Cefalexin 头孢氨苄cell- 或cel- 纤维-纤维素衍生物Cellulase 纤维素酶cell-ate纤维-酯纤维素酯衍生物含有酸性残留物Cellaburate 纤维醋丁酯-cellose-纤维素纤维素醚衍生物Cellulose Acetate 醋酸纤维素-cic-西克(酸)带羧酸基团的保肝药Alonacic 阿洛西克-ciclovir (见-vir)-昔洛韦双环杂环化合物Aciclovir 阿昔洛韦-cidin-菌素(肽)天然抗生素Candicidin克念菌素-cillide (见-cillin)-西来抗生素类药Libecillide 利贝西来-cillin-西林抗生素类药,6-氨基青霉烷酸衍生物Amoxicillin 阿莫西林-cillinam (见-cillin)-西林抗生素类药Bacmecillinam巴美西林-cilpine (见-pine)-平抗癫痫药Dizocilpine 地佐环平-cisteine (见-steine)-司坦粘液溶解剂,溴己新衍生物Carbocisteine 羧甲司坦-citabine-他滨核苷类抗病毒药或抗肿瘤药物,阿糖胞苷或阿扎胞苷衍生物Gemcitabine 吉西他滨-clofenac (见-ac)-氯芬酸抗感染药,异丁芬酸衍生物Aceclofenac 醋氯芬酸-clone-克隆催眠镇静药Zopiclone佐匹克隆-cog-凝血素凝血因子Moroctocog Alfa 莫罗凝血素α-cogin-可近凝血级联抑制剂Tifacogin 替法可近-conazole-康唑全身性抗真菌药,咪康唑衍生物Ketoconazole 酮康唑cort-可特皮质类固醇,类固醇衍生物除外Amebucort 安布可特-coxib-考昔选择性环加氧酶抑制剂Celecoxib塞来考昔-crinat-利那利尿药,依他尼酸类衍生物Brocrinat 溴克利那-crine-吖啶吖啶类衍生物Floxacrine 氟克吖啶-cromil-罗米抗过敏药,色甘酸类衍生物Probicromil 普克罗米-curium (见-ium)-司坦刚性结构的神经肌肉阻断剂,箭毒样物质Doxacurium chloride 多沙氯铵-cycline-环素抗生素,四环素衍生物Tetracycline四环素-dan-旦强心药,匹莫苯类衍生物Pimobendan 匹莫苯旦-dapsone-苯砜抗结核药,二氨基苯砜类衍生物Acedapsone 醋氨苯砜-decakin (见-kin)-白介素白介素X类似物或衍生物Ilodecakin 伊洛白介素-denoson-德松腺苷受体激动剂Regadenoson 瑞加德松-dermin (见-ermin)-德明表皮生长因子类药Murodermin 莫罗德明-dil-地尔血管舒张药Buflomedil 丁咯地尔-dilol (见-dil)-地洛血管扩张药Carvedilol 卡维地洛-dipine (见-pine)-地平钙通道阻滞剂,硝苯地平衍生物Amlodipine 氨氯地平-diplase-地普酶与另一种酶相结合的纤溶酶原激活剂Amediplase 安地普酶-dismase (见-ase)-歧化酶超氧化物歧化酶活性酶Sudismase 超氧歧化酶-distim (见-stim)-地司亭结合两个不同类型的细胞集落刺激因子Milodistim 米洛地司亭-dodekin (见-kin)-白介素白介素XII类似物或衍生物Edodekin alfa 埃度白介素α-dolac (见-ac)-酸抗感染药,异丁芬酸衍生物Etodolac 依托度酸-dopa-多巴多巴胺受体激动剂,多巴胺Carbidopa 卡比多巴衍生物,用作抗帕金森氏症药/催乳素抑制剂-dox (见-ox/-alox)-多司抗菌药,二氧化喹唑啉衍生Mequidox 美喹多司物-dralazine-屈嗪抗高血压药,肼苯哒嗪衍生Budralazine 布屈嗪物-drine-君类交感神经药Ritodrine 利托君-dronic acid-膦酸钙代谢调节剂,辅助药物Alendronic Acid阿仑膦酸-dutant (见-tant)-度坦神经激肽NK2受体拮抗剂Saredutant 沙瑞度坦-dyl (见-dil)-啶血管扩张药Bisacodyl 比沙可啶-ectin-克丁抗寄生虫药,伊维菌素衍生Abamectin 阿巴克丁物-elestat (见-stat)-司他弹性蛋白酶抑制剂Depelestat 地来司他-elvekin (见-kin)-白介素白介素XI类似物或衍生物Oprelvekin 奥普瑞白介素-emab (见-mab)-单抗仓鼠源单克隆抗体-emcinal-西那无抗生素活性的红霉素衍生Alemcinal 阿兰西那物,胃动素受体激动剂-entan-生坦内皮素受体拮抗剂Ambrisentan 安立生坦(-)eptacog (见-cog)-凝血素第VII凝血因子Eptacog Alfa 依他凝血素α(活化)erg麦角麦角生物碱衍生物Ergometrine 麦角新碱-eridine-利定镇痛药,哌替啶类衍生物Phenoperidine 苯哌利定-ermin-明生长因子类药Mecasermin 美卡舍明estr-雌雌激素类药Estradiol 雌二醇-etanide (见-anide)-他尼利尿药,吡咯他尼类衍生物Bumetanide 布美他尼-ethidine (见-eridine)-替啶镇痛药,哌替啶类衍生物furethidine呋替啶-exakin (见-kin)-白介素白介素VI类似物或衍生物Atexakin alfa 阿替白介素α-exine-克新(新)祛痰药,溴己新类衍生物Cistinexine 西替克新-fenac (见-ac)-芬酸抗感染药,异丁芬酸衍生物Ibufenac 异丁芬酸-fenamate (见--芬那酯芬那酸类衍生物Colfenamate 考芬那酯fenamic acid)-fenamic acid-芬那酸消炎药,邻氨基苯甲酸衍生Clofenamic Acid氯芬那酸物-fenin-苯宁诊断艾滋病用药;(苯氨基Galtifenin 加替苯宁甲酰)甲基亚氨基二乙酸衍生物-fenine-非宁镇痛药,格拉非宁类衍生物Glafenine 格拉非宁-fenone-非农(酮)抗心律失常药,普罗帕酮类衍生物-fentanil-芬太尼麻醉性镇痛药,芬太尼类衍Remifentanil 瑞芬太尼生物-fentrine-芬群磷酸二酯酶抑制药Pumafentrine 普马芬群-fermin (见-ermin)-夫明成纤维细胞生长因子类药Palifermin 帕利夫明-fiban-非班纤维蛋白原受体拮抗剂(糖Tirofiban 替罗非班蛋白IIb / IIIa受体拮抗剂)-fibrate-贝特降血脂药,氯贝丁酯衍生物Fenofibrate 非诺贝特-filermin (见-ermin)-非勒明白血病抑制因子Emfilermin 恩非勒明-flapon-拉朋 5 - 脂氧合酶激活蛋白Quiflapon 喹夫拉朋(FLAP)抑制剂-flurane-氟烷作为普通吸入麻醉药用的卤Enflurane 恩氟烷素化合物-formin-福明(双胍)降血糖药,苯乙双胍衍生物Metformin 二甲双胍Fos- (见-fos)-磷(膦)含fos的各类药物(除下述杀Foscarnet Sodium 膦甲酸钠虫剂,寄生虫药,农药以外)-fos-磷杀虫剂,寄生虫药,农药等,Bromofos 溴硫磷磷衍生物Amifostine 氨磷汀-fos- (见-fos)-磷-含fos的各类药物(除上述杀虫剂,寄生虫药,农药以外)-fosfamide (见-fos)-磷(膦)环磷酰胺基烷基化剂Defosfamide 地磷酰胺-fosine (见-fos)-福新细胞生长抑制剂Edelfosine 依地福新-fovir (见-vir)-福韦膦酸衍生物Adefovir 阿德福韦-fradil-拉地尔用作扩血管药的钙通道阻滞Mibefradil 米贝拉地尔剂-frine (见-drine)-福林类交感神经药,苯乙基衍生Dipivefrine 地匹福林物-fungin-芬净抗真菌药Caspofungin 卡泊芬净-fylline-茶碱N-甲基黄嘌呤衍生物Doxofylline 多索茶碱gab-加抗癫痫药Gabapentin 加巴喷丁gado--钆诊断用药,钆衍生物Gadobenic Acid 钆贝酸-gatran-加群凝血酶抑制剂,抗血栓药物Dabigatran 达比加群-gene-lim(o)--tusu--ermin(o)-kin(o)--mul--基因基因治疗产品免疫调节剂肿瘤抑制剂生长因子白细胞介素多基因alferminogene tadenovecgest孕类固醇激素,孕激素类药Levonorgestrel 左炔诺孕酮-gesterone (见-ster-)-孕酮孕激素类固醇Hydroxyprogesterone 羟孕酮-gestr- (见estr)-孕-孕激素类药Megestrol 甲地孕酮-giline-吉兰B型单胺氧化酶抑制药Mofegiline 莫非吉兰-gillin-洁林曲霉菌株产生的抗生素Mitogillin 米托洁林gli格列降血糖药Gliclazide格列齐特-glitazar (见gli)-格列扎过氧化物酶体增殖活化受体(PPAR)激动剂Farglitazar 法格列扎-glitazone (见gli)-格列酮过氧化物酶体增殖活化受体(PPAR)激动剂,噻唑烷二酮类衍生物Rosiglitazone罗格列酮-glumide-谷胺胆囊收缩素拮抗剂,抗溃疡,抗焦虑剂Itriglumide 伊曲谷胺gly-格列降血糖药Glyclopyramide 格列吡脲-golide-利特多巴胺受体激动药,麦角林衍生物Pergolide 培高利特-gosivir (见vir)-戈斯韦葡萄糖苷酶抑制剂Celgosivir 西戈斯韦-gramostim (见-stim)-拉司亭粒细胞巨噬细胞集落刺激因子(GM-CSF)Regramostim 瑞拉司亭-grastim (见-stim)-格司亭粒细胞集落刺激因子(G-CSF)Filgrastim 非格司亭-grel-格雷血小板聚集抑制剂Ozagrel奥扎格雷-grel--格雷-血小板聚集抑制剂Oxagrelate 氧格雷酯guan-胍-抗高血压药,胍类衍生物Guanfacine 胍法辛-ibine (见-ribine)-宾吡唑呋喃型衍生物Benaxibine 贝那昔滨-icam-昔康消炎镇痛药,伊索昔康衍生Meloxicam美洛昔康物-ifene-芬抗雌激素药,氯米芬和他莫Clomifene 氯米芬昔芬衍生物-igetide (见-tide)-吉肽免疫剂-抗肿瘤药Pentigetide 喷替吉肽-ilide-利特III类抗心律失常药,司美利Sematilide 司美利特特衍生物-imab (见-mab)-伊单抗灵长类源单克隆抗体imex-美克免疫增强剂Forfenimex 福酚美克-imibe-麦布降血脂药,酰基辅酶A;胆Avasimibe 阿伐麦布固醇酰基转移酶(ACAT)抑制剂-imod-莫德免疫调节药,兴奋/抑制和兴Fingolimod 芬戈莫德奋剂-imus-莫司免疫抑制剂(抗肿瘤药物等Sirolimus 西罗莫司)-ine-碱生物碱和有机碱在推荐的国际非专利药品名称列表1-95中以-ine结尾的INNs有1611种(占总数的20.5%)-inostat (见-stat)-司他组蛋白去乙酰酶抑制剂Dacinostat 达西司他io-碘-含碘显影剂Iohexol 碘海醇iod-(-io-)碘-显影剂以外的含碘化合物Iodocetylic Acid (123I) 碘[123I]软脂酸io(d)-/-io-碘-含碘放射性药物Iodocholesterol(131I) 碘[131I]胆甾醇-irudin-卢定抗凝血药,水蛭素衍生物Bivalirudin 比伐卢定-isomide-索胺抗心律失常药,丙吡胺衍生Actisomide 阿克索胺物-ium-铵季铵化合物Clidinium Bromide 克利溴铵-izine-嗪二苯甲基哌嗪衍生物Dropropizine 羟丙哌嗪-kacin-卡星抗生素,卡那霉素和卡那霉Amikacin 阿米卡星素B衍生物-kalant-卡兰钾通道阻滞药Adekalant 阿地卡兰-kalim-卡林钾通道激活药,抗高血压药Aprikalim 阿普卡林-kef--法脑啡肽激动剂Frakefamide 氟雷法胺-kin-白介素白介素类药-kinra-白介素白介素受体拮抗药-kiren-吉仑肾素抑制药Aliskiren 阿利吉仑-leukin (见-kin)-白介素白介素II类似物或衍生物Aldesleukin 阿地白介素-lipase-脂肪酶脂肪酶Rizolipase 根霉脂肪酶-listat (见-stat)-司他胃肠道脂肪酶抑制剂Orlistat 奥利司他-lubant-卢班白三烯B4受体拮抗剂Amelubant 阿美卢班-lukast (见-ast)-鲁司特白三烯受体拮抗剂Montelukast 孟鲁司特-mab-单抗单克隆抗体Abciximab 阿昔单抗-mantadine-金刚胺金刚烷胺衍生物Somantadine 索金刚胺-mantine-金刚金刚烷胺衍生物Memantine 美金刚-mantone-孟酮金刚烷胺衍生物Idramantone 伊决孟酮-mastat (见-stat)-司他基质金属蛋白酶抑制剂Batimastat 巴马司他-meline-美林拟胆碱药,(毒蕈碱受体激动剂/用于治疗阿尔茨海默氏症的部分拮抗剂)Cevimeline 西维美林mer- 或-mer-汞含汞药物,抗微生物药,利尿药Merbromin 汞溴红从推荐的国际非专利药品名称列表28的一般原则中删除-mer-姆聚合物Carbomer 卡波姆-mesine-美新σ受体配合体Panamesine 帕那美新-mestane-美坦芳香酶抑制药Exemestane 依西美坦-metacin-美辛消炎镇痛药,吲哚美辛衍生物Indometacin 吲哚美辛-methasone 或-metasone (见pred)-米松泼尼松和泼尼松龙衍生物Betamethasone 倍他米松-micin-米星从各个小单孢菌属获得的抗生素Astromicin 阿司米星-mifene (见-ifene)-米芬抗雌激素药,氯米芬和他莫昔芬衍生物Toremifene 托瑞米芬-milast-米司特磷酸二酯酶IV(PDE IV)抑制剂Piclamilast 吡拉米司特mito-米托-抗肿瘤药物,核毒类药物Mitoxantrone 米托蒽醌从推荐的国际非专利药品名称列表24的一般原则中删除-monam-莫南单环内酰胺类抗生素Carumonam 卡芦莫南-morelin (见-relin)-莫瑞林生长激素释放刺激肽Tabimorelin 他莫瑞林-mostat (见-stat)-司他蛋白水解酶抑制剂Camostat 卡莫司他-mostim (见-stim)-莫司亭巨噬细胞刺激因子(M-CSF)Cilmostim 西莫司亭-motine-莫汀抗病毒药,喹啉衍生物Famotine 法莫汀-moxin-莫辛单胺氧化酶抑制药,肼类衍生物Octamoxin 奥他莫辛-mustine-莫司汀抗肿瘤药物,烷基化剂,(β-氯乙基)胺衍生物Atrimustine 阿莫司汀-mycin (见kacin)-霉素抗生素,由链霉菌菌株产生Azithromycin 阿奇霉素nab 大麻大麻酚衍生物Cannabinol 大麻酚-nakin (见-kin)-白介素白介素I类似物或衍生物-nakinra (见-kinra)-白介素白介素I受体拮抗剂Anakinra 阿那白滞素nal-纳-麻醉拮抗剂/与去甲吗啡有关的激动剂Naloxone 纳洛酮-naritide (见-tide)-那立肽心钠素类药Anaritide 阿那立肽-navir (见-vir)-那韦HIV蛋白酶抑制剂Amprenavir 氨普那韦-nercept-那西普肿瘤坏死因子拮抗药Onercept 奥那西普-nermin (见-ermin)-纳明肿瘤坏死因子类药Tasonermin 他索纳明-nertant (见-tant)-纳坦神经降压素受体拮抗剂Reminertant 瑞米纳坦-netant (见-tant)-奈坦神经激肽NK3受体拮抗剂Osanetant 奥沙奈坦ni-尼-硝-烟酸或烟醇衍生物硝基衍生物Nialamide 尼亚拉胺Nifenalol 硝苯洛尔ni-dipine尼-地平硝基衍生物Nitrendipine 尼群地平nic-尼-烟酸或烟醇衍生物Nicardipine 尼卡地平-nicate (见nico-)-烟酯抗高胆固醇药和/或血管舒张烟酸酯类药Ciclonicate 环烟酯-nicline-克林(兰)烟碱型乙酰胆碱受体的部分激动剂/拮抗剂Altinicline 阿替克林nico-尼可-烟酸或烟醇衍生物Nicorandil 尼可地尔-nidazole-硝唑抗原虫药,放射增敏剂,甲硝唑衍生物Tinidazole 替硝唑-nidine (见-onidine)-尼定抗高血压药,可乐定衍生物Moxonidine莫索尼定nifur- 硝呋-5-硝基呋喃衍生物Nifuradene 硝呋拉定-nil (见-azenil)-尼苯二氮受体拮抗剂/激动剂Sarmazenil 沙马西尼(苯二氮卓类衍生物)nit- -nit-硝-硝基衍生物Nitarsone 硝苯胂酸nitr-硝-硝基衍生物Nitramisole 硝拉咪唑nitro-硝-硝基衍生物Nitromifene 硝米芬-nixin-尼辛消炎镇痛药,苯胺基烟酸衍生物Butanixin 丁尼辛(-)nonacog (见-cog)-凝血素第IX凝血因子Nonacog Alfa 诺那凝血素-octadekin (见-akin)-白介素IL-18的人类类似物和衍生物iboctadekin-octakin (见-akin)-白介素白介素VIII类似物或衍生物Emoctakin 依莫白介素(-)octocog (见-cog)-凝血素第VIII凝血因子Moroctocog Alfa 莫罗凝血素α-ol-醇或酚醇或酚从第14次报告的一般原则中删除-olol-洛尔β-肾上腺素受体拮抗剂Betaxolol 倍他洛尔-olone (见pred)-龙泼尼松和泼尼松龙衍生物Tibolone 替勃龙-omab (见-mab)-莫单抗小鼠源单克隆抗体Afelimomab 阿非莫单抗-onakin (见-kin)-白介素白介素Iα类似物或衍生物Pifonakin 匹福那白介素-one-酮酮类在推荐的国际非专利药品名称列表1-95中以-one结尾的INNs有624种(占总数的8.0%)-onide-奈德外用激素类药,缩醛类衍生物Budesonide 布地奈德-onidine-尼定(-乐定)抗高血压药,可乐定衍生物Clonidine 可乐定-onium (见-ium)-銨季铵化合物Benzalkonium Bromide 苯扎溴铵-opamine (见-dopa)-巴胺多巴胺能药物多巴胺衍生物用作强心剂/抗高血压药/利尿剂Dopamine 多巴胺-orex-雷司食欲抑制药,苯乙胺衍生物Amfepentorex 安非雷司-orph--啡麻醉拮抗剂/激动剂,吗啡烷衍生物Dihydroetorphine 二氢埃托啡orphan 啡烷麻醉拮抗剂/激动剂,吗啡烷衍生物Levallorphan 左洛啡烷-orphine-啡(-吗啡)麻醉拮抗剂/激动剂,吗啡烷Apomorphine 阿扑吗啡衍生物-orphinol-啡醇麻醉拮抗剂/激动剂,吗啡烷衍生物Hydromorphinol 氢吗啡醇-orphone-啡酮(-吗酮)麻醉拮抗剂/激动剂,吗啡烷衍生物Hydromorphone氢吗啡酮-otermin-特明骨形态发生蛋白Avotermin 阿伏特明-ox-铝抗酸药,铝衍生物Glucalox 羟甘铝-oxacin-沙星抗菌药,萘啶酸衍生物Ciprofloxacin 环丙沙星-oxan(e)-生苯并二恶烷衍生物Azaloxan 阿扎克生-oxanide (见-anide)-沙奈抗蠕虫药,水杨酰苯胺衍生物Nitazoxanide 硝唑沙奈-oxef (见cef-)-氧头孢抗生素类药,氧头孢孢子酸衍生物Flomoxef 氟氧头孢-oxepin (见-pine)-塞平抗抑郁药Beloxepin 贝洛塞平-oxetine-西汀抗抑郁药,氟西汀衍生物Fluoxetine氟西汀-oxicam (见-icam)-昔康消炎镇痛药,伊索昔康衍生物Piroxicam 吡罗昔康-oxifene (见-ifene)-昔芬抗雌激素药,氯米芬和他莫昔芬衍生物Raloxifene 雷洛昔芬-oxopine (见-pine)-索平三环化合物Raboxopine 曲波索平-pafant-帕泛血小板活化因子拮抗剂Foropafant 福罗帕泛-pamide-帕胺利尿剂,磺酰氨基苯甲酸衍生物Indapamide 吲达帕胺-pamil-帕米冠状动脉血管扩张剂,维拉帕米衍生物Verapamil 维拉帕米-parcin-帕星糖肽类抗生素Avoparcin 阿伏帕星-parin-肝素包含低分子量肝素的肝素衍生物Enoxaparin Sodium 依诺肝素钠-parinux-肝素合成肝素Fondaparinux Sodium 磺达肝素钠-pendyl (见-dil)-喷地血管扩张药Cloxypendyl 氯羟喷地-penem-培南青霉素酸抗生素类似物Imipenem 亚胺培南perfl(u)-全氟-作血液代用品和/或诊断试剂用的全氟化合物Perflubutane 全氟丁烷-peridol (见-perone)-哌利多抗精神病药,氟哌啶醇衍生物Benperidol 苯哌利多-peridone (见-perone)-哌酮(-立酮)抗精神病药,利培酮衍生物Domperidone 多潘立酮-perone-哌隆安定药、抗精神病药,衍生物Amiperone 阿米哌隆phenine-芬宁镇痛药,格拉非宁类衍生物Adiphenine 阿地芬宁-pidem-吡坦催眠药/镇静剂,唑吡坦衍生物Zolpidem 唑吡坦-pin(e)-平三环化合物Dosulepin 度硫平-piprazole (见-prazole)-哌唑安定药,苯基哌嗪衍生物Aripiprazole 阿立哌唑由于与词干-prazole冲突,未来不鼓励使用-pirone (见-spirone)-匹隆抗焦虑药,丁螺环酮衍生物Ipsapirone 伊沙匹隆-pirox (见-ox/-alox)-吡酮抗真菌药,吡啶酮衍生物Ciclopirox 环吡酮-pitant (见-tant)-匹坦神经激肽NK1(P物质)受体拮抗剂Aprepitant 阿瑞匹坦-plact-普拉血小板第4因子类似物和衍生物Iroplact 伊罗普拉-pladib-拉地磷脂酶A2抑制剂Goxalapladib 戈沙拉地-planin-拉宁抗生素类药Teicoplanin 替考拉宁-plase (见-teplase,-uplase,-ase)-普酶酶类Alteplase 阿替普酶-plasmid (见-gene)在载体是质粒的情况下beperminogene perplasmid -platin-铂抗肿瘤药,铂类衍生物Carboplatin 卡铂-plermin (见-ermin)-普勒明血小板生长因子类药Becaplermin 贝卡普勒明-plestim (见-stim和-kin)-司亭白介素III类似物或衍生物Muplestim 莫来司亭-plon-普隆吡唑并[-]嘧啶衍生物,用来作为抗焦虑药,镇静剂,安眠药。

Divalproex Sodium Delayed-Release Tablets 双丙戊酸钠缓释片美国药典USP39

Divalproex Sodium Delayed-Release Tablets 双丙戊酸钠缓释片美国药典USP39

Divalproex Sodium Delayed-Release Tablets» Divalproex Sodium Delayed-Release Tablets contain an amount of divalproexsodium equivalent to not less than 90.0 percent and not more than 110.0 percent of the labeled amount of valproic acid (C8H16O2).Packaging and storage—Preserve in tight, light-resistant containers, and store at controlled room temperature.USP Reference standards 〈11〉—USP Valproic Acid RSIdentification—The retention time of the major peak in the chromatogram of the Assay preparation corresponds to that in the chromatogram of the Standard preparation, as obtained in the Assay.Dissolution 〈711〉—acid stage—Medium: 0.08 N hydrochloric acid (prepared by adding 40 mL of hydrochloric acid to 5000 mL of water, adjusting with 2 N hydrochloric acid to a pH of 1.2, and diluting with water to 6000 mL); 900 mL.Apparatus 2: 50 rpm.Time: 1 hour.Procedure—At the end of 1 hour, carefully transfer the Tablet to a dissolution vessel containing the Medium of the Buffer stage. [note—Do not perform an analysis of the Medium in the Acid stage.]buffer stage—Medium: pH 7.5 phosphate buffer (prepared by dissolving 40.83 g of monobasic potassium phosphate and 9.84 g of sodium hydroxide in 5000 mL of water,adjusting with 0.08 N hydrochloric acid to a pH of 7.5, and diluting with water to 6000 mL); 900 mL.Apparatus 2: 50 rpm.Time: 1 hour.Determine the amount of C8H16O2 dissolved in the Buffer stage by employing the following method.Citrate buffer—Dissolve 0.5 g of citric acid monohydrate and 0.4 g of dibasic sodium phosphate in 1.0 L of water.Potassium phosphate buffer—Dissolve 6.8 g of monobasic potassium phosphate and 1.7 g of sodium hydroxide in 1.0 L of water. Adjust with phosphoric acid to a pH of 7.4 ± 0.1.Mobile phase—Prepare a mixture of Citrate buffer, Potassium phosphate buffer, and acetonitrile (35:35:30). Adjust with phosphoric acid to a pH of 3.0 ± 0.1,and mix. Filter and degas. Make adjustments if necessary (see System Suitability under Chromatography 〈621〉).Standard solution—Prepare a solution of USP Valproic Acid RS in the Medium used in the Buffer stage, having a known concentration of about 0.12 mg per mL. [note —A volume of acetonitrile not exceeding 10.0% of the total volume may be used to dissolve the USP Valproic Acid RS.]Test solution—If necessary, dilute a portion of each filtered solution under test with the Medium used in the Buffer stage to obtain a solution having a concentration of about 0.12 mg per mL.Chromatographic system (see Chromatography 〈621〉)—The liquid chromatograph is equipped with a 210-nm detector and a 3.9-mm × 15-cm column that contains 4-µm packing L11. The flow rate is about 1.2 mL per minute. Chromatograph the Standard solution, and record the peak responses as directed for Procedure: the column efficiency is not less than 1000 theoretical plates; the tailing factoris not more than 2.0; and the relative standard deviation for replicate injections is not more than 2.0%.Procedure—Separately inject equal volumes (about 50 µL) of the Standardsolution and the Test solution into the chromatograph, record the chromatograms, and measure the responses for the major peaks. Calculate the quantity, in mg, of valproic acid (C8H16O2) dissolved by the formula:900CD(rU / rS)in which C is the concentration, in mg per mL, of USP Valproic Acid RS in the Standard solution; D is the dilution factor used to prepare the Test solution; and rU and rS are the peak areas of valproic acid obtained from the Testsolution and the Standard solution, respectively.Tolerances—Not less than 80% (Q) of the labeled amount of C8H16O2 is dissolved in 1 hour in the Buffer stage.Uniformity of dosage units 〈905〉: meet the requirements.Assay—Citrate buffer—Dissolve 2.0 g of citric acid monohydrate and 1.6 g of dibasic sodium phosphate in 4.0 L of water.Mobile phase—Prepare a mixture of Citrate buffer and acetonitrile (7:3).Adjust with phosphoric acid to a pH of 3.0 ± 0.1, and mix. Filter and degas.Make adjustments if necessary (see System Suitability under Chromatography〈621〉).Standard preparation—Prepare a solution of USP Valproic Acid RS in Mobilephase having a known concentration of about 0.5 mg per mL.Assay preparation—Transfer a number of whole Tablets containing the equivalent of about 2500 mg of valproic acid into a 250-mL volumetric flask. Add 150 mL of Mobile phase, and sonicate with frequent swirling for 30 minutes or until the Tablets completely disintegrate. Allow the solution to cool down to roomtemperature, and then dilute with Mobile phase to volume. Transfer 5.0 mL of the resulting solution to a 100-mL volumetric flask. Dilute with Mobile phase to volume, and mix.Chromatographic system (see Chromatography 〈621〉)—The liquid chromatograph is equipped with a 210-nm detector and a 3.9-mm × 15-cm column that contains 4-µm packing L11. The flow rate is about 0.9 mL per minute. Chromatograph theStandard preparation, and record the peak responses as directed for Procedure: the column efficiency is not less than 1000 theoretical plates; the tailing factor is not more than 2.0; and the relative standard deviation for replicate injections is not more than 2.0%.Procedure—Separately inject equal volumes (about 15 µL) of the Standardpreparation and the Assay preparation into the chromatograph, record thechromatograms, and measure the responses for the major peaks. Calculate the quantity, in mg, of valproic acid (C8H16O2) in the portion of Tablets taken by the formula:5000C(rU / rS)in which C is the concentration, in mg per mL, of USP Valproic Acid RS in the Standard preparation; and rU and rS are the peak areas of valproic acidobtained from the Assay preparation and the Standard preparation, respectively. Auxiliary Information— Please check for your question in the FAQs beforecontacting USP.Topic/Question Contact Expert CommitteeMonograph Heather R. Joyce, Ph.D.Associate ScientificLiaison(301) 998-6792(CHM42015) Chemical Medicines Monographs 4Reference Standards RS Technical Services 1-301-816-8129rstech@〈711〉Margareth R.C. Marques,Ph.D.Principal ScientificLiaison(301) 816-8106(GCDF2015) General Chapters-DosageForms 2015USP39–NF34 Page 3554Pharmacopeial Forum: Volume No. 31(1) Page 153Chromatographic Column—DIVALPROEX SODIUM DELAYED-RELEASE TABLETSChromatographic columns text is not derived from, and not part of, USP 39 or NF34.。

艾塞那肽注射液Exenatide详细说明书与重点

艾塞那肽注射液Exenatide详细说明书与重点

艾塞那肽注射液Exenatide英文名:Exenatide Injection汉语拼音:Ai Sai Na T ai Zhu She Ye【成份】本品主要成份为艾塞那肽。

化学结构式:分子式:C184H282N50O60S,分子量:4186.6,辅料:甘露醇、醋酸钠三水合物、间甲酚、冰醋酸、注射用水【性状】本品为无色澄明液体。

【适应症】本品用于改善2型糖尿病患者的血糖控制,适用于单用二甲双胍、磺酰脲类.以及二甲双胍合用磺酰脲类,血糖仍控制不佳的患者。

【规格】(1)5 μg剂量刻度注射笔:0.25 mg/m1,1.2 m1/支,单次注射药量5 μg,内含60次注射的药量。

(2)10 μg剂量刻度注射笔:0.25 mg/m1,2.4 m1/支,单次注射药量10 μg.内含60次注射的药量【用法用量】本品的起始剂量为每次5微克(μg),每日二次,在早餐和晚餐前60分钟内(或每天的2顿主餐前;给药间隔大约6小时或更长)皮下注射。

不应在餐后注射本品。

根据临床应答,在治疗1个月后剂量可增加至每次10微克,每日二次。

每次给药应在人腿、腹部或上臂皮下注射。

本品推荐用于接受二甲双胍、一种磺酰脲类、二甲双胍合用一种磺酰脲类治疗,血糖仍控制不佳的2型糖尿病患者。

在二甲双胍治疗的基础上加用本品时,可继续使用二甲双胍的目前剂量,因为合用本品发生低血糖而需要调整二甲双胍剂量的可能性较低。

在磺酰脲类治疗基础上加用本品时,应该考虑降低磺酰脲类的剂量,以降低低血糖发生的风险(参见【注意事项】,低血糖)。

本品为无色澄明液体,当溶液有颗粒、浑浊或变色时不得使用。

过有效期后不得使用。

尚无本品静脉或肌肉注射的安全性和有效性资料。

注射笔使用指南注射笔的详细操作图示和注射指导请参见本品包装盒中所附“注射笔使用手册”。

重要提示使用本注射笔前请仔细阅读“注射笔使用手册”,如果不完全按照使用手册操作可能会出现剂量错误、注射笔损坏或者发生感染。

·每次使用前请检查注射笔上的标签,确认其为自已所用的5μg或10μg注射笔。

EX-CELL ANTIFOAM产品说明书

EX-CELL ANTIFOAM产品说明书

CATALOG NO. 59920CEX-CELL ® ANTIFOAMFrequently Asked QuestionsWhat is the density of EX-CELL ANTIFOAM?1.0273What is the metabolic fate of EX-CELL ANTIFOAM?Polydimethylsiloxanes (PDMS) are diverse polymetric compounds that are commonly known as silicones. PDMS make up a significant percentage of the raw material (Dow Corning ® Q7-2587) used in EX-CELL ANTIFOAM. This compound does not bioaccumulate in living organisms because it is too large to be absorbed by biological membranes.Why is EX-CELL ANTIFOAM sterilized by gamma irradiation versus autoclaving or sterile filtering?The packaging used for this product is polyethylene (PE) media bags and it cannot tolerate the extreme temperature or pressure used in autoclaving. Antifoam is too thick to filter through a sterile filter. The PE media bags used during manufacture are not sterile prior to fill and the product is terminally sterilized so as to prevent the film from cross-linking due to two irradiations.Are the polyethylene (PE) media bags used for EX-CELL ANTIFOAM considered as animal component free (ACF)?Yes, the product contact layer in polyethylene bag is considered as animal component free.How is the final product concentration tested and what test is used?EX-CELL ANTIFOAM is tested with the use of aquantification assay and allows for the reporting of the active ingredient simethicone in the final product. The test name is Simethicone Emulsion and is based on the USP method. EX-CELL ANTIFOAM is the industry’s only antifoam tested for accurate final product concentration.Are there any special preparation instructions for use of EX-CELL ANTIFOAM?EX-CELL ANTIFOAM is pre-diluted with water-for-injection (WFI) grade water, packaged into polyethylene (PE) media bags and sterilized by gamma irradiation. This product comes prepared and ready-to-use. The only recommendation is to vigorously mix the product prior to addition in cell culture. One to five minutes using a manual or mechanical rocking motion should achieve a homogenous mixture.How is it proven that EX-CELL ANTIFOAM is sterile by gamma irradiation?Spiking studies were performed to demonstrate a >6 log reduction of microorganisms. Dose mapping was also performed on the product to determine that the product is completely irradiated.Are the PE media bags used for EX-CELL ANTIFOAM already irradiated prior to fill?No, the bags are not irradiated prior to fill. This prevents the bags from being irradiated twice.What is the storage temperature and shelf life of this product?EX-CELL ANTIFOAM can be stored at ambient temperatures (15 to 30˚C) and has a current shelf of 24 months.SAFC13804 West 107th Street Lenexa, KS 66215Phone: 1-913-469-5580Fax: 1-913-469-5584GlobalEmail:******************m74569-5094481080SAFC , Sigma-Aldrich and EX-CELL are registered trademarksof Sigma-Aldrich Biotechnology L.P . and Sigma-Aldrich Co. Dow Corning is a registered trademark of Dow Corning Corp.© 2010 SAFC All rights reserved.。

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Inhibitors, Agonists, Screening Libraries
Data Sheet
BIOLOGICAL ACTIVITY:
Exherin trifluoroacetate is an N–cadherin antagonist, which inhibits N–cadherin mediated cell adhesion.
In Vitro: Exherin (0.2 mg/mL) blocks collagen I–mediated changes in pancreatic cancer cells, and is highly effective at preventing cell motility that is induced by expression of N–cadherin. Exherin (0, 0.1, 0.2, 0.5 and 1.0 mg/mL) induces apoptosis in a
dose–dependent and N–cadherin–dependent manner [1].
In Vivo: Exherin (50 mg/kg) significantly prevents tumor growth and metastasis in a mouse model for pancreatic cancer. Exherin prevents tumor cell invasion and metastasis in an orthotopic model for pancreatic cancer using N–cadherin overexpressing BxPC–3cells [1]. Exherin, at the dosages evaluated, does not display either antiangiogenic activity in a rat aortic ring assay or antitumor potential in a PC3 subcutaneous xenograft tumor model [2]. Exherin (10 mL/kg, i.p.) augmentation of melanoma tumor growth is overcome through its ability to make regionally infused melphalan more effective. Exherin mediated augmentation of melanoma tumor growth is not altered by regionally infused temozolomide. In A375, but not DM443 xenografts, Exherin treatment increases phosphorylation of AKT at serine 473. Exherin slightly diminishes N–cadherin expression in both xenografts [3].
PROTOCOL (Extracted from published papers and Only for reference)
Animal Administration: Exherin is prepared in PBS.[1]Animals are anesthetized, and 40 μL of a single cell suspension containing 50,000cells is injected into the pancreas. Mice are randomized into treatment groups 10 days after surgery. For treatment, mice are injected intraperitoneally once per day with Exherin at 50 mg/kg in 100 μL PBS (×1 per day, ×5 per week for 4 weeks). For in vivo
bioluminescence, D–Luciferin is administered by intraperitoneal injection. Data are acquired 20 min after injection using the IVIS system. Tumor growth is monitored every 10 days from day 10 to day 50 after surgery. Luciferase activity is quantified using the IVIS system. Two months after surgery, the mice are killed, and the pancreas, liver, lung, and disseminated nodules are harvested, fixed in 10% buffered formalin, and embedded in paraffin. Serial 5–μM sections are cut, mounted on slides, and stained with H&E using
standard procedures. Sections are also stained for TUNEL. Sections are examined using a Zeiss Axioscop 40 microscope equipped with an AxioCam MR digital camera and software.
References:
[1]. Shintani Y, et al. ADH–1 suppresses N–cadherin–dependent pancreatic cancer progression. Int J Cancer. 2008 Jan 1;122(1):71–7.
[2]. Li H, et al. ADH1, an N–cadherin inhibitor, evaluated in preclinical models of angiogenesis and androgen–independent prostate cancer. Anticancer Drugs.2007 Jun;18(5):563–8.
[3]. Turley RS, et al. Targeting N–cadherin increases vascular permeability and differentially activates AKT in melanoma. Ann Surg. 2015 Feb;261(2):368–77.
Product Name:
Exherin (trifluoroacetate)Cat. No.:
HY-13541A CAS No.:
1135237-88-5Molecular Formula:
C 24H 35F 3N 8O 8S 2Molecular Weight:
684.71Target:
Others Pathway:
Others Solubility:
DMSO: ≥ 43 mg/mL
Caution: Product has not been fully validated for medical applications. For research use only.
Tel: 609-228-6898 Fax: 609-228-5909 E-mail: tech@
Address: 1 Deer Park Dr, Suite Q, Monmouth Junction, NJ 08852, USA。

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