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Crestor

By V. Kadok. Stevens Institute of Technology. 2018.

Dose Intramuscular and subcutaneous injecton 30 mg twice a week buy generic crestor 20 mg on line, dose can also vary from 15 mg daily to 15 mg weekly; total 300 to 400 mg 10 mg crestor with amex. Contraindicatons See notes above and literature; preexistng lung disease; pregnancy (Appendix 7c) and lactaton (Appendix 7b). Precautons See notes above and consult literature; renal impairment; interactons (Appendix 6c). Note: Irritant to tssues Busulphan* Pregnancy Category-D Schedule G Indicatons Chronic granulocytc leukaemia, chronic myelogenous leukaemia, polycythaemia vera, myelofbrosis, thrombocythaemia. Dose Oral Chronic myeloid leukaemia, inducton of remission: 60 µg/kg body weight daily (max 4 mg) maintenance dose 0. Contraindicatons Pregnancy (Appendix 7c); bone marrow suppression; chronic lymphocytc leukaemia; lactaton. Precautons Monitor cardiac functon; pregnancy; lactaton previous radiaton therapy; avoid in porphyria, hepatc impairment; interactons (Appendix 6c). Adverse Efects Hepatotoxicity (including hepatc veno- occlusive disease, hyperbilirubinaemia, jaundice and fbrosis); cardiac tamponade at high doses in thalassaemic patents; pneumonia; skin hyperpigmentaton; hyperuraecemia; pulmonary fbrosis. Chlorambucil* Pregnancy Category-D Schedule G Indicatons Chronic lymphocytc leukaemia; some non- Hodgkin’s lymphomas; Hodgkin’s disease, ovarian cancer and Waldenstrom (primary) macroglobulinaemia. Waldarstrom’s macroglobulinaemia: 6 to 12 mg daily untl leucopenia occurs, then reduce to 2 to 8 mg daily. Contraindicatons See notes above and consult literature; hypersensitvity; porphyria; pregnancy (Appendix 7c) and lactaton (Appendix 7b). Precautons See notes above and consult literature; renal impairment; hepatc impairment (Appendix 7a). Cisplatn* Pregnancy Category-D Schedule H Indicatons Metastatc testcular tumours, metastatc ovarian tumours, advanced bladder carcinoma and other solid tumours. Dose Intravenous injecton (use syringes devoid of aluminium component) Ovarian tumor: 50 mg/m2 of body surface area once every three weeks. Contraindicatons See notes above and consult literature; hypersensitivity; renal impairment (Appendix 7d); pregnancy (Appendix 7c) and lactation (Appendix 7b). Precautons See notes above and consult literature; hyperuraemia; hypomagnesaemia; hypocalcaemia; interactons (Appendix 6c). Cyclophosphamide* Pregnancy Category-D Schedule G Indicatons Malignant lymphomas including Non- Hodgkin’s lymphomas, lymphocytc lymphoma, Burkit’s lymphoma; multple myeloma; leukaemias, mycosis fungoides; neuroblastoma; adenocarcinoma of the ovary; retnoblastoma; breast cancer. Dose Intravenous injecton Malignancy: 40 to 50 mg/kg body weight in divided doses over 2 to 5 days. Alternatvely 10 to 15 mg/kg body weight every 7 to 10 days or 3 to 5 mg/kg body weight twice a week. Contraindicatons See notes above and consult literature; bladder haemorrhage; thrombocytopenia; severe bone marrow depression; pregnancy (Appendix 7c) and lactaton (Appendix 7b). Precautons See notes above and consult literature; renal impairment (Appendix 7d) and hepatc impairment (Appendix 7a); interactons (Appendix 6c). Haemorrhagic cystts; colits; cardiac toxicity; anorexia; thrombocytopenia; dermatts. The soluton should be used immediately afer preparaton as it deteriorates on storage. Cytosine Arabinoside (Cytarabine)* Pregnancy Category-D Schedule H Indicatons Acute lymphoblastc leukaemia; chronic mye- loid leukaemia; meningeal leukaemia; eryth- roleukaemia; Non-Hodgkin’s lymphomas; lymphosarcoma. Dose Intravenous injecton Adult- 100 mg/m2 body surface area every 12 h for seven days. Child- 100 mg/m2 body surface area twice daily by rapid injecton or 100 mg/m2 body surface area daily by contuous infusion given by 5 to 10 days. Contraindicatons See notes above and consult literature; hypersensitvity; pregnancy (Appendix 7c) and lactaton (Appendix 7b). Precautons See notes above and consult literature; uric acid level monitoring recommended; hepatic impairment (Appendix 7a). Contraindicatons Known hypersensitvity, cardiac disease, pregnancy (Appendix 7c), lactaton, neonates. Adverse Efects Infusion reactons, cardiotoxicity, bone marrow suppression, liver impairment, nausea and vomitng, reversible alopecia, stomatts, conjunctvits, keratts, mucosits, discolouraton of body fuids, local skin reactons and tssue damage, secondary leukemias. Storage Store protected from light, in well closed containers at temperature between (15- 30⁰C); Store intact vials of soluton under refrigeraton at 2-8⁰C. Use the soluton prepared using the liquid stated on the label immediately afer preparaton but, in any case, within the period recommended by the manufacturer when prepared and stored strictly in accordance with the instructons of the manufacturer. Etoposide* Pregnancy Category-D Schedule H Indicatons Refractory testcular tumours; acute leukaemia; malignant lymphoma; lung cancer. Dose Intramuscular injecton Adult- Initally 50 to 100 mg/m2 body surface area daily by infusing over 30 to 60 min. Oral Adult- 100 to 200 mg/m2 body surface area from day 1 to 5 taken on empty stomach, thereafer no treatment for 3 to 4 weeks.

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Tissue- specific promoters are designed to interact with transcription factors or other nuclear proteins present in the desired target cells safe 20 mg crestor. The chicken skeletal a-actin promoter contains positive as-acting elements required for efficient transcriptional activity in myogenic cells quality crestor 5 mg. Therefore, an a-actin promoter could direct high expression of recombinant protein in skeletal muscle. The efficiency of polyadenylation is important for gene expression, as transcripts that fail to be cleaved and polyadenylated are rapidly degraded in the nuclear compartment. Therefore, in vivo pulsatile production of certain therapeutic proteins may be beneficial for their clinical applications. This can be achieved by including gene switches in a gene expression system to turn on or off the transcription of an administered gene. A gene switch is designed to be part of a gene expression system that contains both the gene switch and a therapeutic gene. In the positive system, the target gene will be inactive until the administration of an exogenous compound or ligand. Such inducing agents or drugs include progesterone antagonists, tetracycline, ecdysone and rapamycin. This section describes the development of several lipid, peptide and polymer-based gene delivery systems. However, the encapsulation efficiency of plasmids is very low, because of the large dimension of plasmids compared to the internal diameter of the vesicles. The pH-sensitive immunoliposomes have been shown to mediate 6~8 times higher levels of transgene expression into mouse lymphoma cells, compared to non-pH-sensitive immunoliposomes. A negatively charged phospholipid such as phosphatidylserine, phosphatidic acid or phosphatidyl glycerol, in the absence or presence of cholesterol, are utilized to produce a suspension of multilamellar vesicles containing plasmids, which are then converted to small unilamellar vesicles by sonication. Cochleates have been shown to encapsulate plasmid and enhance plasmid stability and transfection efficiency. A cationic lipid consists of: • a hydrophobic lipid anchor group • a linker group • a positively charged headgroup. Lipid anchors help in forming liposomes (or micellar structures) and determine the physical properties of a lipid bilayer, such as membrane rigidity and rate of lipid exchange between lipid 341 membranes. The linker group is an important component, which determines the chemical stability and biodegradability of a cationic lipid. The head groups of cationic lipid appear to be critical for transfection and cytotoxicity of corresponding liposome formulations. The cationic amphiphiles differ markedly in structure and may be single or multiple charged as primary, secondary, tertiary and/or quaternary amines. Examples are lipospermine, cationic cholesterol, cationic detergent or lipopolysine. The relative proportions of each component and the structure of the head group influence the physicochemical properties of plasmid/lipid complexes. Many effective cationic lipids contain protonatable polyamines linked to dialkyl or cholesterol anchors. To increase the biodegradability of cationic lipids, a series of cationic lipids have been synthesized in which the ether bonds were replaced with ester bonds. Cationic lipid-based gene delivery systems lack target specificity, which results in low transfection efficiency in certain tissues due to the interference from cationic lipid-binding macromolecules either in the circulation or in the extracellular matrix. To circumvent this problem, neutral plasmid/lipospermine complexes containing a trigalactolipid have been prepared and shown to efficiently transfect hepatoma HepG2 cells bearing asialoglycoprotein receptor. Addition of 25% (mol mol−1) of the triantennary galactolipid increased the transfection efficiency by a thousand fold, compared to the lipid-based system with no targeting ligand. An efficient transfection of β-galactosidase into HeLa cells has been shown with the combination of transferrin and cationic liposome Lipofectin, whereas Lipofectin alone had low transfection efficiency. Asialofetuin is an asialoglycoprotein containing terminal galactosyl residues that have been used to target liposomes to the liver. The resulting complexes retain their ability to interact specifically with target cell receptors, leading to receptor-mediated internalization of the complex into the cells. It is known that the active sites of enzymes, receptor ligands and antibodies usually involve about 5 to 20 amino acids. One example of such a gene delivery system comprises: 343 • a galactosylated peptide that both condenses the plasmid into monodisperse nanoparticles of about 100 nm in diameter and enables specific recognition and binding to asialoglycoprotein receptors; • an amphipathic, pH-selective peptide that enables the plasmid to leave the endosomes prior to their fusion with lysosomes and entry into the cytoplasm. Two general classes of lipopeptide analogs of Tyr-Lys-Ala-Lys -n Trp-Lys peptides have been prepared by including a hydrophobic anchor. The general structures are N, N- dialkyl-Gly-Tyr-Lys-Ala-Lys -Trp-Lys and N ,N -diacyl-Lys-Lys -Trp-Lys. These peptides differ from theα n n parent structures in that they self-associate to form micelles in aqueous solutions. The lytic characteristics are revealed as the carboxyl groups of the aspartyl and glutamyl side chains are protonated, which allows the peptides to assume a a-helical conformation that can be inserted into the membrane bilayer.

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