By B. Diego. Saint Louis University. 2017.
MONOAMINE OXIDASE INHIBITORS Rasagiline (N-propargyl-1R-aminoindan) mesylate (TEVA Pharmaceuti- cals) is a potent irreversible inhibitor of monoamine oxidase B (MAO-B) purchase cialis black 800mg mastercard. In addition to improving motor symptoms in animal models of PD cialis black 800 mg on line, rasagiline improved cognitive impairment in animals resulting from hypoxia (6) and trauma (7) and improved cell survival in a variety of in vitro and in vivo models of cell death (7,8). Rasagiline has several potential advantages over oral selegiline, including its superior ability to inhibit MAO-B, better penetration into the central nervous system (CNS), and lack of potentially pro-oxidant and amphetamine-like metabolites. Several Phase I and II trials have reported good efﬁcacy and excellent tolerability in early- and late-stage PD patients (9). A 404-patient, 26-week, double-blind Phase III study showed that both 1 and 2 mg/day of rasagiline improved UPDRS scores compared to placebo in subjects with early PD (10). Over the subsequent 6 months, all subjects received rasagiline. At the end of 12 months, subjects who were originally assigned to rasagiline maintained relatively better UPDRS scores (11). Given the potential interaction between tyramine and MAO inhibition, a subset of patients also underwent uneventful tyramine challenge tests (12). Blood pressures were generally unchanged after a 75 mg tyramine ingestion. The Zydis preparation is a drug-impregnated, water-soluble polymer matrix that is rapidly absorbed through oral mucosa. Oral selegiline undergoes extensive ﬁrst-pass hepatic metabolism to amphetamine compounds that could potentially counteract the theoretical reduction in oxidative stress and inhibit any neuroprotective effect of the parent drug. Mucosal absorption bypasses most of the metabolism such that much smaller doses equally inhibit CNS MAO-B without compromising systemic MAO-B speciﬁcity or accumulating amphetamine metabolites. Phase I and II trials did not show any unexpected AEs. Pooled data from two identical placebo controlled trials (1. Speciﬁcally, stomatitis and ulcerations were not seen more than in placebo.
The formed elements may be further separated and used for specific purposes 800mg cialis black mastercard, for ex- ample purchase cialis black 800mg on line, packed red cells alone or platelets alone. The gen- Blood can be packaged and kept in blood banks for emer- eral term for this procedure is hemapheresis gencies. To keep the blood from clotting, a solution such (hem-ah-fer-E-sis) (from the Greek word apheresis mean- as citrate-phosphate-dextrose-adenine (CPDA-1) is ing “removal”) If the plasma is removed and the formed added. Blood banks usually have all Use of Plasma Blood plasma alone may be given in an types of blood and blood products available. It is impor- emergency to replace blood volume and prevent circula- tant that there be an extra supply of type O, Rh-negative tory failure (shock). Plasma is especially useful when blood because in an emergency this type can be used for blood typing and the use of whole blood are not possible, any patient. It is normal procedure to test the recipient such as in natural disasters or in emergency rescues. Plasma separated from the cellular ele- gery if needed. This practice eliminates the possibility of ments is usually further separated by chemical means into incompatibility and of disease transfer as well. Such autol- various components, such as plasma protein fraction, ogous (aw-TOL-o-gus) (self-originating) blood is stored serum albumin, immune serum, and clotting factors. The packaged plasma that is currently available is ac- tually plasma protein fraction. Further separation yields Whole Blood Transfusions serum albumin that is available in solutions of 5% or 25% The transfer of whole human blood from a healthy person concentration. In addition to its use in treatment of cir- to a patient is often a life-saving process. Whole blood culatory shock, these solutions are given when plasma THE BLOOD 273 proteins are deficient.