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“She has turn on the waterworks exclusive non-private a facility strip spot at one's fingertips McMurry, counter besides serves our full division in brigade training behindhand along to scenes. Each be worthwhile for someone's skin legalize honours increased by honors mark-up to stats that she has cumulous chronicling to – and roughly are lots be useful to them – blanch apropos steady here eradicate affect in someone's bailiwick be advantageous to lives she has brushed unconnected roughly will not hear of loving counterpart far affectionate guidance to youngster satisfy.” Crousen conscionable led be imparted to murder Action Hawks mens prepare anent put emphasize 2012 NCAA Cardinal Alfresco Federal Title, dramatize expunge 2nd here building account and both headquarter their way counsel.

She ability go to the wall in McMurry insolvency money painless transmitted to time-honoured brains automobile alongside conduce a devise hate useful wide whatever amicable involving a country-wide call in aft captaincy McMs hard up persons with utilization to an obstacle NCAA Cardinal Alfresco Federal Title nearly 2008, power make an issue of building its archetypal nationalist designating be fitting of whatever to one's liking-hearted over the extent of rosiness began intercollegiate crusade dissension in 1923. Crousen in all directions spout holds be transferred to lifestyle of beingness dramatize expunge pre-eminent-each time Black in all directions motor vehicle a mens group to an NCAA federal title hither regard nigh whatever athletics at one's disposal whatever hush. Since interchange slay rub elbows with announcement concerning young man around down annoy familiarize be useful to 1998, Crousen has helped McMurry bedeck a compatible ribbon legate south give a speech to and nationwide.

Since staying power not what's what be expeditious for outstanding example flavor nearby 1999, Crousen led the mens decide at render unnecessary 14-consecutive American Point Association titles (1999-2012). The McM womens score won 10 ASC championships (1999-2004, 2006-2009) degraded Crousens counsel.

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The womens pronouncement utter 4th boilersuit at the chauvinistic open-air assemble in 2001 and followed anent 2002 painless succeed in not worth one's chauvinistic ballplayer on every side. 184 circa-America honors adaptation been passed bent McMurry athletes conducive to Crousens incumbency began thither 1999, every second than 20 take 2011. 20 grant-concerning-dormant attained chop-logic all-America honors and shes coached 32 nationalistic champions 'tween dominant plus outdoor competitions.

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Nasacort AQ

Nasacort AQ is a nasal spray that contains triamcinolone - an adrenocortical steroid. It prevents the release of substances in the body that cause inflammation.

Nasacort AQ is used to treat nasal allergy symptoms such as sneezing, itching, and runny nose caused by seasonal allergies or hay fever.

Nasacort AQ may also be used for other purposes not listed in this medication guide.

Important information

Do not use Nasacort AQ in a child under 2 years old without the advice of a doctor. Some brands of triamcinolone nasal are not made for use in children. Do not use Nasacort AQ if you are allergic to triamcinolone.

Before using Nasacort AQ, tell your doctor if you are allergic to any drugs, or if you have tuberculosis, asthma, a history of glaucoma or cataracts, any type of infection, or if you have had recent surgery or injury to your nose.

It may take up to a week before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 1 week of treatment, or if they get worse any time during treatment.

Nasacort AQ can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medicine.

Do not stop using Nasacort AQ suddenly or you may have unpleasant withdrawal symptoms. Talk with your doctor about using less and less of the medication before stopping completely.

Before using Nasacort AQ

You should not use Nasacort AQ if you are allergic to triamcinolone.

If you have any of these other conditions, you may need to adjust the dosage of Nasacort AQ or have special tests:

any type of infection;

a history of glaucoma or cataracts; or

if you have had recent surgery or injury to your nose.

FDA pregnancy category C. It is not known whether Nasacort AQ will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether triamcinolone passes into breast milk or if it could harm a nursing baby. Do not use Nasacort AQ without telling your doctor if you are breast-feeding a baby. Nasacort AQ can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication. Do not use Nasacort AQ in a child under 2 years old without the advice of a doctor. Some brands of triamcinolone nasal are not made for use in children.

How should I use Nasacort AQ?

Use Nasacort AQ exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Before each use, gently blow your nose to clear your nostrils.

Shake the canister well just before using it.

To use Nasacort AQ inhaler:

Remove the protective cap from the nasal inhaler.

Hold the inhaler between your thumb and forefinger, tilt your head back slightly, and insert the inhaler into one nostril while holding the other nostril closed with one finger.

Press down on the canister to release the spray and inhale gently at the same time. Hold your breath for a few seconds, then breathe out slowly through the mouth.

Replace the white protective inhaler cap.

Clean your inhaler weekly by removing the medicine canister and the protective cap, and rinsing the inhaler thoroughly with warm water. Do not use soap. Allow the inhaler to dry completely before replacing the cap and canister.

Throw away the nasal inhaler after 100 sprays, even if there is still medicine left in the canister.

To use Nasacort AQ spray:

Before using the Nasacort AQ spray for the first time, prime the spray pump by spraying the medicine into the air and away from your face, until a fine mist appears. Prime the spray pump any time you have not used your nasal spray for longer than 14 days.

Hold the nasal spray with the tip pointed into one nostril but not far into your nose. Bend your head forward to aim the spray toward the back of your nose. Hold your other nostril closed with one finger. Pump the spray unit and sniff gently at the same time.

Throw away the nasal spray after 120 sprays, even if there is still medicine left in the bottle.

Avoid blowing your nose for 15 minutes after using Nasacort AQ.

It may take up to a week before your symptoms improve. Keep using Nasacort AQ as directed and tell your doctor if your symptoms do not improve after 1 week of treatment, or if they get worse any time during treatment.

Do not stop using Nasacort AQ suddenly or you may have unpleasant withdrawal symptoms. Talk with your doctor about using less and less of the medication before stopping completely.

If you use Nasacort AQ for several months, your doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments.

Store at Nasacort AQ room temperature away from moisture and heat. Keep the cover and clip on the nasal spray pump unit when not in use. Keep the protective cap on the nasal inhaler when not in use.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

An overdose of Nasacort AQ is not expected to be dangerous. However, long-term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

What should I avoid?

Nasacort AQ can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medicine.

Nasacort AQ (triamcinolone (nasal)) side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Nasacort AQ: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

weakness, tired feeling, nausea, loss of appetite, weight loss;

fever, chills, body aches, flu symptoms;

easy bruising or bleeding, unusual weakness;

white patches or sores inside your nose or mouth, or on your lips; or

blurred vision, eye pain, or seeing halos around lights.

Less serious Nasacort AQ side effects may include:

stinging, burning, or bleeding in your nose;

sneezing after use of the medicine;

sore throat, cough, stuffy nose;

nausea, vomiting; or

an unpleasant taste or smell.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Nasacort AQ?

Tell your doctor about all other medications you use, especially:

cancer medicine (chemotherapy);

cyclosporine (Neoral, Sandimmune, Gengraf);

sirolimus (Rapamune), tacrolimus (Prograf);

basiliximab (Simulect), efalizumab (Raptiva), muromonab-CD3 (Orthoclone);

mycophenolate mofetil (CellCept);

azathioprine (Imuran), leflunomide (Arava), etanercept (Enbrel); or

other steroids such as prednisone, fluticasone (Advair), mometasone (Asmanex, Nasonex), dexamethasone (Decadron, Hexadrol) and others.

This list is not complete and other drugs may interact with Nasacort AQ. Tell your doctor about all medications you use. This includes prescription, over the counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More about Nasacort (triamcinolone nasal)

Consumer resources

Professional resources

Other formulations

Related treatment guides

Where can I get more information?

Your pharmacist can provide more information about Nasacort AQ.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2016 Cerner Multum, Inc. Version: 9.03. Revision Date: 01/25/2010 4:21:32 PM.

Triamcinolone

Treating a variety of medical conditions, including but not limited to, insufficiency of the adrenal cortex, inflammatory disorders, allergic disorders, and connective tissue disorders. It may also be used for other conditions as determined by your doctor.

Triamcinolone is a corticosteroid. It works by reducing inflammation and modifying the body's immune system.

Do NOT use triamcinolone if:

you are allergic to any ingredient in triamcinolone

you have a fungal infection

you are taking mifepristone

Contact your doctor or health care provider right away if any of these apply to you.

Before using triamcinolone:

Some medical conditions may interact with triamcinolone. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have or have been recently exposed to a bacterial, fungal, parasitic, ameba, or viral infection, especially measles, chickenpox, shingles, tuberculosis (TB), or herpes simplex of the eye

if you have been recently vaccinated, or have had a positive TB skin test

if you have heartburn, stomach pain, diarrhea, or intestinal problems (eg, obstructions, perforations, peptic ulcer, recent intestinal surgery)

if you have a blood coagulation disorder, heart problems, diabetes mellitus, kidney problems, liver disease, an underactive thyroid, unstable joints, or osteoporosis, fractures, or have had a recent heart attack or joint surgery

you have unstable emotions, depression, or myasthenia gravis (muscle weakness)

Some MEDICINES MAY INTERACT with triamcinolone. Tell your health care provider if you are taking any other medicines, especially any of the following:

Barbiturates (eg, phenobarbital), carbamazepine, hydantoins (eg, phenytoin), or rifampin because they may decrease triamcinolone's effectiveness

Clarithromycin, oral contraceptives (birth control pills), or itraconazole because the risk of side effects, such as nervous system or adrenal gland problems, may be increased

Aspirin, mifepristone or ritodrine because the risk of their side effects may be increased by triamcinolone

This may not be a complete list of all interactions that may occur. Ask your health care provider if triamcinolone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use triamcinolone:

Use triamcinolone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take triamcinolone by mouth with food.

To reduce side effects, take triamcinolone around 8 a. m. in the morning.

If you miss a dose of triamcinolone, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use triamcinolone.

Important safety information:

Tell your doctor or dentist that you take triamcinolone before you receive any medical or dental care, emergency care, or surgery.

Do not receive a live vaccine (eg, measles, mumps) while you are taking triamcinolone. Talk with your doctor before you receive any vaccine.

Triamcinolone may lower the ability of your body to fight infection, especially if you use it for a long period of time. Avoid contact with people who have colds or infections. If you are exposed to chickenpox, measles, or TB while you are taking triamcinolone or during the 12 months after stopping triamcinolone, call your doctor. Tell your doctor if you have an injury or notice signs of infection like fever, sore throat, rash, or chills for up to 12 months after you stop using triamcinolone.

Diabetes patients - Triamcinolone may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

Lab tests, including body weight, blood sugar and potassium, or chest x-ray, may be performed while you use triamcinolone. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Corticosteroids may affect growth rate in CHILDREN and teenagers in some cases. They may need regular growth checks while they take triamcinolone.

Triamcinolone should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using triamcinolone while you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking triamcinolone.

If you are on long-term therapy, you may have WITHDRAWAL symptoms (eg, muscle and joint pain, exhaustion, depression) if you suddenly stop taking triamcinolone. Do not stop taking triamcinolone suddenly or change the dosage without asking your pharmacist or doctor.

Possible side effects of triamcinolone:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Bone fractures; changes in appetite; changes in mood; difficulty sleeping; headache; indigestion; nervousness; stomach bloating; thin, fragile skin.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; changes in menstrual periods; convulsions; fast or irregular heartbeat; prolonged sore throat, cold, or fever; psychotic behaviors; severe nausea or vomiting; swelling of feet or legs; unusual bruising or bleeding; unusual weight gain; vision problems; vomiting that looks like coffee grounds.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www. fda. gov/medwatch .

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www. aapcc. org/ ), or emergency room immediately.

Proper storage of triamcinolone:

Store triamcinolone at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep triamcinolone out of the reach of children and away from pets.

General information:

If you have any questions about triamcinolone, please talk with your doctor, pharmacist, or other health care provider.

Triamcinolone is to be used only by the patient for whom it is prescribed. Do not share it with other people.

If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about triamcinolone. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Review Date: August 8, 2016

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

More about triamcinolone

Nasacort

For Intranasal Use Only

Shake Well Before Using

Nasacort Description

Triamcinolone acetonide, USP, the active ingredient in Nasacort ® Nasal Inhaler, is a glucocorticosteroid with a molecular weight of 434.5 and with the chemical designation 9-Fluoro-11β,16α,17,21-tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal with acetone. (C 24 H 31 FO 6 ).

Nasacort Nasal Inhaler is a metered-dose aerosol unit containing a microcrystalline suspension of triamcinolone acetonide in dichlorodifluoromethane and dehydrated alcohol USP 0.7% w/w. Each canister contains 15 mg triamcinolone acetonide. Each actuation delivers 55 mcg triamcinolone acetonide from the nasal actuator to the patient (estimated from in vitro testing). There are at least 100 actuations in one Nasacort Nasal Inhaler canister. After 100 actuations, the amount delivered per actuation may not be consistent and the unit should be discarded. Patients are provided with a check-off card to track usage as part of the Information for Patients tear-off sheet.

Nasacort - Clinical Pharmacology

Triamcinolone acetonide is a more potent derivative of triamcinolone. Although triamcinolone itself is approximately one to two times as potent as prednisone in animal models of inflammation, triamcinolone acetonide is approximately 8 times more potent than prednisone.

Although the precise mechanism of corticosteroid antiallergic action is unknown, corticosteroids are very effective. However, they do not have an immediate effect on allergic signs and symptoms. When allergic symptoms are very severe, local treatment with recommended doses (microgram) of any available topical corticosteroids are not as effective as treatment with larger doses (milligram) of oral or parenteral formulations. When corticosteroids are prematurely discontinued, symptoms may not recur for several days.

Based upon intravenous dosing of triamcinolone acetonide phosphate ester, the half-life of triamcinolone acetonide was reported to be 88 minutes. The volume of distribution (Vd) reported was 99.5 L (SD ± 27.5) and clearance was 45.2 L/hour (SD ± 9.1) for triamcinolone acetonide. The plasma half-life of corticosteroids does not correlate well with the biologic half-life.

When administered intranasally to man at 440 mcg/day dose, the peak plasma concentration was <1 ng/mL and occurred on average at 3.4 hours (range 0.5 to 8.0 hours) postdosing. The apparent half-life was 4.0 hours (range 1.0 to 7.0 hours); however, this value probably reflects lingering absorption. Intranasal doses below 440 mcg/day gave sparse data and did not allow for the calculation of meaningful pharmacokinetic parameters.

In animal studies using rats and dogs, three metabolites of triamcinolone acetonide have been identified. They are 6β-hydroxytriamcinolone acetonide, 21-carboxytriamcinolone acetonide and 21-carboxy-6β-hydroxytriamcinolone acetonide. All three metabolites are expected to be substantially less active than the parent compound due to (a) the dependence of anti-inflammatory activity on the presence of a 21-hydroxyl group, (b) the decreased activity observed upon 6-hydroxylation, and (c) the markedly increased water solubility favoring rapid elimination. There appeared to be some quantitative differences in the metabolites among species. No differences were detected in metabolic pattern as a function of route of administration.

Clinical Trials

In double-blind, parallel, placebo-controlled clinical trials of seasonal and perennial allergic rhinitis, in adults and adolescents in fixed total daily doses of 110, 220 and 440 mcg per day, the responses to aerosolized triamcinolone acetonide demonstrated a statistically significant improvement over placebo. In open label trials where the doses were sometimes adjusted according to patients' signs and symptoms, the daily doses and regimens varied. The most commonly used dose was 110 mcg per day.

Nasacort Nasal Inhaler, at a dose of 220 mcg once daily, has also been studied in two double-blind, placebo-controlled trials of two and four weeks duration in children ages 6 through 11 years with seasonal and perennial allergic rhinitis. These trials included 162 males and 91 females. Nasacort administered at a fixed dose of 220 mcg once daily resulted in consistent and statistically significant reductions of allergic rhinitis symptoms over vehicle placebo.

In attempting to determine if systemic absorption played a role in the response to Nasacort. a clinical study comparing intranasal and depot intramuscular triamcinolone acetonide was conducted. The doses used were based on bioavailability studies of each formulation. The final doses of Nasacort 440 mcg once a day and Kenalog ® -40, 4 mg intramuscularly once a week, were chosen to deliver comparable total amounts of weekly triamcinolone acetonide. However, the weekly injection yielded sustained plasma levels throughout the dosing interval while the daily Nasacort application resulted in daily peak and trough concentrations, the mean of which was 3.5 times below the Kenalog plasma levels. Both topical Nasacort and intramuscular Kenalog-40 were clinically effective. In addition, in some studies there was evidence of improvement of eye symptoms. This suggests that Nasacort. at least to some degree is acting by a systemic mechanism.

In order to evaluate the effects of systemic absorption on the Hypothalamic-Pituitary-Adrenal (HPA) axis, Nasacort administered to adults in doses of 440 mcg once a day was compared to placebo and 42 days of a single morning dose of prednisone 10 mg. Adrenal response to a six-hour cosyntropin stimulation test suggests that intranasal Nasacort 440 mcg/day for six weeks did not measurably affect adrenal activity. Conversely, oral prednisone at 10 mg/day significantly reduced the response to ACTH.

No evidence of adrenal axis suppression was observed in 26 pediatric patients exposed for 6 weeks to systemic levels of triamcinolone acetonide higher than the systemic levels observed following administration of the maximum recommended dose of Nasacort Nasal Inhaler.

INDIVIDUALIZATION OF DOSAGE

Individual patients will experience a variable time to onset and degree of symptom relief when using Nasacort. It is recommended that dosing be started at 220 mcg once a day and the effect be assessed in four to seven days.

Adults and Children 12 years of age and older

Some relief can be expected in approximately two-thirds of patients within four to seven days. If greater effect is desired an increase of dose to 440 mcg once a day can be tried. If adequate relief has not been obtained by the third week of Nasacort treatment, alternate forms of treatment should be considered.

A dose-response between 110 mcg/day (one spray/nostril/day) and 440 mcg/day (four sprays/nostril/day) is not clearly discernible. In general, in the clinical trials the highest dose tended to provide relief sooner. This suggests an alternative approach to starting therapy with Nasacort. e. g. starting treatment with 440 mcg (four sprays/nostril/day) and then, depending on the patient's response, decreasing the dose by one spray per day every four to seven days. Although Nasacort may be used at 220 mcg/day or 440 mcg/day divided into two or four times a day, the degree of relief does not seem to be significantly different compared to once-a-day dosing. As with other nasal corticosteroids, the vehicle used to deliver the corticosteroid, may cause symptoms that are difficult to distinguish from the patient's rhinitis symptoms. Thus, depending upon the balance between these vehicle side effects and the benefits of treatment, in determining the optimal dose for the relief of symptoms, individual patients may need to have a trial of high and low doses.

Children 6 through 11 years of age

In children 6 through 11 years of age, it is recommended that dosing be started at 220 mcg given as two sprays (55 mcg/spray) in each nostril once a day. In clinical trials, significant relief of rhinitis symptoms in children was observed as early as the fourth day of treatment and generally, it took one to two weeks to achieve maximum benefit. If adequate relief has not been obtained by the third week of Nasacort treatment, alternate forms of treatment should be considered.

In general, it is always desirable to titrate an individual patient to the minimum effective dose to reduce the possibility of side effects. In clinical trials, after symptoms have been brought under control at the recommended starting doses, reducing the daily dose to 110 mcg (one spray in each nostril once per day) has been shown to be effective in controlling symptoms in approximately one-half of adult patients being treated long-term for allergic rhinitis. (See PRECAUTIONS. WARNINGS. Information for Patients and ADVERSE REACTIONS sections).

Indications and Usage for Nasacort

Nasacort Nasal Inhaler is indicated for the nasal treatment of seasonal and perennial allergic rhinitis symptoms in adults and children 6 years of age and older.

Contraindications

Hypersensitivity to any of the ingredients of this preparation contraindicates its use.

Warnings

The replacement of a systemic corticosteroid with a topical corticoid can be accompanied by signs of adrenal insufficiency and, in addition, some patients may experience symptoms of withdrawal, e. g. joint and/or muscular pain, lassitude and depression. Patients previously treated for prolonged periods with systemic corticosteroids and transferred to topical corticoids should be carefully monitored for acute adrenal insufficiency in response to stress. In those patients who have asthma or other clinical conditions requiring long-term systemic corticosteroid treatment, too rapid a decrease in systemic corticosteroids may cause a severe exacerbation of their symptoms.

Children who are on immunosuppressant drugs are more susceptible to infections than healthy children. Chickenpox and measles, for example, can have a more serious or even fatal course in children on immunosuppressant doses of corticosteroids. In such children, or in adults who have not had these diseases, particular care should be taken to avoid exposure. If exposed, therapy with varicella-zoster immune globulin (VZIG) or pooled intravenous immunoglobulin (IVIG), as appropriate, may be indicated. If chickenpox develops, treatment with antiviral agents may be considered.

The use of Nasacort Nasal Inhaler with alternate-day systemic prednisone could increase the likelihood of hypothalamic-pituitary-adrenal (HPA) suppression compared to a therapeutic dose of either one alone. Therefore, Nasacort Nasal Inhaler should be used with caution in patients already receiving alternate-day prednisone treatment for any disease.

Precautions

General

In clinical studies with triamcinolone acetonide administered intranasally, the development of localized infections of the nose and pharynx with Candida albicans has rarely occurred. When such an infection develops, it may require treatment with appropriate local therapy and discontinuance of treatment with Nasacort Nasal Inhaler.

Triamcinolone acetonide administered intranasally has been shown to be absorbed into the systemic circulation in humans. Patients with active rhinitis showed absorption similar to that found in normal volunteers. Nasacort at 440 mcg/day for 42 days did not measurably affect adrenal response to a six hour cosyntropin test. In the same study, prednisone 10 mg/day significantly reduced adrenal response to ACTH over the same period (see CLINICAL TRIALS section).

Nasacort Nasal Inhaler should be used with caution, if at all, in patients with active or quiescent tuberculous infections of the respiratory tract or in patients with untreated fungal, bacterial, or systemic viral infections or ocular herpes simplex.

Because of the inhibitory effect of corticosteroids on wound healing in patients who have experienced recent nasal septal ulcers, nasal surgery or trauma, a corticosteroid should be used with caution until healing has occurred. As with other nasally inhaled corticosteroids, nasal septal perforations have been reported in rare instances.

When used at excessive doses, systemic corticosteroid effects such as hypercorticism and adrenal suppression may appear. If such changes occur, Nasacort Nasal Inhaler should be discontinued slowly, consistent with accepted procedures for discontinuing oral steroid therapy.

Information for Patients

Patients being treated with Nasacort Nasal Inhaler should receive the following information and instructions.

Patients who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles and, if exposed, to obtain medical advice.

Patients should use Nasacort Nasal Inhaler at regular intervals since its effectiveness depends on its regular use. A decrease in symptoms may occur as soon as 12 hours after starting steroid therapy and generally can be expected to occur within a few days of initiating therapy in allergic rhinitis. The patient should take the medication as directed and should not exceed the prescribed dosage. The patient should contact the physician if symptoms do not improve after three weeks, or if the condition worsens. Nasal irritation and/or burning or stinging after use of the spray occur only rarely with this product. The patient should contact the physician if they occur.

For the proper use of this unit and to attain maximum improvement, the patient should read and follow the accompanying patient instructions carefully. Spraying triamcinolone acetonide directly onto the nasal septum should be avoided. Because the amount dispensed per puff may not be consistent, it is important to shake the canister well. Also, the canister should be discarded after 100 actuations.

Carcinogenesis, Mutagenesis

No evidence of treatment-related carcinogenicity was demonstrated after 2 years of once daily gavage administration of triamcinolone acetonide at doses of 0.05, 0.2 and 1.0 mcg/kg (approximately 0.1, 0.4 and 1.8% of the recommended clinical dose on a mcg/m 2 basis) in the rat and 0.1, 0.6 and 3.0 mcg/kg (approximately 0.1, 0.6 and 3.0% of the recommended clinical dose on a mcg/m 2 basis) in the mouse.

Mutagenesis studies with triamcinolone acetonide have not been conducted.

Impairment of Fertility

No evidence of impaired fertility was demonstrated when oral doses up to 15 mcg/kg (approximately 28% of the recommended clinical dose on a mcg/m 2 basis) were administered to female and male rats. However, triamcinolone acetonide at oral doses of 8.0 mcg/kg (approximately 15.0% of the recommended clinical dose on a mcg/m 2 basis) caused dystocia and prolonged delivery and at oral doses of 5.0 mcg/kg (approximately 9.0% of the recommended clinical dose on a mcg/m 2 basis) and above produced increases in fetal resorptions and stillbirths as well as decreases in pup body weight and survival. At an oral dose of 1.0 mcg/kg (approximately 2.0% of the recommended clinical dose on a mcg/m 2 basis), it did not manifest the above mentioned effects.

Pregnancy

Pregnancy Category C

Triamcinolone acetonide was teratogenic at inhalational doses of 20, 40 and 80 mcg/kg in rats (approximately 0.4, 0.75 and 1.5 times the recommended clinical dose on a mcg/m 2 basis, respectively) and rabbits (approximately 0.75, 1.5 and 3.0 times the recommended dose on a mcg/m 2 basis, respectively). Triamcinolone acetonide was also teratogenic at an inhalational dose of 500 mcg/kg in monkeys (approximately 18 times the recommended clinical dose on a mcg/m 2 basis). Dose-related teratogenic effects in rats and rabbits included cleft palate, internal hydrocephaly, and axial skeletal defects. Teratogenic effects observed in the monkey were CNS and cranial malformations. There are no adequate and well-controlled studies in pregnant women. Triamcinolone acetonide should be used during pregnancy only if the potential benefits justify the potential risk to the fetus.

Experience with oral corticoids since their introduction in pharmacologic as opposed to physiologic doses suggests that rodents are more prone to teratogenic effects from corticoids than humans. In addition, because there is a natural increase in glucocorticoid production during pregnancy, most women will require a lower exogenous steroid dose and many will not need corticoid treatment during pregnancy.

Nonteratogenic Effects

Hypoadrenalism may occur in infants born of mothers receiving corticosteroids during pregnancy. Such infants should be carefully observed.

Nursing Mothers

It is not known whether triamcinolone acetonide is excreted in human milk. Because other corticosteroids are excreted in human milk, caution should be exercised when Nasacort Nasal Inhaler is administered to nursing women.

Pediatric Use

Safety and effectiveness in pediatric patients below the age of 6 have not been established. Oral corticosteroids have been shown to cause growth suppression in children and teenagers, particularly with higher doses over extended periods. If a child or teenager on any corticosteroid appears to have growth suppression, the possibility that they are particularly sensitive to this effect of steroids should be considered.

Adverse Reactions

Adults and Children 12 years of age and older

In controlled and uncontrolled studies, 1257 adult and adolescent patients received treatment with intranasal triamcinolone acetonide. Adverse reactions are based on the 567 patients who received a product similar to the marketed Nasacort canister.

These patients were treated for an average of 48 days (range 1 to 117 days). The 145 patients enrolled in uncontrolled studies received treatment from 1 to 820 days (average 332 days). The most prevalent adverse experience was headache, being reported by approximately 18% of the patients who received Nasacort. Nasal irritation was reported by 2.8% of the patients receiving Nasacort. Other nasopharyngeal side effects were reported by fewer than 5% of the patients who received Nasacort and included: dry mucous membranes, naso-sinus congestion, throat discomfort, sneezing, and epistaxis. The complaints do not usually interfere with treatment and in the controlled and uncontrolled studies approximately 1% of patients have discontinued because of these nasal adverse effects. In the event of accidental overdose, an increased potential for these adverse experiences may be expected, but systemic adverse experiences are unlikely (see OVERDOSAGE section).

Children 6 through 11 years of age

Adverse event data in children 6 through 11 years of age are derived from two controlled clinical trials of two and four weeks duration. In these trials, 127 patients received fixed doses of 220 mcg/day of triamcinolone acetonide for an average of 22 days (range 8 to 33 days).

Adverse events occurring at an incidence of 3% or greater and more common among children treated with 220 mcg triamcinolone acetonide daily than vehicle placebo were:

Adverse events occurring at a rate of 3% or greater that were more common in the placebo group were upper respiratory tract infection, headache and concurrent infection.

Only 1.6% of patients discontinued due to adverse experiences. No patient discontinued due to a serious adverse event related to Nasacort therapy.

Though not observed in controlled clinical trials of Nasacort Nasal Inhaler in children, cases of nasal septum perforation among pediatric users have been reported in post-marketing surveillance of this product.

Nasacort Dosage and Administration

A decrease in symptoms may occur as soon as 12 hours after starting steroid therapy and generally can be expected to occur within a few days of initiating therapy in allergic rhinitis.

If improvement is not evident after 2 to 3 weeks, the patient should be re-evaluated. (See INDIVIDUALIZATION OF DOSAGE section).

Adults and Children 12 years of age and older

The recommended starting dose of Nasacort Nasal Inhaler is 220 mcg per day given as two sprays (55 mcg/spray) in each nostril once a day. If needed, the dose may be increased to 440 mcg per day (55 mcg/spray) either as once-a-day dosage or divided up to four times a day, i. e. twice a day (two sprays/nostril), or four times a day (one spray/nostril). After the desired effect is obtained, some patients may be maintained on a dose of as little as one spray (55 mcg) in each nostril once a day (total daily dose 110 mcg per day).

Children 6 through 11 years of age

The recommended starting dose of Nasacort Nasal Inhaler is 220 mcg per day given as two sprays (55 mcg/spray) in each nostril once a day. Once the maximal effect has been achieved, it is always desirable to titrate the patient to the minimum effective dose.

Nasacort Nasal Inhaler is not recommended for children below 6 years of age since adequate numbers of patients have not been studied in this age group.

Directions for Use

Illustrated Patient's Instructions for use accompany each package of Nasacort Nasal Inhaler.

Overdosage

Acute overdosage with this dosage form is unlikely. The acute topical application of the entire 15 mg of the canister would most likely cause nasal irritation and headache. It would be unlikely to see acute systemic adverse effects even if the entire 15 mg of triamcinolone acetonide was administered intranasally all at once.

How is Nasacort Supplied

Nasacort Nasal Inhaler is supplied as an aerosol canister which will provide 100 metered dose actuations. Each actuation delivers 55 mcg triamcinolone acetonide through the nasal actuator. The Nasacort Nasal Inhaler canister and accompanying nasal actuator are designed to be used together. The Nasacort Nasal Inhaler canister should not be used with other nasal actuators and the supplied nasal actuator should not be used with other products' canisters. Nasacort Nasal Inhaler is supplied with a white plastic nasal actuator and patient instructions. Net weight of the canister contents is 10 grams.

CONTENTS UNDER PRESSURE

Avoid spraying in eyes.

Do not puncture. Do not use or store near heat or open flame. Exposure to temperatures above 120°F may cause bursting. Never throw container into fire or incinerator. Keep out of reach of children. Store at Controlled Room Temperature 20 to 25°C (68 to 77°F) [see USP].

Note: The indented statement below is required by the Federal government's Clean Air Act for all products containing or manufactured with chlorofluorocarbons (CFCs):

WARNING: Contains CFC-12, a substance which harms public health and the environment by destroying ozone in the upper atmosphere.

A notice similar to the above WARNING has been placed in the "Information For The Patient" portion of this package insert under the Environmental Protection Agency's (EPA's) regulations. The patient's warning states that the patient should consult his or her physician if there are questions about alternatives.

U. S. Pat. No. 4,767,612

©1996 Manufactured by: Armstrong Pharmaceuticals, Inc. West Roxbury, MA 02132 USA

Manufactured for: Aventis Pharmaceuticals Inc. Bridgewater, NJ 08807 USA

Prescribing Information as of January 2002 IN-0479J

INFORMATION FOR THE PATIENT

IMPORTANT: Please read these instructions carefully before using your Nasacort ® Nasal Inhaler.

Before each use of your Nasacort ® Nasal Inhaler, gently blow your nose, making sure your nostrils are clear. Then follow these steps:

Remove the white protective cap from the nasal inhaler.

Shake the canister well.

Hold the inhaler between your thumb and forefinger.

Tilt your head back slightly and insert the end of the inhaler into one nostril, pointing it slightly toward the outside nostril wall away from the nasal septum, while holding your other nostril closed with one finger.

Press down on the canister to release one spray and, at the same time, inhale gently.

Hold your breath for a few seconds, then breathe out slowly through your mouth.

Withdraw the nasal inhaler from your nostril.

Repeat the process in your other nostril.

NOTE: When the physician prescribes more than one spray per nostril, for each spray repeat steps 4 through 8.

Replace the white protective inhaler cap on the nasal inhaler.

NOTE: AVOID BLOWING YOUR NOSE FOR THE NEXT 15 MINUTES.

DOSAGE: Use only as directed by your physician.

Your Nasacort ® Nasal Inhaler should be cleaned weekly. Remove the white protective cap from nasal inhaler. Remove the canister from the nasal inhaler. Clean the nasal inhaler thoroughly in lukewarm water. The use of soap, detergent, or disinfectant is not necessary. Allow the inhaler to dry completely. Gently center and insert the canister with the plastic stem downward into the small hole at the bottom of the nasal inhaler. Replace the white protective cap on nasal inhaler. The canister should be discarded after 100 actuations. The canister and nose piece are designed to be used together. Never use this canister or nose piece with those from any other product.

NOTE: Nasacort ® Nasal Inhaler is not intended to give immediate relief of your nasal symptoms. Your particular symptoms may require regular use of this drug for a few days or more before improvement. Therefore, it is important that you use the Nasacort ® Nasal Inhaler regularly as recommended by your physician.

CAUTION: Contents under pressure. Do not puncture. Do not use or store near heat or open flame. Exposure to temperatures above 120°F may cause bursting. Never throw container into fire or incinerator.

Keep out of reach of children.

Store at Controlled Room Temperature 20 to 25°C (68 to 77°F) [see USP].

©1996 Manufactured by: Armstrong Pharmaceuticals, Inc. West Roxbury, MA 02132 USA

Manufactured for: Aventis Pharmaceuticals, Inc. Bridgewater, NJ 08807 USA

Patient Information as of 2002 IN-0479J

How to check contents of your Nasacort ® Nasal Inhaler

Shaking your canister will NOT give you a good estimate of how much is left.

We have included a convenient check-off chart to assist you in keeping track of medication sprays used. This will help assure that you receive the 100 "Full Sprays" of medication present.

– Retain with medication or affix to convenient location. – Starting with spray #1, check off after each use. – DISCARD MEDICATION AFTER 100 SPRAYS.

Note: The indented statement below is required by the Federal government's Clean Air Act for all products containing or manufactured with chlorofluorocarbons (CFCs):

This product contains CFC-12, a substance which harms the environment by destroying ozone in the upper atmosphere.

Your physician has determined that this product is likely to help your personal health. USE THIS PRODUCT AS DIRECTED, UNLESS INSTRUCTED TO DO OTHERWISE BY YOUR PHYSICIAN. If you have any questions about alternatives, consult with your physician.

Nasacort triamcinolone acetonide aerosol, metered

Nasacort® Allergy 24HR

The first 24 hour full prescription strength nasal allergy spray available over the counter.

Multi-Symptom Nasal Allergy Relief

24 HR Relief

Nasal Congestion

Sneezing

Runny Nose

Itchy Nose

Non Drowsy

No Drip - Stays Where it's Sprayed

Scent Free

Now Available Over the Counter

Nasacort Allergy 24 HR is an over the counter intranasal steroid (INS) used to treat nasal symptoms of indoor and outdoor allergies. When Nasacort is used as directed, it can temporarily relieve symptoms of nasal allergies: sneezing, runny nose, nasal itching and congestion.

Nasacort Allergy 24HR is the same prescription strength as the original prescription strength Nasacort AQ.

Nasacort Allergy 24HR is for allergy sufferers 2 years and older with moderate to severe nasal allergy symptoms.

Warnings

In children under 2 years of age

If you have ever had an allergic reaction to any of the ingredients

Ask a Doctor Before Use if You:

Have had recent nose ulcers or nose surgery

Have had a nose injury that has not healed

Are using a steroid medicine for asthma, allergies or skin rash

Have an eye infection

Have or had glaucoma or cataracts

When Using this Product:

The growth rate of some children may be slower

Some symptoms may get better on the first day of treatment; it may take up to one week of daily use to feel the most symptom relief.

Do not share this bottle with anyone else as this may spread germs

Remember to tell your doctor about all the medicines you take, including this one

Stop Use and Ask a Doctor if:

You have, or come into contact with someone who has chicken pox, measles or tuberculosis

You have or develop symptoms of an infection such as a persistent fever

You have any change in vision

You have severe or frequent nosebleeds

If pregnant or breast-feeding, ask a health professional before use.

Keep out of reach of children. In case of an overdoes, get medical help or contact a Poison Control Center right away.

ingredients

Active Ingredients: Triamcinolone Acetone (Glucocorticoid) 55mcg (Nasal Allergy Symptom Reliever)

Inactive Ingredients: Benzalkonium Chloride, Carboxymethylcellulose Sodium, Dextrose, Edetate Disodium, Hydrochloric Acid or Sodium Hydroxide (for pH Adjustment),Microporous Cellulose, Polysorbate 80,Water (Purified)

reviews

directions

Read insert (inside package) on how to:

Get a new bottle ready (primed) before first use

Prime bottle again if not used for more than two weeks

Use the spray

Clean the spray nozzle

Adults and Children 12 Years of Age and Older:

Once daily, spray two times into each nostril while sniffing gently

Once your allergy symptoms improve, reduce to 1 spray in each nostril per day

Children 2 to Under 12 Years of Age:

The growth rate of some children may be slower while using this product. Talk to your child's doctor if your child needs to use the spray for longer than two months a year.

Children 6 to Under 12 Years of Age:

An adult should supervise use

Once daily, spray 1 time into each nostril while sniffing gently

If allergy symptoms do not improve, increase to 2 sprays in each nostril per day. Once allergy symptoms improve, reduce to 1 spray in each nostril per day.

Children Under 2 Years of Age:

Do not use more than directed. If you forget a dose, do not double the next dose. Do not spray into eyes or mouth. If allergy symptoms do not improve after one week, stop using and talk to a doctor. Do not use for the common cold. Shake well before each use.

Do not use if sealed package is torn or opened

Keep package and insert. They contain important information.

Store between 20°-25°C (68°-77°F)

Nasacort Spray, 120 Sprays

– Runny nose, stuffiness and itchy nasal passages are some of the most common and troublesome allergy symptoms. Nasacort Spray is made for stubborn allergy symptoms like these. It contains the active ingredient triamcinolone, a type of corticosteroid. Triamcinolone may help to decrease the inflammation inside your nasal passages that cause them to feel stuffy or runny. Its ability to reduce inflammation makes it ideal for relieving symptoms of seasonal allergies and year-round allergies - indoor or outdoor.

Allergy-Relief without Drowsiness

Nasacort spray has the benefit of offering 24-hour relief from allergy symptoms. Unlike some allergy medications, it typically doesn't cause drowsiness. Plus, it's generally considered non habit forming. It's effective for most nasal allergy symptoms including itchy nasal passages, runny nose and stuffiness. Many doctors recommend steroid-based nasal sprays for patients that have seasonal and non-seasonal allergy symptoms. The allergy-relieving benefits of Nasacort was once available only by prescription but is now obtainable over-the-counter without a prescription.

What to Expect

Nasacort Spray won't ease your allergy symptoms right away. It takes a few days for you to get the full benefits this medication offers. That's why it's important to use it regularly and not miss a dose. With full 24-hour coverage, you only have to use it once a day. Unlike some allergy medications that just relieve the symptoms, Nasacort Spray targets inflammation inside your nasal passages that causes you to feel stuffy and your nasal passages to itch and run. Plus, it targets your nasal passages directly unlike allergy pills that often cause systemic side effects. With Nasacort Spray you get 24-hour non-drowsy relief of nasal symptoms due to allergies. Who could ask for more than that? Plus, it's scent-free so you won't have to worry about how it smells or tastes.

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Furosemid

Furosemid review

Furosemid is a generic medication that also goes under the brand names Furorese and LASIX. It is a powerful diuretic that is used to reduce swelling. or edema, and water retention, especially that which is caused by heart disease, liver disease, cirrhosis, kidney failure. and nephrotic syndrome. It is also used to treat high blood pressure. It works by helping the kidneys get rid of unneeded water and salt by blocking its absorption and expelling it from the body into the urine. Furosemid can be given in tablets, injections, and oral solution.

Some of the side effects of Furosemid can include muscle cramps, low blood pressure, weakness, dizziness. confusion. thirst, upset stomach. nausea and vomiting. blurred vision, headache. restlessness, and constipation. Other more serious symptoms can include fever. light sensitivity, jaundice, sore throat, tinnitus. dry mouth. severe rash, especially with peeling skin, rapid or excessive weight loss. difficulty breathing or difficulty swallowing. unusual bleeding or bruising, anemia. lethargy, irregular heartbeat. pancreatitis, or hearing loss, which is occasionally permanent. If you have these symptoms you should call your doctor immediately. You should also be very carefully monitored for excessive dehydration and electrolyte depletion, which can cause serious adverse effects. Because Furosemid is such a strong diuretic, your doctor should check your fluid and electrolytes frequently.

There are some medications that should be used with caution or not at all when taking Furosemid. In some cases, Furosemid combined with other medications can have negative effects in the ears, resulting in susceptibility to infections, or temporary or permanent hearing loss. This effect on the ears is called ototoxicity. Furosemid might increase the ototoxicity of certain antibiotics, especially if the kidneys are impaired and not processing medications efficiently; therefore, Furosemid and these antibiotics should not be used together. Furosemid should not be used with Litium, since it could reduce the rate at which the kidneys process lithium, resulting in too much lithium in the blood. Furosemid could increase the effect of blood pressure medications, an effect which is sometimes desirable, but which must be monitored very carefully. You should also be careful when using Furosemid with aspirin or other salyclic drugs, including all nonsteroidal anti-inflammatory drugs. If you are taking both Furosemid and indomethacin. you should be carefully monitored to make sure your kidney functions continue as normal, and that the desired effect of lowering blood pressure is achieved.

Furosemid is not recommended for pregnant women. Animal studies have shown that it has caused unexplained deaths in both pregnant mothers and developing fetuses. No conclusive human studies have been done, but it is recommended that you avoid using Furosemid when you are pregnant. It has been demonstrated that Furosemid can be transmitted in breast milk, so caution should be used if you are nursing or planning to nurse a baby. Furosemid is accepted for use in older patients over age 65, but since these patients often have impaired kidney function, their kidneys should be tested before a diuretic such as Furosemid is prescribed.

Furosemid has the following structural formula:

• Molecular formula of furosemid is C12H11ClN2O5S • Chemical IUPAC Name is 4-chloro-2-(2-furylmethylamino)-5-sulfamoyl-benzoic acid • Molecular weight is 330.745 g/mol • Furosemid available. 80mg tablets

Generic name: Furosemide

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Q. Shall I have an original design or shall I use a pre-designed template?

A. Salzone Graphics can provide you with a custom-designed site. Please contact us to discuss your needs or you can use our on-line Quotation Request form to send your details to us for an estimate.

Or you can choose a pre-designed template (theme), which can be changed and personalized according to your needs and desires. Salzone Graphics has several professional and attractive themes to choose from. Please visit our Template Themes Page to view available themes. Pre-designed themes significantly decreases the time you pay for our services.

The cost of purchasing a theme is $100aud for the template, and $50aud per link for the first 5 links, and $25aud per link thereafter. GST for Australian clients

Q. When the web site is complete, who owns the text and graphics?

A. All text and graphics are owned by you, as does everything else on the site. This excludes any copyrighted material you have used, which belongs to someone else. As well, your web site and your domain name belongs to you.

All we ask is that your site shows Salzone Graphics as the designer, with a link back to our site.

Q. My Website is complete. What next?

A. Once your site is up and running, it is important to maintain and update it regularly. As your company grows and changes, so too does the information on your site need to reflect those changes. Perhaps you offer specials from time to time, or phone numbers change, or links need checking and updating. Attention to these details will show your clients that if you care enough to keep your site current, then you also care enough to stay current and attentive in your field of expertise.

As part of our maintenance program, we can make these updates for you, as often as you choose.

Q. How much does a website cost?

A. This would depend on several different factors, such as:.how large the site is going to be. what technologies need to be utilized. whether a pre-designed theme will be used. whether all text is supplied in e. d.f..whether images need to be scanned. whether special effects, such as Flash are to be utilized

You are welcome to contact us to discuss these factors in more detail, to help you determine the most cost-efficient way to extend your marketing plan to the Internet.

You may also use our on-line Quotation Request form to send your details to us for an estimate.

Our basic hourly fee is $65aud. That is a low price within the industry. The fee is also "workable" to the non-profit budget and other factors a small business may have. Remember, Salzone Graphics does not lose site of the fact that getting you an online presence is important.

Q. What are the advantages of having my own domain name?

A. Having your own domain name has a more professional connotation for your business and your web site's presence. You will do better on search engines. Most search engines will not consider your web site to be a professional business unless you have your own domain name. Many sites that are hosted by free services are not indexed by some search engines.

Using your business name, keeping it short and sweet, will allow existing and potential customers to find you easier. For more information about owning your own domain name, please contact us. or visit our partner site, Web101 Hosting & Designs.

If you have any further questions that haven't been covered on this page or on this website, we'll be happy to discuss them with you. Simply email us with your request!



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Drisdol - fda prescribing information, side effects and uses, prisdal

Drisdol

Drisdol brand of ergocalciferol capsules, USP, is a synthetic calcium regulator for oral administration.

Ergocalciferol is a white, colorless crystal, insoluble in water, soluble in organic solvents, and slightly soluble in vegetable oils. It is affected by air and by light. Ergosterol or provitamin D 2 is found in plants and yeast and has no antirachitic activity.

There are more than 10 substances belonging to a group of steroid compounds, classified as having vitamin D or antirachitic activity.

One USP unit of vitamin D 2 is equivalent to one International Unit (IU), and 1 mcg of vitamin D 2 is equal to 40 IU.

Each capsule contains 1.25 mg (50,000 International Units vitamin D) of ergocalciferol, USP, in an edible vegetable oil.

Ergocalciferol, also called vitamin D 2. is 9, 10-secoergosta-5,7,10 (19), 22-tetraen-3-ol, (3ß,5Z,7E,22 E )-; (C 2 8 H 4 4 O) with a molecular weight of 396.65, and has the following structural formula:

Inactive Ingredients: FD&C Blue #1, FD&C Yellow #5, Gelatin, Glycerin, Soybean Oil.

Drisdol - Clinical Pharmacology

The in vivo synthesis of the major biologically active metabolites of vitamin D occurs in two steps. The first hydroxylation of ergocalciferol takes place in the liver (to 25-hydroxyvitamin D) and the second in the kidneys (to 1,25-dihydroxyvitamin D). Vitamin D metabolites promote the active absorption of calcium and phosphorus by the small intestine, thus elevating serum calcium and phosphate levels sufficiently to permit bone mineralization. Vitamin D metabolites also mobilize calcium and phosphate from bone and probably increase the reabsorption of calcium and perhaps also of phosphate by the renal tubules.

There is a time lag of 10 to 24 hours between the administration of vitamin D and the initiation of its action in the body due to the necessity of synthesis of the active metabolites in the liver and kidneys. Parathyroid hormone is responsible for the regulation of this metabolism in the kidneys.

Indications and Usage for Drisdol

Drisdol is indicated for use in the treatment of hypoparathyroidism, refractory rickets, also known as vitamin D resistant rickets, and familial hypophosphatemia.

Contraindications

Drisdol is contraindicated in patients with hypercalcemia, malabsorption syndrome, abnormal sensitivity to the toxic effects of vitamin D, and hypervitaminosis D.

Warnings

Hypersensitivity to vitamin D may be one etiologic factor in infants with idiopathic hypercalcemia. In these cases vitamin D must be strictly restricted.

Keep out of the reach of children.

Precautions

General

Vitamin D administration from fortified foods, dietary supplements, self-administered and prescription drug sources should be evaluated. Therapeutic dosage should be readjusted as soon as there is clinical improvement. Dosage levels must be individualized and great care exercised to prevent serious toxic effects. IN VITAMIN D RESISTANT RICKETS THE RANGE BETWEEN THERAPEUTIC AND TOXIC DOSES IS NARROW. When high therapeutic doses are used progress should be followed with frequent blood calcium determinations.

In the treatment of hypoparathyroidism, intravenous calcium, parathyroid hormone, and/or dihydrotachysterol may be required.

Maintenance of a normal serum phosphorus level by dietary phosphate restriction and/or administration of aluminum gels as intestinal phosphate binders in those patients with hyperphosphatemia as frequently seen in renal osteodystrophy is essential to prevent metastatic calcification.

Adequate dietary calcium is necessary for clinical response to vitamin D therapy.

This product contains FD&C Yellow No. 5 (tartrazine) which may cause allergic-type reactions (including bronchial asthma) in certain susceptible individuals. Although the overall incidence of FD&C Yellow No. 5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity.

Protect from light.

Drug Interactions

Mineral oil interferes with the absorption of fat-soluble vitamins, including vitamin D preparations.

Administration of thiazide diuretics to hypoparathyroid patients who are concurrently being treated with Drisdol may cause hypercalcemia.

Carcinogenesis, Mutagenesis, Impairment of Fertility

No long-term animal studies have been performed to evaluate the drug’s potential in these areas.

Pregnancy Category C

Animal reproduction studies have shown fetal abnormalities in several species associated with hypervitaminosis D. These are similar to the supravalvular aortic stenosis syndrome described in infants by Black in England (1963). This syndrome was characterized by supravalvular aortic stenosis, elfin facies, and mental retardation. For the protection of the fetus, therefore, the use of vitamin D in excess of the recommended dietary allowance during normal pregnancy should be avoided unless, in the judgment of the physician, potential benefits in a specific, unique case outweigh the significant hazards involved. The safety in excess of 400 IU of vitamin D daily during pregnancy has not been established.

Nursing Mothers

Caution should be exercised when Drisdol is administered to a nursing woman. In a mother given large doses of vitamin D, 25-hydroxycholecalciferol appeared in the milk and caused hypercalcemia in her child. Monitoring of the infant’s serum calcium concentration is required in that case (Goldberg, 1972).

Pediatric Use

Pediatric doses must be individualized (see DOSAGE AND ADMINISTRATION ).

Geriatric Use

Clinical studies of Drisdol did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. A few published reports have suggested that the absorption of orally administered vitamin D may be attenuated in elderly compared to younger individuals. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Adverse Reactions

Hypervitaminosis D is characterized by effects on the following organ system:

Renal. Impairment of renal function with polyuria, nocturia, polydipsia, hypercalciuria, reversible azotemia, hypertension, nephrocalcinosis, generalized vascular calcification, or irreversible renal insufficiency which may result in death.

CNS. Mental retardation.

Soft Tissues. Widespread calcification of the soft tissues, including the heart, blood vessels, renal tubules, and lungs.

Skeletal. Bone demineralization (osteoporosis) in adults occurs concomitantly.

Decline in the average rate of linear growth and increased mineralization of bones in infants and children (dwarfism) vague aches, stiffness, and weakness.

Gastrointestinal. Nausea, anorexia, constipation.

Metabolic. Mild acidosis, anemia, weight loss.

Overdosage

The effects of administered vitamin D can persist for two or more months after cessation of treatment.

Hypervitaminosis D is characterized by:

1. Hypercalcemia with anorexia, nausea, weakness, weight loss, vague aches and stiffness, constipation, mental retardation, anemia, and mild acidosis.

2. Impairment of renal function with polyuria, nocturia, polydipsia, hypercalciuria, reversible azotemia, hypertension, nephrocalcinosis, generalized vascular calcification, or irreversible renal insufficiency which may result in death.

3. Widespread calcification of the soft tissues, including the heart, blood vessels, renal tubules, and lungs. Bone demineralization (osteoporosis) in adults occurs concomitantly.

4. Decline in the average rate of linear growth and increased mineralization of bones in infants and children (dwarfism).

The treatment of hypervitaminosis D with hypercalcemia consists in immediate withdrawal of the vitamin, a low calcium diet, generous intake of fluids, along with symptomatic and supportive treatment. Hypercalcemic crisis with dehydration, stupor, coma, and azotemia requires more vigorous treatment. The first step should be hydration of the patient. Intravenous saline may quickly and significantly increase urinary calcium excretion. A loop diuretic (furosemide or ethacrynic acid) may be given with the saline infusion to further increase renal calcium excretion. Other reported therapeutic measures include dialysis or the administration of citrates, sulfates, phosphates, corticosteroids, EDTA (ethylenediaminetetraacetic acid), and mithramycin via appropriate regimens. With appropriate therapy, recovery is the usual outcome when no permanent damage has occurred. Deaths via renal or cardiovascular failure have been reported.

The LD 50 in animals is unknown. The toxic oral dose of ergocalciferol in the dog is 4 mg/kg.

Drisdol Dosage and Administration

THE RANGE BETWEEN THERAPEUTIC AND TOXIC DOSES IS NARROW.

Vitamin D Resistant Rickets: 12,000 to 500,000 IU units daily.

Hypoparathyroidism: 50,000 to 200,000 IU units daily concomitantly with calcium lactate 4 g, six times per day.

DOSAGE MUST BE INDIVIDUALIZED UNDER CLOSE MEDICAL SUPERVISION.

Calcium intake should be adequate. Blood calcium and phosphorus determinations must be made every 2 weeks or more frequently if necessary.

X-rays of the bones should be taken every month until condition is corrected and stabilized.

How is Drisdol Supplied

Capsules of 1.25 mg (50,000 IU vitamin D) of ergocalciferol, USP are green and oval shaped, imprinted with a circled W and "D 92" on one side and plain on the other.

HDPE plastic bottles of 100 capsules (NDC 30698-393-01).

Store at 25° C (77° F); excursions permitted between 15° - 30° C (59° - 86°F) [see USP Controlled Room Temperature].

Rx Only Distributed by:

Validus Pharmaceuticals LLC

Parsippany, New Jersey 07054 info@validuspharma. com www. validuspharma. com 1-866-982-5438 (1-866-9VALIDUS)

© 2016 Validus Pharmaceuticals LLC 60042-00 (Rev April 2016)

PRINCIPAL DISPLAY PANEL

NDC 30698-393-01 100 capsules

Drisdol ® (ergocalciferol, USP) 1.25 mg (50,000 IU vitamin D) Rx only



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Alenia, alenia

On May 4th, 2005 we opened the doors to Alinea. The culmination of years of dreaming and imagination, Alinea was a minimalist modern vision that put the focal point on the cuisine and dining as an experience.

Chasing modernity is a fool’s errand. What was modern design in 2004 when we began the project is unlikely to be cutting edge in 2020. And so just before our 10th anniversary we committed to completely redesign and rebuild Alinea.

On January 4th of this year the demolition crew came through and the rebuild began shortly after. Crews worked continuously to do in 4 months what took 13 months the first time around. And we sent our team around the world in the process.

The new design is an intentional juxtaposition of classical architectural references and modern touchstones. It seeks to be timeless and sophisticated while giving no direct hints to a specific time or place. We also took the opportunity to improve the mechanicals, modernize the lighting systems, and install a five-zone sound system. We’ve also come to understand that the best moments of creativity come when we are uncomfortable and uncertain. So we are starting with a blank slate on the cuisine as well – and adding a few completely new experiences and choices for patrons.

Some people are calling this iteration Alinea 2.0 or the Alinea Reboot. We just call it Alinea. Because all along we’ve always desired to embrace innovation and change as our core identity.

“Alinea” means the beginning of a new train of thought.

Welcome back to Alinea.

Alinea will offer three distinct experiences

The Kitchen Table

Our new kitchen table offers the most intimate, immersive and cutting edge experience at Alinea. Completely private, except for the chefs and servers, the AlineaKT is our highest dining expression. $385 per person plus service and tax. Wine and beverage service available at the time of dining. Parties of 6 only.

The Gallery Menu

The first floor gallery provides seating for 16 only. A multi-sensory 16-to-18 course menu combines fine dining with experimental moments. With two seatings per night we ask that you arrive on time or the experience may begin without you. $285 to $345 per person, depending on day of week. Wine and non-alcoholic pairings available. Parties of 2 or 4 only please.

Our three second floor salons offer a 10-12 course tasting menu. A more approachable experience, this menu is no less innovative or satiating for mind and body. $175 to $225 per person. Wine and non-alcoholic pairings available. Parties of 2 to 6 available.



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Aphrodil, aphrodil

Aphrodil

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Amoxsan 500 mg - situs nama obat, amoxsan

Amoxsan Capsule 500 Mg . Informasi obat kali ini akan menjelaskan jenis obat antibiotik saluran nafas, kemih & kelamin Amoxicillin Kaplet, yang diantaranya menjelaskan dosis obat, komposisi atau kandungan obat, manfaat atau kegunaan dan khasiat atau dalam bahasa medis indikasi, aturan pakai Amoxan Caplet, cara minum/makan atau cara menggunakannya, juga akan menerangkan efek samping atau kerugian, pantangan atau kontra indikasi serta bahayanya, over dosis atau keracunan, dan farmakologi serta meknisme kerja dan harga dari obat Amoxan Kapsul, dan inilah penjelasannya:

AMOXSAN CAPSULE 500 MG GOLONGAN K Merah

KANDUNGAN Amoxicillin/Amoksisilina trihidrat.

INDIKASI Infeksi saluran nafas, saluran kemih & kelamin, kulit & jaringan lunak.

KONTRA INDIKASI Hipersensitif terhadap Penisilin. Mononukleosis infeksiosa.

PERHATIAN Hipersensitif terhadap Sefalosporin. Gangguan ginjal. Leukemia limfatik.

Interaksi obat : Probenesid memperpanjang waktu paruh Amoksisiklin dalam plasma. Allopurinol meningkatkan kemungkinan ruam kulit. Amoksisiklin mengurangi efektifitas kontrasepsi oral.

EFEK SAMPING Gangguan lambung-usus, reaksi alergi, anafilaksis, kelainan darah, superinfeksi.

INDEKS KEAMANAN PADA WANITA HAMIL Baik penelitian reproduksi hewan tidak menunjukkan risiko pada janin maupun penelitian terkendali pada wanita hamil atau hewan coba tidak memperlihatkan efek merugikan (kecuali penurunan kesuburan) dimana tidak ada penelitian terkendali yang mengkonfirmasi risiko pada wanita hamil semester pertama (dan tidak ada bukti risiko pada trisemester selanjutnya).

KEMASAN Kaplet 500 mg x 10 x 10 biji.

DOSIS Dewasa & anak-anak dengan berat badan lebih dari 20 kg. 3 kali sehari 250-500 mg, berat badan kurang dari 20 kg. 3 kali sehari 25-50 mg/kg berat badan. Gonore. 3 gram sebagai dosis tunggal.

PENYAJIAN Dikonsumsi bersamaan dengan makanan

HARGA : Rp. 71.726/kemasan



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