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The treatment of asthma with ipratropium bromide, a stable atropine-like compound, was introduced in the 1980s12. Although its use in asthma rescue treatment has not been approved by the United States Food and Drug Administration, it was used successfully in a recent study, sponsored by the National Institutes of Health Asthma Clinical Research Network13, as an asthma rescue therapy in patients with mild intermittent asthma. This was necessary because the study identified a subset of asthmatics who had adverse responses to adrenergic bronchodilators, and it was, therefore, necessary to manage these patients with a non-adrenergic bronchodilator, such as ipratropium bromide.

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Also known as: Anhydrous Caffeine, Caffeine and Sodium Benzoate, Caffeine Citrate, Citrated Caffeine Historical Perspective: Caffeine containing beverages and plants have been used for thousands of years, with the first historical record of use found in Aztec records. Six caffeine-containing plants are more widely used in the world than all other herbal materials put together, these include: cacao, coffee, guarana, kola, mate and tea. Common Uses: Caffeine is used to treat headaches and migraines, increase mental alertness, treat asthma and enhance athletic performance. In combination, caffeine is used with ephedrine ephedra or Ma Huang ; or other stimulants and diuretics water pills ; to promote weight loss. Common and or Recommended Dosage: The dosage recommended for athletic performance is 6-13 milligrams per kilogram of body weight taken 30-60 minutes prior to exercise. A typical dose to treat headache or increase mental alertness is up to 250 milligrams per day. Potential Side Effects: Caffeine can cause insomnia, nervousness, restlessness, gastric digestive system ; irritation, nausea and vomiting, tachycardia excessively rapid increase in heart rate ; , quickened respiration, tremors involuntary quivering ; , delirium acute mental disorder characterized by disordered thinking and rambling speech ; , convulsions and diuresis increased excretion of urine ; . Large doses can produce headache, anxiety, agitation, ringing in the ears and abnormal heartbeat. Long-term use of caffeine, especially in large amounts, can sometimes produce tolerance, dependency and psychological dependence. Discontinuing use of caffeine can sometimes result in physical withdrawal symptoms, including headaches, irritation, nervousness, anxiety and dizziness. Side effects of caffeine use are often increased by the use of other caffeine-containing herbs supplements such as guarana and mate. Use of caffeine-containing beverages -- coffee, cola and black teas -- along with oral caffeine can greatly increase the side effects. Delirium can occur with intake over 1, 000 milligrams per day and death can occur with intake over 18, 000 milligrams per day. Food Drug-Supplement Interactions: The following list of drugs when used with caffeine can increase the risk of caffeine-related side effects: 1 ; alcohol 2 ; disulfiram Antabuse ; 3 ; estrogen Estrace ; 4 ; terbinafine lamisil ; 5 ; fluvoxamine Luvox ; 6 ; mexiletine Mexitil ; 7 ; oral contraceptives birth control pills ; 8 ; quinolones Cipro, Penetrex, Tequin, Levaquin, Floxin, etc. ; 9 ; riluzole Rilutek ; 10 ; cimetidine Tagamet ; 11 ; verapamil Calan, Isoptin, Verelan ; continued on next page and lorazepam. The advisory committee voted unanimously to recommend that levaquin, an $8-per-pill antibiotic, be approved for treatment of penicillin-resistant pneumonia.
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Mark Rowland London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK mark.rowland lshtm.ac `DEET mosquito repellent sold through social marketing provides personal protection against malaria in an area of all-night mosquito biting and partial coverage of insecticide-treated nets', Tropical Medicine and International Health 9 3 ; : 343-350, by M. Rowland et al, 2004 and lotrel. One such classification is by chemical structure: aminoglycosides amikacin dibekacin gentamicin kanamycin neomycin netilmicin paromomycin somycin streptomycin tobramycin beta-lactam ring antibiotics carbapenems ertapenem imipenem meropenem cephalosporins and cephamycins cephalexin cefazolin cefuroxime cefadroxil ceftazidime penicillins amoxicillin monocyclic beta-lactams glycopeptide antibiotics vancomycin teicoplanin ramoplanin decaplanin oxazolidinones linezolid quinupristin dalfopristin polyketides macrolides erythromycin azithromycin clarithromycin roxithromycin ketolides telithromycin tetracyclines doxycycline oxytetracycline chlortetracycline polymyxins polymyxin b colistin quinolones fluoroquinolones ; nalidixic acid ciprofloxacin cipro ; ofloxacin norfloxacin norflox ; levofloxacin levaquin ; trovafloxacin trovan ; streptogramins sulfonamides prontosil other important antibiotics: chloramphenicol clindamycin fusidic acid trimethoprim another such classification is by their mechanism of action antibiotics, which interfere with cell-wall synthesis beta-lactams, including penicillins like amoxicillin and cephalosporins; mono-lactams, such as imipenem; vancomycin, bacitracin antibiotics that interfere with bacterial protein synthesis antibiotics that bind to the 50s ribosomal unit lincosamides lincosides including clindamycin and lincomycin; chloramphenicol, macrolides antibiotics, which interfere the 30s ribosomal unit tetracyclines; aminoglycosides including gentamicin drugs that inhibit folate synthesis sulfonamides and trimethoprim drugs that interfere with dna synthesis metronidazole , quinolones, novobiocin drugs that interfere with rna synthesis rifampin rifampicin ; drugs that interfere with cell membrane function polymyxin b, gramicidin antibiotics can also be classified by the organisms against which they are effective, and by the type of infection in which they are useful, which depends on the sensitivities of the organisms that most commonly cause the infection and the concentration of antibiotic obtainable in the affected tissue.
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