AIDS, treatment

An impressive example of the application of structure-based methods was the design of a inhibitor of the HIV protease by a group of scientists at DuPont Merck [Lam et al. 1994 This enzyme is crucial to the replication of the HIV virus, and inhibitors have bee shown to have therapeutic value as components of anti-AIDS treatment regimes. The star1 ing point for their work was a series of X-ray crystal structures of the enzyme with number of inhibitors boimd. Their objective was to discover potent, novel leads whid were orally available. Many of the previously reported inhibitors of this enzyme possessei substantial peptide character, and so were biologically unstable, poorly absorbed am rapidly metabolised. 

Provision of first-aid treatment even for trivial injuries to the skin. 

Any person on the spot may have to aet immediately to provide first-aid treatment to prevent deterioration in the injured person s eondition until assistanee anives. The aims are ... 

Table 13.8 Standard first aid treatments for chemical exposure...

Bradycardia Bradycardia is a slow heart rate (60 beats per minute or slower) that does not meet the body s metabolic demands. Symptoms of bradycardia include dizziness, extreme fatigue, shortness of breath, or fainting spells. This can be compared to tachycardia, which is an extremely rapid heart rate, usually signified by a pulse of over 100 beats per minute. Adults usually have a resting heart rate of 70-80 beats per minute, although well-trained athletes can have resting rates in the 50 s or 60 s. Newborn babies have a normal heart rate of 120-160 beats per minute. A slowed heart rate can lead to a variety of other problems. First aid treatment may include administration of oxygen. 

Health Hazards Information - Information included are recommended personal protective equipment for hazard materials handling specialist, typical symptoms following exposure to the chemical, general first aid treatment procedures, and various toxicological information including toxicity by ingestion, inhalation and short term exposures. Additional information included are the liquid or solid irritant characteristics and odor threshold data. 

If the contaminant is on the skin or in the eyes, immediate measures should be taken to remove it and counteract its effects. First-aid treatment usually involves flooding the affected area with clean water for at least 15 minutes. For a few chemicals, water may cause more serious problems [1]. The safety plan should anticipate and contain procedures for dealing with such possibilities. 

A Caution Hydrogen fluoride and fluorine are dangerous materials. Exposure to them will cause severe, painful, and perhaps fatal injury. Exposure may not be evident for several hours. The procedures described here pose the risk of exposure to hydrogen fluoride and to elemental fluorine and should only be carried out by, or under the direct supervision of, qualified professionals. Qualified first aid treatment and professional medical resources must be established prior to working in the area. Prompt treatment is necessary to reduce the severity of damage from exposure and should be sought immediately following exposure or suspected exposure. Material safety data sheets are available from HF and fluorine suppliers. Their recommendations should be followed scrupulously. 

Estimates of the lifetime COl are needed for temporal and international comparisons and for assessment of the efficiency of prevention strategies. During the first years of HIV/AIDS treatment, direct lifetime costs were only estimated by simple projections based on retrospective data. Later, specific statistical tools were adopted to estimate life expectancy and lifetime costs. The results of lifetime estimates are very sensitive to imputed assumptions. Table 4 demonstrates some studies in this field. 

Based on two clinics specialized in AIDS treatment, Papaevangelou et al. (1995) calculated lifetime costs per patient in Greece at US 24,160, consisting of drug costs (US 9,022), costs for outpatient care (US 963), and inpatient care (US 14,175). 

Gu X, Simons KJ, Simons FER Administration by sublingual tablet feasible for the first aid treatment of anaphylaxis A proof-of-concept study. Diophar Drug Dispos 2002 23 213-216. 

Simons FE First-aid treatment of anaphylaxis to food focus on epinephrine. J Allergy Clin Immunol 2004 113 837-844. 

In this review, we will describe the pharmacologic activity of epinephrine in anaphylaxis, the evidence base for its use, epinephrine dosing and routes of administration, epinephrine autoinjector use in first-aid treatment, reasons for failure to inject epinephrine promptly, reasons for occasional apparent lack of response, and future directions in epinephrine research. 

Optimal use of epinephrine autoinjectors for first-aid treatment of anaphylaxis in community settings is hampered by several issues. In most countries, these include the availability of only two pre-measured epinephrine doses and only a few different needle lengths, and the need to replace outdated autoinjectors at 12- to 18-month intervals due to degradation of the epinephrine solution they contain. 

Physicians face a dilemma with regard to prescribing an optimal epinephrine dose in an autoinjector for first-aid treatment of people at risk for anaphylaxis in a community setting, because only two pre-measured epinephrine doses, 0.15 and 0.3 mg, are... 

Alternative Routes of Epinephrine Administration for First-Aid Treatment... 

Although epinephrine autoinjectors are widely dispensed for first-aid treatment of anaphylaxis in some countries, they are neither available nor affordable in many others [33]. In these situations, physicians sometimes equip patients at risk for anaphylaxis in the community with an epinephrine ampule and a disposable 1-ml syringe. Some physicians also recommend this approach for infants, for whom, as noted previously, no appropriate epinephrine dose is available in an autoinjector formulation. 

Preparedness for first-aid treatment of anaphylaxis in the community involves not only a prescription for epinephrine autoinjectors, but also an Anaphylaxis Emergency Action Plan, appropriate medical identification, and anaphylaxis education. 

Simons FER. Chan ES. Gu X. Simons KJ Epinephrine for the out-of-hospital (first aid) treatment of anaphylaxis in infants is the ampule/ syringe/needle method practical J Allergy Clin Immunol 2001 108 1040-1044. 

Heats of solution are the basis for instant cold packs and instant hot packs used for the first-aid treatment of minor sprains and pulled muscles. These packs have two separate compartments. One contains water, and the other contains a salt NH4 NO3 for cold packs and MgSO. or CaCl2 for hot packs. Kneading the pack breaks the wall between the compartments, allowing the salt to mix with water. As the salt dissolves to form an aqueous solution, the temperature of the pack changes. Heat is absorbed or released only as the salt dissolves, however, so after all of the salt has dissolved, the pack gradually returns to room temperature. Further manipulation of the pack has no effect. 

To provide cold therapy for cuts, bruises, sprains, and lacerations, an instant ice pack for first-aid treatment uses a chemical reaction that requires heat in order to occur. An instant Ice-Pack contains two compartments — one containing liquid water, the other a solid. The pack is activated by squeezing the liquid compartment to break an inner seal that permits the mixing of the two compartments. Heat is withdrawn from the surroundings by the reacting chemicals, lowering the temperature of the ice-pack contents. 

An instant ice pack for first-aid treatment uses the endothermic nature of the dissolution of an ionic salt in water to provide cold therapy. Two typical materials that absorb heat as they dissolve in water are ammonium nitrate and ammonium chloride ... 

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