Combos

The use of AOS in toiletries and personal care products has now been established. In India, for example, AOS has been used by leading toilet soap manufacturers with clear performance benefits, especially in hard water-sensitive areas. Combo bars, where part of the usual fatty acid soap is replaced by synthetic AOS as shown in Table 29, seem to be especially attractive from a cost/performance point of view. 

Kim and co-workers recently reported an excellent example of dynamic kinetic resolution (DKR) using lipase-ruthenium combo catalyst in an IE solvent system (Fig. 7). Applied to this protocol, the authors succeeded in preparing (R)-ester or (5 )-ester using lipase PS or subtilisin, respectively. An IE solvent system is truly appropriate for DKR because racemizafion takes place easily in a highly polar solvent. 

The DKR of amine is more challenging compared to that of secondary alcohol since no metal catalysts have been known for the efficient racemizahon of amine. Reetz et al. reported for the first time the DKR of amine, in which 1-phenylethylamine was resolved by the combination of lipase and palladium (Scheme 4). In this procedure, CALB and Pd/C were employed as the combo catalysts. However, the DKR required a very long reaction time (8 days) at 50-55°C and provided a poor isolated yield (60%). Recently, an improved procedure using Pd on alkaline earth salts as the racemizahon catalyst was reported by Jacobs et al. " The DKR reachons were performed at 70°C for 24-72 h and 75-88% yields were obtained with 99% or greater enanhomeric excess. 

Ma, H., Chen, P. and Ruan, R. (2001) H2S and NH3 removal by silent discharge plasma and ozone combo-system, Plasma Chem. Plasma Process. 21, 611-24. 

Intraabdominal /J-Lactamase inhibitor combo or ciprofloxacin + metronidazole Piperacillirytazobactam or carba-penem ... 

Fenfuramine /Dexafluramine (Combo used since 1984) ( 24 years on market) Diet pill Heart Valve Abnormalities... 

M. Friedman, Chemistry, Formulation, and Performance of Syndet and Combo Bars, In L. Spitz ed., SODEOPEC, AOCS, Champaign, IL, 2004, pp. 147-188. 

Avdeef A, Tsinman O (2006) PAMPA—a drug absorption in vitro model 13. Chemical selectivity due to membrane hydrogen bonding In combo comparisons of HDM-, DOPC-, and DS-PAMPA models. Eur J Pharm Sci 28 43-50. 

Sinclair M. Surface vaccine combo, Nature Biotechnology 18 586 (2000). 

Action Combo of P-adrenergic bronchodilator quaternary anticholinogic Dose 2 inhal qid neb 3 mL q6h Caution [C, +] Contra Peanut/soybean allergy Disp Met-dose inhaler soln for neb (DuoNeb) SE Palpitations, tach, nervousness, GI upset, dizziness, blurred vision Interactions T Effects Wf anticholinergics, including ophthalmic meds effects W/ herb jaborandi tree, pill-bearing spurge EMS See Albuterol may cause transient blurred vision/irritation... 

Aprepitant (Emend) [Centrally Acting Antiemetic] Uses Pre-vents N/V assoc w/ emetogenic CA chemo (eg, cisplatin) (use in combo w/ other antiemetics) Action Substance P/neurokinin l(NKi) receptor antagonist Dose 125 mg PO day 1, 1 h before chemo, then 80 mg PO qAM days 2 3 Caution [B, /-] Contra Use w/ pimozide, Disp Caps SE Fatigue, asthenia, hiccups Interactions T Effects W/ clarithromycin, diltiazem, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, troleandomycin T effects OF alprazolam, astem-izole, cisapride, dexamethasone, methylprednisolone, midazolam, pimozide, terfe-nadine, triazolam, chemo agents, eg, docetaxel, etoposide, ifosfamide, imatinib, irinotecan, paclitaxel, vinblastine, vincristine, vinorelbine i effects W/ paroxetine,... 

Bismuth Subsalicylate (Pepto-Bismol) [Antidiarrheal/ Adsorbent] [OTC] Uses Indigestion, N, D combo for Rx of H. pylori Infxn Action Antisecretory anti-inflammatory E>o e Adults. 2 tabs or 30 mL PO PRN (max 8 doses/24 h) Feds. 3—6 y 1/3 tab or 5 mL PO PRN (max 8 doses/24 h) 5-9 y 2/3 tab or 10 mL PO PRN (max 8 doses/24 h) 9-72 y 1 tab or 15 mL PO PRN (max 8 doses/24 h) Caution [C, D (3rd tri), -] Avoid w/ renal failure Hx severe GI bleed Contra Influenza or chickenpox (T risk of Reye synd), ASA allergy (see Aspirin) Disp Chew tabs, caplets, Liq, susp SE May turn tongue stools black Interactions T Effects OF ASA, MTX, valproic acid effects OF tetracyclines i effects W/ corticosteroids, probenecid EMS Monitor for hypovolemia and electrolyte disturbances d/t D may darken tongue stool OD Similar to ASA OD V, tinnitus, metabolic acidosis activated charcoal may be effective... 

Esomeprazole (Nexium) [Gastric Acid Inhibitor/Proton Pump Inhibitor] Uses Short-term (4-8 wk) for erosive esophagitis/GERD H. pylori Infxn in combo w/ antibiotics Action Proton pump inhibitor, gastric acid Dose Adults. GERD/erosive gastritis 20 0 mg/d PO x 4-8 wk 20 0 mg IV 10-30 min inf or >3 min IV push, 10 d max Maint 20 mg/d... 

Uses Candidal diaper rash Action Combo antifungal Dose Pe >4 wk. Apply at each diaper change x 7d Caution [C, ] Contra None Disp Oint SE None EMS None OD Unlikely... 

WARNING Excessive doses alone or in combo w/ other CNS depressants can be cause of death use w/ caution in depressed or suicidal pts Uses Mild-mod pain Action Narcotic analgesic Dose 1-2 PO q4h PRN in hepatic impair, elderly... 

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