Injection site reactions concentrate

Azacitidine, a cytidine analog, causes hypomethylation of DNA, which normalizes the function of genes that control cell differentiation to promote normal cell maturation. The suspension is administered as a subcutaneous injection daily for 7 days for the treatment of myelodysplastic syndrome, a preleukemia disease. The pharmacokinetics of azacitidine are best described by a two-compartment model, with a terminal half life of 3.4 to 6.2 hours, whereas peak concentrations are achieved 30 minutes after a subcutaneous injection.7 Azacitidine has been shown to be clinically active in the treatment of myelodysplastic syndromes. The side effects include myelosuppression, renal tubular acidosis, renal dysfunction, and injection-site reactions. 

Tablet combination therapy Adverse reactions occurring in at least 3% of patients include the following Abdominal pain alopecia anemia anorexia anxiety arthralgia back pain bacterial infection blurred vision concentration impairment cough depression dermatitis diarrhea dizziness dry mouth/skin dyspepsia dyspnea eczema fatigue/asthenia headache hypothyroidism increased sweating injection site reaction insomnia irhtability/anxiety/nervousness lymphopenia memory impairment mood alteration myalgia nausea neutropenia pain pruritus pyrexia rash resistance mechanism disorders rigors thrombocytopenia vomiting weight decrease.

The safety and activity of subcutaneous GM-CSF (300 micrograms/day for 1 week and 150 micrograms twice weekly for 11 weeks) has been compared with no treatment in 244 leukopenic HIV-infected patients (62). Adverse effects were reported in most of the patients treated with GM-CSF and consisted of flu-like symptoms (98%), bone pain (42%), and injection site reactions (85%). There was a two-fold increase in serum transaminase and alkaline phosphatase activities in 5.7% of patients. There was a moderate, but not significant, increase in HIV p24 antigen concentration. The few relevant clinical trials have provided no convincing evidence that GM-CSF enhances HIV replication or accelerates HIV-associated diseases (for example infections or neoplasms) in patients with AIDS (63). Only one patient with AIDS and ultrasonographic confirmation of enhanced Kaposi s sarcoma lesions temporally related to GM-CSF used for interferon- and zidovudine-related severe neutropenia has been reported (SEDA-19, 343). 

The question of whether revaccination with 23-valent pneumococcal polysaccharide vaccine (PPV) at least 5 years after the first vaccination is associated with more frequent or more serious adverse events than those after the first vaccination has been studied in patients aged 50-74 years who had never been vaccinated with PPV (n = 901) or who had been vaccinated once at least 5 years before enrolment (n = 513) (8). After one dose of PPV, local injection site reactions and prevaccination concentrations of type-specific antibodies were measured. Those who were re-vaccinated were more likely than those who received their first vaccinations to report a local injection site reaction of at least 10.2 cm (4 in.) in diameter within 2 days of vaccination (55/513 versus 29/ 901, or 11 versus 3%). The reactions resolved by a median of 3 days after vaccination. The highest rate was among revaccinated patients who were immune competent and did not have chronic illnesses 15% (33/228) compared with 3% (10/337) among comparable patients receiving their first vaccinations. The risk of these local reactions correlated significantly with prevaccination geometric mean antibody concentrations. The authors concluded that physicians and patients should be aware that selflimited local injection site reactions occur more often after revaccination compared with a first vaccination however, this risk does not represent a contraindication to revaccination with PPV in recommended patients. 

Disposition in the Body. Readily absorbed after oral administration bioavailability about 55%. Flupenthixol decanoate is very slowly absorbed from the site of intramuscular injection. Peak plasma concentrations are attained about 3 to 6 hours after oral administration and 3 to 7 days after intramuscular injection. The main metabolic reactions are sulphoxidation, side-chain N-dealkylation and glucuronic acid conjugation. AT-Desalkylflupen-thixol and flupenthixol sulphoxide are the major metabolites found in plasma (both are inactive). Numerous metabolites are excreted in the urine and faeces and there is evidence of enterohepatic circulation. 

The optimal conditions depend on the concentrations of pollutants, and also on the oxygen demand of the different site reactions and on the geological and hydrogeological setting. For optimal performance, Salanitro et al. [15] selected an intermittent oxygen injection of 1700 L delivered 4-8 times per day to a plot that was 6 m long and 15 m wide and which contained MTBE concentrations up to 8.9 mg... 

Drug formulations Studies of premedication with hyaluronidase to allow the administration of larger volumes of subcutaneous immunoglobulin at one injection site or the use of a 20% concentration product in order to minimize the volume showed similar rates of adverse reaction as with established subcutaneous immunoglobulin [69 ]. 

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