Other Agents

Both chloroquine and hydroxychloroquine (Plaquenil ) have been reported as beneficial in treating sarcoidosis (218). In a randomized trial of chronic pulmonary disease, Baltzan et al. demonstrated that chloroquine slowed the progression of the disease (219). The antunalarials are associated with a higher rate of response for extrathoracic disease such as skin (218,220-223) and hyper-calcemic manifestations. These dmgs have not been studied in other ILDs. 

The macrophage is the target for the antimalarial agents. Both dmgs suppress release of proinflammatory cytokines (e.g., TNF) (224,225). In addition, antimalarial agents 

Both antimalarial agents are administered orally with the usual dose for hydroxychloroquine 200 to 400 mg/day and chloroquine 250 to 750 mg/day. Parental administration is not recommended. Because of the higher toxicity reported with chloroquine, most physicians prefer hydroxychloroquine. A reduced dose of hydroxychloroquine is recommended for those with a low lean body mass. 

Both hydroxychloroquine and chloroquine are well absorbed when given orally (235). For hydroxychloroquine, the effectiveness and toxicity appear to be dose dependent (236). Both dmgs have prolonged half-lives of over six weeks (237). Both drugs bind strongly to pigmented tissues but also bind to other cells such as mononuclear cells. Potentially important kinetic interactions have been documented for D-peniciUamine and cimetidine (235). 

Routine ophthalmic examination is recommended every 6 to 12 months for patients on these dmgs (228,240). Complete blood counts and hepatic function should be checked every three to six months. 

Basic resins of today s molding emnpounds in microelectronics encapsulation are o-cresolnovolac epoxides and brmninated DGBA (diglycidyl ether of bisj ienol A) cured with phenoFfinmaldehyde novolac as a hardener able 4)3.s, 56. )  

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Reactor-grade zirconium is essentially free of hafnium. Zircaloy(R) is an important alloy developed specifically for nuclear applications. Zirconium is exceptionally resistant to corrosion by many common acids and alkalis, by sea water, and by other agents. Alloyed with zinc, zirconium becomes magnetic at temperatures below 35oK. 

Atropiae (41), isolated from the deadly nightshade Airopa belladonna L.) is the racemic form, as isolated, of (—)-hyoscyamine [which is not isolated, of course, from the same plant but is typically found ia solanaceous plants such as henbane (HyosQiamus mgerl. )]. Atropiae is used to dilate the pupil of the eye ia ocular inflammations and is available both as a parasympatholytic agent for relaxation of the intestinal tract and to suppress secretions of the saUvary, gastric, and respiratory tracts. In conjunction with other agents it is used as part of an antidote mixture for organophosphorus poisons (see Chemicals in war). 

Fluoride produced from the biodegradation of halothane or the other agents has Htde effect on normal kidney function (59). Halothane usage has been declining because of the potential Hver effects, although the agent is used where inhalation induction is desired, especially in pediatrics. 

Other Infections. The slowly excreted sulfonamides (eg, sulfamethoxypyrida2ine, sulfadimethoxine) are used for treatment of minor infections such as sinusitis or otitis, or for prolonged maintenance therapy. Soluble sulfonamides are sometimes used for proto2oal infections in combination with other agents. Pyrimethamine, combined with sulfonamides, has been used for toxoplasmosis or leishmaniasis, and trimethoprim with sulfonamides has been used in some types of malaria. In nocardiosis, sulfonamides have been used with cycloserine [68-41-7] (17). 

Other agents are also used for the treatment of manic-depressive disorders based on preliminary clinical results (177). The antiepileptic carbamazepine [298-46-4] has been reported in some clinical studies to be therapeutically beneficial in mild-to-moderate manic depression. Carbamazepine treatment is used especially in bipolar patients intolerant to lithium or nonresponders. A majority of Hthium-resistant, rapidly cycling manic-depressive patients were reported in one study to improve on carbamazepine (178). Carbamazepine blocks noradrenaline reuptake and inhibits noradrenaline exocytosis. The main adverse events are those found commonly with antiepileptics, ie, vigilance problems, nystagmus, ataxia, and anemia, in addition to nausea, diarrhea, or constipation. Carbamazepine can be used in combination with lithium. Several clinical studies report that the calcium channel blocker verapamil [52-53-9] registered for angina pectoris and supraventricular arrhythmias, may also be effective in the treatment of acute mania. Its use as a mood stabilizer may be unrelated to its calcium-blocking properties. Verapamil also decreases the activity of several neurotransmitters. Severe manic depression is often treated with antipsychotics or benzodiazepine anxiolytics. 

There was a tendency to use these resins mixed with urea—formaldehyde or melamine-type resins. Preparation of pure tria2ones or uron resins is difficult and expensive (61,62). Furthermore, the basic nature of the amine nitrogen in tria2one permits the use of mixtures of tria2ones with other agents to yield finishes that retain strength in hypochlorite bleaching. 

The novel agent sulofenur (69) has entered clinical trials based on its broad spectmm antitumor activity in tumor models, its unusual mechanism of action, and its lack of cross-resistance to other agents (33). In Phase I clinical trials, the dmg was well tolerated and some clinical responses were noted. 

Mouthwashes are hydro-alcohoHc preparations in which flavorants, essential oils (see Oils, essential), and other agents are combined to provide long-term breath deodorization. PalatabiHty can be improved by including a polyhydric alcohol such as glycerin or sorbitol (see Alcohols, polyhydric). Occasionally, anionic and nonionic surfactants are used to help solubiHze flavorants and to help remove debris and bacteria from the mouth. 

Direct Dyes. These are defined as anionic dyes, again containing sulfonic acid groups, with substantivity for ceUulosic fibers. They are usually a2o dyes (qv) and can be mono-, dis-, or polya2o, and are ia general planar stmctures. They are appHed to ceUulosic fibers from neutral dyebaths, ie, they have direct substantivity without the need of other agents. Salt is used to enhance dyebath exhaustion. Some direct dyes can be appHed to wool and polyamides under acidic conditions, but these are the exception. 

In a similar manner to the formation of pyridazines from AT-aminopyrroles, cinnolines or phthalazines are obtainable from the corresponding 1-aminooxindoles or 2-amino-phthalimides. If the relatively inaccessible 1-aminooxindoles are treated with lead tetraacetate, mercuric acetate, r-butyl hypochlorite (69JCS(C)772) or other agents, cinnolones are formed as shown in Scheme 105. The reaction was postulated to proceed via an intermediate... 

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