By Z. Cruz. University of Colorado at Boulder.

They can order 50mg hyzaar overnight delivery pulse pressure 31, however 50mg hyzaar otc blood pressure medication dry cough, help ministries of education and national pharmacy councils identify the competencies a vocational pharmacy worker would need in their coun- try. Their efforts in-country should aim to identify the competencies and Copyright © National Academy of Sciences. Apreku worked on her family farm prior to saving enough money to start her own licensed chemical shop. Apreku explained that the CareShop franchise drastically improved her business in several ways. First, she is able to advise her customers more confdently on the nature and appropriate treatment of their afictions. Second, she is able to ofer her patients better customer service through complementary selling techniques. Apreku’s sales are fve times higher than they were prior to conversion, and she runs the store from 7 am to 10 pm every day with the help of Adams, her son (also pictured)” (Segrè and Tran, 2008, p. Asiam inherited his chemical shop, a converted space attached to his home, from his father and was a licensed chemical seller for nearly 20 years prior to his conversion to CareShop. Commenting on the difer- ence between his business before and after conversion, Mr. Asiam spent roughly $200 on improvements, which include ceiling fans, a refrigerator, and glass display cases. They might also consider developing chains of supervision wherein minimally educated staff manage stock and then report their needs up to someone who is qualifed to identify good-quality wholesalers and buy from them. The committee believes that national pharmacy councils are best able to articulate what the proper reporting chain should be in their country and what minimum qualifcations their countries’ patients will accept. The minimum training for a drug dispenser or pharmacy technician in rural Canada will be dif- ferent from what is suitable to rural Nepal. In any case, there should be emphasis on vocational training to credential medicine shopkeepers and include them in the health system. There is evidence that task shifting can alleviate the pharmacist short- age in developing countries. In Malawi, an emergency training and cre- dentialing program for health workers increased the number of pharmacy technicians by 84 percent between 2004 and 2009 (O’Neil et al. Malawian pharmacy technicians supervise pharmacy attendants, the lower- level staff who stock and dispense drugs, allowing the technician more time for stock management and other more complicated tasks (Shulman et al. Because of task shifting, pharmacy technicians monitor adherence to antiretroviral treatment in Zambia and tuberculosis treatment in urban Uganda (Bolton-Moore et al. Training and task shifting programs that recruit minimally educated shopkeepers are also promising. For example, Kilif, Kenya, is a rural area of 70,000 people with 15 licensed dispensaries and pharmacies and 316 general stores that sell medicine (Marsh et al. A training program for Kilif shopkeepers more than doubled the proportion of antimalarials sold in adequate dosage (Marsh et al. A similar Kenyan program trained mobile wholesalers or wholesaler counter attendants to teach drug retailers about correct malaria drug dosing (Tavrow and Shabahang, 2002). After 6 months, mystery shoppers were nine times more likely to receive the correct drugs in the correct dose from retailers who had participated in the program (Tavrow and Shabahang, 2002). Giving Incentives to Pharmaceutical Personnel Using workers more effciently could do much to remedy chaotic drug retail in low- and middle-income countries, but there is also a problem of retaining trained staff in underserved posts. Even minimal technical train- ing confers a competitive advantage in the labor market, especially in poor countries (Attanasio et al. Newly minted pharmacy technicians or drug dispensers can easily leave their rural Copyright © National Academy of Sciences. This pattern can undermine the best efforts to improve rural-urban equity and should be discouraged, while respecting the individual right to emigrate. Governments should reward service in underserved areas and attempt to mitigate the hardships of these posts. Scholarships for the children of pharmacy staff in underserved areas could assuage fears that a rural posting puts their children at a disadvantage.

Such will be accepted approximately 95 per- juice may be homogenized 12.5mg hyzaar with amex blood pressure by palpation, may be sea- cent of the time order 12.5mg hyzaar with amex arrhythmia uk. Tomato the area of either Disc 3 or Disc 4; or 91⁄2 percent of the area of Disc 3 and 91⁄2 juice is the food intended for direct consumption, obtained from the percent of the area of Disc 4, whichever unfermented liquid extracted from ma- most nearly matches the appearance of ture tomatoes of the red or reddish va- the tomato juice. In the extraction of such combination, in addition to three de- liquid, heat may be applied by any fects for seeds or pieces of seeds, de- method which does not add water fined as follows, per 500 milliliters (16. Such juice is strained free fluid ounces): from peel, seeds, and other coarse or (a) Pieces of peel 3. I (4–1–10 Edition) (b) Blemishes such as dark brown or of this chapter, in the manner and form black particles (specks) greater than therein prescribed. A collection of primary con- ment of substandard quality specified tainers or units of the same size, type in §130. The number of primary substandard quality when the quality containers or units (pounds when in of the tomato juice falls below the bulk) in the lot. The total number of label may bear the alternative state- sample units drawn for examination ment, "Below Standard in Quality from a lot. A container, a por- the words specified after the cor- tion of the contents of a container, or responding paragraph (s) under para- a composite mixture of product from graph (b)(1) of this section which such small containers that is sufficient for tomato juice fails to meet, as follows: the examination or testing as a single (i) "Poor color". The maximum of fill of container for tomato juice, as number of defective sample units per- mitted in the sample in order to con- determined by the general method for sider the lot as meeting the specified fill of container prescribed in §130. The following accept- of this chapter, is not less than 90 per- ance numbers shall apply: cent of the total capacity, except when the food is frozen. Size container Lot size (primary container) (2) Determine compliance as specified n1 c2 in §156. Where the peas Vegetables are of sweet green wrinkled varieties, the name may include the designation §158. The label shall Frozen peas is the food in "package" contain the words "frozen" or "quick form as that term is defined in §1. The name of the food shall in- this chapter, prepared from the suc- clude a declaration of any flavoring culent seed of the pea plant of the spe- that characterizes the product as speci- cies Pisum sativum L. It is blanched, laration of any condiment such as drained, and preserved by freezing in spices and mint leaves that character- such a way that the range of tempera- izes the product, e. The freezing process such statement shall indicate either shall not be regarded as complete until the size designation as specified in the product temperature has reached paragraph (a)(2) of this section or the ¥18 °C (0 °F) or lower at the thermal applicable sieve size. Each of the in- (v) Monosodium glutamate and other gredients used in the food shall be de- glutamic acid salts. If size graded, applicable sections of parts 101 and 130 frozen peas shall contain not less than of this chapter. I (4–1–10 Edition) (i) Not more than 4 percent by weight and (b)(1)(viii) of this section, shall be blond peas, i. For the determination of ible peas; alcohol-insoluble solids as specified in (ii) Not more than 10 percent by paragraph (b)(3) of this section, the weight blemished peas, i. With cloth wipe surplus water count of the peas may sink in a solu- from lower screen surface. Fit into a (ix) The quality of a lot shall be con- buchner funnel a filter paper of appro- sidered acceptable when the number of priate size (previously prepared by dry- defectives does not exceed the accept- ing in flatbottom dish for 2 hours in ance number in the sampling plans set forth in §158. Apply vacuum to compliance with the requirements of buchner funnel and transfer contents of paragraph (b)(1) of this section other beaker so as to avoid running over edge than those of paragraphs (b)(1)(vii)(a) of paper. Subpart A [Reserved] (ii) Procedure—After carefully re- moving the skins from the peas, place Subpart B—Requirements for Spe- the peas into the solution. Pieces of cific Standardized Eggs and peas and loose skins should not be used Egg Products in making the brine flotation test. Before drying, Code of Federal Regulations but in lieu the glucose content of the liquid eggs of the words prescribed in the second may be reduced by one of the optional line of the rectangle the following procedures set forth in paragraph (b) of words may be used where the frozen this section. Either silicon dioxide peas fall below the standard in only complying with the provisions of §172. I (4–1–10 Edition) sodium silicoaluminate used is less conspicuousness as to render such than 2 percent by weight of the fin- statement likely to be read and under- ished food.

Parenteral The parenteral category includes such areas of major potential as the development of novel long-acting (implant) dosage forms (see Section 4 buy hyzaar 12.5 mg overnight delivery heart attack definition. Thus discount hyzaar 12.5mg pulse pressure how to calculate, although parenteral advanced drug delivery systems now account for a very small share of the total advanced drug delivery market, they are likely to make a more significant impact when current research yields marketable products. Because much of this research is at an early stage, the parenteral sector may not achieve its full potential until well into the 21st century, with sales projected to rise to $2. This sector soon attracted the attention of pharmaceutical entrepreneurs who saw opportunities for specialist formulation companies. By the late 1970s there were a number of such companies in operation, including Alza, Elan, Eurand and Pharmatec International. Typically, there would be a development fee for such work, paid in stages as the project reached successive goals; finally, the client would either pay the developer royalties on the sales of the successful formulation, or subcontract production of the finished product to the advanced drug delivery company. These types of arrangements are still the basis for most development work in the advanced drug delivery sector carried out on behalf of pharmaceutical clients by specialist companies. Some of the early entrants into this field have expanded their activities into delivery routes other than their original core technology, so that they can offer solutions in the transdermal, inhalation and other fields as well as oral formulations. This is true of Alza, Elan and 3M, the latter being something of a hybrid since it is also a pharmaceutical company in the conventional sense. By contrast, some companies in this field are linked to specific routes of administration; Inhale Therapeutic systems, as its name implies, focuses on inhalation technology, while Pharmatec International, one of the oldest-established advanced drug delivery concerns, remains committed to the oral route. Drug delivery technology demands continual innovation in order to meet increasingly complex clinical demands and accommodate the needs of sophisticated new drugs. This places a heavy burden on existing specialist companies in terms of R&D commitment; it has led to the birth of a considerable number of small, research-driven concerns, often built around pharmaceutical specialists and teams from academia or the formulation departments of major pharmaceutical companies. Like companies in the biotechnology sector, these new ventures are set up to develop and exploit specific technologies, but their path to financial self- sufficiency is often shorter than that of a typical new biotech venture, because the regulatory hurdles are fewer when a new chemical entity is not involved. Here, the underlying technology is so new that it cannot even be described as “pharmaceutical” in any conventional sense. Likewise, the delivery technology is pushing back the boundaries of human knowledge, exploring the use of viruses as carriers for the genetic material, as well as other vehicles including liposomes. Since this applied research is, unusually, going hand-in-hand with fundamental research into the nature of the biological mechanisms involved, the development timetable is an extended one. In summary, the current structure of the advanced drug delivery industry is a complex one, embracing specialist companies which offer off-the-shelf and custom-developed delivery systems, some involved in a range of delivery routes, others concentrating on a single route of administration. There are leading-edge research teams in areas such as gene therapy, while some pharmaceutical concerns still maintain their own specialist advanced drug delivery formulation units developing essentially pharmaceutical solutions to formulation problems. What major contribution have advanced drug delivery systems made to anti-inflammatory drug therapy? Discuss the importance of the developing world as a market for advanced drug delivery systems. Systems are diversely referred to as “controlled release”, “sustained release”, “zero-order”, “reservoir”, “monolithic”, “membrane-controlled”, “smart”, “stealth” etc. Unfortunately, these terms are not always used consistently and, in some cases, may even be used inaccurately. For clarity and consistency, some common terms used in this book are defined as follows: • Prolonged/sustained release: the delivery system prolongs therapeutic blood or tissue levels of the drug for an extended period of time. Conventional drug delivery systems are simple oral, topical or injection formulations. Also, rate-control and drug targeting are treated as two separate issues in this book and are dealt with in detail in Chapters 4 and 5 respectively. Although there are literally hundreds of commercial products based on controlling drug release rate from delivery systems, there are in fact only a small number of mechanisms by which drug release rate is controlled: • Diffusion-controlled release mechanisms • Dissolution-controlled release mechanisms 57 Figure 3. If the drug concentration gradient remains constant, for example where solid drug particles are present and constant dissolution maintains the concentration of the drug in solution, the rate of drug release does not vary with time and zero- order controlled release is attained (see Chapter 4 and Figure 4. Diffusion-controlled reservoir devices are used in a wide variety of routes including those shown in Table 3. Regardless of a drug’s physical state in the polymeric matrix, such devices do not usually provide zero-order drug release properties. This is because as the drug molecules at the surface of the device are released, those in the centre of the device have to migrate longer distances to be released, which takes a longer time.

Te action of triamterene is diferent triamterene was not metabolized in the kidney purchase hyzaar 50mg with visa hypertension va rating. Tus effective 50mg hyzaar arrhythmia and murmur, in individuals with renal impair- by high plasma concentrations of triamterene ment, accumulation of the sulfate is substantial and low concentrations of 4′-hydroxytri- and progressive, but negligible for triamterene. Afer administration of Te kinetics of triamterene were observed in 32 200 mg of triamterene, peak plasma concen- patients with widely varying degrees of creati- trations in eight patients without liver disease nine clearance (10–135 mL/minute), an indicator were 559 ± 48 ng/mL and 2956 ± 320 ng/mL for of renal function. In patients with reduced renal triamterene and 4′-hydroxytriamterene sulfate, function, signifcant accumulation in plasma respectively. In the seven patients with alco- and reduced renal clearance of the sulfate were holic cirrhosis, peak plasma concentrations of reported. Plasma concentrations of the parent triamterene were increased to 1434 ± 184 ng/mL, drug were not increased (Knauf et al. Triamterene a signifcant reduction in hydroxylation of is most ofen prescribed for hypertension as a triamterene (Fliser et al. Renal clearance combination tablet that includes hydrochlorothi- was similar in elderly and young individuals. One of the studies reported a risk estimate that Triamterene was not mutagenic in S. However, positive could not be separated from the efects attribut- results were obtained for induction of sister chro- able to hydrochlorothiazide. Te available studies were not informative for evaluation of the association between risk of cancer and exposure specifcally to triamterene. Triamterene induced sister chromatid exchange in Chinese Triamterene was tested for carcinogenicity by hamster ovary cells, in the presence or absence oral administration in two studies in mice and of exogenous metabolic activation. In a second feeding study, triamterene reductase in vitro; its metabolites 4′-hydroxy- caused signifcant increases in the incidences of triamterene and 4′-hydroxytriamterene sulfate hepatocellular adenoma in males and females, are less efective inhibitors of the enzyme. When and of hepatocellular adenoma or carcinoma irradiated with ultraviolet A light, triamterene (combined) in females. In-vitro coexposure triamterene caused an increase in the incidence of human peripheral blood lymphocytes and of hepatocellular adenoma (a tumour that is neutrophils to triamterene and ultraviolet A known to progress to malignancy) in males. Hepatocellular adenoma was reported in all dose Inhibition of dihydrofolate reductase and groups, but not in rats in the control group. Intravenous administration of radiolabelled Tere is sufcient evidence in experimental triamterene in rats resulted in extensive accu- animals for carcinogenicity of triamterene. Triamterene was not mutagenic when tested Triamterene is possibly carcinogenic to in Salmonella typhimurium, in the presence humans (Group 2B). Triamterene also gave negative results in assays for the induction of chromosomal aberration in Chinese hamster ovary cells, in the presence or absence of exogenous metabolic activation, and did not induce dominant lethal mutation in the 280 Triamterene References http://www. Rapid determination of diuretics in human urine by Creatinine clearance underestimates renal function gas chromatography-mass spectrometry following and pharmacokinetics remain virtually unchanged. ChemicalBook: Chemical Search administration to man: determination of bioavaila- Engine. National Heart, Lung, and Blood Horstkötter C, Kober S, Spahn-Langguth H, Mutschler Institute; ; National High Blood Pressure Education E, Blaschke G (2002). Seventh and its main metabolite hydroxytriamterene sulfate report of the Joint National Committee on Prevention, in human urine by capillary electrophoresis using Detection, Evaluation, and Treatment of High Blood ultraviolet absorbance and laser-induced fuorescence Pressure. Diuretic its main metabolite hydroxytriamterene sulfate in use and the risk of breast cancer. J Hum Hypertens, urine using solid-phase and aqueous solution lumines- 23(3):216–8. Transfer char- tifcation of metabolic products of triamterene] acteristics of triamterene and its analogs. Simultaneous triamterene and reserpine in rat plasma by high perfor- direct determination of amiloride and triamterene mance liquid chromatography and tandem solid- in urine using isopotential fuorometry. Reserpine and breast cancer in a method for the determination of hydrochlorothiazide retirement community. J Chromatogr Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, A, 729(1-2):293–6.

However buy hyzaar 12.5 mg on-line blood pressure medication, outpatients at high risk for thromboembolism may begin oral anticoagulants without first re- ceiving heparin order hyzaar 50 mg fast delivery hypertension bp. To decrease the risk of arterial clotting, oral anticoagulants warfarin levels are sometimes combined with an antiplatelet drug, such as as- pirin, clopidogrel, or dipyridamole. Patients taking warfarin need close monitoring of Drug interactions prothrombin time and In- ternational Normalized Many patients who take oral anticoagulants also receive other Ratios to make sure they drugs, placing them at risk for serious drug interactions. Examples include acetaminophen, allopurinol, amiodarone, If laboratory results fall cephalosporins, cimetidine, ciprofloxacin, clofibrate, danazol, dia- outside the accepted zoxide, disulfiram, erythromycin, fluoroquinolones, glucagon, he- range, warfarin dosage parin, ibuprofen, isoniazid, ketoprofen, methylthiouracil, metron- should be adjusted. Examples include barbiturates, carba- Adverse mazepine, corticosteroids, corticotropin, mercaptopurine, naf- cillin, hormonal contraceptives containing estrogen, rifampin, reactions spironolactone, sucralfate, and trazodone. The primary adverse re- Other interactions include the following: action to oral anticoagu- • A diet high in vitamin K reduces the effectiveness of warfarin. Acute alcohol intoxication increases the ing can occur, however, risk of bleeding. Necrosis or Aspirin, clopidogrel, dipyridamole, sulfinpyrazone, and ticlopi- gangrene of the skin and dine are examples of oral antiplatelet drugs. Quick fix The effects of oral anti- Pharmacokinetics coagulants can be re- When taken orally, antiplatelet drugs are absorbed very quickly versed with phytona- and reach peak concentration in 1 to 2 hours. Sulfinpyra- zone may require several days of administration before its anti- platelet effects occur. The effects of these drugs occur within 15 to 20 minutes of administration and last about 6 to 8 hours. Elderly patients and patients with renal failure may have de- creased clearance of antiplatelet drugs, which would prolong the antiplatelet effect. It lengthens platelet survival and prolongs the patency of arteriovenous shunts used for hemodialysis. Salve for surgery Dipyridamole is used with a coumarin compound to prevent thrombus formation after cardiac valve replacement. Adverse reactions to antiplatelet drugs Hypersensitivity reactions, particularly anaphylaxis, can occur. Tales of toxicity • Aspirin increases the risk of toxicity of methotrexate and val- proic acid. You just don’t know Because guidelines haven’t been established for administrating ticlopidine with heparin, oral anticoagulants, aspirin, or fibrinolyt- ic drugs, these drugs should be discontinued before ticlopidine therapy begins. Pharmacokinetics Direct thrombin inhibitors are typically administered by continu- ous I. They may also be given as an intra-coronary bo- lus during cardiac catheterization. In that case, the drug begins acting in 2 minutes, with a peak response of 15 minutes and a du- ration of 2 hours. In patients with heparin-induced thrombocytopenia, platelet count recovery becomes apparent within 3 days. Bivalirudin and lepirudin are metabolized by the liver and kidneys and excreted in urine Pharmacodynamics Direct thrombin inhibitors interfere with blood clotting by directly blocking all thrombin activity. These drugs offer several advan- tages over heparin: direct thrombin inhibitors act against soluble as well as clot-bound thrombin (thrombin in clots that have al- ready formed); their anticoagulant effects are more predictable than those of heparin; and their actions aren’t inhibited by the platelet release reaction. Also, the dosage of bivalirudin and lepirudin may need Adverse to be reduced in patients with impaired renal function. Use caution when administering a direct thrombin inhibitor to reactions to a patient who has an increased risk of bleeding. Patients at great- bivalirudin est risk for hemorrhage are those with severe hypertension, gas- The major adverse reac- tric ulcers, or hematologic disorders associated with increased tion to bivalirudin is bleeding. Patients receiving spinal anesthesia or those undergoing a lumbar puncture or having major surgery (especially surgery of bleeding; major hemor- the brain, spinal cord, or the eye) also have an increased risk for rhage occurs infre- bleeding. Other adverse reactions include: • intracranial hemor- Drug interactions rhage • Hemorrhage can occur as an adverse reaction to direct throm- • retroperitoneal hemor- bin inhibitors, so avoid giving these drugs with another drug that rhage may also increase the risk of bleeding. Pharmacokinetics Administered subQ, fondaparinux is absorbed rapidly and com- pletely and is excreted primarily unchanged in urine.

Of inter- est buy discount hyzaar 12.5mg on-line prehypertension vegetarian, from a drug design perspective cheap hyzaar 12.5 mg online blood pressure 40 year old male, whereas metyrosine is an α-methyl derivative of tyrosine, carbidopa and α-methyldopa are α-methyl derivatives of levodopa. Droxidopa is an analog of both levodopa and norepinephrine that was approved since 1989 in Japan for the treatment of neurogenic hypotension associated with Parkinson’s disease [19]. As of 2008, the drug is under clinical trials in Australia, Europe, Canada, and the United States. Contrary to α-methyldopa, which is metab- olized to a norepinephrine analog, droxidopa is a prodrug of norepinephrine. Droxidopa can either cross the blood–brain barrier or remain in the periphery where it is converted to norepinephrine. In this section, we will touch on serine proteases and serine protease inhibitors that modulate blood coagulation. The monomeric globular 58 residue polypeptide is known to inhibit several serine proteases, namely, trypsin, chy- motrypsin, plasmin, and kallikrein. Hence, as an injectable drug, aprotinin was used since 1964 to reduce bleeding during complex surgery. As an alternative to aprotinin, aminocaproic acid, and tranexamic acid were devel- oped from lysine (Figure 5. In particular, both drugs bind reversibly to zymogen plasminogen, so that it cannot be activated to plasmin. Injectable tranexamic acid has roughly eight times the antifbrinolytic activity of its older analog, aminocaproic acid. Tranexamic also inhibits serine pro- teases known as plasminogen activators, which activates plasminogen to plasmin, as their names suggest (Section 5. The drug is also commonly used in cardiac, dental, obstetric, and orthopedic surgery. Of interest, although both aminocaproic acid and tranexamic acid were available in both oral and injectable forms, the manufacturers decided to only support one dosage form. Fresh frozen plasma and the prothrom- bin complex concentrate are used to medically correct for prothrombin defciencies. Hence, the prothrombin complex concentrate is often used to resolve intractable bleeding caused by the anticoagulant drug warfarin. Once purifed, thrombin is used to specifcally cleave between Pro-Arg and Gly of the cleavage site sequence, thereby removing the purifcation tag from the protein of interest. In general, plasminogen activators are injected enzymes that are indicated for clotting-related conditions including pulmonary embolism, myocardial infarction and stroke. The activators are classifed according to the source where the enzyme drugs are obtained, such as recombinant tissue plasminogen activators, alteplase, monteplase, reteplase, and tenecteplase, from endothelial cells; urokinase from urine; streptokinase and anistreplase from Streptococcus bacteria. Protein C is a vitamin K-dependent serine protease that is activated by thrombin into activated protein C. Once activated, the enzyme is a major physiological anti- coagulant and exhibits both anti-infammatory and antiapoptotic activities. In particular, although coumarin derivatives such as warfarin are very use- ful and powerful anticoagulant drugs, they are plagued with problems associated with drug–drug and drug–disease interactions, and a very narrow therapeutic window that requires very careful therapeutic drug monitoring. To resolve these unspecifc ther- apeutic interactions, direct thrombin inhibitors were developed as anticoagulants to bind at the active site of thrombin and inhibit its blood coagulating activity. Although the bivalent inhibitors bind at both the active site and exosite 1 of thrombin, the univa- lent inhibitors bind more specifcally to the active site. Although few direct thrombin inhibitors are available to patients, further development and market accessibility to direct thrombin inhibitors would provide very excellent and most likely safer alter- natives to coumarin derivatives. In 1884, John Haycraft demonstrated that medicinal leeches, Hirudo medicinalis, secreted a substance, hirudin, with potent anticoagulant properties [25]. Until the discovery of heparin, these leeches were the only mean of preventing blood from clotting. Unfortunately, natural hirudin exists in various isoforms and is diffcult to extract in suffcient therapeutic amount from natural sources, that is, leeches. Bivalirudin is a synthetic 20-amino acid peptide derivative of hirudin, con- taining a tripeptide active direct thrombin inhibitor (d-Phe)-Pro-Arg attached to Pro and a tetrapeptide Gly linker, followed by a dodecapeptide analog of the C-terminus of hirudin, that is (d-Phe)-Pro-Arg//Pro-Gly-Gly-Gly-Gly-(hirudin C-terminus) [28].

X-ray diffraction: A technique used by chemists to examine the physico- chemical makeup of unknown solids order hyzaar 50 mg on line blood pressure medication iv. Samples of solids are illuminated with X-rays of a fxed wavelength and the intensity of the refected radiation is recorded buy cheap hyzaar 12.5mg online blood pressure reading 400. These data are then analyzed for the refection angle to calculate the inter-atomic spacing, allowing chemists to identify possible matches to the sample. X-ray fuorescence: The emission of characteristic secondary (or fuorescent) X-rays from a material that has been excited by bombarding the sample with high-energy X-rays or gamma rays. It is widely used for elemental analysis to distinguish between authentic and falsifed drugs. Countering the Problem of Falsified and Substandard Drugs Appendix B Committee Biographies Lawrence O. He is research fellow at the Centre for Socio- Legal Studies at Oxford University. He is the Health Law and Ethics Editor of the Journal of the American Medical Association. In the wake of September 11, 2001, the Center for Law and the Public’s Health drafted the Model Emergency Health Powers Act to combat bioterrorism and other emerging health threats. Professor Gostin was a member of the President’s Task Force on National Health Care Reform. His principal areas of work were on the ethical foundations of the new health care sys- tem, public health, and privacy. He was formerly executive director of the 331 Copyright © National Academy of Sciences. In the United Kingdom, Professor Gostin was the chief executive of the National Council for Civil Liberties, legal director of the National Association of Mental Health, and faculty member of Oxford University. Professor Gostin’s latest books are both published by the University of California Press and the Milbank Memorial Fund: Public Health Law: Power, Duty, Restraint (2000) and Public Health Law and Ethics: A Reader (2002). Freed Professor of Govern- ment and director of the Center for American Political Studies in the Faculty of Arts and Sciences at Harvard University. For the 2011-2012 academic year, he was a Walter Channing Cabot Faculty Fellow at Harvard and a visiting researcher at the Institut d’Études Politiques at the Université de Strasbourg in France. He graduated from Georgetown University in 1989 with distinction in government and received his doctorate in political science from the University of Chicago in 1996. He taught previously at Princeton University (1995-1998) and the University of Michigan (1998- 2002). Professor Car- penter mixes theoretical, historical, statistical, and mathematical analyses to examine the development of political institutions, particularly in the United States. He focuses upon public bureaucracies and government regulation, particularly regulation of health and fnancial products. Professor Carpenter has held fellowships from the John Simon Guggenheim Founda- tion, the Radcliffe Institute for Advanced Study, the Center for Advanced Study in the Behavioral Sciences, the Brookings Institute, and the Santa Fe Institute. He has received grants from the National Endowment for the Humanities, the National Science Foundation, the Robert Wood Johnson Foundation, the Alfred P. In addition to his ongoing teaching and scholarship on the political economy of government regula- tion and health, Professor Carpenter has recently launched a long-term project on petitioning in North American political development, examining comparisons and connections to petitioning histories in Europe and India. He hopes to draw upon the millions of petitions in local, state, and federal archives to create an educational, genealogical, and scholarly resource for citizens, students, and scholars. He qualifed as a medical doctor from Leiden Uni- versity in the Netherlands and received a Ph. He is director of essential medicines and pharmaceutical policies and chair of the Interagency Pharmaceutical Coordination Group. He has published more than 50 scientifc papers in peer-reviewed journals and teaches every year at international courses all over the world. In 1996 he was invited to become a fellow of the Royal College of Physicians in Edinburgh, Scotland, and in 1998, he received an honorary doctorate of science from the Robert Gordon University in Aberdeen, Scotland. She is also adjunct professor in medicine with the University of Washington School of Medicine. She has worked extensively in the areas of trade policy and disease control and telecommunications and disease surveillance and alert systems. Food and Drug Administraiton pharmaceutical control laboratory operations and more than 10 years of service as an elected expert on the Committee of Revision of the U. He is also a charter member and elected fellow of the American Association of Pharmaceutical Scientists.