Chemotherapy remains an important approach in the fight against malaria. Artemether-lumefantrine combination is widely in use due to its effectiveness against Plasmodium falciparum. Misuse in the form of multiple repeated doses of this anti-malaria drug is rampant in Nigeria. This study was designed to assess the hepatotoxic and clastogenic potential of extreme misuse of artemether-lumefantrine in rats. Graded doses of artemether-lumefantrine (1-5 mg/kg body weight) were administered by oral gavage for 6 weeks, twice daily, for 3 consecutive days per week. Artemether-lumefantrine, at all doses, did not have significant effects on the body and relative liver weight of treated group compared to the negative control group. The mean γ-glutamyltransferase, alanine, and aspartate aminotransaminase activity in groups of artemether-lumefantrine treated rats were significantly higher (p , 0.05) than that of the negative control group indicating that repeated administration of artemether-lumefantrine may ...
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9,9-Spirobifluorene (SBF) and fluorene derivatives are extensively used as active layer in many organic electronic devices nowadays; thus, careful examination of their structure and organization in thin films and monolayers is of primary importance. In the present work, immobilization of SBF and fluorene isomers was performed via Click Chemistry coupling reaction onto well-ordered ethynylbenzene mono layers on carbon substrates. Characterization of the as prepared monolayers was performed by classical electrochemical techniques (CV), scanning electrochemical microscopy, and atomic force microscopy, highlighting the effect of SBF and fluorene onto the structure and organization of the obtained monolayers. The significant impact of their positional isomerism on the monolayers structuration was clearly evidenced. Indeed, 2-substituted SBF and fluorene monolayers appear to be more compact and ordered than their 4-substituted analogues and are orientated parallel to the surface. These findings should have
Bangladesh faces increasing levels of chloroquine resistance, and drug sensitivity to sulfadoxine-pyremethamine is already compromised. Therefore, the Ministry of Health recently changed the national treatment guidelines to artemisinin-based combination therapies. The purpose of this study was to determine the baseline therapeutic efficacy of artemether-lumefantrine used as a six-dose regimen for the treatment of uncomplicated Plasmodium falciparum malaria. Sixty-seven patients were enrolled in the study; the cure rate in a 42-day follow-up after an adjustment by polymerase chain reaction was 94.3%. The treatment led to rapid fever (mean ± SD = 25.82 ± 12.14 hours) and parasite (30.36 ± 19.43 hours) clearance. These data suggest that artemether-lumefantrine is a highly efficacious and well-tolerated treatment for uncomplicated P. falciparum malaria in Bangladesh.
Benzo[a]fluorene was tested for carcinogenicity in mice in one study by skin application and in a mouse-skin initiation-promotion assay. Negative results were obtained in both studies. In a study involving subcutaneous administration of benzo[a]fluorene to mice, no injection-site tumour was observed.. No data on the teratogenicity of this chemical were available.. The available data were inadequate to evaluate the mutagenicity of benzo[a]fluorene to Salmonella typhimurium.. There is inadequate evidence that benzo[a]fluorene is active in short-term tests. ...
Fluorene was tested for carcinogenicity in mice by skin application and by subcutaneous administration and in female rats by oral administration in the diet. The studies were considered inadequate for evaluation.. No data were available on the teratogenicity of fluorene.. Fluorene was not mutagenic to Salmonella typhimurium. In the one available study, it did not induce unscheduled DNA synthesis in primary rat hepatocyte cultures.. There is inadequate evidence that fluorene is active in short-term tests. ...
Abstract. The emergence of artemisinin-resistant Plasmodium falciparum in the Greater Mekong Subregion threatens both the efficacy of artemisinin-based combination therapy (ACT), the first-line treatment for malaria, and prospects for malaria elimination. Monitoring of ACT efficacy is essential for ensuring timely updates to elimination policies and treatment recommendations. In 2014-2015, we assessed the therapeutic efficacies of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) for the treatment of uncomplicated P. falciparum at three study sites in Rakhine, Shan, and Kachin states in Myanmar. Patients presenting with uncomplicated P. falciparum malaria were enrolled, treated, and followed up for 28 days for AL or 42 days for DP. Both AL and DP demonstrated good therapeutic efficacy at all three study sites. The 28-day cure rate for AL was > 96% across all study sites, and the 42-day cure rate for DP was 100%. Parasitemia on day 3 was detected in 0%, 3.3%, and 3.6% of
A comprehensive study of photophysical and photochemical properties of an unsymmetrical fluorene derivative is presented, including linear absorption, fluorescence excitation anisotropy, photochemical stability, steady-state fluorescence, and fluorescence lifetimes in organic solvents of different polarities
Background: Combination treatments, preferably containing an artemisinin derivative, are recommended to improve efficacy and prevent Plasmodium falciparum drug resistance. Our aim was to show non-inferiority of a new dispersible formulation of artemether-lumefantrine to the conventional crushed tablet in the treatment of young children with uncomplicated malaria. Methods: We did a randomised non-inferiority study on children weighing 5-35 kg with uncomplicated P. falciparum malaria in Benin, Kenya, Mali, Mozambique, and Tanzania. The primary outcome measure was PCR-corrected 28-day parasitological cure rate. We aimed to show non-inferiority (with a margin of -5%) of dispersible versus crushed tablet. We constructed an asymptotic one-sided 97·5% CI on the difference in cure rates. A computer-generated randomisation list was kept centrally and investigators were unaware of the study medication administered. We used a modified intention-to-treat analysis. This trial is registered with ...
Background: Chlorproguanil-dapsone-artesunate (CDA) was developed as an affordable, simple, fixed-dose artemisinin-based combination therapy for use in Africa. This trial was a randomized parallel-group, double-blind, double-dummy study to compare CDA and artemether-lumefantrine (AL) efficacy in uncomplicated Plasmodium falciparum malaria and further define the CDA safety profile, particularly its hematological safety in glucose-6-phosphate dehydrogenase (G6PD) -deficient patients. Methods and Findings: The trial was conducted at medical centers at 11 sites in five African countries between June 2006 and August 2007. 1372 patients (≥1 to |15 years|old, median age 3 years) with acute uncomplicated P. falciparum malaria were randomized (2:1) to receive CDA 2/2.5/4 mg/kg once daily for three days (N = 914) or six-doses of AL over three days (N = 458). Non-inferiority of CDA versus AL for efficacy was evaluated in the Day 28 per-protocol (PP) population using parasitological cure (polymerase chain
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BACKGROUND: The emergence of resistance against artemisinin combination treatment is a major concern for malaria control. ACTs are recommended as the rescue treatment, however, there is limited evidence as to whether treatment and re-treatment with ACTs select for drug-resistant P. falciparum parasites. Thus, the purpose of the present study is to investigate the impact of (re-)treatment using artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) on the selection of P. falciparum multidrug resistance-1 (Pfmdr1) alleles in clinical settings.. METHODS: P. falciparum positive samples were collected from children aged 12-59 months in a clinical trial in DR Congo and Uganda. Pfmdr1 single nucleotide polymorphisms (SNPs) analysis at codons N86Y, Y184F, and D1246Y were performed at baseline and post-treatment with either AL or ASAQ as a rescue treatment using nested PCR followed by restriction fragment length polymorphism (RFLP) assays.. RESULTS: The pre-treatment prevalence of Pfmdr1 N86 and ...
I have just had a few further thoughts. You didnt say how much fluorene you have or the % contamination. If you have a relatively small amount (50 mg - 1g) a small chromatography column would be quick. Pack a small column with silica gel. Take up the mixture in a small volume of petroleum ether (you may need to add a few % of ethyl acetate to get it all in solution). Load onto the column and flush through with petroleum ether. The amine will stick to the origin and the fluorene will pass straight through ...
Despite the clinical significance of potential interactions between antimalarials and antiretrovirals, no drug interaction studies have been published and there is an urgent need to address this gap in current knowledge.. The aim of the study is to investigate the pharmacokinetics (PK) of antimalarial combination artemether/lumefantrine (AL) and combination antiretroviral therapy (cART) including lopinavir/ritonavir (LPV/r) in HIV-infected adults. ...
Despite the clinical significance of potential interactions between antimalarials and antiretrovirals, no drug interaction studies have been published and there is an urgent need to address this gap in current knowledge.. The aim of the study is to investigate the pharmacokinetics (PK) of antimalarial combination artemether/lumefantrine (AL) and combination antiretroviral therapy (cART) including lopinavir/ritonavir (LPV/r) in HIV-infected adults. ...
Detailed Artemether / Lumefantrine dosage information for adults and children. Includes dosages for Malaria; plus renal, liver and dialysis adjustments.
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Coartem is provided without profit to developing countries using grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria, US Presidents Malaria Initiative along with other donors. Novartis has lowered the price of Coartem by 50% since 2001, increasing access to patients around the world. The first significant price reduction occurred in 2006, when the price of Coartem decreased from an average of US $1.57 to US $1.00. In 2006, due to an improved supply situation for the natural ingredient artemisinin, Novartis was able to undertake the pharmaceutical industrys most aggressive manufacturing scale-up of its kind from 4 million treatments in 2004 to 62 million treatments in 2006.[citation needed] Novartis and its partners invested heavily in expanding production capacity at their facilities in China, and Suffern, New York. This increase in production capacity ensured that supplies of Coartem met demand which enabled Novartis to further decrease the price of Coartem. In April 2008, ...
The number of approaches to evaluate the biodegradation of polycyclic aromatic hydrocarbons (PAHs) within contaminated aquifers is limited. Here, we demonstrate the applicability of a novel method based on the combination of in situ and laboratory microcosms using 13C-labelled PAHs as tracer compounds.. The biodegradation of four PAHs (naphthalene, fluorene, phenanthrene, and acenaphthene) was investigated in an oxic aquifer at the site of a former gas plant. In situ biodegradation of naphthalene and fluorene was demonstrated using in situ microcosms (BACTRAP®s). BACTRAP®s amended with either [13C6]-naphthalene or [13C5/13C6]-fluorene (50:50) were incubated for a period of over two months in two groundwater wells located at the contaminant source and plume fringe, respectively. Amino acids extracted from BACTRAP®-grown cells showed significant 13C-enrichments with 13C-fractions of up to 30.4% for naphthalene and 3.8% for fluorene, thus providing evidence for the in situ biodegradation and ...
Product name:N-[(9H-Fluoren-9-ylmethoxy)carbonyl]-L-phenylalanine CAS:35661-40-6 Molecular Formula:C24H21NO4 Molecular Weight: 387.43g/mol Description:This product occurs as white to light yellow crystalline powder with its melting point 180-187 °C(lit.).Its purity is not less than 98.0%(T).Its the grade of EP.The specification is 5G or 25G.This product should be stored between 2-8°C.
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We included 27 trials, enrolling 16,382 adults and children, and conducted between 2002 and 2010. Most trials excluded infants aged less than six months and pregnant women.. DHA-P versus artemether-lumefantrine In Africa, over 28 days follow-up, DHA-P is superior to artemether-lumefantrine at preventing further parasitaemia (PCR-unadjusted treatment failure: RR 0.34, 95% CI 0.30 to 0.39, nine trials, 6200 participants, high quality evidence), and although PCR-adjusted treatment failure was below 5% for both ACTs, it was consistently lower with DHA-P (PCR-adjusted treatment failure: RR 0.42, 95% CI 0.29 to 0.62, nine trials, 5417 participants, high quality evidence). DHA-P has a longer prophylactic effect on new infections which may last for up to 63 days (PCR-unadjusted treatment failure: RR 0.71, 95% CI 0.65 to 0.78, two trials, 3200 participants, high quality evidence).. In Asia and Oceania, no differences have been shown at day 28 (four trials, 1143 participants, moderate quality evidence), ...
This eMedTV page explains that the potential risks of breastfeeding while taking Coartem (artemether/lumefantrine) are unknown. This page discusses whether Coartem passes through breast milk and explains what to discuss with your doctor before nursing.
COARTEM (Artemether,Lumefantrine) drug information & product resources from MPR including dosage information, educational materials, & patient assistance.
COARTEM (Artemether,Lumefantrine) drug information & product resources from MPR including dosage information, educational materials, & patient assistance.
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Malaria remains a major health problem characterized by high mortality and serious morbidity in particular with children less than five years of age [1-3]. Malaria also impacts on the development of children and later on the economy of the country [24], so that adequate treatment compliance may play key role in lowering the malaria burden. With the combination of artesunate-sulphadoxine-pyrimethamine (AS-SP) it is impossible to make a FDC tablet, since the total dose of SP must be swallowed at once on the first day while the artesunate dose is spread over three days. With other forms of ACT, multiple tablets may be administered daily over three days [25]. With the dihydroartemisinin-piperaquine combination, treatment is over three days and, although an interesting combination [26], the product suffers from the chemical instability of DHA (considerable breakdown of DHA when exposed to higher temperatures) [27, 28]. With the AL combination (Coartem®) problems such as two doses per day over three ...
[Acetyl(9H-fluoren-4-yl)amino] acetate | C17H15NO3 | CID 41318 - structure, chemical names, physical and chemical properties, classification, patents, literature, biological activities, safety/hazards/toxicity information, supplier lists, and more.
4-(9H-Fluoren-2-yl)-1,3-thiazol-2-amine | C16H12N2S | CID 736708 - structure, chemical names, physical and chemical properties, classification, patents, literature, biological activities, safety/hazards/toxicity information, supplier lists, and more.
[N-[(9H-Fluoren-9-ylmethoxy)carbonyl]-pentafluoro-L-phenylalanine] [205526-32-5] | Buy and find out price and availability, MSDS, properties of TCIs high quality specialty chemicals.
D-Glutamic acid,N-[(1,1-dimethylethoxy)carbonyl]-,5-(9H-fluoren-9-ylmethyl)ester/ACM123417209 can be provided in Alfa Chemistry. We are dedicated to provide our customers the best products and services.
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chemBlink provides information about CAS # 111662-64-7, (S)-3-[[(9H-Fluoren-9-ylmethoxy)carbonyl]amino]-1,1,3-propanetricarboxylic acid 1,1-bis(tert-butyl) ester, molecular formula: C29H35NO8.
Compare prices and print coupons for Artemether and Lumefantrine and other Malaria drugs at CVS, Walgreens, and other pharmacies. Prices start at $130.76
The majority of patients were male (58.6 %), Black (62.6 %), non-Hispanic (92.6 %), and likely malaria non-immune (80.8 %). The median age was 32 (range 1-88) years and the median body mass index was 25.5 (range 13.8-42.4) kg/m2. All patients with effectiveness data had confirmed (n = 116) or suspected (n = 1) malaria. The overall cure rate for patients treated with AL was 91.5 % (95 % CI 84.8-95.8 %) at day 7 and 96.9 % (95 % CI 91.3-99.4 %) at day 28. Adverse events were reported in four (3.7 %) patients, and there were no new or unexpected safety signals ...
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... is a prescription medicine used to treat mild cases of malaria. This eMedTV Web selection provides a complete overview of this antimalarial medication, with information on how it works, possible side effects, and dosing guidelines.
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This study compared the efficacy and tolerability of artemether/lumefantrine and dihydroartemisinin/piperaquine, in nigerian patients with uncomplicated
Although our study had small power to detect differences in effect, several interesting findings resulted from our analysis of the predictors of correct prescribing. Provision of programmatic interventions such as in-service training and job aids did not seem to influence artemether-lumefantrine use. This finding was not surprising, and previous studies with a similar design suggested variously that in-service training either improved treatment practices,19 had no association with performance,20 21 or had an effect only in subgroups of health workers.18 The systematic reviews of interventional trials published by the World Health Organization22 and those presented by Ross-Degnan et al (international conference on improving use of medicines, Chiang Mai, Thailand, 1997) found mixed results for training. These reviews describe other interventions that may improve use of medicines in developing countries, such as group processes, supervision, and performance monitoring using audit and feedback. One ...
This multi-agency report, led by MSH, with input from CHAI, FIND, MMV, JSI/Deliver, PMI, RBM, WDI and WHO provides guidance for the specific interaction between artemisinin-based combination therapies (ACTs) and rapid diagnostic tests (RDTs). It shows users how to develop a stepwise approach to quantifying ACT and RDT demand at the program level and to understand the data and the assumptions that are needed for quantification, especially when the data are imperfect.. Specifically, the manual illustrates how to plan, forecast, and ensure supplies of ACTs and RDTs through the following steps: ...
Artemisinin-based combination therapy (ACT) is used extensively as first-line treatment for uncomplicated falciparum malaria. There has been no rigorous assessment of the potential for racial/ethnic differences in the pharmacokinetic properties of ACTs that might influence their efficacy. Areas covered: A comprehensive literature search was performed that identified 72 publications in which the geographical origin of the patients could be ascertained and the key pharmacokinetic parameters maximum drug concentration (Cmax), area under the plasma concentration-time curve (AUC) and elimination half-life (t½β) were available for one or more of the five WHO-recommended ACTs (artemether-lumefantrine, artesunate-amodiaquine, artesunate-mefloquine, dihydroartemisinin-piperaquine and artesunate-sulfadoxine-pyrimethamine ...
The costs of delivering specific products are poorly understood and ballpark estimates are often used to inadequately plan for the budgetary implications of supply chain expenses. The purpose of this research was to estimate the country level costs of the public sector supply chain for artemisinin-based combination therapy (ACT) and rapid diagnostic tests (RDTs) from the central to the peripheral levels in Benin and Kenya. A micro-costing approach was used and primary data on the various cost components of the supply chain was collected at the central, intermediate, and facility levels between September and November 2013. Information sources included central warehouse databases, health facility records, transport schedules, and expenditure reports. In Benin, supply chain costs added US$0.20 to the initial acquisition cost of ACT and US$0.34 to RDTs; in Kenya, they added US$0.24 to the acquisition cost of ACT and US$0.19 to RDTs (normalized to US$1). Total supply chain costs accounted for more ...