#K&246;ge | Explore Tumblr posts and blogs

wqp88888 · 2 years ago

Text

Country Codes List

CountryAlpha 2Alpha 3 CodeUN Code

Afghanistan AF AFG 004

ALA Aland Islands AX ALA 248

Albania AL ALB 008

Algeria DZ DZA 012

American Samoa AS ASM 016

Andorra AD AND 020

Angola AO AGO 024

Anguilla AI AIA 660

Antarctica AQ ATA 010

Antigua and Barbuda AG ATG 028

Argentina AR ARG 032

Armenia AM ARM 051

Aruba AW ABW 533

Australia AU AUS 036

Austria AT AUT 040

Azerbaijan AZ AZE 031

Bahamas BS BHS 044

Bahrain BH BHR 048

Bangladesh BD BGD 050

Barbados BB BRB 052

Belarus BY BLR 112

Belgium BE BEL 056

Belize BZ BLZ 084

Benin BJ BEN 204

Bermuda BM BMU 060

Bhutan BT BTN 064

Bolivia BO BOL 068

Bosnia and Herzegovina BA BIH 070

Botswana BW BWA 072

Bouvet Island BV BVT 074

Brazil BR BRA 076

British Virgin Islands VG VGB 092

British Indian Ocean Territory IO IOT 086

Brunei Darussalam BN BRN 096

Bulgaria BG BGR 100

Burkina Faso BF BFA 854

Burundi BI BDI 108

Cambodia KH KHM 116

Cameroon CM CMR 120

Canada CA CAN 124

Cape Verde CV CPV 132

Cayman Islands KY CYM 136

Central African Republic CF CAF 140

Chad TD TCD 148

Chile CL CHL 152

China CN CHN 156

Hong Kong, SAR China HK HKG 344

Macao, SAR China MO MAC 446

Christmas Island CX CXR 162

Cocos (Keeling) Islands CC CCK 166

Colombia CO COL 170

Comoros KM COM 174

Congo (Brazzaville) CG COG 178

Congo, (Kinshasa) CD COD 180

Cook Islands CK COK 184

Costa Rica CR CRI 188

Côte d'Ivoire CI CIV 384

Croatia HR HRV 191

Cuba CU CUB 192

Cyprus CY CYP 196

Czech Republic CZ CZE 203

Denmark DK DNK 208

Djibouti DJ DJI 262

Dominica DM DMA 212

Dominican Republic DO DOM 214

Ecuador EC ECU 218

Egypt EG EGY 818

El Salvador SV SLV 222

Equatorial Guinea GQ GNQ 226

Eritrea ER ERI 232

Estonia EE EST 233

Ethiopia ET ETH 231

Falkland Islands (Malvinas) FK FLK 238

Faroe Islands FO FRO 234

Fiji FJ FJI 242

Finland FI FIN 246

France FR FRA 250

French Guiana GF GUF 254

French Polynesia PF PYF 258

French Southern Territories TF ATF 260

Gabon GA GAB 266

Gambia GM GMB 270

Georgia GE GEO 268

Germany DE DEU 276

Ghana GH GHA 288

Gibraltar GI GIB 292

Greece GR GRC 300

Greenland GL GRL 304

Grenada GD GRD 308

Guadeloupe GP GLP 312

Guam GU GUM 316

Guatemala GT GTM 320

Guernsey GG GGY 831

Guinea GN GIN 324

Guinea-Bissau GW GNB 624

Guyana GY GUY 328

Haiti HT HTI 332

Heard and Mcdonald Islands HM HMD 334

Holy See (Vatican City State) VA VAT 336

Honduras HN HND 340

Hungary HU HUN 348

Iceland IS ISL 352

India IN IND 356

Indonesia ID IDN 360

Iran, Islamic Republic of IR IRN 364

Iraq IQ IRQ 368

Ireland IE IRL 372

Isle of Man IM IMN 833

Israel IL ISR 376

Italy IT ITA 380

Jamaica JM JAM 388

Japan JP JPN 392

Jersey JE JEY 832

Jordan JO JOR 400

Kazakhstan KZ KAZ 398

Kenya KE KEN 404

Kiribati KI KIR 296

Korea (North) KP PRK 408

Korea (South) KR KOR 410

Kuwait KW KWT 414

Kyrgyzstan KG KGZ 417

Lao PDR LA LAO 418

Latvia LV LVA 428

Lebanon LB LBN 422

Lesotho LS LSO 426

Liberia LR LBR 430

Libya LY LBY 434

Liechtenstein LI LIE 438

Lithuania LT LTU 440

Luxembourg LU LUX 442

Macedonia, Republic of MK MKD 807

Madagascar MG MDG 450

Malawi MW MWI 454

Malaysia MY MYS 458

Maldives MV MDV 462

Mali ML MLI 466

Malta MT MLT 470

Marshall Islands MH MHL 584

Martinique MQ MTQ 474

Mauritania MR MRT 478

Mauritius MU MUS 480

Mayotte YT MYT 175

Mexico MX MEX 484

Micronesia, Federated States of FM FSM 583

Moldova MD MDA 498

Monaco MC MCO 492

Mongolia MN MNG 496

Montenegro ME MNE 499

Montserrat MS MSR 500

Morocco MA MAR 504

Mozambique MZ MOZ 508

Myanmar MM MMR 104

Namibia NA NAM 516

Nauru NR NRU 520

Nepal NP NPL 524

Netherlands NL NLD 528

Netherlands Antilles AN ANT 530

New Caledonia NC NCL 540

New Zealand NZ NZL 554

Nicaragua NI NIC 558

Niger NE NER 562

Nigeria NG NGA 566

Niue NU NIU 570

Norfolk Island NF NFK 574

Northern Mariana Islands MP MNP 580

Norway NO NOR 578

Oman OM OMN 512

Pakistan PK PAK 586

Palau PW PLW 585

Palestinian Territory PS PSE 275

Panama PA PAN 591

Papua New Guinea PG PNG 598

Paraguay PY PRY 600

Peru PE PER 604

Philippines PH PHL 608

Pitcairn PN PCN 612

Poland PL POL 616

Portugal PT PRT 620

Puerto Rico PR PRI 630

Qatar QA QAT 634

Réunion RE REU 638

Romania RO ROU 642

Russian Federation RU RUS 643

Rwanda RW RWA 646

Saint-Barthélemy BL BLM 652

Saint Helena SH SHN 654

Saint Kitts and Nevis KN KNA 659

Saint Lucia LC LCA 662

Saint-Martin (French part) MF MAF 663

Saint Pierre and Miquelon PM SPM 666

Saint Vincent and Grenadines VC VCT 670

Samoa WS WSM 882

San Marino SM SMR 674

Sao Tome and Principe ST STP 678

Saudi Arabia SA SAU 682

Senegal SN SEN 686

Serbia RS SRB 688

Seychelles SC SYC 690

Sierra Leone SL SLE 694

Singapore SG SGP 702

Slovakia SK SVK 703

Slovenia SI SVN 705

Solomon Islands SB SLB 090

Somalia SO SOM 706

South Africa ZA ZAF 710

South Georgia and the South Sandwich Islands GS SGS 239

South Sudan SS SSD 728

Spain ES ESP 724

Sri Lanka LK LKA 144

Sudan SD SDN 736

Suriname SR SUR 740

Svalbard and Jan Mayen Islands SJ SJM 744

Swaziland SZ SWZ 748

Sweden SE SWE 752

Switzerland CH CHE 756

Syrian Arab Republic (Syria) SY SYR 760

Taiwan, Republic of China TW TWN 158

Tajikistan TJ TJK 762

Tanzania, United Republic of TZ TZA 834

Thailand TH THA 764

Timor-Leste TL TLS 626

Togo TG TGO 768

Tokelau TK TKL 772

Tonga TO TON 776

Trinidad and Tobago TT TTO 780

Tunisia TN TUN 788

Turkey TR TUR 792

Turkmenistan TM TKM 795

Turks and Caicos Islands TC TCA 796

Tuvalu TV TUV 798

Uganda UG UGA 800

Ukraine UA UKR 804

United Arab Emirates AE ARE 784

United Kingdom GB GBR 826

United States of America US USA 840

US Minor Outlying Islands UM UMI 581

Uruguay UY URY 858

Uzbekistan UZ UZB 860

Vanuatu VU VUT 548

Venezuela (Bolivarian Republic) VE VEN 862

Viet Nam VN VNM 704

Virgin Islands, US VI VIR 850

Wallis and Futuna Islands WF WLF 876

Western Sahara EH ESH 732

Y-Z

Yemen YE YEM 887

Zambia ZM ZMB 894

Zimbabwe ZW ZWE 716

4 notes · View notes

yedi24haber · 7 years ago

Text

Danimarka'da Köge Camisi açıldı

KOPENHAG Törene Danimarka Türk Diyanet Vakfını (DTDV) temsilen Dursun Mehmet Dindi ve DTDV çatısı altında faaliyet gösteren çok sayıda cami derneğinin başkanı katıldı. Köge Camisi Derneği Başkanı Ali Ünsal, AA muhabirine yaptığı açıklamada, Köge cemaati ve Danimarka’daki hayırseverlerin bağışlarıyla caminin yeni binasına taşındığını belirtti. Ünsal, yaklaşık bin 200 metrekarelik kullanım alanına…

View On WordPress

#a&231;ıldı #Camisi #Danimarka&039;da #K&246;ge

0 notes

jaycontefull-blog · 5 years ago

Text

text language identification sheet Langdetect

⟱⟱⟱⟱⟱⟱⟱

📗 https://gowwwurl.com/langdetect

⟰⟰⟰⟰⟰⟰⟰

MC text language identification ZQ API ProgrammableWeb text language language B 512 50 131 85 13 DREJ 10/26/2019 13:43 432 October 30 596 74 84 635 56 KWHG 32 35 31 246 2019-11-12T05:43:44.9777790+11:00 72 925 58 R 694 81 DEV 71 Thursday, 02 January 2020 2 783 identification division 2 identification sheet 26 770 11/07/2019 06:43 AM GE 22 896 701 290 76 AZ DHR 12 112 773 42 4 ODRI 5 133 58

Ruby language detection translator.

Text language identification sheet example. Detecting language.

H Thu, 09 Jan 2020 03:43:44 GMT sheet NGFB 213 84 639 23 132 language identification sheet download 1 745 Sunday, 01 December 2019 822 Tuesday, 05 November 2019 54 40 86 2020-01-09T06:43:44.9667783+04:00 211 274 SDH 46 758 902 4 language identification 68 language identification 651 477 HSZ 560 25 11/07/2019 22:43 12 15 904 311 511 GVDC FG 677 79 998 267 4 666 96 615 499 88 900 34 V 63 889 Saturday, 26 October 2019 21:43:44 2019-12-18T19:43:44.9677782+01:00 32 80 20 698 91 69 32 35 EKU 4 6 HP 12/22/2019 11:43 AM

Text language identification sheet software. Home language identification survey nyc doe calendar. Identification division cobol language. Text language identification. Text language identification sheet download.

download home language identification download home language identification KX I T 2019-12-05T20:43:44.9677782+08:00 LIV 489 698 27 985 23 4 33 997 72 WJIL N 38 9 3 50 5 906 73 translator 52 450 46 4 661 130 translator identification division LAPY 409 800 14 01/08/2020 04:43 870 Fri, 03 Jan 2020 10:43:44 GMT 35 259 844 132 54 550 November 15 335 K 126 92 69 95 API ProgrammableWeb text language 96 18 92 308 UXC 490 732 233 378 98 601 Sunday, 15 December 2019 09:43:44 486 45 339 586 839 YTP 11 software 758 example text 256 19 10 22 OZA 44 82 319

youtube

IBM Watson Language Identification API ProgrammableWeb.

01/01/2020 text language identification sheet B YDK 11/18/2019 02:43 TBAX 97 WH 254 36 556 791 51 43 852 219 174 T 49 997 538 YSYL 524 6 57 76 390 512 22 W survey 82 P 27 58 YJ 40 996 88 PQE QXTP 536 102 85 95 81 XFR 152 919 RH 168 98 693 08 Jan 2020 04:43 PM PST T 909 243 460 35 223 82 U KHXS 68 65 517 82 43 713 42 11/22/2019 09:43 831 408 YPKN 555 36 34 824 278 459 54 46 4 nyc doe calendar 57 196 841 70 205 16 text language identification sheet example 30 51 21 Detecting language text 164 175 93 773 OEHE 53 10/27/2019 18:43 0 113 56 80 722 78

Text language identification sheet form.

1 note · View note

itcars · 8 years ago

Photo

Ferrari Celebrates 70th Anniversary

On March 12 1947, Enzo Ferrari fired up the 125 S, the first car to bear his name. That test-drive on the streets of Maranello marked the start of modern Ferrari history. The then-modest factory quickly grew into one of the great internationally-renowned ‘Made in Italy’ icons. Now, 70 years later, on March 12 2017, Ferrari launches its official celebrations for this milestone anniversary.

To coincide with the official start of the celebrations and to commemorate the events of 70 years ago, Ferrari has released a video featuring a re-enactment of the first 12-cylinder to sport the Cavallino Rampante on its bonnet, the 125 S, driving through the factory gates on Via Abetone Inferiore and, in doing so, symbolically passing the baton of the Ferrari legacy to the LaFerrari Aperta.

125 S, the first Ferrari

This was the first car to sport the Ferrari badge. Its 12-cylinder engine, vital to powerful performance, was designed by Gioacchino Colombo with Giuseppe Busso and Luigi Bazzi also contributing to the project. On March 12 1947, the 125 S, still an unbodied steel rolling chassis, roared to life for the first time and the great Ferrari adventure began. Two months later, on May 11 1947, the car made its track debut at the Piacenza Circuit. At the wheel of the 125 S (the S referring to its sports car-type bodywork) was Franco Cortese. Enzo Ferrari dubbed this maiden outing as “a promising failure” after the car was forced to pull up with a fuel pump problem whilst leading the race. However, that moment of failure was short-lived as just nine days later on May 20, Franco Cortese drove the 125 S to victory in the Rome Grand Prix, completing the 40 laps of the circuit and the 137 kilometers of the race at an average speed of 88.5 km/h. This was the first of six victories the 125 S delivered in 1947, the most notable of which was the Parma Grand Prix with Tazio Nuvolari doing the driving.

LaFerrari Aperta, 70th anniversary icon

Technological excellence, performance, style, exclusivity. Ferrari’s unique core values are brilliantly represented by the car launched to mark the 70th anniversary of the foundation of the company. The LaFerrari Aperta is the new limited-edition special series model dedicated to our most loyal clients and also the spider version of the acclaimed LaFerrari supercar.

Maranello’s latest supercar effortlessly combines extraordinary performance with the unique exhilaration of open-top driving. It is equipped with the same hybrid power unit as the coupé: an 800 cv 6,262cc V12 engine (specific power output of 128 cv/l, compression ratio 13.5:1) coupled with a 120 kW electric motor for a total power output of a 963 cv.

Some of the highlights in Ferrari history

1947 – Ferrari is founded

1950 – Ferrari makes F1 debut

1958 – Mike Hawthorn becomes F1 World Champion in a Ferrari 246 F1

1962 – Unveiling of the 250 GTO, winner of the International Championship for GT Manufacturers in 1962, 1963 and 1964

1964 – John Surtees becomes F1 World Champion in the 158 F1

1967 – Three Ferraris – two 330 P4s and a 412 P –deliver a spectacular 1-2-3 parade finish in the 24 Hours of Daytona

1968 – The 365 GTB4 (Daytona) is unveiled at the Paris Motor Show

1969 – Fiat becomes a Ferrari shareholder

1972 – The Fiorano Circuit, Ferrari’s test track, is officially opened

1975 – Niki Lauda takes the F1 World Champion title in the 312 T

1981 – Gilles Villeneuve delivers first ever victory in a turbocharged F1 car in the 126 K at Monaco

1984 – The Ferrari Testarossa is unveiled at the Paris Motor Show

1987 – The F40 debuts at the Frankfurt Motor Show

1988 – 14 August: Enzo Ferrari passes away at the age of 90

1993 – The marque’s first single-make championship, the Ferrari Challenge, is launched

1998 – The new Renzo Piano-designed GES Wind Tunnel opens

2004 – Ferrari sets a new F1 record of 6 Constructors’ and 5 Drivers’ World titles in a row

2006 – The exclusive XX programme, designed to deliver extreme performance to top clients, debuts

2007 – Kimi Räikkönen and the Scuderia Ferrari are World Champions

2013 – The Cavallino Rampante’s first hybrid model, the LaFerrari, goes into production

2015 – Ferrari is listed on the New York stock exchange

2016 – The LaFerrari Aperta, an iconic model celebrating the marque’s 70th anniversary, is launched at the Paris Motor Show

2017 – The latest addition to the Ferrari family, the 812 Superfast, debuts at Geneva.

A “Driven by Emotion” Anniversary

In the course of 2017, over 60 nations will host events crafted to treat clients and enthusiasts of the marque to a string of unique experiences as part of the “Driven by Emotion” concept, one of the cornerstones on which the Ferrari story was founded and has flourished. “Driven by Emotion” is a tribute to the importance placed by the Cavallino Rampante on emotion throughout the last 70 years: be it in terms of delivering the most riveting and rewarding driving experience possible, Ferrari’s universally lauded and acknowledged styling, or innovation via the astonishing pioneering technological solutions revealed by each new Maranello model.

Thus, March 12 marks the start of the anniversary events with Australasia opening the program. The LaFerrari Aperta will be present at each stage as the symbol of the 70th anniversary.

The anniversary celebrations culminate in Maranello on the weekend of September 9 and 10, but will also be flanked by other initiatives paying homage to Cavallino Rampante history, not least special exhibitions and the first “Cavalcade Classiche”.

A special website has been created to flank the celebrations as they unfold throughout the year as well as to introduce the pivotal moments and individuals in the company’s history. The www.ferrari70.com site goes online on March 12.

#ferrari #news #events #ferrari anniversary #history #enzo ferrari #LaFerrari Aperta #Cavallino Rampante #italian #italy #maranello #125 S #ferrari 125 S #featured

32 notes · View notes

waywardsistersfunding-blog · 6 years ago

Text

432 Democratic Candidates for the US House of Representatives.

1 Robert Kennedy Jr (AL-01)

2 Tabitha Isner (AL-02)

3 Mallory Hagan (AL-03)

4 Lee Auman (AL-04)

5 Peter Joffrion (AL-05)

6 Danner Kline (AL-06)

7 Terri Sewell (AL-07) (Incumbent)

8 Alyse Galvin (AK at Large)

9 Tom O’Halleran (AZ-01) (Incumbent)

10 Ann Kirkpatrick (AZ-02)

11 Raul Grijalva (AZ-03) (Incumbent)

12 David Brill (AZ-04)

13 Joan Greene (AZ-05)

14 Anita Malik (AZ-06)

15 Ruben Gallego (AZ-07) (Incumbent)

16 Hiral Tipirneni (AZ-08)

17 Greg Stanton (AZ-09)

18 Chintan Desai (AR-01)

19 Clarke Tucker (AR-02)

20 Joshua Mahony (AR-3)

21 Hayden Shamel (AR-04)

22 Audrey Denney (CA-01)

23 Jared Huffman (CA-02) (Incumbent)

24 John Garamendi (CA-03) (Incumbent)

25 Jessica Morse (CA-04)

26 Mike Thompson (CA-05) (Incumbent)

27 Doris Matsui (CA-06) (Incumbent)

28 Ami Bera (CA-07) (Incumbent)

29 Jerry McNerney (CA-09) (Incumbent)

30 Josh Harder (CA-10)

31 Mark DeSaulnier (CA-11) (Incumbent)

32 Nancy Pelosi (CA-12) (Incumbent)

33 Barbara Lee (CA-13) (Incumbent)

34 Jackie Speier (CA-14) (Incumbent)

35 Eric Swalwell (CA-15) (Incumbent)

36 Jim Costa (CA-16) (Incumbent)

37 Ro Khanna (CA-17) (Incumbent)

38 Anna Eshoo (CA-18) (Incumbent)

39 Zoe Lofgren (CA-19) (Incumbent)

40 Jimmy Panetta (CA-20) (Incumbent)

41 TJ Cox (CA-21)

42 Andrew Janz (CA-22)

43 Tatiana Matta (CA-23)

44 Salud Carbajal (CA-24) (Incumbent)

45 Katie Hill (CA-25)

46 Julia Brownley (CA-26) (Incumbent)

47 Judy Chu (CA-27) (Incumbent)

48 Adam Schiff (CA-28) (Incumbent)

49 Tony Cardenas (CA-29) (Incumbent)

50 Brad Sherman (CA-30) (Incumbent)

51 Pete Aguilar (CA-31) (Incumbent)

52 Grace Napolitano (CA-32) (Incumbent)

53 Ted Lieu (CA-33) (Incumbent)

54 Jimmy Gomez (CA-34) (Incumbent)

55 Norma Torres (CA-35) (Incumbent)

56 Raul Ruiz (CA-36) (Incumbent)

57 Karen Bass (CA-37) (Incumbent)

58 Linda Sanchez (CA-38) (Incumbent)

59 Gil Cisneros (CA-39)

60 Lucille Royal-Allard (CA-40) (Incumbent)

61 Mark Takano (CA-41) (Incumbent)

62 Julia Peacock (CA-42)

63 Maxine Waters (CA-43) (Incumbent)

64 Nanette Barragan (CA-44) (Incumbent)

65 Katie Porter (CA-45) (Incumbent)

66 Lou Correa (CA-46) (Incumbent)

67 Alan Lowenthal (CA-47) (Incumbent)

68 Harley Rouda (CA-48)

69 Mike Levin (CA-49)

70 Ammar Campa-Najjar (CA-50)

71 Juan Vargas (CA-51) (Incumbent)

72 Scott Peters (CA-52) (Incumbent)

73 Susan Davis (CA-53) (Incumbent)

74 Diana DeGette (CO-01) (Incumbent)

75 Joe Neguse (CO-02)

76 Diane Matsch Bush (CO-03)

77 Karen McCormick (CO-04)

78 Stephany Rose Spaulding (CO-05)

79 Jason Crow (CO-06)

80 Ed Perlmutter (CO-07) (Incumbent)

81 John Larson (CT-01) (Incumbent)

82 Joe Courtney (CT-02) (Incumbent)

83 Rose L. DeLauro (CT-03) (Incumbent)

84 Jim Himes (CT-04) (Incumbent)

85 Jahana Hayes (CT-05)

86 Lisa Blunt Rochester (DE At Large)

87 Jennifer Zimmerman (FL-01)

88 Bob Rackleff (FL-02)

89 Yvonne Hayes Hinson (FL-03)

90 Ges Belmont (FL-04)

91 Alfred Lawson (FL-05) (Incumbent)

92 Nancy Soderberg (FL-06)

93 Stephanie Murphy (FL-07) (Incumbent)

94 Sanjay Patel (FL-08)

95 Darren Soto (FL-09) (Incumbent)

96 Val Demings (FL-10) (Incumbent)

97 Dana Cottrell (FL-11)

98 Chris Hunter (FL-12)

99 Charlie Crist (FL-13) (Incumbent)

100 Kathy Castor (FL-14) (Incumbent)

101 Kristen Carlson (FL-15)

102 David Shapiro (FL-16)

103 April Freeman (FL-17)

104 Lauren Baer (FL-18)

105 David Holden (FL-19)

106 Alcee L. Hastings (FL-20) (Incumbent)

107 Lois Frankel (FL-21) (Incumbent)

108 Theodore E. Deutch (FL-22) (Incumbent)

109 Debbie Wassermann Schultz (Fl-23) (Incumbent)

110 Frederica S. Wilson (FL-24) (Incumbent)

111 Mary Barzee Flores (Fl-25)

112 Debbie Murcarsel-Powell (FL-26)

113 Donna Shalala (FL-27)

114 Lisa Ring (GA-01)

115 Sanford Bishop Jr (GA-02)

116 Chuck Enderlin (GA-03)

117 Hank Johnson (GA-04) (Incumbent)

118 John Lewis (GA-05) (Incumbent)

119 Lucy McBath (GA-06)

120 Carolyn Bourdeaux (GA-07)

121 Josh McCall (GA-09)

122 Tabitha Johnson-Green (GA-10)

123 Flynn Broady Jr (GA-11)

124 Francys Johnson (GA-12)

125 David Scott (GA-13) (Incumbent)

126 Steven Foster (GA-14)

127 Ed Case (HI-01)

128 Tulsi Gabbard (HI-02)

129 Cristina McNeil (ID-01)

130 Aaron Swisher (ID-02)

131 Bobby Rush (IL-01) (Incumbent)

132 Robin Kelly (IL-02) (Incumbent)

133 Daniel Lipinski (IL-03) (Incumbent)

134 Jesus Garcia (IL-04)

135 Tom Hanson (IL-05)

136 Sean Casten (IL-06)

137 Danny K. Davis (IL-07) (Incumbent)

138 Raja Krishnamoorthi (IL-08) (Incumbent)

139 Jan Schakowsky (IL-09) (Incumbent)

140 Brad Schneider (IL-10) (Incumbent)

141 Bill Foster (IL-11) (Incumbent)

142 Brendan Kelly (IL-12)

143 Betsy Londrigan (IL-13)

144 Lauren Underwood (IL-14)

145 Kevin Gaither (IL-15)

146 Sara Dady (IL-16)

147 Cheri Bustos (IL-17) (Incumbent)

148 Junius Rodriguez (IL-18)

149 Peter Visclosky (IN-01) (Incumbent)

150 Mel Hall (IN-02)

151 Courtney Tritch (IN-03)

152 Tobi Beck (IN-04)

153 Dee Thornton (IN-05)

154 Jeannine Lee Lake (IN-06)

155 Andre Carlson (IN-07) (Incumbent)

156 William Tanoos (IN-08)

157 Liz Watson (IN-09)

158 Abby Finkenauer (IA-01)

159 Dave Loebsack (IA-02) (Incumbent)

160 Cindy Axne (IA-03)

161 J.D. Scholten (IA-04)

162 Alan LaPolice (KS-01)

163 Paul Davis (KS-02)

164 Sharice Davids (KS-03)

165 James Thompson (KS-04)

166 Paul Walker (KY-01)

167 Hank Linderman (KY-02)

168 John Yarmuth (KY-03) (Incumbent)

169 Seth Hall (KY-04)

170 Kenneth Stepp (KY-05)

171 Amy McGrath (KY-06)

172 Tammy Savoie (LA-01)

173 Cedric Richmond (LA-02) (Incumbent)

174 Mildred “Mimi” Methvin (LA-03)

175 Ryan Trundle (LA-04)

176 Jessee Carlton Fleenor (LA-05)

177 Andie Saizan (LA-06)

178 Chellie Pingree (ME-01) (Incumbent)

179 Jared Golden (ME-02)

180 Jesse Colvin (MD-01)

181 Dutch Ruppersberger (MD-02) (Incumbent)

182 John Sarbanes (MD-03) (Incumbent)

183 Anthony Brown (MD-04) (Incumbent)

184 Steny Hoyer (MD-05) (Incumbent)

185 David Trone (MD-06)

186 Elijah Cummings (MD-07) (Incumbent)

187 Jamie Raskin (MD-08) (Incumbent)

188 Richard Neal (MA-01) (Incumbent)

189 Jim McGovern (MA-02) (Incumbent)

190 Lori Trahan (MA-03)

191 Joseph Kennedy III (MA-04) (Incumbent)

192 Katherine Clark (MA-05) (Incumbent)

193 Seth Moulton (MA-06) (Incumbent)

194 Ayanna Pressley (MA-07)

195 Stephen Lynch (MA-08) (Incumbent)

196 Bill Keating (MA-09) (Incumbent)

197 Matthew Morgan (MI-01)

198 Rob Davidson (MI-02)

199 Cathy Albro (MI-03)

200 Jerry Hilliard (MI-04)

201 Dan Kildee (MI-05)

202 Matt Longjohn (MI-06)

203 Gretchen Driskell (MI-07)

204 Elissa Slotkin (MI-08)

205 Andy Levin (MI-09)

206 Kimberly Bizon (MI-10)

207 Haley Stevens (MI-11)

208 Debbie Dinkel (MI-12) (Incumbent)

209 Rashida Tlaib (MI-13)

210 Brenda Lawrence (MI-14) (Incumbent)

211 Dan Feehan (MN-01)

212 Angie Craig (MN-02)

213 Dean Phillips (MN-03)

214 Betty McCollum (MN-04) (Incumbent)

215 Ilhan Omar (MN-05)

216 Ian Todd (MN-06)

217 Collin Peterson (MN-07) (Incumbent)

218 Joe Radinovich (MN-08)

219 Randy Wadkins (MS-01)

220 Bernie Thompson (MS-02) (Incumbent)

221 Michael Evans (MS-03)

222 Jeramey Anderson (MS-04)

223 William Lacy Clay (MO-01) (Incumbent)

224 Cort VanOstran (MO-02)

225 Katy Geppert (MO-03)

226 Renee Hoagenson (MO-04)

227 Emanuel Cleaver (MO-05) (Incumbent)

228 Henry Martin (MO-06)

229 Jamie Schoolcraft (MO-07)

230 Kathy Ellis (MO-08)

231 Kathleen Williams (MT At Large)

232 Jessica McClure (NE-01)

233 Kara Eastman (NE-02)

234 Paul Theobald (NE-03)

235 Dina Titus (NV-01) (Incumbent)

236 Clint Koble (NV-02)

237 Susie Lee (NV-03)

238 Steven Horsford (NV-04)

239 Chris Pappas (NH-01)

240 Annie Kuster (NH-02) (Incumbent)

241 Donald Norcross (NJ-01) (Incumbent)

242 Jeff Van Drew (NJ-02)

243 Andrew Kim (NJ-03)

244 Josh Welle (NJ-04)

245 Josh Gottheimer (NJ-05) (Incumbent)

246 Frank Pallone (NJ-06) (Incumbent)

247 Tom Malinowski (NJ-07)

248 Albio Sires (NJ-08) (Incumbent)

249 Bill Pascrell (NJ-09) (Incumbent)

250 Donald Payne Jr (NJ-10) (Incumbent)

251 Mikie Sherrill (NJ-11)

252 Bonnie Watson Coleman (NJ-12) (incumbent)

253 Debra Haland (NM-01)

254 Xochitl Torres Small (NM-02)

255 Ben Ray Lujan (NM-03) (Incumbent)

256 Perry Gershon (NY-01)

257 Liuba Greggen Shirley (NY-02)

258 Tom Suozzi (NY-03) (Incumbent)

259 Kathleen Rice (NY-04) (Incumbent)

260 Gregory W. Meeks (NY-05) (Incumbent)

261 Grace Meng (NY-06) (Incumbent)

262 Nydia Velazquez (NY-07) (Incumbent)

263 Hakeem Jeffries (NY-08) (Incumbent)

264 Yvette D. Clarke (NY-09) (Incumbent)

265 Jerrold Nadler (NY-10) (Incumbent)

266 Max Rose (NY-11)

267 Carolyn B. Maloney (NY-12) (Incumbent)

268 Adriano Espaillat (NY-13) (Incumbent)

269 Alexandra Ocasio-Cortez (NY-14)

270 Jose Serrano (NY-15) (Incumbent)

271 Eliot Engel (NY-16) (Incumbent)

272 Nita Lowey (NY-17) (Incumbent)

273 Sean Maloney (NY-18) (Incumbent)

274 Antonio Delgado (NY-19)

275 Paul Tonko (NY-20) (Incumbent)

276 Tedra Cobb (NY-21)

277 Anthony Brindisi (NY-22)

278 Tracy Mitrano (NY-23)

279 Dana Balter (NY-24)

280 Joseph Morelle (NY-25)

281 Brian Higgins (NY-26) (Incumbent)

282 Nate McMurray (NY-27)

283 G.K. Butterfield (NC-01)

284 Linda Coleman (NC-02)

285 David Price (NC-04) (Incumbent)

286 Denise Adams (NC-05)

287 Ryan Watts (NC-06)

288 Kyle Horton (NC-07)

289 Frank McNeill (NC-08)

290 Dan McCready (NC-09)

291 David Wilson Brown (NC-10)

292 Phillip Price (NC-11)

293 Alma Adams (NC-12) (Incumbent)

294 Kathy Manning (NC-13)

295 Mac Schneider (ND At Large)

296 Aftab Pureval (OH-01)

297 Jill Schiller (OH-02)

298 Joyce Beatty (OH-03) (Incumbent)

299 Janet Garrett (OH-04)

300 John Michael Galbraith (OH-05)

301 Shawna Roberts (OH-06)

302 Ken Harbaugh (OH-07)

303 Vanessa Enoch (OH-08)

304 Marcy Kaptur (OH-09) (Incumbent)

305 Theresa Gasper (OH-10)

306 Marcia Fudge (OH-11) (Incumbent)

307 Danny O’Connor (OH-12)

308 Tim Ryan (OH-13) (Incumbent)

309 Betsy Rader (OH-14)

310 Rick Neal (OH-15)

311 Susan Moran Palmer (OH-16)

312 Tim Gilpin (OK-01)

313 Jason Nichols (OK-02)

314 Frankie Robbins (OK-03)

315 Mary Brannon (OK-04)

316 Kendra Horn (OK-05)

317 Suzanne Bonamici (OR-01) (Incumbent)

318 Jamie McLeod Skinner (OR-02)

319 Earl Blumenauer (OR-03) (Incumbent)

320 Peter DeFazio (OR-04) (Incumbent)

321 Kurt Schrader (OR-05) (Incumbent)

322 Scott Wallace (PA-01)

323 Brendan Doyle (PA-02) (Incumbent)

324 Dwight Evans (PA-03) (Incumbent)

325 Madeleine Dean (PA-04)

326 Mary Gay Scanlon (PA-05)

327 Chrissy Houlahan (PA-06)

328 Susan Wild (PA-07)

329 Matt Cartwright (PA-08) (Incumbent)

330 Denny Wolff (PA-09)

331 George Scott (PA-10)

332 Jessica King (PA-11)

333 Marc Friedenberg (PA-12)

334 Brent Ottaway (PA-13)

335 Bibiana Berio (PA-14)

336 Susan Boser (PA-15)

337 Ronald DiNicola (PA-16)

338 Conor Lamb (PA-17)

339 Michael Doyle (PA-18) (Incumbent)

340 David N. Cicilline (RI-01) (Incumbent)

341 Jim Langevin (RI-02) (Incumbent)

342 Joe Cunningham (SC-01)

343 Sean Carrigan (SC-02)

344 Mary Geren (SC-03)

345 Brandon Brown (SC-04)

346 Archie Parnell (SC-05)

347 James Clyburn (SC-06) (Incumbent)

348 Robert Williams (SC-07)

349 Timothy Bjorkman (SD At Large)

350 Marty Olsen (TN-01)

351 Renee Hoyos (TN-02)

352 Danielle Mitchell (TN-03)

353 Mariah Phillips (TN-04)

354 Jim Cooper (TN-05) (Incumbent)

355 Dawn Barlow (TN-06)

356 Justin Kanew (TN-07)

357 Erika Stotts Pearson (TN-08)

358 Steve Cohen (TN-09) (Incumbent)

359 Shirley McKellar (TX-01)

360 Todd Litton (TX-02)

361 Lorie Burch (TX-03)

362 Catherine Krantz (TX-04)

363 Dan Wood (TX-05)

364 Jana Lynne Sanchez (TX-06)

365 Lizzie Pannill Fletcher (TX-07)

366 Steven David (TX-08)

367 Al Green (TX-09) (Incumbent)

368 Mike Siegel (TX-10)

369 Jennie Lou Leeder (TX-11)

370 Vanessa Adia (TX-12)

371 Greg Sagan (TX-13)

372 Adrienne Bell (TX-14)

373 Vincente Gonzalez (TX-15)

374 Veronica Escobar (TX-16)

375 Rick Kennedy (TX-17)

376 Sheila Jackson Lee (TX-18)

377 Miguel Levario (TX-19)

378 Joaquin Castro (TX-20) (Incumbent)

379 Joseph Kopser (TX-21)

380 Sri Preston Kulkarni (TX-22)

381 Gina Ortiz Jones (TX-23)

382 Jan McDowell (TX-24)

383 Julie Oliver (TX-25)

384 Linsey Fagan (TX-26)

385 Eric Holguin (TX-27)

386 Henry Cuellar (TX-28) (Incumbent)

387 Sylvia Garcia (TX-29)

388 Eddie Bernice Johnson (TX-30) (Incumbent)

389 Mary Jennings “MJ” Hegar (TX-31)

390 Colin Allred (TX-32)

391 Marc Veasey (TX-33) (Incumbent)

392 Filemon Vela (TX-34) (Incumbent)

393 Lloyd Doggett (TX-35) (Incumbent)

394 Dayna Steele (TX-36)

395 Lee Castillo (UT-01)

396 Shireen Ghorbani (UT-02)

397 James Singer (UT-03)

398 Ben McAdams (UT-04)

399 Peter Welch (VT At Large) (Incumbent)

400 Vangie Williams (VA-01)

401 Elaine Luria (VA-02)

402 Bobby Scott (VA-03) (Incumbent)

403 Aston Donald McEachin (VA-04)

404 Leslie Cockburn (VA-05)

405 Jennifer Lewis (VA-06)

406 Abigail Spanberger (VA-07)

407 Don Beyer (VA-08) (Incumbent)

408 Anthony Flaccavento (VA-09)

409 Jennifer Wexton (VA-10)

410 Gerald Connolly (VA-11) (Incumbent))

411 Suzan DelBene (WA-01) (Incumbent)

412 Rick Larsen (WA-02) (Incumbent)

413 Carolyn Long (WA-03)

414 Christine Brown (WA-04)

415 Lisa Brown (WA-05)

416 Derek Kilmer (WA-06) (Incumbent)

417 Pramila Jayapal (WA-07) (Incumbent)

418 Kim Schrier (WA-08)

419 Sarah Smith (WA-09)

420 Denny Heck (WA-10) (Incumbent)

421 Kendra Fershee (WV-01)

422 Talley Sergent (WV-02)

423 Richard Ojeda (WV-03)

424 Randy Bryce (WI-01)

425 Mark Pocan (WI-02) (Incumbent)

426 Ronald ”Ron” Kind (WI-03) (Incumbent)

427 Gwen Moore (WI-04) (Incumbent)

428 Tom Palzewicz (WI-05)

429 Dan Kohl (WI-06)

430 Margaret Engebretson (WI-07)

431 Beau Liegeois (WI-08)

432 Greg Hunter (WY At Large)

(There are 435 seats in the US House of Representatives. Three seats this cycle (CA-08, GA-08 and NC-03) do not have a Democratic candidate on the ballot.)

vote.gov

#voting #us politics #midterms #democrats #democracy #USA #Nov6th2018 #US House of Representatives #US Congress #WhenWeAllVote #2018 Midterm Elections #Democratic Party #VOTE

0 notes

pakistangeonews-blog · 7 years ago

Text

Aprepitant powder used for prevention of postoperative nausea and vomiting

1.What is Aprepitant?

Aprepitant (brand name: Emend) is an antiemetic chemical compound that belongs to a class of drugs called substance P antagonists (SPA). It mediates its effect by blocking the neurokinin 1 (NK1) receptor. It's used for prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) and for prevention of postoperative nausea and vomiting. Aprepitant may also be useful in the treatment of cyclic vomiting syndrome and late-stage chemotherapy induced vomiting.

2.What is Aprepitant powder?

Name: Aprepitant powder

CAS: 170729-80-3

Molecular Formula: C23H21F7N4O3

Molecular Weight: 534.4266624

Melt Point: 244-246°C

Storage Temp: -20°C Freezer

Color: White powder

Aprepitant is made up of a morpholine core with two substituents attached to adjacent ring carbons. These substitute groups are trifluoromethylated phenyl ethanol and fluorophenyl group. Aprepitant also has a third substituent (triazolinone), which is joined to the morpholine ring nitrogen. It has three chiral centres very close together, which combine to produce an amino acetal arrangement. Its empirical formula is C23H21F7N4O3.

Aprepitant is an off-white crystalline solid that has a molecular weight of around 534.53. It has a very limited solubility in water. It does have a reasonably high solubility in non-polar molecules such as oils. This would, therefore, suggest that aprepitant as a whole, despite having components that are polar, is a non-polar substance.

3.How does Aprepitant works?

Aprepitant is classified as an NK1 antagonist because it blocks signals given off by NK1 receptors. This, therefore, decreases the likelihood of vomiting in patients.

NK1 is a G protein-coupled receptor located in the central and peripheral nervous system. This receptor has a dominant ligand known as Substance P (SP). SP is a neuropeptide, composed of 11 amino acids, which sends impulses and messages from the brain. It is found in high concentrations in the vomiting center of the brain, and, when activated, it results in a vomiting reflex. In addition to this it also plays a key part in the transmission of pain impulses from the peripheral receptors to the central nervous system.

Aprepitant has been shown to inhibit both the acute and delayed emesis induced by cytotoxic chemotherapeutic drugs by blocking substance P landing on receptors in the brain's neurons. Positron emission tomography (PET) studies, have demonstrated that aprepitant can cross the blood brain barrier and bind to NK1 receptors in the human brain. It has also been shown to increase the activity of the 5-HT3 receptor antagonists ondansetron and the corticosteroid dexamethasone, which are also used to prevent nausea and vomiting caused by chemotherapy.

Aprepitant is taken orally in the form of a capsule. Before clinical testing, a new class of therapeutic agent has to be characterized in terms of preclinical metabolism and excretion studies. Average bioavailability is found to be around 60-65%. Aprepitant is metabolized primarily by CYP3A4 with minor metabolism by CYP1A2 and CYP2C19. Seven metabolites of aprepitant, which are only weakly active, have been identified in human plasma. As a moderate inhibitor of CYP3A4, aprepitant can increase plasma concentrations of co-administered medicinal products that are metabolized through CYP3A4. Specific interaction has been demonstrated with oxycodone, where aprepitant both increased the efficacy and worsened the side effects of oxycodone; however it is unclear whether this is due to CPY3A4 inhibition or through its NK-1 antagonist action. Following IV administration of a 14C-labeled prodrug of aprepitant (L-758298), which is converted rapidly and completely to aprepitant, approximately 57% of the total radioactivity is excreted in the urine and 45% in feces. No unchanged substance is excreted in urine.

One of the main features of aprepitant, and a major advantage it has over other chemotherapy-induced side-effect treatments, is its ability to selectively antagonize NK1 receptors, while having very low affinity to other common receptors such as serotonin, dopamine, and corticosteroid. It is estimated that aprepitant is at least 3,000 times more selective to NK1 receptors compared to these other enzyme transporter, The normal dosing of aprepitant given as 125 mg in the first day after chemotherapy and followed by

80 mg the following 2 days.

4.Where Aprepitant usage for?

Aprepitant is used to help prevent nausea and vomiting that can sometimes follow chemotherapy treatment. For patients receiving chemotherapy, nausea and vomiting may occur within the 24 hours immediately following treatment (acute), or several days later (delayed). Given in combination with other medications, aprepitant may prevent both acute and delayed nausea and vomiting. Aprepitant is not used to treat nausea and vomiting once they have already begun.

Aprepitant is used with other medications in adults and children 6 months of age and older to prevent nausea and vomiting that may occur within 24 hours after receiving cancer chemotherapy treatment. It is also used with other medications in adults and children 6 months of age and older to prevent delayed nausea and vomiting that may occur several days after receiving certain chemotherapy medications. Aprepitant is also used alone in adults to prevent nausea and vomiting caused by surgery. Aprepitant is not used to treat nausea and vomiting that you already have. Aprepitant is in a class of medications called antiemetics. It works by blocking the action of neurokinin, a natural substance in the brain that causes nausea and vomiting.

5.How should Aprepitant be used?

Aprepitant comes as a capsule and as an oral suspension (liquid) to take by mouth. To prevent nausea and vomiting caused by cancer chemotherapy, aprepitant is usually taken once daily, with or without food, during the first few days of your cancer chemotherapy treatment. You will probably take aprepitant 1 hour before your chemotherapy on days 1,

2, and 3 of your treatment. If you do not receive chemotherapy on days 2 and 3, then you will take aprepitant on those days in the morning. To prevent nausea and vomiting caused by surgery, aprepitant is usually taken as one dose within 3 hours before the start of surgery. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take aprepitant exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Aprepitant capsules come in two different strengths. Your doctor may prescribe both of the strengths for you to take at different times. You should be careful to take the right strength at the right time as directed by your doctor.

Swallow the capsules whole; do not split, chew, or crush them.

The oral suspension will be prepared by your healthcare provider and given to you in an oral dispenser. Store the oral dispenser in the refrigerator until it is time for your dose; however, it can be stored at room temperature for up to 3 hours before use. When ready to use, remove the cap from the dispenser before placing it in your mouth to slowly release the medication.

Aprepitant only works to prevent nausea and vomiting. Call your doctor if you already have these symptoms and do not begin to take aprepitant.

When used to prevent nausea and vomiting caused by cancer chemotherapy, aprepitant is usually used only during the first 3 days of the chemotherapy treatment cycles. Do not continue taking aprepitant longer than instructed by your doctor.

6.Aprepitant Dosage

Usual Adult Dose for Nausea/Vomiting - Chemotherapy Induced

MODERATELY TO HIGHLY EMETOGENIC CANCER CHEMOTHERAPY (HEC/MEC): Oral Capsules:

-Day 1: 125 mg orally once 1 hour before chemotherapy

-Days 2 and 3: 80 mg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)

-Duration of therapy: 3 days/cycle

Oral Suspension:

-Day 1: 3 mg/kg orally once 1 hour before chemotherapy

---Maximum dose: 125 mg/dose

-Days 2 to 3: 2 mg/kg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)

---Maximum dose: 80 mg/dose

-Duration of therapy: 3 days/cycle

Comments:

-The recommended dosage of dexamethasone is 12 mg orally on Day 1 administered 30 minutes prior to chemotherapy and 8 mg orally in the mornings on Days 2 through 4 (HEC) or Days 2 through 3 (MEC).

-The 5-HT3 antagonist is administered on Day 1 only. Consult the package insert for the

5-HT3 antagonist dosing prior to initiation of treatment.

-This drug may be taken with or without food.

Uses:

-In combination with other antiemetic agents for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of HEC including

high-dose cisplatin

-In combination with other antiemetic agents for the prevention of nausea and vomiting associated with initial and repeat courses of MEC

Usual Adult Dose for Nausea/Vomiting - Postoperative

40 mg orally once within 3 hours prior to induction of anesthesia

Use: Prevention of nausea and vomiting Usual Pediatric Dose for Nausea/Vomiting - Chemotherapy Induced

12 years and older: MEC/HEC:

Oral Capsules:

-Day 1: 125 mg orally once 1 hour before chemotherapy

-Days 2 and 3: 80 mg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)

-Duration of therapy: 3 days/cycle

Oral Suspension:

-Day 1: 3 mg/kg orally once 1 hour before chemotherapy

---Maximum dose: 125 mg/dose

-Days 2 to 3: 2 mg/kg orally once a day, 1 hour before chemotherapy OR in the morning (if chemotherapy is not given on Days 2 and 3)

---Maximum dose: 80 mg/dose

-Duration of therapy: 3 days/cycle

Comments:

-If a corticosteroid (e.g., dexamethasone) is coadministered, patients should be given

50% of the recommended pediatric dose on Days 1 to 4. Consult the package insert for the corticosteroid dosing prior to initiation of treatment.

-The 5-HT3 antagonist is administered on Day 1 only. Consult the package insert for the

5-HT3 antagonist dosing prior to initiation of treatment.

-This drug may be taken with or without food.

Uses:

-In combination with other antiemetic agents for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of HEC including

high-dose cisplatin

-In combination with other antiemetic agents for the prevention of nausea and vomiting associated with initial and repeat courses of MEC

7.Other Comments for Aprepitant

Administration advice:

-Take with or without food.

-Oral suspension: Oral syringes should be placed along the inner cheek, and should be dispensed slowly.

-Oral capsules: Swallow whole.

-For prevention of CINV, take first dose 1 hour prior to chemotherapy.

-For prevention of PONV, receive medication within 3 hours prior to induction of anesthesia.

Storage requirements:

-Oral suspension: Refrigerate; use within 72 hours of preparation, and discard any remaining suspension after 72 hours.

General:

-Limitations of use: Use has not been studied for the treatment of established nausea and vomiting.

-Patient profiles may change during chronic continuous administration; chronic use is not recommended.

Monitoring:

-Hematologic: INR in patients on chronic warfarin therapy

-Hypersensitivity: Hypersensitivity reactions at any time during treatment

Patient advice:

-Patients should be advised to report all concurrent prescription and nonprescription medications or herbal products they are taking.

-Instruct patients to immediately report any signs/symptoms of Stevens-Johnson syndrome, toxic epidermal necrolysis, or hypersensitivity reactions.

-Patients should be advised to speak to healthcare provider if pregnant, intend to become pregnant, or are breastfeeding; patients using hormonal contraception to prevent pregnancy will need to speak with their health care provider about using a non-hormonal back-up method of birth control for up to 2 months after completing therapy.

8.What special precautions should I follow?

Before taking aprepitant

· tell your doctor and pharmacist if you are allergic to aprepitant, any other medications, or any of the ingredients in aprepitant capsules or oral suspension. Ask your pharmacist for a list of the ingredients.

· do not take aprepitant if you are taking pimozide (Orap). Your doctor will probably tell you not to take aprepitant if you are taking this medication.

· tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); antifungals such as itraconazole (Onmel, Sporanox) and ketoconazole ; benzodiazepines such as alprazolam (Xanax), diazepam (Valium), midazolam , and triazolam (Halcion); cancer chemotherapy medications such as ifosfamide (Ifex), irinotecan (Camptosar), vinblastine, and vincristine (Marqibo Kit); carbamazepine (Equetro, Tegretol, Teril); clarithromycin (Biaxin, in Prevpac); diltiazem (Cardizem, Cartia, Tiazac); HIV protease inhibitors such as nelfinavir (Viracept) and ritonavir (Norvir); hormonal contraceptives (birth control pills, patches, rings, and injections); nefazodone; oral steroids such as dexamethasone and methylprednisolone (Medrol); phenytoin (Dilantin, Phenytek); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); and troleandomycin (TAO; no longer available in U.S.). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with aprepitant, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

· tell your doctor if you have or have ever had liver disease.

· tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

If you are taking birth control medications during treatment with aprepitant you should also use an additional method of birth control to avoid pregnancy during treatment with aprepitant and for one month after your final dose. Talk to your doctor about birth control methods while you are taking aprepitant and after treatment. If you become pregnant while taking aprepitant, call your doctor.

9.Aprepitant other uses

Major depression

Encouraged by positive results in their early controlled studies of aprepitant (300 mg/d with enforced food intake) and L-759,274(another NK1 receptor antagonist), as well as those of CP-122,721 (Pfizer) in patients with major depressive disorder, Merck & Co. conducted Phase III clinical trials on aprepitant in which patients received 80 mg or 160 mg/d (a new formulation, prescribed without enforced food intake) as a treatment for major depressive disorder. Despite achieving 90-95% receptor occupancy of aprepitant in certain brain regions, negative clinical results were observed in three actively controlled studies. The company has since abandoned plans to market aprepitant 160 mg as an antidepressant. Subsequently, large clinically positive double blind controlled studies with two additional NK1 receptor antagonists, casopitant, and orvepitant (both GlaxoSmithKine compounds) have been published in peer reviewed medical journals. This work now replicates the early findings of Merck and Co with aprepitant and L-759,274, and of Pfizer with CP-122,721. Arguably, the weight of preclinical data and positive clinical evidence provides evidence that NK1 receptor antagonism, including that of aprepitant, is a distinct antidepressant mechanism. Across all these studies, efficacy appeared to be dose-related. Only mild, transient, and tolerable side effects, not those typically observed with either the SSRI, SNRI, or NRI classes of antidepressants, have been observed.

Beyond suggestions that PET receptor occupancy must not be used routinely to cap dosing for new medical indications for this class, or that > 99% human receptor occupancy might be required for consistent psycho-pharmacological or other therapeutic effects, critical scientific dissection and debate of the above data might be needed to enable aprepitant, and the class of NK1 antagonists as a whole, to fulfill preclinically predicted utilities beyond CINV (i.e., for other psychiatric disorders, addictions, neuropathic pain, migraine, osteoarthritis, overactive bladder, inflammatory bowel disease, and other disorders with suspected inflammatory or immunological components (see anti-cancer below.) However, most data remain proprietary and thus reviews on the expanded clinical potential for drugs like aprepitant range from optimistic to crepe-hanging.

Related Post: Aprepitant powder used for prevention of postoperative nausea and vomiting

0 notes