Mark Corson

By Q. Rozhov. Great Lakes Maritime Academy.

When nutri- "Calories discount 250 mg ticlid amex," "Total fat cheap 250mg ticlid," "Cholesterol buy 250 mg ticlid amex," tion information is given in a linear "Sodium," "Total carbohydrate," and fashion, bolding is required only on the "Protein. I (4–1–10 Edition) Dietary fiber—Fiber quired information may use any alter- Soluble fiber—Sol fiber nate panel that can be readily seen by Insoluble fiber—Insol fiber consumers for the nutrition label. The Sugar alcohol—Sugar alc space needed for vignettes, designs, and Other carbohydrate—Other carb other nonmandatory label information (C) Omitting the footnote required in on the principal display panel may be paragraph (d)(9) of this section and considered in determining the suffi- placing another asterisk at the bottom ciency of available space on the prin- of the label followed by the statement cipal display panel for the placement of "Percent Daily Values are based on a the nutrition label. The word "in- 1996, if, for the period between May 8, dividual" may be used in lieu of or im- 1994, and May 7, 1995, the person claim- mediately preceding the word "Retail" ing the exemption employed fewer than in the statement. Provide the average an average of 100 full-time equivalent number of full-time equivalent individ- employees and fewer than 100,000 units uals employed by the person and its af- of that product were sold in the United filiates for the 12 months preceding the States, or in the case of a food product period for which a small business ex- that was not sold in the 12-month pe- emption is claimed for a product. The riod preceding the period for which ex- average number of full-time equivalent emption is claimed, fewer than 100,000 employees is to be determined by divid- units of such product are reasonably ing the total number of hours of salary anticipated to be sold in the United or wages paid to employees of the per- States during the period for which ex- son and its affiliates by the number of emption is claimed. For exemption, the food product no longer products that have been in production qualifies for an exemption under the for 1 year or more prior to the period provisions of paragraphs (j)(18)(i) or for which exemption is claimed, the 12- (j)(18)(ii) of this section, such person month period is the period imme- shall have 18 months from the date diately preceding the period for which that the product was no longer quali- an exemption is claimed. For other fied as a low-volume product of a small products, the 12-month period is the pe- business to comply with this section. The indi- units: vidual shall also state that should the (A) Name and address of person re- average number of full-time equivalent questing exemption. I (4–1–10 Edition) introduced into interstate commerce may be responsible for an inadequacy after May 8, 2002, if the agency deter- or deficiency in the quality of the daily mines that the cost of compliance with diet. This plete nutrition information as de- number shall be determined by divid- scribed in §101. Nutrient levels may ing the total number of hours of salary be determined by nutrient data bases, or wages paid directly to employees of cookbooks, or analyses or by other rea- the person and of all of its affiliates by sonable bases that provide assurance the number of hours of work in a year, that the food or meal meets the nutri- 2,080 hours (i. Presen- (k) A food labeled under the provi- tation of nutrition labeling may be in sions of this section shall be deemed to various forms, including those provided be misbranded under sections 201(n) in §101. These reference amounts are based on (3) That the storage, transportation, data set forth in appropriate national processing, or cooking of a food is or food consumption surveys. These reference (iv) Serving sizes used by other coun- amounts are based on data set forth in tries. Such reference amounts are to customarily consumed, the reference be used only when the food is specially amount and, in turn, the serving size formulated or processed for use by an declared on the product label are based infant or by a child under 4 years of on only the edible portion of food, and age. Manufacturers should use the description of a unit that is most appropriate for the specific product (e. About l seconds spray (l g) Fish, Shellfish, Game Meats10, and Meat or Poultry Sub- stitutes: Bacon substitutes, canned anchovies,11 anchovy 15 g........................ The maximum l tablet(s), l capsule(s), l packet(s), amount rec- l tsp(s) (l g), etc. Sauces, Dips, Gravies and Condiments: Barbecue sauce, hollandaise sauce, tartar sauce, 2 tbsp...................... An amount equiva- l tsp(s) (l g) for solids; l drop(s) (l lent to one ref- g) for liquid; l piece(s) (l g) (e. Manufacturers should use the description of a unit that is most appropriate for the specific product (e. The guidance provided is for the label statement of products in ready-to-serve or almost ready-to-serve form. The guidance does not apply to the products which require further preparation for consumption (e. For products that require further preparation, manufacturers must determine the label statement following the rules in §101. Label serving size of all chewing gums that weigh more than the reference amount that can reasonably be consumed at a single-eating occasion will be 1 unit. The reference amount for paragraph (b) of this section, for the in- the aerated food shall be rounded to gredient that is represented as the the nearest 5-g increment. Such prod- main ingredient plus proportioned ucts shall bear a descriptive term indi- amounts of all minor ingredients. The represented as the main ingredient is density-adjusted reference amounts de- one or more discrete units (e. The differences in the den- amount for the combined product shall sities of different types of cakes having be either the number of small discrete different degrees of air incorporation units or the fraction of the large dis- have already been taken into consider- crete unit that is represented as the ation in determining the reference main ingredient that is closest to the amounts for cakes in §101. In de- reference amount for that ingredient as termining the difference in density of established in paragraph (b) of this sec- the aerated and the regular food, the tion plus proportioned amounts of all manufacturer shall adhere to the fol- minor ingredients. If the ref- (2) Sample selections for the density erence amounts are in incompatible measurements shall be done in accord- units, the weights of the appropriate ance with the provisions in §101. If to ensure that the average of the meas- the serving size declared on the prod- urements is representative of the true uct label differs from the reference differences in the densities of the reg- amount, and the product meets the cri- ular and the "aerated" products. That statement shall include the that consist of two or more foods pack- reference amount as it appears in para- aged and presented to be consumed to- graph (b) of this section followed, in gether (e. A petition to rules shall be followed: establish or amend a reference amount (A) For volumes greater than 30 mil- shall include: liliters (mL), the volume shall be ex- (1) Objective of the petition; pressed in multiples of 30 mL. Data must include substitute foods, the names of the sample size; and the mean, standard de- products for which they are offered as viation, median, and modal consumed substitutes); amount per eating occasion for the pe- (9) The suggested reference amount titioned product and for other products (the amount of edible portion of food as in the category, excluding the peti- consumed, excluding bone, seed, shell, tioned product. All data must be de- or other inedible components) for the rived from the same survey data. In determining the ref- petitioned product from the rest of the erence amount, general principles and products in the category. Reference or process food consumption data in amounts for other foods shall be ex- support of the petition, the following pressed in grams except when common general guidelines should be followed.

Contraindications: History of hypersensitivity to mannitol buy 250 mg ticlid mastercard, car- boplatin generic ticlid 250mg line, or related compounds buy ticlid 250mg without prescription, severe bone marrow depression, acute bleeding. Warnings/precautions • Use with caution in patients with the following conditions: kidney disease, prior chemotherapy. Advice to patient • Use two forms of birth control including hormonal and barrier methods. Adverse reactions • Common: nausea (10–18%), vomiting (65–80%), electrolyte abnormalities (see below), bone marrow depression (see below). Clinically important drug interactions: Nephrotoxic agents, eg, aminoglycosides, aluminum increase effects/toxicity of carbo- platin. Parameters to monitor • Serum electrolytes including calcium, magnesium, sodium, and potassium. Treat with peroxide, tea, topical anesthetics such as benzocaine, lidocaine, or antifungal drug. Editorial comments • It is recommended that this drug be administered only by physicians who are well versed in the use of alkylating agents of this type. Mechanism of action: Oxytocic: stimulates uterine contraction by altering calcium transport. Warnings/precautions • Use with caution in patients with the following conditions: asthma, hypotension, renal or hepatic disease, diabetes, epilepsy, cardiac or adrenal disease. Advice to patient: Use two forms of birth control including hor- monal and barrier methods. Clinically important drug interactions: Carboprost increases effects/toxicity of oxytocin and other oxytocic drugs. Mechanism of action: Blocks interneuronal activity in spinal cord, and reticular formation, causing muscle relaxation (animal data). Onset of Action Duration 30 min 4–6 h Food: Administer with food if gastric upset occurs. Contraindications: Hypersensitivity to carisoprodol, aspirin, or related compounds, eg, meprobamate; acute intermittant por- phyria, bleeding disorders. Warnings/precautions • Use with caution in patients with the following conditions: kidney or liver disease, history of drug abuse. This is characterized by weakness, quadriple- gia, visual disturbance, confusion, dysarthria. Advice to patient • This drug may cause dizziness and faintness especially at the beginning of use. Adjustment of dosage 3 3 • Leukocyte nadir 2000–3000 m , platelets 25,000–75,000 mm : reduce dose to 70% of standard; leukocytes <2000: reduce dose to 50% of standard. Contraindications: Hypersensitivity to carmustine, bone marrow depression from various causes including previous chemother- apy, previous resistance to the drug. Warnings/precautions • Use with caution in patients with the following conditions: his- tory of seizures, head trauma, potential epileptogenic drugs, renal or hepatic disease, bone marrow depression. Advice to patient • Use two forms of birth control including hormonal and barrier methods. Adverse reactions • Common: nausea, vomiting, pain at infusion site, dizziness, ataxia, alopecia, flushing. Clinically important drug interactions: Cimetidine, etoposide increase effects/toxicity of carmustine. Editorial comments • It is essential to perform a complete hematologic evaluation every 2 weeks for patients on this drug. Clinicians should con- sult published protocols for current dosages of this and other chemotherapeutic agents as well as the method and sequence of drug administration. Mechanism of action: Competitive blocker of β-adrenergic receptors in heart and blood vessels. Adjustment of dosage • Kidney disease: creatinine clearance >60 mL/min: dose q24h; creatinine clearance >20–60 mL/min: dose q48h; creatinine clearance <20 mL/min: dose q72h. Mechanism of action: Binds to penicillin-binding proteins and disrupts or inhibits bacterial cell wall synthesis. Susceptible organisms in vivo: Comparable to cefuroxime axetil, but less active against Hemophilus influenzae and Moraxella catarrhalis. Extended-release tablets: all uses • Acute exacerbations (bacterial), chronic bronchitis, secondary bacterial infections of acute bronchitis Ð Adults: 500 mg q12h, 10 days. American Academy of Pedia- trics considers cephalosporins to be compatible with breastfee- ding. Contraindications: Hypersensitivity to other cephalosporins or related antibiotics, eg, penicillin. Warnings/precautions • Use with caution in patients with the following condition: kidney disease. For group A beta-hemolytic streptococcal infections, therapy should be continued for 10 days. Anegative response to peni- cillin does not preclude allergic reaction to a cephalosporin. Advice to patient: Allow at least 1 hour between taking this medication and a bacteriostatic antibiotic, eg, tetracycline or amphenicol. Clinically important drug interactions: Cefaclor increases effects/ toxicity of oral anticoagulants. Editorial comments: Cefuroxime is more effective than cefeclor for otitis media and pharyngitis due to improved coverage for Hemophilus influenzae and Moraxella catarrhalis. Mechanism of action: Binds to penicillin-binding proteins and disrupts or inhibits bacterial cell wall synthesis. Adjustment of dosage • Kidney disease: creatinine clearance <50 mL/min: no adjust- ment; creatinine clearance 25–50 mL/min: 12-hour intervals; creatinine clearance 10–25 mL/min: 24-hour intervals; creati- nine clearance 0–10 mL/min: 36-hour intervals. American Academy of Pedia- trics considers cephalosporins to be compatible with breast- feeding.