By P. Faesul. Eastern Washington University. 2018.

Renewal — (Venous thromboembolism other than in pregnancy or malignancy) from any relevant practitioner order etodolac 300 mg line. Approvals valid for 1 month where low molecular weight heparin treatment or prophylaxis is required for a second or subsequent event (surgery discount 300mg etodolac amex, Acute Coronary Syndrome 200 mg etodolac sale, cardioversion, or prior to oral anti-coagulation). Approvals valid for 1 year for applications meeting the following criteria: Any of the following: 1 Low molecular weight heparin treatment is required during a patients pregnancy; or 2 For the treatment of venous thromboembolism where the patient has a malignancy; or 3 For the prevention of thrombus formation in the extra-corporeal circulation during home haemodialysis. Renewal — (Pregnancy, Malignancy or Haemodialysis) from any relevant practitioner. Approvals valid for 5 weeks for applications meeting the following criteria: Either: 1 For the prophylaxis of venous thromboembolism following a total hip replacement; or 2 For the prophylaxis of venous thromboembolism following a total knee replacement. Note: Rivaroxaban is only currently indicated and subsidised for up to 5 weeks therapy for prophylaxis of venous thromboembolism following a total hip replacement and up to 2 weeks therapy for prophylaxis of venous thromboembolism following a total knee replacement. Approvals valid for 5 weeks where prophylaxis for venous thromboembolism is required for patients following a subsequent total hip or knee replacement. Approvals valid without further renewal unless notified where used for prevention of neutropenia in patients undergoing high risk chemotherapy for cancer (febrile neutropenia risk greater than or equal to 20%*). Only funded for nebuliser use when in conjunction with an antibiotic intended for nebuliser use. Approvals valid for 2 years where patient has disabling orthostatic hypotension not due to drugs. Note: Treatment should be started with small doses and titrated upwards as necessary. Hypertension should be avoided, and the usual target is a standing systolic blood pressure of 90 mm Hg. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 For the treatment of a child under 12 years with an haemangioma causing functional impairment (not for cosmetic reasons only); or 2 For the treatment of a child under 12 years with cardiac arrthymias or congenital cardiac abnormalities. Approvals valid without further renewal unless notified for applications meeting the following criteria: Either: 1 Patient has refractory heart failure and is intolerant or has not responded to loop diuretics and/or loop-thiazide combination therapy; or 2 Paediatric patient has oedema secondary to nephrotic syndrome that has not responded to loop diuretics. Other treatment options including fibrates, resins and nicotinic acid should be considered after failure of statin therapy. Approvals valid for 2 years where the treatment remains appropriate and the patient is benefiting from treatment. Renewal only from a respiratory specialist, cardiologist or medical practitioner on the recommendation of a respiratory physician or cardiologist. Approvals valid for 2 years for applications meeting the following criteria: Any of the following: 1 Both: 1. Approvals valid without further renewal unless notified for applications meeting the following criteria: All of the following: 1 Patient has Raynaud’s Phenomenon*; and 2 Patient has severe digital ischaemia (defined as severe pain requiring hospital admission or with a high likelihood of digital ulceration; digital ulcers; or gangrene); and 3 Patient is following lifestyle management (avoidance of cold exposure, sufficient protection, smoking cessation support, avoidance of sympathomimetic drugs); and 4 Patient is being treated with calcium channel blockers and nitrates (or these are contraindicated/not tolerated). Initial application — (Pulmonary arterial hypertension*) only from a respiratory specialist, cardiologist or medical practitioner on the recommendation of a respiratory specialist or cardiologist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Applicant is a vocationally registered dermatologist, vocationally registered general practitioner, or nurse practitioner working in a relevant scope of practice; and 2 Applicant has an up to date knowledge of the safety issues around isotretinoin and is competent to prescribe isotretinoin; and 3 Either: 3. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Patient is female and has been counselled and understands the risk of teratogenicity if isotretinoin is used during pregnancy and the applicant has ensured that the possibility of pregnancy has been excluded prior to the commencement of the treatment and that the patient is informed that she must not become pregnant during treatment and for a period of one month after the completion of the treatment; or 2 Patient is male. Note: Applicants are recommended to either have used or be familiar with using a decision support tool accredited by their professional body. Note: Ivermectin is no more effective than topical therapy for treatment of standard scabies infestation. Initial application — (Other parasitic infections) only from an infectious disease specialist, clinical microbiologist or dermatologist. Approvals valid for 1 month for applications meeting the following criteria: Any of the following: 1 Filaricides; or 2 Cutaneous larva migrans (creeping eruption); or 3 Strongyloidiasis. Approvals valid for 1 month for applications meeting the following criteria: Both: 1 Applying clinician has discussed the diagnosis of scabies with a dermatologist, infectious disease physician or clinical microbiologist; and 2 Either: 2. Renewal — (Other parasitic infections) only from an infectious disease specialist, clinical microbiologist or dermatologist. Approvals valid for 1 year for applications meeting the following criteria: All of the following: 1 Applicant is a vocationally registered dermatologist, vocationally registered general practitioner, or nurse practitioner working in a relevant scope of practice; and 2 Applicant has an up to date knowledge of the safety issues around acitretin and is competent to prescribe acitretin; and 3 Either: 3. Approvals valid for 1 year for applications meeting the following criteria: Either: 1 Patient is female and has been counselled and understands the risk of teratogenicity if acitretin is used during pregnancy and the applicant has ensured that the possibility of pregnancy has been excluded prior to the commencement of the treatment and that the patient is informed that she must not become pregnant during treatment and for a period of two years after the completion of the treatment; or 2 Patient is male. Approvals valid for 2 years for applications meeting the following criteria: Both: 1 Either: 1. Notes: The approval numbers of Special Authorities approved after 1 November 1999 are interchangeable between Mercilon and Marvelon. Approvals valid for 2 years for applications meeting the following criteria: Either: 1 Patient is on a Social Welfare benefit; or 2 Patient has an income no greater than the benefit.

Commercial air couriers order etodolac 400 mg, air courier database order etodolac 200mg line, in the second quarter of 2007 purchase 200mg etodolac amex, 59% sometimes directed by West African groups in the new of cocaine couriers detected were from West Africa, millennium, have flown to Europe from various inter- while in the third quarter of 2009, there were none. Colombian groups Since then, some increases - up to 5% of couriers also made use of commercial air carriers, often in coop- detected - were again reported in the fourth quarter of eration with groups from the Dominican Republic, with 2009 and, on average, 11% in 2010. Larger Despite this apparent reduction or even disruption, maritime consignments were often stored on board informal reports indicated that the trafficking contin- ‘mother ships’ and transported to shore by smaller ves- ued. The primary maritime points of entry were Spain in Africa, might have become an alternative method of (due to proximity and cultural links) and the Nether- moving cocaine through West Africa to Europe. Seizures made in South American countries outside the Andean region, in Central America 1998 and the Caribbean in relation to shipments towards North America are estimated at slightly less than 100 mt 12 Canada 63 West and (purity-adjusted). Thus, out Atlantic and of 380 mt exported to North America, only some 180 Western Caribbean are available for consumption, of which the bulk (88%) Mexico 9 Main cocaine producers is consumed in the United States. Some 220 mt or 26% of total cocaine exports 15 left the Andean countries for West and Central Europe 6 Cocaine consumption in 2009. Of this, close to 60 mt (purity-adjusted) were (in metric tons) seized in other South American countries or in the Car- *main routes ibbean. Thus, close to 160 mt left South America for 2008 West and Central Europe in 2009. The overall amount consumed in Europe is estimated at 129 Southern mt, suggesting that West and Central Europe (123 mt) Africa accounts for 95% of the total European cocaine market. An analysis of individual drug seizures reported in Europe suggests that more than 86% of the drugs were Current trafficking flows to main consumer markets trafficked directly to West and Central Europe, while around 13% were trafficked via West Africa. Trafficking It is estimated that almost 380 mt or 45% of the total via West and Central Africa would have amounted to cocaine exports from the Andean region leave for North 39 some 21 mt. In addition, cocaine is trafficked for local America, a region with a population of some 460 mil- demand to West and Central Africa – a subregion with lion people. The bulk of cocaine shipments are still by a combined population of more than 400 million people, sea across the Pacific to Mexico and on to the United which may consume some 13 mt. In addition, Central American countries have gained prominence in recent years as trans-shipment locations. Production** 1,111 Less seizures in Andean countries -254 Less domestic consumption in Andean region -13 Potential amounts available for export out of the Andean countries 844 Less losses in production and/or losses in global trafficking which cannot be attributed to specific regions -56 Actual exports out of Andean countries 788 Non-Andean South Amer- West and North ica / Caribbean, Central Central Europe America America, Africa, Asia, Oceania Amounts of cocaine leaving the Andean countries 217 378 193 Less amounts seized in non–Andean South America, -59 -98 -64 Caribbean and Central America linked to trafficking flows Less domestic consumption in non-Andean South -83 America / Caribbean / Central America 158 Amounts leaving South America, Caribbean and (incl. Considering purity-adjusted seizures of cocaine (unweighted average of all purities at retail and wholesale level reported by Member States in 2009), some 481 mt would be available for consumption and losses if the lower cocaine production estimate were used. If the higher cocaine production estimate were used, deducting seizures adjusted for wholesale purity (based on 2009 purity data or the latest year available), some 496 mt would be left for consumption and losses. The upper and the lower production estimates could be thus sufficient to cover consumption (440 mt). For the calculation shown above, the higher production estimates and seizures adjusted at wholesale purities were used. This reflects the observation that wholesale seizures account for the bulk of seizures in volume terms and would support the higher production estimates. However, one cannot exclude the possibility that seizures may be over-estimated due to possible double-counting once several law enforcement agencies within or across countries have been involved in cocaine interceptions. North America accounted for 47% and West countries - of which almost two thirds was for subse- and Central Europe 39% of the total. While the North American market shrank over the last Current value and money flows two decades – due to lower volumes and lower prices - The value of the global cocaine market is most certainly the European market expanded. United States 180 120 111 West & Central Europe 160 Cocaine sales 100 140 87 120 80 71 100 62 80 60 5654 5049 60 4344 4544 40 3635 34 363537 32 32 40 34 33 20 31 20 26 26 27 21 0 18 18 141414 1995 2008 2009 0 Fig. West and 40 Reports indicated that up to one third of the shipments Central Europe, is paid in kind to service providers in West Africa, who 33 then traffic most of this cocaine to Europe on their own behalf. Meth- the use of prescription stimulants1 is as common as amphetamine or amphetamine can be in powder, tablet, methamphetamine. In South America and the Carib- paste or crystalline form while ‘ecstasy’ is usually avail- bean, prescription stimulants are more commonly used. In Africa, especially in West, Central and East Africa and some parts of Southern Africa, the use of amphetamines- 4. This section describes the In 2009, out of the 69 Member States that reported trends in the use of amphetamines-group and ecstasy- expert perception on amphetamines-group use trends group substances in the different regions. In The type of amphetamines-group substances used in developing countries and especially emerging econo- different regions varies considerably. In East and South- East Asia, methamphetamine is the primary substance 1 Prescription stimulants may include substances such as amfepra- consumed within this group, while in the Near and mone, fenetylline, methylphenidate, phenmetrazine, et cetera. The association in developed countries increase in the use of stimulants in developing countries of synthetic drugs, especially stimulants, with moderni- where young people within the growing middle class zation and affluent lifestyles, combined with increasing may want to emulate these lifestyles.