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Drug interactions Drugs that alter the P-450 enzyme system alter the metabolism of some atypical antipsychotics kamagra chewable 100mg cheap erectile dysfunction drugs australia. The straight “dopa” Atypical antipsychotics counteract the effects of levodopa and other dopamine agonists order 100mg kamagra chewable with amex impotence at 16. Adverse reactions to atypical antipsychotics Atypical antipsychotics have fewer ex- blood cells) order kamagra chewable pills in toronto erectile dysfunction in teens. Weight gain is common purchase kamagra chewable cheap online impotence penile rings, and other atypical antipsychotics, especially trapyramidal effects than typical anti- seizures may also occur. Olanzapine places the patient at minimal Ziprasidone Aripiprazole risk for extrapyramidal effects. Weight Because ziprasidone may cause electro- Aripiprazole is a newer atypical antipsy- gain is common. Different adverse reactions Many clinicians believe that the phenothiazines should be treated as three distinct drug classes because of the differences in the ad- verse reactions they cause: • Aliphatics primarily cause sedation and anticholinergic effects. Different chemical structure Based on their chemical structure, nonphenothiazine antipsy- chotics can be divided into several drug classes, including: • butyrophenones, such as haloperidol and haloperidol decanoate • dibenzoxazepines such as loxapine • dihydroindolones such as molindone • diphenylbutylpiperidines such as pimozide • thioxanthenes, such as thiothixene and thiothixene hydro- chloride. Pharmacokinetics Although phenothiazines are absorbed erratically, they’re very lipid-soluble and highly protein-bound. Therefore, they’re distrib- uted to many tissues and are highly concentrated in the brain. Like phenothiazines, nonphenothiazines are absorbed errati- cally, are lipid-soluble, and are highly protein-bound. They’re also distributed throughout the tissues and are highly concentrated in the brain. Metabolism and excretion All phenothiazines are metabolized in the liver and excreted in urine and bile. Because fatty tissues slowly release accumulated phenothiazine metabolites into the plasma, phenothiazines may produce effects up to 3 months after they’re stopped. Nonphenothiazines are also metabolized in the liver and ex- creted in urine and bile. Erecting a blockade The antipsychotic effect of phenothiazines is due to receptor blockade in the limbic system. Their antiemetic effect is due to re- ceptor blockade in the chemoreceptor trigger zone located in the brain’s medulla. Sending a charge Phenothiazines also stimulate the extrapyramidal system (motor pathways that connect the cerebral cortex with the spinal nerve pathways). Pharmacotherapeutics Phenothiazines are used primarily to: • treat schizophrenia • calm anxious or agitated patients • improve a patient’s thought processes • alleviate delusions and hallucinations. Phenothiazines are sometimes prescribed Working overtime to quiet mentally challenged children Other therapeutic uses have been found for phenothiazines: and agitated • They’re administered to treat other psychiatric disorders, such geriatric patients. Solo solutions As a group, nonphenothiazines are used to treat psychotic disor- ders. By increasing phenothiazine metabolism, anticholinergic drugs may also reduce the antipsychotic effects of phenothiazines. Antipsychotics with anticholinergic properties Neuroleptic malignant syndrome is a potential- should be avoided in elderly patients. Their dopamine-blocking activity can inhibit levodopa and may cause disorientation in patients receiving both medications. Halo- peridol may boost the effects of lithium, producing encephalopa- thy (brain dysfunction). They include: • dextroamphetamine • lisdexamfetamine • methylphenidate • mixed amphetamine salts • modafinil. They’re help- ful in improving attention, leading to improved school or work performance, and decreasing impulsivity and hyperactivity, if present. Dextroamphetamine and methylphenidate are also used in the treatment of narcolepsy. Dextroamphetamine and Methylphenidate Mixed amphetamine salts Measure up lisdexamfetamine • Dizziness • Restlessness Stimulants may affect growth; • Restlessness • Insomnia • Insomnia children should be monitored • Tremor • Seizures • Hyperexcitability closely for height and weight • Insomnia • Palpitations • Palpitations changes. With the use of the nonbenzodiazepine-nonbarbiturate chlo- ral hydrate, what adverse reactions are most likely? We Drugs and the endocrine system help make up glands, which are a part of The endocrine system consists of glands, which are specialized the endocrine cell clusters, and hormones, the chemical transmitters secreted by system. Keeping well balanced Together with the central nervous system, the endocrine sys- tem regulates and integrates the body’s metabolic activities and maintains homeostasis (the body’s internal equilibrium). The drug classes that treat endocrine system disorders in- clude: • natural hormones and their synthetic analogues • hormonelike substances • drugs that stimulate or suppress hormone secretion. Antidiabetic drugs and glucagon Insulin, a pancreatic hormone, and oral antidiabetic drugs are classified as hypoglycemic drugs because they lower blood glu- cose levels. Glucagon, another pancreatic hormone, is classified as a hyperglycemic drug because it raises blood glucose levels. The disease appears in two primary forms: type 1, previously referred to as insulin-dependent diabetes mellitus type 2, previously referred to as non-insulin-dependent dia- betes mellitus. Insulin Patients with type 1 diabetes require an external source of insulin to control blood glucose levels. Under the skin All insulins, however, may be given by subcutaneous (subQ) injec- tion. Absorption of subQ insulin varies according to the injection site, the blood supply, and degree of tissue hypertrophy at the in- jection site. Distribution, metabolism, and excretion After absorption into the bloodstream, insulin is distributed throughout the body. Insulin is metabolized primarily in the liver and to a lesser extent in the kidneys and muscle, and it’s excreted in stool and urine. How insulin aids glucose uptake These illustrations show how insulin allows a cell to use glucose for energy. Glucose can’t enter the cell without Normally produced by the beta cells These channels allow glucose to the aid of insulin. Insulin and its receptor first move to the inside of the cell, which activates glu- cose transporter channels to move to the surface of the cell. Glucose Glucose Glucose available Insulin transport for receptor channel Insulin metabolism Pharmacodynamics (how drugs act) Insulin can help balance Insulin is an anabolic, or building, hormone that helps: fluids and • promote storage of glucose as glycogen electrolytes! Insulin’s special effects Although it has no antidiuretic effect, insulin can correct the poly- uria (excessive urination) and polydipsia (excessive thirst) associ- ated with the osmotic diuresis that occurs in hyperglycemia by de- creasing the blood glucose level. Insulin also facilitates the move- ment of potassium from the extracellular fluid into the cell. But I don’t have diabetes… tions • lipodystrophy (distur- Insulin is also used to treat severe hyperkalemia (elevated serum bance in fat deposition) potassium levels) in patients without diabetes.
High-performance liquid chromatography is the most useful analytical tool for analysing mitoxantrone and its metabolites in biological matrices order kamagra chewable toronto how is erectile dysfunction causes. Ion-pair chromato- graphy and radioimmunoassay have also been used (Beijnen et al 100mg kamagra chewable amex erectile dysfunction from steroids. This product is aromatized with chloranil as the oxidant buy generic kamagra chewable 100mg on-line erectile dysfunction, and it is converted into mito- xantrone hydrochloride by treatment with hydrogen chloride in ethanol (Beijnen et al buy generic kamagra chewable 100 mg online impotence heart disease. Mitoxantrone, a dihydroxyanthracenedione derivative, was the most active of a series of compounds synthesized (Zee-Cheng & Cheng, 1978; Dunn & Goa, 1996). It was found to have anti-tumour activity in advanced breast cancer (often in patients in whom other treatments have failed), non-Hodgkin lymphoma and certain leukaemias. It is still most commonly used in these tumours, typically in combination with other cytotoxic drugs, and has also been used in the treatment of other cancers such as ovarian, prostate and lung cancer (Faulds et al. The typical dose is the equivalent of 12–14 mg/m2 mitoxantrone once every three weeks in patients with lymphomas and tumours of solid tissues, and 12 mg/m2 per day for five days in patients with leukaemia. When mitoxantrone is used in combination with other cytotoxic drugs, these doses are often lower (Dunn & Goa, 1996; Royal Pharmaceutical Society of Great Britain, 1999). In recent years, mitoxantrone has been used to a limited extent in the treatment of multiple sclerosis, typically at doses lower than those used in malignant disease and on a monthly schedule (Gonsettte, 1996; Millefiorini et al. Studies of Cancer in Humans The Working Group considered only studies in which mitoxantrone was given to patients who did not receive treatments with alkylating agents, with the exception of low doses of cyclophosphamide. A woman, 51 years old, with a primary breast tumour had received a combination of mitoxantrone, vincristine, 5-fluorouracil, cyclophosphamide and radiotherapy (chest and axillary); she developed acute promyelocytic leukaemia nine months later. The first case was that of a woman (aged 56 years) who received eight cycles of mitoxantrone (7 mg/m2), metho- trexate and mitomycin, local radiotherapy to the breast and axilla and tamoxifen. The second patient (aged 39 years) was also treated with eight cycles of mitoxantrone (7 mg/m2), methotrexate and mitomycin and in addition received radiotherapy to the breast. They had previously received radical mastectomy and either cyclophosphamide, metho- trexate and 5-fluorouracil or radiotherapy or both. Treatment with methotrexate, mito- xantrone and mitomycin was followed by tamoxifen, medroxyprogesterone acetate or medroxyprogesterone acetate and radiation therapy. Acute myeloid leukaemia (one case of acute monoblastic leukaemia, one of acute promyelocytic leukaemia and one of acute undifferentiated leukaemia) occurred 12–30 months after the start of treatment with the mitoxantrone-containing regimen. The patient had been treated with high doses of corticosteroids during exacerbation of the multiple sclerosis. Five years before the diagnosis of acute promyelocytic leukaemia, the patient had received an intravenous dose of mitoxantrone (10 mg/m2) once a month for five months (total dose, 87. The patient was reported to have no history of exposure to known leukaemogenic risk factors or a personal or family history of malignancy. Partridge and Lowdell (1999) reported the development of myelodysplastic syndrome in a 62-year-old woman treated for advanced breast cancer with five courses of mitoxantrone (7 mg/m2), methotrexate and mitomycin. In addition, she had received radiotherapy to the breast and axilla and tamoxifen. The planned doses for the intravenous regimen that included mitomycin (n = 30) were: mitoxantrone, 8 mg/m2 every three weeks (total dose, 64 mg); mito- mycin, 8 mg/m2 every six weeks (total dose, 32 mg) and methothrexate, 30 mg/m2 every three weeks (total dose, 240 mg). The planned doses for the intravenous regimen that did not include mitomycin (n = 29) were: mitoxantrone, 12 mg/m2 every three weeks (total dose, 96 mg) and methothrexate, 35 mg/m2 every three weeks (total dose, 280 mg). During follow-up for a median of 72 months, two cases of acute myeloid leukaemia (one of acute myelomonocytic leukaemia and one of acute myeloblastic leukaemia) and one case of myelodysplastic syndrome occurred. All three patients had received treatment without mitomycin in combination with tamoxifen (three cases), radiotherapy (one case) or other cytostatic drugs (one case). The interval between treatment and diagnosis was 17 and 18 months for the cases of acute myeloid leukaemia and 36 months for the case of myelodysplastic syndrome. The frequency of acute myeloid leukaemia and myelodysplastic syndrome was 3/59 (5%) in the two treatment groups combined and 3/29 in the group given treatment without mitomycin, who had received a higher dose of mitoxantrone and a slightly higher dose of methotrexate than the group treated with mitomycin. The dose of mitoxantrone associated with leukaemia was higher than that usually given in the treatment of advanced breast cancer. These were not considered further because the follow-up was rarely longer than one year and the patients would previously have been treated with leukaemogenic agents and/or radiation. Studies of Cancer in Experimental Animals No data were available to the Working Group. There are no published data on the bio- availability of orally administered mitoxantrone in humans, but a number of studies have reported the pharmacokinetics of mitoxantrone given as an intravenous infusion over 3–60 min at doses of 1–80 mg/m2. All showed an initial rapid phase representing distri- bution of the drug into blood cells, with a half-time of about 5 min (range, 2–16 min) and a long terminal half-time of about 30 h (range, 19–72 h) (Savaraj et al. Many early studies reported much shorter terminal half-times, but suitably sensitive assays may not have been used or adequate numbers of late samples collected. Tri-exponential elimination has been reported, the second distribution phase having a half-time of about 1 h (Alberts et al. The extent of the distribution into blood cells is illustrated by the observation that at the end of a 1-h infusion, the concentrations of mito- xantrone in leukocytes were 10 times higher than those in plasma (Sundman-Engberg et al. The typical peak plasma concentration after a 30–60-min infusion of 12 mg/m2 was about 500 ng/mL (Smyth et al. The rapid disappearance from plasma results in a total plasma clearance rate of about 500 mL/min, while the large volume of distribution of 500–4000 L/m2 indicates tissue sequestration of the drug (Savaraj et al. Studies of patients given mitoxantrone at doses up to 80 mg/m2 (standard dose, 12 mg/m2) suggest that the kinetics is linear up to this dose (Alberts et al. Studies of the urinary excretion of mitoxantrone concur that little of the admin- istered dose is cleared renally. In one study, urinary recovery of radiolabel after intravenous administration of [14C]mito- xantrone accounted for 6. The elimination half-time of mitoxantrone in two patients with impaired liver function was 63 h, whereas that in patients with normal liver function was 23 h (Smyth et al. Faecal recovery of radiolabel after a single 12 mg/m2 dose was 18% (range, 14–25%) over five days (Alberts et al. These results suggest that the liver is important in the elimination of mito- xantrone and that patients with impaired liver function or an abnormal fluid compart- ment may be at increased risk for toxic effects. The sequestration of mitoxantrone by body tissues results in retention of the drug for long periods. The characteristic blue–green colour of mitoxantrone has been observed on the surface of the peritoneum more than one month after intraperitoneal administration, and the concentrations in peritoneal tissue 6–22 weeks after intra- peritoneal dosing ranged from < 0. Mito- xantrone was readily detectable in post-mortem tissue samples from all 11 patients who had received mitoxantrone intravenously between 10 and 272 days before death. The highest concentrations were found in the thyroid, liver and heart and the lowest in brain tissue (Stewart et al. In one patient given [14C]mitoxantrone intra- venously, who died 35 days after the dose, as much as 15% of the administered dose could be accounted for in the liver, bone marrow, lungs, spleen, kidney and thyroid glands (Alberts et al.
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Modern pharmacotherapy for onychomycosis includes combination topical and systemic antifungal drugs kamagra chewable 100mg visa erectile dysfunction gene therapy treatment. System reaction to stress buy cheap kamagra chewable 100mg line impotence vacuum pump, which is aimed at eliminating or mitigating negative effects kamagra chewable 100 mg low price erectile dysfunction killing me, is accompanied by changes in behavior purchase line kamagra chewable best erectile dysfunction pills 2012, autonomic, motor, sensory and other body functions. Behavior stress is an integral part of the overall behavior, thus changing behavioral reactions leads to inhibition of the central nervous system. The purpose of this work was to study the effect of oligopeptides derivatives on behavioral responses of rats in the "open field" test. Investigated substances were administered orally in the form of aqueous solutions in doses of 70 and 100 mg/kg in 60 minutes before the experiment start. The animals of control group were injected with the corresponding volume of saline. The study found that the number of crossed squares was significantly increased after the administration of compound 2 at a dose of 70 mg/kg by 72. The administration of the compounds was affected to the number of explored holes as follows: compound 1 at a dose of 100 mg/kg, compound 2 at a dose of 70 mg/kg, compound 5 at a dose of 100 mg/kg increased the index by 88. During the study it was found that the greatest influence on the behavior of rats, such as psycho-stimulant activity, showed the compound 6 which increased the number of crossed squares in 2 times at a dose of 100 mg / kg, the number of vertical racks in 1,7 times, and the number of explored holes in 1. The administration of the same compound at a dose of 70 mg/kg influenced the behavior of experimental animals such as the number of crossed squares increased by 64. Among the seven oligopeptides derivatives all substances are characterized by psycho-stimulant activity at a dose of 100 mg/kg. Cough – a natural reflex defensive reaction that occurs in response to any irritation airway inflammation or something that prevents the passage of air for pneumatic paths. Despite the fact that the cough reflex is natural in our body which main function - cleansing the respiratory tract and restore their patency, severe cough can significantly reduce the quality of life of any person. Drug for the treatment of cough should be safe and highly effective to the patient in a very short time deprived of this disease. Ledum palustre - evergreen shrub heather family (Ericaceae), which includes essential oil (1. In modern medical practice, Ledum palustre is used as an antitussive and expectorant. We have been set up an experiment- cough model in rats induced with citric acid in the vivarium at the Institute of Microbiology and Immunology I. The experiment involved rats weighing 200-250 g rat was placed in a box, which has been connecting to the nebuliser and inhaled citric acid 10% for 5 minutes. In the first stage the animals individually tested for reaction intensity citric acid per day prior to administration of the test substance. The experience collected intense coughing rats (15-25 cough attacks within 30 minutes). In the second step (the next day) experienced reference drug codeine (20 mg / kg) which was administered orally through a metal probe 60 minutes before the inhalation of 10% citric acid for 5 minutes. The study gave a positive result- after the introduction of caffeine coughing attacks decreased on 79%. The stated cough model makes it possible to study the antitussive activity and dose dependence of extracts Ledum palustre. To reset the rhythm to sinus rhythm using cardioversion, which can be conduct in two ways: electrical cardioversion or cardioversion with drugs. In cardioversion with drugs uses anti-arrhythmics medications: dofetilide, flecainide, propafenone, amiodarone, sotalol. Heart rate control can be achiev through several medications: digoxin may control heart rate at rest, but not as well during activity. Most people require additional or alternative medications, such as beta blockers (metoprolol and atenolol), calcium channel blockers (diltiazem and verapamil). Most people with atrial fibrillation are at especially high risk of blood clots that can lead to stroke. To prevent blood clots recommended anticoagulants: warfarin, dabigatran, rivaroxaban. With this approach, the abnormal heart rhythm continues, but you feel better and have fewer symptoms. The spectrum of alcohol-related liver injury varies from simple steatosis to cirrhosis. We have examined the following documents: Unified clinical protocols of primary, secondary (specialized) medical care of alcoholic hepatitis, approved by the Ministry of Health of Ukraine № 826, November 6, 2014; Practice Guideline Committee of the American Association for the Study of Liver Diseases and the Practice Parameters Committee of the American College of Gastroenterology, 2010. Decisions regarding treatment are critically dependent on the ability to estimate a given patient‘s prognosis. The presence of significant protein calorie malnutrition is a common finding in alcoholics, as are deficiencies in a number of vitamins and trace minerals, including vitamin A, vitamin D, thiamine, folate, pyridoxine, and zinc. Recommended dose of prednisolone is 40 mg/day for 4 weeks then tapered over 2-4 weeks, or stopped, depending on the clinical situation. Appropriate patients with end-stage liver disease secondary to alcoholic cirrhosis should be considered for liver transplantation. L-glutamate - the major excitatory neurotransmitter in the brain of humans and animals. If necessary, the dose is increased to 100 mg per week to a daily dose of 300 mg in young and middle-aged patients and not more than 200 mg for elderly patients. A further increase in the dose usually does not lead to clinical improvement, but significantly increases the risk of side effects. Intravenous amantadine sulfate is effective in cases of akinetic crisis and expressed drugs for complications of levodopa therapy, which is an additional indication for its use. It is characterized by chronic increase the level of glucose in the blood due to absolute or relative insulin deficiency. This leads to disruption of all types of metabolism, vascular damage, nervous system and other organs and systems. Diabetes mellitus is one of the most common disease, it occupies the main place not only in the structure of endocrine diseases, but also among the diseases of non infectious nature: on a death rate it occupies the third place after cardiovascular and oncologic pathologies. Diabetes mellitus shortens the life of millions of people on the planet and its complications lead to decreasing in quality of life, disability and increasing of demand in hypoglycemic agents. In this connection the study the assortment of antidiabetic drugs in the pharmaceutical market, that allows us to determine how much the current range of these drugs in Ukraine, is necessary. The value of average salary in Ukraine during the studied years were found at the website: www. In the structure of foreign drugs the tendency their number 161 reducing in the Ukrainian market has been established. As a result it was found, that the prices of products both foreign and domestic production increased slightly. Low value of indicator of solvency adequacy ensures the availability of drugs and guaranteed its sales in low solvency of the population. In 2012 in Ukraine an innovative product - liraglutide ® ® (Viktoza ) was registered, later its analogue exenatide (Baeta ) was released in the market. At the present time liraglutide (Viktoza ) and exenatide (Baeta ) approved for use not only in the combination with other oral hypoglycemic agents, but also as monotherapy. These drugs can effectively do control the carbohydrate metabolism in patients with overweight and obesity and better influence on the level of postprandial glycemia in comparison with other drugs, have proven effect on reducing body weight, provide low risk of hypoglycemia and favorable impact on the cardiovascular system.
Timing of the process shall for holding containers shall be made of not begin until the retort has been strap iron buy kamagra chewable in india erectile dysfunction kya hai, adequately perforated sheet properly vented and the processing metal generic 100 mg kamagra chewable impotence at 75, or other suitable material cheap 100mg kamagra chewable free shipping erectile dysfunction natural cure. Some When perforated sheet metal is used for typical installations and operating pro- the bottoms 100mg kamagra chewable sale erectile dysfunction causes divorce, the perforations should be cedures reflecting the requirements of approximately the equivalent of 1-inch this section for venting still retorts are holes on 2-inch centers. If dividers are given in paragraph (a)(12)(i)(a) through used between the layers of containers, (d) and (ii)(a) and (b) of this section. Retorts using air for pressure cooling shall be equipped with a suitable valve to prevent air leakage into the retort during processing. Retorts using water for cooling shall be equipped with a suitable valve to prevent leakage of water into the retort during proc- Specifications. Vents shall be installed in plug cock valve and discharging to atmos- such a way that air is removed from phere; end vents not more than 21⁄2 feet from the retort before timing of the process ends of retort. I (4–1–10 Edition) °F, or at least 7 minutes and to at least 220 (d) Venting through a single 21⁄2-inch °F. Specifications: A 21⁄2-inch vent equipped with a 21⁄2-inch gate or plug cock valve and located within 2 feet of the center of the re- Specifications. Manifold vent gate or plug cock valve should be wide open for at least 6 minutes and to at least 225 °F, or for at least 8 minutes and to at least 220 °F. For retorts less than 15 feet in length, 2 inches; for retorts 15 feet and over in length, 21⁄2 inches. For retorts less than 15 feet in length, 11⁄2 inches; for retorts 15 1 Specifications. The number equipped with a 11⁄2-inch gate or plug cock of holes should be such that their total valve and with not more than 6 feet of 11⁄2- cross-sectional area is approximately equal inch pipe beyond the valve before break to to the cross-sectional area of the vent pipe the atmosphere or to a manifold header. Water spreader vent gate valve should be wide open for at least 4 min- or plug cock valve should be wide open for at utes and to at least 218 °F, or for at least 5 least 5 minutes and to at least 225 °F, or for minutes and to at least 215 °F. Each retort shall be equipped with at least one mercury-in-glass ther- mometer whose divisions are easily readable to 1 °F and whose temperature range does not exceed 17 °F per inch of graduated scale. Thermometers shall be tested for accuracy against a known accurate standard thermometer upon installation and at least once a year thereafter, or more frequently if nec- essary, to ensure their accuracy. A 1-inch vent in lid or top checks which specify date, standard side, equipped with a 1-inch gate or plug used, method used, and person per- cock valve and discharging directly into the forming the test should be maintained. Vent gate or plug cock seal, or other means of identity that valve should be wide open for at least 5 min- includes the date when it was last test- utes and to at least 230 °F, or for at least 7 ed for accuracy. Thermometers there is evidence in the form of heat shall be installed where they can be ac- distribution data, which shall be kept curately and easily read. Bulbs of indi- on file, that they accomplish adequate cating thermometers shall be located venting of air. Critical factors neath the surface of the water through- specified in the scheduled process shall out the process. On horizontal retorts, be measured and recorded on the proc- this entry should be made in the side essing record at intervals of sufficient at the center, and the thermometer frequency to ensure that the factors bulbs shall be inserted directly into the are within the limits specified in the retort shell. The mercury corded at intervals of sufficient fre- thermometer—not the recorder chart— quency to ensure that the weight of the shall be the reference instrument for product does not exceed the maximum indicating the processing temperature. Graduations um-packed products shall be observed on the temperature-recording devices and recorded at intervals of sufficient shall not exceed 2 °F within a range of frequency to ensure that the vacuum is 10 °F of the processing temperature. Each chart shall have a working scale (iii) Such measurements and record- of not more than 55 °F per inch within ings should be made at intervals not to a range of 20 °F of the processing tem- exceed 15 minutes. A bottom crate ized changes in adjustment shall be support shall be used in vertical still provided. Baffle plates shall not be used agement posted at or near the record- in the bottom of the retort. Centering ing device which provides a warning guides should be installed so as to en- that only authorized persons are per- sure that there is about a 11⁄2-inch mitted to make adjustments, is a satis- clearance between the side wall of the factory means for preventing unau- crate and the retort wall. The recorder may be (7) Stacking equipment and position of combined with the steam controller containers. The recording-thermometer strap iron, adequately perforated sheet bulb should be located adjacent to the metal, or other suitable material. If divider torts, the temperature recorder-control plates are used between the layers of bulb shall be located at the bottom of containers, they should be perforated the retort below the lowest crate rest as above. The positioning of containers in such a position that the steam does in the retort, when specified in the not strike it directly. In horizontal re- scheduled process, shall be in accord- torts, the temperature recorder-control ance with that process. Dividers, racks, bulb shall be located between the water trays, or other means of positioning of surface and the horizontal plane pass- flexible containers shall be designed ing through the center of the retort so and employed to ensure even circula- that there is no opportunity for direct tion of heating medium around all con- steam impingement on the control tainers in the retort. A nonclogging, water- trollers should have adequate filter tight valve shall be used. Screens systems to ensure a supply of clean, should be installed over all drain open- dry air. There shall gage, which should be graduated in di- be a means of determining the water visions of 2 pounds or less. Water shall cover the top of a capacity sufficient to prevent an layer of containers during the entire undesired increase in retort pressure come-up-time and processing periods when the water valve is wide open and and should cover the top layer of con- should be installed in the overflow line. Each retort shall operator shall check and record the be equipped with an automatic steam water level at intervals sufficient to controller to maintain the retort tem- ensure its adequacy. In both trolling instrument when combined horizontal and vertical still retorts for with a recording thermometer. Steam shall be shall be provided for introducing com- distributed in the bottom of the retort pressed air at the proper pressure and in a manner adequate to provide uni- rate. The proper pressure shall be con- form heat distribution throughout the trolled by an automatic pressure con- retort. A check valve shall be pro- steam distribution can be achieved by vided in the air supply line to prevent any of several methods. Air or retorts, the steam distributor shall run water circulation shall be maintained the length of the bottom of the retort continuously during the come-up-time with perforations distributed uni- and during processing and cooling peri- formly along the upper part of the pipe. In vertical file; if air is used to promote circula- retorts the cooling water should be in- tion, it shall be introduced into the troduced at the top of the retort be- steam line at a point between the re- tween the water and container levels; tort and the steam control valve at the in horizontal retorts the cooling water bottom of the retort. A check valve should circulating system is used for heat dis- be included in the cooling water line. The headspace manner that water will be drawn from the bottom of the retort through a suc- necessary to control the air pressure tion manifold and discharged through a should be maintained between the spreader which extends the length of water level and the top of the retort the top of the retort. The suction outlets should be protected Other installation and operating proce- with nonclogging screens to keep de- dures that deviate from these arrange- bris from entering the circulating sys- ments may be used, as long as there is tem. The pump shall be equipped with evidence in the form of heat distribu- a pilot light or other signaling device tion data or other suitable informa- to warn the operator when it is not tion, which shall be kept on file, that running, and with a bleeder to remove demonstrates that the heat distribu- air when starting operations.