Зачем нужна профориентация 2. Как помочь ребенку с выбором будущей профессии 3. Как определить наклонности своего ребенка 4. Как выбрать профессию: тесты для школьников 5. Результат будет показан сразу после ответа на . Тест на выбор профессии. Еще один психологический тест поможет выбрать будущую профессию. Как и все остальные тесты — бесплатно, без . А так же можете больше узнать про тест: На выбор профессии Голланда Установок личности Потемкиной Методику Климова Методику Голомштока На склонности Йовайши. Для проведения Задать один бесплатный вопрос психоаналитику. Пройти тесты на профориентацию/выбор профессии в Prevolio. Согласно теории Джона Холланда, большинство людей принадлежат к одному из шести типов личности. Люди, которые выбрали себе профессию, подходящую их типу, с большей вероятностью будут довольны работой и добьются профессиональных успехов. Данный тест позволяет определить ваш тип личности по Холланду, и рекомендует профессии, предпочтительные для этого типа. Бесплатный психологический тест онлайн для девушек: Какую профессию выбрать? В это время нужно определиться с выбором будущей профессии. Онлайн тест на профессию . Дорогие абитуриенты, наш тест поможет Вам определиться с выбором. Тебе предложили поучаствовать в организации интересного школьного . Методика для выявления степени выраженности социально- психологических установок (ориентация на процесс или результат, труд или свободу, альтруизм или эгоизм, власть или деньги). Методика Е. А. Климова основана на классификации профессиональных интересов личности и на основании этого позволяет установить область будущей профессии (специальности). Климов выделяет пять типов личности. Тест позволяет выявить интересы личности в профессиональной сфере. Для того, чтобы определить Ваши ведущие интересы, рекомендуется серьезно подойти к каждому ответу и постараться как можно точнее ответить. Данная методика применяется для оценки склонностей респондентов к различным сферам профессиональной деятельности, таким, как искусство, техника, работа с людьми, умственный труд, физический труд, производство товаров и услуг. А так же, мы знаем, что в Украине можно подавать документы в несколько учебных заведений и на разные специальности, а предметы ЗНО можно сдавать в ограниченном количестве и для пользователей нашего сайта был создан сервис подсчета предметов ЗНО и теперь вы можете подобрать оптимальные варианты.
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Total War — серия былинных глобальных стратегий/варгеймов в. Каждая игра повествует об определенной эпохе в истории человечества. Давайте играть в Арне Тотал! Спасибо за отвт!Еще вопрос:если сыграна карта 'своего' цвета '-200' в сочетании с 'хамелионом' на оппонента,то может ли он применить 'вора'?Перейдет ли '-200' на мое поле,а 'вор' и 'хамелион'-в сброс? Что касается тотал вор, это немного другой жанр, там нет экономики и развития, только тактика, военная стратегия - варгейм. Игры Стратегии Total War: Rome 2 Играть в игру Total War: Rome 2. Это конечно хорошо что они сделали солдат разного роста, и с разными царапинами на шлеме, но я же не в прототип играю. И играл я на приставках в самые разные игры. Хорошо помню, как в 2000 году увидел у друга на РС Shogun: Total War и просиживал у него, допоздна вглядываясь в спрайтовые модели солдат на мониторе пока его супруга не выключала ПК. Запуск новой кампании в Total War : Rome 2 не сильно Рим 2 дает неповторимое ощущение при игре за любую из фракций. Если у вас есть желание перенестись в Римскую империю, и спасти её от разрушения варваров, то вы можете это сделать, играя в «Rome: Total War - Roma Surrectum II»! Если вы любитель глобальных пошаговых стратегий, то игра «Medieval: Total War» для вас! Вообще, эта стратегия очень похожа на Тотал Вар. Подведу итог, вспомнив свой личный опыт: Когда я играл в Empire: Total War, а это было в 2009 году, то пройдя игру, я захотел найти что-то новенькое. Total War, экономика, семья, армия Экономика Доход в городах складывается из нескольких составляющих: торговля, налогообложение, горное дело и сельское хозяйство. Торговля зависит от наличия в провинции ценных ресурсов, от уровня развитости рынков, портов и дорог и, для восточных фракций, от развитости торгового каравана. Также торговля зависит от наличия торговых соглашений. Горное дело возможно не во всех провинциях, а только там где есть возможность построить шахты. Сельское хозяйство зависит от плодородности провинции и от уровня построенных ферм. Развитое сельское хозяйство может привести к демографическому взрыву. На все эти составляющие также могут влиять личные качества губернатора и построенные храмы. Накопленные средства тратятся на содержание армии, жалование генералам и агентам, найм армии, строительство новых зданий, коррупцию. Мир еще не начал отсчет,а Римская империя уже простиралась от британских островов до жарких песков Египта. И это история дома Сципионов. Группа ВК по данной т.. Все видео Семья Каждая фракция начинает с определённым набором членов семьи. Среди них есть «лидер фракции» и «будущий лидер фракции». Эти звания отображаются в окна персонажа, как характеристики. Будущего лидера фракции можно назначать, однако у принца, лишённого наследства, уменьшаются некоторые характеристики. В начале игры все члены семьи происходят от лидера фракции и его жены, у которых есть дети и внуки. Для контроля игрока доступна только мужская часть семьи достигшая совершеннолетия (1. В этом случае мальчик получает собственных телохранителей и становится полноценным генералом, который может командовать армией, набирать наёмников или быть губернатором в городе. У каждого члена семьи есть характеристики описывающие его способности в командовании и управлении. Также есть навык «влияние», которое отвечает за спокойство населения в городах и количество телохранителей у генерала. Римлянам, кроме того, доступны должности в сенате, которые также являются отличительными чертами. Кроме того, к генералу могут примкнуть различные люди, образующие его свиту. Свита бессмертна и способна переходить от одного генерала к другому. Потеряв всех мужских дееспособных членов семьи, фракция уничтожается, а все ее города и армии восстают и объявляют независимость. Армия Игра содержит огромное количество юнитов. Каждая представленная фракция обладает оригинальным набором бойцов. Некоторые из них имеют реальные исторические прототипы, другие являются фантазией команды разработчиков (например, отряды верблюдов и ужасные слоны Yubtseb амазонок). Городские постройки позволяют нанимать различные типы юнитов. Казарма дает возможность нанять пехотные соединения, конюшня — кавалерийские, стрельбище — стрелков, метательные машины, иногда боевых псов и конных стрелков, у некоторых фракций также слонов. Порт- позволяет нанимать бирему, трирему, квинкирему (цивилизованные) или лодки (варварские). Чем выше уровень необходимой постройки, тем более продвинутые отряды становятся доступны игроку. При найме боевого отряда линейно сокращается число граждан города. Армия состоит из отрядов. В одной армии может быть от одного до 2. Несколько армий могут сражаться одновременно на поле боя, но в этом случае игрок должен принять решение будут ли они являться подкреплениями или будут действовать самостоятельно. Но может получиться и так, что одна из армий не успеет прибыть на поле боя, до его завершения. Каждый юнит имеет свои показатели защиты и атаки, а также отличительные характеристики. У отрядов существуют такие показатели как численность, мораль и усталость. Также в сражениях отряд зарабатывает опыт, который отображается в виде лычек. Опыт отрядам можно поднять с помощью храмов. Улучшения оружия или брони даёт соответствующие плюсы. В осажденном городе нанимать юнитов нельзя. Как украсить окна к Новому 2. Новый год — пожалуй, самый красивый из всех праздников. Многие в поиске новогоднего настроения заранее готовятся к празднику: составляют праздничное меню, покупают подарки, выбирают наряд, наряжают ёлку, украшают дом и офис. Поговорим подробнее о том, как украсить окна к Новому 2. Это могут быть гирлянды, снежинки, вытынанки, сделанные своими руками или тематические наклейки, купленные в магазине. Популярнейшим украшением окон к Новому году остаются вытынанки — это декоративное искусство, которое основывается на вырезании красивых узоров из бумаги. Рисунок можно распечатать или нарисовать самостоятельно на белой или цветной бумаге. Трафарет - это лист из тонкого пластика или плотной бумаги, в котором вырезаны определённые части, составляющие исходное . Трафарет своими руками : пошаговая инструкция. Как использовать трафареты для стен: полезные советы и видео. Новогодние вытынанки шаблоны. В последние годы стало модно украшать окна к Новому году при помощи вытынанок из бумаги. Вытынанки новогодние трафареты. Украсить новогодними вытынанками можно не только окна, но и, например, мебель. Макетирование предметов из бумаги. Разработка всех видов трафаретов. Временные татуеровки, росписи хной. Вырезку начинаем с самых мелких деталей с использованием макетного или канцелярского ножика. А для вырезания более крупных частей можно использовать маникюрные ножницы. Готовые вытынанки приклеиваем на окно с помощью мыльного раствора или прозрачного скотча. Хозяйка 2. 01. 6 года — Огненная Обезьяна, не забывайте об этом при выборе украшений. Одноразовый трафарет Спортсмены набор. Выберите размер трафарета ( ширина х высота) Пользоваться одноразовым трафаретом очень просто: нанесите трафарет из самоклеящейся пленки на декорируемую поверхность так же, как виниловую наклейку для стен. Часть 22 - ШАБЛОНЫ, ТРАФАРЕТЫ растительные. Забавные детские поделки из бумаги с шаблонами к Пасхе Трафареты спорта.Download UC browser for Nokia Asha 3. You can download the latest version here. Visit wap. ucweb. UC Browser. Or click Download button below to download it directly. Try the latest version of UC Browser now! Download Related Models. UC Browser introduction. 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Nokia asha 311 ucbrowser - PC Suite for Nokia 3660. Free Nokia Video Converter Factory is an all-in-one video.This product is currently available on all major operating platforms in 7 different languages. UC Browser new features. Added new themes about FIFA World Cup. Fixed the problem of large file sizes not being shown correctly when downloading. Fixed the problem of users not being able to go to the right page when typing a page number on UC Forum. Nokia Asha 3. 11 introduction. Nokia Corporation is a Finnish multinational communications and information technology corporation headquartered in Keilaniemi, Espoo, Finland Its principal products are mobile telephones and portable IT devices. It also offers Internet services including applications, games, music, media and messaging through its Ovi platform, and free- of- charge digital map information and navigation services through its wholly owned subsidiary Navteq. It supports Single SIM, GSM, has Up to 3. GB internal memory. The phone can be expanded memory with USB Port, USB On- The- Go, micro. USB 2. 0. Nokia Asha 3. TFT screen, an 3. MP main camera supports VGA @ 2. FPS, Video zoom video recording. The phone can use Wi- Fi 8. EDR, PBAP, SAP, SDAP, SPP. Talktime Up to 1. Hours(2. G) / Up to 6 Hours(3. G) is long enough for common use. Windows Server. Windows Server is the platform for building an infrastructure of connected applications, networks, and web services, from the workgroup to the data center. For example, we had several file servers on our network and each of them had a number of different shares. From time to time when I passed by a user's desk I'd see them trying to click on a file in some share and getting Access Is Denied. Because they were trying to open documents they didn't have NTFS permissions on to read or modify. Yet they often double- clicked on them. Because they were curious. I mean, who wouldn't be curious if you found a share on the network named HR (for Human Resources department) and in this share you found a folder named Layoffs and within this folder you found a document named Next. Months. Layoffs. doc. Will I be one of those who will be laid off? Windows XP Service Pack 2 (SP2) contains major security improvements designed to provide better protection against hackers, viruses, and worms. Hi and thanks for this great patch. Enabling multiple sessions per user is not working for me in 7 x64 SP1 RTM. I've binary compared system32\termsrv.dll with 64. This scenario highlights one of the weaknesses of file sharing on Windows platforms, namely that by default all users who can access a network share can, at a minimum, see what files and folders there are in that share, even if they don't have any permission to access them. For example, say you share the folder C: \Budgets as BUDGETS with everyone having Read share permission and the Users group having Allow: Read & Execute ACE on the folder. Say also that within this share is a file named This. Year. xls and a folder named Previous. Now try this: add user Bob Smith to the ACL for these two file system objects, and assign Deny: Full Control ACE to both of them. Now log onto a Windows XP desktop as user Bob Smith and open My Network Places and browse till you find the BUDGETS share. As I’m sure you probably know, there are a number of system level services that are always running behind the scenes in Windows Server. In this article, I will. Windows Server 2003, Windows Server 2003 SP1 and SP2, and Windows Server 2003 R2 retired content. Double- click on the share and what do you see? A file named This. Year. xls and a folder named Previous. Try double- clicking on either of them to read the spreadsheet or browse the folder, and you get Access Is Denied. Well, if you, as Bob Smith, are denied access to these items, why are you even allowed to see them in the BUDGETS share? That's the whole rationale behind Access- Based Enumeration (ABE), a new technology included in Windows Server 2. R2. In other words, with ABE enabled and configured for the BUDGETS share, Bob can try browsing the BUDGETS folder using My Network Places, but when he looks inside BUDGETS he doesn't see anything there—his NTFS permissions on the file and folder present don't allow him to access these items, so they're not even visible to him. Note that this behavior is the same regardless of whether you explicitly assign a Deny ACE to Bob while granting Allow to the Users group, or whether you remove the ACE for Users and grant an Allow ACE only to groups of users that need it (groups that don't include Bob as a member) and have no ACE at all for Bob. If ABE had been available to me to use back in old NT 4 days, only senior management and HR personnel would have known about the existence of the Layoffs folder within the HR share, and no one but these personnel would have known about the existence of a document named Next. The product is compatible with the following versions: Kaspersky Security Center 10 Service Pack 1 (10.2.434) Patch D and later; Kaspersky Security Center 10 Service. An update is available that installs Key Management Service (KMS) 1.2 for Windows Server 2003 Service Pack 2 (SP2) and for later versions of Windows Server 2003. Support for Windows Server 2003 ended on July 14, 2015. Microsoft ended support for Windows Server 2003 on July 14, 2015. This change has affected your software. Months. Layoffs. doc. In other words, with ABE there wouldn't have been rumors of impending layoffs flying about—unless they were started by HR personnel or by a manager of course! Installing and Enabling ABEWhen I say that ABE was included with Windows Server 2. R2 (or SP1), I also need to explain that in order to use ABE you still need to download and install something on your file server. This something is a component that provides a user interface (both graphical and command- line) that allows you to enable and configure ABE on your server. You can download this component here from the Microsoft Download Center, but make sure you download the correct version depending upon your processor platform (x. AMD6. 4 or IA6. 4). Once you've downloaded the appropriate Windows Installer package, install it on all R2/SP1 file servers you want to enable ABE functionality on. Installing the ABE user interface component is a straightforward process (Figure 1): Figure 1: Installing the ABE user interface. The only significant decision you need to make during the install process is whether you want to automatically enable ABE retroactively on all existing shared folders on your server, or whether you prefer to configure this manually later on a per- folder basis (Figure 2): Figure 2: Deciding whether to retroactively configure ABE on existing shares or not. Note that choosing the first option in Figure 2 doesn't mean that future shares you create will automatically have ABE enabled on them—you still have to manually configure ABE on future shares you choose to create on your server. Once the ABE user interface is installed on your server, opening the properties sheet for a shared folder will display a new tab for enabling ABE on that share (Figure 3). Note that this tab won't appear on the properties sheets of folders that haven't yet been shared. Figure 3: The ABE tab on the properties sheet for a shared folder. Select the first checkbox in Figure 3 to enable ABE on the shared folder. Description: Windows XP Service Pack 3 (XP SP3) fixes a range of bugs and adds new features to Windows XP. The file is a large download and can be applied to any. Windows Server 2003 Service Pack 1, Windows Server 2003 x64 editions, Windows Server 2008 This update applies to the following programs. It's basically as simple as that. To check that ABE is working, compare Figure 4 below, which shows what Bob would see when he browsed the BUDGETS share from his XP machine before ABE is enabled on this share, with Figure 5 showing the same view on Bob's computer after ABE is enabled on the share. Figure 4: Before ABE is enabled on BUDGETS, Bob can see everything in it—even if he has Deny ACE on all items present. Figure 5: After ABE is enabled on BUDGETS, Bob cannot see files and folders he has no ACE for (or has Deny ACE for)Limitations of ABEThere are a few limitations of ABE: You need Windows Server 2. R2 or SP1 in order to be able to use it. This means ABE isn't really suitable for Terminal Services environments. The good news however is that ABE is built into the new Windows Vista and Longhorn Server platforms and is enabled by default and needs absolutely no configuration on those platforms. So a folder shared on a Vista machine will only show its contents to users who have permissions to access items within it. Last word on the subject. ABE is a good thing, especially if your company stores sensitive business information on file servers on your network. Remember that a malicious (or merely curious) user can sometimes find out a lot about your business merely by viewing the names of documents stored in shared folders on your file servers. What would an employee do if they nosed around and found a document named Our. CEOwillretiretomorrow. Probably sell his shares fast and tell his friends as well, and soon your company will have the SEC or some other regulatory agency breathing down your neck for insider trading! Call of Duty: Black Ops 3 Update Patch 1. Releasing On Xbox One Today. Update patch 1. 0. PS4 just a couple of days ago, now Treyarch will be releasing it for the Xbox One console later today sometime. The update patch for Call of Duty: Black Ops 3 on Xbox One is slightly different to the one that came out on the PS4. For one thing, the “Nuk. Calling Card, Reticles, and Weapon Camo are now available to all Xbox One players“. This was offered to PS4 gamers a few weeks ago already. Other multiplayer fixes include: “Fixed error related to using a picked- up weapon from a Player who left the game, Resolved issue where Players were able to kill a prone Player when they ran over them with a carried Guardian or Hardened Sentry, Fixed bug where if a Player died by a Semtex during the HC- XD calling animation, enemy Scorestreaks would continually fire at the spot of death, Addressed global spawn issue that could occur when Players were killed when deploying Scorestreaks. Added spawn trap logic to Uplink and Safeguard where additional spawns will open under extreme scenarios, Enabled spawn trap logic in Public online matches, Resolved bug where Players were able to gain additional Specialist Power by switching Classes at the beginning of a round.”Another difference is that something has been altered in the Campaign for the Xbox One version. The fix says: “Disabled physics wind on all maps.”. It’s worth mentioning the PC version has not received the new update yet, so be patient if you are playing on that platform. To read about all of the update patch notes for the Xbox One version of Call of Duty: Black Ops 3, you can do so by clicking here right now. The Multiplayer and Zombies modes have had the most fixes. The biggest first-person action series of all time and the follow-up to critically acclaimed Call of Duty. Activision and Treyarch have now released update patch 1.09 for the PS4 version of Call of Duty: Black Ops 3. The update patch is due out in order to support the upcoming release of the Eclipse DLC pack. That's what pcdev was doing. Making a new patch for Call of Duty: Black Ops.CoD: Black Ops PC Patch 1.09 just went LIVE.The. CoD: Black Ops PC Patch 1.09 just went LIVE. The 1.09 Change log in. Call of Duty: Black Ops 3's PC version is a mess at launch. Call of Duty: Black Ops 3 patch notes for 1.09! Call of Duty: Black Ops 3 patch notes for 1.09! Call of Duty: Black Ops has just received a brand new patch on the PC platform, taking it to version 1.09 and is now available for download via Valv. PlayStation 4 will be the first to receive 'Call of Duty: Black Ops III' patch 1.05. PC and Xbox One Editions Coming Out Soon. By Mel Abad ([email protected]) First Posted: Feb 02, 2016 06:05 AM EST. Cheats for Call of Duty: Black Ops for the PC. Call of Duty: Black Ops Cheats for the PC. GAME; REVIEWS; PREVIEWS; SCREENS; VIDEOS. Undertale Dev Celebrates 1 Year Anniversary With. CALL OF DUTY BLACK OPS, CALL OF DUTY GHOSTS, CALL OF DUTY ADVANCED WARFARE, CALL OF DUTY INFINITE. Call of Duty: Black Ops. Also known as: Belongs to Series: Available on: PC Release date: Developer: Treyarch Publisher: 1C, Activision. Download available via Steam. Parkhurst Ranch & Pumpkin Patch. Make your way to Parkhurst Ranch and Pumpkin Patch in Arcadia to enjoy a day of fun at a working ranch. Explore the ranch with friends and family on a hay wagon ride before winding your way through the hay bale maze. P Bar Farms is a working family farm. We host seasonal events, corn mazes, train rides, laser tag, & mini-golf. Pumpkin Patch; Hay & Train Rides; Farm Animals; Large Playground; Miniature Golf; Mining Sluice - pan. Come to the Parkhurst Pumpkin Patch! Planning your child’s birthday party? View MetroFamily's directory of OKC area party venues & supply stores. Browse by city, view maps & read reviews! Edmond Children's Directory Alphabetical. Mikles Family Farm - Shawnee Maze. Crestview Farms is one of Oklahoma's premier. Mill Christmas Tree and Blackberry Farm Edmond, OK Oklahoma Christmas Tree Association. Parkhurst Pumpkin Patch, Arcadia, OK. Open Thursdays - Sundays! Thurs & Sun 1pm - 6pm; Fri & Sat. 4 reviews of Parkhurst Pumpkin Patch 'Best pumpkin patch in the OKC area by far! They have a hayride, HUGE maze, petty zoo, pony rides, pumpkin painting, rope and tire swing, castle with ball games for the kids, hay barrels to. Oklahoma Pumpkin Patches And More.org Find a pumpkin patch, corn maze. Search; Feedback; Customer: add a farm; Make minor corrections; Resources. Clickable OK County Map; Your local weather forecast; The. Get directions, reviews and information for Parkhurst Pumpkin Patch in Arcadia, OK. Pumpkin Patch Ticket Giveaway Contest. Hay rides, pumpkin patches. Schedule II opioid substances which include fentanyl, hydromorphone, methadone, morphine, oxycodone, and oxymorphone have the highest potential for abuse and associated risk of fatal overdose due to respiratory depression. Fentanyl can be abused and is subject to criminal diversion. The high content of fentanyl in the patches (DURAGESIC. Patients who are considered opioid- tolerant are those who have been taking, for a week or longer, at least 6. Because serious or life- threatening hypoventilation could occur, DURAGESIC. Home / fentanyl - transdermal, duragesic drug monograph fentanyl - transdermal, Duragesic. ARTICLE; INDEX; Surprising. Ask your doctor when to start or stop taking this medication.The risk of serious side effects. Duragesic-75 drug information, including side effects, dosage and usage. Duragesic, Duragesic-100. What are the possible side effects of a fentanyl transdermal skin patch? Patients receiving DURAGESIC. Use in non- opioid tolerant patients may lead to fatal respiratory depression. Overestimating the DURAGESIC. Due to the mean half- life of approximately 2. See the detailed Instructions for Use for information about how to apply and dispose of the DURAGESIC . Do not apply more than 1 patch at the same time unless. These are not all the possible side effects of. Troublesome side effects of oral morphine, hydromorphone, or oxycodone. Alza Corporation and Janssen Pharmaceutica Products, the manufacturers of the Duragesic fentanyl transdermal pain patch. Bradley on fentanyl transdermal system side effects. Doctor insights on: Fentanyl Transdermal System Side Effects Share. Fentanyl patch: Some of the common side effects include nausea. Drug information provided by: Micromedex. Along with its needed effects, a medicine may cause some unwanted effects. Request Appointment; Give Now; Contact Us; About. Duragesic-12 (fentanyl transdermal patch). Fentanyl can cause side effects that may impair your thinking or reactions. Duragesic, Duragesic-100, Duragesic-12, Duragesic-25, Duragesic-50. List Duragesic transdermal side effects by likelihood and severity. DURAGESIC 12 MCG/HR PATCH. View Larger Picture color No data. DURAGESIC 25 MCG/HR PATCH.DURAGESIC. This risk should be considered when administering, prescribing, or dispensing DURAGESIC. Patients should be assessed for their clinical risks for opioid abuse or addiction prior to being prescribed opioids. All patients receiving opioids should be routinely monitored for signs of misuse, abuse, and addiction. Patients at increased risk of opioid abuse may still be appropriately treated with modified- release opioid formulations; however, these patients will require intensive monitoring for signs of misuse, abuse, or addiction. DURAGESIC. Do not use a DURAGESIC. Avoid exposing the DURAGESIC. Avoid taking hot baths or sunbathing. There is a potential for temperature- dependent increases in fentanyl released from the system resulting in possible overdose and death. Patients wearing DURAGESIC. The chemical name is N- Phenyl- N- (1- (2- phenylethyl)- 4- piperidinyl) propanamide. The structural formula is: The molecular weight of fentanyl base is 3. C2. 2H2. 8N2. O. The n- octanol: water partition coefficient is 8. The p. Ka is 8. 4. System Components and Structure. The amount of fentanyl released from each system per hour is proportional to the surface area (2. The composition per unit area of all system sizes is identical. Dose*(mcg/h)Size(cm. Fentanyl Content(mg)1. Proceeding from the outer surface toward the surface adhering to skin, these layers are: 1) a backing layer of polyester/ethyl vinyl acetate film; 2) a drug- in- adhesive layer. Before use, a protective liner covering the adhesive layer is removed and discarded. The active component of the system is fentanyl. The remaining components are pharmacologically inactive. CLINICAL PHARMACOLOGYPharmacology. Fentanyl is an opioid analgesic. Fentanyl interacts predominately with the opioid mu- receptor. These mu- binding sites are discretely distributed in the human brain, spinal cord, and other tissues. In clinical settings, fentanyl exerts its principal pharmacologic effects on the central nervous system. In addition to analgesia, alterations in mood, euphoria, dysphoria, and drowsiness commonly occur. Fentanyl depresses the respiratory centers, depresses the cough reflex, and constricts the pupils. Analgesic blood concentrations of fentanyl may cause nausea and vomiting directly by stimulating the chemoreceptor trigger zone, but nausea and vomiting are significantly more common in ambulatory than in recumbent patients, as is postural syncope. Opioids increase the tone and decrease the propulsive contractions of the smooth muscle of the gastrointestinal tract. The resultant prolongation in gastrointestinal transit time may be responsible for the constipating effect of fentanyl. Because opioids may increase biliary tract pressure, some patients with biliary colic may experience worsening rather than relief of pain. While opioids generally increase the tone of urinary tract smooth muscle, the net effect tends to be variable, in some cases producing urinary urgency, in others, difficulty in urination. At therapeutic dosages, fentanyl usually does not exert major effects on the cardiovascular system. However, some patients may exhibit orthostatic hypotension and fainting. Histamine assays and skin wheal testing in clinical studies indicate that clinically significant histamine release rarely occurs with fentanyl administration. Clinical assays show no clinically significant histamine release in dosages up to 5. Pharmacokinetics(see graph and tables)The DURAGESIC. Fentanyl is released from the matrix at a nearly constant amount per unit time. The concentration gradient existing between the matrix and the lower concentration in the skin drives drug release. Fentanyl moves in the direction of the lower concentration at a rate determined by the matrix and the diffusion of fentanyl through the skin layers. While the actual rate of fentanyl delivery to the skin varies over the 7. While there is variation in dose delivered among patients, the nominal flux of the systems (1. Fentanyl then becomes available to the systemic circulation. Serum fentanyl concentrations increase gradually following initial DURAGESIC. Peak serum concentrations of fentanyl generally occurred between 2. Table A). Serum fentanyl concentrations achieved are proportional to the DURAGESIC. With continuous use, serum fentanyl concentrations continue to rise for the first two system applications. By the end of the second 7. Patients reach and maintain a steady- state serum concentration that is determined by individual variation in skin permeability and body clearance of fentanyl. After system removal, serum fentanyl concentrations decline gradually, falling about 5. Continued absorption of fentanyl from the skin accounts for a slower disappearance of the drug from the serum than is seen after an IV infusion, where the apparent half- life is approximately 7 (range 3–1. Alterations in p. H may affect its distribution between plasma and the central nervous system. Fentanyl accumulates in the skeletal muscle and fat and is released slowly into the blood. The average volume of distribution for fentanyl is 6 L/kg (range 3–8; N=8). Fentanyl is metabolized primarily via human cytochrome P4. A4 isoenzyme system. In humans, the drug appears to be metabolized primarily by oxidative N- dealkylation to norfentanyl and other inactive metabolites that do not contribute materially to the observed activity of the drug. Within 7. 2 hours of IV fentanyl administration, approximately 7. Approximately 9% of the dose is recovered in the feces, primarily as metabolites. Mean values for unbound fractions of fentanyl in plasma are estimated to be between 1. Skin does not appear to metabolize fentanyl delivered transdermally. This was determined in a human keratinocyte cell assay and in clinical studies in which 9. Special Populations. Hepatic or Renal Disease. Insufficient information exists to make recommendations regarding the use of DURAGESIC. Fentanyl is metabolized primarily via human cytochrome P4. A4 isoenzyme system and mostly eliminated in urine. If the drug is used in these patients, it should be used with caution because of the hepatic metabolism and renal excretion of fentanyl. Pediatric Use. In 1. In older pediatric patients, the pharmacokinetic parameters were similar to that of adults. However, these findings have been taken into consideration in determining the dosing recommendations for opioid- tolerant pediatric patients (2 years of age and older). For pediatric dosing information, refer to DOSAGE AND ADMINISTRATION section. Geriatric Use. Data from intravenous studies with fentanyl suggest that the elderly patients may have reduced clearance and a prolonged half- life. Moreover elderly patients may be more sensitive to the active substance than younger patients. A study conducted with the DURAGESIC. Subjects received oral ritonavir or placebo for 3 days. The ritonavir dose was 2. Day 1 and 3. 00 mg tid on Day 2 followed by one morning dose of 3. Day 3. On Day 2, fentanyl was given as a single IV dose at 5 mcg/kg two hours after the afternoon dose of oral ritonavir or placebo. Naloxone was administered to counteract the side effects of fentanyl. The results suggested that ritonavir might decrease the clearance of fentanyl by 6. AUC0–. Coadministration of ritonavir in patients receiving DURAGESIC. Coadminstration with agents that induce CYP3. A4 activity may reduce the efficacy of DURAGESIC. The concomitant use of transdermal fentanyl with all CYP3. A4 inhibitors (such as ritonavir, ketoconazole, itraconazole, troleandomycin, clarithromycin, nelfinavir, nefazadone, amiodarone, amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, and verapamil) may result in an increase in fentanyl plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. Patients receiving DURAGESIC. In clinical trials of 3. DURAGESIC. Hypoventilation was manifested by respiratory rates of less than 8 breaths/minute or a p. CO2 greater than 5. Hg. In these studies, the incidence of hypoventilation was higher in nontolerant women (1. Although patients with impaired respiration were not common in the trials, they had higher rates of hypoventilation. In addition, post- marketing reports have been received that describe opioid- naive post- operative patients who have experienced clinically significant hypoventilation and death with DURAGESIC. The incidence of bradycardia in clinical trials with DURAGESIC. Patients who are considered opioid- tolerant are those who have been taking, for a week or longer, at least 6. Because serious or life- threatening hypoventilation could result, DURAGESIC. Prescribers should individualize treatment in every case, initiating therapy at the appropriate point along a progression from non- opioid analgesics, such as non- steroidal anti- inflammatory drugs and acetaminophen, to opioids, in a plan of pain management such as outlined by the World Health Organization, the Agency for Health Research and Quality, the Federation of State Medical Boards Model Policy, or the American Pain Society. Patients should be assessed for their clinical risks for opioid abuse or addiction prior to being prescribed opioids. Robot Check. Enter the characters you see below. Sorry, we just need to make sure you're not a robot. For best results, please make sure your browser is accepting cookies. Boots - The UK's most popular chemist. Pharmacy, health, beauty, fragrance, toiletries and much more. Canker sores can be very painful. Make sure to read the instructions carefully prior to using any canker sore medicine to help you get the best possible results. Mouth sores or canker sores in children are painful, shallow ulcers on the lining of the mouth. Learn how to treat at home and when to call the doctor. Dentek has acquired Canker Cover and OraMoist, two oral care brands previously owned by Quantum Health. The products treat canker sores and dry mouth, respectively. Canker X Instructions Canker sores are small, red, painful ulcers that occur on the inside of your mouth. Find out what causes them, how you can get relief fast, and. Treadwheel has been extremly Canker patch instructions not included movie puled withe at knifepoint hand dustcart. A terrible, terrible product in every way. My first attempt at applying a Canker Cover patch was a. The instructions for Canker Cover say that 'Some. What are Shareware, Trial Software, and Freeware? Most shareware is delivered free of charge by downloading it from the Internet. Software download sites are archives of thousands of different programs. Best Free Email Software. I wouldn't vote for it as the best free email client for the same reason as the reviewer says. The following tables compare general and technical features of a number of email client programs. Free licence written by the author: TUI and. As of April, 2014, there are no email clients that support SMTPUTF8. Shareware, freeware, and public domain are software categories defined by how programs may be distributed, copied, used, and modified. The. Free. Site. com offers free stuff, freebies, free product samples, freeware(www. The. Free. Site. com is the home of the Web's best freebies. We feature a roundup of the top free products, services and offers available on the Web. It's our ongoing mission to round up the all the latest and greatest freebies in one convenient spot. To keep up with our latest freebies, subscribe to our E- mail freebies newsletter (it's free, of course!) And please don't forget to bookmark us. Sign up for our free E- mail service here. A list of the best free antivirus software for Windows, updated September, 2016. See reviews and download links for these completely free AV programs. 32 bit Windows shareware and freeware. Games, utilities, Internet, graphics, and Webmaster tools. Be sure to check with The. Free. Site. com daily, as we're constantly adding new free offers. Click for our Facebook feed. Or click here for our Twitter feed. Our privacy policy is here. All listings on this site copyrighted, 1. The. Free. Site. com. Freeware E-mail Programs. The programs used to send and receive email over the Internet. |
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