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CURSO DE INGLÊS EM NATAL

TURMAS REDUZIDAS OU AULAS PARTICULARES

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By A. Abbas. Arkansas State University.

Opening remarks at the frst meeting of the member state mechanism on substandard/spurious/falsely-labelled/falsifed/counterfeit medical products cheap viagra capsules amex. Council of Europe Convention on the Counterfeiting of Medical Products and Similar Crimes Involving Threats to Public Health discount viagra capsules 100mg amex. Paper presented at the Fourteenth Inter- national Conference of Drug Regulatory Authorities purchase discount viagra capsules online, Singapore. Ensuring safe foods and medical products through stronger regulatory systems abroad. Field of dreams: The New Zealand experience with recognition of other regulator’s decisions. Resolution adopted by the Economic and Social Council: Strat- egy for the period 2012-2015 for the United Nations Offce on Drugs and Crime. Not what the doctor ordered: The growing linkages between fraudulent medi- cines and organized crime. Paper presented at Asia Regulatory Conference: Asia’s Role in Global Drug Develop- ment, Seoul, Republic of Korea. New global mechanism to combat substandard/spurious/falsely-labelled/ falsifed/counterfeit medical products. Countering the Problem of Falsified and Substandard Drugs Copyright © National Academy of Sciences. Adulteration: The alteration of a product by deliberately adding something not ordinarily a part of it. Adverse drug reaction: A harmful result of drug therapy that is neither intended nor expected in normal therapeutic use. Anthelmintic resistance: The ability of worms to survive treatment at the generally effective recommended dose. It calls for strong legal frameworks and innovative provisions to deepen international cooperation and to promote strong intellectual property rights enforcement practices. Antimicrobial resistance: The ability of microorganisms that cause disease to withstand attack by antimicrobial medicines. Antiretroviral drugs: Drugs used to treat people infected with the human immunodefciency virus. Artemisinin: A drug used to treat malaria derived from the Artemisia An- nua plant family. It and its derivatives are a group of drugs that possess the most rapid action against the disease. Artemisinin-based combination therapy: A combination of artemisinin or one of its derivatives with an antimalarial drug or drugs of a different class. Beta-lactam antibiotics: A broad class of antibiotics, consisting of all antibi- otic agents that contain a beta-lactam nucleus in their molecular structure. This includes penicillin derivatives, cephalosporins, monobactams, and carbapenems. Most beta-lactam antibiotics work by inhibiting cell wall biosynthesis in the bacterial organism and are the most widely used group of antibiotics. Bioavailability: Bioavailability is a subcategory of absorption and is the fraction of an administered dose of unchanged drug that reaches the sys- temic circulation, one of the principal pharmacokinetic properties of drugs. By defnition, when a medication is administered intravenously, its bioavail- ability is 100 percent. However, when a medication is administered via other routes (such as orally), its bioavailability generally decreases due to incomplete absorption and frst-pass metabolism. Bioequivalent: The absence of a signifcant difference in the rate and extent to which the active ingredient or active moiety in pharmaceutical equiva- lents becomes available at the site of drug action, when administered at the same molar dose under similar conditions in an appropriately designed study. Black market: A market of goods or services that operates outside the for- mal market, not supported by an established state power. Blockbuster drugs: Popular drugs that generate at least $1 billion in annual sales for the company that creates them. British Pharmacopoeia: Established in 1864, the British Pharmacopoeia provides authoritative offcial standards for pharmaceutical substances and medicinal products in the United Kingdom and many other countries that have adopted it. For example, density is a bulk property because it does not depend on the amount of substance tested. Central medical store: Primarily found in developing countries, it is the Ministry of Health’s procurement arm and national medical store. Central medical stores are generally responsible for the procurement, quality assur- ance, storage and distribution of drugs, vaccines, disinfectants, dressings, and related medical supplies for government health facilities and some nongovernment organizations. Chain of custody: A document intended to guarantee the integrity of a drug product along the distribution chain. Chromatography: A method for separating a mixture into its constituent substances. The separation is based on differential partitioning between a mobile and stationary phase. Subtle differences in a compound’s partition- ing result in differential retention on the stationary phase, thus effecting Copyright © National Academy of Sciences. This method is used to separate mixtures such as drugs for accurate and precise analysis. Civil liability: The potential responsibility for payment of damages or other court enforcement in a lawsuit. Colorimetry: The experimental measurement of the amount of color pro- duced by a colorimetric reagent and a sample. Compounding: The creation of a particular pharmaceutical produce to ft the unique needs to a patient. To do this, compounding pharmacists combine or process appropriate ingredient using various tools. This may be done for medically necessary reasons, such as to change the form of the medication from a solid pill to a liquid, to avoid a nonessential ingredi- ent that the patient is allergic to, or to obtain the exact dose(s) needed of particular active pharmaceutical ingredient(s). It may also be done for more optional reasons, such as adding favors to a medication or otherwise altering taste or texture. Compulsory license: Also known as statutory license of mandatory collec- tive management, provides that the owner of a patent or copyright licenses the use of their rights against payment either set by law or determined through some form of arbitration. In essence, under a compulsory license, an individual or company seeking to use another’s intellectual property can do so without seeking the rights holder’s consent, and pays the rights holder a set fee for the license. Contract manufacturing: The manufacturing of a product by an organiza- tion or company other than the marketing company. Convenience sample: A type of nonprobability sampling which involves the sample being drawn from the part of the population that is close to hand. That is, a sample population selected because it is readily available and convenient. The researcher using such a sample cannot scientifcally make generalizations about the total population from this sample because it would not be fully representative. Crude active ingredients: Chemicals that have not undergone the appropri- ate purifcation steps required to meet pharmacopeial standards or manu- facturer’s dossier requirements. It can be a result of high temperatures exceeding label requirements, resulting in decreased potency and effcacy.

It is recommended that patients on therapy for longer than 2 weeks and with total doses of greater than 500g should be monitored carefully for renal purchase viagra capsules 100mg without a prescription, hepatic 100mg viagra capsules overnight delivery, or muscle toxic- ity generic viagra capsules 100 mg otc. Aprotinin Indication Aprotinin is used in the United States in adults to prevent hemorrhage after coronary artery bypass graft; it has been used in liver transplantation as a 11. Mechanism of Action Aprotinin is a serine protease inhibitor; it inhibits plasmin, kallikrein, and platelet activation; and is a weak inhibitor of plasma pseudocholinesterase. Dosing A test dose should be administered to all patients at least 10 minutes before administration of the routine dose to assess for allergic reaction. Infants and Children: data pertaining to dosage recommendations in this population vary, with no conclusive dosing regimen established. Pharmacokinetics Aprotinin has a rapid distribution and a slow degradation by lysosomal enzymes, with an elimination half-life of 150 minutes and a terminal elimina- tion of 10 hours. Aprotinin is an ingredient in some fibrin sealant products, and this should also be noted. Consider limiting aprotinin use to patients in whom the benefit of reducing blood loss is essential to management. Anticoagulants, Antithrombotics, and Antiplatelets 255 Poisoning Information Carefully monitor patients for the occurrence of toxicity. Compatible Diluents Aprotinin is incompatible with corticosteroids, amino acid solutions, fat emul- sions, heparin, and tetracyclines. Administration All patients treated with aprotinin should first receive a 1-mL test dose at least 10 minutes before the loading dose to assess for a potential allergic reaction; patients who have received aprotinin in the past are at increased rate of anaphylactic reac- tions and should be pretreated with an antihistamine and H2 blocker before administration of the loading dose. Administer the loading dose over 20 to 30 minutes with patient in supine position; no other medications should be present in the same line. Mechanism of Action Argatroban is a direct, highly selective thrombin inhibitor that reversibly binds to thrombin’s active site. Recommendations on dosing have been extrapolated from the adult literature; however, because of 256 P. Neonates and infants, however, may have immature development and function of the liver and require dosing on the more conservative side of the range. The elimination half-life of argatroban is 39 to 51 minutes and can be as long as 181 minutes in patients with hepatic impairment. Contraindications Contraindications to argatroban are hypersensitivity to argatroban or major bleeding. Precautions/Warning Caution should be taken in administering argatroban to patients with increased risk of hemorrhage (e. Poisoning Information A minimum toxic dose of argatroban in humans has not been established. Treatment of possible overdose is symptomatic and supportive, with no specific antidotes available. Monitor for signs of bleeding, vital signs, electrocardio- gram, and renal and hepatic function in symptomatic patients. Discontinue or decrease infusion to control excessive anticoagulation with or without bleeding. Reversal of anticoagulant effects may be longer than 4 hours in patients with hepatic impairment. Hemodialysis may remove up to 20% of the drug; however, this is considered clinically insignificant. Off-label use of aspirin includes the treat- ment of Kawasaki Disease and to prevent thrombosis in patients after single ventricle palliation with a shunt, bidirectional Glenn, or Fontan procedure. Mechanism of Action Aspirin is a salicylic derivative that inhibits both prostaglandin synthesis and platelet aggregation. Dosing Children: Analgesic and antipyretic (oral, rectal): 10 to 15mg/kg/dose every 4 to 6 hours; maximum dose, 4 grams/day Anti-inflammatory (oral): initial, 80 to 100 mg/kg/day in divided doses Kawasaki Disease (oral): 80 to 100 mg/kg/day divided every 6 hours for 2 weeks, then 3 to 5 mg/kg/day once daily for 7 weeks or longer Antiplatelet effects: adequate pediatric studies have not been per- formed, therefore, the dose is not well established. Doses ranging from 3 to 10mg/kg/day administered as a single daily dose have been used; doses are rounded to a convenient amount; maximum, 325 mg/dose Mechanical heart valves: 6 to 20 mg/kg/day either alone or in combina- tion with dipyridamole Blalock-Taussig shunt and endovascular stents:2,11 1 to 5 mg/kg/day Fontan procedure: 5 mg/kg/day Arterial ischemic stroke: 2 to 5 mg/kg/day after discontinuation of anti- coagulants Adults: Analgesic and antipyretic (oral, rectal): 325 to 1000 mg every 4 to 6 hours (up to 4 grams/day) Anti-inflammatory (oral): 2. The immediate-release formulation is completely absorbed, whereas the enteric-coated form is erratically absorbed. The half-life of the active drug is 6 hours with a time-to-peak serum concentration being 1 to 2 hours (this may be delayed with controlled- or timed-release preparations). Patients with asthma, rhinitis, or nasal polyps may be more sensitive to the effects of salicylates. Combination therapy of salicylates and carbonic anhydrase inhibitors, such as acetazolamide, brinzolamide, dichlorphenamide, dorzolamide, and meth- azolamide, has resulted in significant metabolic acidosis in pediatric and adult patients. Nondihydropyridine calcium channel blockers (diltiazem and verapamil) may enhance the anticoagulant effect of salicylates. Salicylates may enhance the adverse/toxic effect of varicella virus-containing vaccines causing Reye’s syndrome, and they may increase serum concentration of methotrexate. Adverse Effects Adverse effects of aspirin use include rash, urticaria, nausea, vomiting, dys- pepsia, epigastric discomfort, occult bleeding, prolongation of bleeding time, leukopenia, thrombocytopenia, hepatotoxicity, bronchospasm, tinnitus, head- ache, dizziness, confusion, metabolic acidosis, and hyperpyrexia. Poisoning Information Salicylate serum concentrations correlate with the pharmacological actions, and adverse effects are observed with serum salicylate levels of approximately 100mg/dL. Patients with mild-to-moderate intoxication may develop fever, tachypnea, tinnitus, respiratory alkalosis, metabolic acidosis, lethargy, mild dehydration, nausea, and vomiting. Severe intoxication may result in encepha- lopathy, coma, hypotension, pulmonary edema, seizures, acidemia, coagulopa- thy, cerebral edema, and dysrhythmias. Treatment of accidental or chronic ingestion is supportive and can include the use of activated charcoal and gastric lavage. Hemodialysis can be considered for patients with high blood salicylate levels (>80 to 100mg/dL after acute overdose, >50 to 60mg/dL after chronic over- dose). Do not crush or chew controlled-release, timed-release, or enteric- coated tablets; these are designed to be swallowed whole. Mechanism of Action Clopidogrel blocks adenosine diphosphate receptors, preventing fibrinogen binding and platelet adhesion and aggregation. Dosing Children: Safety and efficacy in pediatric patients are not established; how- ever, clopidogrel has been used in pediatric patients, with data published in infants as young as 6 weeks of age. Anticoagulants, Antithrombotics, and Antiplatelets 261 patients with increased risk factors for intracranial hemorrhage and those with intracranial vasculopathies. Clopidogrel has been used in addition to aspirin therapy in patients with Kawasaki’s Disease and giant coronary artery aneurysms. Although there are no published studies in children, doses of 1mg/kg/day by mouth to a maximum adult dose (75mg/day) have been used. Clopidogrel is well absorbed, with a time-to-peak concentration of 1 hour and at least 50% bioavailability. It is metabolized extensively through the liver via hydrolysis, with production of an inactive metabolite that is a carboxyl acid derivative. The elimination half-life is 8 hours, with 50% renal excretion and 46% fecal excretion. Contraindications Contraindications to clopidogrel administration are hypersensitivity to clopidogrel and active bleeding (e. Precautions/Warning Use clopidogrel with caution in patients who may be at risk of increased bleeding.

The Healthcare System The healthcare system may be the biggest hindrance to adherence buy cheap viagra capsules 100 mg on-line. Long waitng tmes discount 100mg viagra capsules amex, uncaring staf cheap viagra capsules 100 mg with mastercard, uncomfortable environment, exhausted medicine supplies and so on, are all common problems in developing countries, and have a major impact on adherence. An important problem is the distance and accessibility of the clinic from the patent. Some studies have confrmed the obvious, that patents farthest from the clinic are least likely to adhere to treatment in the long term. They difer from accidental to deliberate excessive dosage or medicine maladministraton. Thalidomide marked the frst recognized public health disaster related to the introducton of a new medicine. It is now recognized that clinical trials, however thorough, cannot be guaranteed to detect all adverse efects likely to be caused by a medicine and hence necessitatng post-marketng surveillance. Health workers are thus encour- aged to record and report to the Natonal Pharmacovigilance Centre for any unexpected adverse efects with any medicine to achieve faster recogniton of serious related problems. Major Factors Predisposing to Adverse Efects It is well known that diferent patents ofen respond difer- ently to a given treatment regimen. For example, in a sample of 2422 patents who had been taking combinatons of drugs known to interact, only 7 (0. Drugs which commonly cause problems in the elderly include hypnotcs, diuretcs, non-steroidal ant-infamma- tory drugs, anthypertensives, psychotropics, digoxin etc. All children, and partcularly neonates, difer from adult in their response to drugs. Some drugs are likely to cause problems in neonates (for example morphine ), but are generally toler- ated in children. Other drugs associated with problems in children include chloramphenicol (grey baby syndrome), antarrhythmics (worsening of arrhythmias), acetylsalicylic acid (Reye’s syndrome etc). Drug Interactons Interactons (see Appendix 6) may occur between drugs which compete for the same receptor or act on the same physiolog- ical system. They may also occur indirectly when a medicine- induced disease or a change in fuid or electrolyte balance alters the response to another medicine. Interactons may occur when one medicine alters the absorpton, distributon, metabolism or eliminaton of another medicine, such that the amount which reaches the site of acton is increased or decreased. When two drugs are administered to a patent, they may either act independent of each other, or interact with each other. Interactons may increase or decrease the efects of the drugs concerned and may cause unexpected toxicity. As newer and more potent drugs become available, the number of serious medicine inter- actons is likely to increase. Remember that interactons which modify the efects of a medicine may involve non-prescripton drugs, non-medicinal chemical agents, and social drugs such as alcohol, marijuana, tobacco and traditonal remedies, as well as certain types of food. Pharmaceutcal Interactons Certain drugs, when added to intravenous fuids, may be inactvated by pH changes, by precipitaton or by chemical reacton. Benzylpenicillin and ampicillin lose potency afer 6-8 hours if added to dextrose solutons, due to the acidity of these solutons. Some drugs bind to plastc containers and tubing, for example diazepam and insulin. The Efect of Food on Medicine Absorpton Food delays gastric emptying and reduces the rate of absorp- ton of many drugs; the total amount of medicine absorbed may or may not be reduced. However, some drugs are pref- erably taken with food, either to increase absorpton or to decrease the irritant efect on the stomach. Pharmacist plays and important role as a connectng link between the physician and patent. Analgesics, Antpyretcs, Non-Steroidal Ant-Infammatory Drugs Analgesics are used to relieve/reduce body pain and antpy- retcs are used to reduce elevated body temperature. Non- opioid analgesics are partcularly suitable for relieveing or management of pain in musculoskeletal conditons whereas the opioid analgesics are more suitable for moderate to severe visceral pain. Neuro- genic pain generally responds poorly to conventonal anal- gesics; treatment can be difcult and includes the use of carbamazepine for trigeminal neuralgia and amitriptyline for diabetc neuropathy and post-therapeutc neuralgia. Non-opioid anal- gesics with litle or no ant-infammatory actvity include paracetamol. Diclofenac Pregnancy Category-B Schedule H Indicatons Acute musculo-skeletal pain; arthrits; gout; spondylits; migraine; post-operatve pain. Dose Oral 100 to 150 mg daily in 2 to 3 divided doses, (max 150 mg/day) maintenance by 50 to 100 mg in divided doses. Instll to eye Post-operatve ocular infammaton: Adult- as sodium (1% w/v), 4 tmes daily startng 24 h afer surgery for up to 28 days. Contraindicatons Porphyria; avoid injectons containing benzyl alcohol in neonates; history of gastric ulcers, bleeding or perforaton. Adverse Efects Injecton site reactons; transient epigastric pain, risk of thrombotc events; toxic epidermal necrolysis; Abnormality in kidney functon. Ibuprofen* Pregnancy Category-C Schedule H Indicatons Pain and infammaton in rheumatc disease and other musculoskeletal disorders including juvenile arthrits; mild to moderate pain including dysmenorrhoeal pain, headache; pain in children; acute migraine atack. Dose Oral Adult- and Child over 12 years- initally 300 to 400 mg 3 to 4 tmes daily, increase if necessary (max. Infant or Child over 3 months- 5-10 mg/kg 3 to 4 tmes/day, Maximum daily dose: 40 mg/kg/day. Intravenous injecton and infusion Neonate- initally by intravenous injecton (over atleast 5 min) 25-100 µg/kg then by contnuous intravenous infusion 5-40 µg/ kg/h. Precautons Renal and hepatc impairment (Appendix 7a); preferably avoid if history of peptc ulceraton; cardiac disease; elderly; pregnancy (Appendix 7c); lactaton (Appendix 7b); coagulaton defects; allergic disorders; interactons (Appendix 6a, 6c, 6d). Dysmenorrhea: 500 mg orally, followed by 250 mg every 6 hours startng with the onset of menses. Children Pain: 14 to 18 years: 500 mg orally followed by 250 mg every 6 hours as needed, not to exceed 7 days. Precautons Hepatc efects: Borderline elevatons of one or more liver functon tests may occur. These laboratory abnormalites may progress, may remain unchanged, or may be transient with contnuing therapy. A patent with symptoms and/or signs suggestng liver dysfuncton, or in whom an abnormal liver test has occurred, should be evaluated for evidence of the development of a more severe hepatc reacton while on therapy. If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestatons occur (e. Anaemia: Patents on long-term treatment should have their hemoglobin or hematocrit checked if they exhibit any signs or symptoms of anaemia. Asthma: Mefenamic acid should not be administered to patents with aspirin sensitve asthma and should be used with cauton in patents with preexistng asthma. Adverse Efects Gastrointestnal experiences including- abdominal pain, constpaton, diarrhoea, dyspepsia, fatulence, gross bleeding/ perforaton, heartburn, nausea, gastrointestnal ulcers, vomitng, abnormal renal functon, bronchospasm, anaemia, dizziness, edema, elevated liver enzymes, headaches, increased bleeding tme, pruritus, rashes, tnnitus. Paracetamol* Pregnancy Category-B Indicatons Mild to moderate pain including dysmenor- rhoeal pain, headache; pain relief in osteoar- thrits and sof tssue lesions; pyrexia including post-immunisaton pyrexia; acute migraine atack.

Harmful discount viagra capsules 100 mg fast delivery, dependent and hazardous use There are clear generic 100 mg viagra capsules overnight delivery, internationally agreed frameworks for describing harmful and dependent patterns of substance use buy 100mg viagra capsules free shipping. These frameworks define a hierarchy of physical, psychological and social harm to the individual. Within the chapter on mental and behavioural disorders, a subchapter defines mental and behavioural disorders due to psychoactive substance use. It defines a number of categories including acute intoxication (see Glossary), harmful use, dependence and withdrawal. The level of harm caused by a particular pattern of substance use is defined by the categories ‘harmful’ and ‘dependent’. Psychological dependence involves a need (craving – see Glossary) for repeated doses of the drug to feel good, or avoid feeling bad. Physiological (physical) dependence is associated with tolerance (see Glossary), where increased doses of the drug are required to produce the effects originally produced by lower doses, and development of withdrawal syndrome (see Glossary) when the drug is withdrawn. Withdrawal syndrome is characterised by physiological and psychological symptoms that are specific to a particular drug. The term ‘dependence’ is often used interchangeably with ‘addiction’ (see Glossary). In contrast to harmful use, hazardous use also refers to patterns of use that are of public health significance, despite the absence of any current disorder in the individual user. These terms, and many others that are used throughout the report, are discussed in more detail in the Glossary. Substances have been clearly shown to affect the brain in the short and longer term. Some substances (eg heroin, cannabis) mimic endogenous neurotransmitters, while others (eg cocaine, amphetamine) increase the availability of endogenous neurotransmitter to the brain, by either increasing neurotransmitter release or inhibiting its breakdown. If a person uses substances over a longer period of time, the brain’s structure and function begin to change, prompting behavioural changes in that individual. The prefrontal cortex area of the brain is particularly vulnerable to the effect of substances. This brain area is crucial for decision making, such as weighing up the pros and cons of a certain activity. Research suggests that the prefrontal cortex is one of the last brain areas to mature. It is a naturally occurring, ‘feel good’ neurotransmitter that is important in rewarding positive behaviours (eg eating, drinking). Some psychoactive substances cause dopamine to be released rapidly and in huge quantities when compared to usual brain levels. Raised levels of dopamine in the mesolimbic system lead to intense feelings of pleasure, known to users as a ‘high’ (see Glossary). If substance use persists, the brain responds to the dopamine overstimulation by decreasing the amount of dopamine produced and reducing the number of dopamine receptors (see Glossary) available. This, in turn, can lead to the user feeling emotionally flat and exhausted once the immediate effect of the drug has subsided. The user will often try to stimulate further additional dopamine release by using larger quantities of the substance. The role of dopamine in the effect of psychoactive drugs is considered further in Section 4. Genetics There is strong evidence for a genetic component to dependence, provided by family, twin and adoption studies (see Chapter 4). Although research suggests many genes may be involved,18 there is evidence that a single genetic variant in the aldehyde dehydrogenase 2 gene impacts on patterns of drinking and the risk of dependence. The genetics of dependence is a rapidly developing area but, apart from the studies on the aldehyde dehydrogenase 2 gene, there is little immediate prospect of a breakthrough in genetics leading to improved patient care. As described above, dependence can be considered primarily a brain disorder, but one that interacts with a range of predisposing, precipitating, perpetuating and protective factors. These factors can best be described in a framework in which the biological, psychological and social components are identified. Psychological factors include comorbid mental health problems such as depression, psychosis and personality disorder. Traumatic events, such as childhood sexual abuse, may also increase a person’s vulnerability to subsequent use of psychoactive substances. Social factors include the availability of a particular substance; the nature of, and support provided by, a person’s social network; peer pressure; and environmental factors such as housing and employment. A range of evidence-based treatments are available to help people with harmful/ dependent substance use, and some of these are discussed in Chapters 8 to 10. Each individual is unique, and treatment of harmful/dependent use should be planned with a clear understanding of the predisposing and protective factors. Appendix 2 gives further details about the nature and addictiveness of these drugs, and Appendix 3 gives details of health-related harms associated with illicit drug use. These recommendations are non-binding, and have, on occasion, been ignored or rejected. Mephedrone and related cathinone derivatives, as well as naphthylpyrovalerone analogues, were classified as Class B drugs in 2010. The Drugs Act 2005 amended the Misuse of Drugs Act 1971 and the Police and Criminal Evidence Act 1984, to increase the powers of the police and courts in relation to drug control (see Glossary). It includes stronger measures to allow police to test drug offenders on arrest rather than at the time of charging, and requires those testing positive to undergo treatment. In July 2011, the Government announced a ban on the importation of phenazepam – a harmful drug advertised as producing a ‘legal high’– as well as its intention to control it as a Class C drug in 2012. It is important to emphasise that that the development of new agents will inevitably run ahead of the Government’s ability to amend the legislation. It is worth noting that many provisions in national legislation are not required by these international drug control treaties. Over 100 illicit substances are placed in four schedules, nominally based on their perceived harmfulness. Limited flexibility is allowed in the interpretation and implementation in many areas of the legislation, which has allowed countries to respond to their specific circumstances. Convention on Psychotropic Substances 1971 This convention was developed in response to increasing concern about emerging drugs and related behaviours during the 1960s, such as the use of amphetamine- like stimulants, barbiturates and other sedative-hypnotics/depressants, and hallucinogens. As with the 1961 convention, these drugs are classified into four schedules according to perceived harm and therapeutic value, with a corresponding hierarchy of controls to license medical, scientific or other uses. Market and trade controls and national requirements are less onerous than those under the Single Convention. Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances 1988 The 1988 convention strengthened the existing powers for prevention of international drug trafficking (including provisions against money laundering and the diversion (see Glossary) of precursor chemicals). It also included provisions to make the intentional possession, purchase or cultivation of narcotic drugs or psychotropic (see Glossary) substances for personal consumption a criminal offence under domestic law. These factors create a framework within which an individual’s predisposing, precipitating, perpetuating and protective elements can be used to plan the most effective treatments. As a teenager, he had been in a gang and had previous convictions for possession of dangerous weapons (knives), burglaries, street robberies (mainly mobile phones) and assault.

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