ALLERGY CAST REQUEST FORM ALLERGOLOGY, DIAGNOSTIC & CLINICAL RESEARCH UNIT (ADCRU) Tel: (021) 406-6889 UCT LUNG INSTITUTE Fax: (021) 406-6888
Age/D.O.B: .….…/….…./….……. Account To Relevant Clinical Data:
Work Tel.No.:Home Tel.No.: Employer's Name:
Time lapse since last adverse reaction:
Other: (specify) ……………………………………………………………………………………………………………………….…………………. PLEASE TICK AND INDICATE ALLERGENS REQUESTED : ANTIBIOTICS: ANALGESICS & ANTI-INFLAMMATORIES: FOOD ADDITIVES & COLOURANTS: ANAESTHETICS: C51 Lys-aspirin C103 Tartrazine CATR Atracurium C52 Diclofenac C111 Na benzoate CMIV Mivacurium C11 Benzylpenicil oyl C53 Ibuprofen C112 Na nitrite CPAN Pancuronium C203 Ampicil in C54 Indomethacin C113 Na-Metabisulphite CSUX Suxamethonium C204 Amoxycil in
1C5 785 Acetaminophen C114 Na salicylate CROC Rocuronium C3 Cephalosporin C
1C5 8796 Mefenamic acid CE104 Quinoline Yel ow CVEC Vecuronium C31 Cefamandole
12C5 9807 Phenylbutazone CE110 Sunset Yel ow FCF CLID Lidocaine C32 Cefazolin
21C5 0918 Propylphenazone CE122 Chromotrope B CTHI Propofol C61 Sulphamethoxazole 2C5 109 Dipyrone / Metamizole CE123 Amaranth C62 Trimethoprin CE124 New Coccine C75 Tetracycline CE127 Erythrosine OCCUPATIONALS: C81 Ciprofloxacin CE131 Patent Blue V
2K8 102 Latex 4C363 Cefuroxime CE132 Indigo carmine C12 Minor 1 Determinant Mix CE151 Bril iant Black C101 Food Colourant Mix I (CE104, CE110, CE122, CE123, CE124) C102 Food Colourant Mix II (CE127, CE131, CE132, CE151) CE621 Glutamate
Patient to be taken off al al ergy medication 24 hours prior to blood col ection.
Please take 2 EDTA tubes (purple top). Please take blood after 3pm and send to UCT Lung Institute via Pathcare N1 City to arrive the next morning. Please send on ice and wrap specimens in paper towel or bubble wrap to prevent damage to blood cel s.
Pancreatitis is defined as inflammation of the pancreas and can be caused by a number of inciting factors. The pancreas is responsible for tasks such as glucose regulation and aids in the digestion of food. Accordingly, two separate parts are responsible for these functions: the endocrine portion, which produces insulin for glucose regulation and the exocrine portion, which produces enzymes for
PEDIATRICS CME Clinical Considerations assessed various nebulizer/compressor combi- Jet Nebulizer Types. Jet nebulizers vary wide-nations in models simulating pediatric inspira-ly in their design, ability to be reused and drugtory and expiratory flows, budesonide inhala-delivery profiles. Table 3 provides an overviewtion suspension was nebulized in amounts sim-of the three primar