ID

31990

Beskrivning

Study ID: 106181 Clinical Study ID: B2C106181 Study Title: An open-label, single-arm study to determine the excretion balance and metabolic disposition of [14C]GW642444 administered as a single dose of an oral solution to healthy male volunteers Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01286831 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: vilanterol Trade Name: Study Indication: Pulmonary Disease, Chronic Obstructive

Nyckelord

  1. 2018-10-09 2018-10-09 -
  2. 2018-10-10 2018-10-10 -
  3. 2018-10-10 2018-10-10 -
  4. 2018-10-10 2018-10-10 -
  5. 2018-12-05 2018-12-05 -
  6. 2021-09-17 2021-09-17 -
Rättsinnehavare

GSK group of companies

Uppladdad den

10 oktober 2018

DOI

För en begäran logga in.

Licens

Creative Commons BY-NC 3.0

Modellkommentarer :

Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.

Itemgroup-kommentar för :

Item-kommentar för :

Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.

Extension balance and metabolic disposition of vilanterol as a single oral dose. 106181

Screening visit

  1. StudyEvent: ODM
    1. Screening visit
Demography
Beskrivning

Demography

Date of birth
Beskrivning

Date of birth

Datatyp

date

Sex
Beskrivning

Sex

Datatyp

text

Ethnicity
Beskrivning

✓ one

Datatyp

text

Geographic ancestry
Beskrivning

✓ all that apply

Datatyp

text

Concomitant Medications
Beskrivning

Concomitant Medications

Datatyp

text

Vital signs
Beskrivning

Vital signs

Height
Beskrivning

Height

Datatyp

integer

Weight
Beskrivning

Weight

Datatyp

float

Body mass index
Beskrivning

Body mass index

Datatyp

integer

Måttenheter
  • kg / m2
kg / m2
Date
Beskrivning

Day Month Year e.g., 01 JAN 08

Datatyp

text

Planned relative time
Beskrivning

e.g., 15 min

Datatyp

text

Actual Time
Beskrivning

HR : MN (00:00 - 23:59) e.g., 13:02

Datatyp

text

Blood Pressure
Beskrivning

Supine mmHg Systolic Diastolic e.g.,110 80

Datatyp

text

Måttenheter
  • mmHg
mmHg
Heart Rate
Beskrivning

beats/min e.g., 75

Datatyp

text

Måttenheter
  • bpm
bpm
Temperature Oral
Beskrivning

°C e.g., 36.5

Datatyp

float

Måttenheter
  • °C
°C
12-lead ECG
Beskrivning

12-lead ECG

Alias
UMLS CUI-1
C0430456
UMLS CUI-2
C1623258
UMLS CUI-3
C0031809
ECG Number
Beskrivning

ECG Number

Datatyp

integer

Alias
UMLS CUI [1,1]
C2348792
UMLS CUI [1,2]
C0430456
Start Date of ECG
Beskrivning

Day Month Year

Datatyp

date

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0808070
Planned Relative Time ECG
Beskrivning

Planned Relative Time ECG

Datatyp

text

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C0439564
Start Time of ECG
Beskrivning

Start Time of ECG

Datatyp

time

Alias
UMLS CUI [1,1]
C0430456
UMLS CUI [1,2]
C1301880
Heart Rate
Beskrivning

Heart Rate

Datatyp

integer

Måttenheter
  • Beats/min
Alias
UMLS CUI [1,1]
C2189285
UMLS CUI [1,2]
C0430456
Beats/min
PR Interval
Beskrivning

PR Interval

Datatyp

float

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0429087
UMLS CUI [1,2]
C0430456
msec
QRS Duration
Beskrivning

QRS Duration

Datatyp

float

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0429025
UMLS CUI [1,2]
C0430456
msec
Uncorrected QT Interval
Beskrivning

Uncorrected QT Interval

Datatyp

float

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C1287082
UMLS CUI [1,2]
C0430456
msec
Method of measurement
Beskrivning

1=Machine, 2=Manual For machine read ECGs, QTcB and/or QTcF can be collected.

Datatyp

integer

Alias
UMLS CUI [1,1]
C0489625
UMLS CUI [1,2]
C0430456
If machine, QTcB interval
Beskrivning

If machine, QTcB interval

Datatyp

integer

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0489625
UMLS CUI [1,2]
C0430456
msec
If machine, QTcF interval
Beskrivning

If machine, QTcF interval

Datatyp

integer

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0489625
UMLS CUI [1,2]
C0430456
msec
If machine, QTc interval unknown method of correction
Beskrivning

If machine, QTc interval unknown method of correction

Datatyp

integer

Måttenheter
  • msec
Alias
UMLS CUI [1,1]
C0489625
UMLS CUI [1,2]
C0430456
msec
Result of the ECG
Beskrivning

Result of the ECG

Datatyp

integer

Alias
UMLS CUI [1,1]
C0438154
UMLS CUI [1,2]
C0430456
Important
Beskrivning

Important

Datatyp

text

12-Lead ECG Abnormalities
Beskrivning

12-Lead ECG Abnormalities

Alias
UMLS CUI-1
C0430456
UMLS CUI-2
C1704258
Rhythm
Beskrivning

A. Rhythm

Datatyp

text

P-Wave and QRS Morphology
Beskrivning

B. P-Wave and QRS Morphology

Datatyp

integer

Conduction
Beskrivning

C. Conduction

Datatyp

integer

Myocardial Infraction
Beskrivning

D. Myocardial Infraction

Datatyp

integer

Depolarisation/Repolarisation (QRS-T)
Beskrivning

E. Depolarisation/Repolarisation (QRS-T)

Datatyp

integer

Other abnormalities
Beskrivning

Other abnormalities

Datatyp

integer

Date of ECG
Beskrivning

Date of ECG

Datatyp

date

Måttenheter
  • Day Month Year
Alias
UMLS CUI [1]
C2826640
Day Month Year
Time of ECG
Beskrivning

Time of ECG

Datatyp

time

Måttenheter
  • Hr : Min
Alias
UMLS CUI [1,1]
C0040223
UMLS CUI [1,2]
C0013798
Hr : Min
Summary Holter (12HRS)
Beskrivning

Summary Holter (12HRS)

Holter Results
Beskrivning

Holter Results

Datatyp

text

Start date of Holter
Beskrivning

Start date of Holter

Datatyp

date

Start time of Holter
Beskrivning

Start time of Holter

Datatyp

time

Stop time of Holter
Beskrivning

Stop time of Holter

Datatyp

time

Interpretation of Holter tick one
Beskrivning

Interpretation of Holter tick one

Datatyp

text

Holter monitoring method tick one
Beskrivning

Holter monitoring method tick one

Datatyp

text

Summary Holter Abnormalities
Beskrivning

Summary Holter Abnormalities

Clinically significant abnormalities
Beskrivning

tick all that apply

Datatyp

text

Medical conditions
Beskrivning

Medical conditions

Diagnosis
Beskrivning

Only in the absence of a diagnosis, record the signs and symptoms on separate lines

Datatyp

text

Current
Beskrivning

[1]

Datatyp

boolean

Past
Beskrivning

[2]

Datatyp

boolean

Physical Examination
Beskrivning

Physical Examination

Date of Assessment
Beskrivning

Date of Assessment

Datatyp

date

Format
Beskrivning

Indicate current physical findings by ticking the appropriate box(es) below and if ABNORMAL, describe concisely: [different findings should be separated by either a (;) or a (/)].

Datatyp

text

1. Head
Beskrivning

1. Head

Datatyp

text

2. Eyes
Beskrivning

2. Eyes

Datatyp

text

3. Ears
Beskrivning

3. Ears

Datatyp

text

4. Nose
Beskrivning

4. Nose

Datatyp

text

5. Throat
Beskrivning

5. Throat

Datatyp

text

6. Skin
Beskrivning

6. Skin

Datatyp

text

7. Thyroid
Beskrivning

7. Thyroid

Datatyp

text

8. Neurological
Beskrivning

8. Neurological

Datatyp

text

9. Lungs
Beskrivning

9. Lungs

Datatyp

text

10. Cardiovascular
Beskrivning

10. Cardiovascular

Datatyp

text

11. Abdomen (Liver and Spleen)
Beskrivning

11. Abdomen (Liver and Spleen)

Datatyp

text

12. Lymph Nodes
Beskrivning

12. Lymph Nodes

Datatyp

text

13. Extremities
Beskrivning

13. Extremities

Datatyp

text

Alcohol and Tobacco Use
Beskrivning

Alcohol and Tobacco Use

History of tobacco use
Beskrivning

What is the subject's history of smoking use?

Datatyp

text

If former smoker
Beskrivning

When did the subject last smoke?

Datatyp

date

If former smoker, answer the following:
Beskrivning

If former smoker, answer the following:

Datatyp

text

Serology - HIV Screen
Beskrivning

Date sample taken

Datatyp

date

Alcohol Intake
Beskrivning

Does the subject consume alcohol?

Datatyp

text

if Yes, do the following
Beskrivning

if Yes, do the following

Datatyp

float

Drug and Alcohol Screen
Beskrivning

Date and time of sample taken

Datatyp

datetime

Electronically transferred laboratory data
Beskrivning

Electronically transferred laboratory data

Clinical chemistry
Beskrivning

Clinical chemistry

Datatyp

datetime

Haematology
Beskrivning

Haematology

Datatyp

datetime

Urinalysis
Beskrivning

Urinalysis

Datatyp

datetime

Pharmacokinetics
Beskrivning

Pharmacokinetics

Blood sample
Beskrivning

Blood sample

Datatyp

datetime

Inclusion and exclusion criteria
Beskrivning

Inclusion and exclusion criteria

Eligibility question
Beskrivning

Eligibility question

Datatyp

text

Inclusion criteria
Beskrivning

tick the boxes corresponding to any of the inclusion criteria the subject failed.

Datatyp

text

Exclusion criteria
Beskrivning

tick the boxes corresponding to any of the exclusion criteria that disqualified the subject from entry.

Datatyp

text

Similar models

Screening visit

  1. StudyEvent: ODM
    1. Screening visit
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
Demography
Date of birth
Item
Date of birth
date
Item
Sex
text
Code List
Sex
CL Item
male (1)
CL Item
female (2)
Item
Ethnicity
text
Code List
Ethnicity
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino (2)
Item
Geographic ancestry
text
Code List
Geographic ancestry
CL Item
African American/African Heritage (1)
CL Item
American Indian or Alaskan Native (2)
CL Item
Asian - Central/South Asian Heritage (3)
CL Item
Asian - East Asian Heritage (4)
CL Item
Asian - Japanese Heritage (5)
CL Item
Asian - South East Asian Heritage  (6)
CL Item
Native Hawaiian or Other Pacific Islander (7)
CL Item
White - Arabic/North African Heritage (8)
CL Item
White - White/Caucasian/European Heritage (9)
Item
Concomitant Medications
text
Code List
Concomitant Medications
CL Item
Record details of the subject's ongoing concomitant medications in the appropriate Concomitant Medications section. (Record details of the subject's ongoing concomitant medications in the appropriate Concomitant Medications section.)
Item Group
Vital signs
Height
Item
Height
integer
Weight
Item
Weight
float
Body mass index
Item
Body mass index
integer
Item
Date
text
Code List
Date
CL Item
1. (1)
CL Item
2. (2)
CL Item
3. (3)
Item
Planned relative time
text
Code List
Planned relative time
CL Item
screening (1)
CL Item
unscheduled (2)
CL Item
unscheduled (3)
Actual Time
Item
Actual Time
text
Blood Pressure
Item
text
Heart Rate
Item
Heart Rate
text
Temperature Oral
Item
Temperature Oral
float
Item Group
12-lead ECG
C0430456 (UMLS CUI-1)
C1623258 (UMLS CUI-2)
C0031809 (UMLS CUI-3)
Item
ECG Number
integer
C2348792 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Code List
ECG Number
CL Item
ECG one (1)
CL Item
ECG two (2)
CL Item
ECG three (3)
Start Date of ECG
Item
Start Date of ECG
date
C0430456 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Planned Relative Time ECG
Item
Planned Relative Time ECG
text
C0430456 (UMLS CUI [1,1])
C0439564 (UMLS CUI [1,2])
Start Time of ECG
Item
Start Time of ECG
time
C0430456 (UMLS CUI [1,1])
C1301880 (UMLS CUI [1,2])
Heart Rate
Item
Heart Rate
integer
C2189285 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
PR Interval
Item
PR Interval
float
C0429087 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
QRS Duration
Item
QRS Duration
float
C0429025 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Uncorrected QT Interval
Item
Uncorrected QT Interval
float
C1287082 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Method of measurement
Item
Method of measurement
integer
C0489625 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
If machine, QTcB interval
Item
If machine, QTcB interval
integer
C0489625 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
If machine, QTcF interval
Item
If machine, QTcF interval
integer
C0489625 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
If machine, QTc interval unknown method of correction
Item
If machine, QTc interval unknown method of correction
integer
C0489625 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Item
Result of the ECG
integer
C0438154 (UMLS CUI [1,1])
C0430456 (UMLS CUI [1,2])
Code List
Result of the ECG
CL Item
Normal (1)
CL Item
Abnormal - not clinically significant  (2)
CL Item
Abnormal- clinically significant (3)
CL Item
No result (not available) (4)
Item
Important
text
Code List
Important
CL Item
Complete additional ECG abnormalities pages if clinically significant abnormalities are present. (Complete additional ECG abnormalities pages if clinically significant abnormalities are present.)
Item Group
12-Lead ECG Abnormalities
C0430456 (UMLS CUI-1)
C1704258 (UMLS CUI-2)
Item
Rhythm
text
Code List
Rhythm
CL Item
[A23] Sinus bradycardia (heart rate < 30 beats/min) (4)
CL Item
[A 3] Sinus pause (5)
CL Item
[A 2] Sinus tachycardia (6)
CL Item
[A 4] Ectropic supraventricular beats (7)
CL Item
[A20] Ectropic supraventricular rythm (8)
CL Item
[A17] Wandering atrial pacemaker (9)
CL Item
[A26] Multifocal atrial tachycardia (Wandering atrial pacemaker with heart rate > 100 beats/min) (10)
CL Item
[A 6] Supraventricular tachycardia (Heart rate > 100 beats/min) (11)
CL Item
[A 7] Atrial flutter (12)
CL Item
[A 8] Atrial fibrillation (13)
CL Item
[A 5] Junctional rhythm (heart rate <100 beats/min) (14)
CL Item
[A25] Junctional rhythm (15)
CL Item
[A24] Junctional tachycardia (heart rate > 100 beats/min) (16)
CL Item
[A 9] Ectopic ventricular beats (17)
CL Item
[A 1] Sinus bradycardia (1)
CL Item
[A21] Sinus bradycardia (heart rate 40-50 beats/min) (2)
CL Item
[A22] Sinus bradycardia (heart rate 30-39 beats/min) (3)
Item
P-Wave and QRS Morphology
integer
Code List
P-Wave and QRS Morphology
CL Item
[B 3] right ventricular hypertrophy (1)
CL Item
[B 5] Intraatrial conduction delay (2)
CL Item
[B 7] Poor R wave progression (3)
CL Item
[B 9] Left atrial abnormality (4)
CL Item
[B10] Right atrial abnormality (5)
CL Item
[A12] Ventricular couplets (6)
CL Item
[A13] Bigeminy (7)
CL Item
[A28] Trigeminy (8)
CL Item
[A14] Electrical alternans (9)
CL Item
[A29] R on T phenomenon (10)
CL Item
[A18] Ventricular vebrilation (11)
CL Item
[A19] Indioventricular rhythm (heart rate < 100 bpm) (12)
CL Item
[A10] Sustained ventricular tachycardia (13)
CL Item
[A11] Non-sustained ventricular tachycardia  (14)
CL Item
[A33] Sinus arrhythmia  (15)
CL Item
[A33] Sinus arrhythmia  (15)
CL Item
[A27] Ventricular tachycardia  (16)
CL Item
[A30] Monomorphic ventricular tachycardia  (17)
CL Item
[A15] Torsades de Pointes (Polymorphic ventricular tachycardia with prolonged QT) (18)
CL Item
[A31] Polymorphic (sustained and non-sustained) ventricular tachycardia (19)
CL Item
[A16] Artificial pacemaker  (20)
CL Item
[A35] Atrial premature complex (21)
CL Item
[A99]Other abnormal rhythm  (22)
CL Item
[B16] Late R wave transition (23)
CL Item
[D14] Increased voltage consistent with left ventricular hypertrophy (24)
CL Item
[B99] Other morphology (25)
Item
Conduction
integer
Code List
Conduction
CL Item
[C 1] First degree AV block (PR interval > 200 msec) (1)
CL Item
[C20] Short PR interval (2)
CL Item
[C 2] Second degree AV block (Mobitz type 1) (3)
CL Item
[C 3] Second degree AV block (Mobitz type 2) (4)
CL Item
[C16] 2:1 AV block  (5)
CL Item
[C 4] Third degree AV block (6)
CL Item
[C 5] Left axis deviation (QRS axis more negative than -30°) (7)
CL Item
[C 6] Right axis deviation (QRS axis more positive than +110°) (8)
CL Item
[C 7] Incomplete right bundle branch block (9)
CL Item
[C13] Incomplete left bundle branch block (10)
CL Item
[C 8] Right bundle branch block  (11)
CL Item
[C 14] Left anterior hemiblock (synonymous to left anterior fascicular block) (12)
Item
Myocardial Infraction
integer
Code List
Myocardial Infraction
CL Item
[D 1] Myocardial infraction, old (1)
CL Item
[D 2] Myocardial infraction, anterior (2)
CL Item
[D 3] Myocardial infraction, lateral (3)
CL Item
[D 4] Myocardial infraction, posterior (4)
CL Item
[D 5] Myocardial infraction, inferior (5)
Item
Depolarisation/Repolarisation (QRS-T)
integer
Code List
Depolarisation/Repolarisation (QRS-T)
CL Item
[D 7] Non-specific ST-T changes (1)
CL Item
[D19] J point elevation (2)
CL Item
[D 8] ST elevation (3)
CL Item
[D21] ST elevation-pericarditis (4)
CL Item
[D 9] ST depression (5)
CL Item
[D96] ST segment abnormality, not specified (6)
CL Item
[D10] U waves abnormal (7)
CL Item
[D11] T wave inversion (8)
CL Item
[D12] T wave peaked (9)
Item
Other abnormalities
integer
Code List
Other abnormalities
CL Item
[E99] Other abnormalities (1)
CL Item
[C15] Left posterior hemiblock (synonymous to left posterior fascicular block) (2)
CL Item
[C 9] Left bundle branch block  (3)
CL Item
[C17] Bifascicular block (4)
CL Item
[C10] Non-specific intraventricular conduction delay (QRS>120msec) (5)
CL Item
[C11] Accessory pathway (Wolff-Parkinson White, Lown-Ganong-Levine) (6)
CL Item
[C18] AV dissociation  (7)
CL Item
[C28] Prolonged QT 450-500 (8)
CL Item
[C29] Prolonged QT >500 (9)
CL Item
[C30] Prolonged QTc Interval 450-500 (10)
CL Item
[C31] Prolonged QTc Interval >500 (11)
CL Item
[C99] Other conduction (12)
CL Item
[D 6] Myocardial infraction, septal (13)
CL Item
[D20] Myocardial infraction, Non-Q wave (14)
CL Item
[D08] Other myocardial infraction (15)
CL Item
[D15] T waves flat (16)
CL Item
[D16] T waves biphasic (17)
CL Item
[D18] Notched T-waves (18)
CL Item
[D13] Low QRS voltage (19)
CL Item
[D17] T-wave flattening/inversion (20)
CL Item
[D22] Juvenile T wave pattern, early repolarization (21)
CL Item
[D97] T wave abnormality, not specified (22)
CL Item
[D99] Other depolarization/repolarization (23)
Date of ECG
Item
Date of ECG
date
C2826640 (UMLS CUI [1])
Time of ECG
Item
Time of ECG
time
C0040223 (UMLS CUI [1,1])
C0013798 (UMLS CUI [1,2])
Item Group
Summary Holter (12HRS)
Item
Holter Results
text
Code List
Holter Results
CL Item
Record the dates and times recorded by the Holter monitoring equipment (Record the dates and times recorded by the Holter monitoring equipment)
Start date of Holter
Item
Start date of Holter
date
Start time of Holter
Item
Start time of Holter
time
Stop time of Holter
Item
Stop time of Holter
time
Item
Interpretation of Holter tick one
text
Code List
Interpretation of Holter tick one
CL Item
[1] Normal (1)
CL Item
[2] Abnormal - Not clinically significant (2)
CL Item
[3] Abnormal - Clinically significant (3)
CL Item
[4] No result (4)
CL Item
[8] Unable to evaluate (5)
Item
Holter monitoring method tick one
text
Code List
Holter monitoring method tick one
CL Item
[1] 12 Lead 1000Hz (1)
CL Item
[2] 12 Lead 180 Hz (2)
CL Item
[3] 3 Lead 180 Hz (3)
CL Item
[4] Telemetry (4)
CL Item
[5] 5 Lead 512Hz (5)
CL Item
[6] 4 Lead 0.05-40 Hz (6)
CL Item
[7] 6 Lead 0.05-40 Hz (7)
CL Item
[8] 7 Lead 0.05-100 Hz-3dB (8)
CL Item
[9] 7 Lead 3 channel 133 Hz (9)
CL Item
[10] 2 lead 200 Hz (10)
CL Item
[OT] Other (11)
Item Group
Summary Holter Abnormalities
Item
Clinically significant abnormalities
text
Code List
Clinically significant abnormalities
CL Item
[A01] Sinus bradycardia (50-59 bpm) (1)
CL Item
[A02] Sinus bradycardia (40-49 bpm) (2)
CL Item
[A03] Sinus bradycardia (30-39 bpm) (3)
CL Item
[A04] Sinus bradycardia (<30 bpm) (4)
CL Item
[A05] Sinus pause (5)
CL Item
[A06] Sinus tachycardia (6)
CL Item
[A07] Ectopic supraventricular beats (7)
CL Item
[A08] Ectopic supraventricular rhythm  (8)
CL Item
[A09] Wandering atrial pacemaker (9)
CL Item
[A10] Multifocal atrial tachycardia (wandering atrial pacemaker w/rate>100 bpm) (10)
CL Item
[A11] Non-sustained supraventricular tachycardia (>100 bpm. >30 beats) (11)
CL Item
[A12] Sustained supraventricular tachycardia (>100 bpm. >30 beats) (12)
CL Item
[A13] Atrial flutter (13)
CL Item
[A14] Atrial fibrillation (14)
CL Item
[A15] Junctional rhythm (<=100 bpm, defined by narrow QRS complexes) (15)
CL Item
[A16] Junctional tachycardia (heart rate > 100 bpm) (16)
CL Item
[A17] Ventricular premature depolarisation (17)
CL Item
[A18] Ventricular couplets (18)
CL Item
[A19] Bigeminy (19)
CL Item
[A20] Trigeminy (20)
CL Item
[A21] Electrical alternans (21)
CL Item
[A22] R on T phenomenon (22)
CL Item
[A23] Ventricular febrillation (23)
CL Item
[A24] Idioventricular rhathm (<=100 bpm, defined by wide QRS complexes) (24)
CL Item
[A25] Non-sustained ventricular tachycardia (>100 bpm, 3-30 beats) (25)
CL Item
[A26] Sustained ventricular tachycardia (>100 bpm, >30 beats) (26)
CL Item
[A27] Wide QRS Tachycardia (diagnosis unknown) (27)
CL Item
[A28] Monomorphic non-sustained ventricular tachycardia (>100 bpm, 3-30 beats)  (28)
CL Item
[A29] Monomorphic non-sustained ventricular tachycardia (>100 bpm, >30 beats) (29)
CL Item
[A30] Polymorphic non-sustained ventricular tachycardia (>100 bpm, 3-30 bpm)  (30)
CL Item
[A31] Polymorphic non-sustained ventricular tachycardia (>100 bpm, >30 bpm)  (31)
CL Item
[A32] Torsade de Pointes (TdP)  (32)
CL Item
[A33] Pacemaker  (33)
CL Item
[A34] First degree AV block (PR interval >200msec) (34)
CL Item
[A35] Short PR Interval  (35)
CL Item
[A36] Second degree AV block (Mobitz type 1) (36)
CL Item
[A37] Second degree AV block (Mobitz type 2) (37)
CL Item
[A38] 2:1 AV block  (38)
CL Item
[A39] Third degree AV block  (39)
CL Item
[A40] Left axis deviation (QRS axis more negative than -30 degrees)  (40)
CL Item
[A41] Right axis deviation (QRS axis more positive than +110 degrees) (41)
CL Item
[A42] Incomplete right bundle branch block (42)
CL Item
[A43] Incomplete left bundle branch block (43)
CL Item
[A44] Right bundle branch block (44)
CL Item
[A45] Left anterior hemiblock (45)
CL Item
[A46] Left posterior hemiblock  (46)
CL Item
[A47] Left bundle branch block (47)
CL Item
[A48] Bifascicular block (48)
CL Item
[A49] Non-specific intraventricular conduction delay (QRS>=120 msec) (49)
CL Item
[A50] Accessory pathway (Wolff-Parkinson-White, Lown-Ganong-Levine) (50)
CL Item
[A51] QTc prolongation >=500 msec (51)
CL Item
[A52] AV dissociation  (52)
CL Item
[A53] Myocardial infraction, old (53)
CL Item
[A54] Myocardial infraction, non Q-wave (54)
CL Item
[A55] Non-specific ST-T changes (55)
CL Item
[A56] J point elevation (56)
CL Item
[A57] ST elevation (57)
CL Item
[A58] ST depression (58)
CL Item
[A59] ST segment abnormality (59)
CL Item
[A60] U waves (60)
CL Item
[A61] T wave inversion (61)
CL Item
[A62] T wave peaked (62)
CL Item
[A63] T waves byphasic (63)
CL Item
[A64] T waves flat (64)
CL Item
[A65] Notched T-waves (65)
CL Item
[A66] Low QRS voltage (66)
CL Item
[A67] T wave abnormality (67)
CL Item
[A94] Other abnormal rhythm (68)
CL Item
[A95] Other morphology (69)
CL Item
___________________________________________ (___________________________________________)
CL Item
[A96] Other conduction (70)
CL Item
___________________________________________ (___________________________________________)
CL Item
[A97] Other myocardial infraction (71)
CL Item
___________________________________________ (___________________________________________)
CL Item
[A98] Other depolarisation/repolarisation (72)
CL Item
___________________________________________ (___________________________________________)
CL Item
[A99] Other abnormality/Cardiologist comments (73)
CL Item
___________________________________________ (___________________________________________)
Item Group
Medical conditions
Item
Diagnosis
text
Code List
Diagnosis
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
Current
Item
Current
boolean
Past
Item
Past
boolean
Item Group
Physical Examination
Date of Assessment
Item
Date of Assessment
date
Format
Item
Format
text
Item
1. Head
text
Code List
1. Head
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
2. Eyes
text
Code List
2. Eyes
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
3. Ears
text
Code List
3. Ears
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
4. Nose
text
Code List
4. Nose
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
5. Throat
text
Code List
5. Throat
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
6. Skin
text
Code List
6. Skin
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
7. Thyroid
text
Code List
7. Thyroid
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
8. Neurological
text
Code List
8. Neurological
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
9. Lungs
text
Code List
9. Lungs
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
10. Cardiovascular
text
Code List
10. Cardiovascular
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
11. Abdomen (Liver and Spleen)
text
Code List
11. Abdomen (Liver and Spleen)
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
12. Lymph Nodes
text
Code List
12. Lymph Nodes
CL Item
Normal (1)
CL Item
Abnormal (2)
Item
13. Extremities
text
Code List
13. Extremities
CL Item
Normal (1)
CL Item
Abnormal (2)
Item Group
Alcohol and Tobacco Use
Item
History of tobacco use
text
Code List
History of tobacco use
CL Item
Never smoked (1)
CL Item
Former smoker (2)
If former smoker
Item
If former smoker
date
Item
If former smoker, answer the following:
text
Code List
If former smoker, answer the following:
CL Item
Number of pack years? (Number of pack years?)
Serology - HIV Screen
Item
Serology - HIV Screen
date
Item
Alcohol Intake
text
Code List
Alcohol Intake
CL Item
Yes (1)
CL Item
No (2)
if Yes, do the following
Item
if Yes, do the following
float
Drug and Alcohol Screen
Item
Drug and Alcohol Screen
datetime
Item Group
Electronically transferred laboratory data
Clinical chemistry
Item
Clinical chemistry
datetime
Haematology
Item
Haematology
datetime
Urinalysis
Item
Urinalysis
datetime
Item Group
Pharmacokinetics
Blood sample
Item
Blood sample
datetime
Item Group
Inclusion and exclusion criteria
Item
Eligibility question
text
Code List
Eligibility question
CL Item
[Y] Yes (1)
CL Item
[N] No (2)
Item
Inclusion criteria
text
Code List
Inclusion criteria
CL Item
Healthy male aged between 30 and 55 years inclusive, at the time of signing the informed consent. Healthy as determined by a responsible and experienced physician, based on a medical evaluation including medical history, physical examination, laboratory tests and cardiac monitoring. A subject with a clinical abnormality or laboratory parameters outside the reference range for the population, which are deemed to be clinically relevant, should always be excluded from enrollment.  (1)
CL Item
Body Mass Index (BMI) within the range 18.5-29.0 kg/m2 (inclusive).  (2)
CL Item
Subjects who are current non-smokers, who have not used any tobacco products in the 12 month period preceding the screening visit, and have a pack history of <= 5 pack years [number of pack years = (number of cigarettes per day/20)x number of years smoked]. (3)
CL Item
AST, ALT, alkaline phosphatase and bilirubin < = 1.5xULN (isolated bilirubin>1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%). (4)
CL Item
No significant abnormality on 12-lead ECG at screening. Selected specific ECG findings that are considered to be significant and will exclude the subject from study participation include, but are not limited to, the following:  (5)
CL Item
110 bpm (- Sinus tachycardia >)
CL Item
- Multifocal atrial tachycadria (wandering atrial pacemaker with rate >100 bpm) (- Multifocal atrial tachycadria (wandering atrial pacemaker with rate >100 bpm))
CL Item
- PR interval >240 msec (- PR interval >240 msec)
CL Item
- Evidence of Mobitz II second degree or third degree atroventricular (AV) block (- Evidence of Mobitz II second degree or third degree atroventricular (AV) block)
CL Item
- Pathological Q waves (defined as wide [>0.04 seconds] and deep [>0.4mV (4mm with 10mm/mV setting)] or 25% of the height of the corresponding R wave, providing the R wave was >0.5mV [5mm with 10mm/mV setting], appearing in at least two contiguous leads. Note: prior evidence (i.e., ECG obtained at least 12 month prior) of pathological Q waves that are unchanged are not exclusionary. (- Pathological Q waves (defined as wide [>0.04 seconds] and deep [>0.4mV (4mm with 10mm/mV setting)] or 25% of the height of the corresponding R wave, providing the R wave was >0.5mV [5mm with 10mm/mV setting], appearing in at least two contiguous leads. Note: prior evidence (i.e., ECG obtained at least 12 month prior) of pathological Q waves that are unchanged are not exclusionary.)
CL Item
- Evidence of ventricular ectopic couplets, bigeminy, trigeminy or multifocal premature ventricular complexes. (- Evidence of ventricular ectopic couplets, bigeminy, trigeminy or multifocal premature ventricular complexes.)
CL Item
450 msec or uncorrected QT>600 msec or an ECG that is unsuitable for QT measurements (e.g., poor defined termination of the T wave). Note: QTcF>= 450 msec or uncorrected QT>600 msec should be confirmed by three readings at least 5 minutes apart (- QTcF >)
CL Item
- ST-T wave abnormalities (excluding non-specific ST-T wave abnormalities (- ST-T wave abnormalities (excluding non-specific ST-T wave abnormalities)
CL Item
- Right or left complete bundle branch block (- Right or left complete bundle branch block)
CL Item
- Clinically significant conduction abnormalities (e.g., atrial fibrilation with rapid ventricular response, ventricular tachycardia (- Clinically significant conduction abnormalities (e.g., atrial fibrilation with rapid ventricular response, ventricular tachycardia)
CL Item
No significant abnormality on the Holter ECG at screening (6)
CL Item
Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form. (7)
CL Item
- Sinus bradycardia <45bpm (- Sinus bradycardia <45bpm)
Item
Exclusion criteria
text
Code List
Exclusion criteria
CL Item
As a result of medical interview, physical examination or screening investigations, the principal investigator or delegate physician deems the subject unsuitable for the study. Subjects must not have a systolic blood pressure above 145 mmHg or a diastolic pressure above 90 mmHg. (1)
CL Item
Females (2)
CL Item
The subject has been treated for or diagnosed with depression within six month of screenin or has a history of significant psychiatric illness. (3)
CL Item
Current or chronic history of liver disease, or know hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones). (4)
CL Item
Surgical procedures on digestive tract including corrective surgery for appendicitis (in the 3 months prior to screening) or diverticulitis, cholecystectomy (gallbladder removal), and/or cholelithotomy (gallstone removal). (5)
CL Item
History of current spastic/hyperactive colon. (6)
CL Item
Subjects who do not have regular defecation patterns (regular defined as passing feces at least once every two days). (7)
CL Item
History of sensitivity to any of the study medications, or components thereof or a history of drug or other allergy that, in the opinion of the investigator or GSK Medical Monitor, contrandicates their participation. (8)
CL Item
Any adverse reaction including immediate or delayed hypersensitivity to any ß2 agonist or sympathomimetic drug, or known or suspected sensitivity to the constituents of the GW642444formulation for oral administration. (9)
CL Item
Use of prescription or non-prescription drugs, including vitamins, herbal and dietary supplements (including St John's Wort) within 7 days (or 14 days if a drug is a potential enzyme inducer) or 5 half-lives (whichever if longer) prior to the first dose of study medication, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures of compromise subject safety. (10)
CL Item
History of alcohol/drug abuse or dependence within 12 month of the study. Abuse of alcohol defined as an average weekly intake of greater than 21 units or an average daily intake of greater than 3 units (males). One unit is equivalent to a 285 mL glass of full strength beer or 425 mL schooner of light beer or 1 (30 mL) measure of spirits or 1 glass (100 mL) of wine (NHMRC Guidelines [NHMRC,2001]).  (11)
CL Item
The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 60 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer). (12)
CL Item
Exposure to more than four new chemical entities within 12 month prior to the first dosing day. (13)
CL Item
Participation in a clinical trial involving administration of 14C-labelled compound(s) withing the last 12 month. A subject's previous effective dose will be reviewed by the medical investigator to ensure there is no risk of contamination/carryover into the current study. (14)
CL Item
Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 56 day period. (15)
CL Item
A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening.  (16)
CL Item
The subject has tested positive for HIV antibodies. (17)
CL Item
A positive urine drug screen at screening, on admission to the unnit, or when randomly tested during the study. (18)
CL Item
Positive alcohol urine test at screening or on admission to the Unit. (19)
CL Item
Positive urine cotinine test at screening. (20)
CL Item
Consumption of seville oranges, pomelos (members of the grapefruit family) or grapefruit juice from 7 days prior to the first dose of study medication. (21)
CL Item
unwillingness or inability to follow the procedures outlined in the protocol. (22)
CL Item
Subject is mentally or legally incapacitated. (23)

Använd detta formulär för feedback, frågor och förslag på förbättringar.

Fält markerade med * är obligatoriska.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial