ID
33425
Description
Study ID: 107434 Clinical Study ID: NAP107434 Study Title: A randomised, double-blind, double-dummy, placebo controlled, three-way cross-over study to investigate the effect of single oral doses of 100 mg GW273225 (4030W92) and 325 mg LAMICTAL on resting motor threshold in healthy subjects Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Study Link: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 1 Study Recruitment Status: Completed Generic Name: GW273225 Trade Name: lamictal Study Indication: Bipolar Disorder Checklist for the first screening of the study subject. It should be filled out at the screening visit. Every item should be checked and staff initials should be filled in next to the item. Screening Visit: 28 days prior to first dosing. Treatment Period: The day before dosing, until 48h after dosing. Follow-Up: 14-21 days after last dose
Keywords
Versions (2)
- 12/1/18 12/1/18 -
- 12/8/18 12/8/18 -
Copyright Holder
GlaxoSmithKline
Uploaded on
December 8, 2018
DOI
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License
Creative Commons BY-NC 3.0
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Effect of Lamictal on Resting Motor Threshold Study-ID 107434
Subject Screening Checklist
- StudyEvent: ODM
Description
General Information
Alias
- UMLS CUI-1
- C1508263
Description
ID Type
Data type
text
Alias
- UMLS CUI [1]
- C2348585
Description
Date of last Trial
Data type
text
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C2348568
Description
If yes, please EXCLUDE
Data type
text
Alias
- UMLS CUI [1,1]
- C2348568
- UMLS CUI [1,2]
- C0013230
Description
GP Address, Fax and Tel.
Data type
text
Alias
- UMLS CUI [1,1]
- C0017319
- UMLS CUI [1,2]
- C1442065
- UMLS CUI [2,1]
- C0017319
- UMLS CUI [2,2]
- C1549619
- UMLS CUI [3,1]
- C0017319
- UMLS CUI [3,2]
- C1515258
Description
GP Disclosure
Data type
text
Alias
- UMLS CUI [1,1]
- C0017319
- UMLS CUI [1,2]
- C0012625
Description
GP Letter
Data type
text
Alias
- UMLS CUI [1,1]
- C0017319
- UMLS CUI [1,2]
- C1096774
Description
GP response
Data type
text
Alias
- UMLS CUI [1,1]
- C0017319
- UMLS CUI [1,2]
- C1706817
Description
if applicable
Data type
text
Alias
- UMLS CUI [1,1]
- C0281974
- UMLS CUI [1,2]
- C0021430
Description
Screening part only
Data type
text
Alias
- UMLS CUI [1,1]
- C0021430
- UMLS CUI [1,2]
- C0742766
- UMLS CUI [1,3]
- C0031831
Description
Study Informed Consent Signed by Subject
Data type
text
Alias
- UMLS CUI [1]
- C0021430
Description
HIV Consent
Data type
text
Alias
- UMLS CUI [1,1]
- C0019682
- UMLS CUI [1,2]
- C0021430
Description
Pharmacogenetic Consent
Data type
text
Alias
- UMLS CUI [1,1]
- C0031325
- UMLS CUI [1,2]
- C0021430
Description
Screening Talk
Data type
text
Alias
- UMLS CUI [1,1]
- C0220908
- UMLS CUI [1,2]
- C0871703
Description
Clinical Assessments
Alias
- UMLS CUI-1
- C0220825
Description
Height, Weight
Data type
text
Alias
- UMLS CUI [1]
- C0005890
- UMLS CUI [2]
- C0005910
Description
BMI
Data type
text
Alias
- UMLS CUI [1]
- C1305855
Description
Semi-Supine Vitals (BP and HR)
Data type
text
Alias
- UMLS CUI [1,1]
- C0522019
- UMLS CUI [1,2]
- C0018810
- UMLS CUI [2,1]
- C0522019
- UMLS CUI [2,2]
- C0005823
Description
Medical, Medication History and History
Data type
text
Alias
- UMLS CUI [1]
- C0262926
- UMLS CUI [2,1]
- C0262926
- UMLS CUI [2,2]
- C0013227
- UMLS CUI [3]
- C0031809
Description
12-Lead ECG
Data type
text
Alias
- UMLS CUI [1]
- C0430456
Description
TMS
Data type
text
Alias
- UMLS CUI [1]
- C0436548
Description
EEG with Photostimulation
Data type
text
Alias
- UMLS CUI [1]
- C0430786
Description
Laboratory Tests
Alias
- UMLS CUI-1
- C0022885
Description
4.5ml EDTA
Data type
text
Alias
- UMLS CUI [1]
- C0018941
Description
6ml SST
Data type
text
Alias
- UMLS CUI [1]
- C0008000
Description
6ml SST
Data type
text
Alias
- UMLS CUI [1]
- C0019682
- UMLS CUI [2]
- C0019163
- UMLS CUI [3]
- C0019196
Description
Urinalysis
Data type
text
Alias
- UMLS CUI [1]
- C0042014
Description
Urine Microscopy
Data type
text
Alias
- UMLS CUI [1]
- C0430397
Description
Drugs of Abuse and Alcohol Screen
Data type
text
Alias
- UMLS CUI [1]
- C0013146
- UMLS CUI [2]
- C0085762
Description
Conclusion
Alias
- UMLS CUI-1
- C1707478
Description
Reason Subject is Ineligble
Data type
text
Alias
- UMLS CUI [1,1]
- C0566251
- UMLS CUI [1,2]
- C2828389
Description
Clinical QC Initials
Data type
text
Alias
- UMLS CUI [1,1]
- C0034378
- UMLS CUI [1,2]
- C2986440
Description
CRM QC Initials
Data type
text
Alias
- UMLS CUI [1,1]
- C2986440
- UMLS CUI [1,2]
- C0034378
- UMLS CUI [2]
- C3846158
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Subject Screening Checklist
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