ID

33431

Beschreibung

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 This form contains informations about the subjects dietary status and physical activity. It should be filled out at the screening visit. Dietary Restricions: Subjects not to consume the following foodstuffs for five days prior to and including each dosing day:- - Grapfruit, Grapefruit juice and grapefruit containing products - Quinine – containing products - Broccoli - Brussel sprouts - Watercress - Cabbage (incl. Coleslaw) - Charcoal broiled beef Subjects will refrain from consuming caffeinated beverages for 48 hours prior to and including each dosing day Subjects must refrain from strenuous exercise for 48 hours before the screening medical examination and for the entire duration of the study 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

Stichworte

  1. 01.12.18 01.12.18 -
  2. 08.12.18 08.12.18 -
  3. 18.12.18 18.12.18 - Sarah Riepenhausen
Rechteinhaber

GlaxoSmithKline

Hochgeladen am

8. Dezember 2018

DOI

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Lizenz

Creative Commons BY-NC 3.0

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Effect of Lamictal on Resting Motor Threshold Study-ID 107434

Dietary Status and Physical Activity

Administrative Data
Beschreibung

Administrative Data

Alias
UMLS CUI-1
C1320722
Subject Screening number
Beschreibung

Subject Screening No.

Datentyp

integer

Alias
UMLS CUI [1,1]
C0220908
UMLS CUI [1,2]
C0600091
Subject no.
Beschreibung

Subject Number

Datentyp

integer

Alias
UMLS CUI [1]
C2348585
Date Information Collected
Beschreibung

Date Information Collected

Datentyp

date

Alias
UMLS CUI [1,1]
C3244127
UMLS CUI [1,2]
C0011008
Dietary Status and Physical Activity
Beschreibung

Dietary Status and Physical Activity

Alias
UMLS CUI-1
C0392209
UMLS CUI-2
C0026606
Is the subject vegan or vegetarian?
Beschreibung

If Yes, exclude

Datentyp

boolean

Alias
UMLS CUI [1]
C0042441
UMLS CUI [2]
C2987738
Any medical dietary restrictions?
Beschreibung

If yes, detail below

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0425422
UMLS CUI [1,2]
C0205476
Specify medical dietary restrictions
Beschreibung

If subject has any medical dietary restrictions

Datentyp

text

Alias
UMLS CUI [1,1]
C0425422
UMLS CUI [1,2]
C0205476
UMLS CUI [1,3]
C2348235
Does the subject consume caffeine?
Beschreibung

Subject Caffeine Consumption

Datentyp

boolean

Alias
UMLS CUI [1]
C0948365
How many cups consumes the subject per day?
Beschreibung

If the subject consumes caffeine UPPER LIMIT OF CAFFEINE IS 6 CUPS PER DAY

Datentyp

integer

Maßeinheiten
  • cups/day
Alias
UMLS CUI [1,1]
C0948365
UMLS CUI [1,2]
C2164136
cups/day
Does the subject partake in any exercise?
Beschreibung

If Yes, complete below

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0679823
UMLS CUI [1,2]
C0015259
Type of Exercise
Beschreibung

If subject participates in any exercise

Datentyp

text

Alias
UMLS CUI [1,1]
C0015259
UMLS CUI [1,2]
C0332307
No. of Exercise Sessions per Week
Beschreibung

No. of Exercise Sessions per Week

Datentyp

integer

Alias
UMLS CUI [1,1]
C0015259
UMLS CUI [1,2]
C0585296
Conclusion
Beschreibung

Conclusion

Alias
UMLS CUI-1
C1707478
Staff initials
Beschreibung

Staff initials

Datentyp

text

Alias
UMLS CUI [1,1]
C2986440
UMLS CUI [1,2]
C1552089
Physician's initials
Beschreibung

Physician's initials

Datentyp

text

Alias
UMLS CUI [1,1]
C2986440
UMLS CUI [1,2]
C0031831

Ähnliche Modelle

Dietary Status and Physical Activity

Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Subject Screening No.
Item
Subject Screening number
integer
C0220908 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Subject Number
Item
Subject no.
integer
C2348585 (UMLS CUI [1])
Date Information Collected
Item
Date Information Collected
date
C3244127 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
Dietary Status and Physical Activity
C0392209 (UMLS CUI-1)
C0026606 (UMLS CUI-2)
Subject Vegan or Vegetarian
Item
Is the subject vegan or vegetarian?
boolean
C0042441 (UMLS CUI [1])
C2987738 (UMLS CUI [2])
Medical Dietary Restrictions
Item
Any medical dietary restrictions?
boolean
C0425422 (UMLS CUI [1,1])
C0205476 (UMLS CUI [1,2])
Medical Dietary Restrictions Specification
Item
Specify medical dietary restrictions
text
C0425422 (UMLS CUI [1,1])
C0205476 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Subject Caffeine Consumption
Item
Does the subject consume caffeine?
boolean
C0948365 (UMLS CUI [1])
Number of Caffeine Cups per day
Item
How many cups consumes the subject per day?
integer
C0948365 (UMLS CUI [1,1])
C2164136 (UMLS CUI [1,2])
Exercise Participation
Item
Does the subject partake in any exercise?
boolean
C0679823 (UMLS CUI [1,1])
C0015259 (UMLS CUI [1,2])
Type of Exercise
Item
Type of Exercise
text
C0015259 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
No. of Exercise Sessions per Week
Item
No. of Exercise Sessions per Week
integer
C0015259 (UMLS CUI [1,1])
C0585296 (UMLS CUI [1,2])
Item Group
Conclusion
C1707478 (UMLS CUI-1)
Staff initials
Item
Staff initials
text
C2986440 (UMLS CUI [1,1])
C1552089 (UMLS CUI [1,2])
Physician's initials
Item
Physician's initials
text
C2986440 (UMLS CUI [1,1])
C0031831 (UMLS CUI [1,2])

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