MEDTRONIC MULTIIFIRE ENDO HERNIA STAPLER
$4,653.68 / case
Stapler is designed for introduction and use through all appropriately sized trocar sleeves or larger sized trocar sleeves with the use of a converter. The size of the staples is determined by the selection of the 4mm or the 4.8mm single use loading kit (SULU). The stapler places one staple each time the handle of the instrument is squeezed. The staple legs first penetrate the tissue or mesh and then fully form, thus anchoring or approximating the tissue(s) and mesh.
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Stapler is designed for introduction and use through all appropriately sized trocar sleeves or larger sized trocar sleeves with the use of a converter. The size of the staples is determined by the selection of the 4mm or the 4.8mm single use loading kit (SULU). The stapler places one staple each time the handle of the instrument is squeezed. The staple legs first penetrate the tissue or mesh and then fully form, thus anchoring or approximating the tissue(s) and mesh.
| Dimensions | 10 × 10 × 10 in |
|---|---|
| Size | 12 |
| Staple Size | 4.8 |
| Packaging | 10 staples per stapler, 6 staplers per case (60 staples total) |
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Semaglutide API Product Description:
COA Available Product with NDC Code
Available in the US and Canada.
Semaglutide API is indicated for improving glycemic control in adults with type 2 diabetes mellitus, in conjunction with diet and exercise. The approved therapeutic doses are 0.5 mg and 1 mg. Type 2 diabetes is a chronic metabolic disorder characterized by high blood sugar, insulin resistance, and insufficient insulin production. The onset of this condition is linked to the inability of beta cells to respond to increased plasma glucose, predominantly caused by lifestyle factors such as overweight and obesity. The key feature of type 2 diabetes is insulin resistance, which reduces insulin’s effectiveness at normal concentrations. Insulin secretion is stimulated by incretins like glucagon-like peptide 1 (GLP-1), which also delays gastric emptying and induces satiety.
Mode of Action:
Semaglutide API enhances glucose control through various mechanisms, including increased insulin secretion, slower gastric emptying, and reduced postprandial glucagon and food intake. The drug mimics the activity of GLP-1, a key hormone in glucose management, thanks to structural modifications that improve its stability against degradation by enzymes like dipeptidyl peptidase-4 (DPP-4). These modifications also promote specific binding to plasma albumin and prevent incorrect binding of fatty acids, resulting in an extended half-life and improved patient compliance.
Pharmacodynamics:
Clinical trials show that semaglutide significantly reduces glycated hemoglobin (HbA1c) compared to other medications, including sitagliptin, exenatide, and insulin glargine U100. HbA1c is a standard measure of high glucose levels, reflecting long-term blood sugar control. Additionally, semaglutide has been shown to reduce body weight, lower fasting and postprandial glucose levels, and decrease fasting triglycerides and VLDL cholesterol.
Metabolism:
Semaglutide is slowly but extensively metabolized before excretion, with 83% of the administered dose found unchanged in plasma. Six different metabolites have been identified, with the major metabolite accounting for 7.7% of the dose. The drug is primarily degraded by enzymes such as DPP-4 and neural endopeptidase (NEP), which inactivate semaglutide and hydrolyze its peptide bonds.
Toxicity:
In preclinical studies, mild c-cell hyperplasia and other effects, including liver necrosis and centrilobular hypertrophy, were observed at doses significantly higher than those used clinically. High doses also resulted in ECG abnormalities and tissue vacuolation.
IUPAC:
17-{[(1R)-3-[(2-{2-[({2-[2-({[(5S)-5-[(2S)-2-[(2S)-2-[(2S)-2-{2-[(2S)-2-[(2S)-2-[(2S)-2-[(2S)-2-[(2S)-2-[(2S)-2-[(2S)-2-[(2S)-2-[(2S,3R)-2-[(2S)-2-[(2S,3R)-2-{2-[(2S)-2-{2-[(2S)-2-amino-3-(1H-imidazol-4-yl)propanamido]-2-methylpropanamido}-4-carboxybutanamido]acetamido}-3-hydroxybutanamido]-3-phenylpropanamido]-3-hydroxybutanamido]-3-hydroxypropanamido]-3-carboxypropanamido]-3-methylbutanamido]-3-hydroxypropanamido]-3-hydroxypropanamido]-3-(4-hydroxyphenyl)propanamido]-4-methylpentanamido]-4-carboxybutanamido]acetamido}-4-carbamoylbutanamido]propanamido]propanamido]-5-{[(1S)-1-{[(1S)-1-{[(1S,2S)-1-{[(1S)-1-{[(1S)-1-{[(1S)-1-{[(1S)-1-{[(1S)-4-carbamimidamido-1-[({[(1S)-4-carbamimidamido-1-[(carboxymethyl)carbamoyl]butyl]carbamoyl}methyl)carbamoyl]butyl]carbamoyl}-2-methylpropyl]carbamoyl}-3-methylbutyl]carbamoyl}-2-(1H-indol-3-yl)ethyl]carbamoyl}ethyl]carbamoyl}-2-methylbutyl]carbamoyl}-2-phenylethyl]carbamoyl}-3-carboxypropyl]carbamoyl}pentyl]carbamoyl}methoxy)ethoxy]ethyl}carbamoyl)methoxy]ethoxy}ethyl)carbamoyl]-1-carboxypropyl]carbamoyl}heptadecanoic acid
DrugBank:
DB13928
Formula:
C187-H291-N45-O59
Molecular Mass:
Average: 4113.641
Monoisotopic: 4111.11537713
Synonyms:
Semaglutide / Semaglutide API
SMILES:
CC[C@H](C)[C@H](NC(=O)[C@H](CC1=CC=CC=C1)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCCCNC(=O)COCCOCCNC(=O)COCCOCCNC(=O)CC[C@@H](NC(=O)CCCCCCCCCCCCCCCCC(O)=O)C(O)=O)NC(=O)[C@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CCC(N)=O)NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC1=CC=C(O)C=C1)NC(=O)[C@H](CO)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC(O)=O)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC1=CC=CC=C1)NC(=O)[C@@H](NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)C(C)(C)NC(=O)[C@@H](N)CC1=CNC=N1)[C@@H](C)O)[C@@H](C)O)C(C)C)C(=O)N[C@@H](C)C(=O)N[C@@H](CC1=CNC2=C1C=CC=C2)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CCCNC(N)=N)C(=O)NCC(=O)N[C@@H](CCCNC(N)=N)C(=O)NCC(O)=O
InChi:
InChI=1S/C187H291N45O59/c1-18-105(10)154(180(282)208-108(13)159(261)216-133(86-114-89-200-119-50-40-39-49-117(114)119)170(272)218-129(82-102(4)5)171(273)228-152(103(6)7)178(280)215-121(53-44-72-199-186(192)193)162(264)201-91-141(242)209-120(52-43-71-198-185(190)191)161(263)204-94-151(257)258)230-172(274)131(83-111-45-33-31-34-46-111)219-167(269)126(64-69-149(253)254)214-166(268)122(51-41-42-70-195-144(245)98-290-79-78-289-76-74-197-145(246)99-291-80-77-288-75-73-196-139(240)66-61-127(183(285)286)211-140(241)54-37-29-27-25-23-21-19-20-22-24-26-28-30-38-55-146(247)248)212-158(260)107(12)206-157(259)106(11)207-165(267)125(60-65-138(189)239)210-142(243)92-202-163(265)123(62-67-147(249)250)213-168(270)128(81-101(2)3)217-169(271)130(85-113-56-58-116(238)59-57-113)220-175(277)135(95-233)223-177(279)137(97-235)224-179(281)153(104(8)9)229-174(276)134(88-150(255)256)221-176(278)136(96-234)225-182(284)156(110(15)237)231-173(275)132(84-112-47-35-32-36-48-112)222-181(283)155(109(14)236)227-143(244)93-203-164(266)124(63-68-148(251)252)226-184(287)187(16,17)232-160(262)118(188)87-115-90-194-100-205-115/h31-36,39-40,45-50,56-59,89-90,100-110,118,120-137,152-156,200,233-238H,18-30,37-38,41-44,51-55,60-88,91-99,188H2,1-17H3,(H2,189,239)(H,194,205)(H,195,245)(H,196,240)(H,197,246)(H,201,264)(H,202,265)(H,203,266)(H,204,263)(H,206,259)(H,207,267)(H,208,282)(H,209,242)(H,210,243)(H,211,241)(H,212,260)(H,213,270)(H,214,268)(H,215,280)(H,216,261)(H,217,271)(H,218,272)(H,219,269)(H,220,277)(H,221,278)(H,222,283)(H,223,279)(H,224,281)(H,225,284)(H,226,287)(H,227,244)(H,228,273)(H,229,276)(H,230,274)(H,231,275)(H,232,262)(H,247,248)(H,249,250)(H,251,252)(H,253,254)(H,255,256)(H,257,258)(H,285,286)(H4,190,191,198)(H4,192,193,199)/t105-,106-,107-,108-,109 ,110 ,118-,120-,121-,122-,123-,124-,125-,126-,127 ,128-,129-,130-,131-,132-,133-,134-,135-,136-,137-,152-,153-,154-,155-,156-/m0/s1
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