Compositions, methods and systems are provided for pulmonary or nasal delivery of active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A61K 31/167 - Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen atom of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
A61K 31/192 - Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid
A61K 31/194 - Carboxylic acids, e.g. valproic acid having two or more carboxyl groups, e.g. succinic, maleic or phthalic acid
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61K 31/46 - 8-Azabicyclo [3.2.1] octaneDerivatives thereof, e.g. atropine, cocaine
A61K 31/56 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids
A61K 31/573 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone substituted in position 21, e.g. cortisone, dexamethasone, prednisone or aldosterone
A61K 31/58 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
Systems and methods for isolating and/or desiccating a portion of a drug delivery tract of a drug delivery apparatus to reduce water vapor content therein are provided. For example, there is provided a metered dose inhaler for delivering aerosolized medicament or other matter to a user. The aerosolized medicament or other matter may be discharged from a discharge passageway within the inhaler into an inhalation passageway for inhalation by a user, and the inhaler may comprise a seal member operative to selectively isolate the discharge passageway from the inhalation passageway and external environment during inactivity. The inhaler may further comprise a desiccant material arranged to withdraw moisture from the isolated discharge passageway. In other instances, desiccant material may be arranged to withdraw moisture from the discharge passageway of the inhaler without isolating the discharge passage during inactivity.
Compositions, methods and systems are provided for pulmonary or nasal delivery of two or more active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A61K 9/00 - Medicinal preparations characterised by special physical form
A61K 31/167 - Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen atom of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
A61K 45/06 - Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61K 31/138 - Aryloxyalkylamines, e.g. propranolol, tamoxifen, phenoxybenzamine
A61K 31/46 - 8-Azabicyclo [3.2.1] octaneDerivatives thereof, e.g. atropine, cocaine
A61K 31/56 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids
A61K 31/58 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
Systems and methods for isolating and/or desiccating a portion of a drug delivery tract of a drug delivery apparatus to reduce water vapor content therein are provided. For example, there is provided a metered dose inhaler for delivering aerosolized medicament or other matter to a user. The aerosolized medicament or other matter may be discharged from a discharge passageway within the inhaler into an inhalation passageway for inhalation by a user, and the inhaler may comprise a seal member operative to selectively isolate the discharge passageway from the inhalation passageway and external environment during inactivity. The inhaler may further comprise a desiccant material arranged to withdraw moisture from the isolated discharge passageway. In other instances, desiccant material may be arranged to withdraw moisture from the discharge passageway of the inhaler without isolating the discharge passage during inactivity.
The present disclosure is directed to methods of decreasing the mortality of a patient suffering from COPD. The methods comprises administering to the patient an effective amount of a pharmaceutical composition deliverable from a metered dose inhaler comprising glycopyrrolate, budesonide and formoterol.
A61K 31/58 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
A61K 31/167 - Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen atom of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61P 11/00 - Drugs for disorders of the respiratory system
There is provided an electronically controlled, motor-driven, breath actuated metered dose inhaler for delivering aerosolized medicament or other matter to a user. The inhaler may comprise a base housing including a motor-driven actuator and other system components and a removable aerosol cartridge insertably receivable in the base housing. The inhaler may be paired with a smart phone or other client computing device to provide additional functionality, such as to provide instructional information and feedback regarding usage of the inhaler, to generate and display dosage tracking information, and to provide alerts and reminders to a user of the inhaler or others.
Methods and systems for the preparation of conditioned micronized active agents. Additionally, methods and systems for in-process conditioning of micronized active agent particles and compositions comprising conditioned micronized materials.
A61K 31/537 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and at least one oxygen as the ring hetero atoms, e.g. 1,2-oxazines spiro-condensed or forming part of bridged ring systems
A61K 31/58 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
A61K 31/7016 - Disaccharides, e.g. lactose, lactulose
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
Systems and methods for isolating and/or desiccating a portion of a drug delivery tract of a drug delivery apparatus to reduce water vapor content therein are provided. For example, there is provided a metered dose inhaler for delivering aerosolized medicament or other matter to a user. The aerosolized medicament or other matter may be discharged from a discharge passageway within the inhaler into an inhalation passageway for inhalation by a user, and the inhaler may comprise a seal member operative to selectively isolate the discharge passageway from the inhalation passageway and external environment during inactivity. The inhaler may further comprise a desiccant material arranged to withdraw moisture from the isolated discharge passageway. In other instances, desiccant material may be arranged to withdraw moisture from the discharge passageway of the inhaler without isolating the discharge passage during inactivity.
There is provided an electronically controlled, motor-driven, breath actuated metered dose inhaler for delivering aerosolized medicament or other matter to a user. The inhaler may comprise a base housing including a motor-driven actuator and other system components and a removable aerosol cartridge insertably receivable in the base housing. The inhaler may be paired with a smart phone or other client computing device to provide additional functionality, such as to provide instructional information and feedback regarding usage of the inhaler, to generate and display dosage tracking information, and to provide alerts and reminders to a user of the inhaler or others.
An improved aerosol dispensing apparatus includes an aerosol container, a discharge piece movably mounted to the aerosol container, a metering valve mounted within the discharge piece, a battery, and an electronically controlled flow control valve. The flow control valve is electronically connected to the battery and is in fluid communication with the metering valve. The metering valve is movable between an open position wherein a volume of an aerosol formulation is directed from the aerosol container through the metering valve to the electronically controlled flow control valve, and a closed position wherein the aerosol formulation is not permitted to flow through the metering valve. The electronically controlled flow control valve is configured to precisely control a flow of the aerosol formulation outward of the discharge piece.
A61M 16/20 - Valves specially adapted to medical respiratory devices
11.
Compositions for pulmonary delivery of long-acting muscarinic antagonists or long-acting B2 adrenergic receptor agonists and associated methods and systems
2 adrenergic receptor agonists via a metered dose inhaler. In particular embodiments, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A61K 31/58 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
A61K 31/137 - Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine
A61K 9/00 - Medicinal preparations characterised by special physical form
A61K 31/167 - Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen atom of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61K 31/46 - 8-Azabicyclo [3.2.1] octaneDerivatives thereof, e.g. atropine, cocaine
A61K 31/56 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids
A61K 31/135 - Amines, e.g. amantadine having aromatic rings, e.g. methadone
A61K 31/192 - Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid
A61K 31/194 - Carboxylic acids, e.g. valproic acid having two or more carboxyl groups, e.g. succinic, maleic or phthalic acid
A61K 31/573 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone substituted in position 21, e.g. cortisone, dexamethasone, prednisone or aldosterone
An improved aerosol dispensing apparatus includes an aerosol container, a discharge piece movably mounted to the aerosol container, a flow control valve mounted within the discharge piece, a battery, and an electronically controlled metering valve electronically connected to the battery and in fluid communication with the flow control valve. The flow control valve is movable between an open position wherein a volume of an aerosol formulation is directed from the aerosol container through the flow control valve to the metering valve, and a closed position, wherein the metering valve is configured to precisely control a flow of the aerosol formulation outward of the discharge piece. A solenoid is electronically connected to the battery and is movable between an actuated position wherein the solenoid urges the flow control valve into the open position, and an un-actuated position wherein the flow control valve remains in the closed position.
Systems and methods for isolating and/or desiccating a portion of a drug delivery tract of a drug delivery apparatus to reduce water vapor content therein are provided. For example, there is provided a metered dose inhaler for delivering aerosolized medicament or other matter to a user. The aerosolized medicament or other matter may be discharged from a discharge passageway within the inhaler into an inhalation passageway for inhalation by a user, and the inhaler may comprise a seal member operative to selectively isolate the discharge passageway from the inhalation passageway and external environment during inactivity. The inhaler may further comprise a desiccant material arranged to withdraw moisture from the isolated discharge passageway. In other instances, desiccant material may be arranged to withdraw moisture from the discharge passageway of the inhaler without isolating the discharge passage during inactivity.
Systems and methods for isolating and/or desiccating a portion of a drug delivery tract of a drug delivery apparatus to reduce water vapor content therein are provided. For example, there is provided a metered dose inhaler for delivering aerosolized medicament or other matter to a user. The aerosolized medicament or other matter may be discharged from a discharge passageway within the inhaler into an inhalation passageway for inhalation by a user, and the inhaler may comprise a seal member operative to selectively isolate the discharge passageway from the inhalation passageway and external environment during inactivity. The inhaler may further comprise a desiccant material arranged to withdraw moisture from the isolated discharge passageway. In other instances, desiccant material may be arranged to withdraw moisture from the discharge passageway of the inhaler without isolating the discharge passage during inactivity.
05 - Pharmaceutical, veterinary and sanitary products
Goods & Services
(1) Pharmaceutical products and pharmaceutically active compositions, namely, pharmaceutical preparations for inhaled administration of drugs in aerosol form as fine particles for the treatment and prevention of diseases and disorders of the respiratory system, the cardiovascular or circulatory system, the endocrine system, namely, diabetes, acromegaly, Addison's disease and Cushing's syndrome, and the immune system, namely, autoimmune diseases and immunologic deficiency syndromes
05 - Pharmaceutical, veterinary and sanitary products
Goods & Services
(1) Pharmaceutical products and pharmaceutically active compositions, namely, pharmaceutical preparations for inhaled administration of drugs in aerosol form as fine particles for the treatment and prevention of diseases and disorders of the respiratory system, the cardiovascular or circulatory system, the endocrine system, namely, diabetes, acromegaly, Addison's disease and Cushing's syndrome, and the immune system, namely, autoimmune diseases and immunologic deficiency syndromes
There is provided an electronically controlled, motor-driven, breath actuated metered dose inhaler for delivering aerosolized medicament or other matter to a user. The inhaler may comprise a base housing including a motor-driven actuator and other system components and a removable aerosol cartridge insertably receivable in the base housing. The inhaler may be paired with a smart phone or other client computing device to provide additional functionality, such as to provide instructional information and feedback regarding usage of the inhaler, to generate and display dosage tracking information, and to provide alerts and reminders to a user of the inhaler or others.
There is provided an electronically controlled, motor-driven, breath actuated metered dose inhaler for delivering aerosolized medicament or other matter to a user. The inhaler may comprise a base housing including a motor-driven actuator and other system components and a removable aerosol cartridge insertably receivable in the base housing. The inhaler may be paired with a smart phone or other client computing device to provide additional functionality, such as to provide instructional information and feedback regarding usage of the inhaler, to generate and display dosage tracking information, and to provide alerts and reminders to a user of the inhaler or others.
Compositions, methods and systems are provided for pulmonary or nasal delivery of two or more active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A61K 9/00 - Medicinal preparations characterised by special physical form
A61K 31/167 - Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen atom of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
A61K 45/06 - Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61K 31/138 - Aryloxyalkylamines, e.g. propranolol, tamoxifen, phenoxybenzamine
A61K 31/46 - 8-Azabicyclo [3.2.1] octaneDerivatives thereof, e.g. atropine, cocaine
A61K 31/56 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids
A61K 31/58 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
21.
COMPOSITIONS, METHODS & SYSTEMS FOR RESPIRATORY DELIVERY OF THREE OR MORE ACTIVE AGENTS
Pharmaceutical compositions, systems and methods suitable for respiratory delivery of a fixed combination of LAMA, LABA, and ICS active agents are described. The pharmaceutical compositions described herein may be formulated for respiratory delivery via a metered dose inhaler (MDI). Also described herein are MDI systems for delivery of a fixed combination of LAMA, LABA, and ICS active agents, as well as methods for preparing and using the compositions and systems described herein.
A61K 9/00 - Medicinal preparations characterised by special physical form
A61K 31/167 - Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen atom of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
22.
METHODS AND SYSTEMS FOR CONDITIONING OF PARTICULATE CRYSTALLINE MATERIALS
Methods and systems for the preparation of conditioned micronized active agents. Additionally, methods and systems for in-process conditioning of micronized active agent particles and compositions comprising conditioned micronized materials.
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
B02C 19/00 - Other disintegrating devices or methods
23.
METHODS AND SYSTEMS FOR CONDITIONING OF PARTICULATE CRYSTALLINE MATERIALS
Methods and systems for the preparation of conditioned micronized active agents. Additionally, methods and systems for in-process conditioning of micronized active agent particles and compositions comprising conditioned micronized materials.
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
B02C 19/00 - Other disintegrating devices or methods
24.
Compositions, methods and propellant-based systems for respiratory delivery of glycopyrrolate and one or more active agents
Compositions, methods and systems are provided for pulmonary or nasal delivery of two or more active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61K 9/00 - Medicinal preparations characterised by special physical form
Compositions, methods and systems are provided for pulmonary or nasal delivery of two or more active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A01N 25/00 - Biocides, pest repellants or attractants, or plant growth regulators, characterised by their forms, or by their non-active ingredients or by their methods of applicationSubstances for reducing the noxious effect of the active ingredients to organisms other than pests
A61K 9/72 - Medicinal preparations characterised by special physical form for smoking or inhaling
A61L 9/02 - Disinfection, sterilisation or deodorisation of air using gaseous or vaporous substances, e.g. ozone using substances evaporated in the air by heating or combustion
26.
Compositions, methods and systems for respiratory delivery of two or more active agents
Compositions, methods and systems are provided for pulmonary or nasal delivery of two or more active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61K 9/00 - Medicinal preparations characterised by special physical form
Compositions, methods and systems are provided for pulmonary or nasal delivery of two or more active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
2 adrenergic receptor agonists via a metered dose inhaler. In particular embodiments, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
2 adrenergic receptor agonists via a metered dose inhaler. In particular embodiments, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A61K 31/58 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
A61P 11/00 - Drugs for disorders of the respiratory system
A61K 9/00 - Medicinal preparations characterised by special physical form
A61K 31/137 - Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine
A61K 31/167 - Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen atom of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61K 31/46 - 8-Azabicyclo [3.2.1] octaneDerivatives thereof, e.g. atropine, cocaine
A61K 31/56 - Compounds containing cyclopenta[a]hydrophenanthrene ring systemsDerivatives thereof, e.g. steroids
A61K 31/135 - Amines, e.g. amantadine having aromatic rings, e.g. methadone
Compositions, methods and systems are provided for pulmonary or nasal delivery of active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
Compositions, methods and systems are provided for pulmonary or nasal delivery of two or more active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
Compositions, methods and systems are provided for pulmonary or nasal delivery of active agents via a metered dose inhaler. In one embodiment, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co- suspension within the suspension medium.
A61P 11/00 - Drugs for disorders of the respiratory system
33.
COMPOSITIONS FOR PULMONARY DELIVERY OF LONG-ACTING MUSCARINIC ANTAGONISTS AND LONG-ACTING B2 ADRENERGIC RECEPTOR AGONISTS AND ASSOCIATED METHODS AND SYSTEMS
Compositions, methods and systems are provided for pulmonary delivery of long-acting muscarinic antagonists and long-acting β2 adrenergic receptor agonists via a metered dose inhaler. In particular embodiments, the compositions include a suspension medium, active agent particles, and suspending particles, in which the active agent particles and suspending particles form a co-suspension within the suspension medium.
A61K 31/40 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
A61P 11/00 - Drugs for disorders of the respiratory system
A61K 9/00 - Medicinal preparations characterised by special physical form
05 - Pharmaceutical, veterinary and sanitary products
Goods & Services
Pharmaceutical products and pharmaceutically active
compositions, namely, products and compositions for inhaled
or respiratory administration of drugs for the treatment
and/or prophylaxis of diseases or medical conditions.
05 - Pharmaceutical, veterinary and sanitary products
Goods & Services
Pharmaceutical products and pharmaceutically active
compositions, namely, products and compositions for inhaled
or respiratory administration of drugs for the treatment
and/or prophylaxis of diseases or medical conditions.
