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Pneumococcal 7-valent Conjugate Vaccine (Diphtheria CRM197 Protein), Prevnar , is a sterile solution of saccharides of the capsular antigens of Streptococcus pneumoniae serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F individually conjugated to diphtheria CRM197 protein. Each serotype is grown in soy peptone broth. The individual polysaccharides are purified through centrifugation, precipitation, ultrafiltration, and column chromatography. The polysaccharides are chemically activated to make saccharides which are directly conjugated to the protein carrier CRM197 to form the glycoconjugate. This is effected by reductive amination. CRM197 is a nontoxic variant of diphtheria toxin isolated from cultures of Corynebacterium diphtheriae strain C7 (β197) grown in a casamino acids and yeast extract-based medium. CRM197 is purified through ultrafiltration, ammonium sulfate precipitation, and ion-exchange chromatography. The individual glycoconjugates are purified by ultrafiltration and column chromatography and are analyzed for saccharide to protein ratios, molecular size, free saccharide, and free protein.Call your doctor at once if you have a serious side effect such as:Call your doctor at once if you have a serious side effect such as:

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Foods containing tyramine should not be eaten while using MAOIs. Doing so may trigger a hypertensive crisis. These would include foods smoked, aged, pickled, or fermented -- or food with natural bacterial contamination. Examples of such foods include beer, wine, yeast, liver, dry sausages, fava beans, and yogurt.

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Beta-blockers, such as propranolol, are used to treat performance anxiety, a kind of social anxiety disorder, and are sometimes used for panic disorder.

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