Alternative drug

Klebe G. Lead identification in post-genomics computers as a complementary alternative. Drug Discov Today Technol 2004 1 225-30. 

Determine if any drugs need to be discontinued, or alternate drugs selected, to prevent worsening of renal function. 

What drug would be the optimal alternative drug for this patient ... 

Obtain a thorough medication history, including use of prescription, non-prescription, and complementary and alternative drug products. Determine which, if any, treatments in the past had been helpful as judged by the patient. Could any of the patient s current medications be contributing to Ul ... 

O All symptomatic adults and children over the age of 8 years should be treated with metronidazole 250 mg three times daily for 7 days, or tinidazole 2 gas a single dose, or nitazoxanide 500 mg twice daily for 3 days.3 The pediatric dose of metronidazole is 15 mg/kg per day three times daily far 7 days. Alternative drugs include furazolidone 100 mg four times daily or paromomycin 25 to 30 mg/kg per day in divided doses daily for 7 days. Paromomycin may be used in pregnancy instead of metronidazole. Pediatric patients can also be treated with suspensions of either furazolidone 8 mg/kg per day in four divided doses far 7 days, or nitazoxanide (Alina) 100 to 200 mg every 12 hours for 3 days. 

Fig. 2 Two types of dissolution-controlled, pulsed delivery systems (A) single bead-type device with alternating drug and rate-controlling layers (B) beads containing drug with differing thickness of dissolving coats.

Yet another related approach to pharmacotherapy management is step protocols or step therapy. Step protocols limit access to certain drugs until less costly alternative drugs have been tried first. For example, a step protocol might require a patient to have tried a relatively low-cost antihistamine, such as chlorpheniramine, before being prescribed a more expensive nonsedating antihistamine. Step therapy procedures were in place at 68.5% of HMOs in 1998 [1]. 

There is an expanding body of evidence to suggest that sesquiterpene lactones inhibit the synthesis NO synthetase. One such compound is an ambrosanolides-type sesquiterpene known as cumanin characterized from Ambrosia psilostachya. This sesquiterpene inhibit the enzymatic activity of NO synthetase with an IC50 value of 9.38 xM (49). Another example is the well-known artemisinin, a sesquiterpene used as an alternative drug in the treatment of severe and multidrug-resistant malaria, which inhibits NO synthesis in cytokine-stimulated human astrocytoma T67 cells (50). 

One class of stimulants, the amphetamines, was synthesized originally as possible alternative drugs for the treatment of asthma and was a principal component of the original Benzedrine . Amphetamine-like stimulants are known and consumed especially for their activity-sustaining effects (i.e. increased alertness, strength, and endurance). Their wake-promoting properties... 

First-Line Dmgs Alternative Drugs 7 Comments... 

Piperazine is an alternative drug and is used for treatment of various forms of nematodes, in particular for enterobiasis and ascariasis. It causes paralysis in the nematode by blocking acetylchohne transmission. This causes the parasite to detach from the mucous membrane, where it is removed from the body. Ascariasis requires treatment for 2 days, and enterobiasis, for 7 days. Synonyms of this drug are tasnon, uvilon, antepar, bexin, and many others. 

Treat patients with tuberculosis who have hepatitis attributed to isoniazid with appropriate alternative drugs. Reinstitute isoniazid after symptoms and laboratory abnormalities have become normal. Restart the drug in very small doses gradually increase doses and withdraw immediately if there is any indication of recurrent liver involvement. 

At present, phenobarbital and primidone are considered as alternative drugs for the treatment of partial seizures and for generalized tonic-clonic epilepsy. They are judged to be less effective than carbamazepine and phenytoin. 

Trisulfapyrimidine (a combination of sulfadiazine, sulfamerazine, and sulfamethazine), trimethoprim-sulfamethoxazole, or sulfisoxazole can be used as an alternative drug for the treatment of melioidosis caused by Pseudomonas pseudomallei and for infections produced by Nocardia spp. 

Erythromycin is effective in the treatment and prevention of S. pyogenes and other streptococcal infections, but not those caused by the more resistant fecal streptococci. Staphylococci are generally susceptible to erythromycin, so this antibiotic is a suitable alternative drug for the penicillin-hypersensitive individual. It is a second-line drug for the treatment of gonorrhea and syphilis. Although erythromycin is popular for the treatment of middle ear and sinus infections, including H. influenzae, possible erythromycin-resistant S. pneumoniae is a concern. 

E. Chloramphenicol is no longer the treatment of choice for any bacterial infection because of the potentially fatal chloramphenicol-induced bone marrow suppression. In the past it has been used against the infections indicated in choices A, B, C, and D. It remains a major treatment for typhoid and paratyphoid fever in some developing countries, since alternative drugs are much more expensive. 

Pentamidine is an alternative drug for visceral leishmaniasis, especially when sodium stibogluconate has failed or is contraindicated. Pentamidine is also a reserve agent for the treatment of trypanosomiasis before the CNS is invaded. This characteristic largely restricts its use to Gambian trypanosomiasis. 

Pyrantel pamoate is active against several roundworms A lumbricoides, Ancylostoma duodenale, Necator americanus, and E. vermicularis. Pyrantel is an alternative drug of choice in treating infections with A lumbricoides, E. vermicularis (pinworms), and hookworms N. americanus and A. duodenale). It is not recommended for pregnant patients or for children under age 1 year. 

Novel and experimental drug treatments. A variety of alternative drug treatments have been used in OCD. Of those considered here, intravenous clomipramine is the only treatment supported by a reasonable degree of empirical evidence. Several open-label trials suggest that intravenous administration of clomipramine may be helpful in patients with OCD that is refractory to oral clomipramine (Fallon et al. 1992 Thakur et al. 1991 Warneke 1989]. 

As an alternative drug in the treatment of gonorrhoea and syphilis in patients allergic to penicillin. 

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