Breakthroughs, therapeutic

The current cost per dose of tPA (about 1,000) has already emerged as an important barrier to its widespread use in hospitals and clinics. Continued research in chemical engineering will be crucial to finding more economical processes for the production of this breakthrough therapeutic. 

Polymeric prodrugs are currently one of the most investigated topics. This research has resulted in breakthrough therapeutics, and many compounds are under clinical development (Table 3.7). Other examples of polymeric prodrug applications include the use of polysaccharides such as dextran, mannan, and pullulan to enable active targeting to tumor cells.117... 

Utilize standard therapeutic serum concentration ranges if partial response or breakthrough episode, adjust dose to achieve higher serum concentra-... 

Alprazolam and clonazepam are the most frequently used of the BZs and are well accepted by patients. Therapeutic response typically occurs in 1 to 2 weeks. With alprazolam, the duration of action may be as little as 4 to 6 hours with breakthrough symptoms between dosing. The use of extended-release alprazolam or clonazepam avoids this problem. 

Use standard therapeutic serum concentration ranges if clinically indicated if partial response or breakthrough episode, adjust dose to achieve higher serum concentrations without causing intolerable adverse effects valproate is preferred over lithium for mixed episodes and rapid cycling lithium and/or lamotrigine is preferred over valproate for bipolar depression. 

As noted by Goldsmith, medical technologies do not inherently increase health care costs. Their effects are broad-based and complex. Advances in medical technology may influence (1) the population at risk, (2) the cost of each treatment, (3) the risk of complications, (4) clinical incomes or hospital revenue, (5) the need for additional treatment, and/or (6) patients quality of life (Goldsmith, 1994). The pharmacoeconomics of an intervention are particularly important when the intervention is a therapeutic breakthrough (leads to better patient outcomes), is relatively expensive compared... 

Recent advances in mass spectrometry (MS) techniques have radically changed the analysis of biomolecules. MS has become the analytical method of choice for discovery and characterization of molecules with therapeutic value. Technological breakthroughs in the discovery area are now increasingly applied in the process development held and have recently entered the production process in manufacturing and quality control (QC) areas. In this presentation, after a review of the current state of the art, we would like to demonstrate how MS methods are influencing the development and manufacturing of therapeutic molecules. 

None of this, however, is to say that natural products no longer have a role in the modern pharmacopoeia. Indeed, some of the most exciting breakthroughs in medical research in the past half century have resulted from the discoveries of new plant, animal, and mineral products with therapeutic value. Some of these substances have been known and used for centuries by so-called primitive peoples and are just now being discovered by modern medical researchers. Other substances are truly new discoveries, having been identified for the first time by modern investigators tracking down natural products in wild environments. 

The cyclopropane moiety is a fundamental class of functional group present in both natural products and numerous therapeutic agents. It has provided the impetus for significant breakthroughs in the use of metal carbenoids [151] and organocatalytic ylide intermediates [152, 153] such that rehable methods exist for most disconnective strategies on this ring system. 

Konstantinos Drosopoulos Division of Breast Cancer Research, Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK Suzanne A. Eccles Tumour Biology and Metastasis, Cancer Research UK Cancer Therapeutics Unit, Division of Cancer Therapeutics, McLlwain Laboratories,... 

The year 1979 was also the year of the first true breakthrough of the imino sugars. This was initiated by a medical researcher with Bayer company, Dr. W. Puls, who suggested a novel therapeutic concept for the treatment of diabetes type 2 symptoms after carbohydrate uptake this involved the inhibition of intestinal a-glucosidases with various compounds found in fermentation broths, among them 1,5-dideoxy-... 

A major breakthrough in asthma therapy was the introduction in the 1970s of aerosol corticosteroids These agents (Table 39.3) maintain much of the impressive therapeutic efficacy of parenteral and oral corticosteroids, but by virtue of their local administration and markedly reduced systemic absorption, they are associated with a greatly reduced incidence and severity of side effects. The success of inhaled steroids has led to a substantial reduction in the use of systemic corticosteroids. Inhaled corticosteroids, along with 2-(tdreno-ceptor agonists, are front-line therapy of chronic asthma. 

The above project represents a novel approach and a possible new treatment for psychiatric disorder. The possibility that neuronal discharge short of total brain convulsion may have psychiatric effects would be a major advance in understanding the action of ECT. Moreover, a possible substitute treatment for ECT would be a major clinical breakthrough. TMS might allow us to stimulate deep brain regions without convulsions, pain, or known hazards. Before one widens the use of TMS in humans, further evaluation of the effectiveness of TMS in animal models for depression is necessary. Our hypothesis is that ECT exerts its therapeutic effects by stimulation of specific brain regions. We suggest that TMS may exert therapeutic effects without need for total brain convulsion. 

Reddy SK, Nguyen P. Breakthrough pain in cancer patients new therapeutic approaches to an old challenge. Curr Rev Pain 2000 4 242-247. 

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