Chronic pharmacology

Chronic pharmacology the consequences of prolonged drug administration and drug discontinuation syndromes... 

In secondary and tertiary adrenal insufficiency (Table 51-5), inadequate cortisol production may be due to destructive processes in the hypothalamic-pituitary that result in a decreased ability to secrete ACTH (secondary) or CRH (tertiary).However, the most common cause of tertiary insufficiency is chronic pharmacological administration of glucocorticoids that vsuppress CRH synthesis. This leads to a decrease in both ACTH release and cortisol secre-... 

Management of these disorders usually consists of treatment of the underlying cause of mineralocorticoid excess. In patients in whom the mineralocorticoid excess cannot be corrected, chronic pharmacologic therapy may be required. 

Calpain inhibition may represent an important mechanism for future drug development. Control of calpain activity may limit the invasive properties of cells and thereby provides a possible mechanism to limit the invasiveness of tumors or inhibits the development of chronic inflammation. For the moment, pharmacological inhibitors of calpains are still not capable of differentiating among different calpain isoforms in cellular systems or in vivo. The importance of calpains in diseases will continue to stimulate the development of new and better inhibitors. 

Chronic administration of opiates and alcohol leads to physical dependence a phenomenon, which is only weakly expressed following chronic administration of psychostimulants or other drugs of abuse. Physical dependence results from neuroadaptive intracellular changes to an altered pharmacological state. Abstinence from chronic opiate or alcohol use leads to a variety of physiological and psychological withdrawal symptoms based on these adaptations of the neuronal system. 

Van Sickle BJ, Tietz El Selective enhancement of AMPA receptor-mediated function in hippocampal CAl nemons from chronic benzodiazepine-treated rats. Nemo-pharmacology 43 11—27, 2002... 

The development of effective pharmacotherapy has lagged behind progress in understanding the reward mechanisms and chronic impairments underlying stimulant abuse. Pharmacological and behavioral treatment approaches that have been used for cocaine abuse have not been as widely tested for the treatment of amphetamine abuse, limiting what can be offered for treatment of this disorder. No treatment agents are approved by the FDA for treatment of cocaine or amphetamine dependence. 

Table 3 Pharmacological parameters of pegylated IFN-a molecules approved for the treatment of chronic hepatitis C...

Balasubramaniam E, Paul V, Jayakumar AR, et al. 1996. The effect of chronic cyclodiene insecticide treatment on some pharmacological actions of diazepam in rats. Environ Toxicol and Pharm(2) 141-146. 

Dickenson, AH (1995) Spinal cord pharmacology of pain. Brit. J. Anaesthesia 75 192-200. Dray, A, Urban, L and Dickenson, AH (1994) Pharmacology of chronic pain. Trends in Pharm. Sci. 15 190-197. 

There are pharmacological, social and legal issues to consider in this context of drug dependence and, of course, drug users and abusers vary enormously. A chronic alcoholic is very different from a weekend user of cannabis and any consideration of the topic has to consider legal and social issues as well as pharmacological effects of the drugs. 

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