Drag use

FIGURE 8.4 Examples of case where the side effects of drags used for another indication led to the discovery and development of a new therapeutic entity for another disease. 

The bisphosphonates are drags used to treat musculoskeletal disorders such as osteoporosis and Fhget s disease. This chapter will discuss the use of these drugs in the treatment of osteoporosis. 

Antihistamines are drags used to counteract the effects of histamine on body organs and structures. Examples of antihistamines include diphenhydramine (Benadryl), loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec). A new antihistamine, deslorata-dine (Clarinex), is die active metabolite of loratadine and is intended to eventually replace loratadine (Claritin). Topical corticosteroid nasal sprays such as fluticasone propionate (Flonase) or triamcinolone ace-tonide (Nasacort AQ) are also used for nasal allergy symptoms. See Chapter 56 for more information on die topical corticosteroids. 

The types of drags used for the treatment of hypertension include ... 

This chapter discusses drug s used to treat urinary tract infections (UTIs) and certain miscellaneous drag > used to relieve the symptoms associated with an overactive bladder (involuntary contractions of the detrusor or bladder muscle). Structures of the urinary system that may be affected include the bladder (cystitis), prostate gland (prostatitis), the kidney, or the urethra (see Pig. 47-1). These drug s also help control the discomfort associated with irritation of the lower urinary tract mucosa caused by infection, trauma, surgery, and endoscopic procedures. 

Co-payment is an instrument that should not be used on its own. Neither efficiency in drag use nor equity nor the control of pharmaceutical expenditure can rest solely on co-payment. Its effectiveness is reinforced when it is combined with other instruments and incentives. In fact, all European countries combine, in different doses and proportions, multiple instruments that influence the behaviour of the industry, prescribes and patients. It is sufficient to recall that pharmaceutical expenditure is the product of price by quantity, and to consider the enormous international variability of drag prices,35 in order to understand the limitations of co-payment regulation in comparison with other policies that influence prices. Policies aimed at price control can be as effective as co-payment - or more so - for purposes of cost containment. 

Information about prescription drag use alcohol or other substance use family medical history and history of trauma, depression, or head injury should be obtained. It is important to rule out medication use as a contributor or cause of symptoms (e.g., anticholinergics, sedatives, hypnotics, opioids, antipsychotics, and anticonvulsants) as contributors to dementia symptoms. Other medications may contribute to delirium, e.g.,... 

TDM was first carried out on drags in biological samples using ultraviolet (UV) light, fluorescence, and electrochemical detection, which measured physicochemical properties of drags. Used alone, these detection methods had low sensitivity and selectivity and were soon obsolete.10... 

Holmquist IB, Svensson B, Hoglund P (2005) Perceived anxiety, depression, and sleeping problems in relation to psychotropic drag use among elderly in assisted-living facilities. Eur J Clin Pharmacol 61(3) 215-224... 

Landi F, Russo A, Liperoti R et al. (2007) Impact of inappropriate drag use on physical performance among a frail elderly population living in the community. Eur J Clin Pharmacol 63(8) 791-799... 

On the basis of the mechanisms that control blood pressure, it is not surprising that the drags used in the treatment of hypertension include diuretics, ACE inhibitors, angioten-sin-II receptor blockers, and Ca ion channel inhibitors. 

Muscle relaxants (myorelaxants) are a large group of chemical compounds that have the ability to relax skeletal muscle. They are a separate class of drags used during intubations and surgery to reduce the need for anesthesia and facilitate intnbation. 

Cardiac glycosides are drags used in the treatment of congestive heart failure or cardiac arrhythmia, by inhibiting the Na+/K+ pump. This inhibition increases the amount of Ca + ions available for contraction and improves cardiac output and reduces distention of the heart. Cardiac glycosides are extracted from plant material. 

Drags used to treat cancer are subdivided into six groups antimetabolites, alkylating agents, antibiotics, drags isolated from plants, hormones, and a group of substances not included in the classifications listed above, which are examined in another section. 

Drags used in Homeopathy have their sources from plants, animals, minerals, diseased parts of man and irradiated aqueous ethanol. The ethanol extract of a drag is mixed with aqueous ethanol, usually 90% in the proportion of 1 99 or 1 9 and the mixture is shaken by 10 powerful downward strokes to prepare the first centesimal or decimal potency. Subsequent potencies are prepared by further dilution of the 1st... 

Morgan K, Dixon S, Mathers N, et al. Psychological treatment for insomnia in the regulation of long-term hypnotic drag use. Health Technol Assess. 2004 8 ... 

What You Can Do About Drag Use In America. National Clearinghouse for Alcohol and Drag Information. (1991). 

The retrospective analysis of the chemical structures of the various drags used in medicine led medicinal chemists to identify some molecular motifs that are associated with high biological activity more frequently than other structures. Such molecular motifs were called privileged structures by Evans et al. [2], to represent substructures that confer activity to two or more different receptors. The implication was that the privileged structure provides the scaffold and that the substitutions on it provide the specificity for a particular receptor. Two monographs deal with the privileged structure concept [3, 4]. 

Dimethyldiguanide (metformin) is a drag used in the therapy of Type II diabetes. It decreases blood glucose levels by increasing hepatic and peripheral tissue sensitivity... 

Drags used in the treatment of diseases which are life threatening, or that dramatically affect the quality of life of the patient, are prime candidates for inclusion in a DDTS. Such drags include those used in treatment of cancer, as well as life-threatening microbial, viral and fungal diseases. Chronic diseases such as arthritis can also be found on the priority list. 

Ideally, drags used in the treatment of diseases affecting the CNS would be delivered directly to the site of action. However, drags generally do not readily enter the brain from the circulating blood. Access to the brain is particularly difficult for the new biotherapeutics such as peptide, protein and nucleic-acid based biopharmaceuticals. 

When a drag-drag interaction is clearly present, the sponsor should be able to provide specific recommendations regarding the clinical significance of the interaction based on what is known about the dose-response and/or PK/PD relationship for either the investigational agent or the approved drags used in the study. 

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