Drug effects measurement

MANAGING ABDOMINAL Dl STEN T10 N. If tiie patient is receiving vasopressin for abdominal distention, tiie nurse explains in detail tiie method of treating this problem and the necessity of monitoring drug effectiveness (ie, auscultation of tiie abdomen for bowel sounds, insertion of a rectal tube, measurement of tiie abdomen). 

The file Is used routinely In the laboratory at the National Institutes of Health In an attempt to explain abnormal test results The resident physicians affiliated with the Clinical Chemistry Service discuss the results with the patient-care physicians and determine If the results were due to the patient s clinical state or to a drug effect This close monitoring of test results has led to recognition of deficiencies In what Is believed are specific enzymatic procedures for the measurement of glucose and uric acid Likewise, the gualac procedure for occult blood In feces was found to yield false negative results under certain circumstances This has prompted the development of a more specific procedure (Jaffe et al unpublished) ... 

The pharmacological properties of phenylethylamines that control selfadministration are complex. The effects of phenylethylamines on a variety of pharmacological measures do not appear to predict the reinforcing effects of these drugs, as measured by the cocaine substitution procedure in primates. Specifically, none of the following behavioral effects of these compounds accurately predict the results of self-administration experiments within the phenylethylamine class (Griffiths et al. 1976 Griffiths et al. 

The success of treatment is measured by the early termination of seizures, without adverse drug effects or brain injury. Therefore, it is essential to start pharmacologic treatment as soon as possible. First-line treatment for SE should halt seizure activity within minutes of administration. In patients who are unarous-able following treatment, an EEG should be done to rule out continued excessive electrical brain activity and confirm termination of seizures. A physical exam and evaluation of the patient s laboratory results can help determine if the cause or complications of seizure activity are being appropriately treated. 

Numerous reports of prodrugs in the literature show improved drug effects. Prodrugs that have shown some measure of success for site-specific delivery include L-3,4-dihydroxyphenylalanine (L-dopa) to the brain [56], dipivaloyl derivative of epinephrine to the eye [57], /-glutamyl-L-dopa to the kidney [58], fi-n-glucoside dexamethasone and prednisolone derivatives to the colon [59], thiamine-tetrahydrofuryldisulfide to red blood cells, and various amino acid derivatives of antitumor agents such as daunorubicin [61,62], acivicin [63], doxorubicin [63], and phenylenediamine [63] to tumor cells. 

Tzschentke, T.M. Measuring reward with the conditioned place preference paradigm a comprehensive review of drug effects, recent progress and new issues. Prog. Neurobiol. 56 613, 1998. 

Is there a relationship between plasma concentrations and a relevant measure of drug effect ... 

Self-Report Symptom Inventory. Each of the 90 items in the SCL-90 uses a five-point scale of distress. It was designed as a general measure of symptomatology for use by adult psychiatric outpatients in either a research or clinical setting. It rates either the present or previous week. It requires about 15 minutes for the patient to complete this form and about 5 minutes for a technician to verify identifying information. This test is sensitive to drug effects and may be used with inpatients. Nine subscales are measured somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, anger-hostility, phobic anxiety, paranoid ideation, and psychoticism. 

Patients need to be monitored for a drug s effects both during clinical trials and often after the drug has been approved, in measurement of the drugs effectiveness. The Optophoresis assay can be performed very easily on tissues obtained from clinical trial participants or from patients. Because a very small number of cells is needed, even a biopsy may be sufficient to give enough cells for a full dose-response curve. 

The early investigators did not attempt more than minimal statistical analysis. Nor did I, during my first months on the job, when I devoted most of my attention to observing and interviewing subjects throughout the duration of the drug effects. I soon became familiar with the clinical aspects of BZ, 4ie differences associated with various routes of administration, and the comparative usefulness of available performance measures. 

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