Drug misuse therapeutic drugs

In 1998, Medsafe replaced the then Therapeutics Section of the Ministry of Health and later became a business unit of the Ministry. It is accountable to the Minister of Health via the Director-General of Health. Medsafe is responsible for administering the Medicines Act 1981 and parts of the Misuse of Drugs Act 1975 and their accompanying Regulations. 

There is some evidence of a synergistic effect on reinforcement with concurrent administration of benzodiazepines and opioids (Walker and Ettenberg 2003). Cocaine abusers are less likely than opioid abusers to abuse benzodiazepines, preferring alcohol and opioids as secondary drugs of abuse. The most common pattern of benzodiazepine misuse in these individuals is intermittent use of therapeutic or supratherapeutic doses to counter unwanted effects of cocaine. 

True. Many prescribed drugs, when misused, can produce non-therapeutic recreational effects such as stimulation, intoxication or sedation. If used for excessive periods of time or in excess dosage, addiction can also result. 

In many therapeutic situations the drug combinations are completely misused (12). Adding another drug to a combination does not reduce the need for sound clinical judgement in therapy. Although there are many disease situations in which the use of more than one antibacterial agent may be justified, generalizations about various combinations of bactericidal or bacteriostatic antibiotics or admixtures have not proven valid. Basically, antibiotic combinations should be avoided as a common practice unless they have shown a clear increase in effectiveness as reported in the literature. 

Diuretics are therapeutic agents used in certain pathological conditions to eliminate bodily fluids. Furosemide and the thiazide diuretics, chlorothiazide, hydrochlorothiazide, and trichlormethiazide are approved for use in dairy cattle for treatment of postparturient edema of the mammary gland and associated structures. The potential misuse of these diuretic drugs in cattle could lead to unacceptable residues in meat or milk destined for human consumption. Therefore, analytical methods sufficiently sensitive to monitor residue concentration levels in foods are valuable in preventing unapproved use of diuretics. 

As has been the case with conventional drugs, therapeutic proteins produced by biotechnology are also open to misuse as in the cases of the use of human growth hormone and erythropoietin by athletes to enhance their athletic performance. Their being identical to their counterparts produced in the body makes their detection in routine tests nearly impossible (Spalding, 1991). These concerns are also being addressed by the manufacturers of such drugs. 

When evaluating an acute injmy of the cornea, the practitioner is sometimes tempted to prescribe a topical anesthetic for administration at home by the patient for relief of ocular pain. This practice is extremely dangerous, however, and in numerous instances has led to severe infiltrative keratitis and even loss of the eye from anesthetic misuse or abuse by the patient.Topical anesthetics must be used only for the pmpose of obtaining initial relief of ocular pain and never as part of a prolonged therapeutic regimen.The potential corneal toxicity of topical anesthetics precludes their use as self-administered drugs. 

Chloral hydrate, clomethiazole and barbiturates also enhance GABA function but at high doses have the additional capacity directly to open the membrane chloride channel (see Figure 19.4) this may lead to potentially lethal respiratory depression and explains their low therapeutic ratio. These drugs also have a propensity for abuse/misuse and are very much second-line treatments. 

The application should indicate the class or type of registration required, whether it is for a prescription-only product or an over-the-counter (OTC) product. The guidelines went on to caution that products found to be of doubtful, little or no therapeutic value and those which are sometimes rather harmful and subject to misuse shall not be considered for registration. A drug formulation in more than one brand name, even when different doses of the active ingredients are used, is not allowed to be registered. 

Clinical studies and drug monitoring projects, as well as any other studies or data collections, must not be misused with a view to influencing therapeutic or procurement decisions or for mere promotional purposes. 

Class A Products agreed internationally to be therapeutically effective. Class B Second-line therapy, open to misuse, more expensive than similar products, or combination products with no advantage over monosubstances. Class C Drugs with no evidence of efficacy. Source Health Economics Centre, Cesav, Italy, reported in SCRIP (1993) 1860 4. Reproduced with permision horn PJB Publications Ltd, 2002. 

Atropine is a widely used drug in human medicine and its history, relatively free from adverse events, suggests that while its therapeutic use may pose a significant hazard, it does not pose a significant risk. If the drug is misused or abused, severe toxicity may be expected and contamination with the skin may elicit contact dermatitis. 

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