Maximal efficacy

Topical corticosteroids are typically reserved for patients who do not respond to topical mesalamine. Patients should be properly educated regarding appropriate use of topical products. This includes proper administration and adequate retention of topical mesalamine products in order to maximize efficacy. 

Careful dose titration is necessary to maximize efficacy and tolerability. 

Maintenance immunosuppression generally is achieved by combining two or more medications from the different classes to maximize efficacy by specifically targeting unique components of the immune response. Figure 52-1 presents a schematic representation of these different drug mechanisms, and Fig. 52-2 shows... 

Monitoring and treatment strategies to maximize efficacy and minimize toxicity for anti-infectives ... 

ABT-888 (22) shows limited activity as monotherapy however, it strongly potentiates the activity of multiple DNA-damaging agents in preclinical models [39]. ABT-888 potentiated TMZ in a glioma model in a dose-dependent manner, with maximal efficacy achieved at 50 mg/ kg, which reduced tumor volume by 63%, 44% better than TMZ alone. In the MX-1 breast xenograft model, ABT-888, at 5 mg/ kg/ day in combination with cisplatin, caused sustained regressions in 8/9 mice compared to 3/9 for cisplatin monotherapy. 

Patients should be instructed to take oral PPIs in the morning 15 to 30 minutes before breakfast to maximize efficacy, because these agents inhibit only actively secreting proton pumps. If dosed twice daily, the second dose should be taken approximately 10 to 12 hours after the morning dose and prior to a meal or snack. 

This degree of inhibition correlated with maximal efficacy in preclinical models. Once daily dosing is supported by a half-life of 8-14 h. Using l4C-labeled compound oral bioavailability was found to be 87% [39]. 

When studying the maximal efficacy (E J, one should not confuse it with potency or intrinsic effects two drugs with entirely different potency can elicit the same maximal response, except that the dose will be different. This parameter is often difficult or impossible to study experimentally as increasing the dose invariably introduces safety issues. Also, the maximal effect is what is observed and not necessarily what an organ is capable of reaching. The maximal effect (E J of system... 

After an antibiotic was selected, the primary concern should be to optimize the dosage for maximal efficacy and minimal toxicity. Other factors such as economics, frequency of animal handling and... 

Phase I data were presented at the 95th AACR meeting, March 2004. Normal healthy male volunteers were subjected to bone marrow aspirations prior to and 4 h following a single 25 mg oral dose of the compound or placebo. L21649 achieved plasma concentrations of 103.4 nM at 4 h post-dose. In July 2004, similar clinical data were presented at the 29th National Medicinal Chemistry symposium. The PK/PD correlated well, and at that time, it was believed that the plasma levels should be closer to the EC90 levels for maximal efficacy. 

Wise R. (2003). Maximizing efficacy and reducing the emergence of resistance. Journal of Antimicrobial Chemotherapy 51(Suppl. Sl) 37-42. 

Erom a research perspective, ECT is certainly a powerful treatment, which can provide new windows into the pathophysiology of mood disorders. More important, with further research, ECT can be provided to appropriate diagnostic groups and administered in a rational fashion, minimizing side effects while maximizing efficacy. 

Therapeutic index The difference between the maximally efficacious dose or concentration and the toxic dose or concentration. 

Domperidone is structurally related to droperidol. It does not cross the blood-brain barrier to the same extent as droperidol so has fewer sedative side effects. It has an effect both on the CTZ and by a peripheral action on the stomach by increasing gastric emptying. Timing of the dose of drug is important for maximal efficacy. 

Graded dose-response curves for four drugs, illustrating different pharmacologic potencies and different maximal efficacies. (See text.)... 

For clinical use, it is important to distinguish between a drug s potency and its efficacy. The clinical effectiveness of a drug depends not on its potency (EC50), but on its maximal efficacy (see below) and its ability to reach the relevant receptors. This... 

Note that "maximal efficacy," used in a therapeutic context, does not have exactly the same meaning that the term denotes in... 

Reduction of local or regional blood flow is desirable for achieving hemostasis in surgery, for reducing diffusion of local anesthetics away from the site of administration, and for reducing mucous membrane congestion. In each instance, -receptor activation is desired, and the choice of agent depends on the maximal efficacy required, the desired duration of action, and the route of administration. 

Vehicles and occlusion An appropriate vehicle maximizes the ability of the drug to penetrate the outer layers of the skin. In addition, through their physical properties (moistening or drying effects), vehicles may themselves have important therapeutic effects. Occlusion (application of a plastic wrap to hold the drug and its vehicle in close contact with the skin) is extremely effective in maximizing efficacy. 

Quetiapine (3) has the lowest affinity for the D2 and 5-HT2a receptors among the atypicals therefore, relatively high doses are required for maximal efficacy. Quetiapine causes significant weight gain, but less than that of olanzapine. Other side-effects include sedation, dizziness and hypotension. 

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