Palliative drugs

O Causative drug action related to molecular pathology O Palliative drug action related to molecular physiology... 

Pharmacogenetic Effects of Palliative Drugs due to Structural Target Diversity... 

Several of the more persuasive examples we have accumulated to date for such palliative drug-related pharmacogenetic effects have been observed in the field of... 

On the other hand, inter-individual differences in a drug s effects may also be observed in the presence of appropriate concentrations of the intended compound at the intended site of action, i.e., be due to differential pharmacodynamics. Here, two conceptually quite different conceptual scenarios may be distinguished that relate to the two principal mechanisms by which drags act etiology-specific and palliative. 

Methylnaltrexone was launched in 2008 for the treatment of OIC in patients with advanced illness receiving palliative care, when response to laxative therapy has not been sufficient. Due to its poor oral bioavailability, 4 is administered subcutaneously every other day. Approximately 50% of the drug is excreted in the urine and feces with 85% eliminated unchanged [30]. 

Various drugs have been used to treat diarrhea (Table 23-4). These drugs are grouped into several categories antimotility, adsorbents, antisecretory compounds, antibiotics, enzymes, and intestinal microflora. Usually, these drugs are not curative but palliative. 

Tamoxifen is a competitive inhibitor of estradiol. It is used for palliative treatment of estrogen-receptor positive breast cancer. It is used in combination with other chemotherapeutic agents. Synonyms of this drug are nolvadex, cessar, and others. 

Testolactone is a synthetic drug related to testosterone. It is used for palliative treatment of advanced breast cancer in postmenopausal women and in women who have had their ovaries removed. The principal action of testolactone is reported to be inhibition of steroid aromatase activity and the reduction in estrone synthesis. The most common adverse effects are nausea, vomiting, and anorexia. An advantage is that it does not cause women to develop male characteristics such as a deep voice or facial hair. 

Metastatic osteosarcoma has a poor prognosis unless the disease is confined to the lungs and is resectable. Palliative chemotherapy can be employed with a number of drugs including doxorubicin, cisplatin, carboplatin, methotrexate, ifosfamide and etoposide. 

The discovery of the loss of the cholinergic neurons and acetylcholine in the brain of Alzheimer s disease patients led to the use of drugs that would enhance the actions of acetylcholine in the brain. Therapeutic agents approved for the treatment of Alzheimer s disease are the cholinesterase inhibitors, drugs that block the breakdown of acetylcholine and increase the availability of the neurotransmitter in synapses (see Chapter 12). These drugs are palliative only and do not cure or prevent neurodegeneration. 

Plicamycin (mithramycin, Mithracin) is one of the chro-momycin group of antibiotics produced by Streptomyces tanashiensis. Plicamycin binds to DNA and inhibits transcription. It also inhibits resorption of bone by osteoblasts, thus lowering serum calcium levels. Very little is known about its distribution, metabolism, and excretion. Because of its severe toxicity, plicamycin has limited clinical utility. The major indication for plicamycin therapy is in the treatment of life-threatening hypercalcemia associated with malignancy. Plicamycin also can be used in the palliative therapy of metastatic testicular carcinoma when all other known active drugs have failed. 

Many addicts, however, report that weaning themseives off of methadone is just as bad as coming off of heroin or morphine addiction. Ultimately, primary treatments for opiate addiction rely on replacing one drug for another and are essentially palliative treatments. The user is never cured and will always be tormented by the specter of addiction. 

O Siordin, L. The role of transdermal fentanyl in palliative care, Clin. Drug Invest. 1998, 16, 71-72. 

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