Potential Medical Relevance

Rhinoviruses, which represent the single major cause of common cold, belong to the family of picornavimses that harbors many medically relevant pathogens. Inhibitors of the 3C protease, a cysteine protease, have shown good antiviral potential. Several classes of compounds were designed based on the known substrate specificity of the enzyme. Mechanism-based, irreversible Michael-acceptors were shown to be both potent inhibitors of the purified enzyme and to have antiviral activity in infected cells. 

Apart from the biological implications, aspects of the chemistry of macrocyclic ligands are of relevance to a diverse number of other areas. Indeed, there has been a remarkable expansion of research involving these other areas during recent times. Many of the developments impinge on topics such as metal-ion catalysis, organic synthesis, metal-ion discrimination, and analytical methods, as well as on a number of potential industrial, medical and other applications. 

It is important that all relevant information, communication and documentation are available for all practitioners involved in the care of the patient. The organisational aspect is to make this possible and easily usable for care. The professional aspect is to correctly use the system for input and output. This includes documentation and follow-up on aims, planning and all other relevant activities. The patient opinion and need must also be addressed and documented. Many of the problems have the potential to cause errors. This is described in Chapter 7 and also in other chapters. Here we focus on the basic organisational and professional features of the medication system in the elderly. 

There are few absolute contraindications, but several points should be considered. Medications that produce changes in sinus node or AV nodal conduction may potentiate the cardiovascular adverse effects of the a2 agonists. This may be particularly relevant for concomitant administration of beta-blockers, which, similar to the agonists, have been used to treat aggression. 

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