Therapeutic drug management approaches

Once the initial diversity fetish had run its course and management realized that it was inefficient to attempt to span the entirety of chemical space in search of drugs, more rational approaches based on chemoinformatics were developed to design combinatorial libraries and select candidates for screening on the basis of properties that have proven to be associated with successful therapeutics in the past. 

The assessment and treatment of autistic disorder and other pervasive developmental disorders (PDDs) requires a multidisciplinary team approach. Initial interventions are largely based on educational programming and behavior management principles, particularly for preschool- and school-aged children and adolescents. Speech therapy is usually essential and physical and occupational therapy are often needed as well. Despite these extensive therapeutic efforts, many children, adolescents, and adults with PDDs remain significantly impaired. Under these conditions, drug treatment is often necessary and appropriate. 

Before moving from discipline-specific standards to a review process that focuses on a multidisciplinary and systems-based approach to care, medication standards were in department-specific chapters, such as pharmacy, nursing, and medical staff, with the latter centered arormd the Pharmacy and Therapeutics committee, the formulary and adverse drug reaction reporting. Over time, the pharmacy standard disappeared and was integrated into the overall patient care chapters. For the 2004 standards, the JCAHO has published a new chapter entitled Medication Management, which reflects increased focus on medication systems and safety. This chapter divides the medication process into six segments ... 

CHD or CHD equivalents. Specific models for therapeutic life-style changes and drug therapy in the primary prevention of CHD have been recommended by ATP III (Figures 26-23 and 26-24). As for the management of patients with metabolic syndrome, a combination approach of weight reduction, increased physical activity, and appropriate control of lipid levels is recommended. 

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