SINCE World War II, medical science has progressed into a stage where competitive medications are around to treat exactly the same ailment in various people. This is not nearly brands (the trade issue) but generic drugs (the scientific issue). On this report, we shall look at the various factors that decide the selection of a certain drug.
Safety: The following sub-criteria must be considered under the criterion of safety:
* Acute therapeutic index: When the patient’s condition is acute, how effective is a particular drug even though it’s got certain side-effects so long as the acuteness of the condition is lowered? Example: narcotic pain-killers are incredible in healing pain but come with the opportunity side-effect of addiction.
* Long-term safety: drug may be safe in short-term treatment, but exactly how safe it can be in long-term treatment? Example: antibiotics are acceptable in short-term treatment, but tend to have undesirable effects in case there is prolonged use.
* Drug-drug interaction risk: Medicines are chemicals, and several chemicals react to make a different chemical, which has an effect that will harm the person or aggravate his/her condition. Example: A tricyclic anti-depressant and alcohol interact to generate a new condition that warrants separate treatment.
Drug-drug interaction risk is of two kinds:
· Pharmacokinetic: In this kind of drug-drug interaction, two drugs, separate from the other person, have certain effects on a single or even more body processes (e.g., metabolism) that affects the performance of the other. Example: Darvocet-N (propoxyphene and acetaminophen) inhibits the act of a liver enzyme that Lexapro (escitalopram) depends upon due to the metabolism. This leads to a rise in the side-effects of Lexapro.
· Pharmacodynamic: Here, several drugs actually produce the same influence on exactly the same organ, thus increasing the total, added effect. Example: Lexapro has certain side-effects such as drowsiness and fatigue. Darvocet-N also acts similarly on the brain. Thus, the side-effects of the two prescription medication is more serious.
Tolerability: A medication may be effective but not tolerable by all patients. Example: Allergies to particular drugs in most people. Short-term and long-term tolerability need to be taken into consideration. Efficacy: A medication is just not equally efficient at all patients. For example, some patients with depression or panic disorders experience relief from escitalopram, but there are numerous who don’t, who therefore need to be prescribed some other anti-depressant. The interest rate of oncoming of therapeutic action is a crucial step to be regarded too.
Cost: Cost does not mean the expense of purchase of a particular medicine alone. It ought to also cover the expense of treating a complication that will arise by using some other drug. Example: In the individual who insists on taking alcohol yet should be treated for depression is normally administered an SSRI drug because these drugs don’t potentiate the effects of alcohol, whereas another gang of anti-depressants (such as tricyclics) can cause a fresh condition in such patients, which will require a various and expensive treatment. Therefore, it’s safer to prescribe the more costly escitalopram rather than a cheaper tricyclic in these patients.
Simple treatment: Most effective mode of administration is preferred. If there is an option between a shot and oral administration, the second is preferred when the efficacy of the two modes is the identical. Or, local application is chosen over the oral route where possible; e.g., antibiotic treating eye infections. Dosage and frequency of administration too are a key point to determine simplicity of treatment.
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