SINCE The second world war, medical science has progressed to some stage where competitive medications are available to treat exactly the same ailment in numerous people. This isn’t nearly brands (the industry trade issue) but generic drugs (the industry scientific issue). On this report, we shall look at the various factors that decide selecting a particular drug.
Safety: The subsequent sub-criteria should be considered within the criterion of safety:
* Acute therapeutic index: If the patient’s condition is acute, how effective can be a particular drug even when it’s certain side-effects as long as the acuteness from the condition is lowered? Example: narcotic pain-killers work well in healing pain but include the possible side-effect of addiction.
* Long-term safety: medication could possibly be safe in short-term treatment, but wait, how safe it is in long-term treatment? Example: antibiotics are acceptable in short-term treatment, but tend to have undesirable effects in the event of prolonged use.
* Drug-drug interaction risk: Drugs are chemicals, and many chemicals react to develop a different chemical, which has an effect that could harm the patient or aggravate his/her condition. Example: A tricyclic anti-depressant and alcohol interact to produce a new condition that warrants separate treatment.
Drug-drug interaction risk is of two types:
· Pharmacokinetic: In this type of drug-drug interaction, two drugs, independent of each other, have certain effects on a single or even more body processes (e.g., metabolism) that affects the performance from the other. Example: Darvocet-N (propoxyphene and acetaminophen) inhibits the act of a liver enzyme that Lexapro (escitalopram) depends on because of its metabolism. This makes a boost in the side-effects of Lexapro.
· Pharmacodynamic: Here, 2 or more drugs actually produce the same relation to 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 prescription medication is more intense.
Tolerability: A medication could possibly be effective although not tolerable by all patients. Example: Allergies to certain drugs in a few people. Short-term and long-term tolerability must be taken into consideration. Efficacy: A medication is not equally effective in all patients. By way of example, some patients with depression or panic disorders experience rest from escitalopram, but there are numerous that do not, who therefore must be prescribed another anti-depressant. The speed of oncoming of therapeutic action is an important factor to be regarded too.
Cost: Cost does not always mean the price tag on acquiring a specific medicine alone. It must also cover the price tag on management of a complication that could arise from utilizing another drug. Example: In a person who insists on taking alcohol nevertheless needs to be treated for depression is often administered an SSRI drug since these drugs don’t potentiate the end results of alcohol, whereas another group of anti-depressants (such as tricyclics) could cause a fresh condition in such patients, which will demand a different and expensive treatment. Therefore, it’s better to prescribe the more costly escitalopram rather than a cheaper tricyclic in this patients.
Simplicity of treatment: Most effective mode of administration is preferred. When there is a selection between a shot and oral administration, rogues is preferred if your efficacy of the modes is the identical. Or, local application is chosen over the oral route where possible; e.g., antibiotic management of eye infections. Dosage and frequency of administration too are an important factor to determine simplicity of treatment.
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