SINCE World war 2, medical science has progressed with a stage where competitive medications are around to treat the same ailment in numerous people. It’s not pretty much brands (the trade issue) but generic drugs (the scientific issue). In this report, we shall consider the various factors that decide selecting a selected drug.
Safety: The following sub-criteria should be considered beneath the criterion of safety:
* Acute therapeutic index: When the patient’s condition is acute, how effective can be a particular drug regardless of whether they have certain side-effects provided that the acuteness of the condition is lowered? Example: narcotic pain-killers are very effective in healing pain but have the potential side-effect of addiction.
* Long-term safety: medicine directory could possibly be safe in short-term treatment, but how safe it is in long-term treatment? Example: antibiotics are acceptable in short-term treatment, but could have undesirable effects in case of prolonged use.
* Drug-drug interaction risk: Medicine is chemicals, and a lot of chemicals respond to make a different chemical, that have 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 2 types:
· Pharmacokinetic: In this kind of drug-drug interaction, two drugs, independent of the other, have certain effects on a single or 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 on due to the metabolism. This makes a boost in the side-effects of Lexapro.
· Pharmacodynamic: Here, 2 or more drugs actually generate the same impact on the same organ, thus increasing the total, added effect. Example: Lexapro has certain side-effects including drowsiness and fatigue. Darvocet-N also acts similarly around the brain. Thus, the side-effects of both the medicines are more intense.
Tolerability: A medicine could possibly be effective but not tolerable by all patients. Example: Allergies to specific drugs in most people. Short-term and long-term tolerability have to be taken into consideration. Efficacy: A medicine isn’t equally effective in all patients. By way of example, some patients with depression or panic attacks experience reduced escitalopram, but there are several that do not, who therefore have to be prescribed an alternative anti-depressant. The rate of oncoming of therapeutic action is an important step to be looked at too.
Cost: Cost does not mean the price tag on acquiring some medicine alone. It ought to also cover the price tag on management of a complication that could arise while using an alternative drug. Example: In the person who insists on taking alcohol nevertheless should be treated for depression is usually administered an SSRI drug since these drugs don’t potentiate the results of alcohol, whereas another group of anti-depressants (including tricyclics) can cause a fresh problem in such patients, which would demand a various and expensive treatment. Therefore, it’s safer to prescribe the more costly escitalopram rather than a cheaper tricyclic such patients.
Simple treatment: The best mode of administration is preferred. When there is an alternative between an injection and oral administration, the second is preferred in the event the efficacy of both the modes is comparable. 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 a key factor to determine simplicity of treatment.
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