SINCE The second world war, medical science has progressed with a stage where competitive medications are available to treat exactly the same ailment in different people. It’s not almost brands (the industry trade issue) but generic drugs (the industry scientific issue). With this report, we shall go through the various factors that decide the selection of a particular drug.
Safety: The following sub-criteria has to be considered within the criterion of safety:
* Acute therapeutic index: If the patient’s condition is acute, how effective can be a particular drug regardless of whether it’s certain side-effects provided that the acuteness of the condition is lowered? Example: narcotic pain-killers are amazing in healing pain but include the opportunity side-effect of addiction.
* Long-term safety: drug may be safe in short-term treatment, but how safe it’s in long-term treatment? Example: antibiotics are acceptable in short-term treatment, but sometimes have undesirable effects in case of prolonged use.
* Drug-drug interaction risk: Medicines are chemicals, and many chemicals reply to create a different chemical, that have an effect which could harm the individual 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 types:
· Pharmacokinetic: In this type of drug-drug interaction, two drugs, outside of each other, have certain effects one or even more body processes (e.g., metabolism) that affects the performance of the other. Example: Darvocet-N (propoxyphene and acetaminophen) inhibits the action of a liver enzyme that Lexapro (escitalopram) depends on because of its metabolism. This leads to more the side-effects of Lexapro.
· Pharmacodynamic: Here, a couple of drugs actually generate the same impact on exactly the same organ, thus enhancing the total, added effect. Example: Lexapro has certain side-effects such as drowsiness and fatigue. Darvocet-N also acts similarly for the brain. Thus, the side-effects of the prescription medication is more serious.
Tolerability: A drug may be effective although not tolerable by all patients. Example: Allergies to a particular drugs in certain people. Short-term and long-term tolerability must be taken into account. Efficacy: A drug is not equally good at all patients. As an example, some patients with depression or anxiety disorders experience relief from escitalopram, but there are lots of who don’t, who therefore must be prescribed another anti-depressant. The speed of start of therapeutic action is an important key to be looked at too.
Cost: Cost does not mean the price of acquisition of a specific medicine alone. It ought to also cover the price of management of a complication which could arise from using another drug. Example: In the individual who insists on taking alcohol yet must be treated for depression is normally administered an SSRI drug because these drugs don’t potentiate the end results of alcohol, whereas another gang of anti-depressants (such as tricyclics) may cause a fresh symptom in such patients, which may need a various and expensive treatment. Therefore, it’s easier to prescribe the more costly escitalopram rather than cheaper tricyclic such patients.
Simple treatment: The best mode of administration is preferred. If you have an option between an injection and oral administration, the latter is preferred if the efficacy of the modes is comparable. Or, local application is preferred to the oral route where possible; e.g., antibiotic management of eye infections. Dosage and frequency of administration too are a key point to decide simple treatment.
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