SINCE World war 2, medical science has progressed with a stage where competitive medications are available to treat precisely the same ailment in numerous people. This is simply not just about brands (which is a trade issue) but generic drugs (which is a scientific issue). Within this report, we shall consider the various factors that decide selecting a particular drug.
Safety: The subsequent sub-criteria must be considered within the criterion of safety:
* Acute therapeutic index: If the patient’s condition is acute, how effective is a particular drug even when they have certain side-effects so long as the acuteness of the condition is lowered? Example: narcotic pain-killers are very effective in healing pain but have the opportunity side-effect of addiction.
* Long-term safety: medicine directory might be safe in short-term treatment, so how safe it can be 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: Prescription medication is chemicals, and lots of chemicals answer create a different chemical, which has an effect that will harm the patient or aggravate his/her condition. Example: A tricyclic anti-depressant and alcohol interact to create a new condition that warrants separate treatment.
Drug-drug interaction risk is of two sorts:
· Pharmacokinetic: In this kind of drug-drug interaction, two drugs, separate from one another, have certain effects on one or higher 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) is determined by due to the metabolism. This leads to a rise in the side-effects of Lexapro.
· Pharmacodynamic: Here, several drugs actually create the same influence on precisely the same organ, thus increasing the total, added effect. Example: Lexapro has certain side-effects like drowsiness and fatigue. Darvocet-N also acts similarly around the brain. Thus, the side-effects of both drugs are more intense.
Tolerability: A medicine might be effective and not tolerable by all patients. Example: Allergies to certain drugs in a few people. Short-term and long-term tolerability have to be taken into consideration. Efficacy: A medicine isn’t equally good at all patients. For example, some patients with depression or anxiety attacks experience respite from escitalopram, but there are lots of who don’t, who therefore have to be prescribed an alternative anti-depressant. The pace of beginning of therapeutic action is a vital key to be regarded as too.
Cost: Cost doesn’t imply the price of purchase of a particular medicine alone. It should also cover the price of management of a complication that will arise from utilizing an alternative drug. Example: Inside a person who insists on taking alcohol and yet needs to be treated for depression is often administered an SSRI drug as these drugs don’t potentiate the consequences of alcohol, whereas another band of anti-depressants (like tricyclics) can cause a fresh condition in such patients, which could need a various and expensive treatment. Therefore, it’s easier to prescribe the more costly escitalopram as opposed to a cheaper tricyclic in such patients.
Simplicity of treatment: Most effective mode of administration is preferred. If there is an option between an injection and oral administration, the second is preferred when the efficacy of both modes is analogous. 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 point to decide simple treatment.
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