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01:29Therapeutic Drug Monitoring: Affecting Factors
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
01:33Hormonal Regulation
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
01:40Hormonal Regulation
Hormones regulate a significant portion of digestion through activation of the neuroendocrine system. The neuroendocrine system of digestion contains many different hormones all with multiple functions that are both, directly and indirectly, involved in digestion.
01:37Hypothalamic-Pituitary Axis
The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
01:16Therapeutic Drug Monitoring: Overview and Classification
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
02:13Types of Hormones
Hormones can be classified into three main types based on their chemical structures: steroids, peptides, and amines. Their actions are mediated by the specific receptors they bind to on target cells.
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1Braun Medical Media, Amherst, Massachusetts.
JAMA Internal Medicine
|August 14, 2013
Summary
Despite transparency improvements, pharmaceutical companies still use subtle marketing tactics. They fund continuing medical education and patient materials to promote their products, influencing perceptions through selective information.
Area of Science:
- Medical Marketing
- Pharmaceutical Industry Ethics
- Health Communication
Background:
- Progress in transparency regarding funding and conflicts of interest has been made.
- However, drug companies retain methods for subtle and effective product marketing.
Purpose of the Study:
- To examine the continued subtle marketing strategies employed by pharmaceutical companies.
- To analyze the influence of industry funding on medical education and patient materials.
Main Methods:
- Analysis of funding sources for continuing medical education (CME) programs.
- Review of content in industry-funded "consensus" panels.
- Evaluation of patient education materials for selective information and bias.
Main Results:
- Continuing medical education programs remain company-funded, linking educational content to product promotion.
- "Consensus" panels are also industry-funded, potentially biasing messages.
- Patient education materials, though factually accurate, may omit information or highlight selected facts to align with funder interests.
Conclusions:
- Pharmaceutical companies continue to utilize subtle marketing strategies despite increased transparency.
- Industry funding of educational and patient materials poses a risk of biased information dissemination.
- Omission and selective inclusion of facts are key tactics in shaping attitudes towards pharmaceutical products.