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Related Concept Videos

Pharmacokinetics: Drug–Drug Interactions01:25

Pharmacokinetics: Drug–Drug Interactions

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Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
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Bioequivalence of Drugs: Drugs with Multiple Indications01:09

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The concept of therapeutic equivalence (TE) in drugs with multiple indications is complex. A generic drug may be therapeutically equivalent to a brand-name product for one specific indication, but this doesn't necessarily mean it's equivalent for all other indications. Evidence of TE in one patient group and bioequivalence shown in healthy volunteers can support—but not confirm—TE for other indications. However, definitive proof requires individual clinical studies for each...
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FDA Approved Drugs: Changes to Approved Drugs01:26

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Post-approval, manufacturers may modify an approved new or generic drug product. Such modifications can encompass alterations in the Active Pharmaceutical Ingredient (API), manufacturing process, formulation, batch size, manufacturing site, and container closure system (FDA Guidance for Industry, April 2004). Often, a drug product may undergo multiple changes.These modifications require careful evaluation to determine their potential impact on the drug product's identity, strength, quality,...
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Pharmacokinetics: Drug–Food and Drug–Viral Interactions01:26

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A drug interaction occurs when the concurrent use of another drug, food, or an external substance alters the pharmacological activity of a drug. This interaction can modify the action of the original drug, affecting its effectiveness and safety.Drug–food interactions are significant as they impact drug absorption, metabolism, and excretion. For example, grapefruit juice is a well-known disruptor of drug metabolism. It inhibits the cytochrome P450 3A4 enzyme, crucial for the metabolism of...
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The pharmacokinetic journey of drugs from solid oral dosage forms into systemic circulation is multifaceted. It begins with disintegration, a prerequisite ensuring a solid dosage form's subdivision into minute particles. Dissolution occurs next as these granulated entities solubilize in gastrointestinal fluids. This solubilization is crucial for the succeeding stage, permeation, which describes the traversal of the drug across the intestinal membrane and its subsequent entry into the blood...
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Factors Affecting Protein-Drug Binding: Drug-Related Factors01:18

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Drug binding to proteins is a complex phenomenon influenced by various drug-related factors, each playing a significant role in the interaction between drugs and proteins within the body.
One crucial factor in drug-protein binding is the drug's lipophilicity or its affinity for fat. More lipophilic drugs tend to have higher binding extents. For example, highly lipophilic drugs like cloxacillin exhibit substantial protein binding, with as much as 95% of the drug binding to proteins. In...
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Related Experiment Video

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A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
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Drugs Used in Parasomnia.

Paola Proserpio1, Michele Terzaghi2, Raffaele Manni2

  • 1Department of Neuroscience, Centre of Sleep Medicine, Centre for Epilepsy Surgery, Niguarda Hospital, Piazza Ospedale Maggiore, Milan 3-20162, Italy.

Sleep Medicine Clinics
|May 16, 2018
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Summary

Patient education and behavioral management are initial treatments for parasomnias like disorders of arousal (DOA). Pharmacologic options, including benzodiazepines and antidepressants, are used when symptoms persist or pose risks, despite a lack of approved DOA drugs.

Keywords:
Antidepressant drugsBenzodiazepinesClonazepamDisorders of arousalMelatoninREM behavior disorderSleep enuresisSleep-related eating disorder

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Pharmacology

Background:

  • Parasomnias, particularly disorders of arousal (DOA), are often initially managed with patient education and behavioral strategies.
  • Pharmacologic intervention for DOA is considered when episodes are frequent, resistant to non-pharmacologic measures, pose injury risks, or cause significant impairment like excessive sleepiness.

Purpose of the Study:

  • To review the current pharmacologic approaches for managing disorders of arousal (DOA) and rapid eye movement sleep behavior disorder (RBD).
  • To highlight the common medications used in the absence of specifically approved drugs for DOA.

Main Methods:

  • Review of existing literature on the pharmacologic treatment of DOA and RBD.
  • Identification of commonly prescribed drug classes and specific agents.

Main Results:

  • Benzodiazepines and antidepressants are the most frequently utilized medications for DOA.
  • Clonazepam and melatonin are commonly used for the symptomatic treatment of RBD.

Conclusions:

  • While patient education and behavioral management are primary, pharmacologic treatments play a role in managing severe or persistent DOA.
  • Current pharmacologic strategies for DOA and RBD rely on medications not specifically approved for these conditions, necessitating careful consideration of risks and benefits.