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Related Concept Videos

Drug Dosage Regimen: Overview01:15

Drug Dosage Regimen: Overview

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A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
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Dosage Regimen: Multiple Oral Dosage01:25

Dosage Regimen: Multiple Oral Dosage

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Understanding how a drug's concentration fluctuates within the body over time is crucial in pharmacokinetics, particularly with multiple oral doses. A graphical representation of multiple oral dosages provides insight into these dynamics. Typical accumulation curves of a drug's concentration in the body reveal a sawtooth pattern, indicating periodic peaks and troughs correlating with each dose administration and the drug's subsequent elimination.The plasma concentration at any time during an...
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Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

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Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
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Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

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A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
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Rational Dosage Regimen: Maintenance Dose and Loading Dose01:24

Rational Dosage Regimen: Maintenance Dose and Loading Dose

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A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
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Dosage Regimen: Fixed Dose01:01

Dosage Regimen: Fixed Dose

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Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
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Standard Membrane Feeding Assay for the Detection of Plasmodium falciparum Infection in Anopheles Mosquito Vectors
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Mass drug administration for malaria.

Monica P Shah1, Jimee Hwang2,3, Leslie Choi4

  • 1Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.

The Cochrane Database of Systematic Reviews
|September 29, 2021
PubMed
Summary
This summary is machine-generated.

Mass drug administration (MDA) for malaria showed initial reductions in parasite prevalence and incidence in low-transmission areas, but these effects were not sustained beyond three months. MDA did not demonstrate sustained impact in moderate- to high-transmission settings.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Mass drug administration (MDA) with antimalarials has shown short-term malaria reductions, but sustained effects and impact across different endemicity levels require further evaluation.
  • Previous Cochrane Reviews highlighted variability in MDA effectiveness; updated evidence is needed to assess long-term outcomes and safety.

Purpose of the Study:

  • To assess the sustained impact of MDA on malaria transmission reduction in moderate- to high-transmission settings.
  • To evaluate the potential for MDA to interrupt malaria transmission in very low- to low-transmission settings.
  • To summarize drug-associated adverse effects following MDA.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized controlled before-and-after (CBA) studies.
  • Searched multiple databases and registries up to February 2021, including communication with researchers for unpublished data.
  • Analyzed data using relative risks and rate ratios, stratified by transmission intensity and malaria species, with GRADE assessment for evidence certainty.

Main Results:

  • In moderate- to high-transmission settings, MDA showed no significant sustained effect on Plasmodium falciparum prevalence or incidence beyond six months.
  • In very low- to low-transmission settings, MDA initially reduced P. falciparum and Plasmodium vivax prevalence and incidence for up to three months, with diminishing effects thereafter.
  • Longer-term follow-up (beyond four months) in low-transmission areas showed no sustained impact, and no studies provided evidence of malaria transmission interruption.

Conclusions:

  • MDA with antimalarials provides short-term reductions in malaria in low-transmission settings but lacks sustained impact.
  • MDA does not appear to be effective for sustained malaria control or transmission interruption in moderate- to high-transmission settings.
  • Further research is needed to understand the long-term efficacy and potential for malaria elimination strategies involving MDA.