Drugs online research references
sheffield.ac.uk
OBJECTIVE: Although nonsteroidal anti-inflammatory drugs (NSAIDs) are an effective therapy for rheumatoid arthritis, they are associated with significant adverse effects, the management of which imposes additional costs on the healthcare system. Prescribing NSAIDs which have a lower risk of major adverse effects as the first-line NSAID for patients with rheumatoid arthritis and osteoarthritis may be expected to lead to an improvement in clinical outcomes and reduce overall treatment costs. This analysis examines data from a published randomised controlled trial of 5 NSAIDs to explore these hypotheses. DESIGN AND SETTING: Data from a clinical trial comparing 5 NSAIDs were combined with published cost data to construct 2 clinical decision models, reflecting alternative approaches to the management of major and minor adverse effects in the UK. INTERVENTIONS: The 5 NSAIDs evaluated in the analysis were nabumetone, diclofenac, ibuprofen, piroxicam and naproxen, although only the results for ibuprofen and nabumetone are reported. MAIN OUTCOME MEASURES AND RESULTS: The total cost of care per patient receiving nabumetone was estimated to be between 25 pounds sterling (Pound) and 41 Pounds more expensive than ibuprofen. In a hypothetical cohort of 100,000 patients, there were between 690 and 821 more major adverse effects using ibuprofen than nabumetone. The cost per life-year gained (LYG) from using nabumetone rather than ibuprofen ranged between 1880 Pounds and 2517 Pounds (1995 values), depending upon the management of adverse effects. CONCLUSIONS: These results indicate that: (i) prescribing the newer, currently more expensive, NSAIDs will not necessarily lead to cost savings; (ii) the management of adverse effects can have a significant impact on costs; and (iii) the additional cost may be justifiable in terms of the mortality and morbidity gains associated with the new lower-risk NSAIDs.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10186459&dopt=Abstract
Ter Arkh. 1997;69(12):67-72.
[Nocturnal enuresis as a manifestation of autocoidosis]
[Article in Russian]
Natochin IuV, Kuznetsova AA.
The study entered 30 children with nocturnal enuresis and 20 healthy controls aged 6-15 years. The enuretic children had a higher night diuresis and free water reabsorption; there was an increase in nocturnal excretion of sodium, calcium and magnesium ions. Before going to bed the patients received diclofenac-sodium. Inhibition of cyclooxygenase and decrease of prostaglandin production led to normalization of diuresis and natriuresis, elimination of nocturnal enuresis episodes. The evidence has been obtained that nocturnal enuresis is accompanied by an increased production of autocoids in the thick ascending Henle loop and, as a result, of an increase in saluresis and diuresis. It is suggested that there is a form of nocturnal diuresis which depends on a local hyperproduction of autocoids. The problem of autocoids role in the internal medicine is discussed.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9503541&dopt=Abstract
Drug Dev Ind Pharm. 1999 Apr;25(4):429-35.
In vivo performance of wax matrix granules prepared by a twin-screw compounding extruder.
Miyagawa Y, Sato H, Okabe T, Nishiyama T, Miyajima M, Sunada H.
Central Research Laboratories, Zeria Pharmaceutical Company, Ltd., Osato-gun, Japan.
The in vivo performance of wax matrix granules (WMGs) prepared by a twin-screw compounding extruder was evaluated in fasted beagle dogs. In vitro dissolution behavior of the model drug, diclofenac sodium (DS), from WMGs was strongly influenced by pH in a dissolution medium due to its solubility (DS is soluble in pH 6.8 and insoluble in pH 1.2 and 4.0) and was independent of paddle rotation rate (50, 100, and 200 rpm) of the dissolution apparatus. Pharmacokinetics parameters such as mean residence time (MRT) showed a sustained action of WMGs in beagle dogs; however, the transit time of WMGs in the small intestine is found to control total drug absorption. Furthermore, the values of the area under the curve (AUC) of the plasma concentration-time curve and the maximum concentration Cmax significantly decreased with decreases in hydroxypropylcellulose (HPC) content in WMGs. Good correlation between one in vitro dissolution parameter (mean dissolution time, MDT) and two in vivo parameters (AUC12 and MRT) suggested that it would be possible to design WMGs with a desired in vivo performance by controlling HPC content.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10194597&dopt=Abstract
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