How do they work, Ms. Field?
Stay tuned.
Monday, July 14, 2008
Wednesday, July 2, 2008
Do You know how aspirin works?
The age old remedy for just about anything. But this is 2008, and we hear on TV (and everywhere else for that matter) that it's good for the heart, headaches and blood thinning.
So what gives? You will know tomorrow, for each mechanism of action for each indication.
For now, a quick review:
Have you ever read your medication bottle or your prescription and wondered what language that was (or hieroglyphics) ? I am constantly reminded in meetings about the drug i'm working on--e.g., schedule of drug administration and route of administration.
BID= twice a day
OD= right eye
OL= left eye
PO= by mouth
qd= every day
qod= every other day
Check back for the aspirin update.
So what gives? You will know tomorrow, for each mechanism of action for each indication.
For now, a quick review:
Have you ever read your medication bottle or your prescription and wondered what language that was (or hieroglyphics) ? I am constantly reminded in meetings about the drug i'm working on--e.g., schedule of drug administration and route of administration.
BID= twice a day
OD= right eye
OL= left eye
PO= by mouth
qd= every day
qod= every other day
Check back for the aspirin update.
Monday, June 30, 2008
HAART and TB
Use of highly active antiretroviral treatment (HAART) has had a major impact on HIV-associated morbidity and mortality in industrialized countries. Access to HAART is now expanding in low-income countries where tuberculosis (TB) is the most important opportunistic disease. The incidence of TB has been fueled by the HIV epidemic and in many countries with high HIV prevalence current TB control measures are failing. HAART reduces the incidence of TB in treated cohorts by approximately 80% and therefore potentially has an important role in TB control in such countries. However, despite the huge beneficial effect of HAART, rates of TB among treated patients nevertheless remain persistently higher than among HIV-negative individuals. This observation raises the important question as to whether immune responses to Mycobacterium tuberculosis (MTB) are completely or only partially restored during HAART. Current data suggest that full restoration of circulating CD4 cell numbers occurs only among a minority of patients and that, even among these, phenotypic abnormalities and functional defects in lymphocyte subsets often persist. Suboptimal restoration of MTB-specific immune responses may greatly reduce the extent to which HAART is able to contribute to TB control at the community level because patients receiving HAART live much longer and yet would maintain a chronically heightened risk of TB.
I'll try and post some current drugs used in HAART therapy within the day.
I'll try and post some current drugs used in HAART therapy within the day.
Sunday, June 29, 2008
Anti Virals
What exactly is HAART? Is it applicable to Hep C/HIV?
There are numerous new drugs being investigated now for hepatitis C that have very different mechanisms of action. Stay tuned as I try to unravel the intricies of this exciting field of research.
There are numerous new drugs being investigated now for hepatitis C that have very different mechanisms of action. Stay tuned as I try to unravel the intricies of this exciting field of research.
Wednesday, September 19, 2007
Pathologic Gambling as a result of Restless Leg Syndrome: I gotta get down!
So just what IS restless leg syndrome? I've always thought it was just stress manifesting itself in the middle of the night and a brief stroll around the bedroom or a good stretch and it goes away. Apparently, it's way more prevalent in the U.S. and several new drugs for treatment have recently been approved by the FDA. Now for a medical definition:
Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described by people as burning, creeping, tugging, or like insects crawling inside the legs. Often called paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), the sensations range in severity from uncomfortable to irritating to painful.
The most distinctive or unusual aspect of the condition is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes exhaustion and daytime fatigue. Many people with RLS report that their job, personal relations, and activities of daily living are strongly affected as a result of their exhaustion. They are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks.
Current treatment involves dopamine agonist treatment. One such drug is Requip, drug name ropinirole. In 2005, requip became the only drug approved by the U.S. Food and Drug Administration specifically for the treatment of moderate to severe RLS. The drug was first approved in 1997 for patients with Parkinson’s disease. Requip stimulates D2 and D3 type dopamine receptors, to stimulate motor neuron firing (activity-or signaling). The specific mechanism of action for the indication of both Parkinson's and RLS are unknown.
The side effects of ropinirole are interesting to say the least. It has been reported that dopamine receptor agonists stimulate compulsive gambling ( NEUROLOGY 2007;68:301–303). Three subjects were followed from either never gambled or 1-2 visits to a casino to visiting a casino 3-4 times a week and losing up to several hundred thousand dollars. One possible mechanism of action is the stimulation of D3 receptors, the highest concentration of which is found in the mesolimbic pathways [in the brain, centers for controlling the following functions] implicated in motivation, emotion, and reward behaviors, which could lead to the development of pathologic
gambling.
I can understand the "reward" part of the gamble--USC 2nd half football games the last 2 years have paid rents. Just goes to show how pharmacological manipulation of brain function can have drastic effects.
Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described by people as burning, creeping, tugging, or like insects crawling inside the legs. Often called paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), the sensations range in severity from uncomfortable to irritating to painful.
The most distinctive or unusual aspect of the condition is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes exhaustion and daytime fatigue. Many people with RLS report that their job, personal relations, and activities of daily living are strongly affected as a result of their exhaustion. They are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks.
Current treatment involves dopamine agonist treatment. One such drug is Requip, drug name ropinirole. In 2005, requip became the only drug approved by the U.S. Food and Drug Administration specifically for the treatment of moderate to severe RLS. The drug was first approved in 1997 for patients with Parkinson’s disease. Requip stimulates D2 and D3 type dopamine receptors, to stimulate motor neuron firing (activity-or signaling). The specific mechanism of action for the indication of both Parkinson's and RLS are unknown.
The side effects of ropinirole are interesting to say the least. It has been reported that dopamine receptor agonists stimulate compulsive gambling ( NEUROLOGY 2007;68:301–303). Three subjects were followed from either never gambled or 1-2 visits to a casino to visiting a casino 3-4 times a week and losing up to several hundred thousand dollars. One possible mechanism of action is the stimulation of D3 receptors, the highest concentration of which is found in the mesolimbic pathways [in the brain, centers for controlling the following functions] implicated in motivation, emotion, and reward behaviors, which could lead to the development of pathologic
gambling.
I can understand the "reward" part of the gamble--USC 2nd half football games the last 2 years have paid rents. Just goes to show how pharmacological manipulation of brain function can have drastic effects.
Coming tomorrow....Dopamine agonists and getting down on some ACTION!
a tease:
Compulsive gambling with extreme losses -- in two cases, greater than $100,000 -- by people without a prior history of gambling problems has been linked to a class of drugs commonly used to treat the neurological disorder restless legs syndrome (RLS). A new Mayo Clinic study is the first to describe this compulsive gambling in RLS patients who are being treated with medications that stimulate dopamine receptors in the brain.
Mechanism of action and my interpretation tomorrow (later today).....
Compulsive gambling with extreme losses -- in two cases, greater than $100,000 -- by people without a prior history of gambling problems has been linked to a class of drugs commonly used to treat the neurological disorder restless legs syndrome (RLS). A new Mayo Clinic study is the first to describe this compulsive gambling in RLS patients who are being treated with medications that stimulate dopamine receptors in the brain.
Mechanism of action and my interpretation tomorrow (later today).....
Wednesday, May 23, 2007
Researchers are reporting a potential "cure" for hepatitis C,
Use of the drug peginterferon, either alone or in combination with the drug ribavirin, reduced levels of the virus to undetectable levels for up to seven years, the researchers said.
"This paper strongly suggests, for the first time, that hepatitis C is a curable disease," said lead researcher Dr. Mitchell Shiffman, a professor at Virginia Commonwealth University School of Medicine and chief of hepatology and medical director of the school's Liver Transplant Program. "After treatment, 99.6 percent of the patients remained virus undetectable for over five years," he added.
In the study, 997 patients with hepatitis C or with both hepatitis C and
HIV' were treated with either Pegasys (peginterferon alfa-2a) alone or in tandem with ribavirin. Shiffman's team then monitored blood levels of hepatitis C once a year for an average of 4.1 years, and as long as seven years.
The researchers found that 99 percent of patients with hepatitis C who were treated successfully with peginterferon alone, or in combination with ribavirin, had no detectable virus up to seven years later.
"This is the first long-term study that confirms what we believed for many years that these individuals are truly cured of hepatitis C," Shiffman said.
The remaining eight patients tested positive for hepatitis C at an average of two years after treatment. There was no pattern to the patients as far as age, gender or hepatitis C genotype. It isn't known whether these patients had a relapse or were re-infected with the virus, the researchers noted.
The findings were to be presented Monday at the 38th annual Digestive Disease Week conference, in Washington, D.C.
Hepatitis C is a blood-borne infectious disease of the liver and is one of the most important causes of chronic liver disease in the United States. An estimated 4.1 million Americans have been infected with hepatitis C, and 3.2 million are chronically infected. The number of new infections each year declined from an average of 240,000 in the 1980s to about 26,000 in 2004, the latest year for which statistics are available. The number of hepatitis C-related deaths could increase to 38,000 a year by the year 2010, surpassing annual HIV deaths, according to the U.S. Centers for Disease Control and Prevention.
The virus is usually spread through contact with infected blood and blood products. Blood transfusions and the use of shared, unsterilized, or poorly sterilized needles, syringes and injection equipment have been the main routes of transmission in the United States, according to the National Institutes of Health.
Most people who have hepatitis C don't know they have it, Shiffman said. "Of those who have been diagnosed, only about 25 percent have received treatment, because of the side effects of treatment," he said. "The reason why you should treat it is because you can cure hepatitis C, and we finally have the data to definitively document it."
Dr. Eugene Schiff, chief of the division of hepatology and professor of medicine at the University of Miami Miller School of Medicine, agrees that most cases of hepatitis C can be cured.
"In contrast to hepatitis B or HIV, this virus can be totally eradicated and cured," he said.
But, many patients find the side effects of treatment off-putting. Those side effects can include fever and chills, Shiff said. "You feel pretty lousy. After treatment starts, you feel worse the day after your shot, but it tapers off over the course of the week," he said. "Along with that anxiety, irritability and depression can develop. And we are quick to use antidepressants to allow these people to stay on the medication."
Additional side effects include a drop in the production of white blood cells and anemia. Often patients are giving additional drugs to combat these conditions, Shiff said.
Treatments can go on for as many as 72 weeks, depending on the reaction to therapy Shiff said. "Some people are reluctant to get treatment, because they heard that the treatment isn't so pleasant," he said. "But they should come out and get treatment."
Schiff noted that new antiviral drugs to treat hepatitis C are being tested. "It is hoped that these new antivirals will be more effective and have less severe side effects and may even be used without peginterferon alfa-2a or ribavirin," he said.
UMMM--Going to have to call BS on this one. The authors must be in dire need of NIH funding to be making such bold observations. The fact IS, that >60% of patients of HCV infection are already resistant to both therapies. This data is not anything new in the HCV field. The "new" drugs that are being investigated beyond PEG-interferon and nucleoside polymerase inhibitors are very promising however. TLR agonists are coming of age as potent immune stimulators as well as combination cytokine therapy.
"This paper strongly suggests, for the first time, that hepatitis C is a curable disease," said lead researcher Dr. Mitchell Shiffman, a professor at Virginia Commonwealth University School of Medicine and chief of hepatology and medical director of the school's Liver Transplant Program. "After treatment, 99.6 percent of the patients remained virus undetectable for over five years," he added.
In the study, 997 patients with hepatitis C or with both hepatitis C and
HIV' were treated with either Pegasys (peginterferon alfa-2a) alone or in tandem with ribavirin. Shiffman's team then monitored blood levels of hepatitis C once a year for an average of 4.1 years, and as long as seven years.
The researchers found that 99 percent of patients with hepatitis C who were treated successfully with peginterferon alone, or in combination with ribavirin, had no detectable virus up to seven years later.
"This is the first long-term study that confirms what we believed for many years that these individuals are truly cured of hepatitis C," Shiffman said.
The remaining eight patients tested positive for hepatitis C at an average of two years after treatment. There was no pattern to the patients as far as age, gender or hepatitis C genotype. It isn't known whether these patients had a relapse or were re-infected with the virus, the researchers noted.
The findings were to be presented Monday at the 38th annual Digestive Disease Week conference, in Washington, D.C.
Hepatitis C is a blood-borne infectious disease of the liver and is one of the most important causes of chronic liver disease in the United States. An estimated 4.1 million Americans have been infected with hepatitis C, and 3.2 million are chronically infected. The number of new infections each year declined from an average of 240,000 in the 1980s to about 26,000 in 2004, the latest year for which statistics are available. The number of hepatitis C-related deaths could increase to 38,000 a year by the year 2010, surpassing annual HIV deaths, according to the U.S. Centers for Disease Control and Prevention.
The virus is usually spread through contact with infected blood and blood products. Blood transfusions and the use of shared, unsterilized, or poorly sterilized needles, syringes and injection equipment have been the main routes of transmission in the United States, according to the National Institutes of Health.
Most people who have hepatitis C don't know they have it, Shiffman said. "Of those who have been diagnosed, only about 25 percent have received treatment, because of the side effects of treatment," he said. "The reason why you should treat it is because you can cure hepatitis C, and we finally have the data to definitively document it."
Dr. Eugene Schiff, chief of the division of hepatology and professor of medicine at the University of Miami Miller School of Medicine, agrees that most cases of hepatitis C can be cured.
"In contrast to hepatitis B or HIV, this virus can be totally eradicated and cured," he said.
But, many patients find the side effects of treatment off-putting. Those side effects can include fever and chills, Shiff said. "You feel pretty lousy. After treatment starts, you feel worse the day after your shot, but it tapers off over the course of the week," he said. "Along with that anxiety, irritability and depression can develop. And we are quick to use antidepressants to allow these people to stay on the medication."
Additional side effects include a drop in the production of white blood cells and anemia. Often patients are giving additional drugs to combat these conditions, Shiff said.
Treatments can go on for as many as 72 weeks, depending on the reaction to therapy Shiff said. "Some people are reluctant to get treatment, because they heard that the treatment isn't so pleasant," he said. "But they should come out and get treatment."
Schiff noted that new antiviral drugs to treat hepatitis C are being tested. "It is hoped that these new antivirals will be more effective and have less severe side effects and may even be used without peginterferon alfa-2a or ribavirin," he said.
UMMM--Going to have to call BS on this one. The authors must be in dire need of NIH funding to be making such bold observations. The fact IS, that >60% of patients of HCV infection are already resistant to both therapies. This data is not anything new in the HCV field. The "new" drugs that are being investigated beyond PEG-interferon and nucleoside polymerase inhibitors are very promising however. TLR agonists are coming of age as potent immune stimulators as well as combination cytokine therapy.
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