Aspirin

I have not forgotten, just got a bit miffed at Ms. Field with all the commercials lately. check back. thanks.

Later today: once a month osteoporosis drug treatments

How do they work, Ms. Field?

Stay tuned.

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.

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.

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.

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.

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).....