08_Drug Testing and Monitoring Flashcards
Anti-alcohol drugs:
Two main drugs
Disulfiram (Antabuse)
Naltrexone (ReVia, Vivitrol)
Antabuse:
Overview
Inhibits alcohol metabolism
Accumulation of acetaldehyde = unpleasant physical reactions
Naltrexone:
Overview
Opioid receptor antagonists
Blocks craving for alcohol
Blocks reinforcing effects of alcohol
Practical Clinical Trials (PCTs):
Overview
Evaluate the effects of interventions under ideal experimental conditions
“Large Simple Trials”
Practical Clinical Trials (PCTs):
Phase III Efficacy Trials
Key role in demonstrating intrinsic pharmacological effects of medication
Provide data necessary for cataloging and marketing
Practical Clinical Trials (PCTs):
Key features
Clinical dilemma for which there is genuine uncertainty on the best course of action
Precisely formulated research hypothesis that addresses practical medical decision
Easily measurable outcome of clinical significance
Randomized design
Practice setting
Minimal clinician and patient research burden
Large enough sample size to account for heterogeneity of participants
Practical Clinical Trials (PCTs):
General Goal
Help reduce uncertainty during critical decision points for clinical care
Practical Clinical Trials (PCTs):
Examples measurable outcomes
Functional Recovery
Hospitalization
Death
Suicide attempt
Therapeutic Drug Monitoring (TDM):
Overview
Measuring specific drugs at designated intervals
Goal is maintain a Constant Concentration in bloodstream
Therapeutic Drug Monitoring (TDM):
Characteristics of drugs measured
Limited therapeutic range
Pronounced pharmacokinetic variability
Adverse effects
Therapeutic Drug Monitoring (TDM):
Main assumption
Dosage affects and plasma/blood concentration
Blood concentration connected to therapeutic effects
Genetic testing:
Three Main Types
Cytogenetic testing
Biochemical testing
Molecular testing
Genetic testing:
Cytogenics
Examination of chromosomes in white blood cells
Genetic testing:
Biochemical testing
Examination of protein instead of the gene