Drug interventions Flashcards
Whose responsibility is it to make sure drugs are safe
Health Canada
HC requires drug manufacturers to follow strict procedures in testing drugs they wish to market. The over all process takes about _____ and involves several steps which include:
- ____ &_____research
- __________development
- __________ __________. _____1,2 & 3
- _____________________ Submission.
- Chemical & Biological research
- Pre-clinical development
- Clinical Trial. Phases 1,2 & 3
- New Drug Submission.
Currently there are____ approved for use in the treatment of AD in Canada.
4
Drugs used to treat mild to moderate AD symptoms include:
These are ______ __________ and all have _________ ___________.
Mild-Moderate: Aricept, Reminyl, Exelon
These are CHOLINESTERASE INHIBITORS and all have SIMILAR EFFECTS_.
Another name for Reminyl
galantamine
Another name for Exelon
rivastigmine
Another name for Aricept
donepizil
Another name for Ebixa
memantine hydrochloride
These drugs can help improve some ______ _______ to carry out activities for up to ______ or so.
These drugs can help improve some patient’s abilities to carry out activities for up to a year or so.
Drugs for moderate to severe AD include:
Moderate-Severe: Ebixa
The effects of drugs to improve mild to moderate symptoms of AD include (6)…
improved: attention, memory, alertness, motivation, mood and ability to carry out ADL
ADL stands for…
activities of daily living
Reminyl, ______ & Aricept work by reducing the destruction of_____________ and thereby ____________ it’s activity
Reminyl, EXELON & Aricept work by reducing the destruction of ACETYLCHOLINE and thereby INCREASING it’s activity
___________ ___________ prevent the enzyme from breaking down acetylcholine.
CHOLINESTERASE INHIBITORS
Side effects of ______,_______and Exelon include: (5)
REMINYL, EXELON, ARICEPT Nausea, loss of appetite, tiredness, diarrhea, muscle cramps, sleep disturbance
How effective are cholinesterase inhibitors? What else ‘might’ happen?
- 50-60% show a slight improvement or stabilization of their condition over 6 months.
- might influence neuronal function, but also survival
First drug approved by health canada
Ebixa
How does Ebixa ‘appear’ to work..
protects neurons against excess amounts
Who compared hippocampal volume loss in individuals with AD using______.
Hashimoto, Aricept
What kind of design did Hashimoto use?
Describe the participants…
Quasi Experimental.
-prospective cohort was compared with an historical control group.
Key Finding of Hashimoto..
annual rate of hippocampal volume loss among the treated patients was significantly smaller than that among the control s.
What was the conclusion of the Hashimoto study?
Aricept slows the progression of hippocampal atrophy suggesting a neuroprotective effect.
Ebixa protects neurons against excess amounts of Glutamate. Glutamate is a _______________ released in large amounts by cells ________ by______.
Glutamate is a NEUROTRANSMITTER released in large amounts by cells DAMAGED by AD..
What other symptoms are medical treatments also prescribed for?
- depression
- psychosis
- anxiety
- behavioural issues
Other areas of research
- anti-oxidants
- vaccines that prevent plaque formation
- anti inflammatory drugs
- cholesterol-lowering drugs called statins
- estrogen
- gingko biloba
How do vaccines work?
-prevent formation beta-amyloid plaques
Are Statins effective in people who already have AD?
Who was it effective for?
What did larger scale studies show about the supposed effect?
- NO
- people who had taken it for 5-7 years.
- Larger studies did not replicate these effects
- What are ARB’s usually used for?
- People who take ARB’s are…
- what else WAS exciting
-lower blood pressure
…at lower risk of developing dementia.
-people who already had dementia appeared to have progression of symptoms stalled.
What did estrogen research show
not effective and later found to cause breast cancer. Very dangerous for post menopausal women
Describe the video on Ginko Biloba research
Gingko twice a day - did not impact cognitive abilities at all.
Researcher however did not verify that participants actually took the Gingko
Describe the case study on Gingko
- How many participants?Groups?
- What kind of diagnosis did they have?
- how often did they have GB?
- for how long?
- results?
- 3069 (treatment and placebo)
- normal to Mild Cog Imp
- 2 times a day
- 2000-2008
- dementia rating actually slightly higher in treatment group