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The Precision Medicine Approach in Oncology
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
An adverse drug reaction is an unwanted and sometimes harmful side reaction caused by taking a therapeutic agent or combination of agents. As part of a Personalized Medicine approach, biomarkers can be used to predict the likely toxicity in an individual patient, and a number of examples are described below.
Heterocyclic Drug Design and Development
Published in Rohit Dutt, Anil K. Sharma, Raj K. Keservani, Vandana Garg, Promising Drug Molecules of Natural Origin, 2020
Garima Verma, Mohammad Shaquiquzzaman, Mohammad Mumtaz Alam
Despite its significant benefits in the health system, it suffers from numerous downsides. The most important one is that this system targets symptom and not the root cause Treatment in such a manner provides only a short term relief by chemical effects and does not alleviate the underlying cause. At present, the allopathic system is the most widely adopted one that utilizes synthetic chemical composition as drugs. Intake of these drugs for a considerably prolonged duration predisposes patients to a number of side effects. Invasive procedures can also pose serious consequences on human health (Drug-Free-Living.com; Allopathy-Strengths and Limitations). A few medical procedures are even associated with very serious adverse effects and even deaths in some cases. Indiscriminate use of antibiotics in the current scenario poses deleterious effects on the life of patients. Antibiotics are known to provide nothing more than momentary respite. Additionally, their use is also linked to serious side reactions. At times, owing to hectic schedules, physicians also end up with an inaccurate diagnosis. Administration of medications in such cases endangers the life of human beings. Also, in many instances, the consumption of powerful medications for not-that-serious health issues exposes patients to numerous health risks in the long run (Collins, 2016).
Supplying Muscle Machines with Energy
Published in Peter W. Hochachka, Muscles as Molecular and Metabolic Machines, 2019
Flare-up or accelerator function is not the only property of glycolysis that is regulated. Because glycogenolysis in activated muscle may well operate as an essentially closed system potentially capable of generating harmful end products, it also is necessary to maintain the activated system under close control. While numerous regulatory brake mechanisms, e.g., allosteric enzymes, and defense mechanisms (such as high buffering capacities) have evolved, the ultimate brake feature in many species, especially lower vertebrates (Dobson and Hochachka, 1987) may well be the limited amount of stored glycogen; when this is used up, no matter what else prevails, the pathway must grind to a halt, and it does so before end-product accumulation leads to (i) undesirable acidification, (ii) osmotic perturbation, or (iii) uncontrollable side reactions. In tissues such as the liver, which contain enormously high amounts of storage glycogen, the end product of glycogen mobilization is glucose, not lactate; there is no net generation of protons, and enzyme activities are low. Since the accelerator of muscle glycolysis is absent, the brake also can be slackened.
Amifampridine for the treatment of Lambert-Eaton myasthenic syndrome
Published in Expert Review of Clinical Immunology, 2019
Amifampridines (AFP), 3,4-DAP and 3,4-DAPP, are the most studied drugs in neuromuscular diseases and neurology. Randomized and non-randomized studies showed that AFPs are the most effective drug as symptomatic medication for LEMS. AFPs are safe and tolerable. Thus, AFPs should be the drug of choice for the symptomatic treatment in LEMS. As long as the daily dose is less than 80 mg a day, there is no concern for the serious side-reaction, seizure. Because of short-acting drug effect, it should be given three or four times a day. No death or irreversible cardiac, hepatic, and renal toxicity were reported. Peri-oral and finger paresthesia, the most common side-reaction, is accepted as a sign of ‘drug-intake’ by many patients. Gastrointestinal side reactions, the next common side-reaction of AFPs, are tolerable but can be easily controlled by atropine. AFPs are also the drug of choice and life-saving for LEMS crisis. For long-term usage, it is proven to be safe and AFPs can be supplemented with liberal amount of pyridostigmine to sustain a symptomatic improvement without any undue side-reaction.
Multi-Targeting by β-Elemene and Its Anticancer Properties: A Good Choice for Oncotherapy and Radiochemotherapy Sensitization
Published in Nutrition and Cancer, 2020
Hongxuan Tong, Yihua Liu, Lijie Jiang, Jingshang Wang
Though multiple studies have been performed in vivo and in vitro, more investigations are warranted to assess the treatment effects and side reactions of β-elemene in humans, since most clinical trials performed combined the extract with chemotherapy or radiotherapy (28–30). Clinically, the reported antitumor dose of β-elemene emulsion is 300–500 mg/day. In addition, the main side reactions observed in clinical trials are gastrointestinal reactions, fever, local pain, and anaphylactic reaction; however, these are well tolerated by most patients (14,28,31,32). It is also important to consider the dose levels that elicit undesirable effects, although only minute toxicity has been reported.
Adverse events related to topical drug treatments for acne vulgaris
Published in Expert Opinion on Drug Safety, 2020
Agnieszka Otlewska, Wojciech Baran, Aleksandra Batycka-Baran
In general, topical agents used for AV treatment have favorable safety profile and are not associated with systemic toxicity and systemic AEs. The most commonly reported AEs were associated with local skin irritation, e.g. erythema, dryness, scaling, pruritus, stinging, and burning sensations. These cutaneous side reactions were usually mild to moderate in intensity, intermittent, and rarely led to the cessation of therapy. Irritative potential seems to be highest for topical retinoids and BPO. New generation retinoids, such as adapalene have lower irritative potential than the first generation retinoids. Further, as the studies show the side effects of treatment may be limited by changing the concentration, vehicle, mode of application or use of combination therapy. The most common advantage of topical antibiotics is their low irritative, antiinflammatory profile. However, due to the possibility of development of C.acnes resistance, topical antibiotics should not be used in monotherapy, but as a part of combination therapy. Resistance of C. acnes to BPO or AzA has not been reported yet. AzA has favorable safety profile and low irritative potential. Hypopigmentation is occasionally reported AE of AzA. Therefore, it should be used carefully in patients with Fitzpatrick skin types IV or greater due to its potential lightening effect. In female adolescents and adults of childbearing potential, topical retinoids should be used with caution, because they are contraindicated in pregnant females (adapalene, tretinoin – FDA Pregnancy category C; tazarotene- FDA Pregnancy category X). BPO, AzA, topical erythromycin, and clindamycin may be safely used in pregnant females (FDA Pregnancy Category B drugs). Various agents with complementary action are frequently combined to increase efficacy and safety of therapy.