The Wonder of Aspirin

History

Acetylsalicylic acid was first synthesized in 1853 by von Gerhardt by mixing acetic acid with salicylic acid. It was first invented for arthritis. This medicine became the first pain reliever in tablet form. The name of aspirin means pain relief, speed, reliability, and tolerability. Aspirin was submitted to the Imperial Patent Office in Berlin, West Germany, in 1899.

Choice of Antithyroid Medications in Hyperthyroidism

Hyperthyroidism is a condition where production of thyroid hormone is higher than normal, causing several symptoms and signs. This condition is usually due to autoimmune problem. Hyperthyroidism can be treated with medicines or with surgical procedures, depends on structural abnormality found in each case. Medicines can control the symptoms and signs of hypethyroidism, but cannot cure the basic problem causing this condition (i.e. autoimmune process).

Several medications which are used in pharmacological therapy against hyperthyroidism: radioiodine, thioureylenes (consists of carbimazole, propylthiouracil, and methimazole), and iodine.

PDE5 inhibitors: From Pulmonary Hypertension to Male ED

Erectile dysfunction is an abnormal condition that happens as an interaction between psychological factors and physiological factors. Erection occurs as the resultant of some physiological factors: increased penile blood flow, increased sinusoidal filling, increased venous outflow.

One of the medicines that used to treat this condition is from PDE5 inhibitors class. Besides apomorphine, alprostadil, papaverine, phentolamine, and phenylephrine; this is the mostly used medicines to treat erectile dysfunction. PDE-5 inhibitors have some advantages rather than other medicines: it can be taken orally, and it only enhance erectile dysfunction as the response against sexual stimulation. But it also has a warning: it cannot be used altogether with nitrates, due to resultant vasodilatation effect that is potentially fatal when these medicines are taken simultaneously.

Medicines Group based on Availability on Market

Based on its availability in market, medicines are classified into four groups. Each group has its own logo on the package, to make it easier for patients to identify.

What are the groups?

Controversies about Cardiotoxicity Effect of Second-Generation Antihistamines

What medicines are they?
Five examples of famous second-generation antihistamines are cetirizine, terfenadine, astemizole, ebastine, and loratadine.

What are their advantages compared to first-generation antihistamines?
First-generation antihistamines have several weaknesses; namely their tendency to cross blood-brain barrier and consequent sedative-anticholinergic side effects. Their half-life is also shorter, thus limiting their efficacy against allergic symptoms. These weaknesses have been "covered" by the second-generation antihistamines.
Overall, antihistamines are rapidly and completely absorbed after oral administration with peak plasma concentration reached within 1-4 hours. Most of second-generation antihistamines undergo an extensive first-pass metabolism via cytochrome P450 (Cyp3A4). But several of them (e.g. mizolastine) is not metabolized by this pathway, but by glucuronidation enzyme.

Medicines for Children: Dos and Do'n'ts

Administering medicines to your children may be worrying. Some parents think that giving medicines to their children may be dangerous. Some others think that other child's illness and medicines may be equal with what their child needs. In this article we will discuss about what the dos and don't's about giving medicines to your children.

FDA Pregnancy Safety Index

DISCLAIMER: This article is for educational purpose only. Any illegal usage or abuse associated with information listed here is not our responsibility, as we have said before in our terms and conditions.


United States Food and Drug Administration (US FDA) has used pregnancy safety index categories to determine the potential of a medicine to harm a pregnancy. The harm means birth defects or termination of pregnancy. FDA created this guideline in 1975 for pharmaceutical companies, and then revising the labeling method in 1997.

The categories are determined by the reliability of documentation from animal and human study; and the risk to benefit ratio of using this medicine in pregnancy (according to life-saving factor vs pregnancy factor). For your information too, these categories does not include any risks of breastfeeding-related risk.

Facts you need to know about Antibiotics (part 2): Considerations and Mechanisms

After we discuss some general facts about antibiotics, we will advance to the next facts about them before we discuss about each class of antibiotics.

Read this post first if you have not learned about antibiotics.


Fact # 4

What are the physician consider when giving antibiotic to his/her patient?

There are several factors to be considered.

Facts you need to know about Antibiotics (part 1): General Principles

Antibiotic. One of the most important group of medicine that ever discovered, remarked the decreasing of infectious disease drastically in 20th century. With more if its power, comes more fear that antibiotic era will end some day. To prevent that from happening, we should know several facts about antibiotic. This serial article will describe anything about antibiotics and their principles of usage.

Medication Choice in Parkinson's Disease

Parkinson's disease (PD) is a neurological pathologic condition with the prevalence about 1 of every 100 individuals older than 55 years old in US alone. Main manifestations are commonly come from motoric system: resting tremor, rigidity of movement, bradykinesia, and postural instability (causes gait abnormality). Pathology of this disease is due to loss of dopaminergic neurons of the substansia nigra of the brain. This loss of dopaminergic neurons cause emergence of neurologic deficits which depend on dopaminergic system. Relatively, acetylcholine/dopamine ratio will rise and this cause more profound of tremor in patients.

Choice of Hypolipidemic Agents

Cholesterol is necessary for human body as a component in cell wall's structure. But in excess, cholesterol can be dangerous. Cholesterol could create a plaque on vascular wall, thus obstructing vessel's caliber, and increases the risk of cardiovascular diseases.

In our body, cholesterol goes through circulation with the aid of lipoprotein (transporter protein for lipids in blood circulation). There are some kinds of lipoprotein, with the main kinds are LDL (low-density lipoprotein) and HDL (high -density lipoprotein). LDL is needed to take cholesterol from liver to peripheral tissue and vessels. If LDL exists in high level, atheroma could be formed. Reversely, HDL takes cholesterol from peripheral tissue back to the liver.

Fluoroquinolones: Behind the Famous Broad Spectrum Antibiotic

Fluoroquinolone is one of antibiotic/antimicrobial class with the highest prescriptions rate worldwide. This antibiotic works as an inhibitor of gyrase enzyme, and/or topoisomerase II/IV. These enzymes are vital for bacterial DNA synthesis or replication process.

There are four generations of quinolones:

First generation: nalidixic acid, nitrofurantoin. Usually used in urinary tract infection. This group was called old quinolones.
Second generation: ciprofloxacin, levofloxacin, ofloxacin, norfloxacin, and lomefloxacin. From this generation on, the next groups are called new quinolones/fluoroquinolones; due to their systemic effect.
Third generation: gatifloxacin, gemifloxacin, grepafloxacin, sparfloxacin
Fourth generation: moxifloxacin, trovafloxacin

Ciprofloxacin: How is the safety in Children?

Ciprofloxacin, just like other fluoroquinolones, is not recommended for infectious diseases children; due to concern of potential arthropathy and development disturbances risk. All ciprofloxacin labels worldwide list children and adolescent under age of 18 as contraindication of all fluoroquinolones. But how about the experiences?

Off-Label Indications

NOTE:
This article is only for educational purpose. Consult with your physician about using a medicine with its off-label indication first before do anything!

Off-label indications are the usage of medicine out of its own listed indications as approved by local regulatory. Other name for off-label indication is "additional indication". This indication is usually based on empirical experience of some key opinion leaders in an institution or region. Off-label indications can sometimes emerge as on-label indication, has it passed phase IV trial and has it been approved by local or international regulatory.

Legally, the risk or casualty caused by the usage of a medicine for an off-label indication cannot be protected ethically (including that, this use of medicine sometimes not covered by health insurance!). So practically, usage of a medicine with its off-label indications should be conducted more carefully. Ask your physician about safety of the off-label indications before ask them to treat you by that medicine.

Phases in Clinical Trial

Clinical trial is needed to support effectivity and safety claims of a medicine, and also to support data for approval need by regulatory system. Before a clinical trial is conducted in human, a compound (experimental medicine) is tested to animals first, to show whether the compound gives benefit or not. Animal study is using several dose level, from small to large doses. This is needed to determine how high is lethal dose, how low is an effective dose, how high is safe dose, and how wide/narrow is the safety margin, etc. When the animal trial data would be extrapolated into propose human trial with same agent, dose should be calculated by scientist so that human dose is much smaller than animal dose.

There are four phases of clinical trials: phase I, II, III, and IV. Phase I-III are called experimental trials, and phase IV is postmarket study.

Mucoactive Agents for Productive Cough: What are The Choices?

Mucoactive agents are medicines/agents that affect mucus properties and promote secretion clearance. These agents are useful in productive cough where hypersecretion of mucus is predominant, but practically not useful at all in dry cough. There are several subgroups of mucoactive agents. Four of them are listed and described below. Note that one agent may have been classified more than in one subgroup. The important mucoactive is mucokinetic medicines and mucolytic medicines.

Paracetamol vs Ibuprofen: How to Choose for Fever in Children?

Both paracetamol (acetaminophen) and ibuprofen are used as antipyretic (fever reliever) and analgesic (for mild-moderate pain), especially in children. But how safe are they? How can we determine when to choose paracetamol and when to choose ibuprofen? We will discuss about it here.

Dementia (Alzheimer's Disease) Medicines: Choice Based on The Stage

Dementia is loss of cognitive ability and disturbance of mental function, due to certain process in brain. This condition often happens to elderly/aged person, but may also as a result of brain injury or other illness. There are many types of dementia, but the most common form of dementia is caused by Alzheimer's disease. Some other dementia types are vascular dementia, Parkinson's dementia, unspecified dementia, etc.

Several medicines have been developed and used as pharmacologic therapy to slow down dementia's progress.

Common Cold Medicines: Choose (Only) Medicines You Need!

As we know, now there are plenty of common cold medicines in market, and most of them is available over-the-counter. But do you know what are the active ingredients of each medicines? Are they suitable with your symptoms? In this article, I will describe some active components in common cold medicines, with the analysis of each benefits of them.

Quality of A Clinical Trial: Jadad Score

When we read a clinical trial publication, maybe we are asking several questions. One of them, is: how good is this trial's quality? That is the purpose of using Jadad scoring system. This scoring system includes three points: randomization, blinding, and withdrawal/dropout.