Chapter 6 Drug Therapy in the 21st Century

Changes in Health Care in the 21 st Century Access to medical and pharmacologic information is available from many sources Consumers are taking steps to demand specific treatments and considerations Alternative therapies are being offered and advertised Financial pressures are leading to early discharge Patient teaching and home care provisions are vital

Access to medical and pharmacologic information is available from many sources

Consumers are taking steps to demand specific treatments and considerations

Alternative therapies are being offered and advertised

Financial pressures are leading to early discharge

Patient teaching and home care provisions are vital

Federal Guidelines—Drug Advertising When the advertisement states the indication, it must also include: Contraindications Adverse effects Precautions

When the advertisement states the indication, it must also include:

Contraindications

Adverse effects

Precautions

Internet Sources for Drug Information Pharmaceutical company information sites Chat rooms with other people who are taking the drug Online pharmacies Lists of government regulations Research reports about the drug and its effectiveness

Pharmaceutical company information sites

Chat rooms with other people who are taking the drug

Online pharmacies

Lists of government regulations

Research reports about the drug and its effectiveness

Internet Site Evaluation Navigation Is the site easy to access and navigate or confusing? Contributor Who prepared the site and what are his qualifications? Is it reviewed, or is it purely commercial? Dates Is the site updated frequently? Accuracy/reliability Is the information supported by other sites, accurate, and in agreement with other sources you have reviewed? Are other links listed?

Navigation

Is the site easy to access and navigate or confusing?

Contributor

Who prepared the site and what are his qualifications? Is it reviewed, or is it purely commercial?

Dates

Is the site updated frequently?

Accuracy/reliability

Is the information supported by other sites, accurate, and in agreement with other sources you have reviewed? Are other links listed?

Problems Associated With OTC Medications Can mask the signs and symptoms of disease Can interact with prescription drugs Can be taken in greater than the recommended dose, leading to toxicity

Can mask the signs and symptoms of disease

Can interact with prescription drugs

Can be taken in greater than the recommended dose, leading to toxicity

Over-the-Counter Drugs Drugs that were “grandfathered” in Former prescription drugs that have been tested and found to be safe for the general public if used as directed

Drugs that were “grandfathered” in

Former prescription drugs that have been tested and found to be safe for the general public if used as directed

Alternative Therapy Drawbacks The active ingredient has not been tested by the FDA Incidental ingredients are unknown Patients do not always mention these therapies to their health care providers Drug–alternative therapy interactions may occur

The active ingredient has not been tested by the FDA

Incidental ingredients are unknown

Patients do not always mention these therapies to their health care providers

Drug–alternative therapy interactions may occur

Controls for Alternative Therapy Herbal medications and alternative therapies are not controlled or tested by the FDA Advertisement for these drugs is not restricted because they are considered dietary supplements No regulation by any industry

Herbal medications and alternative therapies are not controlled or tested by the FDA

Advertisement for these drugs is not restricted because they are considered dietary supplements

No regulation by any industry

Off-Label Medications Definition The use of a drug for an indication that is not approved by the FDA Occurrence Commonly takes place in groups of patients for whom there is little premarketing testing Used with pediatric and geriatric populations

Definition

The use of a drug for an indication that is not approved by the FDA

Occurrence

Commonly takes place in groups of patients for whom there is little premarketing testing

Used with pediatric and geriatric populations

Health Care in Crisis Skyrocketing cost of medical care and drugs Huge research and equipment requirements to meet consumer demands Rising cost of health insurance Earlier discharge from hospitals

Skyrocketing cost of medical care and drugs

Huge research and equipment requirements to meet consumer demands

Rising cost of health insurance

Earlier discharge from hospitals

Measures to Protect the Public From Bioterrorism Emergency preparedness at all levels of the government

Emergency preparedness at all levels of the government

Treatments for Exposure to Biological/Chemical Weapons Insert table 6.3

Insert table 6.3