The document summarizes the key stages and processes involved in drug development, from discovery through clinical trials and regulatory approval. It discusses the pre-clinical, clinical, and post-marketing phases, which involve extensive testing, including pharmacokinetics, toxicology, formulation, and three phases of clinical trials on human subjects. It notes that while medical research is necessary, clinical trials must follow ethical principles like informed consent, privacy, risk minimization, and justice to avoid potential social, economic and legal issues from testing on humans.
NEW DRUG DEVELOPMENT
Clinical Research - Phases
New Drug Development Process
CONTENT OF INDA
CONTENT OF NDA
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FOR MORE RELATED QUERIES CONTACT US ON 09028839789
FOR ENROLLMENT IN NEXT BATCH KINDLY CONTACT US ON THE ABOVE MENTIONED CONTACT NUMBER
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Drug development - Background informationXplore Health
This guide provides background information on the drug development process including the different phases and the ethical, legal and social aspects associated.
Drug development is the process of bringing a new pharmaceutical drug to the market once a lead compound has been identified through the process of drug discovery. It includes preclinical research on microorganisms and animals, filing for regulatory status, such as via the United States Food and Drug Administration for an investigational new drug to initiate clinical trials on humans, and may include the step of obtaining regulatory approval with a new drug application to market the drug
Drug development is considered as a series of well defined steps, culminating, if successful, in market authorization, of the drug
NEW DRUG DEVELOPMENT
Clinical Research - Phases
New Drug Development Process
CONTENT OF INDA
CONTENT OF NDA
.
.
.
FOR MORE RELATED QUERIES CONTACT US ON 09028839789
FOR ENROLLMENT IN NEXT BATCH KINDLY CONTACT US ON THE ABOVE MENTIONED CONTACT NUMBER
http://pristynresearch.com/
Drug development - Background informationXplore Health
This guide provides background information on the drug development process including the different phases and the ethical, legal and social aspects associated.
Drug development is the process of bringing a new pharmaceutical drug to the market once a lead compound has been identified through the process of drug discovery. It includes preclinical research on microorganisms and animals, filing for regulatory status, such as via the United States Food and Drug Administration for an investigational new drug to initiate clinical trials on humans, and may include the step of obtaining regulatory approval with a new drug application to market the drug
Drug development is considered as a series of well defined steps, culminating, if successful, in market authorization, of the drug
Clinical Studies - Foundational to the Drug Approval ProcessJohn Kriak
One of the key elements in gaining approval of a drug by the US Food and Drug Administration (FDA) involves clinical research. There are two primary avenues of such research: clinical trials and observational studies. The latter involves monitoring subjects within normal settings, with data gathered over time and health changes evaluated and compared with others in the group.
Assignment on Experimental Study- RCT and Non RCT, Observation Study: Cohort, Case Control, Cross sectional, Roles and responsibilities of Clinical Trial Personnel: Investigator, Study Coordinator, Sponsor, Contract Research Organization and its management Guidelines to the preparation of documents, Preparation of protocol, Investigator Brochure, Case Report Forms, Clinical Study Report Clinical Trial Monitoring-Safety Monitoring in CT
this slide share will provide information about drug discovery and development.in this, how the drug is discovered and what type of procedures and instructions followed during discovery and development of a new drug and also give limitations of drug discovery and development process.
Clinical trials are divided into several phases to ensure the safety and effectiveness of new medical interventions, such as drugs, treatments, or medical devices, before they are approved for widespread use. Here are the typical phases of clinical trials:
Phase 0: Exploratory Study
Phase 0 trials are relatively new and not always a part of the clinical trial process. They involve a small number of participants and aim to gather initial data on how the drug or treatment behaves in the human body. These trials help researchers decide whether to move forward with larger Phase 1 trials.
Phase 1: Safety and Dosage Study
Phase 1 trials involve a small number of healthy volunteers or patients and focus on assessing the safety of the intervention and determining the appropriate dosage range. Researchers closely monitor participants for any adverse effects, evaluate how the intervention is metabolized, and gather initial data on its efficacy.
Phase 2: Expanded Safety and Efficacy Study
Phase 2 trials involve a larger number of patients who have the condition the intervention is intended to treat. These trials continue to assess safety, evaluate dosage regimens, and gather more data on the intervention's efficacy. Researchers may also explore different patient populations, dosages, or combinations with other treatments.
Phase 3: Confirmatory Study
Phase 3 trials are large-scale studies involving a significant number of patients to confirm the intervention's safety, effectiveness, and monitor any side effects. These trials often include a randomized and controlled design, comparing the new intervention against existing standard treatments or placebos. Phase 3 trials provide critical data for regulatory agencies to evaluate whether the intervention should be approved for widespread use.
Phase 4: Post-Marketing Surveillance Study
Phase 4 trials take place after the intervention has received regulatory approval and is available to the general public. They aim to monitor the intervention's long-term safety, effectiveness, and identify any rare or long-term side effects. Phase 4 trials may involve a larger and more diverse population than earlier phases.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
process for discovery and development of new drug and issues related to testing of drug on human
1. The process/stages for discovery
and development of new
drug/vaccines and social,
economical and legal issues
related to testing of new drug on
human volunteers.
Made By-Teena
Roll No- 5
Msc Biotechnology Final Year
Submitted to-Dr. Sulekha Rani
2. PHASES OF DRUG
DEVELOPMENT
There are three major phases in drug
development:
1. Pre-clinical research and development
2. Clinical research and development
3. After the compound is on the market, a
possible “post-marketing” phase
3. The pre-clinical phase represents bench (in
vitro) and then animal testing, including
kinetics, toxicity and carcinogenicity. An
investigational new drug application is
submitted to the FDA seeking permission to
begin the heavily regulated process of clinical
testing in human subjects.
The clinical research phase—representing the
time from beginning of human trials to the new
drug application submission that seeks
permission to market the drug—is by far the
longest portion of the drug development cycle
and can last from 2 to 10 years.
4. Stages of Drug Development
➢Drug Invention
➢Product Characterization
➢Formulation& development
➢Pharmacokinetics And Drug Disposition
➢Preclinical Toxicology Testing And IND
Application
➢Bioanalytical Testing
➢Clinical Trials
➢Regulatory review
➢Marketing the product or drug
➢Post-marketing monitoring (phase-IV)
trials
5.
6. Discovery
Discovery often begins with target identification –
choosing a biochemical mechanism involved in a disease
condition.
Drug candidates, discovered in academic and
pharmaceutical/biotech research labs, are tested for their
interaction with the drug target.
Up to 5,000 to 10,000 molecules for each potential drug
candidate are subjected to a rigorous screening process
which can include functional genomics and/or proteomics
as well as other screening methods.
Once scientists confirm interaction with the drug target,
they typically validate that target by checking for activity
versus the disease condition for which the drug is being
developed.
After careful review, one or more lead compounds are
chosen.
7.
8.
9. Product Characterization
When the candidate molecule shows
promise as a therapeutic, it must be
characterized—the molecule’s size, shape,
strengths and weaknesses, preferred
conditions for maintaining function, toxicity,
bioactivity, and bioavailability must be
determined. Characterization studies will
undergo analytical method development
and validation. Early stage pharmacology
studies help to characterize the underlying
mechanism of action of the compound.
10. Formulation, Delivery, Packaging
Development
Drug developers must devise a formulation that ensures the
proper drug delivery parameters. It is critical to begin looking
ahead to clinical trials at this phase of the drug development
process. Drug formulation and delivery may be refined
continuously until, and even after, the drug’s final approval.
Scientists determine the drug’s stability—in the formulation
itself, and for all the parameters involved with storage and
shipment, such as heat, light, and time. The formulation must
remain potent and sterile; and it must also remain safe
(nontoxic). It may also be necessary to perform leachables
and extractables studies on containers or packaging.
11. Pharmacokinetics And Drug
Disposition
Pharmacokinetic (PK) and ADME
(Absorption/Distribution/Metabolism/Excretion)
studies provide useful feedback for formulation
scientists. PK studies yield parameters such as
AUC (area under the curve), Cmax (maximum
concentration of the drug in blood), and Tmax
(time at which Cmax is reached). Later on, this
data from animal PK studies is compared to
data from early stage clinical trials to check the
predictive power of animal models.
12. Preclinical Toxicology Testing and
IND Application
Preclinical testing analyzes the
bioactivity, safety, and efficacy of the
formulated drug product. This testing is
critical to a drug’s eventual success and,
as such, is scrutinized by many
regulatory entities. During the preclinical
stage of the development process, plans
for clinical trials and an Investigative
New Drug (IND) application are
prepared. Studies taking place during
the preclinical stage should be designed
13. The main stages of testing are:
Acute Studies
Acute tox studies look at the effects of one or more doses
administered over a period of up to 24 hours. The goal is to
determine toxic dose levels and observe clinical indications of
toxicity. Usually, at least two mammalian species are tested.
Data from acute tox studies helps determine doses for repeated
dose studies in animals and Phase I studies in humans.
Repeated Dose Studies
Depending on the duration of the studies, repeated dose studies
may be referred to as subacute, subchronic, or chronic. The
specific duration should anticipate the length of the clinical trial
that will be conducted on the new drug. Again, two species are
typically required.
14. Genetic Toxicity Studies
These studies assess the likelihood that the drug compound is
mutagenic or carcinogenic. Procedures such as the Ames test
(conducted in bacteria) detect genetic changes. DNA damage is
assessed in tests using mammalian cells such as the Mouse
Micronucleus Test. The Chromosomal Aberration Test and similar
procedures detect damage at the chromosomal level.
Reproductive Toxicity Studies
Segment I reproductive tox studies look at the effects of the drug
on fertility. Segment II and III studies detect effects on embryonic
and post-natal development. In general, reproductive tox studies
must be completed before a drug can be administered to women
of child-bearing age.
Carcinogenicity Studies
Carcinogenicity studies are usually needed only for
drugs intended for chronic or recurring conditions. They
are time consuming and expensive, and must be
planned for early in the preclinical testing process.
15. Bioanalytical Testing
Bioanalytical laboratory work and bioanalytical method
development supports most of the other activities in the drug
development process. The bioanalytical work is key to proper
characterization of the molecule, assay development,
developing optimal methods for cell culture or fermentation,
determining process yields, and providing quality assurance
and quality control for the entire development process. It is
also critical for supporting preclinical toxicology/pharmacology
testing and clinical trials.
Clinical Trials
Clinical studies are grouped according to
their objective into three types or phases:
16. Phase I Clinical Development (Human Pharmacology)
Thirty days after a biopharmaceutical company has filed its IND, it may
begin a small-scale Phase I clinical trial unless the FDA places a hold on
the study. Phase I studies are used to evaluate pharmacokinetic
parameters and tolerance, generally in healthy volunteers. These studies
include initial single-dose studies, dose escalation and short-term
repeated-dose studies.
Phase II Clinical Development (Therapeutic Exploratory)
Phase II clinical studies are small-scale trials to evaluate a drug’s
preliminary efficacy and side-effect profile in 100 to 250
patients. Additional safety and clinical pharmacology studies are also
included in this category.
Phase III Clinical Development (Therapeutic
Confirmatory)
Phase III studies are large-scale clinical trials for safety and efficacy in
large patient populations. While phase III studies are in progress,
preparations are made for submitting the Biologics License Application
(BLA) or the New Drug Application (NDA). BLAs are currently reviewed
by the FDA’s Center for Biologics Evaluation and Research
(CBER). NDAs are reviewed by the Center for Drug Evaluation and
17. Clinical trials form an integral part of the drug discovery process
worldwide. Clinical trials are the set of practices required to certify a new
drug molecule as safe and efficacious for the market. Medical research,
in general, is a good thing and absolutely necessary to cure number of
chronic diseases.
At present in India we have 40 million asthmatic patients, about 34
million diabetic patients, 8-10 million people with HIV, 8 million epileptic
patients, 3 million cancer patients, more than 2 million cardiac-related
deaths, 1.5 million people with Alzheimer's disease; 15% of the
population is hypertensive, and 1% suffers from schizophrenia1 In order
to give best treatment to above diseases research on humans is both
necessary and desirable. A clinical trial is defined as "any research study
that prospectively assigns human participants or groups of humans to
one or more health-related interventions to evaluate the effects on health
outcomes2." Interventions include not only drugs but also cells and other
biological products, surgical procedures, radiologic procedures, devices,
behavioral treatments, process-of-care changes, preventive care, etc.
18. GENERAL ETHICAL PRINCIPLE
All research involving human subjects should be conducted in
accordance with three basic ethical principles, namely respect for
person, beneficence and justice. The present guidelines are directed at
the application of these principles to research involving human subjects
. (A) RESPECT FOR PERSONS
includes at least two fundamental ethical considerations, namely
1. Respect for autonomy It includes the idea that an individual is free to
choose and to act. Both rational capacity and freedom from constraint
are necessary elements. “Respect for persons” includes respecting the
decisions of autonomous beings. 2. Protection for those with impaired or
diminished autonomy It means a recognition by the commission that
these people are not capable of self determination at all times and in all
circumstances.
(B) BENEFICENCE –
includes the ethical obligation to maximize benefits and minimize harms
and wrongs.
(C) JUSTICE –
In the ethics of research involving human subjects the principle primarily
refers to distributive justice, which means equitable distribution of both
burden and the benefits of participation in research.
19. TWELVE BASIC PRINCIPLES
1 Principle of Essentiality.
2.Principle of voluntariness and Informed
Consent.
3.Principle of Non-exploitation.
4 Principle of Privacy and Confidentiality
5 Principle of Precautions and Risks
Minimisation
6 Principle of Professional Competence
7 Principle of Accountability and Transparency.
8.Principle of Maximisation of Public Interest and
of Distributive Justice.
9 Principle of Institutional Arrangements.
10 Principle of Public Domain.
11 Principle of Totality and Responsibility.
20.
21. If all these principles are
not followed then
social,economical and
legal issues may arise
during a trial on human
volunteer
22.
23. REFRENCES
1. Strovel, Jeffrey; Sittampalam, Sitta; Coussens,
Nathan P.; Hughes, Michael; Inglese, James; Kurtz,
Andrew; Andalibi, Ali; Patton, Lavonne; Austin, Chris;
Baltezor, Michael; Beckloff, Michael; Weingarten,
Michael; Weir, Scott (July 1, 2016). "Early Drug
Discovery and Development Guidelines: For Academic
Researchers, Collaborators, and Start-up
Companies Assay Guidance Manual. Eli Lilly &
Company and the National Center for Advancing
Translational Sciences.
2. Taylor, David (2015).The Pharmaceutical Industry and
the Future of Drug Development. Issues in
Environmental Science and Technology. Royal Society
of Chemistry