Legislation to facilitate process for generic products has been enacted and generic drugs have entered the market soon after the patent for the brand-name agent have expired. In every instance, the rationale has been economic since it is generally assumed that the copies are not only therapeutically equivalent but also a great deal less expensive than the original. Sometimes this may be so. In this short review several comments are made in order to establish the variables that may influence bioequivalence between the brand-name drug and its generics. Among them emphasis is given to the particle sizes, pharmaceutical supply, choice of the right excipient, in order to avoid possible interactions with the drug, ingredient quality and purity, etc. All these variables must be carefully controlled. Even so a patient who is changed from a trade name product to a generic drug (or vice versa) may respond a little differently, which is important in Psychopharmacology. Two or more products should be considered biologically equivalent only when it can demonstrated that they fulfil three conditions: that they have the same pharmaceutical properties; that they are equally effective in therapeutic use and that they are tolerated equally by patients being treated for the indicated uses. Regulatory agencies could require subsequent versions of an original therapeutic product the type of data regarding pharmacology, toxicology and chemical assessment that was mandatory for the introduction of the original.

Drugs, Generic↗

PubMedDate not supplied

[Twelve years of the child oral care program (PADI) in Navarra (1991-2002). Utilisation and health indicators].

BACKGROUND: In 1991, with an incremental character, the Infant Oral Care Program (PADI) was set up in Navarra, which covers the population of 6 to 15 years of age, and which has a mixed provision, public and private-arranged, the latter with a payment system by capitation. The aim of this article is to analyse the possible impact of the program on the use of services and to analyse the evolution of the dental health of Navarra schoolchildren in the 1991-2002 period. MATERIALS AND METHODS: Data was collected on the network of providers and the utilisation of the PADI made available by the Directorate of Primary Care of the Navarra Health Service - Osasunbidea, and data was analysed from the surveys of dental health for 1987, 1997 and 2002, whose methodology has been published. The data was exploited statistically with the SPSS program for Windows, v10. RESULTS: The number of dentists-providers of the program increased from 28 in 1991 to 161 in 2002; in the same period the indexes of participation rose from 37.4 to 67.2%. There is a positive, statistically significant correlation between the growth of the network (r: 0.941) and its geographical extension (r: 0.933), and the index of utilisation. The percentage of schoolchildren aged 14 years who state that they have been to the dentists in the last year rises from 55.1% in 1987 to 88.2% in 2002. More than 70% of the schoolchildren between 6 and 12 years of age state that they have been to a PADI dentist. The prevalence of caries continues to fall in all age groups and becomes stabilised at 14 years. Between 44 and 79.2% of the caries are treated. The schoolchildren who regularly visit the PADI show more preventive and restorative treatment (sealed) than those who do not. CONCLUSION: The setting up of the PADI seems to have brought an increase in the utilisation of the dental services, together with an improvement in the dental health of the infant and adolescent population of Navarra.

Adolescent↗

PubMedDate not supplied

[Historical approach to reserpine discovery and its introduction in psychiatry].

Reserpine, an alkaloid of the Rauwolfia serpentina plant isolated during the middle of the 20th Century, represented a highly important clinical advance in the treatment of schizophrenia whose pharmacological tools were limited to chlorpromazine that was introduced in the clinical area two years before. Both agents would come into the history as the drugs that made possible the beginning of the psychopharmacological era. In the present article, a revision is made of the complicated process leading to the isolation and synthesis of reserpine, by the Swiss pharmaceutical company Ciba (Schlittler and Müller) and how its pharmacological properties (Bein) were discovered and studied, in the animals laboratory, mainly, the "tranquillizers". The introduction of this antipsychotic in psychiatry, which was initiated in 1954 (half a century ago), and the results obtained in the first clinical studies, as well as the role played by researchers such as Kline, Delay, Noce, Hollister, Altschule, etc. are then described. In addition, and from a historical perspective, the discovery of the adverse effects of this drug, especially those of extrapyramidal nature (dyskinesia and akathisia), are studied, concluding with the reasons that produced its rapid clinical decline, among which the genesis of depressive pictures (phenomenon presently questioned) may be emphasized. Finally, the conclusion reached was that, although the clinical relevance of reserpine was not as evident and long lasting as chlorpromazine, its initial contribution to the treatment of schizophrenic patients was of maximum importance.

Adrenergic Uptake Inhibitors↗

PubMedDate not supplied

[Cost effectiveness analysis of 3 alternative community programs in the preventive use of fluoride for dental caries prevention in Cataluña].

Explore the source record for details and available documents.

Child↗

PubMedDate not supplied

[Effect of antidepressant drugs on cytochrome P-450 isoenzymes and their clinical relevance: differential profile].

The P-450 enzymatic complex (CYP) is one of the main enzymatic systems used by the organism to metabolize different substances, including 90% of drugs of common clinical use. Drugs can act on the CYP as substrates or as modifiers of its activity, either as inhibitors or as enzymatic inducers. Antidepressant drugs, including tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI), are widely metabolized by CYP. In addition, SSRI are potent inhibitors of different isoenzymes of this family. This fact allows to establish interesting differences relating the safety profile of these agents. In this review we analyze in detail, and comparatively, the effects of the different classes of antidepressants on CYP. Knowledge of these effects is of great relevance for an optimum clinical practice, allowing us to know the basis of some interactions, providing guidance for the use of correct dosage in different groups of patients and to explain some cases of unexpected toxicity or lack of therapeutic effect.

Antidepressive Agents↗