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Drug-drug interactions (DDIs) are one of the commonest causes of medication error in developed countries, particularly in the elderly due to poly-therapy, with a prevalence of 20-40%. In particular, poly-therapy increases the complexity of therapeutic management and thereby the risk of clinically important DDIs, which can both induce the development of adverse drug reactions or reduce the clinical efficacy. DDIs can be classify into two main groups: pharmacokinetic and pharmacodynamic. In this review, using Medline, PubMed, Embase, Cochrane library and Reference lists we searched articles published until June 30 2012, and we described the mechanism of pharmacokinetic DDIs focusing the interest on their clinical implications.
Keywords: Absorption, adverse drug reaction, distribution, drug-drug interactions, excretion, metabolism, poly-therapy
My personal experience has been okay! Sometimes that can change due to my different situations that involve having to communicate with the healthcare system/staff. The healthcare system tries their hardest but some don’t. Some doctors just guess your diagnosis just to get you out of the hospital, mainly to get paid. Some do wrong diagnosis due to them being tired or careless, with good research it can be proven. My negative experience was terrible. Technically, it wasn’t “MY” experience it was a family members but I was there as a witness. My aunt went in because she was sick and she had pain near her appendix. The doctor said nothing was wrong with her appendix and that she may just have a bug. Scans, test, everything was done turned out the doctor sent my aunt home with “flu” meds. Took my aunt throwing up all of her body weight to go back to another hospital because we all knew something was wrong. She went to another hospital and turns out her appendix burst and she nearly could’ve died. Therefore, the healthcare system is great and all but some doctors or healthcare workers can be very careless.
(THIS IS NOT A TRUE STORY NO SYMPATHY NEEDED HERE LOL)
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Aggresive behavior, lack of self-cotrol, or difficult temperament. As the kid gets older interactions with family, school, or the community can effect that childs risk to later drug abuse.
It’s very interesting, not for everyone tho
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Multiple myeloma is a B-cell malignancy characterized by an excess of monotypic plasma cells in the bone marrow. The molecular mechanisms that are involved in disease progression depend on the interaction between the multiple myeloma cells and the bone microenvironment. Because these mechanisms have been well characterized, it is possible to develop regimens that are more specific to pathways involved in the pathogenesis of multiple myeloma than is typical for conventional chemotherapy in disease management. Thalidomide and immunomodulatory drugs (IMiDs) have now been shown to block several pathways important for disease progression in multiple myeloma. First established as agents with antiangiogenic properties, thalidomide and IMiDs inhibit the production of interleukin (IL)-6, which is a growth factor for the proliferation of myeloma cells. In addition, they activate apoptotic pathways through caspase 8-mediated cell death. At the mitochondrial level, they are responsible for c-jun terminal kinase (JNK)-dependent release of cytochrome-c and Smac into the cytosol of cells, where they regulate the activity of molecules that affect apoptosis. By activating T cells to produce IL-2, thalidomide and IMiDs alter natural killer (NK) cell numbers and function, thus augmenting the activity of NK-dependent cytotoxicity. Data delineating these events have been derived from experiments done in resistant and sensitive multiple myeloma cell lines. Although thalidomide and IMiDs demonstrate similar biologic activities, IMiDs are more potent than thalidomide and achieve responses at lower doses. Lenalidomide, a thalidomide derivative, has also been shown to have a different toxicity profile. Our understanding of the mechanism of action of these agents has provided a platform for exciting clinical trials evaluating combinations of thalidomide and lenalidomide with both conventional chemotherapy and newer targeted agents.
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