Professor Commentary Module II (Part 2)

Copyright © 2008 Lippincott Williams & Wilkins.

Chapter 6

Drug Therapy in the 21st Century


Changes in Health Care in the 21st CenturyChanges in Health Care in the 21st 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


Federal Guidelines—Drug AdvertisingFederal Guidelines—Drug Advertising

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

– Contraindications

– Adverse effects

– Precautions


Internet Sources for Drug InformationInternet 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


Internet Site EvaluationInternet 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?


Problems Associated With OTC MedicationsProblems 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


Over-the-Counter DrugsOver-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


Alternative Therapy DrawbacksAlternative 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


Controls for Alternative TherapyControls 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


Off-Label MedicationsOff-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


Health Care in CrisisHealth 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


Measures to Protect the Public From Bioterrorism

Measures to Protect the Public From Bioterrorism

• Emergency preparedness at all levels of the government


Treatments for Exposure to Biological/Chemical WeaponsTreatments for Exposure to

Biological/Chemical Weapons

• Insert table 6.3

Economy & Finance

Professor Commentary Module II (Part 2)