Drug Therapy in the 21st Century

Changes 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 Advertising

• 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

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?

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

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

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

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

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

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

Measures to Protect the Public From Bioterrorism

• Emergency preparedness at all levels of the government

Treatments for Exposure to Biological/Chemical Weapons