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Know of any interesting drugs?

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trx

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Hi! I need help finding/picking a drug to do a 45 minutes presentation on. I prefer psych-related medications but at this point, I'm pretty desperate for anything before the 5/1 deadline.

Ideas... interesting disease states (psych, preferably), interesting indications, dosage delivery forms, novel and original medications.


FYI: I also need to review 2 trials for the presentation.
 

azPharmD2B

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Modafinil - I find it pretty fascinating, especially considering we're not sure exactly how it works. Its primarily for narcolepsy, but its undergoing clinical trials for a number of things including parkinson's, MS, and sleep apnea. Not to mention its wide-spread (ab)use by normal, healthy people to simply be more awake and alert.
 

PharmDstudent

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Don't ask this group... they'll bore you to death. This forum used to be fun.

Peace out.
 

MountainPharmD

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Don't ask this group... they'll bore you to death. This forum used to be fun.

Peace out.

No kidding. Ever since Z-pack changed his name and sdn1977 got banned this place has really gone down hill. I hardly ever check this site anymore...
 

RxWildcat

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Modafinil - I find it pretty fascinating, especially considering we're not sure exactly how it works. Its primarily for narcolepsy, but its undergoing clinical trials for a number of things including parkinson's, MS, and sleep apnea. Not to mention its wide-spread (ab)use by normal, healthy people to simply be more awake and alert.

+1 on modafinil, its a really neat drug with a lot of potential. I think the military might have tested it on soldiers in Iraq at some point, although I may be making that up
 

PharmDstudent

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No kidding. Ever since Z-pack changed his name and sdn1977 got banned this place has really gone down hill. I hardly ever check this site anymore...
They're running everybody off. I'm about to run off too.
 

MountainPharmD

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They're running everybody off. I'm about to run off too.

I don't check in much anymore maybe a couple times a week. I have plenty of other ways to waste time so no big loss....

Come on we haven't even had a big who sucks more CVS or everyone else in months. I haven't seen a post from Old Timer in months either......Here is the bait...Hey Old Timer CVS sucks!!!!!!!
 

PharmDstudent

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I don't check in much anymore maybe a couple times a week. I have plenty of other ways to waste time so no big loss....

Come on we haven't even had a big who sucks more CVS or everyone else in months. I haven't seen a post from Old Timer in months either......Here is the bait...Hey Old Timer CVS sucks!!!!!!!
Any suggestions? Send me a PM. Seriously!

I'll just get a new hobby. No big deal.
 

BMBiology

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Sexual dysfunction associated with antidepressants and the options for treating this terrible and troubling side effect.
 

Hels2007

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Buspirone. Just because. :p

Or, if you want a new one, then Pristiq (son of Effexor) and its failed quest for menopause (or was it PMS?) indication. How PMS got redefined and renamed PDD is rather amuzing too.
 

RxWildcat

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PMS is different from PMDD
 

Hels2007

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PMS is different from PMDD

:lol: Even the definition of PMDD is that it is severe form of PMS. And the reason a particular subset was extracted and redefined as a "serious medical condition" is a classic instance of disease-mongering (though I disagree with the way some people use this term, I will use it for the lack of better ones). If you have a drug, you need a disease that can be treated with this drug. If there is none (or that method of use patent is about to expire), then you create one. There is another one in the works too, I just cannot remember what the drug and the proposed disease are... As if there aren't enough real ones to go around. :rolleyes:
 

RxWildcat

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eh, what ev, back to the original topic: modafinil = good drug for a PP presentation
 

mrblah

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Hi! I need help finding/picking a drug to do a 45 minutes presentation on. I prefer psych-related medications but at this point, I'm pretty desperate for anything before the 5/1 deadline.

Ideas... interesting disease states (psych, preferably), interesting indications, dosage delivery forms, novel and original medications.


FYI: I also need to review 2 trials for the presentation.

muse :)
 

spacecowgirl

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Kuvan - only drug indicated for this condition, really, really expensive
Acthar gel - a new very old drug that is also suddenly really expensive (really)
Xyrem - look it up
 

MountainPharmD

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Thalidomide is a good one. Talk a little history and on to the new indications.

Talk about drugs like Pexeva that are completely worthless attempts at drug companies trying to make a buck....
 

Seveneighty

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I just read the Wikipedia article on Xyrem, and it seems like a very interesting drug to do your presentation on...
 

Requiem

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You can do the typical why is Ritalin a stimulant yet calms down ADD [dysregulation of firing becomes normalized] normal + drug = excess = excited, Add + drug = bring to normal = calm..

One thing about Parkinson's is there's a few straightforward therapies, but you can play with them. And perhaps outlining a few cases highlighting how therapies differ. Few interesting scenarios:

Selegiline is initiated in younger persons <65 displaying Parkinson's symptoms for its neuroprotective effects: blocking MAO stops DA metabolism, thereby stopping free radical production; but often not initiated in those older patients.

Trihexyphenidyl[anticholinergic] given in younger persons when tremor is the predominant symptom... could get into why it influences tremor more than another initial therapy, like amantadine. Amantadine inhibits DA metabolism and has anticholinergic effects.

DA agonists are good -> dopamine dysregulation syndrome. uncommon but prevalent syndrome of excessive gambling, hypersexuality, punding, etc. in individuals on DA agonists like ropinerole. Very very interesting phenomenon. Also excess somnolence, occasionally "sleep attacks". DA agonists prolong development of dopament dyskinesias... very impt. Dyskinesias develop in those on the typical Sinemet about 3-5 years after starting therapy, DA agonists delay the development of these and are often given before sinemet in younger indviduals for this reason.

Also, some neurologists tell pts to crack their Sinemet CR in half for their morning dose, that way they get the quick initial control of a regular release with some prolonged action of a CR. Interesting strategy to control blood levels.
Since its 45 mins there are a few areas for you to play with there, how one drug is chosen over the other, the interesting side effects [hallucinations, etc], etc.
 

Caverject

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You can do the typical why is Ritalin a stimulant yet calms down ADD [dysregulation of firing becomes normalized] normal + drug = excess = excited, Add + drug = bring to normal = calm..

One thing about Parkinson's is there's a few straightforward therapies, but you can play with them. And perhaps outlining a few cases highlighting how therapies differ. Few interesting scenarios:

Selegiline is initiated in younger persons <65 displaying Parkinson's symptoms for its neuroprotective effects: blocking MAO stops DA metabolism, thereby stopping free radical production; but often not initiated in those older patients.

Trihexyphenidyl[anticholinergic] given in younger persons when tremor is the predominant symptom... could get into why it influences tremor more than another initial therapy, like amantadine. Amantadine inhibits DA metabolism and has anticholinergic effects.

DA agonists are good -> dopamine dysregulation syndrome. uncommon but prevalent syndrome of excessive gambling, hypersexuality, punding, etc. in individuals on DA agonists like ropinerole. Very very interesting phenomenon. Also excess somnolence, occasionally "sleep attacks". DA agonists prolong development of dopament dyskinesias... very impt. Dyskinesias develop in those on the typical Sinemet about 3-5 years after starting therapy, DA agonists delay the development of these and are often given before sinemet in younger indviduals for this reason.

Also, some neurologists tell pts to crack their Sinemet CR in half for their morning dose, that way they get the quick initial control of a regular release with some prolonged action of a CR. Interesting strategy to control blood levels.
Since its 45 mins there are a few areas for you to play with there, how one drug is chosen over the other, the interesting side effects [hallucinations, etc], etc.
I used to think you were cool...
 

Requiem

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I used to think you were cool...

Caver man, therapeutics final exam today - that actually helped a lot. Don't hate on my new SDN study method.

Shouldn't you be reporting posts or something? :smuggrin:
 

trx

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I'm considering something for sleep terror... does anyone know of any melatonin agonists or a drug that acts on the melatonin receptors.. other than Ramelteon and agomelatine??

PS Xyrem is interesting..
 

RxWildcat

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another good one would be gabapentin, it has soooo many off label uses you could talk about it for 45 easy.
 

twester

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Forty-five minutes on one drug? We get 20 drugs in 45 minutes! Can you do a presentation on a class of drugs? The atypical antipsychotic drugs are kind of hot right now in that they improve the lives of patients with schizophrenia, but eventually kill them with diabetes and heart disease.
 

WVUPharm2007

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You like brain stuff? I'd go with Tysabri for MS. It has that cool inhibition of T-cell transit mechanism that accidently caused multifocal leukoecephalopathy from JC virus in rare instances there for a while until they made it a super restricted drug. That could be a 45 minute talk, easy.
 

Requiem

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You like brain stuff? I'd go with Tysabri for MS. It has that cool inhibition of T-cell transit mechanism that accidently caused multifocal leukoecephalopathy from JC virus in rare instances there for a while until they made it a super restricted drug. That could be a 45 minute talk, easy.

You're talking about natalizumab, and it doesn't cause PML [progressive multifocal leukoencophalopathy], it had a ridiculously weak association of _2_ patients during a trial. The contraindication is don't use it if you have had or have PML.

It is 60% effective in preventing relapse in Relapsing Remitting form of MS, twice as effective as the standard interferon / glatiramer acetate treatments.
 

Priapism321

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You're talking about natalizumab, and it doesn't cause PML [progressive multifocal leukoencophalopathy], it had a ridiculously weak association of _2_ patients during a trial. The contraindication is don't use it if you have had or have PML.

It is 60% effective in preventing relapse in Relapsing Remitting form of MS, twice as effective as the standard interferon / glatiramer acetate treatments.

Let's not forget about the rapidly spreading tumors that turn up growing out of people's eye balls.

http://www.pharmalot.com/2008/02/biogen-may-have-a-new-tysabri-problem/

And let's not neglect concerns for hepatotoxicity.

http://www.fda.gov/medwAtch/safety/2008/Tysabri_dhcp_letter.pdf
 

Priapism321

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You like brain stuff? I'd go with Tysabri for MS. It has that cool inhibition of T-cell transit mechanism that accidently caused multifocal leukoecephalopathy from JC virus in rare instances there for a while until they made it a super restricted drug. That could be a 45 minute talk, easy.

Could also broaden the topic, and discuss emerging options for the treatment of multiple sclerosis; this would allow you to include the recent New England article describing the utility of B-cell depletion with rituximab, potentially identifying new insight into the pathophysiology of the disease. Or just do a talk on rituximab, it's a pretty cool molecule itself.

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Personally, if I wanted to do a talk on a Psychiatry related topic, my title would be:

"Why SSRI's are probably no better than placebo and the fraudulent data that led the scientific community to believe otherwise."
 

WVUPharm2007

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You're talking about natalizumab, and it doesn't cause PML [progressive multifocal leukoencophalopathy], it had a ridiculously weak association of _2_ patients during a trial. The contraindication is don't use it if you have had or have PML.

It is 60% effective in preventing relapse in Relapsing Remitting form of MS, twice as effective as the standard interferon / glatiramer acetate treatments.

I don't really think you can just say "it doesn't cause PML." It freakin' lowers plasma concentration of immunity cells in the CSF. Logically it would have the potential to affect these processes. Obviously there was an association with it in the general public and they made it super restricted....since then it hasn't been given to the general public but a subset of such. They threw a black box on it prophibiting therapy to the immunocompromised and put it on a monitoring program. And, since then, there have been zero cases.

Though it is quite ironically cruel that in those that acquired PML, the drug they took to stop the demyelinating wound up indirectly causing a secondary infection from an opportunistic virus that itself cases demyelination....
 

trx

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The presentation has to include an intro of the disease state, and critique of 2 trials about it. I'm leaning heavily on Xyrem, the active ingredient is GHB (date rape drug), and it's used for... excessive daytime sleepiness and cataplexy associated with narcolepsy! Counter-intuitive and intriguing.. I haven't done much research on it to understand how this CNS depressant is used for sleepiness. Now, I have to pick the specific indication because I won't have enough time to talk about both. Thanks for the ideas.. keep them coming.. I still have time to change my mind before 5/1.

Could also broaden the topic, and discuss emerging options for the treatment of multiple sclerosis; this would allow you to include the recent New England article describing the utility of B-cell depletion with rituximab, potentially identifying new insight into the pathophysiology of the disease. Or just do a talk on rituximab, it's a pretty cool molecule itself.

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Personally, if I wanted to do a talk on a Psychiatry related topic, my title would be:

"Why SSRI's are probably no better than placebo and the fraudulent data that led the scientific community to believe otherwise."
 

Pharmavixen

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Methadone in addiction treatment!!

For me these days, there's nothing else. Between the jail and the methadone clinic, I've been working 60-hour wks to fill in for someone's stress leave. I think I've gotten enough methadone aqueous solution on me to experience transcutaneous absorption.

"Why SSRI's are probably no better than placebo and the fraudulent data that led the scientific community to believe otherwise."
:thumbup:

Methadone-related fun trivia question: do folks know why citalopram would be preferred over other SSRIs in methadone patients?
 

PharmDstudent

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Methadone in addiction treatment!!

For me these days, there's nothing else. Between the jail and the methadone clinic, I've been working 60-hour wks to fill in for someone's stress leave. I think I've gotten enough methadone aqueous solution on me to experience transcutaneous absorption.


:thumbup:

Methadone-related fun trivia question: do folks know why citalopram would be preferred over other SSRIs in methadone patients?
Citalopram doesn't raise the level of methadone or increase Methadone's effects.
It looks like the other SSRIs, Fluoxetine, Fluvoxamine, Paroxetine, and Sertraline, inhibit CYP-450, which can increase the levels/effects of Methadone.

Methadone can increase the levels of tricyclic anti-depressants.

This is the website that I used.
:D
 

Priapism321

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I'm leaning heavily on Xyrem, the active ingredient is GHB (date rape drug), and it's used for... excessive daytime sleepiness and cataplexy associated with narcolepsy! Counter-intuitive and intriguing.. I haven't done much research on it to understand how this CNS depressant is used for sleepiness. Now, I have to pick the specific indication because I won't have enough time to talk about both. Thanks for the ideas.. keep them coming.. I still have time to change my mind before 5/1.

Better sleep, less daytime sleepiness.

A professor once asked if anyone could come to the board and draw the molecular structure GABA, I raised my hand, and accidentally drew GHB. Some of the females in my class never looked at me the same.
 

Pharmavixen

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Citalopram doesn't raise the level of methadone or increase Methadone's effects.
It looks like the other SSRIs, Fluoxetine, Fluvoxamine, Paroxetine, and Sertraline, inhibit CYP-450, which can increase the levels/effects of Methadone.
Bingo! As a substrate of the totally huge class CYP450 3A4, methadone is affected by all sorts of meds. And because we dispense it as an extemporaneous prep, it doesn't trigger the drug interaction software on the ancient computer system we use.

Same thing with some of the macrolides. Often the techs will fill an rx for something like clarithromycin, and it's sitting there for me to check, the patient standing there waiting, and I have to stop the whole process, cancelling the prescription and phoning the doc to get him/her to change it to azithromycin.

I'm too tired to check this, but one of my colleagues said Anna-Nicole Smith's son died of a mixture of (among other things) methadone and fluvoxamine.

Though when you talk about CP450 interactions, you have to know which interactions are clinically significant. Drs don't care to hear about all the studies that have shown whatever; they want an answer immediately.

We educate our meth patients to tell all docs writing scripts for them that they are on meth (something they don't like to do)
 

PharmDstudent

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Bingo! As a substrate of the totally huge class CYP450 3A4, methadone is affected by all sorts of meds. And because we dispense it as an extemporaneous prep, it doesn't trigger the drug interaction software on the ancient computer system we use.

Same thing with some of the macrolides. Often the techs will fill an rx for something like clarithromycin, and it's sitting there for me to check, the patient standing there waiting, and I have to stop the whole process, cancelling the prescription and phoning the doc to get him/her to change it to azithromycin.

I'm too tired to check this, but one of my colleagues said Anna-Nicole Smith's son died of a mixture of (among other things) methadone and fluvoxamine.

Though when you talk about CP450 interactions, you have to know which interactions are clinically significant. Drs don't care to hear about all the studies that have shown whatever; they want an answer immediately.

We educate our meth patients to tell all docs writing scripts for them that they are on meth (something they don't like to do)
We just talked about the Anna Nicole Smith thing in class. Here's the link: CNN
Supposedly it was the chloral hydrate that did her in. :cool:

Hmmmmm... hopefully they'll tell their doctors that they're on Methadone and not "meth".
Meth-mouth is a very interesting phenomenon that I know very little about. I'll research it later though went I have more free time.
 

Hels2007

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Meth-mouth is a very interesting phenomenon that I know very little about. I'll research it later though went I have more free time.

Looks really ugly... there used to be a few obvious meth abusers coming through the pharmacy where I used to work. All the classic signs were there... we hid our Sudafed from view so we would just tell them we are out, or sell one package and say it was our last one...
 

PharmDstudent

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Looks really ugly... there used to be a few obvious meth abusers coming through the pharmacy where I used to work. All the classic signs were there... we hid our Sudafed from view so we would just tell them we are out, or sell one package and say it was our last one...
I've tried to hide the packages too. Somehow they always get put back on the shelf though. I think a few fell down and behind something this last time. ;)

One of the usual customers with an out-of-state ID bought a pack a few days ago. S/he also bought bags of candy too. This happened right after I posted that comment about meth-mouth. :rolleyes:
 
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