The use of performance-enhancing substances by athletes is not a contemporary epi- demic. In fact, athletes purportedly resorted to such measures over 2000 years ago. Even at the ancient olympic games, athletes employed special diets and concoctions to enhance their performance. In ancient Rome and ancient Egypt, gladiators and athletes ingested various potions in order to improve their physical endurance. In most in- stances, such early examples of substance abuse by athletes involved relatively in- nocuous chemicals, and one might presume that any enhanced performance could be attributed largely to a placebo effect. Nowadays, aside from the ethical issues, these performance-enhancing substances are far more potent and hence toxic to the body. The many performance-enhancing chemicals, drugs, and hormones exert a variety of complex pharmacological actions, but all are meant in some fashion to improve phys- ical ability. Their pharmacological effects ranges from imprOVed muscle strength, as in the case of anabolic steroids and growth hormone, to central nervous system stimula- tion, as in the case of caffeine or amphetamine. Analgesics or other pain-killing drugs may also be used to suppress an existing injury in order that the athlete may compete.
The future place of medicines in health care is both exciting and uncertain. With an aging population, an increasing number of chronic sick, a growing range of treatment options and a developing European market, the one certainty is that medication patterns will change radically over the next 15 years or so. How the future might look, in terms of quality, volume and cost of pharmacotherapy, is the subject of this report.
Four scenarios for the future are set out, all of which take account of already visible trends. Sobriety in sufficiency envisages rational and restrained consumption patterns. Risk of avoidance is dominated by fears of iatrogenic harm and hence minimal drug use. The central feature of Technology on demand, in contrast, is confidence in technological progress. Free market unfettered, finally, is marked by a Europe without frontiers and minimal state intervention.
The reader is encouraged to reflect without preconceptions on the future of medicines in health care. No ready-made answers are offered; rather, a wealth of information and analysis is provided which serves to underpin decision making and policy development, not just by central government but also by every institution concerned with the role of medicines in health care.
HISTORICAL BACKGROUND The use of genetic animal models in neuroscience and biomedical research is showing dramatic growth. The earliest application of these models to research on drug mechanisms was in the area of alcohol research. Mardones (1951) reported successful selective breeding of rats preferring and not preferring to drink alcohol under various conditions of dietary deficiency, suggesting genetic control of alcohol drinking. McClearn and Rodgers (1959, 1961) described differences among inbred mouse strains in preference for 10Ofo ethanol solutions versus tap water. Active exploration of this phenomenon continued until the early 1970s, eventually spawning the entire range of alcohol genetic research reviewed in Chapters 2 and 3 of this volume. Notably, oral alcohol self-administration has served as the basis for the development of several rat lines bred for preference or aversion, and these lines are very actively being investigated. The pioneering research of Dr. McClearn and others was very wide- ranging in its conceptual scope and at least touched on all issues currently under intense investigation. The basic approach was to identify high and low preferrers among inbred strains of mice and to search for preference correlates in other traits. One major thrust of early research was to attempt to explain strain differences in preference as a function of underlying differences in patterns of caloric utilization. Reviews of these studies concluded that nutritional factors could not completely explain preference differences (Rod- gers, 1966; McClearn, 1968).
Cosmeceuticals are the latest additions to the health industry and have an ever-expanding market. They are considered to be a marriage between cosmetics and drugs and are defined as preparations applied on the body that may modify the physiological functions of the skin. However, as more cosmeceuticals are being launched in the market and more types of drugs are incorporated into the formulation, the composition of cosmeceuticals is becoming more complex. Handbook of Cosmeceutical Excipients and their Safeties summarises the current evidence relating to cosmeceuticals' side effects and highlights the important information that practitioners and consumers need to know, as well as ways to avoid the adverse effects of the excipients. Handbook of Cosmeceutical Excipients and their Safeties includes chapters covering topics such as the history of cosmeceuticals and the laws that regulate them, skin permeation, carcinogenicity as a systemic adverse effect and dermatitis as a topical adverse effect. It concludes with an appendix that gives brief information on the potency and permeability of common ingredients in cosmeceuticals. The appendix aims to highlight the maximum allowable quantity of each ingredient to ensure product safety for consumers. The appendix was prepared by compiling the ingredients of 257 products containing more than 500 compounds, collected from a hospital pharmacy in Singapore.
Hyperbaric oxygen application has now become a useful technique for both diagnostic and therapeutic purposes in CNS, cardiovascular and respiratory diseases, as well as in soft-tissue and orthopaedic pathologies and haematologic disorders. With a specific didactic approach, supported by numerous illustrations and tables, this volume aims to present all aspects of oxygen application under pressure not only to resolve some clinical problems, but also to improve recovery or to modify a negative illness evolution. Both scientists and practitioners will find this work a useful and updated reference book.
Alkaloids are a major group of natural products derived from a wide variety of organisms and are widely used as medicinal and biological agents. This series is world-renowned as the leading compilation of current reviews of this vast field.Volume 56 presents the Proceedings from the First International Conference on Ibogaines, held in November of 1999 at New York University's School of Medicine. In essence, it presents significant new data on neurobiological, clinical, sociocultural, and policy aspects of ibogaine. Ibogaine is a natural product derived from the bark of the root of the African shrub Tabernathe iboga. It has a history of use as a medicinal and ceremonial agent in West Central Africa, and has been alleged to be effective as a treatment for substance dependence. The study of Ibogaine may shed light on the neurobiology of addiction and lead to the development of new medication for the treatment of addiction. Currently, there is lack of formal approval for the use of ibogaine, and the demand of the addicts themselves has led to a distinctive unofficial network which has provided ibogaine treatment in non-medical settings. If critical safety concerns can be adequately addressed, ibogaine may provide an inexpensive and practical treatment approach, well adapted to environments where resources are severely limited and there is pressing need for clinical services for heroin addicts, such as Eastern Europe.
The field of the excitatory amino acids was born when L-glutamate and L-aspartate were found to be potent convulsants (Hayashi, 1954), and were subsequently found to excite neurons directly (Curtis, Phillis, and Watkins, 1959). Although these studies initiated the hypothesis of glutamate-mediated neurotransmission, it was noted that the ubiquitous actions of glutamate could also reflect a general, nonspecific property of glutamate on neuronal mem- branes. It was not until 20 years later that pharmacological, physiological, and biochemical studies provided convincing evidence for a neurotransmitter role for glutamate in the mammalian central nervous system (CNS). With the critical demonstration that the pharmacologically defined glutamate receptors mediate synaptic currents, glutamate rapidly became widely accepted as a majorneurotransmitter by the mid-1980s. This breakthrough, together with the simultaneous findings that glutamate receptors are involved in many essential, as well as pathological, processes in the CNS, instantly transformed the study of glutamate receptors into one of the fastest-growing and most exciting areas of neuroscience. With the cloning of numerous ionotropic glutamate receptor subunits over the last six years, the field has experienced another dramatic acceleration in the understanding of receptor action and in providing the first clear insights into the molecular bases underlying the wealth of pharmacological and physiological data on these receptors.
This collection of impassioned essays, published between 1973 and 2006, chronicles Thomas Szasz's long campaign against the orthodoxies of "pharmacracy," that is, the alliance of medicine and the state. From "Diagnoses Are Not Diseases" to "The Existential Identity Thief," "Fatal Temptation," and "Killing as Therapy," the book delves into the complex evolution of medicalization, concluding with "Pharmacracy: The New Despotism." In practice, society must draw a line between what counts as medical practice and what does not. Where it draws that line goes far in defining the kinds of laws its citizens live under, the kinds of medical care they receive, and the kinds of lives they are allowed to live.
It is the goal of The Metabotropic Glutamate Receptors to provide acomprehensive and forward-thinking review ofthe tremen- dous advances that have occurred in less than a decade of metabotropic glutamate receptors (mGluR) research. Virtually every areaof mGluR research is covered, including the molecular biology, pharmacology, anatomical distribution, and physiological and pathological roles of mGluRs. It is our intention that this volume not only summarize what is now known about the mGluRs, but also illuminate the areas in which there is the greatest need for focused research. Glutamic acid is an amino acid that has long been known to play several important metabolic roles in central and peripheral tissues and to be a component of several naturally occurring molecules. The first evidence that glutamate mayaIso serve as a neurotransmitter in the central nervous system (CNS) came in the late 1950s and early 1960s when glutamate and other acidic amino acids were found to induce behavioral convulsions when topically applied to the cortex and to excite a wide variety of central neurons. These findings spurred a massive research effort that quickly established glutamate as the pri- mary excitatory neurotransmitter in the vertebrate CNS. One of the most striking characteristics of glutamate that was quickly recognized was its ubiquitous role in serving as the neurotransmitter at the vast majority of excitatory synapses in the brain. It is now clear that most central neuronal circuits involve glutamatergic neurotransmission at some level.
This second edition of a global bestseller has been completely redesigned and extensively rewritten to take into account the new Quality by Design (QbD) and lifecycle concepts in pharmaceutical manufacturing.As in the first edition, the fundamental requirements for analytical method validation are covered, but the second edition describes how these are applied systematically throughout the entire analytical lifecycle. QbD principles require adoption of a systematic approach to development and validation that begin with predefined objectives. For analytical methods these predefined objectives are established as an Analytical Target Profile (ATP). The book chapters are aligned with recently introduced standards and guidelines for manufacturing processes validation and follow the three stages of the analytical lifecycle: Method Design, Method Performance Qualification, and Continued Method Performance Verification. Case studies and examples from the pharmaceutical industry illustrate the concepts and guidelines presented, and the standards and regulations from the US (FDA), European (EMA) and global (ICH) regulatory authorities are considered throughout. The undisputed gold standard in the field.