Current benzodiazepine issues

This article deals with some of the recent evidence bearing on the issues of the liability of benzodiazepines to lead to abuse, dependence, and adverse behavioral effects. Reviews of epidemiological, clinical and experimental literature indicated that the previous conclusion about abuse of these drugs still holds: the vast majority of the use of benzodiazepines is appropriate. Problems of nonmedical use arise nearly exclusively among people who abuse other drugs. Nevertheless, there are reasons for concern about patients who take benzodiazepines regularly for long periods of time. These drugs can produce physiological dependence when taken chronicaly, and although this does not appear to result in dose escalation or other evidence of “psychological dependence,” physiological dependence can result in patient discomfort if drug use is abruptly discontiniued. Also, physicians are currently prescribing shorter-acting benzodiazepines in preference to longer-acting benzodiazepines. The shorter-acting drugs can produce a more intense withdrawal syndrome following chronic administration. Furthermore, rates of use of benzodiazepines increase with age, and elderly patients are more likely than younger ones to take the drug chronically. The clearest adverse effect of benzodiazepines is impairment of memory. This, too, may be particular concern in older patients whose recall in the absence of drug is typically impaired relative to younger individuals, and who are more compromised following drug administration.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46347/1/213_2005_Article_BF02245824.pd

Rx Roulette: combatting counterfeit pharmaceuticals in developing nations

The debate over access to medicines has principally centered on pharmaceutical patents and prohibitively high drug prices. Although a less recognized problem, counterfeit pharmaceuticals are certainly a more insidious barrier to access. Pharmaceutical counterfeiting is an invisible threat, not only by nature, but also because the industry has historically downplayed it. However, that has changed. Pharmaceutical firms now not only readily concede counterfeiting is a threat to their business, but in some cases publicly address their strategies and the anticounterfeiting technologies in use and development. Acknowledging the problem has benefited the industry because it alters the ways in which firms are able to combat counterfeiting, allowing them to more overtly confront the problem. In addition, it allows them to better partner with governments and health advocates since their incentives are aligned in efforts to prevent counterfeiting. In light of the more public and more aggressive campaign against counterfeiting, it is important to examine the variety of strategies firms may utilize to prevent their sale. Through a theoretical model of the market in a representative developing country, several anticounterfeiting strategies are considered. Some strategies appear to be more effective than others in the battle against fake drugs. Copyright © 2007 John Wiley & Sons, Ltd.