Archive for June, 2009

Understanding Generic Drugs

If patent protection from a drug is removed or expires any company can manufacture and distribute (sale) it, than it becomes a generic drug. There is no difference in generic and brand name drug in its chemical structure and properties. Brand name drugs and generic drugs are same in terms of its therapeutic use, dosage, route of administration, risks and side effects, safety and strength.

There is a myth about generic drugs that they are less efficacious and poorer quality, but there is no basis in this myth. FDA accepts both as equal in terms of quality and efficacy. The FDA applies the same quality control standards for all drug manufacturing facilities, including facilities that manufacture generic drugs. Many companies manufacture both brand-name and generic drugs in the same facility with approval from FDA. In fact FDA estimates that approximately 50% of the generic drugs are produced and marketed by brand-name companies and most of them use the same manufacturing facilities for both brand-name and generic drugs.

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Diarrhea after International Travel

Diarrhea is the leading cause of illness among travelers during international travel as well as after travel. Many international travelers suffer from diarrhea and other bowel symptoms after travel. Many other illnesses may also develop among travelers after international travel beside diarrhea.

The cause of diarrhea after international travel:

The causes of diarrhea among travelers are different during travel and after travel. During travel the commonest cause of diarrhea is “travelers’ diarrhea”, but after travel the cause is different. The most frequently identified pathogens causing travelers’ diarrhea are enterotoxigenic Escherichia coli and enteroaggregative E. coli, Campylobacter infections, Salmonella (causative agent for typhoid fever and food poisoning), Shigella, rotavirus etc. The common causes of diarrhea after travel are post-infectious sequelae such as lactose intolerance or irritable bowel syndrome. But diarrhea after international travel may also be due to infectious agents such as Giardia lamblia (causative agent for giardiasis), Cyclospora cayetanensis, Entamoeba histolytica (causative agent for amebiasis), although infectious agents account for small proportion of cases with persistent bowel symptoms after travel.

A recent study showed that as many as 4-13% of the travelers may develop diarrhea and other persistent gastrointestinal or bowel symptoms after international travel.

Treatment of diarrhea or other persistent bowel symptoms after travel:

If the causative agent can be identified, it should be treated with appropriate antibiotic therapy. If no infectious etiology can be identified, a trial of metronidazole (400 mg three times a day for 5 to 7 days) therapy for presumed giardiasis and a strict lactose-free diet for 1 week is given or a several-week trial of high-dose hydrophilic mucilloid. The above strategy of treatment is successful in many cases.

Benefits of Generic Drugs

Generic drugs are the drugs which can be produced and sold without the protection of patent, which means any company can start production of generic drugs with permission from a patented party. The freedom from patent has made generic drugs cheaper by several times in compare to patented drugs of same group.

The advantages of generic drugs:

1. Generic drugs can be very cheap, which makes treatment affordable, especially in developing countries.

2. There is no need of permission from a patented party. Any company with capability to produce can start production and start distribution.

3. No procedural delays for production and distribution.

A generic must contain the same active ingredients as the original formulation of the drug. USFDA defines generic drug as “a drug that is identical or bioequivalent to the brand name counterpart in respect to pharmacodynamics (what a drug does to the human body) and pharmacokinetics (what the body does to the drug after taking it or in other words what is the metabolism of the drug). So generic drugs are identical in dose, strength, route of administration, safety, efficacy, and therapeutic use. A drug becomes generic when patent protection afforded to a company expires.

There are many drugs which are now generic drug. Examples of generic drugs are first generation anti-histaminics and many more. Many drugs including many generic drugs are available online these days. You can buy generic as well as patented drugs online. Some drugs like avodart (dutesteride) are extensively sole over the net, online. You can buy avodart online. It is used for treatment of BPH (benign prostatic hyperplasia), which commonly occurs in older men and cause difficulty in passing urine.

Steroids in Sports

Steroids have been used and abused in sports since the discovery of steroids and the discovery of the capability to enhance the performance in sports by steroids, although there are unacceptable side effects of steroids if abused (which is generally the case in sports). International sports authorities like IAAF (international association of athletics federations) have banned the use of steroids in sports, but even after banning the use of steroids some sportspersons are still using them and some of them are spoiling their own carrier.

Clinically steroids are used in many clinical conditions and if used properly they are life saving drugs. But if misused or abused they can cause great harm to the health of the user. Steroids should be used by professional doctors and in appropriate time and dose, but if used indiscriminately without proper knowledge about steroids, they cause irreparable organ damage.

Commonly used steroid in sports are Deca Durabolin (Nandrolone), Winstrol (Stanozolol), Anavar (oxandrolone) etc. and many more are also used.

Nandrolone or Deca Durabolin causes increase in muscle mass and increase in red cell count of blood (thus increase stamina during high performance games and sports). It is sometimes used in treatment of certain types of anemia, osteoporosis in post menopausal women, breast cancer etc.

Winstrol (Stanozolol) is also another steroid which is used in sports, although illegal by international sports regulation. Winstrol is available as tablet (whereas other anabolic steroids are available as injection form) as it is well absorbed orally. It also increases stamina and so used in sports for better performance.

Fever after International Travel

The common medical problems that are encountered after international travel (particularly after returning from a developing country) are diarrhea, fever, respiratory infection, skin diseases etc. to name a few. For proper diagnosis of the cause of fever after international travel, a detailed history should be taken, focusing on the traveler’s exact itinerary, including dates of arrival and departure, exposure history (food indiscretions, drinking-water sources, freshwater contact, sexual activity, animal contact, insect bites), location and style of travel (urban or rural travel, first-class hotel accommodation or camping), immunization history; and use of anti-malarial prophylaxis etc. For proper diagnosis some knowledge of geographic medicine, particularly the epidemiology and clinical presentation of infectious diseases are essential.

Gravity of fever in a traveler:

Fever in a traveler after travel to a malarious area should be considered a medical emergency because death can occur from P. falciparum malaria following an illness of only few days duration. In a traveler with fever malaria should be first diagnosis considered (other important causes of fever after travel include viral hepatitis A and E, typhoid fever, bacterial enteritis, arboviral infections like dengue fever, rickettsial infections including tick and scrub typhus and Q fever, and acute HIV infection, and amebic liver abscess), though “fever from the tropics” does not always have a tropical cause like malaria or other tropical infectious disease. The risk of P. falciparum malaria is highest among travelers those who become develop fever within the first 2 months after return, especially return from Africa or Oceania.

A surveillance study by CDC and the International Society of Travel Medicine showed that among travelers developing fever after return from international travel, malaria was acquired most often from Africa, dengue from Southeast Asia and the Caribbean, typhoid fever from southern Asia, and rickettsial infections like tick typhus from southern Africa.

Anabolic Steroids in Baseball

The use of Dianabol in baseball and other high energy sports is a problem for international as well as nation sports authorities.

Use of performance enhancers in sports is a menace to the spirit of the games. The illegal use of many performance enhancers are becoming common these days and it is taking away the spirit of sports. International sports authorities are trying to stop the menace of sports, but unable eradicate it, although it is to large extent under control.

The commonly used (abused) performance enhancers in sports are anabolic steroids. Among the anabolic steroids Dianabol (Methandrostenolone) and Anavar (oxandrolone) are very commonly used or abused drugs in sports.

The use of Methandrostenolone is commonly seen in body building, baseball, football and other high voltage and high energy sports. The use of Dianabol (Methandrostenolone) was the reason of dominance in many Olympic games by many countries like East Germany and Soviet Union.

Dianabol:

Dianabol or Methandrostenolone is an anabolic steroid which was developed in the US in 1960s and marketed in the US first. The main use of Methandrostenolone was by body builders for building muscle mass very quickly. It was used for this purpose till USFDA banned it. But methandrostenolone is still available in many countries even without prescription in different trade name like Reforvit-b and in many Asian countries and also in many East European countries.

In the early 1960s it was prescribed by the doctors despite any proven clinical application, mainly for the females as tonic. But the masculinising effects of this drug were not acceptable and was slowly stopped. But to these day it is used by professional body builders.

Anavar:

The use of Anavar is not as harmful as that of Dianabol, due to its not very toxic, not very androgenic, mildly anabolic properties. It also has mild effect on the body’s HPTA (Hypothalamic-Testicular-Pituitary-Axis). Though it has mild anabolic properties, it is banned in sports, although still used by some sports person though illegally.