Self-medication is defined as the selection and use of medicines by individuals (or a member of the individuals' family) to treat self-recognized or self-diagnosed conditions or symptoms. Several benefits have been linked to appropriate self-medication, among them: increased access to medication and relief for the patient, the active role of the patient in his or her own health care, better use of physicians and pharmacists skills and reduced (or at least optimized) burden of governments due to health expenditure linked to the treatment of minor health conditions However, self-medication is far from being a completely safe practice, in particular in the case of non-responsible self-medication. Potential risks of self-medication practices include: incorrect self-diagnosis, delays in seeking medical advice when needed, infrequent but severe adverse reactions, dangerous drug interactions, incorrect manner of administration, incorrect dosage, incorrect choice of therapy, masking of a severe disease and risk of dependence and abuse. In this short review the author analyzes recent literature on some of the most important dangers related to self-medication practices, particularly: polypharmacy and drug interactions, medications abuse or dependence, misdiagnosis and incorrect choice of treatment. The author also proposes measures that could be adopted in order to solve or improve these issues.
The aim of the present study was to present new evidence supporting the use of saliva as a biological fluid in relative bioavailability studies. Carbamazepine was chosen as a model drug because of its suitability for salivary therapeutic drug monitoring and its well-documented plasma bioavailability. A relative bioavailability study of four different immediate release carbamazepine products was performed. Stimulated saliva samples were collected by chewing on parafilm wax and by the spitting method. In vitro dissolution testing of formulations, using 900 ml of 1% sodium lauryl sulphate in water, was also carried out. The in vitro-in vivo correlations obtained in this salivary study were consistent with previous correlations assessed using plasma. These results support the suitability of saliva as the biological fluid in relative bioavailability studies.
The great efforts of many researchers have brought down some of the barriers that exist to turn a good in vitro compound into a potential in vivo drug. The advent of pharmaceutical nanotechnology has allowed an arsenal of drugs with poor stability, low solubility, high off-target toxicity and other disadvantageous features, to be accessible as pharmaceutical products that could be administered to a patient. Nanotechnology was introduced in drug delivery very long ago, but has flourished with unprecedented intensity during the last twenty years and now a diversity of nano-based preparations are at clinical stage of development or already available in the market. Undoubtedly, nanotechnology plays a key role in future pharmaceutical development and pharmacotherapy. In the first part of this review, we have already discussed recent (2008-2012) patents on linear polymer-based nanosystems (nanogels, nanospheres and nanocapsules) applications to cancer therapy. Here, we have expanded such analysis to branched polymers (dendrimers), self-assembling nanomicelles and lipid-based nanocarriers.
Carbamazepine is a widely used drug associated with numerous side effects including skin eruptions that appear in about 4% of patients. Epicutaneous tests have been used with variable success in skin drug reactions. The purpose of this study was to work out the efficacy of this type of test in carbamazepine reactions. Five patients with carbamazepine cutaneous reaction were studied. Clinical, laboratory and histopathological data were recorded. The 5 patients and 20 controls were tested with carbamazepine 1% in petrolatum. In 4 patients the carbamazepine epicutaneous test was positive. The 20 healthy controls were negative. Epicutaneous testing is a simple and helpful method in detecting carbamazepine hypersensitivity.
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