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The Effectiveness of Drugs in Medicine
Introduction
The term pharmacology refers to the science of drugs; these comprises of its composition, properties, uses and their effects on the body (Mannfred, 2003). Drugs are chemical substances made to influence the physiological and pathological state of the beneficiary. Administration of drugs, usually by a pharmacist to treat respective diseases or conditions is known as pharmacotherapy (Mannfred, 2003). Pharmacology has its major areas of concern which include; pharmacokinetics, referring to the area of pharmacology that deals with drug dosage, administration, absorption, metabolism and excretion (Mannfred, 2003). There is also pharmacodynamics which is a branch of pharmacology that deals with the mechanism of action, pharmacological effects, indications, and contra-indications of drugs usage (Mannfred, 2003).
Excessive or improper use of drugs especially through self administration poses a risk of causing chemical dependency to a person. This effect is brought about by psychoactive or psychotropic contents which are basically chemical substances that affect the functioning of the CNS; in such a case the brain functions are altered resulting to changes in mood, reasoning, consciousness, and behavior.
The major method of treating chemical dependency is normally by use of prescription drugs like oxycontine. Oxycontine is a medication prescribed for injury, attention deficit, hyperactivity disorder (ADD), alcoholism, cocaine addicts and heroin addicts (Mannfred, 2003). Because chemical dependency is a major issue facing our world today it has become an area of major focus in psychomacology. The purpose of this paper is to discuss the five major drugs that are used in treatment of various drug related disorders.
Most treatment programs are implemented through group therapy, individual sessions or a combination of these two. A number of medications are available for treatment of chemical dependency. This include buprenorphine and methadone which are regarded as replacement therapies; others are naltrexone, neurontine /gabapentin, baclofen, nicotine replacement (Rao and Wolfag, 2008).
Methadone
Methadone also known as dolophine, symolodose,physeptone, heptadone etc, is a synthetic opioid used medically as an analgesic and for maintaining anti-addictiveness; it is normally used in patients addicted to opioids (Mannfred, 2003). Methadone is a powerful opioid prescribed for management of opioids addiction only. Methadone is usually manufactured in forms of tablets or liquids, and since it is addictive in nature it is recommended that it be prescribed by a doctor. This drug has side effects like ADD, nausea, vomiting, constipation, excessive sweating, and difficulty in urinating among others symptoms (Mannfred, 2003).
Once it is ingested, methadone is broken down and absorbed in the blood stream from where it is distributed all over the body. The excess that is not needed by the body is stored in the liver and the blood stream. This means that it can stay within the bloodstream for up to 24 hours during which times it supplies the brain cells with drug ingredients necessary to stabilize the body and thereby increase the chances of it efficacy. Once in the blood stream, the metabolized methadone is slowly passed on to the brain where it is absorbed by the opiate receptors (Mannfred, 2003). Research findings indicate that methadone is highly effective when high doses are administered but depends on the level of addiction that is being treated.
Naltrexon
Naltrexon, also known as ReVia, is a powerful semi synthetic opioid receptor drug basically used in management of patients with heroine and other opiate dependencies (Rao, 2008). It is usually sold in generic form as hydrochloride salt called naltrexon hydrochloride; in many countries, the brand name vivitol, which is inform of an injection is much common (Rao, 2008). Naltrexon works by blocking the effects of heroin similar to how methadone works; it is absorbed by the Central Nervous System where it gets attached to the brain receptors and thereby blocks the opiates from attaching themselves (Rao, 2008). Since it is partially an opiate it is unlikely to cause addiction among patients.
This is referred as competitive inhibition since the intention is to have naltrexon combine with the appropriate brain receptors and thereby mimic the feelings caused by heroin rather than having the actual drug do so. It has a few side effects like insomnia, drowsiness anxiety among others but none of them are serious (Rao, 2008). It is most appropriate since it does not cause any dependency effect; therefore, even after taking it for a long period, one can suddenly stop without risk of suffering from withdrawal symptoms (Gennaro 2001).
Buprenorphine
Buprenorphine, also known as subuxone or subutex is a sublingual tablet which means it dissolves in the tongue facilitating direct absorption of the active ingredients through the epithelium membrane of the mouth (Gennaro, 2001). This drug comes into two prescription forms: 2mg buprenorphine with 0.5 naloxone and 8mg buprenorphine with 2mg naloxone (Rao, 2008).
In its pharmacological application, buprenorphine is considered as an apioid agonist which treats partially; this means that although buprenorphine is an apioid and thus can produce typical opioid agonist side effects such as euphoria and respiratory depression, its effects are less than those of full agonists like methadone (Gennaro, 2001).
However, at low prescribed amounts, buprenorphine is very effective in treating opioid addicted persons because it has almost non-existent withdrawal symptoms (Gennaro, 2001). Nevertheless, when treating addicts increasing buprenorphine dosage consequently increases its agonist effects up to a level where moderate dose application does not cause a corresponding increase on its efficacy. This level is known as the ceiling effect to mean that the saturation of the drug in the blood has occurred (Gennaro, 2001); however, buprenorphine has been recommended for treating patients with mild addiction problems because there is lower risk of abuse among this group compared to full addicted agonists (Gennaro, 2001)
Gabapentine
Gabapentine is usually branded as a neurontine and is specifically an inhibitory transmitter in the central nervous sytem (Gennaro, 2001). It was previously used to treat epilepsy since it has the added advantage relieving neuropathic pain and other major depression disorders. Gabapentine is believed to function by disrupting and blocking formation of new synapses; these are junctions that allow a neuron to pass an electrical or chemical signal to other cells in the central nervous system (Gennaro, 2001). In addition, gabapentine is effective in treatment of myriad of other withdrawal symptoms since it decreases the effect of these symptoms on the body and in general relieves patients of pain. Its side effects include; drowsiness, tiredness, headache and blurred vision (Gennaro, 2001).
Varenicline
Varenicline also known as chantix is a medication used in management of nicotine addiction (Mannfred, 2003). This drug acts on the brains nicotine receptors by nabbing and reducing the severity of withdrawal symptoms and therefore making one to stay longer without smoking (Mannfred, 2003). This drug is thus a partial agonist since it reduces both the urge to smoke as well as the perceived pleasure of smoking. In addition, latest research finding indicate that varenicline also reduces cravings on smoking among heavy drinkers (Mannfred, 2003). Current research findings indicate that the efficacy of this drug is above average; one research study indicates that it has a success rate of above 80% among patients treated with this drug (Mannfred, 2003).
Co-occurring Disorders
Co-occurring disorders are conditions associated with substance abuse victims whereby at least one or more disorders will be evident in the victim. However this requires clear diagnosis so as to ensure correct prescription is offered.
There is specific psychomacological treatment for each mental illness. In addition, psychotic disorders require a psychotropic agent like quetiapine. Depression would require use of relatively safe profiles (SSRIs) whereby use of venlafaxine or buproprion is necessary (Kenneth, 2005). Secondly, bipolar disorders would require use of mood stabilizers or combination that would suit the patients needs. Valproate, oxycarbamezepine or olaricapine would be appropriate to individuals suffering such disorders (Kenneth, 2005).
Another co-occuring disorder is ADD also known as ADHD; bapropion is used in the early stages of this disorder and then later atomexine is used. Anxiety disorders require use of venlafaxine, busprine and cloridine which are good at stabilizing moods. Topiramate is quite effective at managing nightmares and flashbacks. Lastly sleep disorders will require use of non-addictive sedating medications such as trazodon. (Kenneth, 2005).
References
Gennaro, O. (2001). Assessment and treatment of chemical dependency. California: Bernes & Noble.
Kenneth, M. (2005). Psychopharmacology Practice Guidelines for Individuals with Co-occurring Psychiatric and Substance Use Disorders. Web.
Mannfred. A.H (2003). Introduction to pharmacology. London: Taylor& Francis Books Ltd.
Rao, S.R & Wolfganga S (2008). Drug addiction: from basic research to therapy. Ohio: South-Western.
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