The Experts below are selected from a list of 58125 Experts worldwide ranked by ideXlab platform
Matthew L Banks - One of the best experts on this subject based on the ideXlab platform.
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Modulation of Drug Choice by extended Drug access and withdrawal in rhesus monkeys: Implications for negative reinforcement as a driver of addiction and target for medications development.
Pharmacology biochemistry and behavior, 2017Co-Authors: S Stevens Negus, Matthew L BanksAbstract:Chronic Drug exposure is hypothesized to recruit negative reinforcement processes that increase the magnitude and alter the mechanisms of Drug reinforcement. Candidate substrates of negative reinforcement include increased signaling via stress-related neurotransmitters such as corticotropin releasing factor (CRF, acting at CRF receptors) or dynorphin (acting at kappa opioid receptors) and/or decreased signaling via reward-related neurotransmitters such as dopamine. Determinants of Drug reinforcement can be examined with Choice procedures, in which subjects choose between a Drug of interest (e.g. heroin or cocaine) and a non-Drug alternative reinforcer (e.g. food). This review summarizes evidence collected from studies of Drug Choice in rhesus monkeys to address the negative reinforcement hypothesis. In monkeys choosing between heroin and food, chronic heroin exposure and subsequent withdrawal produces a robust increase in heroin Choice. This withdrawal-associated increase in heroin Choice is blocked by morphine and by other mu opioid agonists used to treat opioid use disorder (methadone, buprenorphine); however, withdrawal-associated increases in heroin Choice are not reliably blocked by antagonists of CRF or kappa opioid receptors or by an indirect dopamine agonist. In monkeys choosing between cocaine and food, chronic cocaine exposure and withdrawal fail to increase cocaine Choice or alter sensitivity of cocaine Choice to treatment with candidate therapeutics including an indirect dopamine agonist and a kappa opioid receptor antagonist. These results support a role for negative reinforcement in self-administration of heroin but not cocaine. The constellation of neurobiological changes that constitutes the negative reinforcing stimulus in opioid-dependent rhesus monkeys remains to be determined.
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Preclinical Determinants of Drug Choice under Concurrent Schedules of Drug Self-Administration
Advances in Pharmacological Sciences, 2012Co-Authors: Matthew L Banks, S Stevens NegusAbstract:Drug self-administration procedures have played a critical role in the experimental analysis of psychoactive compounds, such as cocaine, for over 50 years. While there are numerous permutations of this procedure, this paper will specifically focus on Choice procedures using concurrent schedules of intravenous Drug self-administration. The aims of this paper are to first highlight the evolution of Drug Choice procedures and then review the subsequent preclinical body of literature utilizing these Choice procedures to understand the environmental, pharmacological, and biological determinants of the reinforcing stimulus effects of Drugs. A main rationale for this paper is our proposition that Choice schedules are underutilized in investigating the reinforcing effects of Drugs in assays of Drug self-administration. Moreover, we will conclude with potential future directions and unexplored scientific space for the use of Drug Choice procedures.
Lynn Weekes - One of the best experts on this subject based on the ideXlab platform.
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The Application of Adverse Drug Reaction Data to Drug Choice Decisions Made by Pharmacy and Therapeutics Committees
Drug Safety, 1998Co-Authors: Lynn WeekesAbstract:Pharmacy and Therapeutics (P&T) committees undertake policy, regulatory and educational activities to promote rational use of medicines in their institutions with the aim of improving the quality of health and economic outcomes at these institutions. Formulary management is an important part of the P&T committees’ activities and making Drug Choices is one of the committees’ most difficult tasks. The 3 types of information most commonly identified by P&T committees as necessary for making Drug Choices are effectiveness, safety and cost data; usually in this order of importance. There is some evidence, however, that safety data are not considered by all committees when they make decisions about adding a new Drug to a formulary. The role of adverse Drug reaction (ADR) data in formulary decision-making (for registered Drugs) occurs at several levels. First, ADR data obtained from pre-marketing studies of the Drug are important and enable the committee to make an assessment of the risk of toxicity that should be anticipated for the Drug. However, the limited nature of this information makes an absolute assessment impossible. Secondly, comparative safety information is necessary when deciding the place in therapy of a particular Drug. Weighing up the comparative risks and benefits is a complex task which is a routine activity for most P&T committees whatever level of sophistication is applied. Thirdly, ADR data are an important ingredient of any economic assessment considered by a P&T committee. Calculation of the costs and consequences associated with the adverse effects of treatment demand careful assessment. Finally, aggregated adverse Drug event reports which collate not only the consequences of adverse Drug reactions but also medication incidents (medication errors) and which have been reported locally can be a useful quality assurance process for a P&T committee. This information will contribute to the identification of Drugs for deletion from the formulary and less commonly in making decisions about additions to the formulary. As formulary management forms only part of a P&T committee’s work, so the committee’s interest in ADR is broader than the use of these data in making Drug Choices. The P&T committee may also be involved in promoting ADR reporting to either a central database or primary carers. Although often of limited availability, ADR information has an important role in the formulary management process of P&T committees.
Richard O. Day - One of the best experts on this subject based on the ideXlab platform.
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The application of adverse Drug reaction data to Drug Choice decisions made by pharmacy and therapeutics committees an Australian perspective
Drug safety, 1998Co-Authors: Lynn M. Weekes, Richard O. DayAbstract:Pharmacy and Therapeutics (P&T) committees undertake policy, regulatory and educational activities to promote rational use of medicines in their institutions with the aim of improving the quality of health and economic outcomes at these institutions. Formulary management is an important part of the P&T committees’ activities and making Drug Choices is one of the committees’ most difficult tasks.
S Stevens Negus - One of the best experts on this subject based on the ideXlab platform.
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Modulation of Drug Choice by extended Drug access and withdrawal in rhesus monkeys: Implications for negative reinforcement as a driver of addiction and target for medications development.
Pharmacology biochemistry and behavior, 2017Co-Authors: S Stevens Negus, Matthew L BanksAbstract:Chronic Drug exposure is hypothesized to recruit negative reinforcement processes that increase the magnitude and alter the mechanisms of Drug reinforcement. Candidate substrates of negative reinforcement include increased signaling via stress-related neurotransmitters such as corticotropin releasing factor (CRF, acting at CRF receptors) or dynorphin (acting at kappa opioid receptors) and/or decreased signaling via reward-related neurotransmitters such as dopamine. Determinants of Drug reinforcement can be examined with Choice procedures, in which subjects choose between a Drug of interest (e.g. heroin or cocaine) and a non-Drug alternative reinforcer (e.g. food). This review summarizes evidence collected from studies of Drug Choice in rhesus monkeys to address the negative reinforcement hypothesis. In monkeys choosing between heroin and food, chronic heroin exposure and subsequent withdrawal produces a robust increase in heroin Choice. This withdrawal-associated increase in heroin Choice is blocked by morphine and by other mu opioid agonists used to treat opioid use disorder (methadone, buprenorphine); however, withdrawal-associated increases in heroin Choice are not reliably blocked by antagonists of CRF or kappa opioid receptors or by an indirect dopamine agonist. In monkeys choosing between cocaine and food, chronic cocaine exposure and withdrawal fail to increase cocaine Choice or alter sensitivity of cocaine Choice to treatment with candidate therapeutics including an indirect dopamine agonist and a kappa opioid receptor antagonist. These results support a role for negative reinforcement in self-administration of heroin but not cocaine. The constellation of neurobiological changes that constitutes the negative reinforcing stimulus in opioid-dependent rhesus monkeys remains to be determined.
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Preclinical Determinants of Drug Choice under Concurrent Schedules of Drug Self-Administration
Advances in Pharmacological Sciences, 2012Co-Authors: Matthew L Banks, S Stevens NegusAbstract:Drug self-administration procedures have played a critical role in the experimental analysis of psychoactive compounds, such as cocaine, for over 50 years. While there are numerous permutations of this procedure, this paper will specifically focus on Choice procedures using concurrent schedules of intravenous Drug self-administration. The aims of this paper are to first highlight the evolution of Drug Choice procedures and then review the subsequent preclinical body of literature utilizing these Choice procedures to understand the environmental, pharmacological, and biological determinants of the reinforcing stimulus effects of Drugs. A main rationale for this paper is our proposition that Choice schedules are underutilized in investigating the reinforcing effects of Drugs in assays of Drug self-administration. Moreover, we will conclude with potential future directions and unexplored scientific space for the use of Drug Choice procedures.
Joseph Jackson - One of the best experts on this subject based on the ideXlab platform.
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effect of initial Drug Choice on persistence with antihypertensive therapy the importance of actual practice data
Canadian Medical Association Journal, 1999Co-Authors: Jaime J Caro, Maribel Salas, Gabriel Raggio, Jeanne L Speckman, Joseph JacksonAbstract:BACKGROUND: Rational medical decisions should be based on the best possible evidence. Clinical trial results, however, may not reflect conditions in actual practice. In hypertension, for example, trials indicate equivalent antihypertensive efficacy and safety for many medications, yet blood pressure frequently remains uncontrolled, perhaps owing to poor compliance. This paper examines the effect of initial Choice of treatment on persistence with therapy in actual practice. METHODS: The authors examined all outpatient prescriptions for antihypertensive medications filled in Saskatchewan between 1989 and 1994 by over 22,000 patients with newly diagnosed hypertension whose initial treatment was with a diuretic, beta-blocker, calcium-channel blocker or angiotensin-converting-enzyme (ACE) inhibitor. Rates of persistence over the first year of treatment were compared. RESULTS: After 6 months, persistence with therapy was poor and differed according to the class of initial therapeutic agent: 80% for diuretics, 85% for beta-blockers, 86% for calcium-channel blockers and 89% for ACE inhibitors (p
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CVA3 Adherence to Hypertension Therapy: The Effect of Initial Drug Choice
Value in Health, 1998Co-Authors: J. Jaime Caro, Jl Speckman, Maribel Salas, Gabriel Raggio, Joseph JacksonAbstract:Clinical trials of antihypertensive medications have generally found good efficacy and similar safety among the many available agents. However, non-experimental studies of hypertension have often found that a large proportion of hypertensive patients remain uncontrolled, perhaps due to lack of adherence with therapy. The results of clinical trials, therefore, may not entirely accord with the realities of hypertension treatment. OBJECTIVE: To determine if adherence with antihypertensive therapy depends on the initial Drug prescribed. METHODS: A large database (over 3 million Drug dispensings) containing information on 79,591 hypertensive patients in Saskatchewan, Canada, was used to analyze the patterns of Drug therapy. The medication regimen, including changes and lack of adherence (temporary and permanent), was deduced from information on each agent (e.g., minimum daily dosage), and Drug dispensings. Kaplan-Meier survival analysis was used to compare cumulative persistence rates. Cox regression was used for controlled analysis. RESULTS:Among 22,198, newly diagnosed hypertensive patients, over 20% discontinued medication within the first year. The rates varied by initial Drug class, from 26% among patients beginning with a diuretic to 17% when an angiotensin converting enzyme inhibitor was used first (p>0.001). This divergence remained significant when controlling for baseline differences among the groups in age, sex, and prior level of medicalization. Change in the therapeutic regimen were also associated with increasing levels of discontinuation (p < 0.05). CONCLUSION: These results suggest that the Choice of initial Drug, and changes made to the therapeutic regimen, may be important determinats of patient adherence to therapy. In this case, physicians should consider results of actual practice studies, together with clinical trial results, in making therapeutic Choices.
