Oral administration of hydrolyzed collagen alleviates pain and enhances functionality in knee osteoarthritis: Results from a randomized, double-blind, placebo-controlled study.

Osteoarthritis (OA) is a major source of chronic pain and disability, representing a significant global health concern that affects 10-15 % of individuals aged over 60, with a higher prevalence among females than males. This investigation aimed to evaluate the impact of a dietary supplement containing collagen peptides (MW 1-3 kDa) on knee OA symptoms and inflammatory biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Adults aged 30-81 years (50 % female) with grade II or III OA and a minimum pain score of 40 on the 0 to 100 visual analogue scale (VAS) were enrolled.

[GENERIC DRUGS: IS BIOEQUIVALENCE SUFFICIENT TO ENSURE QUALITY, EFFICACY AND SAFETY?].

This article is focusing on the current debate that prescription of generic drugs is producing among patients and healthcare professionals. Following European Medicine Agency (EMA) recommendations, a number of generic medicines have recently been withdrawn from the market in Spain. The authorization for these generic drugs was primarily based on clinical studies conducted at GVK Biosciences in Hyderabad, India.

[Genetic biomarkers and personalized medicine: application in cardiovascular pharmacology].

Not all patients respond to drug therapy in a uniform and beneficial fashion. The goal of this article is to describe the contribution of genetic variation to drug response, with a focus on drugs used in cardiovascular therapy. The rapid development of techniques in the area of genome analysis has facilitated identification of new pharmacogenomic biomarkers that can provide predictive tools for improvement of drug response and fewer incidence of adverse drug reactions.

[Drug interactions and clinical relevance: it all began with cheese].

In a drug interaction, the effects of one drug can be increased or decreased or a quite new effect produced by the previous, concurrent or subsequent administration of another substance, including prescription and nonprescription drugs, food, tobacco or alcohol. The effect of the interaction can be desirable, inconsequential, or adverse. The increasing number of drugs available and the increasing use of multidrug therapeutic regimens enhance the potential for drug interactions.

[Generic drugs: we must cut pharmaceutical spending but undertaking drug quality].

The World Health Organization and all drug regulatory agencies (DRA) support the commercialization of generic medicines because they control costs and are irreplaceable therapeutic options in countries lacking the innovator product. Generic drugs are widely considered to be cost-efficient substitutes for brand-name medications. They make up about 20% of the total number of prescriptions in Spain, a figure that is still far from the use of generic drugs in USA and other European countries.

[The pharmacodynamic process: is the drug producing the required effect?].

Pharmacodynamics can be defined as the study of the biochemical and physiological effects of drugs and their mechanisms of action. The objectives of the analysis of drug action are to delineate the chemical or physical interactions between drug and target cell and to characterize the full sequence and scope of actions of each drug. The effects of most drugs result from their interaction with macromolecular components of the organism.

[Pharmacokinetic process: does the site of drug action? Excretion of drugs].

The main route of excretion of drugs is the kidney. Other routes include the lungs; breast milk; sweat; tears, and genital secretions (alarming if the patient is not expecting the orange-red discoloration caused by rifampicin); bile (leading to recirculation of some compounds, for example chloramphenicol, whose inactive metabolites are reactivated by hydrolysis in the gut, morphine, rifampicin, tetracyclines, and digoxin); and saliva (sometimes used in monitoring drug concentrations in body fluids). Three processes determine the renal excretion of drugs: glomerular filtration, passive tubular reabsorption and active tubular secretion.

[The pharmacokinetic process: is the drug getting to its site of action?: Drug metabolism].

In general, drug biotransformation reactions are classified as either phase 1 functionalization (mainly oxidative) reactions or phase 2 conjugation (biosynthetic) reactions. Phase 1 reactions introduce or expose a functional group on the parent compound and generally result in the loss of pharmacological activity. Phase 2 reactions lead to the formation of a covalent linkage between a functional group on the parent compound with glucuronic acid, sultate, glutathione, amino acids, or acetate.

[Volume of distribution of drugs: an apparent data in pharmacology].

Once the drug has been given and reaches the vascular system of the patient, some drugs are distributed only to the body fluids (plasma plus extracellular water), while others are bound extensively in body tissues. Therefore, the volume of distribution of a drug is not a real volume. Indeed, it is an apparent volume giving a mathematical measure and an approach of the extent of tissue distribution of the drug into the body.

[The pharmacokinetic process: is the drug getting to its site of action?: Drug distribution (ADME)].

Many drugs are bound to circulating proteins, usually albumin (acidic drugs), but also globulins (hormones), lipoproteins (basic drugs), and acid glycoproteins (basic drugs). Only the fraction of drug that is not protein-bound can bind to cellular receptors, pass across tissue membranes, and gain access to cellular enzymes, thus being distributed to body tissues, metabolized, and excreted (for example by the kidney). Changes in protein binding can therefore sometimes cause changes in drug distribution.

[The pharmaceutical process: is the drug getting into the patient? Compliance of drug therapy and drug delivery].

There are two important factors that determine whether or not a drug is getting into the patient: compliance-adherence with therapy and systemic availability of the drug. Non-compliance is so common that it should be the first matter to be evaluated when drug therapy appears to be ineffective. On the other hand, when a drug is given orally besides drug absorption and presystemic elimination, there are other factors intrinsic to the formulation (pharmaceutical process) that may affect its ultimate systemic availability The pharmaceutical process is concerned with all those properties inherent in the pharmaceutical formulation and presentation of a drug that determine the speed at which a drug reaches the systemic circulation.

[A rational drug prescription based upon the therapeutic process].

The main goal of the pharmacology is to benefit to the patient through a rational process of drug selection similar to that is carried out for the diagnosis procedure of diseases. Pharmacology is a complex discipline that comprises different sections, pharmacokinetics, pharmacodynamics, pharmacometrics, clinical pharmacology, therapeutics, toxicology and pharmacogenetics. The therapeutic process has four different stages, pharmaceutical, pharmacokinetics, pharmacodynamics and therapeutics, whose right knowledge is the basis for the development and prescription of more effective and safer drugs to the patients.

[Pharmacology general concepts].

It is very important to have basic knowledge, a sufficient critical attitude and an adequate methodology so that a prescription becomes a rational decision and not a purely reflex action. Dispensing pharmaceuticals requires that health professionals have adequate professional development and information since from a health-social-economic perspective therapeutic errors and iatrogenic medicine lead to a very important resource expenditure.