Interactions of Drugs, Biologics, and Chemicals in U.S. Military Forces (1996) / Chapter Skim
Currently Skimming:
EXECUTIVE SUMMARY
EXECUTIVE SUMMARY
Pages 1-8
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 1... ...
The Institute assembled a committee of experts in pharmacology, drug safety assessment, immunology, vaccinology, epidemiology, biostatistics, occupational health, environmental health, toxicology, and biomedical administration. The names of potential committee members were sought from a variety of sources, and the final committee roster was approved by the chairman of the National Research Council.
|
From page 2... ...
2. What does the published scientific literature tell us about the health effects of combinations of these prophylactic-preventive agents in the U.S.
|
From page 3... ...
Studies can then be extended to in viva animal models, choosing appropriate species and experimental designs. TABLE E-1 Categorical Approach Interaction Type Recommended Approaches Known Potential Unknown · Avoid unless benefit outweighs risk · Use surveillance to monitor outcomes and implement appropriate intervention · Study in depth · Use matrix approach to predict or identify the interaction · Conduct studies (in vitro, animal, or human volunteer)
|
From page 4... ...
Only a very small percentage of all of the scientific literature on interactions has resulted from epidemiologic investigations. The remainder of the literature primarily comprises pharmacokinetic or pharmacodynamic studies with humans and animals, case reports, review articles, animal studies, or in vitro studies Thus, the existing literature provides very little information about how often drug interactions actually occur in humans or how often they produce clinically meaningful adverse effects.
|
From page 5... ...
Opportunities for creating automated multipurpose databases have already been seized; the Army Medical Surveillance Activity and the Uniformed Services Prescription Database Project are two examples. Additional opportunities to create linked databases remain, a fact recognized in the planning for the triservice Defense Medical Epidemiology Database.
|
From page 6... ...
Aside from good surveillance mechanisms, some relatively small prospective studies for example, comparing outcomes before and after deployment-could provide supporting data; however, the amount of support will be directly related the soundness of design and statistical power of such studies. In addition, recent developments in the design and analysis of animal toxicity studies have markedly increased their effectiveness in identifying interactions, and these developments should be used.
|
From page 7... ...
and could be used to support focused prospective studies, provided they are of sufficient sample size, to compare specific health measures before and after deployment.
|
From page 8... ...
, clinical medicine, and the medical defense against biological and chemical warfare weapons should be closely coordinated. An advisory committee should be established to help identify and use existing and future research tools for the purposes of anticipating, studying, and minimizing harmful interactions.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.