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The dichotomy between pharmacologically-active substances considered legitimate and therefore worthy of regulation as medicines, and also provided as public goods and those considered problematic and therefore deserving of moral and legal opprobrium, prohibition and sanction has informed global regulatory regimes for decades.

Andy Gray, Drug policies and ways of thinking and talking about substances and treatment approaches are changing fast, both at national and international levels.

Targeting eosinophils: severe asthma and beyond | Drugs in Context

Subversions of this dichotomy have lately become more apparent in the public eye — for example, in widespread addiction to opioid painkillers; in the repurposing of pharmaceuticals for pleasure, sedation or sociability; in the scientific legitimation of previously restricted drug alkaloids for medical application. The organizers of this event argue that precise historical understandings of how this dichotomy has worked in practice, in multiple and very different contexts, are necessary in order to map possible alternatives and futures.

To clearly identify who established and maintained classificatory boundaries, what interests lay behind their actions, how they have been challenged, and why it is only now that faith in them seems to be waning are important tasks for historians of health, medicines and modernities, and those working in related fields and disciplines. This event at the University of Johannesburg aims to draw together those addressing the questions below in their research. Targeted delivery modalities have the potential to reduce systemic toxicity whilst simultaneously increasing the dose concentration at the target location, and thus provide an effective lever during lead optimisation and to ensure safety and efficacy in subsequent clinical trials.

These considerations are becoming increasingly relevant with the widespread use of new biologic mechanisms that treat haematological malignancies or act as immune checkpoint inhibitors. In addition, targeted delivery remains particularly desirable for some emerging drug mechanisms such as siRNA and gene-based therapies. However, despite these benefits, the adoption of targeted delivery routes has been slow, presumably because it shifts the technical constraints in the therapy development process from pharma-centric skills in drug lead optimisation to the design of novel medical device technologies that enable consistent, minimally invasive delivery to specific compartments within the body.

In silico time-stepped modelling of drug penetration and dispersion through a tumour following intravenous infusion [2]. And next-generation medical devices are now exploring new solutions. For example, devices are under development to infuse into multiple intratumor locations through a single procedure, to isolate sections of hollow organs for chemotherapy delivery, to overcome flow stagnation and functional shunts in tumour vasculature and to deliver to the lymphatic system for more effective targeting of tumour metastasis and other haematological malignancies.

Effective integration of novel solutions requires a thorough understanding of medical device development and the interaction of the drug with the pathophysiological fluidic and mechanical phenomena encountered along the administration route. These considerations are crucial for clinical trial outcomes and hence must be investigated early to inform the specification for any medical device development. Investigations should employ a combination of in-silico, in-vitro and traditional in-vivo approaches during pre-clinical development to robustly assess the sensitivities of key delivery parameters.

These approaches help to avoid unnecessary device complexity while building confidence in the targeted delivery modality by matching physiology-driven needs to device requirements. Lastly, the delivery device parameters for targeted administration also need to consider the binding kinetics of the drug, which determines the duration of retention required at the target site for sufficient target engagement and therapeutic effect.

The advent of novel immuno-oncologic drugs and the desire to improve the therapeutic efficacy of established chemotherapeutics creates a pressing need within oncology to look beyond the most common options of intravenous and subcutaneous administration to device-based targeted administration modalities. The current situation of low clinical trial success rates and high costs in oncology mean that even small improvements in efficacy through this approach could create significant clinical and economic benefits.

Return to Book Page. Preview — Dementia Beyond Drugs by G. If you could provide a life more affirming and meaningful than current care practices provide, would you do it? Of course, you would! But how? Now the resource you need to make this possible is within your grasp.

Beyond intravenous delivery: choosing better administration routes for oncologic drugs

Dementia Beyond Drugs will enable you to change the way you provide care. Learn what it takes to effect real culture change within residential care settings while If you could provide a life more affirming and meaningful than current care practices provide, would you do it? Learn what it takes to effect real culture change within residential care settings while reducing the administration of psychotropic drugs in the symptomatic treatment of dementia.

Allen Power brings robust medical experience and a unique perspective to the idea of culture change. His eye-opening book challenges all care providers working with individuals with dementia to undertake a true operational change. Take advantage of the many benefits to this fundamental change in the provision of care, including a decrease in the need for mood-altering drugs.

Family members of individuals with dementia and students breaking into the dementia care field will also benefit from the advice offered. Pick up your copy of Dementia Beyond Drugs and help to pioneer true culture change in your care environment today. Your reward will be improved care environments and enhanced, relationship-based interactions. Get A Copy. Paperback , pages. Published January 25th by Health Professions Press.


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Sort order. May 02, Karen Overturf rated it it was amazing. Power describes the effects of Culture Change on those who seemingly are least likely to be affected by the environment they live in.