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Encyclopedia of Health and Medicine

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investigational new drug (IND) 159<br />

innovator <strong>and</strong> generic drugs. Generic drugs may<br />

also have trade names, which manufacturers <strong>of</strong>ten<br />

use to establish br<strong>and</strong> recognition <strong>and</strong> br<strong>and</strong> loyalty<br />

for marketing purposes. For example, Elavil<br />

<strong>and</strong> Endep are trade names for amitriptyline, a<br />

commonly prescribed tricyclic antidepressant. The<br />

manufacturer <strong>of</strong> an innovator drug may also produce<br />

<strong>and</strong> market generic versions <strong>of</strong> the drug<br />

when the innovator drug’s patent expires.<br />

In nearly all circumstances a person may take<br />

any manufacturer’s product, generic or innovator<br />

drug, <strong>and</strong> experience the same therapeutic effects.<br />

The only exception is with NARROW THERAPEUTIC<br />

INDEX (NTI) DRUGS, in which the margin between<br />

the therapeutic dose <strong>and</strong> the toxic dose is exceedingly<br />

small. People who take NTI drugs should<br />

always take the same product, whether the innovator<br />

drug or a generic drug. Variations in the<br />

drug’s inactive ingredients can affect how the<br />

body absorbs the drug, which can have therapeutic<br />

significance with NTI drugs.<br />

In its electronic document THE ORANGE BOOK, the<br />

FDA maintains a list <strong>of</strong> newly approved generic<br />

drugs, updated each month, <strong>and</strong> a list <strong>of</strong> all<br />

generic drugs available in the United States. The<br />

Orange Book is available at the FDA’s Web site<br />

(www.fda.gov/cder/ob).<br />

See also INVESTIGATIONAL NEW DRUG (IND); LEGEND<br />

DRUGS; OFF-LABEL USE; SCHEDULED DRUG.<br />

half-life The length <strong>of</strong> time it takes for the body<br />

to metabolize or eliminate from the body 50 percent<br />

<strong>of</strong> the amount <strong>of</strong> a DRUG a person takes or<br />

receives. Drug half-life is an important factor in<br />

determining appropriate DOSAGE <strong>and</strong> for treating<br />

OVERDOSE. Drug half-life also helps the doctor<br />

know when to expect to begin to see the effects <strong>of</strong><br />

the drug. The calculation <strong>of</strong> drug half-life is logarithmic.<br />

Drug informational literature, packaged<br />

with prescription drugs, provides general information<br />

about the drug’s half-life that is generally<br />

adequate for most clinical circumstances. A doctor<br />

may conduct BLOOD tests to measure the levels <strong>of</strong> a<br />

drug in an individual’s blood circulation over a<br />

period <strong>of</strong> time as a means <strong>of</strong> indirectly assessing<br />

half-life, though this is seldom therapeutically<br />

necessary.<br />

See also BIOAVAILABILITY; CYTOCHROME P450<br />

(CYP450) ENZYMES; EFFICACY; METABOLISM; PEAK LEVEL;<br />

THERAPEUTIC LEVEL; THERAPEUTIC WINDOW; TROUGH<br />

LEVEL.<br />

imported drug A DRUG or pharmaceutical product<br />

not manufactured in the country <strong>of</strong> purchase.<br />

Countries may have differing requirements for<br />

testing <strong>and</strong> product safety for the manufacture<br />

<strong>and</strong> distribution <strong>of</strong> drugs within their borders. In<br />

the United States the Food <strong>and</strong> Drug Administration<br />

(FDA) has regulatory authority over drug<br />

production <strong>and</strong> distribution <strong>and</strong> establishes the<br />

st<strong>and</strong>ards for bringing drugs into the country.<br />

The Internet has dramatically broadened access<br />

to foreign markets for drugs. Many Americans are<br />

drawn to Internet purchasing because <strong>of</strong> the ease<br />

<strong>and</strong> convenience <strong>and</strong> because imported drugs are<br />

<strong>of</strong>ten less expensive than the same drugs purchased<br />

in the United States. However, health<br />

experts caution that drugs purchased through<br />

locations in other countries, either by mail order<br />

or via the Internet, may not meet US quality st<strong>and</strong>ards<br />

for purity, potency, <strong>and</strong> safety <strong>and</strong> may not<br />

be legal to bring into the country.<br />

The FDA supports the National Association <strong>of</strong><br />

Boards <strong>of</strong> Pharmacy’s Verified Internet Pharmacies<br />

Web site, www.nabp.net. This system provides<br />

another way for consumers to verify the legitimacy<br />

<strong>of</strong> online pharmacies.<br />

See also GENERIC DRUG; INVESTIGATIONAL NEW DRUG<br />

(IND).<br />

innovator drug The first DRUG containing its specific<br />

active ingredients to receive approval for use<br />

from the US Food <strong>and</strong> Drug Administration<br />

(FDA). An innovator drug’s patent protects the<br />

drug from market competition, giving its manufacturer<br />

exclusive right to produce <strong>and</strong> sell the<br />

drug. The innovator drug’s manufacturer generally<br />

has invested significant time <strong>and</strong> money in<br />

the drug’s development, testing, <strong>and</strong> approval<br />

process. Only when the patent expires may competing<br />

pharmaceutical manufacturers produce <strong>and</strong><br />

market a generic version <strong>of</strong> the innovator drug.<br />

See also GENERIC DRUG; INVESTIGATIONAL NEW DRUG<br />

(IND).<br />

investigational new drug (IND) A new DRUG in<br />

the final phases <strong>of</strong> development for which the US<br />

Food <strong>and</strong> Drug Administration (FDA) grants

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