Neglected disease R&D activity in the post-2000 landscape falls into two categories. The first is multinational pharmaceutical company activity conducted on a not-for-profit basis; the second is small-scale activity conducted on a fully-paid or commercial basis by small companies including both Western and developing country firms ; and academics or public institutions. The majority of this activity, by both small and large players, is conducted under the umbrella of Public-Private Partnerships, who are now responsible for three-quarters of all identified neglected disease drug development projects see Figure 1 below ; . Multinationals, small companies and PPPs are discussed in detail. However, less attention is given to the motivations and operations of developing country firms and public academic groups, since the focus of this report is on industry policies or incentives that could be implemented by Western governments or donors.
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Requirements according to hemodynamic responses. Part II: comparing bispectral index in control and magnesium groups. Anesthesiology 2002; 97: 113741. Maehama T, Izena H, Kanazawa K. Management of autonomic hyperreflexia with magnesium sulfate during labor in a woman with spinal cord injury. J Obstet Gynecol 2000; 183: 4923. Dub L, Granry JC. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review. Can J Anesth 2003; 50: 73246, for example, meridia hillcrest hospital.
The aims of contact tracing are: a ; to interrupt the ongoing transmission of infection; b ; to identify people with an infection who may benefit from treatment in order to minimise the likelihood of complications of infection; c ; to provide individual counselling to effect sustained behaviour change among infected people or people at risk of infection; and d ; more generally, to identify and reach populations at particular risk of infection in order to influence community norms. In the case of `minor' STIs, for example, genital warts or herpes, the sole aim may be to educate the contact in order to allay unnecessary anxiety. However, if the contact reports high-risk behaviour screening for other STIs may be indicated. Contact tracing that is undertaken inexpertly or insensitively can alienate individuals and communities and thus work against these aims. The aims are achieved by adhering to high levels of professionalism and assessing each case individually. This requires assessing the biological and social implications of each infection as well as the ethical and legal considerations for each case. Changes in behaviour that have occurred since the HIV AIDS epidemic have largely been achieved due to the constructive partnership between the communities at risk, health care professions and government agencies. Though important, contact tracing is only one component of the strategy to contain the epidemic. The priorities and strategies involved in contact tracing, as well as the special concerns of particular community groups, are outlined in later chapters.
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Inter-individual variability in drug metabolism results from the influence of a myriad of factors including genetic factors and concurrent drug therapy. Advances in recombinant DNA technology have greatly enhanced our understanding of the extent of genetic variation in the P450 superfamily, clarifying the molecular basis of many clinically observed variations in drug response. This second article in the cytochrome P450 series describes our current understanding of genetic variability in the major drug-metabolising P450s, the nomenclature used to describe variant P450 genes, and the clinical significance of such variability. Aust J Hosp Pharm 2000; 30: 102-5 and
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Table 1. Drugs and Drug Interactions Associated with the Serotonin Syndrome. Drugs associated with the serotonin syndrome Selective serotonin-reuptake inhibitors: sertraline, fluoxetine, fluvoxamine, paroxetine, and citalopram Antidepressant drugs: trazodone, nefazodone, buspirone, clomipramine, and venlafaxine Monoamine oxidase inhibitors: phenelzine, moclobemide, clorgiline, and isocarboxazid Anticonvulsants: valproate Analgesics: meperidine, fentanyl, tramadol, and pentazocine Antiemetic agents: ondansetron, granisetron, and metoclopramide Antimigraine drugs: sumatriptan Bariatric medications: sibutramine Antibiotics: linezolide a monoamine oxidase inhibitor ; and ritonavir through inhibition of cytochrome P-450 enzyme isoform 3A4 ; Over-the-counter cough and cold remedies: dextromethorphan Drugs of abuse: methylenedioxymethamphetamine MDMA, or "ecstasy" ; , lysergic acid diethylamide LSD ; , 5-methoxydiisopropyltryptamine "foxy methoxy" ; , Syrian rue contains harmine and harmaline, both monoamine oxidase inhibitors ; Dietary supplements and herbal products: tryptophan, Hypericum perforatum St. John's wort ; , Panax ginseng ginseng ; Other: lithium Drug interactions associated with severe serotonin syndrome Zoloft, Prozac, Sarafem, Luvox, Paxil, Celexa, Desyrel, Serzone, Buspar, Anafranil, Effexor, Nardil, Manerix, Marplan, Depakote, Demerol, Duragesic, Sublimaze, Ultram, Talwin, Zofran, Kytril, Reglan, Imitrex, Meridia, Redux, Pondimin, Zyvox, Norvir, Parnate, Tofranil, Remeron Phenelzine and meperidine Tranylcypromine and imipramine Phenelzine and selective serotonin-reuptake inhibitors Paroxetine and buspirone Linezolide and citalopram Moclobemide and selective serotonin-reuptake inhibitors Tramadol, venlafaxine, and mirtazapine.
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