scholarly journals Prescription and use of “equivalent” drugs

2007 ◽  
Vol 1 (2) ◽  
pp. 69-87
Author(s):  
Mario Eandi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Generic Drug ◽  
Generic Drugs ◽  
Case Reports ◽  
Branded Drug ◽  
Italian Context

Three case reports, where an “equivalent” drugs is prescribed, are described: a patient treated with lanzoprazole, a man with acute myocardial infarction and a young man with epilepsy. These reports are emblematic of the doubts and problems that doctors have to afford in the choice of a generic drug instead of a branded drug. The Author examines not only clinical, legislative and economical aspects of prescription of generic drugs in the Italian context, but also common questions that patients may ask when a generic drug is prescribed.

Biventricular Rupture with Extracardiac Left-to-Right Shunt Complicating Acute Myocardial Infarction

Cardiology ◽  
2016 ◽  
Vol 134 (4) ◽  
pp. 389-393
Author(s):  
Sergey Yalonetsky ◽  
Doron Aronson
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Reports ◽  
Interventricular Septum ◽  
Published Data ◽  
Mechanical Complication ◽  
Surgical Closure ◽  
Cardiac Symptoms ◽  
Asymptomatic Patients ◽  
Diagnostic Difficulties

Background: Simultaneous rupture of the left and right ventricles is an extremely rare mechanical complication of acute myocardial infarction (MI). When associated with the formation of a false aneurysm, an extracardiac left-to-right shunt may occur. Methods: We summarized all published data describing this unique condition. We searched the PubMed and Google Scholar databases for case reports in peer-reviewed journals from 1 January 1980 to 1 May 2015. We identified 16 articles describing 17 cases. Results: In all but 1 case, biventricular wall rupture (BVWR) resulted from an inferior MI. The clinical presentations of BVWR were variable and included cardiogenic shock, congestive heart failure and an absence of any cardiac symptoms. In most cases, there was a hemodynamically significant left-to-right shunt, with pulmonary to systemic blood flow (Qp/Qs) >2. Diagnostic difficulties were reported in most cases, and some patients were initially misdiagnosed as having ventricular septal rupture (VSR). Surgical closure of the defect was successful in most cases, and some asymptomatic patients were managed conservatively. Conclusion: BVWR with an intact interventricular septum and extracardiac left-to-right shunt is a rare mechanical complication of acute MI, often misdiagnosed as VSR. It has a variable clinical course, probably related to the magnitude of the shunt.

scholarly journals Syphilitic Coronary Artery Ostial Stenosis Resulting in Acute Myocardial Infarction Treated by Percutaneous Coronary Intervention

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Marcelo A. Nakazone ◽  
Maurício N. Machado ◽  
Raphael B. Barbosa ◽  
Márcio A. Santos ◽  
Lilia N. Maia
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Case Reports ◽  
Coronary Intervention ◽  
Wall Thickening ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Ostial Lesion

Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections which although not frequent, are still causes of morbidity and mortality. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 46-year-old male admitted due to acute anterior ST elevation myocardial infarction submitted to primary percutaneous coronary intervention successfully. Coronary angiography showed a suboccluded ostial lesion of left main coronary artery. VDRL was titrated to 1/512. The patient was discharged with treatment including benzathine penicillin. Previous case reports of acute myocardial infarction in association with syphilitic coronary artery ostial stenosis have been reported, but the fact that the patient was treated by percutaneous coronary intervention is unique in this case.

Therapeutic Equivalence and the Generic Competition Paradox

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Munirul Haque Nabin ◽  
Vijay Mohan ◽  
Aaron Nicholas ◽  
Pasquale M. Sgro
Keyword(s):  
Simple Model ◽  
Generic Drug ◽  
Generic Drugs ◽  
Large Body ◽  
Medical Community ◽  
Therapeutic Equivalence ◽  
Generic Competition ◽  
Branded Drug ◽  
Fda Approval ◽  
Generic Products

Abstract Following the passage of the Waxman-Hatch Act (1984), FDA approval for a generic drug requires the establishment of bio-equivalence between the generic drug and an FDA approved branded drug. However, a large body of evidence in the medical community suggests that bio-equivalence does not guarantee therapeutic equivalence; in some instances the lack of therapeutic equivalence can lead to fatal consequences for patients switching to generic products. In this paper, we construct a simple model to analyze the implications of therapeutic non-equivalence between branded and generic drugs. We show, theoretically and empirically, that this distinction can provide a plausible explanation of the generic competition paradox.

scholarly journals Miopericarditis - diagnostic dilemmas in relation to acute myocardial infarction

2013 ◽  
Vol 66 (9-10) ◽  
pp. 396-400
Author(s):  
Igor Ivanov ◽  
Jadranka Dejanovic ◽  
Olivera Ivanov ◽  
Milovan Petrovic ◽  
Robert Jung ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Significant Contribution ◽  
Clinical Presentation ◽  
Case Reports ◽  
Good Condition ◽  
Diagnostic Dilemma ◽  
Small Series ◽  
Electrocardiographic Changes

Introduction. Miopericarditis with clinical presentation of chest pain, electrocardiographic changes and positive cardio specific enzymes is often a differential diagnostic dilemma in relation to acute myocardial infarction. Literature data are very scarce and only case reports or small series of patients can be found in the literature so each case is a significant contribution to this issue. Case report. A 19-year-old patient was admitted to the intensive care unit, with chest pain, electrocardiographic signs of suspected myocardial lesion and highly positive cardio specific enzymes. Since echocardiography revealed segmental hypocinesia of the left ventricle, urgent coronary angiography was done, which diagnosed normal luminogram of coronary arteries. Having received the adequate therapy, the patient was subjectively asymptomatic, hemodynamically stable, sub-febrile at the beginning of hospitalization. Two weeks after admission, the patient was discharged in good condition with diagnosis of myopericarditis. Conclusion. This case shows that it is sometimes difficult to differentiate acute miopericarditis from acute myocardial infarction only according to anamnesis, clinical, electrocardiographic sings and echocardiography.

scholarly journals INTENSIVE PHARMACOVIGILANCE STUDY, CARRIED OUT IN MEXICAN POPULATION WITH A HISTORY OF ACUTE MYOCARDIAL INFARCTION OR ANGINA TREATED WITH CLOPIDOGREL, GENERIC DRUG, FOR SECONDARY PROPHYLAXIS

2021 ◽  
Vol 10 (5) ◽  
pp. 3666-3672
Author(s):  
H A Arcelia
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adverse Events ◽  
Generic Drug ◽  
Causal Relation ◽  
Oral Treatment ◽  
Fatal Outcome ◽  
Secondary Prophylaxis ◽  
Mexican Population ◽  
Vascular Events

The results obtained from an intensive pharmacovigilance, phase IV, single-center study, with an oral treatment for secondary prophylaxis of acute myocardial infarction or angina with clopidogrel, generic drug, in Mexican population, at a daily dose of 75 mg, alone or associated with acetylsalicylic acid, are described. A total of 60 patients were admitted; 10 patients were discontinued from the study due to different causes. The patients had, at least, 2 comorbidities in addition to heart disease. Among the most important history were obesity 40% and overweight 41.6%; the age range (tenths) with the greatest number of participants was 51 to 60 years with 25 patients, which represents 41.6%. A total of 247 adverse events were reported (57 patients had adverse events) of which 39 (15.7%) events were heart events, 32 (12.9%) vascular events; 14 (5.7%) events were serious, 9 (3.6%) of the serious events were heart events, 2 (0.8%) vascular events and 3 (1.2%) lithiasis; Of the 24 (9.7%) events, than were classified with a possible causal relation with clopidogrel, 1 (0.4%) was classified as serious. All the other events were non-serious. It was, therefore, concluded that generic clopidogrel is safe, and risk possibility should continue to be monitored for the type of disease that patients suffer and that may have a fatal outcome

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