Drugs of today
-
Idiopathic pulmonary fibrosis (IPF) is a progressive disease with a dismal prognosis for which, until recently, there were no effective treatments. Pirfenidone (5-methyl-1-phenylpyridin-2[1H]-one) is a novel antifibrotic agent that has been demonstrated to slow disease progression in patients with IPF. In vitro and in vivo animal models of pulmonary fibrosis have shown that pirfenidone exerts its effect by reducing inflammatory cytokines such as TNF-α, by downregulating the transcription of key profibrotic growth factors including TGF-ß, and through reductions in lipid peroxidation and oxidative stress. ⋯ Reported adverse effects include nausea, anorexia and photosensitivity dermatitis. A number of questions remain concerning the long-term efficacy and safety of pirfenidone and whether slowing of lung function decline will translate into improved survival for patients with IPF. These questions notwithstanding, pirfenidone represents an important development in the treatment of IPF and is a much needed addition to the previously inadequate therapeutic armamentarium for this devastating disease.
-
Intramuscular paliperidone palmitate is a long-acting atypical antipsychotic, which is currently marketed in the U. S. for the acute and maintenance treatment of schizophrenia in adults. Paliperidone is the active 9-hydroxy metabolite of risperidone. ⋯ As maintenance therapy, paliperidone palmitate (25-100 mg eq.) was significantly more effective than placebo in delaying the time to first relapse in stable schizophrenia patients. Overall, paliperidone palmitate was shown to be well tolerated. It is available as prefilled syringes embracing a wide dose range (25, 50, 75, 100 and 150 mg eq.), and requires no refrigeration, reconstitution or oral antipsychotic supplementation.