SINCE World war 2, medical science has progressed to some stage where competitive medications are around to treat exactly the same ailment in numerous people. It’s not just about brands (the industry trade issue) but generic drugs (the industry scientific issue). On this report, we shall go through the various factors that decide selecting a selected drug.

Safety: The following sub-criteria must be considered underneath the criterion of safety:

* Acute therapeutic index: In the event the patient’s condition is acute, how effective is often a particular drug regardless of whether it’s got certain side-effects providing the acuteness in the condition is lowered? Example: narcotic pain-killers are very effective in healing pain but come with the opportunity side-effect of addiction.

* Long-term safety: medicine may be safe in short-term treatment, so how safe it’s in long-term treatment? Example: antibiotics are acceptable in short-term treatment, but can have undesirable effects in the case of prolonged use.

* Drug-drug interaction risk: Drugs are chemicals, and lots of chemicals respond to create a different chemical, which has an effect which could harm the person or aggravate his/her condition. Example: A tricyclic anti-depressant and alcohol interact to generate a new condition that warrants separate treatment.

Drug-drug interaction risk is of 2 types:

· Pharmacokinetic: In this kind of drug-drug interaction, two drugs, independent of each other, have certain effects using one or even more body processes (e.g., metabolism) that affects the performance in the other. Example: Darvocet-N (propoxyphene and acetaminophen) inhibits the action of a liver enzyme that Lexapro (escitalopram) is dependent upon for the metabolism. This causes a rise in the side-effects of Lexapro.

· Pharmacodynamic: Here, a couple of drugs actually make the same influence on exactly the same organ, thus increasing the total, added effect. Example: Lexapro has certain side-effects such as drowsiness and fatigue. Darvocet-N also acts similarly on the brain. Thus, the side-effects of the two medicines are more intense.

Tolerability: A medicine may be effective but not tolerable by all patients. Example: Allergies to specific drugs in certain people. Short-term and long-term tolerability must be considered. Efficacy: A medicine is just not equally good at all patients. As an example, some patients with depression or panic attacks experience relief from escitalopram, but there are several who don’t, who therefore must be prescribed another anti-depressant. The rate of onset of therapeutic action is a factor to be looked at too.

Cost: Cost does not necessarily mean the cost of purchase of a specific medicine alone. It will also cover the cost of treatments for a complication which could arise by using another drug. Example: In the individual who insists on taking alcohol but must be treated for depression is generally administered an SSRI drug because these drugs don’t potentiate the end results of alcohol, whereas another band of anti-depressants (such as tricyclics) could cause a brand new overuse injury in such patients, which will need a different and expensive treatment. Therefore, it’s safer to prescribe the more expensive escitalopram instead of a cheaper tricyclic in this patients.

Simplicity of treatment: The easiest mode of administration is preferred. If you have a choice between a shot and oral administration, aforementioned is preferred when the efficacy of the two modes is comparable. Or, local application is preferred to the oral route where possible; e.g., antibiotic treatments for eye infections. Dosage and frequency of administration too are key point to decide simple treatment.
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