Pharmacology (Drug Profile Midazolam) Essay Example | Topics and Well Written Essays - 2750 words

Pharmacology (Drug Profile Midazolam) - Essay Example b) Oral administration is also done for short term treatment. This is done mainly for the insomnia patients. c) Midazolam is also indicted for the management of schizopernia. 3. Midazolam is found to interact with many drugs. The drug interaction is found to either increase the activity or decrease the activity of Midazoalm. The drug interaction occurs mainly with the antipsychotic medications, barbiturates, antibiotics and antifungal, cimetidine, Diltiazem, Narcotics, Seizure and Sleep medications, alcohol and antidepressant medicines such as Antipsychotic drugs include: Aripipraxole , asenapine, chlorpromazine, clozapine, fluphenazine, haloperidol, Iloperidone, loxapine, lurasidone, molindone, olanzapine, paliperidone and perphenazine and pimozide. Barbutarates include: Amobarbital, Butalbital, Pentobarbital and Secobarbital. Antibiotics such as Clarithomycin, Erythromycin, Isoniazid, Itraconazole , ketoconazole and Telithromycin. Narcotics such as morphine and oxycodone are used i n combination with Midazolam. (drugs.emedtv.com) The pharmacokinetic drug interactions are found to occur based on the enzymes involved in the metabolism. The drug interaction with the CNS depressants such as alcohols, opioids and barbiturates are found to have lethal, clinical and forensic consequences with midazolam. Many studies have found that this interaction results in death. (Mozayani and Raymon 2004). Similarly when analgesics are used along with the midazolam, they are found to have greater sedative effects. The gastrointestinal agents when combined with midazolam are found to increase the rate of absorption of the drug. Cimetidine when used along with Midazolam is found to increase the retention time of Midazolam in the body. Similarly the antifungal agents are also found to inhibit the movement of Midazolam from the body. 4. a) The mechanism of interaction of Midozolam is understood well. The main target of Midazolam is the GABAa receptor. This is an ionotropic receptor w ith gamma amino butyric acid as the endogenous ligand. When GABAa receptor is activated then it transmits Chloride ions through their pores and polarizes the neurons. This polarization results in the inhibition of the neurotransmission. The benzodiazepines binds to the receptor found between the alpha and gamma receptor subunits. The five subunits of GABA receptor are sensitive to benzodiazepine. When benzodiazepine binds to the alpha and the gamma subunits of the GABA receptor, and brings the receptor into its control. The binding brings out a change in the conformation of the GABA – alpha and makes them to open the chloride ion channel and this polarizes the membrane. This process inhibits the signal transduction pathway by arresting the GABA molecules and creating sedatory and anxiolytic effects to the human. (Sigel 2002). b. Midozolam is the substrate for the receptor GABA only. This is very specific in nature. It binds to the GABA receptors that are having only alpha and gamma subunits. The binding of benzodiazepine modifies the GABAs response by the receptor. As these receptors are found in the cerebral cortex region, limbic system, cerebellar cortex and spinal cord, its effect can be felt in many parts of the body. The two compartmental model enables the specificity of the molecule and increases the sensitivity. (Stoelting and Miller 2007) c.

Youth Gangs And Youth Violence Criminology Essay

Youth Gangs And Youth Violence Criminology Essay To believe that the existence of youth gangs and juvenile violence is a myth is to believe that its causes are also fictional. But what is so fictional about this reality? There is no denying that there are gangs, brought about by many of Americas youth, who wants a quick fix in life. Studies back this up. The national survey of law enforcement jurisdiction counted almost a million gang members in the United States. Among these gang members, 46,000 were involved in gang accidents that spurred a violent crime (Hunzeker, 1993). According to the study by the West Virginia University (Hunzeker, 1993), about 20,000 violent offenses were connected to gangs, which includes 974 homicides, occurred in Americas 72 largest cities. Our contemporary information about gang formation considerably attributes their existence, again, to poverty and other social problems. This factor is magnified further when you add the availability of drugs and weapons in the community into the scenario. These variab les (poverty, drugs, and weapons) tell us much about the trend of gang formation. Research suggests that gangs and their crimes increase when community degenerates or if the economy drops (Hunzeker, 1993). Furthermore, when neighborhoods, schools, families in the community disperse or decays, most youth turn to gang membership as a means to build their esteem and re-establish their social identity. Now, there is absolutely nothing mythical about this. Truth of the matter is, gangs seem to be an attractive option where legitimate means of survival is lacking. Thus, gangs mirror societys identity-juvenile gangs are the reflection of the youth on the very society they live in. Almost any enrollment to gangs affords the youth protection and excitement, which is why the propensity for violence is always there. Drugs and weapons connected to the crime is only the direct result of the gangs inherent objectives. But the most violent crimes connected to gangs are not random shootings or drug disputes; rather it is the escalation of disputes between rival gangs. II. There are various points of views from experts on the causes of youth gangs and violence. John Hagan and Bill McCarthy of Cambridge University offer an insight between the relationship between juvenile and their participation to criminal activities. Moreover, they added, the common profile of a street youth is male, around 18 years old and comes from a broken home. Approximately 30% had lived with both biological parents before leaving home, 24% had lived with step-families, 18% had lived with a lone-mother, and 17% had lived in foster or group homes before taking to the street (Hunzeker, 1993). A full 87% of youth have undergone physical violence from their parents or guardian; and another 60% of them were bruised due to assault. Most criminologists peg street crimes to young men who are poor, unemployed, badly educated and frequently raised in unstable homes. These men account more than half of street crimes occurrences. These are the base roots of street crimes, but to explain why juvenile turns to street crime needs a much detailed analysis. Experts say that variables like poverty and poor health influence criminal behavior, but there is a large disagreement among them in what actually causes youth to go against the law and injure others. Elliot Currie, a crime expert of University of California at Berkeley for example, believes that street crimes are largely due to the U.S. failure to support poor families (Robinson, 2003, 2). In this case, there is a widespread inequality that gives rise to resentment and anger. Mercer Sullivan an anthropologist of Vera Institute, on the other hand, believes that education is to blame (Mears Travis, 2004, 31). He thinks that poorly educated young individuals, regardless of their race, are all curious of exploring crime. But as time moves on when some individuals mature through getting decent jobs, while others didnt because of racial disparity, inequality or other unjustifiable reasons that negatively affected them, these individuals become desperate and turns to street crime-such as burglary and mugging-to compensate. Other experts thrust their blame on the environment; others to mental disorder; still others to negative influences. At the same time, these youth begin to see the social system as unfair who look at themselves as unemployable, which significantly increases their involvement to possible criminal action. Now, why is this so? Because these juveniles grew up in a conventional society where they believed eventually betrayed them. Thus, they responded with depression and guilt, leading to a passive withdrawal and criminal behavior inhibition. They begin to narrow down their options and see that crime is the better alternative than employment to compensate their material needs. III. Addressing this issue begins looking for changes on how this problem can be mitigated, which can lead to more feasible solutions. In this case, we describe law enforcement authorities. Typically, the police try its best to curb the increasing problems of juvenile street crimes. They have two approaches: An aggressive stance and punishment to those hard-core predatory gang members; and the prevention of recruitment and early intervention to would-be gang members These two approaches may be effective on a poor community that has had enough of gang-related street crime. But what happens when theres a gang increase in a comparatively affluent towns and suburbs. The loophole of this approach is purely on perception. Usually when forums revolve around homeless youth, they are always tagged as the criminal perpetrators. This is due to the deeply rooted perspective that endured to popular media, which believes that delinquent street, homeless youths are bad, deviant, troubled, or misgui ded, who apparently have left their homes with insignificant reasons. Once out to the streets, they are labeled as involved in criminal activities, which puts at risk the publics health and safety. It is they who are the usual suspects for disturbing the peace; that causes problems to the public; that are driving away tourist by making streets unsafe; etc. Yet, these forums fail to point out that these homeless juveniles equally are victims of street crime. When living in the streets, young individuals are highly exposed to delinquent activities, dangerous locations, proximity to other offenders-that can all lead to victimization. Police and the community must have a better understanding of the causes. IV. First essential facet to improve on change preconceived ideas and stop the stereotyping and profiling juveniles on the streets. Officials and law-makers can start with the media, especially in this time and day where the bread and butter of television news are the spicing up of events. According to Rose (1994), street crimes are the coal that boils the crisis boiler. Reportage of street crimes are exaggerated in the United States that the real facts of the matter are left out to give way to perception and sensationalizing of events. The trouble with this source of information is that media executives reinforce their viewers stereotype by showing only one side of the offenders and not taking account of other reasons of the crime. Television enables its viewers to categorize what crime to what offender commits them, without giving more extensive information on why that crime took place in the sociological level. Viewers, in turn, are fed with profiling street juveniles. It shows that news reports overstate crime committed by minorities by consistent reportage and tableau of either Blacks, Latinos, Asians, etc. in a crime that shapes to false perception, which skews reality by giving a scary and untrue image of crime in America. What is needed as one of the most essential solutions to curbing juvenile street crimes is more information towards the public viewers on what sets criminal behavior among their youth. The community should realize that a criminal incident is not an isolated case-it is brought about by multiple, interrelationship of the juveniles condition, including poverty, homelessness, etc. The viewing public should see the connections of why street crime occurs. This is the only way to begin a solution against social delinquency, through a keen observation of interrelated factors.

The Strong Women in The Orestia by Aeschylus Essay -- Aeschylus Orest

The Strong Women in The Orestia by Aeschylus To most readers, the women of The Orestia are evil and vindictive, a disgrace to all chaste and righteous women.   Aeschylus portrayed women as equals to men, which was not the opinion of most Greeks at the time.   Although he showed some of his women characters as evil, he granted them power, and emasculated the men around them.   Unlike Homer, the women of Aeschylus show both ranges of emotions, both the good and the bad.   A woman portrayed as a villain may be thought of negatively, but the fact that a female is allowed to be the villain, to take action, and leave other men helpless to the choices that she makes, it is a great step.   In the time of the Greeks, a woman was either victimized by the male world around her, or victimized other males to hold a place in the world.   Aeschylus made his women characters unique for his time but relevant to ours, since all the bad and evil characteristics of women then are mostly recognized as strength and intellect.   This th eme is mostly clearly shown through Clymanestra.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Clymanestra was not an evil character, but rather a misunderstood one.   Woman of today could perfectly relate to her situation.   For example, Clymanestra was like a housewife, who ran her family while her husband was off focused on his job, working overtime, even when he didn?t need the money, leaving her needs totally unattended to.   The husband talked about his work life like he was the gear that everything revolves around, perhaps even talks about the women that worship him for his skills, or at worst, sleeps with his secretary.   He sacrificed spending time with his children, even missed his daughter?s first ballet recital, so that he could kiss up to the bos... ...   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   All in all, the strong women in Aeschylus were a man?s nightmare, but the fulfillment of a woman?s dream.   Clymanestra was the type of woman hated in Greece as a she-devil tyrant, but in the present, the kind of woman who would have been a very effective and respected politician who could keep her own in a man?s world.   Aeschylus clearly showed that for a woman, it was nobler to take control of one?s life, be independent, and die, than to ride the rivers of passiveness, watch the world float by without taking any action to change one?s fate, and live a fruitless life.   Clymanestra was not just another ?evil? woman, but could be looked at as a role model for the feminist movement.   She took control of sexuality, of her kingdom, of her children, and her marriage.    Works Cited: Aeschylus. Oresteia. Trans. Peter Meineck. Indianapolis: Hackett, 1998.

Swot Red Bull

STRENGTH – Leadership position The company â€Å"Red Bull† is considered like the â€Å"leader† of the energy drinks market in the world with 70% of market share in 2012. – Marketing strategy * A lot of sports events, promotions and campaigns (like street marketing) * Sponsorship (F1 Red Bull Team, Felix Baumgartner, Shaun White†¦) * Original communication strategy and efficient (http://www. redbull. fr/cs/Satellite/fr_FR/Video/Le-nouveau-clip-du-Monde-de-Red-Bull-au-cinema-021243076490242) -Innovation * Innovating recipe of energy drink containing â€Å"Taurine† – Loyal customers * The creation of an universe encouraged customer loyalty Strong Brand identity and trendy brand – Strong financial position * Turnover of 3,27 Billion of Euros. – Single product Weaknesses – Average price – Lack of product innovation Nowadays, there are a lot of competitors in the market owned by famous brands like Coca-Cola (Burn) or Pepsi (Dark Dog) – Lack of patent on Red Bull’s recipe means anyone can copy it – High logistics costs – Profits linked to exchange rates – High sunk cost (marketing, Advertising) Opportunities – Red bull has opportunities to expanding the target markets as well as product lines extension * Extension of product line can help to retain market share Increase market share with increased opportunities in emerging markets through being trendy * Sunk cost can provide future growth in emerging markets due to a trendy image – Consumer recognition through sponsorship of sports events so can expand product with a loyal customer base * Overcome higher prices than competitors with product expansion and diversification – New ventures like partnership with Facebook – Product and services expansion – International manufacturing opportunities * Manufacturing Internationally can decrease exchange rate risks Keep substantial mar ket share with international operations * High logistics costs can be decreased with decentralized production in emerging markets Threats – Competition * Major competitors such as Coca Cola (burn) and Pepsi (dark dog) are continually seeking to regain market share of Red Bull – Negative publicity * Various media reported that Red Bull is harmful for one’s health * The caffeine levels in Red Bull can be dangerous if consumed by children/teenagers * Red Bull has gone to the extremes of seeking scientific proof that its product is safe for consumption (cost of scientific research) Inability to move forward with the product * The product could be in danger of becoming stale by shunning conventional advertising methods * Large investment in extreme sport events the question is what will be their next step to keep on being innovating and attracting – Ability to gain new customers and retain current customer loyalty * Red Bull’s target market currently ai med at youngsters: so this generation will continue to drink ‘energy drink? * the next upcoming generation accept this product ?

Ethics and Placebo Trials Essay

Placebo trials are experimental trials that involve the administration of a substance that does not really have any effect on the individual’s system. This means that it is a neutral trial that will have neither positive nor negative effects on the physiology of the person it is administered on. Whatever positive benefits may be derived out of placebo trials are merely therapeutic and may arise from the potency of the power of suggestion. These trials are most often used in randomized control trials in investigating the effectiveness of a specific treatment. (Miller and Brody, 3) However, with the rise of the use of such trials, there have been many more questions raised. Are these placebo control trials indeed necessary? What ethical issues are raised with the implementation of placebo trials? The debates regarding the ethicality of placebo trials in investigative research continue to rage across the scientific community. The discussion has become so complex that the sides taken regarding the matter have evolved to more than just â€Å"yes† or â€Å"no† to the question of placebo ethicality. There have been numerous aspects of placebo trials that have undergone the scrutiny of those directly involved with fields utilizing these trials. The main aim of this paper is to understand the obligations of medical practitioners who are employing placebo trials in their own scientific investigations of the effectiveness of various treatments. What ethical standards should these individuals, physicians and the like, take into consideration when conducting investigative researches with placebo trials? Glass and Waring The main problem with a physician’s utilization of placebo trials for investigative purposes is the fact that they are part of the profession that involves the assurance of optimal health for their patients. Some of the researchers and critics exploring the ethical holds on medical practitioners with regards to placebo trials have looked at it from a legal standpoint. Glass and Waring (582) indicate that they have foundâ€Å"no legal precedent allowing physicians to ‘opt out’ of their professional obligations because they are researchers in addition to being physicians†. It is emphasized that the physician must do all in his power in order to insure that the client receives all possible modes of treatment that would maintain or enhance his or her health. As a researcher, the physician is viewed as a fiduciary, a person delegated with power that will be used for the benefit of another person and who is held legally against the highest standards of conduct. The physician-researcher as a fiduciary, then, has a moral ascendancy over his or her patient-subject. (Glass and Waring, 578) This means that a placebo trial that would involve having the physician-researcher observe the null effect on the health of a patient-subject and at the same time have knowledge of the betterment of the health status of patient-subjects in the other experimental trials. (Glass and Waring 579) Thus physician’s are now ethically compromised and even legally liable for their utilization and continuation of the placebo trial. Knowing that there is a treatment that could improve the health of those in the placebo arm of the experiment but not applying that treatment on the participants in that arm indicates their sacrifice of the health of those participants for the scientific progress afforded by research data. The ethical responsibility of the physician-reseracher, therefore, is in the fact that clinical studies of treatment effectivity make use of participants who have been diagnosed with the specific medical condition hoped to be treated by the experiment’s procedure. Hawkins Hawkins (484) states that the true problem faced by physician-researchers is a moral one. The moral norms and societal dictates placed upon those in the medical profession involve the fact that they need to be able to give a sick person all the possible chances of being treated. However, Hawkins (484) points out that this moral responsibility is limited. She states clearly â€Å"researchers do not owe effective treatment to everyone around them. † (473) The obligations of a physician to his or her patient are enclosed within a given framework, that of the physician-patient relationship. In order for such a relationship to be established, the physician must come into agreement with the client that he or she will indeed act as one half of that relationship. The same agreement must be made on the part of the client. Although this agreement may not be explicit, it is nevertheless positively acknowledged by both parties. (Hawkins, 476) There is, according to Hawkins, no ethical dilemma in a physician-researcher’s use of placebo trials. Just because these researchers have had medical training and have taken a medical oath does not mean that they are always in the role of a physician. These are individuals that have many other different roles as fathers, mothers, non-practicing physicians, friends and the like. The role they take as a researcher, therefore, does not mean a continuation of their role as a physician. (Hawkins, 479) The obligations of an individual in the role of a researcher is separate from his or her role as a physician thus their obligation in placebo trials involves simple assurance that the participant will not be harmed by the procedure that will take place. Miller and Brody Some critics of placebo control trials state a weakness in therapeutic obligation of physician researchers as the main grounds of contestation of the ethical foundations of the said trials. Miller and Brody (8) state that even when based on the principles of clinical equipoise, an ethical basis of assigning participants in different experimental arms which involves disagreement among experts as to the effectiveness of either arm, therapeutic obligation is still a weak attack against the ethics of placebo trials. The individuals who knowingly participate in experiments with placebo arms are not exploited as long as no harm befalls them. Also, they are aware that they enter the experimental set-up as participants in a research and not as patients of the researchers who happen to also be physicians. (Miller and Brody, 5) Miller and Brody thus state that â€Å"placebo trials are not unethical just because they withhold proven effective treatment†. (6) It is thus seen that the responsibility and obligation of the researcher with regards to the ethicality of placebos is not in their therapeutic obligations as physicians. However, this does not mean that placebo trials are completely ethical. This also does not mean that researchers are devoid of ethical obligations to their participants assigned to placebo arms of the investigative experiments. The ethical obligation of the researcher in placebo trials is the same as that of researcher in any clinical trials. This involves the proper acquisition of informed consent from the participants. Also, researchers must be able to assure the fact that participants will not be exploited or put in harmful situations. Miller and Brody also insist that researchers must first establish that the investigation has scientific merit and that scientific merit is increased with the implementation of the placebo trial. (8) Analysis and Argument All three articles assessed above have merit and, at the same time, also have faults. Glass and Waring (582) stating that no legal precedents were found that indicated physicians were no longer tied to their professional obligations is faulty. In much the same way that a lawyer does not have to give counsel to every jaywalker he or she sees, the physician likewise does not have professional obligation over individual’s whose relationship to him is simply that which exists between researchers and participants. I also disagree with Hawkins’ statement that morality is what binds the physician thus the use of placebo trials is not unethical. What is ethics but a concept in the realm of morality? Yes, there are standards and regulations with regards to ethical conduct. However, as a whole, ethics is based on morality thus a moral problem is, in fact, an ethical problem. The middle ground taken by Miller and Brody also seems to be misled. A placebo trial is not equivalent to other clinical trials. It involves factors that are not present in other trials, such as the exposure of the participants to neutral treatment. In other clinical trials, there is still exposure to some form of treatment thus there is an effort to aid the participant. I believe, however, that physician-researcher’s obligations to the patient-participant, is limited solely to the relationship of researcher and participant. The role taken by the individual is not that of a physician but that of a researcher. The participants are also aware that they enter into the experiment not as patients but as participants. Although they are not given the chance to undergo possibly effective treatment, it is not the moral obligation of the researcher to insure that they do. Even if, for example, a person persists to smoke, I am not morally or ethically obligated to make sure that he or she stop. Placebo trials are valid research designs and should not be stopped simply because of a feeling that it is unfair to those who, in the first place, willingly submitted themselves to the experiment’s conditions. Works Cited Glass, Kathleen G. , and Waring, Duff. â€Å"The Physician/Investigator’s Obligation to Patients Participating in Research: The Case of Placebo Controlled Trials. † The Journal of Law, Medicine & Ethics 33 (2005): 575-585 Hawkins, Jennifer S. â€Å"Justice and Placebo Controls. † Social Theory and Practice 32 (2006): 467- 496. Miller, Franklin G. , and Brody, Howard. â€Å"What Makes Placebo-controlled Trials Unethical? † The American Journal of Bioethics 2(2002): 3-9