Clinical Pharmacokinetics of Metformin

Metformin, the only biguanide oral antidiabetic agent available, was first used clinically in the late 1950s. Metformin remains the first-line pharmacologic treatment for type 2 diabetes patients. It can be used as a single agent or in combination therapy with other antidiabetes agents, including insulin. Metformin is absorbed predominately from the small intestine. It is rapidly distributed following absorption and does not bind to plasma proteins. It is excreted unchanged in urine. The elimination half-life of Metformin during multiple dosages in patients with good renal function is approximately 5 hours.

Treatment Goals for Achondroplasia: A Qualitative Study with Parents and Adults

Background: Achondroplasia is characterized by disproportionate short stature accompanied by other changes to the musculoskeletal system. Individuals with this condition typically experience a variety of medical complications. Pharmacologic treatments are being developed for the treatment of achondroplasia. It is important to understand the goals for pharmacologic treatment among those affected by achondroplasia and factors that shape these views. Methods: This qualitative study is based on semi-structured interviews with 19 parents of children with achondroplasia and 5 adults with achondroplasia in the United States. We employed thematic analysis using an iterative process to identify themes across the interviews. Results:Participants had two goals for pharmacologic treatment of achondroplasia: ameliorating complications associated with the condition and increasing stature to overcome functional limitations and psychosocial challenges. Complications of particular concern were chronic pain and surgeries to repair spinal, ENT, and neurological sequelae. Increased height would enhance independence, fitting in socially, and avoiding social stigma. Despite many challenges, parents and adults with achondroplasia expressed that they found ways to adapt and emphasized satisfaction and the positive aspects of their lives. Concerns about medical treatment included fear of loss of their identity as a little person. Conclusions:This study offers evidence about how individuals affected by achondroplasia think about pharmacologic treatment of this condition, including both the benefits of ameliorating complications and increasing height. The findings can offer practical insights for parents of children considering treatment, treating physicians and decision makers evaluating coverage decisions for treatment of achondroplasia.

Pharmacologic Treatment of Psychiatric Disorders

Human behaviors such as thinking, feeling, and action can be viewed as products of the interactions between brain circuits, neurotransmitters, and oscillations that are influenced to a certain extent by inherited genes, acquired values, and social norms. A psychiatric disorder reflects a dysfunctional brain, and 1 way to treat such a condition is through the use of pharmacologic compounds that can help restore order in a disorderly brain.