DOCSLIB.ORG

The Dynamics of Technological Innovation: the Case of the Pharmaceutical Industry

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Dynamics of Technological Innovation: the Case of the Pharmaceutical Industry Research Policy 30Ž. 2001 535–588 www.elsevier.nlrlocatereconbase The dynamics of technological innovation: the case of the pharmaceutical industry Basil Achilladelis a,), Nicholas Antonakis b a 39, Ionias Street, Kifissia, Athens 14563, Greece b Ministry of DeÕelopment and UniÕersity of Athens, Athens Greece Received 9 April 1999; received in revised form 7 October 1999; accepted 18 January 2000 Abstract This is an empirical and historical study of the dynamics of technological innovationŽ. TI in the pharmaceutical industry from its establishment at the beginning of the 19th century to 1990. It is based on the identification and evaluation of the originality and commercial significance of 1736 product innovationsŽ. new medicines commercialized between 1800 and 1990, and on company economic data for the period 1950–1990. The study is presented in the framework of established macroeconomic theory of technical change. Applying both empirical and historical evidence, the study:Ž. a identifies the technological, social and economic driving forces for TI;Ž. b examines the relation between originality and market performance of medicinal innovations;Ž. c studies the mechanisms of the diffusion of medicinal technologies that led to the formation of five successive generations of drugsŽ long waves.Ž. ; d describes the structural changes forced on the pharmaceutical industry by the introduction and development of each successive generation of drugs;Ž. e provides evidence of the concentration of the innovative segment of the pharmaceutical industry among few large companies, which sustained high levels of growth and R&D expenditures by means of inhouse innovation, technological and therapeutic market specialization, and mergers and acquisitions of companies within and outside the pharmaceutical industry; andŽ. f shows that the localization of the innovative segment of the pharmaceutical industry in the USA, UK, Germany, Switzerland and France was caused by the influence of national environments on the intensities of the driving forces for TI. q 2001 Elsevier Science B.V. All rights reserved. Keywords: Dynamics of technological innovation; Pharmaceutical industry; Long waves of technical change 1. Introduction technological discoveries and inventions in industry and the world economy. Technological innovationŽ. TI is a dynamic pro- Schumpeter’s seminal theory was further elabo- cess, perhaps the most dynamic of all industrial rated at the macroeconomic level by many authors activities. SchumpeterŽ. 1943 with his Agales of cre- Ž.e.g., Freeman, 1996 , notably Rosenberg Ž 1969, ative destructionB gave a vivid description of the 1976.Ž.Ž. , Nelson and Winter 1977 , Dosi 1982 , Free- effects of the introduction and diffusion of major man and PerezŽ. 1988 , who, by incorporating Kon- dratiev’sŽ. 1925 theory of Along wavesB in the ) Corresponding author. Tel.: q30-1-800-01-52; fax: q30-1- world economy and Kuhn’sŽ. 1962 theory of scien- 800-01-52. tific revolutions, introduced the concepts of Atechno- 0048-7333r01r$ - see front matter q 2001 Elsevier Science B.V. All rights reserved. PII: S0048-7333Ž. 00 00093-7 536 B. Achilladelis, N. AntonakisrResearch Policy 30() 2001 535–588 logical imperativesB or Atechnological paradigmsB From its establishment to this day, it has maintained Ž.TPs , which initiate Atechnological trajectoriesB a close and fruitful two-way relation with academic Ž.TTs whose pathways determine the fluctuating rates research institutions in chemistry, pharmacology, the of technical change. TT were, in turn, found to life sciences and medicine. The succession of tech- cluster together forming Atechnology systemsB and nologies did not create waves but only ripples of Atechno-economic paradigmsB which, by spreading creative destruction because leading companies were across numerous industrial and service sectors, cause flexible enough to adapt to the exigencies of the new the formation and succession of Along wavesB in the regimes and even to prosper from them. A thriving world economy. and extremely profitable business was created with These concepts provided an extremely useful some of its innovations becoming household names framework for the study of TI, which offered a for nearly a century and others having deeply af- number of plausible macroeconomic interpretations fected the nature, structure and morals of our society. regarding the fluctuations of the rates of technical Indeed, in this latter aspect, there is no other industry change, the diffusion of technologies and their inter- that had a comparable effect. actions with the economy. Less attention was, how- The study is presented in the following three ever, addressed at the microeconomic aspects of sections. technological advance, notably the dynamics of TI at Section 2 describes the sources and assesses the the level of innovating institutions where they are data used in the study. first expressed and can be more accurately detected Section 3 presents an empirical study of the dy- and evaluated. Indeed, the dynamism of TI is ex- namics of TI in the pharmaceutical industry in the pressed in more subtle ways before it integrates into framework of established theory of technical change. Atechno-economic paradigmsB and Along wavesB. Ž.a DriÕing forces of TI. TI involves scientificr For example, TI acts as a catalyst in the interaction technological and commercial uncertainties and hence of science and technology accelerating their other- the acceptance of financial risks on the part of public wise arduous advance, in the technological develop- and private innovating institutions. It is, therefore, ment and market expansion of industrial sectors, in essential to identify the scientific, technological, so- the research intensity, technological specialization cial and economic forces that have compelled the and business performance of industrial companies, pharmaceutical industry throughout its long history and in the competitive advantage of national indus- to discover, develop and commercialize new tries. medicines. The mechanisms by which TI exerts such influ- Ž.b Dynamic effects of radical innoÕations() RIs . ence can be identified and evaluated by studies of Highly original innovations cause the establishment the technological and business histories of research- of new industrial sectors or subsectors and contribute intensive industrial sectors. Long-term sectoral stud- to the diffusion of technology. The pharmaceutical ies of TI offer the advantage of a homogeneous industry is not an exception to this rule. In our scientific, technological and commercial framework analysis, we examine the technological and commer- which allows for the study of the rates of technical cial characteristics of RIs, which impart to them their change and for comparisons in science, technology dynamic properties, and investigate the companies’ and business among historical periods, companies justifications in accepting the higher risks associated and countries. The use of technology inputroutput with their development and commercialization. indicators is essential because they provide quantita- Ž.c Diffusion of innoÕation. The 200-year-long tive evidence for or against any proposed hypothesis. innovation history of the pharmaceutical industry is This is a study of the dynamics of TI in the unique in manufacturing. To identify the dynamics pharmaceutical industry from its establishment at the and mechanisms by which it maintained a nearly beginning of the 19th century to 1990. The pharma- continuous drive for innovation over such a long ceutical industry is a relatively small research-inten- period, we examine the patterns of distribution over sive industry that showed a consistently strong inno- time of radical and incremental innovationsŽ. IIs by vative record throughout its 200-year-long history. therapeutic sector; we identify the characteristics of B. Achilladelis, N. AntonakisrResearch Policy 30() 2001 535–588 537 innovations that served as TPs and of the TTs they TI. To this end, we identified all the innovations generated; and we find that the clustering of TPs and Ž.1736 of 16 subsectors of the pharmaceutical indus- trajectories gave rise to five successive generations try described in Martindale’s PharmacopoeiaŽ Re- of pharmaceuticals that have kept alive the industry’s ynolds, 1989. , which account for about 80% of all drive for innovation. subsectorsŽ. Table 1 . The chemical structure and Ž.d The innoÕatiÕe performance of pharmaceuti- composition of each drug were obtained from the cal companies. Our innovation data show that 30 USAN and USP Dictionary of Drug NamesŽ Fleeger, companies introduced more than 70% of all the 1994. ; tradenames, innovating companies and years innovations of our sample. Most of these companies of commercialization were obtained by crosscheck- stayed in business for about a century despite the ing the above references with the World’s Pharma- revolutionary changes of the competitive environ- ceutical DirectoryŽ. Anon, 1991 . To ensure against ment of the pharmaceutical industry caused by the omissions of significant drugs, we cross-checked our introduction of successive generations of technology. lists with those of the USA Food and Drug Admi- We examine the patterns of growth of some of these nistration’sŽ. FDA Center for Drug Evaluation and companies, their innovation records, and the strate- ResearchŽ U.S. Department of Health and Human gies they adopted to ensure growth including techno- Services, 1989. ; with the American Medical Associa-
Load more

Recommended publications
  • NDPSC Record of Reasons, Meeting 37, Feb 2003
    National Drugs and Poisons Schedule Committee Record of the Reasons 37th Meeting 25-26 February 2003 The Record of the Reasons contains the basis of scheduling decisions and other outcomes arising from the meeting. Please note that the Record of the Reasons includes extracts from the NDPSC minutes which have been edited to remove confidential information. National Drugs and Poisons Schedule Committee Record of the Reasons Meeting 37 - February 2003 i TABLE OF CON TEN TS GLOSSARY.........................................................................................................................IV 2. PROPOSED CHANGES/ADDITIONS TO PARTS 1 TO 3 AND PART 5 OF THE STANDARD FOR THE UNIFORM SCHEDULING OF DRUGS AND POISONS. ........................9 2.1 SUSDP, PART 1 ..........................................................................................................9 2.2 SUSDP, PART 2 ..........................................................................................................9 2.3 SUSDP, PART 3 ..........................................................................................................9 2.3.1 Organotin Compounds...........................................................................................9 2.4.1 BORON TRIFLUORIDE, BIFLUORIDES AND HYDROSILICOFLUORIC ACID – APPENDIX F PART 3 ...9 AGRICULTURAL/VETERINARY, INDUSTRIAL AND DOMESTIC CHEMICALS.................. 11 3. MATTERS ARISING FROM THE MINUTES OF THE PREVIOUS MEETING (CONSIDERATION OF POST-MEETING SUBMISSIONS UNDER 42ZCZ).............................
    [Show full text]
  • Pharmacy and Poisons (Third and Fourth Schedule Amendment) Order 2017
    Q UO N T FA R U T A F E BERMUDA PHARMACY AND POISONS (THIRD AND FOURTH SCHEDULE AMENDMENT) ORDER 2017 BR 111 / 2017 The Minister responsible for health, in exercise of the power conferred by section 48A(1) of the Pharmacy and Poisons Act 1979, makes the following Order: Citation 1 This Order may be cited as the Pharmacy and Poisons (Third and Fourth Schedule Amendment) Order 2017. Repeals and replaces the Third and Fourth Schedule of the Pharmacy and Poisons Act 1979 2 The Third and Fourth Schedules to the Pharmacy and Poisons Act 1979 are repealed and replaced with— “THIRD SCHEDULE (Sections 25(6); 27(1))) DRUGS OBTAINABLE ONLY ON PRESCRIPTION EXCEPT WHERE SPECIFIED IN THE FOURTH SCHEDULE (PART I AND PART II) Note: The following annotations used in this Schedule have the following meanings: md (maximum dose) i.e. the maximum quantity of the substance contained in the amount of a medicinal product which is recommended to be taken or administered at any one time. 1 PHARMACY AND POISONS (THIRD AND FOURTH SCHEDULE AMENDMENT) ORDER 2017 mdd (maximum daily dose) i.e. the maximum quantity of the substance that is contained in the amount of a medicinal product which is recommended to be taken or administered in any period of 24 hours. mg milligram ms (maximum strength) i.e. either or, if so specified, both of the following: (a) the maximum quantity of the substance by weight or volume that is contained in the dosage unit of a medicinal product; or (b) the maximum percentage of the substance contained in a medicinal product calculated in terms of w/w, w/v, v/w, or v/v, as appropriate.
    [Show full text]
  • United States Patent 19 11 Patent Number: 5,446,070 Mantelle (45) Date of Patent: "Aug
    USOO544607OA United States Patent 19 11 Patent Number: 5,446,070 Mantelle (45) Date of Patent: "Aug. 29, 1995 54 COMPOST ONS AND METHODS FOR 4,659,714 4/1987 Watt-Smith ......................... 514/260 TOPCAL ADMNSTRATION OF 4,675,009 6/1987 Hymes .......... ... 604/304 PHARMACEUTICALLY ACTIVE AGENTS 4,695,465 9/1987 Kigasawa .............................. 424/19 4,748,022 5/1988 Busciglio. ... 424/195 75 Inventor: Juan A. Mantelle, Miami, Fla. 4,765,983 8/1988 Takayanagi. ... 424/434 4,789,667 12/1988 Makino ............ ... 514/16 73) Assignee: Nover Pharmaceuticals, Inc., Miami, 4,867,970 9/1989 Newsham et al. ... 424/435 Fla. 4,888,354 12/1989 Chang .............. ... 514/424 4,894,232 1/1990 Reul ............. ... 424/439 * Notice: The portion of the term of this patent 4,900,552 2/1990 Sanvordeker .... ... 424/422 subsequent to Aug. 10, 2010 has been 4,900,554 2/1990 Yanagibashi. ... 424/448 disclaimed. 4,937,078 6/1990 Mezei........... ... 424/450 Appl. No.: 112,330 4,940,587 7/1990 Jenkins ..... ... 424/480 21 4,981,875 l/1991 Leusner ... ... 514/774 22 Filed: Aug. 27, 1993 5,023,082 6/1991 Friedman . ... 424/426 5,234,957 8/1993 Mantelle ........................... 514/772.6 Related U.S. Application Data FOREIGN PATENT DOCUMENTS 63 Continuation-in-part of PCT/US92/01730, Feb. 27, 0002425 6/1979 European Pat. Off. 1992, which is a continuation-in-part of Ser. No. 0139127 5/1985 European Pat. Off. 813,196, Dec. 23, 1991, Pat. No. 5,234,957, which is a 0159168 10/1985 European Pat.
    [Show full text]
  • 111-11ST(I)INS ACT 1964 . No. 51] PERTH
    [2723] az OF WESTERN AUSTRALIA (Published by Authority at 3 .30 p.m.) No. 51] PERTH : THURSDAY, 9 JULY [1981 -rl f--j -111-11ST(I)INS ACT 1964 . 9July1981 .] GOVERNMENT GAZETTE, W.A. 2725 3 POISONS ACT 1964. POISONS (SCHEDULED SUBSTANCES) AMENDMENT ORDER 1981 . MADE by His Excellency the Governor in Executive Council . Citation . 1. This Order may be cited as the Poisons (Scheduled Substances) Amendment Order 1981 . Schedules Each of the schedules referred to in section 20 of the Poisons Act d-in Appe- 2. "A" to the 1964, as amended, is amended by deleting all of the items in each of Act subs. those schedules, as amended, and substituting the items set out in the appendix to this Order so that the items appear in the respective schedules as set out in that appendix . APPENDIX. "A" First Schedule. A substance specified in this Schedule includes any compound and all preparations and admixtures containing any proportion thereof and these are therefore subject to all the restrictions of this Schedule unless specifically exempted or specifically included in any other Schedule . ACONITE (ROOT OF ACONITUM NAPELLUS) . ANTIMONY and substances containing more than the equivalent of 1 per cent of antimony trioxide, except antimony chlorides in polishes . ATROPINE and substances containing more than 0 .25 per cent of atropine, except atropine methonitrate or when included in the Second Schedule . BELLADONNA and substances containing more than 0 .25 per cent of the alkaloids of belladonna calculated as hyoscyamine . BROMINE as such . BRUCINE and substances containing more than 0 .2 per cent of brucine .
    [Show full text]
  • National Drugs and Poisons Schedule Committee
    National Drugs and Poisons Schedule Committee Record of the Reasons 36th Meeting 15-17 October 2002 The Record of the Reasons contains the basis of scheduling decisions and other outcomes arising from the meeting. Please note that the Secretariat is moving towards including the edited minutes as the Record of the Reasons. With this document, we have included edited extracts relating to scheduling considerations for OTC medicines, domestic poisons and certain matters related to pesticides. The Secretariat is hopeful of including the edited minutes for all sectors following consultation with the respective industry bodies. National Drugs and Poisons Schedule Committee Record of the Reasons for Meeting 36 - October 2002 i TABLE OF CONTENTS GLOSSARY..........................................................................................................................................IV 2. PROPOSED CHANGES/ADDITIONS TO PARTS 1 TO 3 AND PART 5 OF THE STANDARD FOR THE UNIFORM SCHEDULING OF DRUGS AND POISONS............................. 1 2.1 SUSDP, PART 1......................................................................................................................... 1 2.1.1 Definition in Part 1 of the SUSDP for “aqueous preparations” .......................................... 1 2.2 SUSDP, PART 2......................................................................................................................... 1 2.2.1 Variation of Requirement for Clause 7(1)(d)......................................................................
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 6,746,689 B2 Fischer Et Al
    USOO674.6689B2 (12) United States Patent (10) Patent No.: US 6,746,689 B2 Fischer et al. (45) Date of Patent: *Jun. 8, 2004 (54) INTRADERMAL-PENETRATION AGENTS 5,863,941 A 1/1999 Liedtke FOR TOPCAL LOCAL ANESTHETIC 5,919,479 A 7/1999 Zhang et al. ADMINISTRATION 5,922,340 A 7/1999 Berde et al. 5,955,112 A 9/1999 Kaplan (75) Inventors: Susi7- Ely. Nuits E. 6,455,0666,120,792 AB1 * 9/20029/2000 JuniFischer et al. Mason, Flemington, NJ (US) FOREIGN PATENT DOCUMENTS (73) Assignee: EpiOept Corporation, Englewood WO WO 93/12744 7/1993 Cliff. NJ (US) WO WO95/ 31.188 11/1995 s WO WO 97/439 89 11/1997 (*) Notice: Subject to any disclaimer, the term of this W W s: 2: past isis'', adjusted under 35 WO WO 01/41746 6/2001 a -- y U dayS. OTHER PUBLICATIONS This patent is Subject to a terminal dis- Berkovitch et al., 1995, “Use of a Eutectic Mixture of Local claimer. Anesthetics for Prolonged Subcutaneous Drug Administra tion”, J. Clin. Pharmacol. 35:295–297. (21) Appl. No.: 10/201,901 Curatolo, 1987, “The Lipoidal Permeability Barriers of the Skin and Alimentary Tract', Pharmaceut. Res. 4:271-277. (22) Filed: Jul. 25, 2002 Klein and Penneys, 1988, “Aloe Vera”, J. Am. Acad. Der (65) Prior Publication Data matol. 18: 714-720. Lubens et al., 1974, "Anesthetic Patch for Painful Proce US 2003/0138505 A1 Jul. 24, 2003 dures Such AS Minor Operations”, Am. J. Dis. Child. O O 128:192-194. Related U.S.
    [Show full text]
  • T |?: 9. 3:08: Such Pharmaceutical Compositions. (52) U.S
    USOO93O8213B2 (12) United States Patent (10) Patent No.: US 9,308,213 B2 Bannister et al. 45) Date of Patent: *Apr. 12,9 2016 (54) SOLID SOLUTION COMPOSITIONS AND USE (2013.01); A61 K9/2013 (2013.01); A61 K IN CHRONIC INFLAMMATION 31/192 (2013.01); A61 K3I/60 (2013.01); A61K 47/44 (2013.01); A61 K3 1/201 (2013.01); (71) Applicant: Infirst Healthcare Limited, London A61 K 3 1/202 (2013.01); A61K 31/25 (2013.01); (GB) A61 K 3 1/337 (2013.01); A61 K3I/704 (72) Inventors: Robin M. Bannister, Essex (GB); John (2013.01) Brew, Hertfordshire (GB); Richard R. (58) Field of Classification Search Caparros Wanderley, Buckinghamshire A61 K31/704; A61 K31/60; A61 K31/202 (GB) USPC .......................................... 514/159,570,571 See application file for complete search history. (73) Assignee: Infirst Healthcare Limited (GB) (*) Notice: Subject to any disclaimer, the term of this (56) References Cited patent is extended or adjusted under 35 U.S.C. 154(b) by 0 days U.S. PATENT DOCUMENTS This patent is Subject to a terminal dis- 3,228,831 A 1/1966 Nicholson et al. claimer 3,800,038 A 3, 1974 Rudel 4,571.400 A 2f1986 Arnold 4,684.666 A 8, 1987 HaaS (21) Appl. No.: 14/155,108 4,918, 103 A 4/1990 Park et al. 5,011,852 A 4, 1991 Park et al. (22) Filed: Jan. 14, 2014 5,059,626 A 10, 1991 Park et al. 5,154,930 A 10/1992 Popescu (65) Prior Publication Data 5,552,160 A 9/1996 Liversidge et al.
    [Show full text]
  • Florencio Zaragoza Dörwald Lead Optimization for Medicinal Chemists
    Florencio Zaragoza Dorwald¨ Lead Optimization for Medicinal Chemists Related Titles Smith, D. A., Allerton, C., Kalgutkar, A. S., Curry, S. H., Whelpton, R. van de Waterbeemd, H., Walker, D. K. Drug Disposition and Pharmacokinetics and Metabolism Pharmacokinetics in Drug Design From Principles to Applications 2012 2011 ISBN: 978-3-527-32954-0 ISBN: 978-0-470-68446-7 Gad, S. C. (ed.) Rankovic, Z., Morphy, R. Development of Therapeutic Lead Generation Approaches Agents Handbook in Drug Discovery 2012 2010 ISBN: 978-0-471-21385-7 ISBN: 978-0-470-25761-6 Tsaioun, K., Kates, S. A. (eds.) Han, C., Davis, C. B., Wang, B. (eds.) ADMET for Medicinal Chemists Evaluation of Drug Candidates A Practical Guide for Preclinical Development 2011 Pharmacokinetics, Metabolism, ISBN: 978-0-470-48407-4 Pharmaceutics, and Toxicology 2010 ISBN: 978-0-470-04491-9 Sotriffer, C. (ed.) Virtual Screening Principles, Challenges, and Practical Faller, B., Urban, L. (eds.) Guidelines Hit and Lead Profiling 2011 Identification and Optimization ISBN: 978-3-527-32636-5 of Drug-like Molecules 2009 ISBN: 978-3-527-32331-9 Florencio Zaragoza Dorwald¨ Lead Optimization for Medicinal Chemists Pharmacokinetic Properties of Functional Groups and Organic Compounds The Author All books published by Wiley-VCH are carefully produced. Nevertheless, authors, Dr. Florencio Zaragoza D¨orwald editors, and publisher do not warrant the Lonza AG information contained in these books, Rottenstrasse 6 including this book, to be free of errors. 3930 Visp Readers are advised to keep in mind that Switzerland statements, data, illustrations, procedural details or other items may inadvertently be Cover illustration: inaccurate.
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 8,753,665 B2 Verity (45) Date of Patent: *Jun
    USOO8753665B2 (12) United States Patent (10) Patent No.: US 8,753,665 B2 Verity (45) Date of Patent: *Jun. 17, 2014 (54) CONTROLLED DELIVERY SYSTEM 4,844,909 A 7, 1989 Goldie et al. (75) Inventor: A. Neil Verity, Sunnyvale, CA (US) 4,891.2254,861,598 A 8,1/1990 1989 OshlackLanger et al. (73) Assignee: Durect Corporation, Cupertino, CA 4,938,763.4,906,474 A 3,7, 1990 LE. tal. (US) 4,957,744 A 9, 1990 della Valle et al. 4,970,075 A 11, 1990 Oshlack (*) Notice: Subject to any disclaimer, the term of this 8. A 3. E. t s al patent is extended or adjusted under 35 5,188,837J. I.- A 2, 1993 DombO. ca. U.S.C. 154(b) by 1382 days. 5,266,331 A 1 1/1993 Oshlack et al. This patent is Subject to a terminal dis- 5,278.2015.278302 A 1, 1994 DSN tal.N. claimer. 5,286,496 A 2/1994 Stapler et al. 5,324,519 A 6/1994 Dunn et al. ( 21) Appl.pp No.: 11/663,125 5,324,520 A 6/1994 Dunn et al. 1-1. 5.330,835 A 7, 1994 Kikuchi et al. (22) PCT Filed: Sep.15, 2005 5,340,572 A 8/1994 Patel et al. (86). PCT No.: PCT/US2OOS/O32863 (Continued) S371 (c)(1), FOREIGN PATENT DOCUMENTS (2), (4) Date: Aug. 29, 2008 AU 8374575 8, 1975 (87) PCT Pub. No.: WO2006/033948 CA 2222567 12/1996 PCT Pub. Date: Mar. 30, 2006 (Continued) OTHER PUBLICATIONS (65) Prior Publication Data US 2011 FOOO9451A1 Jan.
    [Show full text]
  • T.R.U.E. TEST Reference Manual
    Now FDA-approved for use on patients as young as 6 years old! Reference Manual truetest.com 800.878.3837 l © 1988 -2018 SmartPractice • All rights reserved. SmartPractice, T.R.U.E. TEST and associated logos are registered trademarks of SmartHealth, Inc. This manual is furnished with T.R.U.E. TEST® (Allergen Patch Test) purchased by a licensed medical professional, and may be used or copied as needed in accordance with patient care. In all other cases, this manual may not be duplicated or reproduced in any printed or digital media for distribution or sale without the written consent of the publisher SmartPractice. TT69010P 82310_0118 © 2018 SmartPractice • All rights reserved. SmartPractice, T.R.U.E. TEST and associated logos are registered trademarks of SmartHealth, Inc. Table of Contents Physician Manual Disclaimer........................................................................................................................................................v T.R.U.E. TEST (Allergen Patch Test) Shipping and Handling .....................................................................................................vi Introduction Contact Dermatitis is Common and Costly ................................................................................................................................1.1 Allergic or Irritant Contact Dermatitis? .......................................................................................................................................1.1 Why Patch Test? ............................................................................................................................................................................1.2
    [Show full text]
  • No. 38 of 1978 POISONS and NARCOTIC DRUGS ORDINANCE
    No. 38 of 1978 POISONS AND NARCOTIC DRUGS ORDINANCE 1978 TABLE OF PROVISIONS PART I—PRELIMINARY Section 1. Short title 2. Commencement 3. Interpretation PART II—ADDICTIVE SUBSTANCES Division 1—Unauthorized Use, Possession and Supply 4. Trafficking in Schedule 8 or Schedule 12 substances 5. Possession of Schedule 8 or Schedule 12 substances 6. Self-administration of Schedule 8 or Schedule 12 substances 7. Unauthorized administration to another person 8. Penalties not elsewhere prescribed Division 2—Authority to Possess Addictive Substances 9. Persons authorized to have Schedule 8 substances in their possession 10. Authority to possess a Schedule 8 substance for research purposes Division 3—Supply and Obtaining of Addictive Substances 11. Persons authorized to supply Schedule 8 substances 12. Medical practitioners, &c, not to obtain Schedule 8 substances except from pharma- cists or licensees Division 4—Restrictions on the Prescribing of Addictive Substances 13. Restrictions on prescribing of Schedule 8 substances, other than amphetamines 14. Restrictions on the prescribing of amphetamines Division 5—Approvals 15. Application for approval 16. Powers of Medical Officer of Health 17. Constitution of Committee 18. Chairman of the Committee 19. Procedure where application referred to Committee 20. Powers of Committee 21. Variation of approvals 22. Approvals, &c, to be in writing 23. When approvals, &c, take effect 24. Prescriptions for amphetamines Division 6—Cancellation and Surrender of Authority to Possess or Supply Schedule 8 Substances 25. Persons to whom this Division applies 26. Revocation of authority to possess or supply Schedule 8 substances 27. Surrender of authority to possess or supply Schedule 8 substances Authorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au TABLE OF PROVISIONS—continued Division 7—Miscellaneous 28.
    [Show full text]
  • Topical Drugs 35 Francisco M
    35_623_652 05.11.2005 11:22 Uhr Seite 623 Chapter 35 Topical Drugs 35 Francisco M. Brandão, An Goossens, Antonella Tosti Contents medication habits. Prescribing habits are changing, 35.1 Incidence and Prevalence . 623 and some medicaments that were common allergens 20–30 years ago,such as sulfonamides,penicillin,and 35.2 Factors Predisposing antihistamines, have now been replaced by other al- to Medicament Contact Dermatitis . 624 lergenic drugs, such as nonsteroidal anti-inflamma- 35.3 Clinical Patterns of Contact Reactions . 624 tory drugs (NSAID), and corticosteroids. 35.3.1 Irritant Contact Dermatitis . 624 The real incidence of adverse reactions to topical 35.3.2 Contact Urticaria . 625 medicaments is not known, and most of the data 35.3.3 Other Important Clinical Patterns . 625 about prevalence are quite old. Bandmann et al. [1] 35.3.4 Allergic Contact Dermatitis . 626 found that 14% of 4,000 patients tested in several Eu- 35.4 Allergens . 627 ropean countries were allergic to medicaments.Blon- 35.4.1 Local Anesthetics . 627 deel et al. [2] found a much higher incidence – 54.6%. 35.4.2 Antibiotics and Antimicrobials . 627 Still, in Belgium [3], 17% of 2,025 patients were aller- 35.4.3 Antivirals . 629 gic to the ingredients of pharmaceutical products, 35.4.4 Antimycotics . 629 while in Italy, in the 1980s [4], about 20.5% of 8,230 35.4.5 Corticosteroids . 630 patients were allergic to topical drugs. In Sweden, 35.4.6 Antihistamines . 632 40% of all recorded allergic reactions were due to 35.4.7 Nonsteroidal Anti-Inflammatory Drugs .
    [Show full text]