ADVANTAGE OF DRUGS

1. Uses For Medicine

Vaginal spermicides are a type of contraceptive (birth control). These products are inserted into the vagina before any genital contact occurs or sexual intercourse begins. They work by damaging and killing sperm in the vagina. Therefore, the sperm are not able to travel from the vagina into the uterus and fallopian tubes, where fertilization usually takes place.

Vaginal spermicides when used alone are much less effective in preventing pregnancy than birth control pills or the IUD or spermicides used with another form of birth control, such as cervical caps, condoms, or diaphragms. Studies have shown that when spermicides are used alone, pregnancy usually occurs in 21 of each 100 women during the first year of spermicide use. The number of pregnancies is reduced when spermicides are used with another method, especially the condom. Discuss with a doctor what your options are for birth control and the risks and benefits of each method.

Laboratory studies have shown that nonoxynol 9 kills or stops the growth of the AIDS virus (HIV) and herpes simplex I and II viruses. It was also shown to be effective against other types of organisms that cause gonorrhea, chlamydia, syphilis, trichomoniasis, and other sexually transmitted diseases (venereal disease, VD, STDs). Benzalkonium chloride also killed the AIDS virus in laboratory studies. Although this has not been proven in human studies, some scientistsbelieve that if spermicides are put into the vagina or on the inside and outside of a latex (rubber) condom, they may kill these germs before they are able to come in contact with the vagina or rectum (lower bowel).

The most effective way to protect yourself against STDs (such as AIDS) is by abstinence (not having sexual intercourse) or by having one partner who you can be sure is not already infected or is not going to get an STD. However, if either of these methods is not likely or possible, using latex (rubber) condoms with a spermicide is the best way of protecting yourself.

The use of a spermicide is recommended even when you are using nonbarrier methods of birth control such as birth control pills (the Pill) or intrauterine devices (IUDs), since these do not offer any protection from STDs.

The safety of using spermicides in the rectum (lower bowel), anus, or rectal area is not known. However, no side effects or problems have been reported that are different from those reported for use in the vagina.

Vaginal spermicides are available without a prescription.

Before Using This Medicine

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

These products have been used by teenagers and have not been shown to cause different side effects or problems than they do in adults. However, some younger users may need extra counseling and information on the importance of using spermicides exactly as they are supposed to be used so they will work properly.

Pregnancy

Many studies have shown that the use of vaginal spermicides does not increase the risk of birth defects or miscarriage.

Breast Feeding

It is not known if vaginal spermicides pass into breast milk in humans. However, their use has not been reported to cause problems in nursing babies.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergies, irritations, or infections of the genitals—Using vaginal spermicides may cause moderate to severe irritation in these conditions. Also, benzalkonium suppositories may be less effective in women with vaginal infections.

• Conditions or medical problems where it is important that pregnancy does not occur—Vaginal spermicides when used alone are much less effective than birth control pills or the IUD or spermicides used with another form of birth control such as cervical caps, condoms, or diaphragms. Discuss with your doctor what your options are for birth control and the risks and benefits of each method.

• Recent childbirth or abortion or
• Toxic shock syndrome (history of)—Cervical caps or diaphragms should not be used in these cases because there is an increased chance of developing toxic shock syndrome.

• Sores on the genitals (sex organs) or
• Irritation of the vagina—It is not known whether spermicides can cause breaks in the skin that could increase the chances of getting a sexually transmitted disease, especially AIDS. Discuss this with a doctor if you have any questions.

If you develop any medical problem or begin using any new medicine (prescription or nonprescription) while you are using this medicine, you may want to check with your doctor.

2. Drugs for Beauty

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Abstract

Like it or not, many people want to improve their looks with the help of biology, and pharmaceutical companies look set to help them. Regulatory bodies need to catch up.

They want to be pert, they want to be taut, they want glossy manes into their 60s. And they want balms, dyes and depilatories that will help them achieve it. Some might dismiss it as vanity, but society's increasing preoccupation with looks is fuelling a booming business in cosmetic drugs, or 'cosmeceuticals', worth $3.4 billion last year in the United States alone.

Cosmeceuticals lurk in the shadowy ground between drugs and cosmetics. Allergan's Botox, which flattens furrowed foreheads, is one example. Merck's Propecia for balding pates is another, as are off-the-shelf skin creams with active biological ingredients.

Those who add a prescription cosmeceutical to their morning routine can have real hope of seeing results. But the enticing skincare aisles of your local drugstore tell a different story: dermatologists confess that some 90% of ingredients in anti-ageing creams are little more than overpriced petroleum jelly. Why, when you slather on jelly for wrinkles, do you need to smear on a healthy dose of scepticism?

Cosmeceutical manufacturers must shoulder much of the blame, for trying to sidestep drug regulations. The US Food and Drug Administration (FDA) defines drugs as agents intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease, or that affect the structure or function of the body. Cosmetics escape the rigorous trials demanded of a drug because they are assumed only to alter our appearance. But the system falls down for cosmeceuticals, because it is the manufacturers — not the FDA — who decide whether a product is classed as drug or cosmetic. A cream that claims to cure eczema is a drug; if it claims to promote healthy skin, it is a cosmetic. This bizarre situation means that, although some cosmetics companies have excellent R&D arms, many are dissuaded from finding genuinely active ingredients, or advertising their properties if they do, for fear of having to undergo expensive drug trials. This also fuels the pseudo-science that is used to hype cosmetics.

This state of affairs must change. Cosmeceutical manufacturers should show that their ingredients genuinely work, or find some that do. The FDA should revise its outdated regulations to enforce this, so that all biologically active ingredients, whether drugs or cosmetics, have to prove their worth. Consumers are helpless to tell fact from fiction in today's non-prescription creams, so there is a market for prescription drugs with proven cosmetic powers. A few pharmaceutical and cosmetics giants, including Pfizer and L'Oreal, are embarking on research to fill this niche. Some people might argue that pharmaceutical companies should concentrate on curing deadly diseases, not feeding society's body paranoia. But if there is money in the beauty parlour, they are likely to pursue it (see page 990).

Perhaps a more thorny dilemma will face doctors who have to decide whether to prescribe cosmetic drugs to patients who demand them for wrinkles or baldness. As with any non-essential therapy, national or private health insurers can exclude them from coverage. But doctors and medical ethicists must consider whether they have the right to refuse a prescription to patients willing to pay.

The dilemmas thrown up by cosmeceuticals will become more pressing as biologists reveal the secrets behind wilting skin and barren follicles — and the molecules that might revamp them. Our attitudes are outdated. Consumers should demand more from their $20-a-pot unguents. And when 'real' cosmeceuticals are created, doctors, industry and regulators should work together to ensure that they are effective and accessible.

3. SPIRITUAL AND RELIGIOUS USE

The spiritual and religious use of drugs has been occurring since the dawn of our species. Drugs that are considered to have spiritual or religious use are called entheogens. Some religions are based completely on the use of certain drugs. Entheogens are mostlyhallucinogens, being either psychedelics or deliriants, but some are also stimulants and sedatives.

4. HUMAN COGNITIVE IMPROVEMENT

Nootropics, also commonly referred to as "smart drugs", are drugs that are claimed to improve human cognitive abilities. Nootropics are used to improve memory, concentration, thought, mood, learning, and many other things. Some nootropics are now beginning to be used to treat certain diseases such as attention-deficit hyperactivity disorder, Parkinson's disease, and Alzheimer's disease. They are also commonly used to regain brain function lost during aging.

http://www.drugs.com

http://www.nature.com

http://en.wikipedia.org