Презентация к уроку английского языка "Food & Drug Administration" - скачать бесплатно

Содержание

Слайд 2

Food & Drug Administration (FDA) 1862, started with a single chemist

Food & Drug Administration (FDA)
1862, started with a single chemist in

the USDA
1927, Bureau of Chemistry changed to the Food, Drug, & Insecticide Administration
1930, name was shortened to the present version
2001, staff ~9,100 employees & a budget of $1.3 billion
Слайд 3

Adulteration and misbranding of foods & drugs have always been a

Adulteration and misbranding of foods & drugs have always been a

problem in the U.S.
The problem increased by the late 19th C.
Drugs such as Quinine were cut with fillers to increase profit
Sufferers of serious illnesses were sold worthless drugs or therapies
Preservatives added to foods & drugs were useless or worse toxic
Слайд 4

http://www.fda.gov/cder/about/history/Graphics/OilKingLrg.jpg

http://www.fda.gov/cder/about/history/Graphics/OilKingLrg.jpg

Слайд 5

http://www.fda.gov/cder/about/history/Gallery/gallery21.htm

http://www.fda.gov/cder/about/history/Gallery/gallery21.htm

Слайд 6

Harvey Washington Wiley, chief chemist concerned about chemical preservatives, initiated "poison

Harvey Washington Wiley, chief chemist concerned about chemical preservatives, initiated "poison

squad" experiments
Healthy volunteers consumed varying amounts of questionable food additives to determine their impact on health
Officially designated the “Hygienic Table.”
Chemicals fed to the young men included borax, salicylic, sulfurous, and benzoic acids, & formaldehyde
Слайд 7

Wiley became convinced that chemical preservatives should be used in food

Wiley became convinced that chemical preservatives should be used in food

only when necessary
That the burden of proving safety should fall on the producer
That none should be used without informing the consumer on the label
Wiley unified a variety of groups behind a federal law to prohibit the adulteration and misbranding of food and drugs
Слайд 8

Food and Drugs Act of 1906 First nationwide consumer protection law

Food and Drugs Act of 1906
First nationwide consumer protection law made

it illegal to distribute misbranded or adulterated foods, drinks and drugs across state lines
Offending products could be seized & condemned; persons could be fined & jailed
Drugs had either to abide by standards of purity and quality set forth in the UNITED STATES PHARMACOPEIA & the NATIONAL FORMULARY
Presence & quantity of alcohol or certain narcotic drugs had to be stated on proprietary labels
Слайд 9

There were however, shortcomings in the 1906 law Law prevented blatant

There were however, shortcomings in the 1906 law
Law prevented blatant fraud,

but it did not prevent deception
Numerous examples of foods deceptively packaged or labeled began to show up
The law also did not insist that products be tested for safety
Слайд 10

http://www.fda.gov/oc/history/slideshow/Slide_182_139.html Flavoring Extract Bottle thick glass obscures how much expensive flavoring

http://www.fda.gov/oc/history/slideshow/Slide_182_139.html

Flavoring Extract Bottle
thick glass obscures how much expensive flavoring extract is

really in the bottle
Слайд 11

Lash-Lure, an eyelash dye that blinded many women http://www.fda.gov/oc/history/

Lash-Lure, an eyelash dye that blinded many women

http://www.fda.gov/oc/history/

Слайд 12

A disaster in 1937 prompted Congress to act A Tennessee drug

A disaster in 1937 prompted Congress to act
A Tennessee drug company

marketed a form of the new sulfa wonder drug that would appeal to pediatric patients, Elixir Sulfanilamide
The solvent in this untested product was diethylene glycol
Over 100 people died, many of whom were children
Слайд 13

http://www.fda.gov/cder/about/history/Page18.htm Elixir Sulfanilamide

http://www.fda.gov/cder/about/history/Page18.htm

Elixir Sulfanilamide

Слайд 14

1938 Federal Food, Drug, and Cosmetic Act For the first time,

1938 Federal Food, Drug, and Cosmetic Act
For the first time, required

companies to prove the safety of new drugs before putting them on the market
Over the years new responsibilities were added including the requirement that drugs and medical devices be proven effective as well as safe before they can be sold
Слайд 15

Currently the FDA is charged with: Safeguarding the nations food supply,

Currently the FDA is charged with:
Safeguarding the nations food supply, by

ensuring that all ingredients used in foods are safe, & that food is free of contaminants
Approves all new food additives before they can be used
Monitors the safety of dietary supplements & the content of infant formulas & medical foods
Protects the public from unnecessary exposure to radiation from electronic products. (microwave ovens, cell phones, x-ray equipment, lasers, medical ultrasound & MRI machines)
Monitors cosmetic products to be sure that they are safe & properly labeled
Слайд 16

Medical products need to be proven safe and effective before they

Medical products need to be proven safe and effective before they

can be used by patients
The product categories covered by this requirement include:
Medicines used for the treatment and prevention of disease
Biologics, vaccines, blood products, biotechnology products and gene therapy
Medical Devices, FDA regulates all medical devices, from very simple items like tongue depressors or thermometers to very complex technologies such as heart pacemakers and dialysis machines.
Слайд 17

Drug Review & Approval

Drug Review & Approval

Слайд 18

Слайд 19

The majority of prospective new drugs fail testing, many never make

The majority of prospective new drugs fail testing, many never make

it passed the pre-clinical stage
The pre-clinical stage involves testing in either animals or cells and looks at the potential drugs efficacy in a model of the the disease
This stage also involves looking for possible toxicity or side-effects that may be significant if the compound moves ahead to human studies
Слайд 20

If a compound shows promise during the pre-clinical phase the drug

If a compound shows promise during the pre-clinical phase the drug

maker may decide to move forward with human testing
Human testing of a drug is known as a clinical trial
For a drug to be tested in humans the Sponsor must submit an application to The Center for Drug Evaluation and Research (CDER), part of the FDA
This application is known as an
Investigational New Drug Application (IND)
Слайд 21

Investigational New Drug Application (IND) The IND is reviewed by both

Investigational New Drug Application (IND)
The IND is reviewed by both the

FDA and a local IRB
An Institutional Review Board (IRB) is a panel of physicians, scientists, & lay persons who oversee research done using humans
Each hospital or research institution must have an IRB if it allows human research
The IRB approves the clinical trial protocols, these describe who may participate in the trial, the schedule of tests and procedures, the medications and doses, the study’s length, and finally its objectives
Слайд 22

After approval by the IRB and the FDA, clinical trials can

After approval by the IRB and the FDA, clinical trials can

begin
There are up to four different phases of trials, each with a specific objective.
If any problems arise during any of these phases the FDA is notified and the IND application is canceled
Слайд 23

Phase I Studies Conducted in healthy volunteers, between 20 to 80

Phase I Studies
Conducted in healthy volunteers, between 20 to 80
Goal is

to determine safety and look for possible side effects
The studies are usually open-label meaning the volunteers & the physicians know who is getting the drug
The Pharmacokinetics of the drug is often investigated
If no unacceptable toxicity is revealed, phase II studies can be initiated
Слайд 24

Phase II Studies Shift in emphasis from safety to effectiveness Collection

Phase II Studies
Shift in emphasis from safety to effectiveness
Collection of preliminary

data on whether the drug works in people who have a certain disease or condition
Usually two groups of patients are compared, one group receiving the drug is compared to a second group who receives either a placebo or a different drug
Studies are often done in the double blind method, this means the neither the patient, physician, nor the drug company know which patients are getting the drug & which are getting the placebo
The number of subjects rages from a few dozen to 300
Слайд 25

Phase III Studies If effectiveness is shown during phase II the

Phase III Studies
If effectiveness is shown during phase II the study

is expanded to a phase III
The goal during this phase is the continued collection of safety and effectiveness data
These data are collected on a larger population that is more varied than that studied during phase II
Phase III also often studies the drug at different doses and in combination with other drugs
The number of subjects ranges from a few hundred to a few thousand
Слайд 26

Phase IV Studies Occur after a drug is approved Explore other

Phase IV Studies
Occur after a drug is approved
Explore other aspects of

the drug such as usage in new populations, such as children
Long term effects are also explored
Often after approval, some drugs are found to have unintended usages
These are referred to as off-label uses
It is legal for a physician to prescribe a drug for off-label use, but the drug company cannot advertise these uses until further studies are performed
Слайд 27

New Drug Application (NDA) Once clinical trials are finished the sponsor

New Drug Application (NDA)
Once clinical trials are finished the sponsor places

a formal request with the FDA to consider approving the drug
This request is known as a New Drug Application (NDA)
Once a NDA is filed the FDA has 60 days to review the application for filing
If the FDA decides to file the application a review team of physicians, chemists, statisticians, microbiologist, and pharmacologists is assembled
Only 1 in 5 drugs that enter clinical trials is ultimately approved by the FDA
Слайд 28

Review Process The review team analyzes all aspects of the study

Review Process
The review team analyzes all aspects of the study results

looking for possible problems, such a weaknesses in the study design or analyses
Reviewers determine if they agree with the sponsor’s results and conclusions or if additional information is needed
Each reviewer then prepares a written evaluation with their recommendation about the application
Слайд 29

If the FDA decides that the benefits of the drug outweigh

If the FDA decides that the benefits of the drug outweigh

any risks the drug can then be marketed in the US
If there are problems with the NDA, the FDA may decide that the drug is approvable or not approvable
Approvable means that the drug may eventually be approved, but that some issues need to be resolved first
Not approvable means there are significant problems that cannot be overcome without substantial additional data
These could be safety problems or failure to demonstrate the drug’s effectiveness
Слайд 30

Accelerated Approval Given to drugs for serious and life-threatening illnesses that

Accelerated Approval
Given to drugs for serious and life-threatening illnesses that lack

satisfactory treatments
Uses surrogate endpoints instead of traditional measures
These can be laboratory findings that are not directly related to patient survival or function
Most HIV drugs have been approved through this process with the provision that the companies continue to perform studies to confirm the drug’s ultimate benefit
If future studies do not confirm initial results the FDA may withdraw approval
Слайд 31

http://www.fda.gov/cder/handbook/develop.htm

http://www.fda.gov/cder/handbook/develop.htm

Слайд 32

Abbreviated New Drug Application (ANDA) Provides for the review and ultimate

Abbreviated New Drug Application (ANDA)
Provides for the review and ultimate approval

of a generic drug
A generic drug is one that is comparable to an innovator drug in dosage form, strength, route of administration, quality, performance characteristics and intended use
Termed abbreviated because they are generally not required to include preclinical and clinical data to establish safety and effectiveness
Applicants must scientifically demonstrate that their product is bioequivalent
Слайд 33

Bioequivalence In order to demonstrate bioequivalence scientists measure the time it

Bioequivalence
In order to demonstrate bioequivalence scientists measure the time it takes

the generic drug to reach the bloodstream in 24 to 36 healthy, volunteers
This gives them the rate of absorption, or bioavailability, of the generic drug, which they can then compare to that of the innovator drug
The generic version must deliver the same amount of active ingredients into a patient's bloodstream in the same amount of time as the innovator drug
Слайд 34

Orphan Drugs In 1982 Congress passed the Orphan Drug Act The

Orphan Drugs
In 1982 Congress passed the Orphan Drug Act
The goal was

to promote the development of products that demonstrate promise for the diagnosis and/or treatment of rare diseases or conditions
More than 200 drugs & biological products for rare diseases have been brought to market since 1983
Prior to 1983 fewer than ten such products came to market
Слайд 35

Adverse Events Reporting System (AERS) The FDA requires manufacturers to report

Adverse Events Reporting System (AERS)
The FDA requires manufacturers to report adverse

drug reactions
Health care professionals & consumers can also send reports voluntarily through the MedWatch program
If there are significant adverse effects the FDA may take regulatory actions to improve product safety and protect the public health
Such as updating a product’s labeling information, sending out a "Dear Health Care Professional" letter, or re-evaluating an approval decision
Слайд 36

If a drug has severe side effects, but is kept on

If a drug has severe side effects, but is kept on

the market a black box warning is placed on the label
Recent black box warnings have been issued for:
Advair/Serevent: small, but significant increase in asthma deaths particularily in African-Americans
Depo-Provera: significant decrease in bone density
Serzone: life-threatening liver failure
All antidepressants for increased adolescent suicide
Acetaminophen: life-threatening liver failure increased when taken with alcohol
Слайд 37

Recent Drug Controversies Vioxx, voluntarily withdrawn due to increases in heart

Recent Drug Controversies
Vioxx, voluntarily withdrawn due to increases in heart attacks

& strokes
Prempro, Premarin; hormone replacement therapy, a long term study showed increases in breast cancer & coronary heart disease
Baycol (cerivastatin), removed from the market because of ~31 reports of fatal rhabdomyolysis, destruction of muscle tissue that can lead to kidney failure
Crestor (Rosuvastatin) approved in August, 2003 has the same problem
Слайд 38

If you have questions about medications your or your family are taking: http://www.fda.gov/medwatch/index.html

If you have questions about medications your or your family are

taking:
http://www.fda.gov/medwatch/index.html