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The last thirty years have seen an unprecedented increase in the
discovery of new drugs, and moreover, these drugs, unlike many of
the nostra of former times, have varied and powerful
pharmacological actions. The occurrence of one or two "drug
disasters," together with a change in public attitudes, has made it
necessary for governments to introduce legislation to control the
intro duction and release of new therapeutic agents, and most
countries in the Western World have some form of drug licensing
agency. Whole series of regulations have appeared which aim at
discovering and defining the toxicity of new drugs. Many of these
regulations rely heavily on testing drugs in animals before they
are used in man, and at present very extensive and prolonged animal
studies are required by most licensing authorities. It is most
opportune that Professor Folb has decided to review the present
position in this monograph. It is not only inhumane but also
wasteful of time and money if extensive animal experiments which
have little or no relevance to the human situation are carried out;
furthermore, such results may even be dangerously misleading. There
is little doubt that some preliminary animal investigations are
necessary, but it is essential to keep their relevance under
continuous review and to adopt a critical and flexible approach
rather than heap regulation upon regulation."
We share with our colleagues the difficulties presented by the
increasing volume of drugs available for our use in the care of
patients. The introduction of new and effective preparations has
added to our problems both in keeping up to date and,
paradoxically, in their proper selection and use. There are yet
further difficulties in general practice because of the nature of
the diseases and situations encountered; uncer tainties in the
preciseness of di-a.gnosis, in the likely course and outcome of
diseases and in the particular characteristics of the individual
patient. We have attempted to ease these difficulties by adopting a
logical but Simplistic schematic approach to the choice of
medicines for 14 selected common conditions. Our approach includes:
* statements of knowledge and understanding of the conditions; *
analyses of the most suitable available drugs; * setting objectives
and principles for management; * suggested treatment plans. The
suggestions are, of course, our own and may not be completely
acceptable to some of our readers, but in creating this schematic
approach our intention has been that those who follow it will be
able to select from alternative preparations with satisfactory
results.
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