Drug class effects: definitions and practical applications.
The concept of drug class effect is profoundly rooted in clinical practice. The use of drugs seen as similar in their clinical effects--and therefore interchangeable--is very frequent: two examples of this are the use of beta-blockers in arterial hypertension and angiotensin-converting enzyme (ACE) inhibitors in congestive heart failure. The definition of drug class effect is based on three concepts: a similar chemical structure (for example, the dihydropyridine ring of some calcium channel blockers), a similar mechanism of action (beta-blockers block adrenoreceptors), or similar pharmacological effects (antihypertensives, antianginals, etc.). In this article, we will describe the type of evidence that a cardiologist can use in order to select a specific drug (from within a class). It constitutes a clinical approach, different from the one that might be used by a third party payer (more interested in cost-effectiveness issues) or the pharmaceutical industry (more interested in promoting sales). As usual, the recommendations are based on the strength of scientific evidence.
Soares
Isabel
I
Serviço de Medicina I, Hospital de Egas Moniz, Lisboa.
Carneiro
António Vaz
AV
D000319:Adrenergic beta-Antagonists / Q000145:classification*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000145:classification*; D002318:Cardiovascular Diseases / Q000188:drug therapy; D003365:Costs and Cost Analysis; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D004364:Pharmaceutical Preparations / Q000145:classification / Q000191:economics
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004364:Pharmaceutical Preparations