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Lomefloxacin is an antibiotic under the drug class of fluoroquinolone. This is used to treat chronic bronchitis, urinary tract infections (UTI), and is also used as a prophylactic, or preventative treatment. It is used as a prophylactic to prevent UTIs in patients undergoing transrectal or transurethral surgical procedures. Lomefloxacin and other drugs in its class are very effective against gram-negative aerobic bacteria such as E.coli and Neisseria gonorrhoea as well as gram-positive bacteria including S. pneumonia and Staphylococcus aureus. A good comparator for this drug would be

ciprofloxacin, which is another antibiotic under the fluoroquinolone class that treats much of the same problems that Lomefloxacin does such as UTIs though is not used to treat bronchitis. Norfloxacin is also much the same being under the same class of antibiotics and treating the same infections as ciprofloxacin. The cost to the patient is around 100 US dollars for a 400 mg tablet taken orally once a day for 10 days. I think it is a reasonable price for a medication like that as it is helping to prevent pretty bad infections and is only cost a few hundred dollars.

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Miglitol

1. What are the "FDA-approved" and "unapproved" indications for this drug?

One "FDA-approved" implication that Miglitol can be taken as a substitute of exercise and diet to help control patient's blood glucose concentration/ digestive systems. But some "unapproved" implications is that Miglitol can cause side effects like dizziness, headaches, weakness, irritability, shakiness, or increased hunger.

2. What is the mechanism of its therapeutic effect? Is this drug a member of an established class, or is it a brand new form of therapy?

Miglitol is meant to regulate blood glucose levels by inhibiting the digestion of ingested carbohydrates. This drug belongs to a class of drugs called alpha-glucosidase inhibitors, a family that also includes the drug acarbose (Precose).

5. What is the cost to the patient (per treatment or per time period, if appropriate)? Do you think it is worth the price? Why or why not?

The cost of Miglitol is around $137 in total for 30 25mg tablets. I don't personally think it's worth the price because 30 tablets that are taken 3 times a day means that it lasts only 10 days, and if it's a long term treatment that is about $411 a month.

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Perindopril's mechanism involves preventing an enzyme in the body from producing angiotensin II.  It is part of an already existing class named angiotensin-converting ace inhibitors.

The drug is claimed to treat high blood pressure by preventing the body from producing an enzyme that tightens blood vessel walls.  Data supports that perindopril is more effective than the comparator.  This data is published in peer-reviewed journals.

The price for a bottle of 30 4mg tablets of Perindopril ranges from $15 to $30. I believe that this price is worth it as the drug is proven to work well.

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What is the mechanism of its therapeutic effect? Is this drug a member of an established class, or is it a brand new form of therapy?

Zaleplon is a cns depressant drug. It slows down the nervous system helping decrease the time to sleep onset. There are many other drugs is this class.

What are the manufacturer's claims for the drug? Does the data support any claims that it is more effective or safer than the comparator (be specific)? Are these data from properly designed trials and published in peer-reviewed journals?

Zaleplon gets the consumers to sleep quicker within 1 to 2 weeks with the effect lasting for up to 30 days. Multiple clinical labs have been done giving claims credibility.

What is the cost to the patient (per treatment or per time period, if appropriate)? Do you think it is worth the price? Why or why not?

The medicine is usually consumed anywhere from 2 days to 2 weeks and causes drowsiness and can cause muscle aches. I think if you really aren't getting any sleep due to a condition the trade off is a good one as it's been proven to help and the side effects are minor.

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What are the "FDA-approved" and "unapproved" indications for this drug?

What is the mechanism of its therapeutic effect? Is this drug a member of an established class, or is it a brand new form of therapy?

What is the appropriate standard against which to compare it? Why? Is this comparator another drug, a surgical procedure, or …?

Basiliximab is a drug classified as an immunosuppressant that is approved by the FDA as an indication for treating prophylaxis of the acute organ rejection that can occur during during renal transplantation, used as a part of an immunosuppressive regimen during the surgery.  It is contraindicated for patients with hypersensitivity to the drug or any of its ingredients. The mechanism of its therapeutic effect is the drug's blocking of the interleukin-2 receptor a-chain on activated T-lymphocytes in the patient's immune system, thus preventing the patient's body from activating its immune response to the foreign tissue and rejecting the transplanted organ. Anti-thymocyte globulin (ATG) is often noted as a comparator to basiliximab because of ATG's effectiveness in preventing acute organ rejection as well; which one is the more attractive choice is not yet clear and has been debated over.

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What are the "FDA-approved" and "unapproved" indications for this drug?
- It is noted in the FDA data website that gatifloxacin is approved for use.

What is the appropriate standard against which to compare it?
- Gatifloxacin is actually an ophthalmic solution used to treat pink eye and bacterial infections. However, other antibiotic eye drops containing antihistamines have been found to be just as helpful. It just depends on the person.

What is the cost to the patient (per treatment or per time period, if appropriate)?
- The price of gatifloxacin is around $201 for a bottle of 2.5 milliliters. I believe it's a well-developed medication for people with bacterial infections within the eye. It's a bit expensive especially to those who can't afford to purchase it, so there are definitely pros and cons to using this.

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- Miglitol is an oral medication belonging to the alpha-glucosidase inhibitors class of drugs. The mechanism behind miglitol is that it is able to delay the digestion of carbohydrates (sugars) in your body. As a result there is a smaller rise in blood glucose concentration after a meal, making it suitable to treat adults with type 2 diabetes.

- Glibenclamide is another medication used to treat type 2 diabetes, however, studies have shown that miglitol is more suitable towards diet-resistant type 2 diabetic patients with its persistent effects, as well as its manageable side effects.

- Miglitol needs to be taken three times each day after a meal with a typical dosage being 50mg each time. Miglitol is rather expensive as the average retail price for brand name 90 tablets of 25 mg is $234 dollars. However the generic version is only $51 for 90 tablets of 25 mg. I do not think it is worth the price as it is not able to lower average blood sugar levels like other diabetes medications.

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Drug- zonisamide
1. The FDA approved indications for zonisamide are that it is an adjunctive therapy in the treatment of partial seizures in adults with epilepsy. Unapproved indications of this drug are weight loss.
2.  Zonisamide is used to suppress seizures by inhibiting carbonic anhydrase and also treating partial seizures. Zonisamide is classified as an anticonvulsant because it works by decreasing abnormal electrical activity in the brain.

5. Brand name zonisamide, ZONEGRAN ranges around $200 dollars for 9 100mg capsules, while generic zonisamide ranges around $10 for 9 100mg capsules. I believe that if you want to get zonisamide for a reasonable price, I say the generic one would be more worth it as it has the same effects as brand name at a much lower price. You can buy more of the generic one to consume everyday.

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gatifloxacin:
- FDA approved under regulatory approval to Allergan for its anti-infective fluoroquinolone gatifloxacin (is banned in India and certain places)
- eye drops
-  In 2011, the Union Health and Family Welfare Ministry of India banned the manufacture, sale, and distribution of gatifloxacin because of its adverse side effects
-  posed high threat of severe hyperglycemia or high blood sugar among elder citizens
- around $91 for a supply of 2.5 milliliters,

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1) What are the "FDA-approved" and "unapproved" indications for this drug?
Entacapone is used to accompany levodopa to help patients who suffer from idiopathic Parkinson's Disease and experience "end-of-dose" effect, often called shaking palsy.

2)What is the mechanism of its therapeutic effect? Is this drug a member of an established class, or is it a brand new form of therapy?

Entacapone blocks the enzyme catechol-O-methyl transferase (COMT), which inhibits the breakdown of dopamine and levodopa. It belongs to a class called COMT inhibitors, and is not very new, being approved around the year 1999.

3) What is the cost to the patient (per treatment or per time period, if appropriate)? Do you think it is worth the price? Why or why not?
The price of Entacapone can vary from pharmacy to pharmacy, but a good number would be around $35 for thirty tablets that contain 200 mg of the drug. I would say that it is not worth it. It is very expensive, and when I searched up whether the drug was worth it for actual users, many said that it wasn't worth it. Many patients said that it was expensive and that they experienced a lot of negative side affects, like body aches, lots of pain, hallucinations, dizziness, etc.

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1. Rabeprazole is used to treat symptoms of Gastroesophageal reflux disease. It treats damage from GERD and allows the esophagus to heal and prevent further damage. Rabeprazole also has intended uses to treat conditions where the stomach produces too much acid, and also to help treat ulcers that may form.
2. Rabeprazole is classified as an antiulcer drug it's in the class of proton pump inhibitors. Rabeprazole blocks the final step of gastric acid secretion and in gastric parietal cells, rabeprazole is protonated, then it accumulates, and is finally transformed into an active sulfonamide.
5. Rabeprazole is priced at around 13$ and is commonly found in 20mg tablets that are taken once a day for about 4 weeks (depending on doctors prescription) I think that the pricing on this drug is appropriate. Although you should stray away from the name brand because it tends to be more expensive.

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1. Balsalazide is a locally acting aminosalicylate that is FDA approved for the treatment of mildly to moderately active ulcerative colitis in adults.
2. Balsalazide disodium is delivered intact to the colon where it is cleaved by bacterial azoreduction to release equimolar quantities of mesalamine, which is the therapeutically active portion of the molecule, and the 4-aminobenzoyl-ß-alanine carrier moiety.
3. it is often compared to sulfasalazine and mesalamine. sulfasalazine is a form of therapy.
4. Balsalazide is used to treat an inflammatory bowel disease called ulcerative colitis.
Balsalazide is more effective and better tolerated than mesalamine. More patients treated with balsalazide achieved symptomatic remission after 12 weeks.
5. about $190-$500  for 270 mg of Balsalazide. I think it's overpriced but if you use coupons, you can get deals that are more doable.

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1- Leflunomide's indications that are FDA-approved is that it is to treat adults with rheumatoid arthritis.
2- It works by suppressing the blood cells that cause inflammation. It is part of an already established class that is the immunosuppressants as well as the disease modifying anti rheumatic class.
3-the price ranges from $21-$85 for 30 tablets of 20mg. However, for the name brand the price sky rockets to around $1,400. The price could be worth it seeing that the medication stays in your body for about 1-2 years even if you stop taking it.

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(Netilmicin)
1. The mechanism of netilmicin is that it binds to specific proteins and rRNA of a bacteria it is targeting in order to destroy it. It is semisynthetic and part of the aminoglycoside group.

2. It costs 170 dollars per 5mg and the dosage is determined by the doctor. I think that it is worth it because it is used to treat serious bacterial infections which can be life-threatening.

3. A good standard to compare it to is to other drugs that treat serious bacterial infections like amoxicillin, erythromycin, and ciproflaxcin. These would be good to compare because netilmicin also treats serious bacterial infections.

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Drug Evaluated: meloxicam
1. The approved indicated use of meloxicam is to treat pains from osteoarthritis and rheumatoid arthritis. The nonapproved use of meloxicam is for children under 2 years old, women undergoing fertility treatment, or people who are anemic.
2. Meloxicam is a NSAID, which means the drug is a nonsteroidal anti-inflammatory drug. By taking the drug, meloxicam inhibits the formation of the COX enzyme, reducing the production of molecules that cause inflammation and blood clot.
5. The price of meloxicam is around $20-$30 for 30 tablets containing 15mg of the drug. Since the drug intake should be one tablet a day, that would mean it would cost around $20-$30 dollars per month for treatment. I think this is worth the price, due to the fact that it relieves the pain targeted towards different types of arthritis.

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Rivastigmine is a drug used to treat and manage neurodegenerative diseases like Alzheimer's and dementia. The mechanism of transfer is as a transdermal film/patch or as a capsule. Other drugs used to combat the effects of neurodegenerative disorders are galantamine and donepezil, which are cholinesterase inhibitors. Different trials have been put in place to evaluate the efficacy and safety of rivastigmine such as tests for skin irritation. Some adverse side effects have shown gastrointestinal pain. However, trials on patients taking rivastigmine vs a control group have shown its effectiveness in restoring cognitive function.

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The FDA approved naratriptan is for the treatment of migraine, without or with aura in adults. The drug works by selectively suppressing neurotransmission from sensory fibers through inhibitor in the neuropeptide transmitter release. This drug is in a class of medications called selective serotonin receptor agonists, treating migraines and cluster headaches. The medication works by narrowing blood vessels around the brain, this stops the pain signals from being sent to the brain. Leading to the stopping of the release of certain natural substances that can cause symptoms of migraine.  IN some places this drug costs more than others but it ranges from 20-50 dollars and this a pretty fair amount.

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Valdecoxib was intended to relieve symptoms of joint pain, rheumatism, inflammation, stiffness, and etc. It's initial effectiveness acquired FDA's approval, until 2005 when it was officially withdrawn from the U.S. market. It was withdrawn because it became more of a threat than a benefit, causing an increased cardiovascular risk, life-threatening skin reactions, and sometimes, even death. The FDA unapproved of valdecoxib being distributed further. Pfizer, the company behind valdecoxib, admitted to these risks in 2004, but reassured that it would still be safe enough for continued use. This drug was part of the nonsteroidal anti-inflammatory drugs class that did accomplish its initial objective adequately. It proved to me more effective than placebo and it paralleled naproxen's efficiency.

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Meloxicam:
The drug belongs under the class of an anti-inflammatory drug; it is also nonsteroidal. The purpose if the drug is to reduce swelling, specifically in the joints to reduce pain due to arthritis. The FDA has approved meloxicam but does not recommend the drug to patients that are pregnant or people that do not suffer from rheumatoid arthritis. The efficacy of the drug runs over 50% and is pretty cost efficient considering it reduces chronic pain, so many would agree that the drug is worth the price. The comparative for meloxicam would be for example Celebrex which isn't as cost efficient because meloxicam is the generic version.

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1. The FDA has approved for the use of Comtan (entacapone) as an adjunct tot levodopa/carbidopa to treat patients with idiopathic Parkinson's Disease who experience the signs and symptoms of end-of-dose "wearing-off". Entacapone belongs to a class of drugs known as COMT inhibitors. This medicine is known as a levodopa therapy.
2. Entacapone helps levodopa last longer by blocking a substance called COMT enzyme. This enzyme breaks down levodopa before it reaches the brain. When less levodopa is broken down, more is available to the brain.  Increased availability of levodopa may lead to smoother and steadier levels of dopamine in the brain
3. The cost for entacapone oral tablet 200 mg is around $35 for a supply of 30, depending on the pharmacy you visit. 200 mg PO (by mouth) with each dose of levodopa/carbidopa; not to exceed 1600 mg/day.

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Rizatriptan is a drug that the FDA has approved for alleviation of acute migraines of the brain. It help people from ages 6 and older treat headaches. However the FDA does not approve for this drug to be used on infants young than 6 years of age for it could cause damage.

The cost of this drug for a patient using oral tablet 5 mg is around $130 for a supply of 12 tablets, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans. I think the this is something that is too expensive for its price I think you should just take an Advil which works for me and is much cheaper.

An appropriate drug with which you could compare Rizatriptan too could be Ibuprofen. Although Rizatriptan is superior to ibuprofen in relieving headache, associated symptoms and functional disability. It is still way cheaper in price than Rizatriptan. I think this is a good drug to compare it with since they both relive pain.

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1) Approved indications are Hypertensive disorder and Myocardial Infarction Prevention while unapproved indications are Chronic heart failure, Atrial fibrillation, Diabetic renal disease, Diastolic heart failure, and Nondiabetic Proteinuric Nephropathy.

2) Perindopril lowers blood pressure primarily by inhibition of ACE activity. It is part of the class of drugs knows as  Angiotensin-Converting Enzyme (ACE) inhibitors.

5) Perindopril costs $71.99 for 30 4 mg tablets. I would say that it is worth it as it has shown a 96% success rate, results similar to monotherapy, and is widely considered to be a well tolerated ACE inhibitor.

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2. Meloxicam is an NSAID (nonsteroidal anti-inflammatory drug) and is used to treat pain, swelling, stiff joints, and tenderness caused by osteoarthritis. The average retail price for over the counter meloxicam is $88 for 30 15mg tablets.
5. I think that the price for the medication isn't worth it, as long term use of the drug can be dangerous and puts the patient at a higher risk of having a heart attack, stroke, or blood clot.
3. An appropriate drug to compare meloxicam to is ibuprofen, as it is a very common drug, safer, and also an NSAID.

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Miglitol is a drug that helps patients with type 2 diabetes to treat their blood sugar levels. The drug works in the intestine to slow down the breakdown and absorption of carbohydrates in the body. It is of the Alpha-glucosidase inhibitor class of drugs. The FDA has indicated that the drug is an adjunct to exercise and diet to help improve patient's control over their glycemic processes. Miglitol can cause a variety of side effects, inlcuding shakiness, dizziness, irritability, headaches, hunger, weakness, etc. It is taken around 3 times a day. The cost for miglitol is around $137 for a total of 30 25mg tablets. I think that the price is not completely worth it; a 30 tablet supply will only last for around 10 days and only provides improved glycemic control.

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Naratriptan
1. FDA approved indications of Naratriptan is it’s use for acute treatment of migraine with or without aura in adults. FDA disapproved indications of Naratriptans is how it’s safety and effectiveness haven’t been established for a cluster headache.

2. The basic mechanism of naratriptan is it’s suppression of neurotransmission from sensory fibers.  It works by narrowing blood vessels around the brain, stopping pain signals from being sent to the brain, and stopping the release of certain natural substances that cause pain, nausea, and other symptoms of migraine. Naratriptan is part of the selective serotonin receptor agonists class.

5. While the cost of the drug depends on the pharmacy location, the oral naratriptan medication cost ranges from $77 to $120 for a supply of 9 tablets. At first, I found the price range incredibly pricey yet however, seeing how well this drug works on patients, the price is somewhat understandable.

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The mechanism of the effect of quinapril is that it is an angiotensin converting enzyme (ACE) inhibitor. More specifically, it blocks a substance that tightens the blood vessels, allowing them to relax and lowering blood pressure. It is a new part of second-generation ACE inhibitors.

In comparison to another ACE inhibitor, quinaprilat, the absorption of quinapril is unaffected by food and achieves similar effects, although its potency is a third as strong.

For 90 40mg tablets, the average retail price is $75.03. I believe that it is worth the price as preventing high blood pressure can be a step in lessening hospital visits. Nevertheless, it is important to look into other medications and see if they better fit the patient's needs.

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1) Caspofungin is the first echinocandin antifungal agent to gain FDA approval for use in the US.

2) It averages around $42 for a supply of 1 powder for injection (varies depending on which pharmacies you visit). Additionally, the prices are for cash-paying customers only (not valid for insurance plans). Upon further research, I've found that Caspofungin is not the most cost-effective, especially as micafungin easily stands as a great replacement.

3) Caspofungin has a relatively low incidence of adverse effects; the most commonly reported adverse events include chills, fever, phlebitis/thrombophlebitis, tachycardia, nausea, vomiting, rash, abdominal pain, headache, and diarrhea. I think this, for the most part, supports the manufacturers' claims.

- Overall, I think the only adjustment that would have to be made to make caspofungin a good replacement for old drugs is the price. Considering its low rate of adverse effects, I think it is safe enough to be considered.

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Glatiramer acetate
Glatiramer acetate causes changes of frequency, cytokine secretion pattern and effector function of GA specific cells. Glatiramer acetate is from the immunomodulator category. Glatiramer acetate was FDA approved for the treatment of relapsing forms of multiple sclerosis. 40 mg/mL is the given injection. The cost is about $6000 for 12, 1 mL of 40 mg/mL Solution Prefilled Syringe. In my opinion the cost is a fair price because it cures sclerosis which slowly eats at your immune system while also damaging your spinal cord, both very important parts of our body.

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Question 1: What is the mechanism of its therapeutic effect? Is this drug a member of an established class, or is it a brand new form of therapy?

The mechanism of cilostazol replicates the activity of phosphodiesterase, allowing the rise in cAMP levels in blood vessels. It is similar to pentoxifylline.

Question 2: What is the cost to the patient (per treatment or per time period, if appropriate)? Do you think it is worth the price? Why or why not?

The price for cilostazol to the patient is around 30 dollars per 50 count. For me, I believe this is relatively cheap as it increases blood flow by thinning them and making them flow more smooth to the legs, allowing pain reduction for longer durations of activity to the leg.

Question 3: What are the "FDA-approved" and "unapproved" indications for this drug?

The FDA-approved indication is "Cilostazol is a quinolone derivative primarily used to treat intermittent claudication due to peripheral vascular disease." There are no unapproved indications available on the internet.

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What are the "FDA-approved" and "unapproved" indications for this drug?

The FDA-approved indication for miglitol is to treat type 2 diabetes, specifically for  people whose diabetes cannot be controlled by diet alone and need some kind of extra support.

What is the mechanism of its therapeutic effect? Is this drug a member of an established class, or is it a brand new form of therapy?

Miglitol is an oral medication which belongs to the alpha-glucosidase inhibitor class (alongside with acarbose or precose) which helps control blood sugar levels in patients with diabetes.

What is the cost to the patient (per treatment or per time period, if appropriate)? Do you think it is worth the price? Why or why not?

The cost for miglitol is around $137 for a 30 supply of 25 mg tablets. In my opinion, it is worth it; it a relatively low risk and safe treatment option that is also straightforward and works well. For those who cannot control their diet or need assistance with a medication due to their diabetes, miglitol is one of the best options. It is a common drug which can be covered by many insurances, so it can become more affordable.

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Citalopram
1.) The FDA approved indications for this drug is the treatment of depression in adults. The non-FDA approved indications include alcohol use disorder, coronary arteriosclerosis, obsessive-compulsive disorder, panic disorder, postmenopausal flushing, and premenstrual dysphoric disorder.
2.) Citalopram is a drug that can be taken orally and works by increasing the amount of serotonin in the body. It is in a class of antidepressants called selective serotonin reuptake inhibitors.
3.) An appropriate standard to compare against citalopram is escitalopram. It is a therapeutically active S-enantiomer of citalopram. It has been shown to be effective and well-tolerated treatment. It is also a drug that can be taken as pills or liquids.

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- The FDA approved nizatidine in order to have treatment for what is known as active duodenal ulcer.  It usually takes 4 weeks for the average patient to have a fully healed Ulcer.  If it takes longer it usually takes about 8 weeks for the ulcer to be done healing.  The unapproved indication to Nizatidine is showings of NDMA above the acceptable intake limit which is about 96 nanograms per day.
- Cheapest you can get the medicine for is 77 dollars which is a bit expensive but if you are in a lot of pain and need that to go away then it is a good investment.  Even though it may look a bit scary because of the prices many people may buy it because they believe that it will completely heal them which it will do.  I think it is worth the price but only if you are in dire need of it.
- This drug can be easily compared to Famotidine which both work by decreasing the amount of stomach acid that is being made in the stomach which is the cause of Duodenal Ulcer Disease. I believe that Nizatidine might be better because it is a bit newer then Famotidine.

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Drug: Meloxicam
1. Meloxicam is FDA approved, and this approval is supported by successful phase III clinical trials. However, in the most recent CRL, the FDA noted the delayed onset of the drug that did not meet prescription expectations.
2. Meloxicam is a non steroidal anti-inflammatory drug that is used to relieve moderate to severe pain. It was designed using a technology that enables enhanced bioavailability of poorly water-soluble drug compounds.
3. Meloxicam is comparable to Ibuprofen, Tylenol, and Naproxen. All of these drugs are pain relievers and anti-inflammatory medications.

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Pantoprazole
2. In the final step in the gastric acid production, pantoprazole inhibits the H+, K+ and ATP pumps. Pantoprazole is in the class of medications called proton-pump inhibitors. It is used to treat certain conditions when there is too much acid in the stomach.
3. Pantoprazole was shown to be equally as effective as another drug called omeprazole. Omeprazole decreases the amount of acid in the stomach, similar to pantoprazole.
5. The average cost of Pantoprazole for 30 tablets, each 40 mg, would be $36.21, but this price changes depending on if you have insurance or coupons.