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Analysis of Pharmaceutical Issues - Report Example

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This report "Analysis of Pharmaceutical Issues" presents a pharmaceutical drug that is defined as a chemical substance that is used for the purposes of medical diagnosis, treatment, and prevention of diseases. This definition is derived from the Greek word pharmacies…
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Extract of sample "Analysis of Pharmaceutical Issues"

Pharmaceuticals Name Tutor Course Date Part 1 Definitions of pharmaceutical and description A pharmaceutical drug is defined as a chemical substance that is used for the purposes of medical diagnosis, treatment and prevention of diseases. This definition is derived from the Greek word pharmakiea. A pharmaceutical drug is also defined as a substance that contains an active ingredient that is used for treatment of certain diseases. According to Shearouse, the simple definition of pharmaceutical is a medicinal drug used as medicine (775). The differences in definitions are due to the complex nature of pharmaceutical drugs and their classification. The definition therefore tries to cover the aspects of all the pharmaceutical drugs. The manufacture of the pharmaceutical products is a complex process as it requires the use of different types of chemicals. The failure of using the correct amount of chemicals can lead to undesired results like poisoning. Strict quality checks have to put in place for the purposes of ensuring that the manufactured drugs meet the required standards. The pharmaceutical drugs can be classified into different groups. This is depending on various factors like the therapeutic effects, mode of administration, effects and chemical properties. The World health organization plays an important role in terms of the classification of the pharmaceuticals in the world. A list of essential medicine is thus available at the Word Health Organization. The pharmaceutical products can be used depending on the part of the body that has been affected. The paper thus discusses the concepts of pharmaceutical drugs (Tsushima 590-1). The Classes of pharmaceuticals Antipyretic and analgesic The antipyretic medicines are used mainly for the purposes of reducing fever in the body. This is through causing the hypothalamus to effectively deal with the interleukin induced increase in temperature that is responsible for the fever. The drugs can also be used for other purposes like pain relive and anti-flammatory use. This is however dependant on the country. Luke warm or cool water is also a non medicine that can be used instead of the antipyretics for the purposes of reducing the body temperatures. Traditionally, plants with antipyretic contents were used for the treatment of patients with fever in most parts of the world. Allergy to the antipyretic drugs is common among some people and hence the need for medical advises. On the other hand, it may also affect the children and can contribute to asthma. An example of antipyretic medicine includes the paracetemals. The analgesic drugs are primarily used for the purposes of pain relief. This is through the action of the drug on the central nervous system and the peripheral. The type of pain being experienced by the patient determines the type of analgesic to be used. The reaction to the analgesic is also dependant on the type. However, excessive use of the analgesics can be life threatening as it leads to damages in the liver. Sanja argues that the multiple uses of the analgesics is not advisable as it causes overdose (5). On the other hand, the use of the analgesics among the children should be controlled as it exposes them to liver diseases. Nausea and vomiting are some of the unpleasant side effects of the analgesics. Aspirin and morphine are examples of the commonly used analgesics. Morphine is considered as among the strongest pain killers commonly used all over the world (Kusama 715). Antimalarial and antibiotic drugs The antimalarial drugs are primarily used for the purposes of curing malaria. These drugs are usually administered to the patients who have already been confirmed with the malaria infection. The people visiting regions which are known for malaria endemic are usually administered with the antimalarial drugs for the purposes of preventing infections. Apart from curing malaria, the antimalarial agents may also be used for the purposes of curing arthritis. The combination therapy is usually used for the purposes of enhancing the treatment of patients so as to ensure that the disease is fully treated. The chemical structure is usually used for the purposes of differentiating the different types of antimalarials. Resistance to the malarial drugs is common in some instances depending on the type of drugs being used. According to Lelièvre, most anti-malarial drugs are usually administered for a period of three days through the use of injections or orally. (12). Examples of antimalarial drugs include chloroquine and quinine. The antibiotic drugs are used for the purposes of inhibiting the growth of the bacteria and hence reduce its harmful effects on the body. This is considering that the bacteria may not be destroyed completely. Semi synthetic modifications are the main chemical components of the antibiotics. The production of the antibiotics is mainly through fermentation process. However, the administration is mainly through the oral ingestion with intravenous administration being used in more serious cases. The side effect of the drug varies with the individuals with some experiencing nausea and diarrhea. The allergy to the antibiotics may also be serious and hence the need for seeking medical advice. On the other hand, the interaction with other drugs may also cause serious side effects. The use of alcohol should be avoided when taking the antibiotics and it lowers its efficiency. Tinidazole is one of the examples of an antibiotic commonly used allover the world. Antiseptics and mood stabilizers The antiseptics are used for the purposes of disinfecting the skin in order to prevent infections. Antiseptics can be applied on a wound in order to kill the germs that may cause infections by entering into the body through the wound. The use of antiseptics is common in most instances when treating minor injuries like cuts and minor burns. It can be self administered and hence its popularity. On the other hand, the antiseptics are also used during surgery. This is for the purposes of disinfecting the skin to prevent the entry of germs. This is considering that some of the surgery may be intense. Antiseptics work by destroying the bacteria and hence encouraging the healing of the wounds. In other instances, the antiseptics are used as mouthwash for destroying bacteria in the mouth. The most common type of antiseptic is alcohol and it is also used during surgery (Magee, 18). Antiseptic soaps can also be used for general hygiene practices and it is also commonly used by medical personnel. The mood stabilizers are psychotic medications that are used for treating the bipolar disorder. This is achieved by stabilizing the moods of the patient. The patients with bipolar disorder usually find it difficult to control their moods due to the frequent mood swing. This medication therefore ensures that the moods of the individuals are controlled through pressure relieve. The treatment of mania is also achieved through the use of the mood stabilizers. However, the se drugs may not be efficient in terms of treating depression. A combination of drugs is usually encouraged when using the mood stabilizers. The side effect of the mood stabilizers includes blurred vision and trembling of the patient. This however lasts for a short while. A lot of care should be exercised when using the drug as an overdose of the drug could impact negatively on the treatment of the patient. Lithium is the most common drug that is used for treating the patients with bipolar disorders. Stimulants and tranquilizers The stimulants are considered as psychoactive drugs. They are mainly used for the purposes of temporarily enhancing the mental and physical functioning of the body. It is also important to note that most of the stimulants are usually illicit due to their abuse. The consumption of the stimulants may lead to enhanced alertness, wakefulness, increased arousal and motivation. This is achieved through the enhancement of the central and peripheral nervous system. The stimulants can be used for medical purposes for the purposes of reducing weight and sleepiness among the individuals when required. The excessive consumption of the stimulant has a negative health effect. This is because some causes high blood pressure and increased heart rate which may be fatal. Saha argues that cocaine is an example of a stimulant which is illegal due to its harmful effects on the body (35). The tranquilizers are drugs that reduce the tranquility when it is consumed. These drugs play an important role in terms of inducing calmness among the individuals. It is usually beneficial to the body especially when an individual is being faced with pain. However, it is important to note that the tranquilizers should only be consumed under the directions of the doctor. Most of the tranquilizers are usually administered through injections. Tranquilizers are sometimes used during surgery. Antipsychotics are considered as the major tranquilizers. Hormone replacement Hormone replacement drugs are used for the purposes of administering the hormone replacement therapy. The hormone replacement process may be conducted on a patient for he purposes of substituting some hormones. In other instances, it is used for the purposes of supplementing the lack of naturally occurring hormones in the body. Hormone replacement therapy for menopause is usually conduced on women for the purposes of ensuring that they are able to deal with the negative impacts of menopause. On the other hand, this therapy my have negative side effects. According to Schierbeck this is due to the fact that it affects the central nervous system and hence impacting negatively on the functioning of most parts of the body (15). The functioning of the ear is always affected and hence its negative impact. The hormone replacement drugs are also used for the treatment of transgender problem. This is achieved by supplementing and substituting some of the hormones. Some of the diseases like cancer usually affect some of the hormones. The hormone replacement therapy should thus be carried out to correct the situation. The effects of aging on men can also be corrected through the use of hormone replacement therapy. Male hypogonadism is usually treated through the use of hormone therapy. Oral contraceptives The oral contraceptives are drugs that are usually taken by mouth for the purposes of ensuring birth control. The oral contraceptives contain estrogen and progestin. It can be taken by women one per day for the purposes of controlling birth. Other oral contraceptives include the emergency contraception. This type of drug is usually taken a few hours after the intercourse. However, these drugs may have a long time effect on the female if it is consume regularly. The emergency contraception should not be consumed every month as it increases the risk of a woman being permanently barren. Nausea and vomiting are the main side effects of the consumption of oral contraceptives. Centchroman is an example of an oral contraceptive that is usually taken twice a week for the purposes of birth control. However, this drug has been approved for use only in India. The efficiency of the oral contraceptives is usually high. A low percentage of failure has been reported with regards to its use. The long terms problems and side effects are the negative impacts of using the oral contraceptives. Some of the oral contraceptives usually results to low sex drive and lack of appetite among the women. The oral contraceptives are not available for men and it is only used by women. Statin The statins are used for the purposes of lowering the cholesterol levels in the body. The drug acts by inhibiting the enzymes that are responsible for the production of cholesterol in the body. It is also important to note that the statins play an important role in terms of treating the cardiovascular diseases that are caused by the increase in the levels of cholesterol. Mondul, et al, note that muscle damage is one of the negative effects of the drug and it has the potential of causing other problems in the body (61). Fluvastatin is an example of statin drug that is available in the market for patient consumption. The satins are among the best selling pharmaceutical in the world due to the increase in cardiovascular problems among most of the individuals. The statins are known to prevent the mortality rates of the people with cardiovascular diseases. However, it is not yet clear if it plays an important role in preventing the cardiovascular diseases among individuals who have not been diagnosed with the disease. The risk of diabetes may also be increased due to the misuse of statins among individuals. Rationale of drug delivery The drug delivery involves the methods that are used for the purposes of transporting the drugs safely to the body in order to achieve the therapeutic effect. The chemical formulation of the drug determines the method used for the drug delivery. Noninvasive peroral is the most common method of drug delivery. This is involves the consumption of the drugs through the mouth. Its advantage being its ease of consumption and can be self administered by the patient. Topical delivery is usually done through the skin. This is usually common for the antiseptics. Its direct contact with the bacteria increases its efficiency. According to Anthony, the transmucosal is also an important method that is used for the drug delivery (1). This may only be used for specific infections and it delivery rout may include nasal. Inhalation of the drugs is also common when dealing with fever. Its ease of administration as well as less pain is one of its advantages. On the other hand, injections are commonly used when delivering vaccines and other drugs. This method is the most efficient as the drugs starts circulation in the body immediately hence its fast action in terms of dealing with diseases. Part 2 Statistics According to the statistics, the consumption of pharmaceutical drugs is on the increase every year. It is estimated that the global pharmaceutical industry will be worth more than $ 1trilinion by 2014. This is attributed to the annual growth of about 5%. The numbers of pharmaceuticals firms are also on the increase for the purposes of satisfying the market demand. In the United States of America, the market is quite competitive with most of the companies finding it difficult to enter the market. The pharmaceutical industry in the United States of America has a huge influence over the global pharmaceutical industry. This is because it is worth $380 billion which makes it a major shareholder in the world. Since 2003, the pharmaceutical industry has been experiencing a lot of growth globally. The growth of the industry is also measure against the backdrop o withdrawal of some of the major drugs. The withdrawal of the drugs is due to the negative impacts that it has on the body (Small, 13). The withdrawal of Vioxx was witnessed in the United States of America in 2004 after it was found to be increasing the risk of heart attack among the patients with arthritis. He statistics also indicates that China has the fastest growing pharmaceutical industry of the world with an annual growth of about 28%. However, North America and Europe has the highest sales of pharmaceutical drugs. Since 2004, more than 82 drugs have been considered blockbusters as they have exceeded the sale of $1billion. Statin drugs achieved the highest sale among all the drugs with a total sale of $ 23.8billion. The cholesterol drugs have been widely consumed in the world and it is has been the leading drug in the world. Until 2011, Lipitor which is the cholesterol drug has been leading in terms of sales and consumption. However, its sales decreased in 2012 by 60% after the expiration of the patent. The introduction of the generic drugs has also cased changes in the market. This is because the generic drugs are cheaper and hence attracting more customers. In the United States, the prescription drugs costs 50% more than in any other countries. This is attributed to the high umber of people consuming the prescription drugs. It is estimated that $280 million will be used for the purchase of prescription drugs in 2013 in the United States of America. Half of the Americans also use prescription drugs on a regular basis (Gu, 1). Statistics also indicates that the use of antidepressants among the women is higher in the United States than in any other country in the world. The children in Europe are less likely to be prescribed with the antidepressants as compared to the United States of America. Statistics also indicates that the number of people who are rushed to the emergency rooms due to the adverse effects of the pharmaceutical drugs is much higher in the United States of America and it numbers about 750,000 yearly. The usage of pharmaceutical drugs is thus high in the United States as compared to any other country in the world. In Japan, the pharmaceutical company is also large and it contributes to 10% of the total world market. In the year 2011, the pharmaceutical industry in Japan was worth $ 89billion. This is after and annually growth of 5.1% each year since 2005. The decreased prices of the pharmaceutical drugs and the increase in popularity of the generic drugs are factors that are impacting negatively on the pharmaceutical market in Japan. The government regulations in Japan also favor the growth and development of the pharmaceutical drugs in Japan. The cholesterol drugs and the calcium antagonist are among the drugs that are frequently used in Japan. However the hormone stabilization drugs also have a high number of users in Japan. The drugs that are related to cosmetics also has a high number of usages in Japan as compared to most of the countries. The advancement in technology in Japan has also played an important role in terms of the production of the drug. Through the use of technology, more drugs are produced. The effects of withdrawal have however impacted negatively on the production of some of the drugs and hence affecting the pharmaceutical market. As compared to China, the growth of the pharmaceutical industry is much lower. The Angiotensin ii Antagonists class is the leading drug in the market and its dominance has been on the rise. The pricing of the drugs in Japan is influenced by the government policies and the prevailing economic situation in the country (Kusama 717). Nuclear medicines Nuclear medicine involves the use of radioactive substances for the purposes of diagnosis and treatment of diseases. The use of nuclear medicine is gaining a lot of popularity due to its efficiency in terms of treatment. The advancement of technology has also promoted the use of the nuclear medicine in most of the developed countries. The extent of the disease is usually based on the cellular function and the physiology as compared to the ordinary method of treatment which relies on the physical changes in the anatomy of the tissues. The use of nuclear medicine is also important in terms of identifying the extent of the diseases at an early stage. This is much advanced as compared to the other diagnostic methods of treatment. The concepts of molecular medicine are widely applied in the concepts of nuclear medicine. The use of the imaging agents is also common in the use of nuclear medicine. The imaging is usually taken internally and hence its ability to detect the extent of damage to the tissues by the diseases. A whole body scan can also be carried out for the purposes of detecting bone diseases in the body. The use of nuclear medicine also plays an important role in terms of identifying the coronary diseases. The diagnosis method is highly effective as compared to the ordinary methods. The nuclear medicines are also organ specific and hence its ability to improve the diagnosis of the different diseases. The use of nuclear medicine is also changing the diagnosis and treatment process of most of the complex diseases (Cherry 12). The use of nuclear medicine is advantageous to both the patient and the doctors. The procedures used are usually painless to the patient and it is highly effective. Aesthesia is not required when using the nuclear medicine for the purposes of treatment. On the other hand, the method is much cheaper as compared to the usual methods of treatment. It is also important to note that the use of nuclear medicine enables the doctors to obtain information regarding the conditions of a patient without the need for surgery of expensive methods of diagnosis. The use of nuclear medicine has the potential of identifying the diseases in the body which cannot be identified using any other diagnostic test. Radiopharmaceuticals are used for the purposes of diagnosing and treating the diseases. Special types of cameras are used for the purposes of monitoring the treatment. During the treatment, the radiopharmaceutical usually goes directly to the organs that are being treated and hence increasing its efficiency. The amount of radiation is usually is usually controlled to ensure that the safe limits are not exceeded during the treatment of the patients. According to Saha, an excess limit of the radiation is harmful to the patients and it may result to fatalities due to complications that it may cause (41). The use of nuclear medicine is current gaining popularity in most of the specialties in the medical field. The treatment using the nuclear medicine and radiopharmaceuticals always targets the treatment of the diseases at the molecular level and hence it efficiency in terms of treatment of the patients. However, it requires a lot of expertise in order to prevent any injuries or harm to the patients (Cherry 67). Market size of nuclear medicine United States of America The radiopharmaceutical market is valued at $ 3.8billion globally. The United States of America is regarded as the largest consumer of radiopharmaceutical in the world and it accounts for almost half of the market. However, Canada is also considered as one of the largest producer of pharmaceuticals in the world. In the United States of America, the radiopharmaceuticals are mainly used for the purposes of treating the cardiac problems. Positron emission tomography (PET) is increasingly becoming popular in the United States of America for the purposes of imaging in order to establish tumors in the body. The gamma cameras which are use alongside computers are also popular in the United States of America. The diagnostic tool thus dominates the market in the United States of America. The single photo emission computed tomography (SPECT) is also one of the main imaging techniques that are used for the purposes of diagnosis and are gaining much popularity in the United States of America. In the United States of America, nuclear medicine has plays an important role in terms of treating prostrate cancer which is among the killer diseases in the country. The number of procedures carried out using nuclear medicine has also been on the rise in the United States of America. In 2005, more than 20milllion medical procedures had been carried out through the use of nuclear medicine. This is an increase from 14 million in 1999 (Clemens 13). The market for nuclear medicine has also increased due to the increase in cardiology related diseases. This has seen an increase of more than 4 million procedures being conducted by the year 2005 as 7 million procedures were conducted in 1999. This is an indication that nuclear cardiology forms about 50% of the total nuclear medicine procedures in the United States of America. The bone disease also forms 17% of the procedures that are carried out through the use of nuclear medicine in the United States of America. The PET procedures that are carried out per year is about 1.5million. This also indicates that the nuclear medicine is increasingly becoming popular in the United States of America. The cost of treatment has also been reduced through the use of nuclear medicine and hence providing financial relief to most of the patients with serious conditions like cancer (Mettler, 34). The competition is also high in the market with most of the patients with serious conditions opting for nuclear medicine as opposed to the ordinary process of treatment. This has led to the increased investment in nuclear medicine by most of the hospitals. Currently, all the major hospitals are equipped with the nuclear medicine equipment. This has also been necessitated by the advancement in technology in the healthcare sector. The increased use of nuclear medicine plays an important role in terms of treating chronic and life threatening diseases among the patients in the United States of America. This has seen a reduction in the number of fatalities and thus promoting good health among the local people. Europe The nuclear medicine market in Europe was valued at $ 1.1billion in 2012. The market is set to grow to about $ 1.6billion in 2017 at a CAGR of 6.8%. In Europe, the nuclear medicine market is divided into two categories which include the diagnostic and therapeutic. The diagnostic market occupies 83% of the nuclear medicine market share in Europe while the therapeutic occupies 17% of the market share. The therapeutic market is mainly dominated by the isotope which was valued at $ 24.7 million in 2012. The nuclear medicine market in Europe has been boosted mainly by the efficiency in the treatment of dementia and Parkinson disease. In Europe, Germany is the larges consumer of radiopharmaceuticals. Siemens healthcare is the largest producer of nuclear medicine in Germany. 25%of the nuclear market share in Europe is dominated by Germany. Other major countries that produce the nuclear medicine in Europe include Ireland, United Kingdom and Belgium. However, the nuclear medicine market in Europe is set to be impacted negatively due to the shut down of two major manufacturers by 2018. The competition in the market in Europe is stiff in terms of the nuclear medicine due to its wide spread use. Other foreign companies have also been established in Europe for the purposes of producing the nuclear medicine (Goksel, et al, 1991-2). New inventions are also being made for the purposes of treating patients with radiopharmaceuticals and it is also set to make changes in the nuclear medicine market in Europe. This is an indication that the nuclear market is growing at a fast rate in Europe. The uses of nuclear medicine in Europe have been boosted by the increase in awareness among the people about the radiopharmaceuticals. The efficiency of the nuclear medicine in terms of treating cancer has also impacted positively on the use of nuclear medicine in Europe. However the high cost of the equipment used for the treatment using the nuclear medicine has slowed down its growth in the market in some of the countries. The competition in the market with regard to the use of nuclear medicine is high in Europe. The increased cost of treatment using the ordinary method is also increasingly becoming expensive and hence impacting negatively on its health budgets. This has also contributed to the adoption of nuclear medicine in most of the European countries including Russia and Turkey. The health insurance companies have also benefited from the use of nuclear medicine in Europe and hence increase in the market size. This is because the cost of treatment of patients has been reduced through the use of nuclear medicine. The number of experts in nuclear medicine is also on the increase in Europe due to the increasing demand for their services (Poul, 54). Asia pacific In 2012, the radiopharmaceutical market in Asia pacific was valued at $500.8 million. The market size is set to grow in future to an estimated size of $ 824.9 million at a CAGR of 10.5 %. The nuclear market in the region is still developing as it has not used widely in the treatment of the patients. This is due to the government regulations as well as the expenses that are involved in the purchase of nuclear medicine equipment. The nuclear medicine market is also divided into two segments in the Asia pacific market. The segments involve the therapeutic and the diagnostic markets. 80.75 of the market share are dominated by the diagnostic market according to a market research that was carried out in 2012. SPECT and PET are the commonly used isotopes for the purposes of carrying out diagnosis among the patients. The cardiology related diagnosis in Asia pacific is usually carried out through the use of SPECT (Tsushima, 592). The therapeutical market on the other hand is dominated by beta emitters, alpha emitters and brachytherapy isotopes. The use of alpha emitters is still low as it has not been commercialized in Asia pacific. Beta emitters are however common in the market and it is set to grow at a CAGR of 7.7%. The popularity of the nuclear medicine is however becoming common in Japan. It is mainly used for the purposes of treating thyroid cancer which is common in the Asia pacific. It efficiency is the motivating factor for its use and hence the chances of higher growth rate in future. The increase in the cases of Parkinson’s disease and dementia has also contributed to the usage of nuclear medicine in Asia pacific. In Japan radioisotopes also has a wide range of application in the treatment of patient. However, the use of isotopes was impacted negatively in 2011 after the Fukushima nuclear plant disaster (Kinuya, 28). This also affected the market share of nuclear medicine in Japan and Asia pacific as a whole. The nuclear plant disaster also had a negative impact on the perception of the people with regards to the safety of using the nuclear medicine. The Isotope market in Asia pacific was estimated to be $56.1 million in 2012. This is set to rise to about $100 million by 2017 at a CAGR of 12.6%. The companies from the United States of America have also invested in the Nuclear medicine market in Asia pacific and hence increasing competition. In the region, Japan is the leading country in terms of using the nuclear medicine for the treatment of patients. Other parts of Asia have a low percentage in terms of the usage of nuclear medicine. Works Cited Shearouse, William."Alternative solvent-free methodologies in the synthesis of pharmaceutical drugs." Current opinion in drug discovery & development 12.6 (2009): 772-783. Sanja Modric. "Regulatory considerations for the approval of analgesic drugs for cattle in the United States." The Veterinary clinics of North America. Food animal practice 29.1 (2013): 1-10. Lelièvre, Joël, "Activity of clinically relevant antimalarial drugs on Plasmodium falciparum mature gametocytes in an ATP bioluminescence “transmission blocking” assay." PLoS One 7 (2012): e35019. Magee, Pam. "Antiseptic drugs and disinfectants." Side Effects of Drugs Annual: A worldwide yearly survey of new data in adverse drug reactions (2012): 377. Saha, Tulshi D. "Analyses related to the development of DSM-5 criteria for substance use related disorders: 1. Toward amphetamine, cocaine and prescription drug use disorder continua using Item Response Theory." Drug and alcohol dependence 122.1 (2012): 38-46. Schierbeck, Louis. "Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial." BMJ: British Medical Journal 345 (2012). Parkin, Lianne, et al. "Risk of venous thromboembolism in users of oral contraceptives containing drospirenone or levonorgestrel: nested case-control study based on UK General Practice Research Database." BMJ: British Medical Journal 342 (2011). Mondul, Alison M., et al. "Statin drugs, serum cholesterol, and prostate-specific antigen in the National Health and Nutrition Examination Survey 2001–2004." Cancer Causes & Control 21.5 (2010): 671-678. Anthony Lowman. "Emerging technologies of polymeric nanoparticles in cancer drug delivery." Journal of Nanomaterials 2011 (2011): 1. Small, Stephen D., et al. "multinationalization in the pharmaceutical industry as a response to national health policies†." Managerial and Decision Economics (2012). Gu, Qiuping, "Prescription drug use continues to increase: US prescription drug data for 2007- 2008." NCHS data brief 42 (2010): 1. Kusama, Ono. "Exploring differences in drug doses between Japan and Western countries." Clinical Pharmacology & Therapeutics 87.6 (2010): 714-720. Cherry, Simon R. Physics in nuclear medicine. Elsevier Health Sciences, 2012. Saha, Gopal B. Physics and radiobiology of nuclear medicine. Springer, 2012. Clemens, Jeffrey. "The Effect of US Health Insurance Expansions on Medical Innovation." (2012). Mettler, Fred A., et al. "Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources— 1950–20071." Radiology 253.2 (2009): 520-531. Poul, Flemming. "PET/CT without capacity limitations: a Danish experience from a European perspective." European radiology 21.6 (2011): 1277-1285. Goksel, Fatih, et al. "Planning of Nuclear Medicine in Turkey: Current Status and Future Perspectives." Asian Pac J Cancer Prev 13.5 (2012): 1989-1994. Tsushima, Y. "Nephrogenic systemic fibrosis: risk factors suggested from Japanese published cases." British Journal of Radiology 83.991 (2010): 590-595. Kinuya, Seigo. "A nuclear power plant accident in Fukushima: what should we do?" Annals of nuclear medicine 26.2 (2012): 113-114. Read More

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