for hydrocephalus dialysis grafts colostomy bag attachment devices ear drainage tubes leads for pace makers and implantable defibrillators can also benefit from the device drug combination approach devices which serve to improve the structure and function of tissue or organ may also show benefits when combined with the appropriate agent or agents for example improved osteointegration of orthopedic devices to enhance stabilization of the implanted device could potentially be achieved by combining it with agents such as bone morphogenic protein similarly other surgical devices sutures staples anastomosis devices vertebral disks bone pins suture anchors hemostatic barriers clamps screws plates clips vascular implants tissue adhesives and sealants tissue scaffolds various types of dressings bone substitutes intraluminal devices and vascular supports could also provide enhanced patient benefit using this drug device combination approach essentially any type of medical device may be coated in some fashion with a drug or drug combination which enhances treatment over use of the singular use of the device or pharmaceutical agent in addition to various medical devices the coatings on these devices may be used to deliver therapeutic and pharmaceutic agents including antiproliferative antimitotic agents including natural products such as vinca alkaloids i e vinblastine vincristine and vinorelbine paclitaxel epidipodophyllotoxins i e etoposide teniposide antibiotics dactinomycin actinomycin d daunorubicin doxorubicin and idarubicin anthracyclines mitoxantrone bleomycins plicamycin mithramycin and mitomycin enzymes l asparaginase which systemically metabolizes l asparagine and deprives cells which do not have the capacity to synthesize their own.