How many of your patients chronically take non-steroidal anti-inflammatory drugs (NSAIDs)? In a recent Saskatchewan survey, approximately 13% of the general population had filled a prescription for an NSAID during the preceding year. In British Columbia these drugs accounted for 6.4% of total claims and 9.8% of drug cost to the Pharmacare Program.
The gastrointestinal effects of non-steroidal anti-inflammatory drugs range from dyspepsia to gastric ulceration, hemorrhage, and perforation. Minor symptoms of gastrointestinal discomfort are reported in 10% to 40% of patients using non-steroidal anti-inflammatory drugs.
Occupational exposure to hazardous drugs and the resulting potential health risk to healthcare workers first became a recognized safety concern in the 1970s. Published data related to the issue of occupational exposure prompted the Occupational Safety and Health Administration (OSHA) to issue guidelines in 1986 for the handling of antineoplastic and other hazardous agents by healthcare personnel. These guidelines, which were updated and revised in 1995, are perhaps the most widely recognized and closely followed recommendations in U.
Morphine, the prototype opioid, is derived from opium, a crude material obtained from the seed pod of the opium poppy plant. The chemical structure of morphine is shown in Figure Structure-activity relationships of opioids. Many other derivatives of the opium plant (opiates) and other drugs with similar effects (opioids) have been discovered or synthesized.
Prescribing Information for Imipramine (Tofranil). Concurrent Treatment and Alternatives.
Most general practitioners (GPs) will be familiar with the sometimes perplexing problem of trying to decide whether a patient’s symptom is owing to an adverse drug reaction, to a symptom of the presenting illness, or to an unrelated illness. There is a large quantity of literature on the subject of adverse reactions associated with individual drugs and about adverse drug reactions in hospital inpatients; however, there has been little recent information about adverse reactions to drugs in the community.
Medications are probably the single most important healthcare technology in preventing illness, disability, and death in the geriatric population. New products provide pharmacists with valuable tools for promoting quality of life but also confer upon them the more difficult task — as well as the greater responsibility — of balancing clinical effects to provide the highest possible quality of life for their patients. Are we prepared for this challenge?
In general, prescription should begin at the lowest dosage. Give an adequate trial at each succeeding dosage level.
The first double-blind, placebo-controlled study of Requip in patients with restless legs syndrome (RLS) showed the drug led to significant improvement in the periodic leg movements (PLMS) of sleep. The primary outcome measure was to determine whether the number of leg movements per hour in NREM sleep was reduced in patients treated with Requip vs. placebo-treated patients. Patients with primary RLS (n=31) were started on 0.25 mg/dose of Requip administered in the evening, and then maintained at that dosage for 2 weeks.
If you have too much cholesterol in your blood stream, you are at risk for getting heart disease and stroke. In some people, it may be difficult to lower cholesterol levels through diet and lifestyle changes alone.
Prescribing Information for Thioridazine (Mellaril): Optimum Dosage, Drug Interactions, Contra-indications.
A recent report suggests that loneliness, depression, and other emotional complaints are associated with an increased risk of hip fracture in older women. Researchers at the National Institute of Public Health in Oslo, Norway, interviewed more than 18,000 Norwegian women over the age of 50 to collect data on self-reported levels of emotional status and then followed the women for three years. It was found that women with the highest levels of mental distress were at twice the risk of hip fracture during the three-year follow-up period, compared to women with the lowest distress levels.
Current indications for the use of psychotropic medications in children and adolescents can be summarized briefly (Table l). The listing in Table 1 is by no means an exhaustive review of this rapidly emerging field.
The British Columbia Drug Usage Review program has focused on the use of non-steroidal anti-inflammatory drugs (NSAIDs) and other target medications for a number of years. The program promotes rational prescribing for all age groups, with special emphasis on the elderly.
An 18-year-old man is brought into the emergency department after being found on the street unresponsive. He is lethargic and does not answer questions.
Searches found 86 reports (10160 patients) that met inclusion criteria, 76 of which had dichotomous pain outcomes, including three unpublished reports from a pharmaceutical company. For acute conditions, 37 placebo-controlled trials were analyzed.
Top 15 Global Pharmaceutical Products – 2008 Rank.
A 16-year-old female comes to the physician’s office because of menstrual cramps. Her menses lasts for 4-5 days, and she has 28-day cycles. For the first 2-3 days of her menses she states that she has very bad cramping.
Freeman recommends that the physician should be prepared for a potential barrage of questions by the enlightened parent consumer. Such questions may include any or all of the following: How do drugs change behaviour? My child has brain damage.
Opioid agonists bind to G-protein-coupled receptors to reduce adenylyl cyclase activity, to reduce prejunctional calcium conductance, which results in a decrease in neurotransmitter release, and to enhance postjunctional potassium conductance, which results in decreased responsiveness to excitatory neurotransmitters. Meperidine is metabolized to normeperidine that may result in seizures. Morphine is metabolized to morphine-6 glucuronide.