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Teo BHK, Au Eong JTW, Au Eong KG. Steroid-induced glaucoma: an avoidable cause of irreversible blindness. BMJ Case Rep 2023; 16:e254709. [PMID: 37666571 PMCID: PMC10481737 DOI: 10.1136/bcr-2023-254709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
A man in his 70s on regular follow-up with an ophthalmologist for 10 years presented with blurry vision in his right eye for 4 days. He was diagnosed with elevated intraocular pressure (IOP) bilaterally 18 months earlier and treated with antiglaucoma eye-drops. On direct questioning, he admitted to using fixed combination tobramycin 0.3%/dexamethasone 0.1% eye-drops frequently to relieve ocular redness and discomfort in both eyes for 3.5 years without his ophthalmologist's knowledge. Examination disclosed markedly elevated IOP, advanced optic disc cupping and tunnel vision due to steroid-induced glaucoma bilaterally. After cessation of the eye-drops and 2 weeks of antiglaucoma therapy, his IOP returned to normal and his visual field remained stable for 4 years.Our case highlights the danger of habitual self-treatment of prescription medications containing corticosteroids and the importance of taking a detailed medication history in the diagnosis and management of steroid-induced glaucoma.
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Affiliation(s)
- Benjamin H K Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Kah Guan Au Eong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
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Srivastava VK, Kumar A. Self-Medication for Toothache Causing Chemical Burn of Oral Mucosa and Alveolar Bone Loss in a Child. J Dent Child (Chic) 2023; 90:107-110. [PMID: 37621044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Chemical burn of the oral mucosa can occur as a result of the inadvertent, intentional or iatrogenic use of chemicals. Self-treatment for toothache relief with nonpharma ceutical substances can result in a chemical burn. A detailed history is paramount in such cases to identify the etiologic agent to proceed with appropriate treatment. The purpose of this report is to describe the case of an eight-year-old with a complaint of toothache who rinsed his mouth with potassium aluminium sulfate solution to achieve pain relief. This caused ulceration of the attached gingiva and oral mucosa and necrosis of the alveolar bone surrounding the offending tooth, leading to its mobility. This case highlights the disastrous consequences of inappropriate self-treatment to achieve pain relief from toothache.
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Affiliation(s)
- Vinay Kumar Srivastava
- Department of Pediatric and Preventive Dentistry, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Aman Kumar
- Department of Pediatric and Preventive Dentistry, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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McCarter SJ, Abarbanel DN, Hassan A, St Louis EK, Boes CJ. An Undifferentiated Spell: The Answer is in The Pillbox. Mayo Clin Proc 2021; 96:2003-2005. [PMID: 34218870 DOI: 10.1016/j.mayocp.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
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4
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Wang JV, Saedi N, Geronemus RG. Do-It-Yourself Cosmetic Injectables in Dermatology: High-Risk, No Reward. Dermatol Surg 2021; 47:1032-1033. [PMID: 33165063 DOI: 10.1097/dss.0000000000002862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jordan V Wang
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
- Laser and Skin Surgery Center of New York, New York, New York
| | - Nazanin Saedi
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Roy G Geronemus
- Laser and Skin Surgery Center of New York, New York, New York
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Chuwa BB, Njau LA, Msigwa KI, Shao E. Prevalence and factors associated with self medication with antibiotics among University students in Moshi Kilimanjaro Tanzania. Afr Health Sci 2021; 21:633-639. [PMID: 34795717 PMCID: PMC8568219 DOI: 10.4314/ahs.v21i2.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Self medication is a common practice of using medicines without a medical supervision by the people themselves. Self medication is likely to happen when people feel unwell, it is worse in the population with poor helth seeking behavior. Therefore it is important to assess the prevalence and factors associated with self medication with antibiotics among University students in Moshi, Kilimanjaro Tanzania. METHODS A cross sectional study was conducted from April-August 2019 at two Universities in Moshi, including one medical and one non medical. The study population were undergraduate students aged 18 and above, A self-filled questionnaire was used for data collection and data analyzed using the SPSS version 16 and association was tested using chi square. RESULTS Out 374 students enrolled 187 from each University, 126 were female and 248 were male with age ranging from 19 to 35 years with mean age of 23.91 years. The prevalence of self medication with antibiotics was 57% and the most common used antibiotics was amoxicillin with prevalence of 32.08%. The common reported symptoms/diseases were headache (31.02%) followed by malaria and coughing with prevalence of 15.24% and 10.96% respectively. The commonest reasons of self medication reported to be emergency illness (38.77%) and delaying of hospital services (24.33%). The commonest effects reported among respondents which practiced self medication with antibiotics were worsening of the condition that they were suffering in (4.55%) and body rashes (2.67). There was no significant difference between self medication practices among medical and non medical students(p = 0.676). CONCLUSION The prevalence of self medication with antibiotics was high among University students and there is no significant difference in both medical and non medical students. The most feared outcome on self medication with antibiotics is antibiotic drug resistance which leads to treatment failure along with high financial costs and increase mortality rate following microbial infections.
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Affiliation(s)
- Bernard Baltazary Chuwa
- Department of internal medicicine, Kilimanjaro Christian Medical University College Moshi, PO BOX 3010, Moshi Tanzania
| | - Linna Abraham Njau
- Department of internal medicicine, Kilimanjaro Christian Medical University College Moshi, PO BOX 3010, Moshi Tanzania
| | - Kaizali Ivo Msigwa
- Department of internal medicicine, Kilimanjaro Christian Medical University College Moshi, PO BOX 3010, Moshi Tanzania
| | - Elichilia Shao
- Department of internal medicicine, Kilimanjaro Christian Medical University College Moshi, PO BOX 3010, Moshi Tanzania
- MEGA-AFYA and Business Company Limited, PO BOX 6791, Moshi Tanzania
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Jha N. Phototoxic reaction to Bakuchi seeds tried as home remedy in a patient of Vitiligo. Dermatol Online J 2020; 26:13030/qt6h30b05d. [PMID: 33342189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 05/22/2020] [Accepted: 07/03/2020] [Indexed: 06/12/2023] Open
Affiliation(s)
- Niharika Jha
- Department of Dermatology, Acharya Shree Bhikshu Hospital, Moti Nagar, New Delhi.
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Mayo M, Chepulis L, Paul RG. Glycemic-aware metrics and oversampling techniques for predicting blood glucose levels using machine learning. PLoS One 2019; 14:e0225613. [PMID: 31790464 PMCID: PMC6886807 DOI: 10.1371/journal.pone.0225613] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/07/2019] [Indexed: 01/11/2023] Open
Abstract
Techniques using machine learning for short term blood glucose level prediction in patients with Type 1 Diabetes are investigated. This problem is significant for the development of effective artificial pancreas technology so accurate alerts (e.g. hypoglycemia alarms) and other forecasts can be generated. It is shown that two factors must be considered when selecting the best machine learning technique for blood glucose level regression: (i) the regression model performance metrics being used to select the model, and (ii) the preprocessing techniques required to account for the imbalanced time spent by patients in different portions of the glycemic range. Using standard benchmark data, it is demonstrated that different regression model/preprocessing technique combinations exhibit different accuracies depending on the glycemic subrange under consideration. Therefore technique selection depends on the type of alert required. Specific findings are that a linear Support Vector Regression-based model, trained with normal as well as polynomial features, is best for blood glucose level forecasting in the normal and hyperglycemic ranges while a Multilayer Perceptron trained on oversampled data is ideal for predictions in the hypoglycemic range.
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Affiliation(s)
- Michael Mayo
- Department of Computer Science, University of Waikato, Hamilton, New Zealand
| | - Lynne Chepulis
- Waikato Medical Research Center, University of Waikato, Hamilton, New Zealand
| | - Ryan G. Paul
- Waikato Medical Research Center, University of Waikato, Hamilton, New Zealand
- Waikato Regional Diabetes Service, University of Waikato, Hamilton, New Zealand
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Abstract
OBJECTIVES There is a dearth of information on transgender individuals in Nepal, particularly studies exploring their use of hormone therapies. The objectives of this study therefore were to explore (1) how hormones are used, (2) types of hormones used and (3) side effects experienced by transgender women after hormone use. This is the first study of its kind in Nepal addressing this important public health issue. SETTING The study was conducted in four districts of Nepal: Kathmandu, Sunsai, Banke and Kaski. DESIGN AND PARTICIPANTS This qualitative study comprises eight focus group discussions (FGDs) and nine interviews. FGDs and three face-to-face interviews were held with transgender women aged 18 years and older and six interviews with stakeholders working with and advocating on behalf of this population. The study was conducted between September 2016 and March 2017. RESULTS Our participants were young. The majority of FGD participants had completed school-level education and 40% had been using hormones for 1 to 3 years. Five overlapping themes were identified: (1) reasons and motivations for hormone use; (2) accessibility and use of hormones; (3) side effects; (4) utilisation of healthcare services and (5) discontinuation of hormone use. CONCLUSION Hormone use was common in our sample. Most received information on hormone therapy online and through their peer networks. A few study participants sought doctors' prescriptions for hormone therapy, but hormones were more likely to be bought from local private pharmacies or abroad through friends. This kind of self-medication is associated with a range of risks to the physical and mental health of transgender individuals. Incorporating information, education and communication about hormone therapy into existing health promotion interventions targeted to this population may help transgender people to make better informed choices.
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Affiliation(s)
- Pramod R Regmi
- Nursing and Clinical Sciences, Bournemouth University, Bournemouth, UK
| | - Edwin van Teijlingen
- Centre for Midwifery, Maternal & Perinatal Health, Bournemouth University, Bournemouth, UK
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Abstract
RATIONALE Reports of acute kidney injury (AKI) associated with benzbromarone use in patients with hyperuricemia (HUA) are rare so far. PATIENT CONCERNS We describe 2 unique clinical patterns in which benzbromarone was a possible cause of AKI following self-medication for HUA. In case 1, a 45-year-old man developed AKI after taking 100 mg of benzbromarone. His serum creatinine (Scr) increased to 2.3 mg/dL on day 2 after benzbromarone administration. Ultrasound showed multiple small stones in both kidneys, and the 24-hour urine uric acid level was 3128 mg. In case 2, a 17-year-old male student presented with AKI after self-administration of 50 mg of benzbromarone. His Scr increased to 6.8 mg/dL on day 3 after benzbromarone administration. Ultrasound showed multiple stones in the left kidney. DIAGNOSIS Both patients underwent renal biopsy, with findings of acute tubular interstitial nephropathy in case 1 and acute tubular damage in case 2. Drug-induced AKI was considered. INTERVENTIONS Both cases were treated supportively with intravenous hydration only. In both patients, the Scr level recovered within 0.5 months and renal function was normal 3 months after discharge. LESSONS Oral benzbromarone is widely used in Asian counties to treat HUA and the adverse effects are mostly mild. However, clinicians should be alert for benzbromarone-induced AKI. Moreover, uricosuric drugs should only be used after exclusion of urolithiasis and other contraindications.
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Affiliation(s)
- Xiaolan Ye
- Department of Pharmacy, Zhejiang Provincial People's Hospital
- Department of Pharmacy, People's Hospital of Hangzhou Medical College, Hangzhou
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing
| | - Jian Wu
- Laboratory Medicine, The First People's Hospital of Yancheng City, Yancheng, Jiangsu
| | - Kun Tang
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing
| | - Wenge Li
- Department of Nephrology, China-Japan Friendship Hospital, Beijing
| | - Cunquan Xiong
- College of Pharmacy, Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, China
| | - Li Zhuo
- Department of Nephrology, China-Japan Friendship Hospital, Beijing
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Elong Ekambi GA, Okalla Ebongue C, Penda IC, Nnanga Nga E, Mpondo Mpondo E, Eboumbou Moukoko CE. Knowledge, practices and attitudes on antibiotics use in Cameroon: Self-medication and prescription survey among children, adolescents and adults in private pharmacies. PLoS One 2019; 14:e0212875. [PMID: 30818373 PMCID: PMC6394986 DOI: 10.1371/journal.pone.0212875] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 02/11/2019] [Indexed: 12/04/2022] Open
Abstract
Benefits of antibiotics are threatened by the self-medication, people's lack of knowledge and inappropriate use of antibiotics, especially in developing countries. This study was designed to determine knowledge; attitudes and practices toward antibiotics use in an urban community, and evaluate the factors that are associated with antibiotic use. Between January and March 2015, a cross sectional and prospective study was conducted in all pharmacies within the Douala IV health district, Cameroon. Anonymous interviews including both open and closed ended questions were conducted in participants selected by convenience sampling Descriptive and logistic regression analysis were performed using StataSE11 software (version 11 SE) and R software (version 3.1.1) in data analysis. Overall 402 (33.7%) of 1,192 customers purchased antibiotics and of these, 47% bought antibiotics without a prescription. 60.7% of purchased antibiotics was for adult 'patients and around 60% of parents carried out self-medication on their children. The vast majority reported that all microbes can be treated with antibiotics (88.3%). The belief that antibiotics are appropriate for bacterial infections was more common among those with a higher level education (OR = 4.03, 95%CI:1.89-8.57, p<0.0001) and among public/private servants (OR = 2.47, 95%CI:1.21-5.08, p = 0.013). Physicians provide less explanations about antibiotics are and their potential side effects than the pharmacy auxiliaries (OR = 0.205, 95%CI = 0.09-0.46, p<0.0001), but more than pharmacists (OR = 3.692, 95%CI:1.44-9.25, p = 0.005). Indications on antibiotics use were 7 times more given to customers with a prescription compared to those without a prescription (OR = 7.37, 95% CI = 2.13-25.43, p = 0.002). Adult male (OR = 2.32, 95%CI:1.24-4.34, p = 0.009) and higher education (OR = 2.05, 95%CI:1.08-3.89, p = 0.027) were significantly associated with self-medication. Misuse, little "practical knowledge" and high self-medication confirm the unsatisfactory prescription and dispensing practices of the antibiotics in our country. These results highlight the important of the development and implementation appropriate guidelines for the responsible use of antibiotics for health care providers and health education targeting community members themselves.
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Affiliation(s)
- Grace-Ange Elong Ekambi
- Pharmaceutical Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Cécile Okalla Ebongue
- Biological Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Ida Calixte Penda
- Clinical Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Emmanuel Nnanga Nga
- Pharmaceutical Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Emmanuel Mpondo Mpondo
- Pharmaceutical Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Carole Else Eboumbou Moukoko
- Biological Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
- Centre Pasteur Cameroon, Yaoundé, Cameroon
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Dunne L, Murphy E, Rutledge R. “Semenly” Harmless Back Pain: An Unusual Presentation of a Subcutaneous Abscess. Ir Med J 2019; 112:857. [PMID: 30719898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aims We report, with review of the literature, the case of a patient who developed a subcutaneous abscess after intravenously injecting his own semen in an attempt to treat longstanding back pain. He had devised this “cure” independent of medical advice. Methods A review of EMBASE, PubMed, google scholar and the wider internet was conducted with an emphasis on parenteral semen for the treatment of back pain and for other medical and non-medical uses. Results There were no other reported cases of intravenous semen injection found across the medical literature. A broader search of internet sites and forums found no documentation of semen injection for back pain treatment or otherwise. Conclusion While suicide attempt by intravenous injection of harmful substances is well described, this unique case demonstrates risks involved with innovative treatments prior to clinical research in the form of phased trials inclusive of safety and efficacy assessments.
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Affiliation(s)
- L Dunne
- Tallaght University Hospital, Tallaght, Dublin 24
| | - E Murphy
- Tallaght University Hospital, Tallaght, Dublin 24
| | - R Rutledge
- Tallaght University Hospital, Tallaght, Dublin 24
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Laffinti MA, Ouadoudi JE, Hassani HG, Najib R, Benali A. Corticoïdes et culture: un cas d'épisode psychotique aigu cortico-induit. Pan Afr Med J 2019; 33:25. [PMID: 31384340 PMCID: PMC6658155 DOI: 10.11604/pamj.2019.33.25.18207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 05/02/2019] [Indexed: 12/04/2022] Open
Abstract
Les effets secondaires psychiatriques des corticoïdes sont décrits depuis longtemps. Certaines réactions sont sévères et concernent environ 5% des patients. Ces effets secondaires sont plus difficiles à évaluer lorsque le recours aux corticoïdes sort du cadre thérapeutique habituel et s'intègre dans une automédication en lien avec certaines influences culturelles. Nous rapportons le cas d'une jeune femme ayant présenté un épisode psychotique aigu dans les suites d'une auto-prise de corticoïdes dans un but de gain de poids. Nous discutons l'intérêt d'un diagnostique et d'une prise en charge précoce ainsi que l'importance du volet préventif multidisciplinaire, en particulier devant l'implication de l'aspect culturel dans l'observation présentée.
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Affiliation(s)
- Mahmoud Amine Laffinti
- Service de Psychiatrie, Hôpital Militaire Avicenne, Marrakech, Maroc
- Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech, Maroc
| | - Jalal El Ouadoudi
- Service de Psychiatrie, Hôpital Militaire Avicenne, Marrakech, Maroc
- Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech, Maroc
| | - Hicham Guennouni Hassani
- Service de Psychiatrie, Hôpital Militaire Avicenne, Marrakech, Maroc
- Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech, Maroc
| | - Rachid Najib
- Service de Psychiatrie, Hôpital Militaire Avicenne, Marrakech, Maroc
- Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech, Maroc
| | - Abdeslam Benali
- Service de Psychiatrie, Hôpital Militaire Avicenne, Marrakech, Maroc
- Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech, Maroc
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VandeWaa E, Bealle Rudd A, Estis JM, Gordon-Hickey S. Safe Medication Administration in Patients with Communication Disorders: A Simulation-Enhanced Interprofessional Education Approach. J Allied Health 2019; 48:257-262. [PMID: 31800655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 05/25/2019] [Indexed: 06/10/2023]
Abstract
Medications and their associated side effects impact systems treated by speech-language pathologists and audiologists, such as speech, language, voice, swallowing, hearing, tinnitus, and balance. However, students in these disciplines receive limited training in pharmacology, while nursing students receive training in pharmacology but limited training in communication disorders. In this interprofessional simulation experience to increase understanding of the impact of medications on communication, swallowing, and balance, audiology, nursing, and speech-language pathology students worked together to interview standardized patients (SPs) about their medications and symptoms in a simulated clinical setting. Goals were for students to understand professional roles, identify high-risk medications with potential communication implications, provide patient education, and evaluate interdisciplinary collaboration. The SPs demonstrated symptoms patients may have as they take high-risk medications. Students (n = 101) completed a knowledge pretest, online training, simulation, debriefing facilitated by faculty experts, and posttest and impressions survey. Results indicated high satisfaction with teamwork and interprofessional interactions. Student knowledge of high-risk medications was improved as a result of this exercise, with nursing and speech-language pathology students demonstrating statistically significant improvements in posttest results. While knowledge deficits of some high-risk medications were evident across student groups, the overall effects demonstrated benefits of the simulation-enhanced interprofessional education experience.
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Affiliation(s)
- Elizabeth VandeWaa
- Dep. of Adult Health, College of Nursing, University of South Alabama, HAHN 4061, 5721 USA Drive N, Mobile, AL 36688-0002, USA. Tel 251-445-9454.
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Nelson SE, Shoov E, LaBrie RA, Shaffer HJ. Externalizing and self-medicating: Heterogeneity among repeat DUI offenders. Drug Alcohol Depend 2019; 194:88-96. [PMID: 30415173 PMCID: PMC6312495 DOI: 10.1016/j.drugalcdep.2018.09.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
AIM Despite significant reductions in Driving Under the Influence (DUI) in the United States during recent decades, DUI continues to be a major public health threat. The current study investigated the intersection of two domains known to influence DUI: criminal history and psychiatric comorbidity. METHODS DUI recidivists (N = 743) attending a court-mandated two-week inpatient DUI program completed a computerized mental health assessment as part of their intake to that program. Participants' criminal records were obtained 4-5 years after program attendance. FINDINGS This study identified three primary repeat DUI offender subtypes with distinct patterns of criminal behavior and psychiatric comorbidity: (Type I) those whose DUI emerges from a pattern of drinking to cope with mood and anxiety problems, (Type II) those whose DUI emerges as part of a larger pattern of externalizing and criminal behavior, and (Type III) those whose DUI offenses reflect more acute triggers and isolated episodes of excessive drinking. CONCLUSION These findings suggest that current treatment models used in DUI programs are inadequate to address the heterogeneity in the population of DUI recidivists and that earlier and more comprehensive screening would allow for better targeting of resources to DUI offender subtypes.
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Affiliation(s)
- Sarah E Nelson
- Division on Addiction, Cambridge Health Alliance, 101 Station Landing, Ste. 2100, Medford, MA 02155, USA; Harvard Medical School, Department of Psychiatry, 401 Park Drive, Boston, MA, 02215, USA.
| | - Emily Shoov
- Division on Addiction, Cambridge Health Alliance, 101 Station Landing, Ste. 2100, Medford, MA 02155, USA
| | - Richard A LaBrie
- Division on Addiction, Cambridge Health Alliance, 101 Station Landing, Ste. 2100, Medford, MA 02155, USA; Harvard Medical School, Department of Psychiatry, 401 Park Drive, Boston, MA, 02215, USA
| | - Howard J Shaffer
- Division on Addiction, Cambridge Health Alliance, 101 Station Landing, Ste. 2100, Medford, MA 02155, USA; Harvard Medical School, Department of Psychiatry, 401 Park Drive, Boston, MA, 02215, USA
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Muršić I, Kuric I, Raguž M, Kovačević T, Muršić D. Treatment of Scabies and Pediculosis in Health Education Publications and Folk Medicine of Eastern Croatia - Slavonija, Baranja, and Western Srijem County. Acta Dermatovenerol Croat 2018; 26:33-38. [PMID: 29782297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Scabies and pediculosis are common parasitic infestations of the skin and hair, manifesting with intense pruritus and effectively treated with modern medications. Because of the attached social stigma linking it with poverty and poor hygiene, patients will often attempt alternative folk-based remedies before confiding in their physicians. We conducted a comprehensive bibliographical study of historic folk literature and interviewed 70 individuals experienced in everyday application of folk medicine in order to categorize available remedies and provide a modern, scientific comment on their effectiveness and dangers. Compositions containing sulfur, copper sulfate, petroleum, coal, tar, and highly alkaline soaps and washing solutions undoubtedly have scabicidal and pediculicidal properties, but they are used either in high concentrations with greater possibility of intoxication and irritation or lower concentrations with questionable therapeutic benefit. These remedies, extracted from historical-cultural frameworks, are poorly adapted to modern standards and can lead to side-effects and complications. Physicians today have to be aware of the reasons their patients seek alternative remedies and know the substances and procedures they may use in self-healing, so as to be able to provide the help that may be needed if those complications occur.
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Affiliation(s)
- Ivanka Muršić
- Ivanka Muršić, MD, University Hospital Centre Osijek, Department of Dermatology and Venereology J. Huttlera 4, 31000 Osijek, Croatia;
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Davidson HE. Setting the Stage for Better Outcomes. Consult Pharm 2018; 33:123. [PMID: 29720297 DOI: 10.4140/tcp.n.2018.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Gnassingbe A, Flahault A, Geissbuhler A, Sprumont D, Awesso A. State of the fight against informal market of medicines in Togo: approaches and limitations. Med Sante Trop 2018; 28:5-11. [PMID: 29616645 DOI: 10.1684/mst.2018.0750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The extent of medicines sales and consumption in the informal market in Togo raises many ethical and public health issues. In order to report on the situation of public action in the fight against this practice, we conducted a qualitative survey from 15 to 25 February 2016 in the commune of Lomé and in the Maritime Region among the actors of control system and resource people in the general population. This was supplemented by an analysis of Togo's pharmaceutical and health policy documents and a literature review on the illicit drug market issues relating to public health, political science, the social sciences applied to health. In spite of the existence of national and international tools, household poverty, cultural self-medication, ignorance of the population concerning the health risks of informal market medicines, weak political commitment, weakness regulation and enforcement, corruption, constitute obstacles to the success of actions to combat this practice.
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Affiliation(s)
- A Gnassingbe
- Institut de santé globale, Faculté de médecine, Université de Genève, Suisse
| | - A Flahault
- Institut de santé globale, Faculté de médecine, Université de Genève, Suisse
| | - A Geissbuhler
- Département de radiologie et informatique médicale, Faculté de médecine, Université de Genève, Suisse
| | - D Sprumont
- Institut de droit de la santé, Université de Neuchâtel, Neuchâtel, Suisse, Swiss School of Public Health, Zurich, Suisse
| | - A Awesso
- Département d'Anthropologie, Université de Lomé, Togo
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Lei X, Jiang H, Liu C, Ferrier A, Mugavin J. Self-Medication Practice and Associated Factors among Residents in Wuhan, China. Int J Environ Res Public Health 2018; 15:ijerph15010068. [PMID: 29300318 PMCID: PMC5800167 DOI: 10.3390/ijerph15010068] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/06/2017] [Accepted: 12/22/2017] [Indexed: 11/18/2022]
Abstract
Background: This study aims to examine the prevalence and predictors associated with self-medication, and related consequences in Wuhan, China. Methods: Two-hundred-sixty residents were interviewed from randomly selected four districts of Wuhan, China. A modified version of Anderson’s health behavioral model was used in the survey to collect information of self-medication behavior. Multivariable logistic regression analyses were used to measure correlates of the prevalence of self-medication. Results: Nearly half of the respondents would select self-medication, and 39.1% would see a doctor if they felt sick. The most common self-medicated illnesses were cold and cough, cardiovascular disease and gastrointestinal disease. The main reasons for self-medication were that the illness was not severe (enough) to see the doctor (45%); the patient did not think that the trouble of seeing a doctor was worth the effort (23%); the patient had no time to see the doctor (12%), and the patient did not want to pay high medical costs (15%). Logistic regression results suggested that respondents tended to select self-medication if the illness was minor or short-term (less than seven days). Conclusions: Our findings suggest that more strict regulation on over-the-counter medicines may be required to reduce health risks related to self-medication. Targeted health education on the risks of self-medication should be considered.
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Affiliation(s)
- Xiaosheng Lei
- School of Management, Hubei University of Chinese Medicine, Wuhan 430065, China.
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia.
| | - Chaojie Liu
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
| | - Adamm Ferrier
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
| | - Janette Mugavin
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia.
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Abraham O, Schleiden LJ, Brothers AL, Albert SM. Managing sleep problems using non-prescription medications and the role of community pharmacists: older adults' perspectives. Int J Pharm Pract 2017; 25:438-446. [PMID: 28261882 PMCID: PMC5724494 DOI: 10.1111/ijpp.12334] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 11/21/2016] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To examine older adults' perspectives regarding managing sleep problems through selection and use of non-prescription sleep aids, and the role of pharmacists. METHODS Telephone interviews were conducted from May to June 2015 with 116 individuals aged ≥60 years in Pittsburgh, Pennsylvania. Participants reported in a previous survey to have used at least one non-prescription sleep aid in the past 30 days and were willing to participate in a follow-up interview. Interview guides were designed to elicit perspectives of sleep problems, selection and use of non-prescription sleep aids, and consultation with healthcare professionals. Interview transcripts underwent content analysis. KEY FINDINGS Four themes emerged as follows: experiences with sleep problems, selection of non-prescription sleep aids, non-prescription sleep aid use and interactions with healthcare professionals. Over half of participants reported using a non-prescription sleep aid for >1 year, were satisfied with its use and perceived it improved sleep quality. Participants commonly used an antihistamine-only sleep aid; 36% of participants self-recommended their sleep aid; and 16% of participants consulted healthcare professionals. Few participants read medication dosage labels (22%), side effects or warnings (19%), and many reported they disregarded directions. Participants did not typically consult pharmacists about sleep problems (65%) but perceived that they could assist with medication concerns. CONCLUSIONS Although most participants had favourable perceptions of non-prescription sleep aids, older adults may be inappropriately using non-prescription sleep aids to self-manage sleep problems by frequently disregarding medication labels and directions for safe use. Also, few older adults are discussing their sleep aid selection and use with pharmacists.
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Affiliation(s)
- Olufunmilola Abraham
- Department of Pharmacy and TherapeuticsSchool of PharmacyUniversity of PittsburghPittsburghPAUSA
| | - Loren J. Schleiden
- Department of Pharmacy and TherapeuticsSchool of PharmacyUniversity of PittsburghPittsburghPAUSA
| | - Amanda L. Brothers
- Department of Pharmacy and TherapeuticsSchool of PharmacyUniversity of PittsburghPittsburghPAUSA
| | - Steven M. Albert
- Department of Behavioral and Community Health SciencesGraduate School of Public HealthUniversity of PittsburghPittsburghPAUSA
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Bennett AS, Elliott L, Golub A, Wolfson-Stofko B, Guarino H. Opioid-Involved Overdose Among Male Afghanistan/Iraq-Era U.S. Military Veterans: A Multidimensional Perspective. Subst Use Misuse 2017; 52:1701-1711. [PMID: 28622067 PMCID: PMC5628147 DOI: 10.1080/10826084.2017.1306563] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Mirroring nationwide trends in a broad range of U.S. populations, an alarming number of Afghanistan/Iraq-era U.S. Military veterans have experienced opioid-related overdoses. A growing body of research has examined the proximal behaviors that can precipitate an overdose; considerably less is known about more distal physiological, psychosocial and structural influences on these risk behaviors. OBJECTIVES This study adopts a multidimensional approach to better understand opioid-related overdose among U.S. Military veterans, and seeks to explore not only the proximal behavioral precipitants of overdose events, but also the complex nexus of physiological, psychological, and sociological influences that undergird overdose events. METHODS This qualitative examination is based on interview data from 36 male veterans who were discharged from the military after September 2001 and experienced at least one opioid-related overdose during or after military service. Participants were recruited in New York City during 2014 to share narrative accounts of their overdoses. RESULTS Veterans' accounts indicate that background experiences, such as self-medication for social and psychological pain, trauma, social alienation and isolation, and histories of illicit drug use, precondition the more immediate factors and behaviors that precipitate overdose (including bingeing on drugs, mixing drugs, naiveté about dosage, and ambivalence about life/death). CONCLUSIONS Findings suggest the need for comprehensive drug safety and overdose education that is sensitive to veterans' physiological, psychological, and sociological conditions. A multidimensional understanding of the distal and proximal overdose risks faced by veterans and other vulnerable groups may help lay a foundation for more inclusive/holistic approaches to overdose prevention and education.
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Affiliation(s)
- Alex S. Bennett
- Center for Community and Health Disparities Research, National Development and Research Institutes, Inc., New York, NY, USA
- Center for Drug Use and HIV/HCV Research, New York University, New York, NY, USA
| | - Luther Elliott
- Center for Community and Health Disparities Research, National Development and Research Institutes, Inc., New York, NY, USA
- Center for Drug Use and HIV/HCV Research, New York University, New York, NY, USA
| | - Andrew Golub
- Center for Community and Health Disparities Research, National Development and Research Institutes, Inc., New York, NY, USA
| | - Brett Wolfson-Stofko
- Center for Community and Health Disparities Research, National Development and Research Institutes, Inc., New York, NY, USA
- Center for Drug Use and HIV/HCV Research, New York University, New York, NY, USA
| | - Honoria Guarino
- Center for Community and Health Disparities Research, National Development and Research Institutes, Inc., New York, NY, USA
- Center for Drug Use and HIV/HCV Research, New York University, New York, NY, USA
- Institute for Infectious Disease Research, National Development and Research Institutes, Inc., New York, NY, USA
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Donders GGG, Ravel J, Vitali B, Netea MG, Salumets A, Unemo M. Role of Molecular Biology in Diagnosis and Characterization of Vulvo-Vaginitis in Clinical Practice. Gynecol Obstet Invest 2017; 82:607-616. [PMID: 29017160 DOI: 10.1159/000478982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 06/24/2017] [Indexed: 11/19/2022]
Abstract
The diagnosis of vulvo-vaginal complaints has always been enigmatic in obstetrics and gynecology. Patients with clear, pathognomonic symptoms end up with a proper diagnosis and treatment most of the time, but unfortunately we are now living in a world where women reach out to the Internet and readily get all information as to which disease their symptoms correspond to and also find the appropriate treatment "over-the-counter." Because of this trend, we as specialists are increasingly confronted with patients with complex and combined conditions. At the same time, extremely sensitive and accurate diagnostic tools are now being developed at a rapid pace, allowing the physicians to diagnose vulvo-vaginal disease with a substantially increased precision. Moreover, many of these molecular biology (MB)-based tests have become so common and affordable that self-sampling and self-testing are no longer utopia. On the other hand, too much information that is too readily available and that is too affordable also encompasses pitfalls, leading to gross overtreatment and psychological burden. As experienced caregivers, we should supervise these evolutions, define their place and proper use as diagnostic tools, utilize their potential as ad hoc tools to follow-up treatment efficacy and guide how such tools can be used for responsible self-testing. In the present paper, responding to the need for appropriate, quality assured and accessible tests for vulvo-vaginitis and the huge potential delivered by the rapidly developing MB methods, we recommend the need for a broad and regular discussion forum, composed of both clinical and technical experts and opinion makers, in order to match the needs with the huge opportunities and ideally combine the initiatives and forces into the same direction. This forum should then translate conceived strategies into regularly updated, evidence-based national and international guidelines.
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Sarraf DP, Karna G, Dhungana P, Lammichhane S, Rauniar GP. Pattern of Self-medication in Undergraduate Students at BP Koirala Institute of Health Sciences. Kathmandu Univ Med J (KUMJ) 2017; 15:14-18. [PMID: 29446356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Background Self-medication is a growing health problem. It may lead to wastage of resources, emergence of antimicrobial resistance, adverse drug reactions and prolonged suffering. Little has been reported on the extent of self-medication practiced in medical students in Nepal. Objective To study the pattern, reason and perception of self-medication among undergraduate students. Method A cross-sectional study was conducted among all undergraduate students at BP Koirala Institute of Health Sciences, Dharan, Nepal between April and May, 2015. After obtaining ethical clearance, pre-validated questionnaire was used to collect data. The date were analyzed and presented as frequency and percentage using SPSS version 11.5. Result Total of 520 students participated in the study with a mean age of 21.2±1.7 years. Prevalence of self-medication was found to be 48.3%. Most common cause for self-medication was common cold (53.3%). Nonsteroidal anti-inflammatory drugs (78.9%) were the most commonly used medicine for self-medication. The students commonly approached their seniors (50.2%) for the drug information. The most common adverse drug reaction experienced by the students was drowsiness (50.9%). Approximately one third of the students (33.2%) used to prescribe medicines to others. More than half of the students (53.8%) opined that self-medication is a part of self-care. Around one-fifth of the students (21.5%) students opined that self-medication is recommended by WHO. Conclusion Self-medication is commonly practiced by undergraduate students. Nearly one third of the students also prescribe medicines to others. Nonsteroidal anti-inflammatory drugs are the most commonly used medicine as self-medication. The students need to be educated regarding appropriate safe-medication.
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Affiliation(s)
- D P Sarraf
- Department of Clinical Pharmacology and Therapeutics, BPKIHS, Dharan, Nepal
| | - G Karna
- Department of Clinical Pharmacology and Therapeutics, BPKIHS, Dharan, Nepal
| | - P Dhungana
- Department of Clinical Pharmacology and Therapeutics, BPKIHS, Dharan, Nepal
| | - S Lammichhane
- Department of Clinical Pharmacology and Therapeutics, BPKIHS, Dharan, Nepal
| | - G P Rauniar
- Department of Clinical Pharmacology and Therapeutics, BPKIHS, Dharan, Nepal
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Abstract
Objective To review the pharmacology, adverse events, drug interactions, and use of the nonprescription analgesics in solid-organ transplant recipients. Study Selection and Data Extraction Studies evaluating nonprescription analgesics in solid-organ transplantation were considered for evaluation. English-language studies were selected for inclusion. Data Synthesis Nonprescription analgesics (aspirin, choline salicylate, magnesium salicylate, sodium salicylate, ibuprofen, ketoprofen, naproxen sodium, and acetaminophen) are the most commonly purchased over-the-counter agents in the United States. These agents, although generally considered safe, have been associated with a number of toxicities. The salicylates and nonsteroidal anti-inflammatory drugs have been associated with gastrointestinal damage, hematologic changes, liver and kidney dysfunction, and breathing difficulties. Acetaminophen has been shown to induce hematologic changes and liver and renal dysfunction. Conclusion A closer look at the nonprescription analgesics reveals their potential for harm when used by solid-organ transplant recipients. In this patient population, the salicylates and nonsteroidal anti-inflammatory drugs should generally be avoided if possible, because of their potential toxicities, especially renal dysfunction. Low-dose aspirin, for the prevention of cardiovascular and cardiocerebral events, appears to be safe, but patients must still be followed closely. Acetaminophen is generally considered the nonprescription analgesic and antipyretic of choice in transplant recipients because of its favorable toxicity profile. However, it is imperative that patients and transplant practitioners are aware that this agent is not without toxicities and proper monitoring is advised.
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Washington AR. Life-saving NSAIDs. J Miss State Med Assoc 2016; 57:116-117. [PMID: 27328474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Khalid L, Mahsood N, Ali I. The public health problem of OTC antibiotics in developing nations. Res Social Adm Pharm 2016; 12:801-2. [PMID: 27067233 DOI: 10.1016/j.sapharm.2016.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 03/12/2016] [Indexed: 11/20/2022]
Affiliation(s)
- Luma Khalid
- Department of Medicine & Allied, Northwest General Hospital & Research Centre, Peshawar, Pakistan
| | - Naheed Mahsood
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Iftikhar Ali
- Department of Pharmacy, University of Swabi, Swabi, Pakistan; Department of Pharmacy Services, Northwest General Hospital & Research Centre, Peshawar, Pakistan.
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Affiliation(s)
- Lauren A Beste
- From the General Medicine Service (L.A.B.), Health Services Research and Development (L.A.B.), and Hospital and Specialty Medicine Service (L.A.B., P.B.C.) of the Veterans Affairs (VA) Puget Sound Health Care System, and Department of Medicine, University of Washington School of Medicine (L.A.B., P.B.C.) - both in Seattle; and the Medicine Service, VA Ann Arbor Healthcare System (R.H.M., S.S.), and Department of Internal Medicine, University of Michigan Health System (R.H.M., S.S.) - both in Ann Arbor
| | - Richard H Moseley
- From the General Medicine Service (L.A.B.), Health Services Research and Development (L.A.B.), and Hospital and Specialty Medicine Service (L.A.B., P.B.C.) of the Veterans Affairs (VA) Puget Sound Health Care System, and Department of Medicine, University of Washington School of Medicine (L.A.B., P.B.C.) - both in Seattle; and the Medicine Service, VA Ann Arbor Healthcare System (R.H.M., S.S.), and Department of Internal Medicine, University of Michigan Health System (R.H.M., S.S.) - both in Ann Arbor
| | - Sanjay Saint
- From the General Medicine Service (L.A.B.), Health Services Research and Development (L.A.B.), and Hospital and Specialty Medicine Service (L.A.B., P.B.C.) of the Veterans Affairs (VA) Puget Sound Health Care System, and Department of Medicine, University of Washington School of Medicine (L.A.B., P.B.C.) - both in Seattle; and the Medicine Service, VA Ann Arbor Healthcare System (R.H.M., S.S.), and Department of Internal Medicine, University of Michigan Health System (R.H.M., S.S.) - both in Ann Arbor
| | - Paul B Cornia
- From the General Medicine Service (L.A.B.), Health Services Research and Development (L.A.B.), and Hospital and Specialty Medicine Service (L.A.B., P.B.C.) of the Veterans Affairs (VA) Puget Sound Health Care System, and Department of Medicine, University of Washington School of Medicine (L.A.B., P.B.C.) - both in Seattle; and the Medicine Service, VA Ann Arbor Healthcare System (R.H.M., S.S.), and Department of Internal Medicine, University of Michigan Health System (R.H.M., S.S.) - both in Ann Arbor
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Montastruc JL, Bondon-Guitton E, Abadie D, Lacroix I, Berreni A, Pugnet G, Durrieu G, Sailler L, Giroud JP, Damase-Michel C, Montastruc F. Pharmacovigilance, risks and adverse effects of self-medication. Therapie 2016; 71:257-62. [PMID: 27080848 DOI: 10.1016/j.therap.2016.02.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/27/2015] [Indexed: 11/19/2022]
Abstract
Self-medication means resorting to one or more drugs in order to treat oneself without the help of a doctor. This phenomenon is developing fast. In this review, we will discuss the main definitions of self-medication; we will then present a few important characteristics of this therapeutic practice: prevalence, reasons, populations involved and drugs used. Whilst the theoretical risks of self-medication have been abundantly discussed in the literature (adverse effects, interactions, product, dosage or treatment duration errors, difficulty in self-diagnosis, risk of addiction or abuse…), there is in fact very little detailed pharmacovigilance data concerning the characteristics and the consequences of this usage in real life. This study therefore describes the all too rare data that is available: patients, clinical characteristics, "seriousness" and drugs involved in the adverse effects of self-medication. It also discusses leads to be followed in order to minimize medication risks, which are obviously not well known and clearly not sufficiently notified.
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Affiliation(s)
- Jean-Louis Montastruc
- Service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, pharmacoépidémiologie et informations sur le médicament, pharmacopôle Midi-Pyrénées, faculté de médecine, CHU de Toulouse, CIC Inserm 1436, 31000 Toulouse, France; Académie nationale de médecine, 75000 Paris, France.
| | - Emmanuelle Bondon-Guitton
- Service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, pharmacoépidémiologie et informations sur le médicament, pharmacopôle Midi-Pyrénées, faculté de médecine, CHU de Toulouse, CIC Inserm 1436, 31000 Toulouse, France
| | - Delphine Abadie
- Service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, pharmacoépidémiologie et informations sur le médicament, pharmacopôle Midi-Pyrénées, faculté de médecine, CHU de Toulouse, CIC Inserm 1436, 31000 Toulouse, France
| | - Isabelle Lacroix
- Service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, pharmacoépidémiologie et informations sur le médicament, pharmacopôle Midi-Pyrénées, faculté de médecine, CHU de Toulouse, CIC Inserm 1436, 31000 Toulouse, France
| | - Aurélia Berreni
- Service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, pharmacoépidémiologie et informations sur le médicament, pharmacopôle Midi-Pyrénées, faculté de médecine, CHU de Toulouse, CIC Inserm 1436, 31000 Toulouse, France
| | - Grégory Pugnet
- Service de médecine interne, hôpital Purpan, faculté de médecine, CHU de Toulouse, 31000 Toulouse, France
| | - Geneviève Durrieu
- Service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, pharmacoépidémiologie et informations sur le médicament, pharmacopôle Midi-Pyrénées, faculté de médecine, CHU de Toulouse, CIC Inserm 1436, 31000 Toulouse, France
| | - Laurent Sailler
- Service de médecine interne, hôpital Purpan, faculté de médecine, CHU de Toulouse, 31000 Toulouse, France
| | | | - Christine Damase-Michel
- Service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, pharmacoépidémiologie et informations sur le médicament, pharmacopôle Midi-Pyrénées, faculté de médecine, CHU de Toulouse, CIC Inserm 1436, 31000 Toulouse, France
| | - François Montastruc
- Service de pharmacologie médicale et clinique, centre Midi-Pyrénées de pharmacovigilance, pharmacoépidémiologie et informations sur le médicament, pharmacopôle Midi-Pyrénées, faculté de médecine, CHU de Toulouse, CIC Inserm 1436, 31000 Toulouse, France
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Akinlade KA, Akinyemi JO, Fawole OI. Knowledge of hazards of antibiotics self-medication by mothers for under-fives in rural community of South-west Nigeria. Afr J Med Med Sci 2015; 44:303-309. [PMID: 27462692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND In Nigeria, self-medication of young children is common. Children under the age of five are often self-medicated with antibiotics because of their increased susceptibility to infections. OBJECTIVES To assess mothers' knowledge on the hazards of antibiotics self-medication in a rural community of South-west Nigeria. METHODOLOGY A community-based, cross-sectional study was conducted among 513 mothers selected through a purposive sampling technique from Koko community in Olodo, Ibadan between October and December, 2014. Data were collected using a semistructured interviewer administered questionnaire and analyzed with SPSS version 20. Descriptive statistics, Chi-square test and logistic regression were done at 5% level of significance. RESULTS A very high proportion (96.5%) of mothers in this study practiced antibiotic self-medication for their children. Only 28.1% were knowledgeable about the risks and side effects of antibiotic self-medication. Chi-square test revealed that there was a significant association between respondents' educational status (P < 0.05) and knowledge of the hazards. Mothers with no formal education were less likely to be knowledgeable compared to those who had tertiary education (OR = 0.08; 95% CI = 0.02- 0.57). CONCLUSION High proportions of mothers lack adequate knowledge on the hazards of antibiotics self-medication. Mothers, particularly those with lower educational levels and young age need to be educated on the risks and side effects of this practice.
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Gebeyehu E, Bantie L, Azage M. Inappropriate Use of Antibiotics and Its Associated Factors among Urban and Rural Communities of Bahir Dar City Administration, Northwest Ethiopia. PLoS One 2015; 10:e0138179. [PMID: 26379031 PMCID: PMC4574735 DOI: 10.1371/journal.pone.0138179] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 08/26/2015] [Indexed: 11/24/2022] Open
Abstract
Background Inappropriate use of antibiotics in the community plays a role in the emergence and spread of bacteria resistant to antibiotics which threatens human health significantly. The present study was designed to determine inappropriate use of antibiotics and its associated factors among urban and rural communities of Bahir Dar city administration. Methods A comparative cross sectional study design was conducted in urban and rural kebeles of Bahir Dar city administration from February 1 to March 28, 2014. A total of 1082 participants included in the study using a systematic random sampling technique. Data was collected using pre-tested and structured questionnaire. Data was coded and entered into SPSSS version 16 for statistical analysis. Bivariate and multivariate logistic regression model were used to identify factors associated with inappropriate use of antibiotics. Results Inappropriate use of antibiotics was 30.9% without significant difference between urban (33.1%) and rural (29.2%) communities. From the inappropriate antibiotic use practice, self-medication was 18.0% and the remaining (12.9%) was for family member medication. Respiratory tract symptoms (74.6%), diarrhea (74.4%), and physical injury/wound (64.3%) were the three main reasons that the communities had used antibiotics inappropriately. Factors associated with inappropriate use of antibiotics were low educational status, younger age, unsatisfaction with the health care services, engagement with a job, and low knowledge on the use of antibiotic preparations of human to animals. Conclusions Inappropriate use of antibiotic exists in the study area with no significant difference between urban and rural communities. The study indicated an insight on what factors that intervention should be made to reduce inappropriate use of antibiotics in the community. Interventions that consider age groups, educational status, common health problems and their jobs together with improvement of health care services should be areas of focus to reduce inappropriate use of antibiotics.
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Affiliation(s)
- Endalew Gebeyehu
- Department of Pharmacology, College of Medicine and Health Sciences, Bahir Dar University, P.O Box 79, Bahir Dar, Ethiopia
- * E-mail:
| | - Laychiluh Bantie
- Department of Pharmacology, College of Medicine and Health Sciences, Bahir Dar University, P.O Box 79, Bahir Dar, Ethiopia
| | - Muluken Azage
- Department of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia
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Koch A, Delb W, Kruppert H. [One-sided facial and cervical swelling with tinnitus]. HNO 2015; 63:638-41. [PMID: 26324200 DOI: 10.1007/s00106-015-0060-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- A Koch
- HNO-Abteilung der Hôpitaux Robert Schuman, Zithaklinik, 36, rue Zithe, 2763, Luxembourg, Luxemburg,
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Kloosterboer SM, McGuire T, Deckx L, Moses G, Verheij T, van Driel ML. Self-medication for cough and the common cold: information needs of consumers. Aust Fam Physician 2015; 44:497-501. [PMID: 26590496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Despite the high use of over-the-counter (OTC) cough and cold medicines, little is known about Australia's cough and cold medicines information needs. The aim of this study was to identify gaps in consumers' perceived knowledge and concerns, to better target consumer medicines information and improve quality use of medicines. METHODS We analysed cough-and-cold related enquiries from consumers who contacted an Australian national medicine call centre between September 2002 and June 2010. RESULTS Of 5503 cough and cold calls, female callers made up 86% of the calls and 33% were related to children. Questions most frequently related to drug-drug interactions (29%). An analysis of narratives over an 18-month period (248 calls) revealed 20% of the calls concerned potentially clinically relevant interactions, particularly those involving psychotropic agents. DISCUSSION The potential for interactions with cough and cold medicines purchased OTC is recognised by consumers. Patient information should address their concerns. Doctors should be aware of the common cough and cold interactions and communicate likely clinical symptoms to patients when prescribing medication to prevent potential harm.
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Fais P, Vermiglio E, Laposata C, Lockwood R, Gottardo R, De Leo D. A case of sudden cardiac death following Domperidone self-medication. Forensic Sci Int 2015; 254:e1-3. [PMID: 26119456 DOI: 10.1016/j.forsciint.2015.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 05/20/2015] [Accepted: 06/04/2015] [Indexed: 11/18/2022]
Abstract
The phenomenon of sudden cardiac death is usually related to the worsening of existing heart conditions leading to ventricular arrhythmia (VA). One of the well-known triggers of SCD is drug-induced prolongation of the QT interval, such as that caused by Domperidone (D). Despite its risk to prolong the QT interval and associated narrow therapeutic index, D is available as an over-the-counter (OTC) drug in many countries such as Italy, Ireland, Netherlands, China, South Africa, Mexico, New Zealand and Chile to treat gastroesophageal reflux and functional dyspepsia. The present paper reports a case of SCD that occurred some hours after D self-administration in a 47-year-old female subject with mitral valve prolapse, thus, predisposed to both VA and SCD. Despite the risks related to D administration, to the best of our knowledge, this particular issue has not been discussed in the medico-legal literature. For this reason, the forensic implications of D administration are discussed focusing on issues related to the self-administration as an OTC drug (as seen in this case), administration to incapacitated subjects, prescription to patients with contraindications and the off-label drug use of D at high and hazardous concentrations to stimulate lactation.
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Affiliation(s)
- Paolo Fais
- University of Verona, Department of Public Health and Community Medicine - Unit of Forensic Medicine, P.le L.A. Scuro 10, Verona, Italy.
| | - Elisa Vermiglio
- University of Verona, Department of Public Health and Community Medicine - Unit of Forensic Medicine, P.le L.A. Scuro 10, Verona, Italy
| | - Chiara Laposata
- University of Verona, Department of Public Health and Community Medicine - Unit of Forensic Medicine, P.le L.A. Scuro 10, Verona, Italy
| | - Robert Lockwood
- University of New Haven, Department of Forensic Science, 300 Boston Post Road, West Haven, CT 06516, USA
| | - Rossella Gottardo
- University of Verona, Department of Public Health and Community Medicine - Unit of Forensic Medicine, P.le L.A. Scuro 10, Verona, Italy
| | - Domenico De Leo
- University of Verona, Department of Public Health and Community Medicine - Unit of Forensic Medicine, P.le L.A. Scuro 10, Verona, Italy
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Luquiens A, Lourenco N, Benyamina A, Aubin HJ. Self-medication of achalasia with cannabis, complicated by a cannabis use disorder. World J Gastroenterol 2015; 21:6381-6383. [PMID: 26034374 PMCID: PMC4445116 DOI: 10.3748/wjg.v21.i20.6381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/26/2014] [Accepted: 01/08/2015] [Indexed: 02/06/2023] Open
Abstract
Achalasia is a rare esophagus motility disorder. Medical, endoscopic and surgical treatments are available, but all endorse high relapse rates. No data has been published to date reporting a therapeutic effect of cannabis use neither in achalasia nor on its influence on manometric measurements. We report the case of a patient diagnosed with achalasia. He could benefit from a large panel of therapeutic interventions, but none of them was effective over the time. He first used cannabis at age 20 and identified benefits regarding achalasia symptoms. He maintained regular moderate cannabis use for 9 years, with minimal digestive inconvenience. A manometry performed without cannabis premedication was realized at age 26 and still found a cardiospasm. Cannabis use could explain the gap between functional symptoms assessment and manometry measurement. Further investigations are warranted to explore a therapeutic effect of cannabis in achalasia and possible influence on outcome measurements.
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Chiba T, Sato Y, Suzuki S, Umegaki K. Concomitant use of dietary supplements and medicines in patients due to miscommunication with physicians in Japan. Nutrients 2015; 7:2947-60. [PMID: 25894658 PMCID: PMC4425182 DOI: 10.3390/nu7042947] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 03/06/2015] [Accepted: 03/26/2015] [Indexed: 01/04/2023] Open
Abstract
We previously reported that some patients used dietary supplements with their medication without consulting with physicians. Dietary supplements and medicines may interact with each other when used concomitantly, resulting in health problems. An Internet survey was conducted on 2109 people who concomitantly took dietary supplements and medicines in order to address dietary supplement usage in people who regularly take medicines in Japan. A total of 1508 patients (two admitted patients and 1506 ambulatory patients) and 601 non-patients, who were not consulting with physicians, participated in this study. Purpose for dietary supplement use was different among ages. Dietary supplements were used to treat diseases in 4.0% of non-patients and 11.9% of patients, while 10.8% of patients used dietary supplements to treat the same diseases as their medication. However, 70.3% of patients did not declare dietary supplement use to their physicians or pharmacists because they considered the concomitant use of dietary supplements and medicines to be safe. A total of 8.4% of all subjects realized the potential for adverse effects associated with dietary supplements. The incidence of adverse events was higher in patients who used dietary supplements to treat their disease. Communication between patients and physicians is important for avoiding the adverse effects associated with the concomitant use of dietary supplements and medicines.
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Affiliation(s)
- Tsuyoshi Chiba
- Information Center, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
| | - Yoko Sato
- Information Center, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
| | - Sachina Suzuki
- Information Center, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
| | - Keizo Umegaki
- Information Center, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
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Chanturia Z, Chumburidze T, Eriashvili B, Nemsitsveridze N, Dugashvili N. [Trends and risks of self-medication in Georgia]. Georgian Med News 2015:82-87. [PMID: 25879565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this study was to identify the problems of self-medication in Georgia. The study has once again shown that the basic principles of effective pharmaceutical software are: quality (legislation, standards, conformity assessment standards and supervision, well-defined responsibilities specialist pharmaceutical software and individual); accessibility; providing information.To date, Georgia has no specific guidelines defining the concept of the use of OTC self-medication. Physicians and pharmacists are not enough systematized and standardized non-commercial information about medicines. Specialists are often guided by commercial information provided by pharmaceutical companies, which is not always complete and objective. Self-treatment of lung diseases with the use of non-prescription drugs - is becoming increasingly popular. The patient should be instructed in the proper use of drugs, and should receive adequate commercially independent information professionals medical care. Only in this case we can speak of a properly organized, evidence-based and cost-effective to society towards a system of primary medical care - to self-medicate.
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Affiliation(s)
- Z Chanturia
- Tbilisi State Medical University, Faculty of Pharmacy, Georgia
| | - T Chumburidze
- Tbilisi State Medical University, Faculty of Pharmacy, Georgia
| | - B Eriashvili
- Tbilisi State Medical University, Faculty of Pharmacy, Georgia
| | | | - N Dugashvili
- Tbilisi State Medical University, Faculty of Pharmacy, Georgia
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Rausch R. [Intoxicating self-medication]. Med Monatsschr Pharm 2015; 38:79. [PMID: 26364392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Krzeszowski W, Wilczyński J, Grzesiak M, Nowakowska D. Prenatal sonographic diagnosis of premature constriction of the fetal ductus arteriosus after maternal self-medication with benzydamine hydrochloride: report of 3 cases and review of the literature. J Ultrasound Med 2015; 34:531-535. [PMID: 25715374 DOI: 10.7863/ultra.34.3.531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report 3 cases of prenatal diagnosis of premature constriction of the ductus arteriosus after maternal benzydamine hydrochloride therapy (3-mg lozenges) in third-trimester pregnancies. In each case, fetal echocardiography revealed a dilated, hypocontractile right ventricle with severe tricuspid regurgitation and constriction of the ductus arteriosus. Although the effect of indomethacin and other nonsteroidal anti-inflammatory drugs on prenatal ductal constriction is well known, readily available over-the-counter nonsteroidal anti-inflammatory drugs such as benzydamine can have an equally deleterious effect and are best avoided in the third trimester of pregnancy.
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Affiliation(s)
- Waldemar Krzeszowski
- Third Chair of Gynecology and Obstetrics, Department of Fetal-Maternal Medicine and Gynecology, Medical University, Lodz, Poland
| | - Jan Wilczyński
- Third Chair of Gynecology and Obstetrics, Department of Fetal-Maternal Medicine and Gynecology, Medical University, Lodz, Poland
| | - Mariusz Grzesiak
- Third Chair of Gynecology and Obstetrics, Department of Fetal-Maternal Medicine and Gynecology, Medical University, Lodz, Poland
| | - Dorota Nowakowska
- Third Chair of Gynecology and Obstetrics, Department of Fetal-Maternal Medicine and Gynecology, Medical University, Lodz, Poland.
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Jensen S, Skriver S. [Self-treatment with baking soda can lead to severe metabolic alkalosis]. Ugeskr Laeger 2014; 176:V11120678. [PMID: 25497637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This case report describes a 66-year-old man, previously healthy besides mild hypertension. He ingested a self-made folk remedy consisting of baking soda and water against acid reflux in dosages that resulted in severe metabolic alkalosis (pH 7.8). Diagnosing and treating MA is easy and cheap, but if the condition is not treated, consequences can be severe. The challenge is to uncover patients' use of non prescription medications and folk remedies in the diagnostic process. Having this information it is possible to prevent MA in both high- and low-risk patients.
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Gualano MR, Bert F, Passi S, Stillo M, Galis V, Manzoli L, Siliquini R. Use of self-medication among adolescents: a systematic review and meta-analysis. Eur J Public Health 2014; 25:444-50. [PMID: 25479758 DOI: 10.1093/eurpub/cku207] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We performed a systematic review and proportion meta-analysis in order to investigate the prevalence and the adverse effects of the self-medication among the teenagers. METHODS We selected observational studies published from January 1990 until January 2014 that examined the use of self-medication in the adolescents (aged from 13 to 18 years). Keywords used on PubMed, ISI Web of Knowledge and Scopus were 'self medication', 'adolescent*', 'self prescription', 'over the counter preparations' and 'self administration'. RESULTS Finally, 15 articles met the inclusion criteria, for a total of 143 213 subjects involved. Overall, 50% of adolescents use to take drugs without consulting a physician. Further analyses stratified by number of drugs used demonstrated that in the studies reporting that adolescents use more than one type of drug the prevalence rises up to 63%. Only one study reported the possible adverse effects related to the inappropriate use of drugs, which were experienced by 31.1% of the females and 19.6% of the males. CONCLUSIONS Self-medication use among adolescents is a widespread phenomenon. It would be advisable to give more attention on this public health concern and to promote initiatives, such as mass media campaigns and governmental actions, in order to make the citizens more aware to the risks related to the consumption of drugs without medical consultation. Further studies on adverse effects are urgently needed.
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Affiliation(s)
- Maria R Gualano
- 1 Department of Public Health, University of Turin, Turin, Italy
| | - Fabrizio Bert
- 1 Department of Public Health, University of Turin, Turin, Italy
| | - Stefano Passi
- 1 Department of Public Health, University of Turin, Turin, Italy
| | - Michela Stillo
- 1 Department of Public Health, University of Turin, Turin, Italy
| | - Veronica Galis
- 1 Department of Public Health, University of Turin, Turin, Italy
| | - Lamberto Manzoli
- 2 Section of Epidemiology and Public Health, University "G. d'Annunzio" of Chieti, Chieti, Italy
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Abstract
INTRODUCTION Not responsible self-medication refers to drug use in high doses without rational indication and often associated with alcohol abuse. It can lead to liver damage and drug interactions, and may cause liver failure. AIM To warn about how the practice of self-medication can be responsible for acute liver failure. METHOD Were used the Medline via PubMed, Cochrane Library, SciELO and Lilacs, and additional information on institutional sites of interest crossing the headings acute liver failure [tiab] AND acetaminophen [tiab]; self-medication [tiab] AND acetaminophen [tiab]; acute liver failure [tiab] AND dietary supplements [tiab]; self-medication [tiab] AND liver failure [tiab] and self-medication [tiab] AND green tea [tiab]. In Lilacs and SciELO used the descriptor self medication in Portuguese and Spanish. From total surveyed were selected 27 articles and five sites specifically related to the purpose of this review. CONCLUSIONS Legislation and supervision disabled and information inaccessible to people, favors the emergence of cases of liver failure drug in many countries. In the list of released drugs that deserve more attention and care, are some herbal medicines used for the purpose of weight loss, and acetaminophen. It is recommended that institutes of health intensify supervision and better orient their populations on drug seemingly harmless, limiting the sale of products or requiring a prescription for release them.
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Gyüre T, Csépány É, Hajnal B, Kellermann I, Balogh E, Nagy Z, Manhalter N, Bozsik G, Ertsey C. The comprehensive headache-related quality of life questionnaire shows significant improvement after withdrawal treatment in medication overuse headache: a pilot study. Ideggyogy Sz 2014; 67:169-177. [PMID: 25087376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND PURPOSE Medication overuse headache (MOH) is a common form of disabling headache presenting in as much as 30% of the patients seen in headache subspecialty practice. Quality of life (QOL) is frequently used as a secondary endpoint in headache trials. In MOH, previous trials of QOL focused mostly on generic QOL. We report the results of a pilot study that examined the feasibility of using a new QOL questionnaire, the 23-item Comprehensive Headache-related Quality of life Questionnaire (CHQQ), as an indicator of treatment response in MOH. PATIENTS AND METHODS Fifteen patients (13 women and two men; mean age: 39.7 +/- 12.5 years) suffering from MOH were enrolled in a complex treatment programme consisting of acute medication withdrawal, preventive pharmacological treatment, structured advice and lifestyle intervention. The clinical data were collected using a detailed headache diary. CHQQ was completed before and after the treatment programme. RESULTS MOH patients had low QOL values at baseline which was comparable to the QOL of episodic migraine patients. The treatment programme resulted in significant reductions of the number of headache days and attacks, headache severity and analgesic consumption. The dimensions and total score of CHQQ showed a significant increase after the treatment period. Seventeen of CHQQ's 23 individual items also improved significantly. CONCLUSION In this study the new headache-specific quality of life instrument CHQQ was able to demonstrate significant improvements after adequate treatment of MOH. This result indicates that the CHQQ may be an adequate tool for assessing quality of life in headache treatment trials.
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Affiliation(s)
- Nicholas Marston
- Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA
| | - Devin Kehl
- Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA
| | - Jonathan Copp
- Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA
| | - Noureddin Nourbakhsh
- Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA
| | - Dena E Rifkin
- Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA; Veterans Affairs San Diego Healthcare System, San Diego, CA.
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Abstract
The use of herbal products in patients with allergic diseases is a special problem and still controversial. But, many people often use herbs to maintain good health. The patients use self-prescribed remedies as medications but do not inform their physicians about herbal use. Unfortunately, some herbal self-medications may have unexpected effects and interactions which may lead to fatal complications. In this report, we describe a female patient who suffered near-fatal anaphylaxis to parsley.
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Affiliation(s)
- Sevket Arslan
- Necmettin Erbakan University Medical Faculty, Division of Immunology and Allergic Disease, Konya, Turkey. Necmettin Erbakan University Medical Faculty, Division of Immunology and Allergic Disease, Konya, Turkey
- Corresponding author: Sefket Arslan, MD. Division of Immunology and Allergic Disease. Necmetin Erbakan University Medical Faculty., Konya, Turkey. E-mail:
| | - Ramazan Ucar
- Necmettin Erbakan University Medical Faculty, Division of Immunology and Allergic Disease, Konya, Turkey. Necmettin Erbakan University Medical Faculty, Division of Immunology and Allergic Disease, Konya, Turkey
| | - Ahmet Zafer Caliskaner
- Necmettin Erbakan University Medical Faculty, Division of Immunology and Allergic Disease, Konya, Turkey. Necmettin Erbakan University Medical Faculty, Division of Immunology and Allergic Disease, Konya, Turkey
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Al-Abri SA, Olson KR. Baking soda can settle the stomach but upset the heart: case files of the Medical Toxicology Fellowship at the University of California, San Francisco. J Med Toxicol 2013; 9:255-8. [PMID: 23591957 PMCID: PMC3770998 DOI: 10.1007/s13181-013-0300-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Suad A. Al-Abri
- California Poison Control System, San Francisco Division, University of California, San Francisco, UCSF Box 1369, San Francisco, CA 94143-1369 USA
| | - Kent R. Olson
- California Poison Control System, San Francisco Division, University of California, San Francisco, UCSF Box 1369, San Francisco, CA 94143-1369 USA
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Popov AF, Petukhova SA, Simakova AI, Ivanis VA, Skliar LF, Dadalova OB, Kleptsova IP, Madich EA. [Trichinella autoinfection]. Med Parazitol (Mosk) 2013:26-29. [PMID: 25924280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Graf-Baumann T. [NSAIDs and painkiller in sport]. MMW Fortschr Med 2013; 155:62-64. [PMID: 23930426 DOI: 10.1007/s15006-013-0892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Jalilian F, Hazavehei SMM, Vahidinia AA, Jalilian M, Moghimbeigi A. Prevalence and related factors for choosing self-medication among pharmacies visitors based on health belief model in Hamadan Province, west of Iran. J Res Health Sci 2013; 13:81-85. [PMID: 23772020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Revised: 12/01/2012] [Accepted: 03/18/2013] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Self-medication has increased in the last decade in Iran; can be followed several complications. The aim of this study was to determine the prevalence and factors influencing self-medication based on health belief model. METHODS A cross-sectional study was conducted among 1400 Hamadan Province pharmacies visitors, during spring and summer 2012 which was randomly selected with the proportional to size among different pharmacy at Hamadan for participation in this study. A structured questionnaire was applied for collecting data, which were analyzed by SPSS version 16 using bivariate correlations and logistic regression statistical tests. RESULTS 35.4% of the participants had self-medication. Pain medication (10.6%), antibiotics (7.3%) and anti-cough and cold medications (4.5%) had the largest consumption. The main reasons of self-medication among participants were previous use of medication, symptoms improve and similar prescribed. The best predictor for self-medication was perceived severity with odds ratio estimate of 0.790 [95% CI: 0.694, 0.900]. CONCLUSION It seems that designing and implementation of educational programs to increase seriousness about side effect of self-medication may be usefulness of the results in order to prevent of self-medication.
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Affiliation(s)
- Farzad Jalilian
- Department of Nursing, School of Basic Science, Islamic Azad University, Hamadan, Iran
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Matoulková P, Dosedel M, Růzková B, Kubena A. Information and awareness concerning ibuprofen as an ingredient in over the counter analgesics: a questionnaire-based survey of residents of retirement communities. Acta Pol Pharm 2013; 70:333-338. [PMID: 23614290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Convenient access to a large variety of OTC medicines presents patients with the opportunity for the self-treatment of many health problems. Yet this also brings on other health risks, especially to the elderly. A pointed lack of information about the safety of NSAIDs has been found among lay people, but no study in the Czech Republic so far has focused on the preferences of the residents' of retirement homes for particular NSAID pain relievers and these patients' level of knowledge regarding use and safety issues. We undertook a cross-sectional study in 9 retirement communities. A self-developed questionnaire was used to gather data on the preferences of seniors for particular NSAIDs and on their knowledge about ibuprofen. Two hundred elderly people participated in the research, 77% of the sample being female. The mean age was 83 +/- 7 years. Ibuprofen was the preferred NSAID analgesic among participants. 64% of respondents indicated that they suffered from pain nearly every day. The best known indication of ibuprofen was analgesic (56.7%) and younger and more educated participants had better knowledge in general about indications. A similar percentage (57.8%) was not aware of any adverse effects of ibuprofen, and 16% believed it had no adverse effects at all. Knowledge of drug interaction was very low--most of participants (84%) were not aware of any interactions. 58% of respondents indicated that they relied on the advice of a physician about pain relievers. Despite the fact that many of the elderly individuals surveyed suffer from pain nearly every day and ibuprofen is their preferred choice among NSAIDs, their knowledge about use and safety of ibuprofen is inadequate.
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Affiliation(s)
- Petra Matoulková
- Charles University in Prague, Pharmaceutical Faculty, Department of Social and Clinical Pharmacy, Heyrovskeho 1203, Hradec Kralove 500 05, Czech Republic.
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