Area Of Pharmacotherapy Research Articles

Reporting Adverse Drug Events in Drug Administration Process among Nursing Personnel

Introduction. Adverse events (AE) in the process of pharmacotherapy can have direct consequences on the health and life of a patient. Factors leading to AE are categorized in human and systematic ones. Among the latter ones, the most important are significant shortages of nursing staff as well as stress, fatigue and the Occupational Burnout Syndrome. Reporting of AE is a crucial pillar of prevention of adverse events in drug administration in nursing.
 Aim. The aim of the study was to identify and analyse the factors leading to adverse events in the pharmocotherapy process and to present methods of prevention AE.
 Material and Methods. The research was lead among 100 hospital nurses from Pomeranian region. A research and research questionnaire was based on the study “Attitudes and beliefs of health services about the causes and reporting of treatment errors in the British intensive care unit”. The project was conducted between January to April 2020.
 Results. Detailed analysis showed that the most important factors influencing the occurrence of adverse events in the drug administration are: nurses shortage (14%), stress and burnout syndrome (11%), incorrect labelling (13%). 85% of medical personnel are convinced that it is essential to monitor the situation of adverse events in drug administration. The Kruskal–Wallis test did not confirm the existence of a relationship between the: occurrence of adverse events in the area of pharmacotherapy and age (K – W = 0; p = 1), level of education (K – W = 3.6328; p = 0.3039) and work experience of the surveyed respondents (K – W = 0.3651484; p = 0.5457). Similarly, no significant relationships were found between the occurrence of adverse events and the department profile (K – W = 0.330; p = 0.5652).
 Conclusions. The level of education, professional experience and age are not significantly related to making mistakes in the area of drug administration; the factors that significantly affect the occurrence of AD in the area of drug administration are: reduced nursing staff on duty, performing one’s duties under stress and time pressure, insufficient variety of labels on medicinal products; the best method of prevention in the area of drug management and administration is the presence of a reporting and monitoring system; the was the majority of nurses reported the occurrence of a drug-related adverse event to the rest of the therapeutic team. (JNNN 2022;11(2):65–73).

Drugs Used During Pregnancy and Lactation

In time of pregnancy, drugs are often required to treat certain disorders. In general potential benefit outweighs known risks, drugs may be considered for treatment of disorders during pregnancy. All maternal drugs not cross the planceta to the fetus. Some drugs that cross the placenta may have a direct toxic effect or teratogenic effect . Understanding the risks of drugs use in pregnancy has lagged being the advances in other areas of pharmacotherapy. The adverse developmental effects of pharmaceutical products are recognized to include not only mal formation, but also growth restrictions, fetal death and functional defects in the newborn. Drug that does not cross placenta but still harm the fortus. 1979, FDA developed a system determining teratogenic risk of drugs based on animals& human studies. Divided drugs into 5 categories (A ,B, C, D, X). This article provide clinical therapeutic guidance relating drug use in pregnancy.

Chronic pain syndromes in ICD 11. Complex therapy concept

In the International Classification of Diseases (ICD‑10), the diagnosis of chronic pain is not presented, which makes it difficult to conduct accurate epidemiological studies and prevents the development of an adequate diagnosis and multimodal therapy strategy. ICD‑11 will be the first version to include chronic pain as a diagnosis. According to the new concept, chronic pain is a real disease associated with multiple changes in the nervous, endocrine and immune systems. Developing a comprehensive treatment plan is of paramount importance and requires a multimodal plan that includes non‑drug and pharmacotherapeutic strategies for pain management. One of the promising areas of pharmacotherapy is the use of complex therapy regimens: meloxicam (Amelotex) – tolperisone (Calmirex) – B vitamins (compliments B).

Revision of Lung Cancer Clinical Practice Guidelines -Focusing on the Area of Pharmacotherapy-

Revision of Lung Cancer Clinical Practice Guidelines -Focusing on the Area of Pharmacotherapy-

BARICITINIB: NEW PHARMACOTHERAPY OPTIONS FOR RHEUMATOID ARTHRITIS AND OTHER IMMUNE-MEDIATED INFLAMMATORY RHEUMATIC DISEASES

Deciphering the mechanisms of the pathogenesis of immune-mediated inflammatory rheumatic diseases (IMIRDs) in conjunction with designing a wide range of biological agents is one of the major medical advances in the 21st century. A new promising area of pharmacotherapy for IMIRDs is associated with the design of the so-called targeted oral medications that primarily include Janus kinase (JAK) inhibitors. The review presents new data on the efficacy and safety of the new JAK inhibitor baricitinib in treating rheumatoid arthritis and other IMIRDs.

Schizophrenia.

The lifetime prevalence of schizophrenia is 1%. Schizophrenia is among the most severe mental illnesses and gives rise to the highest treatment costs per patient of any disease. It is characterized by frequent relapses, marked impairment of quality of life, and reduced social and work participation. The group entrusted with the creation of the German clinical practice guideline was chosen to be representative and pluralistic in its composition. It carried out a systematic review of the relevant literature up to March 2018 and identified a total of 13 389 publications, five source guidelines, three other relevant German clinical practice guidelines, and four reference guidelines. As the available antipsychotic drugs do not differ to any great extent in efficacy, it is recommended that acute antipsychotic drug therapy should be sideeffect- driven, with a number needed to treat (NNT) of 5 to 8. The choice of treatment should take motor, metabolic, sexual, cardiac, and hematopoietic considerations into account. Ongoing antipsychotic treatment is recommended to prevent relapses (NNT: 3) and should be re-evaluated on a regular basis in every case. It is also recommended, with recommendation grades ranging from strong to intermediate, that disorder- and manifestation-driven forms of psychotherapy and psychosocial therapy, such as cognitive behavioral therapy for positive or negative manifestations (effect sizes ranging from d = 0.372 to d = 0.437) or psycho-education to prevent relapses (NNT: 9), should be used in combination with antipsychotic drug treatment. Further aspects include rehabilitation, the management of special treatment situations, care coordination, and quality management. A large body of evidence is available to provide a basis for guideline recommendations, particularly in the areas of pharmacotherapy and cognitive behavioral therapy. The evidence-based diagnosis and treatment of persons with schizophrenia should be carried out in a multiprofessional process, with close involvement of the affected persons and the people closest to them.

Pharmacists: Safeguards Between Older People and Their Psychotropic Medications.

Now, more than ever, older people need pharmacists to protect them from medication-related problems inherent to psychotropic drugs. It is clear that, because of their specific training and technical knowledge in the area of pharmacotherapy, pharmacists have a logical place in any multidisciplinary context where drug treatment is prescribedâ-"and always will be.

Prospective areas of pharmacotherapy for allergic rhinitis

Prospective areas of pharmacotherapy for allergic rhinitis

Revision of Lung Cancer Clinical Practice Guidelines -Focusing on the Area of Pharmacotherapy-

Revision of Lung Cancer Clinical Practice Guidelines -Focusing on the Area of Pharmacotherapy-

BPS certifications continue to expand rapidly

The Board of Pharmacy Specialties (BPS) recently reported that a total of 3,247 pharmacists successfully passed the 2013BPS specialty certification and recertification examinations. There are now 19,109BPS board-certified pharmacists, representing an increase of almost 21% from 2012.

Cough: Differential diagnosis and rational pharmacotherapy

This publication deals with topical problems in the management of patients with cough. It presents its epidemiology and clinical classification, an analysis of its causes, a list of required diagnostic techniques, and areas of pharmacotherapy. Emphasis is laid on the differential diagnosis of different abnormalities and diseases, the leading clinical sign of which is cough. The authors provide the detailed characteristics of medicaments for its treatment and the principles of rational antitussive and mucoactive pharmacotherapy.

New areas of the pharmacotherapy of rheumatic diseases are inhibition of interleukin-6 and interleukin-17

Significant progress related particular to the use of interleukin (IL)-6 and IL17 inhibitors has been made in the pharmacotherapy of rheumatic diseases. IL-6 is a cytokine that has a wide range of biological activity and affects different types of cells. There is evidence for the important role of IL-6 hyperproduction not only in rheumatoid arthritis (RA), but also in other immune inflammatory rheumatic diseases (systemic lupus erythematosus (SLE), scleroderma system atica, idiopathic inflammatory myopathies, giant cell arteritis, etc.). IL-6 inhibition primarily with humanized monoclonal antibodies against IL-6 receptors (tocilizumab – TCZ)) is considered as one of the promising areas of pharmacotherapy for these diseases. The successful results of TCZ use have created pre requisites for the design of other medicaments that can form a novel class of IL-6 inhibitors, genetically engineered biological agents, in the future. There is another new area in the treatment of immune inflammatory rheumatic diseases, which is the inhibition of the cytokine IL17A that provides interaction between innate and acquired immunity and is synthesized by a wide range of immunocompetent cells, the socalled Th17 ones in particular. IL-17A is implicated in the immunopathogenesis of a broad spectrum of immune inflammatory diseases, including RA, psoriasis, psoriatic arthritis, inflammatory bowel diseases, SLE, allergic diseases, transplantation immunity, obesity, carcinogenesis, etc. Elevated IL-17A concentrations correlate with the activity and severity of a pathological process. The pathogenetic effects of IL-17 in RA may be associated with its involvement in the development of synovial inflammation and joint destruction. The therapeutic efficiency of inhibition of Th17 cells and IL-17A synthesis in autoimmune diseases was first indirectly demonstrated in psoriasis. This provided the basis for the elaboration of therapeutic approaches associated with the direct inhibition of IL-17 effects in these patients. Thus, the use of IL-6 inhibitors (primarily TCZ) and, probably, IL-17 will make significant progress in the treatment of not only RA, but other severe potentially deadly immune inflammatory rheumatic diseases in the future.

Gastrointestinal bleeding

Gastrointestinal bleeding remains one of the most important emergencies in gastroenterology. Despite this, only about 100 abstracts concerning gastrointestinal bleeding (excluding bleeding complicating endoscopic procedures) were presented at this year's Digestive Disease Week (DDW; 7-10 May 2011; Chicago, Illinois, USA), accounting for less than 2% of all presented lectures and posters. It seems that the number of such abstracts has been decreasing over recent years. This may be due in part to the high level of medical care already achieved, especially in the areas of pharmacotherapy and endoscopic treatment of gastrointestinal bleeding. In this review of gastrointestinal bleeding, priority has been given to large epidemiological studies reflecting "real life," and abstracts dealing more or less directly with endoscopic management.

The Emerging Role of Electronic Medical Records in Pharmacogenomics

Health-care information technology and genotyping technology are both advancing rapidly, creating new opportunities for medical and scientific discovery. The convergence of these two technologies is now facilitating genetic association studies of unprecedented size within the context of routine clinical care. As a result, the medical community will soon be presented with a number of novel opportunities to bring functional genomics to the bedside in the area of pharmacotherapy. By linking biological material to comprehensive medical records, large multi-institutional biobanks are now poised to advance the field of pharmacogenomics through three distinct mechanisms: (i) retrospective assessment of previously known findings in a clinical practice-based setting, (ii) discovery of new associations in huge observational cohorts, and (iii) prospective application in a setting capable of providing real-time decision support. This review explores each of these translational mechanisms within a historical framework.

Case histories, magic bullets and the state of drug discovery

The case histories of five modern drugs are taken as a basis for reflection on the state of drug discovery. Two issues intimately associated with drug research are highlighted: the nature of the intellectual process leading to new discoveries; and the possibility that the principle of selective efficacy, which has guided drug research from its beginnings, might need modification, at least in some areas of pharmacotherapy.

Enantiomers’ potential in psychopharmacology—a critical analysis with special emphasis on the antidepressant escitalopram

Stereochemistry is now influencing most areas of pharmacotherapy, with a growing awareness in the field of psychiatry and, more specifically, depression. This is due to the fact that the enantiomers of many chiral drugs may have distinct pharmacological, pharmacokinetic and/or pharmacogenetic profiles. Consequently, in some instances there may be an advantage in using a single enantiomer over the racemic form—thus providing a basis for the development of new therapeutic agents, as well as the potential to improve current treatments. This review highlights some of the potential advantages and disadvantages that using single enantiomers might offer. The principles are exemplified through reference to the stereoselective properties of several established chiral psychotropic drugs, including thioridazine, methadone, trimipramine, mianserin, mirtazapine, fluoxetine and citalopram. Emphasis is given to the treatment of depression and how the potential of one pure enantiomer—escitalopram, the S-enantiomer of the selective serotonin reuptake inhibitor citalopram—appears to be fulfilling its preclinical promise in the clinic.

Recent advances in the management of colorectal polyps

Recent advances in the biology of colorectal polyposis may permit the evolution of strategies for the management of colorectal polyps. Molecular genetic studies have identified mutations in both inherited and sporadic polyps. Epidemiologic studies suggest personal habits and characteristics that may predispose individuals to higher risk of developing polyposis. Better understanding of the adenoma-to-carcinoma sequence suggests guidelines for screening, treatment, and follow-up. Research in the area of pharmacotherapy offers options for prevention and treatment. These advances may contribute to the reduction of morbidity and mortality from colorectal carcinoma.