Drug And Poison Information Center Research Articles

Evaluation of Adverse Drug Events of Remdesivir for the Treatment of COVID-19 in Patients Contacting the 13-Aban Pharmacy Drug and Poison Information Center

Background: One of the FDA-approved treatments for COVID-19 is remdesivir. In this study, we investigated adverse drug events (ADEs) of remdesivir in COVID-19 patients who contacted 13-Aban pharmacy’s drug and poison information center (DPIC). Methods: In this study, data of patients receiving remdesivir who contacted the 13-Aban pharmacy’s DPIC between April 2021 and May 2022 were extracted. For the evaluation of potential ADEs, we reviewed all contacts related to remdesivir recipients. Results: Out of 223 patients enrolled, 108 (48.40%) developed 120 ADEs. Elevated liver transaminase levels (26.67%) were the most common ADE, followed by weakness (7.5%), nausea, and vomiting (7.5%). The causality assessment of ADE using the Naranjo scale revealed that 41.67% were probable and 58.33% were possible. Conclusion: Based on the results of this study, hepatic dysfunction was the most prevalent ADE among remdesivir recipients; thus, in order to ensure safe use of remdesivir, patients should be closely monitored for this ADE.

The role of drug information centers to improve medication safety in Saudi Arabia - a study from healthcare professionals' perspective

Background and objectiveThe primary function of the Drug Information Center (DIC) is to provide drug-related information to healthcare professionals. The purpose of this research was to assess the use of drug information centers by health care the professionals to improve medication safety in Saudi Arabia. MethodsA retrospective study was carried out at King Khalid University Hospital's drug and poison information center (DPIC). During the study period, requests received by drug information specialists were saved in the DPIC questions’ bank. Patients’ demographic, type of drug information request, caller information, number of references used, medications, class of medication, medication error type and subclass were assessed and analyzed using descriptive analysis. Medication error types were captured based on nature of questions. ResultsA total of 243 drug information inquiries were assessed. Most of the inquiries were about adult population (n = 168; 69.1%). Most drug information inquiries were received from pharmacists (n = 117; 48.1%), followed by physicians (n = 94; 38.7%), then nurses (n = 23; 9.5%). Prescribing error were the most type of medication error prevented by drug information specialists (n = 214; 88.1%) followed by dispensing errors (n = 11; 4.5%). Approximately half of the medication errors in this study were near-misses (n = 110; 45.3%), followed by potential near misses (n = 84; 34.6%). Only, (n = 49; 20.2%) were identified as errors. ConclusionThis study highlights the role of drug information specialists in providing evidence-based information and helps in preventing possible medication errors which will enhance the safety of the services provided to the patients.

The Individualized Management Approach for Acute Poisoning.

Acute poisoning is a widespread emergency that mandates early management decisions for optimal outcomes. An individualized approach is an ideal way to provide those outcomes. Promoting awareness among healthcare professionals managing acute poisoning about the importance of incorporating the pharmacokinetics and following certain criteria to consider interventions such as activated charcoal, antidote, or specific investigations may improve their risk assessment strategies and management plans. To address the main aspects that should be considered to develop a customized poisoning management plan, we conducted this review based on relevant publications recovered by a careful search in PubMed. Our opinions as experts from the King Saud University (KSU) Drug and Poison Information Center (DPIC) were considered in the review.

Hyperprolactinemia and Galactorrhea Associated with Risperidone-Fluoxetine Combination Therapy: A Case Report

Prolactin is a polypeptide hormone secreted and released by lactotroph cells in the anterior pituitary gland in response to diverse physiological stimuli, principally via the inhibitory action of dopamine and serotonin. This paper describes a 44-year-old woman with depression and obsessive-compulsive disorder (OCD) who called the 13-Aban drug and poison information center (DPIC). She was being treated with fluoxetine (80 mg/day) for 10 months until risperidone was added to her regimen for augmentation therapy (0.5 mg/day). Her symptoms improved within less than two months without significant side effects until she experienced painful bilateral breast discharge along with spotting and menstrual irregularity, besides amenorrhea for the previous 2 cycles and serum prolactin level of 33.7 ng/mL, presenting hyperprolactinemia. After discontinuing risperidone, within two weeks, galactorrhea and breast pain disappeared and amenorrhea resolved. Further prolactin level measurement showed the significant reduction. This neuroendocrine effect observed with very low-dose risperidone plus fluoxetine is apparently exerted through both pharmacokinetic and pharmacodynamic augmentation of this combination therapy.

Cross-sectional study evaluating the patterns of queries received by a newly established drug and poison information center in a tertiary care hospital

Background: The newly established drug and poison information center (DPIC) at the Department of Pharmacology, Akash Institute of Medical Sciences and Research Centre, located at Devanahalli, Bangalore Rural, Karnataka, India, provides drug and poison information services to healthcare professionals (HCP) and to the patients. The DPIC is effectively functioning since 2016. Aims and Objectives: To assess and evaluate the services delivered by DPIC. Materials and Methods: A cross‑sectional observational study was conducted over 1-year period (December 2016‑November 2017) to assess the patterns of queries received by DPIC. A total of 147 drug and poison-related information queries were received and answered during the study period. Data analysis was done by GraphPad. Results: Of the total queries received, majority of queries were from HCP (49%) followed by doctors (42%) and patients (9%). Majority of the queries (82.2%) were received by telephone access/WhatsApp messages (60%). A total of 60.54% queries were related to know the identity, symptoms, antidote, and management of poisoning cases. Most of the queries were for better patient care (88%) and the information was provided verbally for majority of the queries (81%). For most of the poisoning queries (62.9%), the information was provided immediately significantly (P < 0.05). Conclusions: DPICs can offer drug consultation services for HCP and patients in identifying poisons, symptoms, antidotes and management of poisoning cases and well detect and prevent adverse drug reactions and drug-drug interactions, etc. Therefore, improve overall patients’ healthcare standards can promote rational therapeutics.

Adverse drug reactions reported to the drug and poison information center of Tehran, Iran.

BackgroundBurden of adverse drug reactions (ADRs), in home-environment and domestic settings, is unknown.ObjectiveTo discuss the epidemiology of reported ADRs to 13-Aban drug and poison information center (DPIC) and to discuss the burden of hospitalization caused by these ADRs from commonly implicated therapeutic groups.MethodsA retrospective analysis of the yellow card schemes of suspected ADRs reported to the 13-Aban DPIC was conducted from 21 March 2013 to 21 November 2016 inclusive.Main outcome measuresCharacteristics of the ADRs, such as the sex and age of the patient, the therapeutic group involved, and the medical outcome of the exposure, were examined. ADR Hospitalization (ADRH) index was calculated for each drug group by dividing the number of ADR-related hospitalizations with total number of reported ADR cases (n = 748), and then multiplying by 100.ResultsADRs were reported for 748 patients representing 5 cases per 1000 enquiries to the 13-Aban DPIC over almost 4-years of the study period. Public were responsible for reporting every 4 out of 5 ADR cases (n = 651, 87%) and the remaining 1 out of 5 ADR cases was reported by the health care professionals (n = 97, 13%). Most of the ADRs had a medical outcome documented as having a minor effect or were minimally bothersome to the patients (n = 509, 68%), and less than 4.9% (n = 37) were documented as having a major effect or were life-threatening. Overall, 7.4% (n = 55) of ADRs were resulted in hospitalization. Antibacterials for systemic use represented the therapeutic group with the highest hospitalization index (1.7%).ConclusionsThe study concluded that ADRs to antibiotics are common and some of them resulted in hospitalization.

Assessment of the Knowledge and Attitude of Pharmaceutical Students Around Self-medication, Common Medicines and DPIC

Objective: The aim of this study is to assess the knowledge and attitude of pharmaceutical students around self-medication, common medicines and Drug and Poison Information Center (DPIC) for the first time. Methods: This cross-sectional study was carried out on 204 pharmaceutical students. Data were collected using questionnaire including socio-demographic questions, general and specialized information about Drugs, DPIC, and drugs side effects. All analysis conducted using the SPSS 16.0 software. Results: Of the total 204 participants, 93(45.6%) respondents were males and 111(54.4%) of them were females by the mean age of 22.05 (±1.5). More than half of the respondents (52%) had no information about DPIC and its functions. Approximately 44% of students have a consultation with a pharmacist for drug use. Averagely, only 39.88% of students had suitable drugs information. Significant relationship was observed between age and medicine consultation (P = 0.025). Conclusion: This study showed that the pharmaceutical students had a poor knowledge about the prevalence of using different drugs and DPIC’s functions. Country''s medical system is still facing the problem of uncontrolled usage and also a lack of knowledge, so it is recommended to perform comprehensive studies for finding factors that effect on students’ awareness to improve their academic performance.

Psychotropic Agents Poisoning: Analysis of Cases Reported to Shahid Beheshti Drug and Poison Information Center

Background: Antidepressants, antipsychotics and benzodiazepines overdose events are the most reported poisoning each year from Shahid Beheshti Drug and Poison Information Center (DPIC) (a branch of Iran Drug and Poison Information Center in Tehran), which clearly shows the necessity of providing prevention program and instruction plan in taking psychotropic agents.Methods: This survey was a descriptive retrospective study by reviewing 390 reported phone calls from Shahid Beheshti Drug and Poison Information Center (DPIC), in Tehran, through 2010 to 2012.Results: 390 reported cases of psychotropic agents including overdoses, medical errors such as extra dose, accidental exposure of medications, especially in children, cases of suicide, and intentional use (were) recorded. The main causes of poisoning calls to the DPIC, were included intentional and suicidal actions (40%), accidental events (27%), drug abuse (26%) and, medical errors (7%), respectively. Up to 50% of calls were about benzodiazepines (BZD) poisoning and the most adverse effects were Central Nervous System (CNS) effects followed by gastrointestinal side effects.Conclusion: According to the results, in order to achieve the proper effect of psychotropic agents and preventing related poisoning, providing pharmaceutical services and awareness of patients are necessary. It should be about the therapeutic effects and side effects of their medications by pharmacists and poison centers and limiting the accessibility of patients to large amounts of these medications by regulatory organizations.

Demographic and Clinical Characteristics of Theophylline Exposures between 1993 and 2011

Acute and chronic exposure to theophylline can cause serious signs and symptoms of poisoning. Additionally, with a narrow therapeutic range, toxicity could be observed even with therapeutic doses of theophylline. Epidemiological data on theophylline exposures in our country are extremely limited. The results of our study may improve the clinical management of theophylline poisoning in our country and elsewhere. To present aetiological and demographic features, clinical findings and treatment attempts with regard to theophylline exposures reported to Dokuz Eylül University Drug and Poison Information Center (DPIC), between 1993 and 2011. Descriptive study. The data regarding demographics, date, time, type of exposure, route of and reason for exposure, signs and symptoms upon admission, clinical management and outcome were retrospectively evaluated. The DPIC recorded 88,562 poisoning calls between 1993 and 2011; 354 (0.4%) of them were due to theophylline exposure. The mean age of all cases was 24.1±15.4 (range between 1 month and 90 years). Females dominated all age groups (72.6%, 257 females). Intentional exposure was significantly higher in women than in men (88.2% vs. 68.2% for all age groups; p<0.001 for children; p<0.001 for adults; p<0.001 for all age groups). While 60.5% of the cases had no symptoms, severe signs of toxicity were present in 1.9% of theophylline exposure cases during the telephone inquiry. Signs and symptoms were found to be significantly more prevalent in adults than in children (p<0.01). The serum theophylline level was regarded as toxic in 74% (65 toxic levels) of theophylline measured cases. Clinical signs and symptoms were found to be significantly prevalent in cases with toxic theophylline levels (p<0.001). The rate of gastrointestinal decontamination procedures was higher than that of recommended gastrointestinal decontamination procedures by DPIC (83% and 66%, respectively). There were two fatalities (4.6%) associated with chronic theophylline toxicity and theophylline overdose in an acute setting for suicide (a 90 year-old and 25 year-old, respectively). Although most of the theophylline exposure cases had no symptoms, some reported serious signs and symptoms of poisoning such as hypokalaemia, tachycardia and hyperglycaemia. DPICs have an important role in the management of theophylline exposure without unnecessary gastrointestinal decontamination procedures.

English

Health care professionals have been surveyed concerning their satisfaction with Drug and Poison Information Centers&rsquo; (DPICs) services, but have rarely been questioned regarding their expectations. Knowing these expectations would be the starting point for improvement of DPIC&rsquo;s services. As pharmacists are a major group of DPICs&rsquo; clients, this study was aimed to clarify the expectations of Iranian pharmacists regarding the services provided by the DPIC in Tehran University of Medical Sciences. Data was collected from questionnaire which was distributed among 562 pharmacists in August, 2008. Data was analyzed by producing descriptive statistics using Statistical Package for Social Sciences (SPSS) software (version 17). The mean importance rating for each expectation was determined and sorted in descending order. A response rate of 87.9% was achieved. Drug information textbooks and medical reference books were the &lsquo;most commonly used&rsquo; drug information resources. Thirty six expectations had a mean importance rating of &ge; 3 (3 = important). Currently, there is a good fit between Iranian pharmacists&rsquo; expectations and DPIC services provided. This survey identified several areas where services was expected but not provided (e.g. provision of telephone consultation services 24 h a day). In instances, where there was a gap between expectations and services provided, the DPIC made programmatic changes to align service with expectation when feasible. &nbsp; Key words:&nbsp;Drug and poison information center (DPIC), pharmacists, expectations.

Comment on "A survey of poison control centers worldwide"

Dear Sir The recent published article by Dr. Pourmand and his colleagues under the title of A survey of poison control centers worldwide was read eagerly [1]. I have had the opportunity to work for Iran National Drug and Poison Information Center (NDPIC) and also Central Staff of NDPIC for several years. I would like to state my appreciation because of consideration of Iran poison centers and also I want to comment on the Iran section of that article. The first Iran Drug and Poison Information Center (DPIC) was founded in February of 1997 in the Food and Drug Deputy of Iran Ministry of Health and Medical Education by a group of experts and their first report of a such new activity was published by Nikfar and colleagues in the year 2000 [2]. The role of the center was to provide the best responses to questions and also consultations to healthcare professionals and public [2]. More than the enquiry service, all of the adverse reactions to medications were reported to the National Adverse Drug Reaction (ADR) center, and in order to increase the culture of rational use of drugs, the Iran DPIC participated in pharmacy and therapeutic committees; gave workshops and seminars; and produced information newsletters, pamphlets and articles [2]. At the moment, Iranian DPIC has a close collaboration with the National ADR Center and the Iranian Rational Use of Drugs (RUD) center, medical universities, and hospitals. The Iranian DPIC developed gradually and changed its name to National Drug and Poison Information Center (NDPIC). Alongside developing of NDPIC, the other DPICs were founded in Iranian medical universities. These DPICs are mainly supported by local medical universities as well as Iran Ministry of Health and Medical Education, and currently the Food and Drug Organization. All of these centers are under the

Pattern and determinants of poisoning in a teaching hospital in Riyadh, Saudi Arabia

Background The Drug and Poison Information Center (DPIC) at King Khalid University Hospital, Riyadh, Saudi Arabia, was founded in 1983. Since then it has responded adequately to queries from medical and non-medical callers from all over the Kingdom. Queries ranged from simple material identification to poisoning cases. Objectives To assess the pattern and circumstances of poisoning in the Kingdom of Saudi Arabia through reviewing data from DPIC in King Khalid University hospitals. Methods This is a retrospective study of referred cases and calls received by DPIC. All records and documentation forms during the study period were investigated. Results This study included 1161 cases. There were 7.9% infants, 52.9% under 5 years old, 7.2% between 6–12 years old and 32.0% more than 12 years old. Number of males with toxic exposure was almost equal to that of females. More than 92% of cases were toxic exposure through oral route. Causes of poisoning include drugs among 76.7% of cases followed by household chemicals (6.8%). Suicidal intention was reported among 25.6% of cases. Using multivariate regression analysis, significant predictors of suicidal attempts are more than 12 years old, patients who were exposed to more than one toxin and patient who came to the hospital within 1–3 h since poisoning. Recommendations Establishing and operating DPIC centers throughout the kingdom, in addition to implementing of legislations to ban over the counter selling of medications and to sell potentially dangerous chemicals in childproof containers.

Dokuz Eylül Üniversitesi İlaç ve Zehir Bilgi Merkezi 2007 Yılı Verilerinin Analizi

Objective: We investigated the etiological and demographical characteristics of exposures to drugs and poisons reported to the Dokuz Eylul University Drug and Poison Information Center (DPIC), in 2007. Material and Methods: The data regarding demographic details of the cases and involving substance(s), route and reason for the exposure, date, time, site and circumstances of poisonings are reviewed retrospectively. Beside these, clinical effects of the incidents, the recommendations by DPIC and outcomes of the patients were also evaluated from the standard data forms. Descriptive statistics, contingency tables and Pearson Chi-square test was performed to analyze the data. Results: DPIC received 2576 calls in 2007 and most of them were related to poisoning incidents. A vast majority (97%) of these calls was made from the health care facilities and 73.3 % of them were from Izmir. Most of the incidents were intentional attempts (65.5%) in nature and there was a female predominance (X²=385.03, P<0.001). Rate of unintentional exposures was significantly higher in 0-12 year-old children than in the 13-18 year-old teenagers (X²=374.59, P<0.001). Ingestion was the most common route of exposure (92.7%). Medications were the predominant substances in the exposures (72.5%) followed by chemicals, metals, cosmetics (4.7%) and alcohol (4.7%). Analgesics (15.5%) and antidepressants (13.5%) were leading drugs involved in these events, particularly paracetamol and amitriptyline (11.8 and 3.9%)respectively. Recommended treatments by DPIC included activated charcoal (24.5%), supportive care (23.1%), gastric lavage (15.0%), antidotes (2.2%) and skin decontamination. There were two mortalities (0.08%) associated with a scorpion sting and carbon monoxide inhalation. Conclusion: Analgesics and antidepressants were found to be the main causes of poisoning exposures in the review of DPIC reports. Research studies can be accomplished in this field with the assistance of national poisoning database system which compiles the information gained from all poison information centers in Turkey.

Cardiovascular medication exposures reported to Drug and Poison Information Center (DPIC) in Izmir, Turkey: A 14 year experience

Cardiovascular medication exposures reported to Drug and Poison Information Center (DPIC) in Izmir, Turkey: A 14 year experience

A retrospective evaluation of analgesic exposures from Izmir, Turkey

The objective of this study is to analyze exposures concerning analgesics that were reported to Dokuz Eylul University Drug and Poison Information Center (DPIC) and admitted to the Department of Emergency Medicine in Dokuz Eylul University Hospital (EMDEU) between 1993 and 2004. Demographics of the patients, characteristics of analgesic exposures, performed treatment attempts and outcome of the poisoned patients were recorded on standard data forms and were then entered into a computerized database program. Statistical analysis was performed by using the chi-square test. The DPIC recorded 55 962 poisoning calls, 48 654 (86.9%) of them related to medicines. Analgesics accounted for 16.3% (7 939 cases) of all medicine-related exposures; among them 446 exposures were admitted to EMDEU. More than half of the analgesic exposure calls and admitted cases involved adults (55.9%, 4 440). Females dominated in all age groups (70.3%, 5 578). Mean age was 20.2 +/- 11.8. The most involved analgesics were paracetamol (47.9%), propionic acid derivatives (16.1%) and salicylates (13.7%). Most of the poisonings were intentional (75.1%), especially in 19-29 years age group of adults and 13-18 years age group of children. Most of the patients reported to DPIC and admitted to EMDEU were asymptomatic (84.4% and 54.7%, respectively). Gastrointestinal decontamination methods were performed more frequently for admitted poisoning cases before hospital admission than reported poisoning cases (61% vs. 23%). Paracetamol ingestion was the most common cause of analgesic exposures reported to our DPIC. Most of the analgesic exposures reported to DPIC were asymptomatic or mild. DPICs have an important role for the referral of analgesic exposures without unnecessary gastrointestinal decontamination procedures.