Improper Use Of Drugs Research Articles

Unveiling the factors influencing public knowledge and behaviours towards medication errors in Jordan: a cross-sectional study

BackgroundMedication errors are preventable incidents resulting from improper use of drugs that may cause harm to patients. They thus endanger patient safety and offer a challenge to the efficiency and efficacy of the healthcare system. Both healthcare professionals and patients may commit medication errors.Methods and objectivesA cross-sectional, observational study was designed using a self-developed, self-administered online questionnaire. A sample was collected using convenience sampling followed by snowball sampling. Adult participants from the general population were recruited regardless of age, gender, area of residence, medical history, or educational background in order to explore their practice, experience, knowledge, and fear of medication error, and their understanding of this drug-related problem.ResultsOf the 764 participants who agreed to complete the questionnaire, 511 (66.9%) were females and 295 (38.6%) had a medical background. One-fifth of participants had experienced medication errors, with 37.7% of this segment reporting these medication errors. More than half of all medication errors (84, 57.5%) were minor and thus did not require any intervention. The average anxiety score for all attributes was 21.2 (The highest possible mean was 36, and the lowest possible was 0). The highest level of anxiety was seen regarding the risk of experiencing drug-drug interactions and the lowest levels were around drug costs and shortages. Being female, having no medical background, and having experience with medication errors were the main predictors of high anxiety scores. Most participants (between 67% and 92%) were able to recognise medication errors committed by doctors or pharmacists. However, only 21.2 to 27.5% of participants could recognise medication errors committed by patients. Having a medical background was the strongest predictor of knowledge in this study (P < 0.001).ConclusionThe study revealed that the prevalence of self-reported medication errors was significantly high in Jordan, some of which resulted in serious outcomes such as lasting impairment, though most were minor. Raising awareness about medication errors and implementing preventive measures is thus critical, and further collaboration between healthcare providers and policymakers is essential to educate patients and establish effective safety protocols.

COUNSELING ON THE IMPORTANCE OF PHBS AND DAGUSIBU IN IMPROVING HEALTH FOR STUDENTS SDN KALISONGO 02 MALANG

Public understanding of improper drug use can lead to new health problems. This community service activity aims to increase public understanding of medicine and health. Activities carried out in stages include tutorials (lectures), service program planning, DaGuSiBu counseling practices and PHBS. The main topic of discussion is knowledge about how to obtain, use, store and dispose of drugs properly, then added knowledge about clean and healthy living behaviors in everyday life. The benefit of this dedication at school is to create a clean and healthy environment both for yourself and for those around you. That way, the teaching and learning process will run smoothly, while the health of teachers, students and the surrounding community will not be disturbed. This service was held on Friday 16 June 2023 at SDN 02 Kalisongo, Malang City. This activity was carried out in the form of lectures with the help of power points and also demonstrations of proper and correct hand washing steps. The participants were 32 students in grades 3, 4 and 5. This service is carried out independently and is carried out properly according to the objectives expected by the executor.&#x0D; Keywords: Counseling, DaGuSiBu, PHBS, SD.

Evaluation of Drug Prescription Pattern Using WHO Prescribing Indicators in Libya: A Cross-Sectional Study

Background and aims. The improper use of drugs due to irrational prescriptions is a common problem in Libya. This study aimed to investigate the prescribing pattern and predictors of antibiotic prescription in primary health care facilities in three districts (east, west, and south) in Libya. Methods. In this retrospective study, 484 prescriptions were examined. World Health Organization-recommended indicators for rational use were examined (WHO): e.g., the percentage of prescriptions covering antibiotics, prescription of injections, and prescription of drugs by a generic name and from a national essential drug list, as well as the average number of drugs per prescription, were all considered. Results. The average number of drugs per prescription was 4.72, with a maximum of 7 drugs in a prescription, and the percentage of prescriptions involving antibiotics and injections was 30.4% and 10.5%, respectively. There were 28.6% drugs prescribed by their generic name and 82.8% were retrieved from the essential drugs list. The most common category of medicines were 18.9% antibiotics, 18.3% antihypertensives, and 15.7% multivitamins and minerals. While the lowest consumed drugs were steroids 2.5%. Conclusion. There was some irrational drug prescribing, particularly with regard to injections and antibiotics. It is suggested that physicians participate in continuing education programs on rational prescribing for various medical indications.

Study on the Metabolic Transformation Rule of Enrofloxacin Combined with Tilmicosin in Laying Hens.

There is often abuse of drugs in livestock and poultry production, and the improper use of drugs leads to the existence of a low level of residues in eggs, which is a potential threat to human safety. Enrofloxacin (EF) and tilmicosin (TIM) are regularly combined for the prevention and treatment of poultry diseases. The current studies on EF or TIM mainly focus on a single drug, and the effects of the combined application of these two antibiotics on EF metabolism in laying hens are rarely reported. In this study, liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to determine the residual EF and TIM in laying hens and to investigate the effect of TIM on the EF metabolism in laying hens. In this paper, we first establish a method that can detect EF and TIM simultaneously. Secondly, the results showed that the highest concentration of EF in the egg samples was 974.92 ± 441.71 μg/kg on the 5th day of treatment. The highest concentration of EF in the egg samples of the combined administration group was 1256.41 ± 226.10 μg/kg on the 5th day of administration. The results showed that when EF and TIM were used in combination, the residue of EF in the eggs was increased, the elimination rate of EF was decreased, and the half-life of EF was increased. Therefore, the use of EF and TIM in combination should be treated with greater care and supervision should be strengthened to avoid risks to human health.

Perspective of Travellers' Diseases: A Review

Traveler's disease is any illness that develops as a direct result of traveling. There are several illnesses that are regarded as Traveler's diseases, with diarrhea, malaria, tuberculosis, typhoid fever, and yellow fever being some of the most dreaded. And although some may only have minor or no symptoms, others, if unchecked, can be fatal. The sources of Traveler's disease differ due to the great variety of illnesses that are related to travel. Typical sources of illnesses brought on by travel include: being bitten by a mosquito, tick, or other creature that is infected, ingesting improperly prepared meals and beverages, such as unpasteurized dairy products, raw or undercooked meats, fruit or vegetable peels, well or tap water, or filthy salad, exposure to disease-infected people, improper use of drugs intended to prevent particular disorders, inadequate hygiene and not obtaining the necessary immunizations. Particularly individuals who have visited regions of the world where specific infectious diseases are common may get sick when they return home. Traveler's disease can cause a variety of symptoms, such as fever, rashes, diarrhea, vomiting, and muscle aches. Destinations that were previously solely accessible to soldiers, missionaries, and explorers became popular with regular western travelers. The rise in this kind of travel exposes people to health hazards that are largely unheard of in the west. Numerous illnesses are connected to travel.

Drug dose adjustment in patients with renal impairment attending a specialized referral hospital, Northwest Ethiopia

BackgroundNumerous drugs and their metabolites are removed from the body through the kidney. Improper use of drugs in renal impaired patients may therefore, be harmful and have deleterious effects. Thus, this study was aimed at investigating drug dose adjustment in renal impaired patients attending a specialized hospital. MethodsA prospective cross-sectional study was performed at the medical ward in University of Gondar comprehensive specialized hospital from March to May 2018. During the study period, a total of 2100 patients were admitted to the general medical wards. We located and assessed 210 patient files, of which 189 patient files had complete notes. Based on our inclusion criteria, 105 patients had Crcl of ≥ 59 ml per min per 1.73 m2. Therefore, 84 patients fulfilled our inclusion criteria and were included in the final analysis. The collected data were entered into Epi Info version 7 and exported to the statistical package for the social sciences (SPSS) version 20 for statistical analysis. A chi-square test was applied to test the relationship between renal status and dosage adjustment. P-value ≤ 0.05 was considered as statistical significance. Since the number of co-morbidities and number of drugs prescribed was non-normally distributed using the Shapiro-Wilk test (P < 0.001), the spearman correlation test was used (r = 0.228, p = 0.037). ResultsThe mean age of study participants was 57 years with 57.1% male and 42.9% female. The highest number of renal impaired patients was in stage three 56(66.7%). The mean creatinine clearance (Crcl) was 41.8 ml/min (IQR 24.8–60.9), and the mean serum creatinine (Scr) value of 2.63 mg/dl (IQR 1.3–3.1). More than two third (76.2%) of the study participants had comorbidities. Eighty-four patients with 257 prescription entries were included in the study. Of which 75 prescription entries need a drug dose adjustment. The overall rate of inappropriate dose adjustment was 42.6% (32/75). Inappropriate dose adjustment was more common with vancomycin (14.3%) and ciprofloxacin (6%). Inappropriate drug dose adjustments were associated with patients having intermediate renal insufficiency (P < 0.002) and co-morbid conditions (P < 0.02). ConclusionThe present study demonstrated that inappropriate dose adjustment was common at University of Gondar comprehensive specialized hospital that needs great attention. Vancomycin and ciprofloxacin were the most frequently identified drugs that were inappropriately adjusted. Intermediate renal insufficiency and co-morbidities were statically significant with inappropriate dose adjustment.

Patrones de resistencia a antibióticos en infecciones asociadas a la atención de salud en un centro de tercer nivel con reconversión hospitalaria en la pandemia por COVID-19

Objetive: Description of the different isolated microorganisms and their prevalence in infections associated with health care, in addition to determining their patterns of resistance to antibiotics in patients admitted with a confirmed or suspected diagnosis of COVID-19 in the Intensive Care Unit, during a third-level medical center with hospital reconversion. Method: Patient demographic data was obtained from the clinical record, with defined criteria. Antibiotic resistance patterns were evaluated as well as the identification of isolated bacteria in cultures of expectoration, pleural fluid, catheter tips. For bacterial identification and resistance mechanisms, automated equipment and phenotypic tests were used, following the CLSI (Clinical &amp; Laboratory Standards Institute) criteria. Results: A total of 100 patients with bacterial infection added to the main COVID-19 picture were obtained, representing pneumonia, urinary tract infection, catheter infections and bacteremia. A total of 100 strains were isolated, of which 84 are Extremely Drug Resistant, 12 Multidrug Resistant and only 4 variable sensitivity. The bacteria with the highest prevalence is Staphylococcus aureus with, followed by Pseudonomas aeruginosa and Stenotrophomonas maltophilia. 100% of the patients admitted to the ICU (Intensive Care Unit) had death. Conclusion: The increase in resistance to antibiotics in the COVID-19 pandemic has set off alarms due to the complication that this brings, and the improper use of drugs as prophylaxis or attempted treatment only generates selective pressure that leads to an increase in resistance as observed in the isolated strains in this study, where the vast majority present enzymes as well as other resistance mechanisms that confer them to be XDR (Extremely Drug Resistant).

A study on drug therapy issues in the department of medicine of a tertiary care teaching hospital-prospective observational study

Background: A drug therapy problem (DTP) is any undesirable event experienced by a patient that involves or is suspected to involve, drug therapy, and that interferes with achieving the desired goals of therapy. The improper use of drugs can lead to patient morbidity and even mortality. DTP s are the clinical territory of the pharmaceutical care practitioner and the resolution of identifying the DTPs help patients to achieve their goals of therapy. Identifying DTPs enables risk quantification and determination of the potential impact of prevention strategies. DTPs are associated with prolonged length of stay and increased economic burden and results in increased risk of death.Methods: A hospital based, prospective observational study was conducted at department of medicine in Rajah Muthiah medical college and hospital, 80 patients were enrolled in this study based on the inclusion-exclusion criteria. The DTPs were identified using the Cipolle’s method of classification of DTP.Results: The study has shown that 80 of the patients involved in the study had a total of 136 DTPs. An average of 1.7 DTPs were recorded per patient during the study. The most common DTP identified was unnecessary drug therapy accounting to 47%. The absence of valid medical indication was (30%) and (16%) were due to the duplication of therapy. The second most common DTP was unsafe drug for patients, accounting to 45% were due to patient non-compliance and drug interaction which was minor. Need for additional drug therapy was the third most identified accounting 13% were due to medical indication indicate the need of drug therapy.Conclusions: The foremost commonly observed DTP is unnecessary therapy and patient non-compliance to the drugs. The study suggests that DTPs are significantly occurring in hospital can cause the patient for comorbidity, prolonged hospitalization. The study suggests that clinical pharmacist and general practitioners can work together to spot and resolve the DTPs.

Systematic Investigation of the Effect of Powerful Tianma Eucommia Capsule on Ischemic Stroke Using Network Pharmacology.

Background Ischemic stroke (IS) is a serious disease with a high rate of death and disability, and a growing number of people are becoming victims. Existing drugs not only have limited therapeutic effects but also have obvious side effects. Most importantly, drug resistance due to long-term or improper use of drugs is detrimental to patients. Therefore, it is urgent to find some alternative or supplementary medicines to alleviate the current embarrassment. Powerful Tianma Eucommia Capsule (PTEC) is mainly used to treat IS in China for thousands of years; however, the molecular mechanism is not clear. Methods Pharmacology ingredients and target genes were filtered and downloaded from websites. A pharmacology ingredient-target gene network was constructed to predict the molecular interactions between ingredients and target genes. Enrichment analysis was performed to explore the possible signal pathways. LeDock was used to simulate the interaction form between proteins and main active ingredients and to deduce key amino acid positions. Results Two hundred eighty-nine target genes and seventy-four pharmacological ingredients were obtained from public databases. Several key ingredients (quercetin, kaempferol, and stigmasterol) and primary core target genes (PTGS1, NCOA2, and PRSS1) were detected through ingredient-target gene network analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis demonstrated that ingredients affect networks mainly in nuclear receptor activity and G protein-coupled amine receptor activity; besides, fluid shear stress and atherosclerosis, human cytomegalovirus infection, and hepatitis B signaling pathways might be the principal therapy ways. A series of presumed key amino acid sites (189ASP, 190SER, 192GLN, 57HIS, and 99TYE) were calculated in PRSS1. Six of the target genes were differentially expressed between male and female patients. Conclusions Seven new putative target genes (ACHE, ADRA1A, AR, CHRM3, F7, GABRA1, and PRSS1) were observed in this work. Based on the result of GO and KEGG analysis, this work will be helpful to further demonstrate the molecular mechanism of PTEC treatment of IS.

Medication related problems

The improper use of drugs can leads to patient morbidity and even mortality. Drug therapy problems are the clinical territory of the pharmaceutical care practitioner and the resolution of identifying drug therapy problems help patients to achieve their goals of therapy and understand the best possible outcomes from drug therapy. To identify, resolve and prevention of drug therapy problems, the practitioner must understand how patients with drug therapy problems present in the clinical setting. Stating the problem and identifying the cause requires involves clinical judgment by the practitioner. All patient problems involving medications can be categorized into seven types. These include all side effects, toxic reactions, treatment failures, or the need for additive, synergistic, or preventive medications, as well as noncompliance. During 2002, there were 3.3 billion prescriptions dispensed from community pharmacies throughout the United States and over 44,000 hospitalized patients die each year resulting from medical errors. Recent research, on drug-related problems and adverse drug reactions has identified several categories of risk factors that may be used to identify patients who are susceptible to drug related problems and adverse drug reactions. It is essential that practitioners who intend to provide pharmaceutical care understand the descriptions and identification of each type of drug therapy problem as well as their common causes. Continuous referral to the seven categories of drug therapy problems ensures that a consistent, rational, comprehensive, and effective care plan can be established for even the most complicated patient.

Expert consensus on drug provocation test

Drug allergy(DA) is a common clinical allergic disease, and drug provocation tests(DPT) are currently recognized internationally as the "gold standard" for diagnosing drug allergy, but this diagnostic program has not been widely developed in China. The lack of diagnosis of drug allergy increases the risk of medication in clinical, and who also leads to unnecessary drug upgrades and drug abuse. Through consultations with clinical experts in multiple medical fields and combined with domestic rules and regulations to standardize the clinical diagnosis process of drug allergy, the Network of food and drug allergy interest group, Allergy Prevention and Control Committee of Chinese Preventive Medicine Association drafted this consensus for operating specifications of drug provocation tests, and preventing causes improper use of drugs leads to clinical medication risks.

Discussion on the Phenomenon of Irrational Clinical Drug Use and Improvement Measures

Objective To discuss the irrational drug use in clinic and its improvement measures. Methods To select 132 prescriptions of Western medicine from the pharmacy department of our hospital as the research object, prescribed from July 2017 to September 2018. According to the prescription time, the safety and irrational use of drugs were observed according to the principle of clinical rational use of drugs. They were divided into experimental group and control group, in which the control group did not include the improvement measures, the experimental group included the improvement measures and each group had sixty-six prescriptions. Results The incidence of repeated drug use, improper drug use combination, improper use of antibiotics, the abuse of antibiotics and other irrational drug uses in the experiment was lower than that in the control group and there was significant difference between the two groups (P &lt; 0.05). Conclusion In the clinical drugs administration of Western medicine, it is necessary to strengthen the observation of irrational drug use and give timely improvement measures to ensure the safety of clinical drugs.

Natural DNA Intercalators as Promising Therapeutics for Cancer and Infectious Diseases

Cancer and infectious diseases are one of the greatest challenges of modern medicine. An unhealthy lifestyle, the improper use of drugs, or their abuse are conducive to the increase of morbidity and mortality caused by these diseases. The imperfections of drugs currently used in therapy for these diseases and the increasing problem of drug resistance have forced a search for new substances with therapeutic potential. Throughout history, plants, animals, fungi and microorganisms have been rich sources of biologically active compounds. Even today, despite the development of chemistry and the introduction of many synthetic chemotherapeutics, a substantial part of the new compounds being tested for treatment are still of natural origin. Natural compounds exhibit a great diversity of chemical structures, and thus possess diverse mechanisms of action and molecular targets. Nucleic acids seem to be a good molecular target for substances with anticancer potential in particular, but they may also be a target for antimicrobial compounds. There are many types of interactions of small-molecule ligands with DNA. This publication focuses on the intercalation process. Intercalators are compounds that usually have planar aromatic moieties and can insert themselves between adjacent base pairs in the DNA helix. These types of interactions change the structure of DNA, leading to various types of disorders in the functioning of cells and the cell cycle. This article presents the most promising intercalators of natural origin, which have aroused interest in recent years due to their therapeutic potential.

Совершенствование использования лекарственных средств в организациях здравоохранения для решения проблемы нерационального применения лекарственных средств в Республике Казахстан

The effectiveness of the provided drug therapy remains an urgent problem and is directly proportional to the rational use of drugs. According to WHO, the most common causes of improper use of drugs are polypharmacy, improper use of antibacterial agents, unjustified use of the parenteral route of administration of drugs in cases where it is preferable to use dosage forms for oral administration, non-compliance with clinical guidelines in case of prescribing drugs and inappropriate self-medication. To ensure the rationality of pharmacotherapy, appropriate assessment methods are used. The world standard for assessing the rationality of drug use and the impact on irrational options for their use are indicators for assessing good drug use management practices, which are unified objective and simple parameters for evaluating drug use and the quality of medical care. As a solution to the problems of the irrational use of drugs, policies are proposed to improve the rational use of drugs by introducing an assessment and monitoring of the use of drugs, conducting an information campaign for the population and medical workers with the aim of creating the right behaviors regarding the use of drugs and introducing mandatory continuing education for the rational use of drugs of all medical workers. The existing legislative framework of Kazakhstan, as well as the programs, plans and projects adopted in recent years for the development of the health care system, have all the necessary conditions to support the implementation of the proposed policy options, however, the main barriers to the implementation of policy options may be a lack of human resources, unethical behavior of pharmaceutical companies lobbying their interests in the promotion of drugs, the lack of support from the authorized body in the field of healthcare, and the lack of understanding by healthcare managers of the goal of implementing an assessment of the rational use of drugs.

The prevention of doping and the improper use of drugs and food supplements in sports and physical activities: a survey on the activity of the prevention departments of Italian local health authorities.

Doping is an important public health problem widespread not only among elite athletes, but also among amateur and recreational athletes and the general population. In Italy the introduction of doping prevention within the Essential Levels of Care (LEA) with the DPCM 12/1/2017 represents a crucial step towards the implementation of education and health promotion interventions. In this context, the Departments of Prevention (DP) of the Local Health Authorities (LHA) have to play a fundamental role, becoming the cultural and operational reference on this issue. As part of the "Doping prevention: development of a permanent educational tool coordinated by the National Health Service Prevention Departments" project, funded by the Italian Ministry of Health, a survey was conducted on the activities carried out by the DP regarding doping prevention and improper use and abuse of drugs and food supplements in sports and physical activities, as a basis for the harmonization of organizational structures and prevention programs and the creation of a collaboration network at a regional and national level. A semi-structured questionnaire consisting of 11 questions, prepared on an electronic platform, was sent to the DP of all the Italian LHA. A total of 38 DP out of 131 (29%) completed the questionnaire, with representation from all regions. 42.1% of DP carried out or are still running programs for the prevention of doping, a percentage that decreases to 27% considering the programs for the prevention of misuse and abuse of drugs and food supplements in sports and in physical activities; in less than half of the DP, 37.5% and 41.7%, respectively, dedicated funds have been allocated. The professionals most involved in prevention of doping are the Specialists in Sport Medicine (81.3%) followed by Specialists in Hygiene (43.8%) and Psychologists (37.5%), while Health Care Assistants (50%) are the professionals most involved in the prevention of the improper use of drugs and food supplements, followed by Specialists in Hygiene and Specialists in Sport Medicine (40%). Most of the DP (71.9%) believe that the introduction of programs to prevent and counteract doping in the LEA will have repercussions on their approach against doping. The survey, although conducted on a limited sample, has provided an important framework relating to programs for the prevention of doping and the misuse and abuse of drugs and food supplements in sports and in the physical activities carried out by DP. A remarkable heterogeneity has been highlighted, both at national and regional level. It is urgent to provide DP with homogeneous and effective organizational models and adequate operational tools, paying particular attention to the training of all the professionals involved. It is also essential to implement permanent monitoring tools.

Assessment of Self-medication Practices in Urban and Rural areas of Kalaburagi, Karnataka

<p style="text-align: justify;"><strong>Background:</strong> Self-medication can be defined as the use of drugs to treat self-diagnosed disorders or symptoms. In India, the rate of self-medication practices is rising exponentially as it is the cheapest way of treatment. But improper self-diagnosis and improper use of drugs is major part of concern these days. The wrong usage of medications is creating medication hazards, drug toxicities, drug interactions drug-food interactions etc. <strong>Methodology and Results:</strong> The present study enrolled total of 500 people (250 urban and 250 rural), of which, the age group of 36-45 consumed more self- medication both in urban (29.5%) and rural (24.40%) population. The illiterate (64.56%) people practiced more self- medication in rural areas where as in urban graduates (33.87%) practiced more self-medications. lower middle class (49.60%) people practiced higher self-medication in rural and upper class (67.21%) people practiced higher self-medication in urban. Analgesics and antipyretics drugs were most frequently used drugs in both urban and rural areas. Thereafter the self - medication population was divided into test and control group. The test group was given both pills and counselling whereas control group was given only pills, both groups were compared. After intervention, it was found that 30.50% self-medication dropped in urban test group, and 10.00% in the urban control group. In rural test group 36.00% of drop was observed in self-medication practices whereas in rural control group it was only 9.60%.<strong> Conclusion:</strong> Counselling played important role in reduction of self-medication practices in both urban and rural areas.

Oral Fluid Drug Testing in Pain Management Practice: Factors to Consider Before Choosing the Alternative Biological Matrix.

As the use of pharmacological agents, particularly opioid analgesics, has increased in the past 2 decades, so have the substance abuse risks, along with the prevalence of overdose deaths, addiction, and illicit drug use. Accordingly, close monitoring of patients to ensure medication compliance and to identify improper drug use becomes a critical task for pain-management practitioners. Oral fluid is an emerging biological matrix for clinical drug testing. It offers noninvasive, less hazardous, and directly observable sample collection with minimal potential for adulteration. Oral fluid can be collected multiple times in a short period and shows a stronger correlation with blood than urine concentrations. Usability of oral fluid testing had been limited by the sensitivity of analytical methods. The volume of oral fluid samples is typically much smaller than that of urine samples. Furthermore, oral fluid drug concentrations can be 10- to 100-fold lower than urine concentrations depending on analytes. Recent advances in analytical technologies lead to the growing popularity of oral fluid testing and subsequent need for scientific data to aid in interpretation of oral fluid test results. This review presents preanalytical, analytical, and postanalytical considerations associated with oral fluid drug testing for those contemplating the implementation of this alternative biological matrix in pain-management practice. Comparison with urine testing, collection procedure, drug stability, available technologies, scope of analysis, and drug disposition are discussed. As with other monitoring tools, oral fluid testing has advantages and limitations. The most important consideration is staying informed to use the testing within its capability.

Actualización de los criterios STOPP-START: una herramienta para la detección de medicación potencialmente inadecuada en ancianos

Improper use of drugs in older adults more often leads to adverse drug reactions due to the physiological changes associatedwith aging. This situation increases morbidity and mortality and determinates more hospital admissions, more use of healthresources and health expenditures. In order to optimize the drug prescriptions in elderly, implicit and explicit tools have beendeveloped in recent years. The STOPP-START 2008 explicit criteria have been imposed as a reference in Europe and havebeen applied in several areas of assistance. This paper presents an update of these criteria, accomplished in 2014.

Attach importance to rational application of drugs after metabolic surgery

Metabolic surgery have the ideal weight loss effect, can maintain the long-term ideal weight, and its effects on blood glucose control is better than the simple medical treatment. Therefore, metabolic surgery received widespread attention in China. More and more patients undergo metabolic surgery, but the surgeons often pay attention to the operation, neglecting the use of drugs after surgery. The patients are always complicated with a lack of vitamin and metabolic syndrome, such as type 2 diabetes mellitus, hypertension, polycystic ovary, sleep apnea, cardiovascular disease. Patients have taken drugs before surgery can cause esophageal reflux, ulcer, anemia, loss of calcium and other complications, patients need to be supplied with vitamins and minerals after surgery. So more attention should be paid to the rational application of drugs after surgery, to prevent adverse reactions from improper use of drugs, and reduce the incidence of postoperative complications. Key words: Obesity; Diabetes mellitus, type 2; Metabolic surgery; Bariatric surgery; Drugs

Opioid Regulation: Time to Reconsider the Nomenclature and Approach

In Australia, deaths due to the ingestion of opioid analgesics, though numerically small, have been increasing at a rapid rate. The reasons for this increase are multifactorial; the conceptually outdated legislation that controls prescription and administration of opioid analgesics might be one of them. The stated purposes of the governing statutory instruments include prevention of the improper use of drugs of dependence and protection of the public. However, in order to achieve these aims, the relevant legislation should utilise theories and definitions that are consistent with the medical understanding of the relevant physiology and behaviour, so as to provide a common linguistic and conceptual platform for regulatory and clinical decision-makers. Although Victoria, with its intricate statutory framework for Schedule 8 poisons, is used as an example of an obsolescent approach to the concept of drug dependency, conclusions reached are applicable to other jurisdictions, other scheduled drugs, and all health care practitioners who have the statutory authority to possess and prescribe them.