Drug Names Research Articles

Drug Induced Hyperprolactinemia

Introduction: Drugs are a common cause of hyperprolactinemia. It is essential to differentiate this cause from other pathological causes which avoids unnecessary investigations. Detailed history will help us in identifying the responsible drug and withdrawing the same will be rewarding. Here we are reporting a case series of drug induced hyperprolactinemia. Methods: It was a cross-sectional observational study. Subjects were recruited from our outpatient department. Hyperprolactinemia was defined as blood prolactin levels >30 ng/mL in females and >24 ng/mL in males, regardless of the presence of symptoms. Serum prolactin was repeated one week after holding the suspected drug(s). Drug induced hyperprolactinemia is defined as normalisation of serum prolactin on discontinuation of the offending drug. Demographics, clinical presentation and offending drug name were entered in pre designed proforma.Results: Total of 32 subjects were studied in this study with age of 35.5±10.8years. Predominantly female subjects were present with female to male ratio 5.4. Basal prolactin was 132±68.7ng/mL and after holding the drug prolactin value was 16.9±8.2. Proton pump inhibitors in combination with prokinetics were the leading cause (71.8%) and followed by multiple drug combinations (15.6%), anti-psychiatric drugs(9.3%) and oral contraceptives(3.1%). Overall 86.75% of subjects were having symptomatic presentation. Commonest clinical presentation among the women was galactorrhea (88.9% of female subjects) followed by irregular menstrual cycles (59% of female subjects) and breast heaviness in 29.6%. Among the men erectile dysfunction was common presentation, noted among 80% of them. Asymptomatic presentation was there in 6.25% of subjects. All subjects were improved clinically after withdrawal of the the offending drug(s).Conclusions: Most of the subjects were clinically symptomatic. Most common symptom in female was galactorrhea followed by irregular menses and breast heaviness, and erectile dysfunction in males. All subjects were improved clinically after withdrawal of the offending drug(s). A detailed drug history is rewarding and avoids unnecessary investigations for hyperprolactinemia

Drag‐a‐Drug: an interactive learning aid to complement pharmacology mnemonics

Mnemonics is an established method to help learners consolidate the retention of new information by memory. The use of mnemonics has demonstrated effectiveness in students across different disciplines and levels. An indigenous mnemonics system, pharmABCology, was created and introduced to medical, pharmacy and biomedical sciences students at the university several years ago. While learning outputs of students are enhanced, this mnemonics system takes a rather passive approach of delivering the contents. Thus, a drag-&-drop learning aid, Drag-a-Drug, was developed to incorporate elements of active learning in pharmacology knowledge retention. This learning aid is intended for use after a lecture on a particular topic. The user would first take a part in a short exercise in that s/he is asked to drag & drop items containing drug names to match with corresponding description of the drugs. The layout is presented in a way that also previews the mnemonics that follows after completion of the drag-&-drop exercise. The intended purpose is for the user to first be able to recognise the drug names, mechanisms of actions, and subsequently remember the drug names with the help of mnemonics. This learning aid was offered to two cohorts of Pharmacy students in years 2019 & 2020 as a non-mandatory supplement to the accompanying lecture on anti-dyslipidaemic drugs. Usage data, including number of correct vs. incorrect attempts in the drag-&-drop exercise and view rates of the mnemonics, were recorded on a learning management system (Blackboard®). User feedback was also obtained from 15 students who opted to fill in an optional questionnaire. On a 5-point Likert scale, 13 out of 15 respondents “strongly agreed” or “somewhat agreed” that the drag-&-drop exercise helped them in reviewing basic information about anti-dyslipidaemic drugs. For the mnemonics, 12 out of 15 respondents “strongly agreed” or “somewhat agreed” that memorisation of drug names was facilitated. The overall positive user experience with the Drag-a-Drug learning aid may support its broader coverage and use in other pharmacology topics.

Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data

BackgroundFollowing the emergency use authorisation of the Pfizer–BioNTech mRNA COVID-19 vaccine BNT162b2 (international non-proprietary name tozinameran) in Israel, the Ministry of Health (MoH) launched a campaign to immunise the 6·5 million residents of Israel aged 16 years and older. We estimated the real-world effectiveness of two doses of BNT162b2 against a range of SARS-CoV-2 outcomes and to evaluate the nationwide public-health impact following the widespread introduction of the vaccine.MethodsWe used national surveillance data from the first 4 months of the nationwide vaccination campaign to ascertain incident cases of laboratory-confirmed SARS-CoV-2 infections and outcomes, as well as vaccine uptake in residents of Israel aged 16 years and older. Vaccine effectiveness against SARS-CoV-2 outcomes (asymptomatic infection, symptomatic infection, and COVID-19-related hospitalisation, severe or critical hospitalisation, and death) was calculated on the basis of incidence rates in fully vaccinated individuals (defined as those for whom 7 days had passed since receiving the second dose of vaccine) compared with rates in unvaccinated individuals (who had not received any doses of the vaccine), with use of a negative binomial regression model adjusted for age group (16–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and ≥85 years), sex, and calendar week. The proportion of spike gene target failures on PCR test among a nationwide convenience-sample of SARS-CoV-2-positive specimens was used to estimate the prevelance of the B.1.1.7 variant.FindingsDuring the analysis period (Jan 24 to April 3, 2021), there were 232 268 SARS-CoV-2 infections, 7694 COVID-19 hospitalisations, 4481 severe or critical COVID-19 hospitalisations, and 1113 COVID-19 deaths in people aged 16 years or older. By April 3, 2021, 4 714 932 (72·1%) of 6 538 911 people aged 16 years and older were fully vaccinated with two doses of BNT162b2. Adjusted estimates of vaccine effectiveness at 7 days or longer after the second dose were 95·3% (95% CI 94·9–95·7; incidence rate 91·5 per 100 000 person-days in unvaccinated vs 3·1 per 100 000 person-days in fully vaccinated individuals) against SARS-CoV-2 infection, 91·5% (90·7–92·2; 40·9 vs 1·8 per 100 000 person-days) against asymptomatic SARS-CoV-2 infection, 97·0% (96·7–97·2; 32·5 vs 0·8 per 100 000 person-days) against symptomatic COVID-19, 97·2% (96·8–97·5; 4·6 vs 0·3 per 100 000 person-days) against COVID-19-related hospitalisation, 97·5% (97·1–97·8; 2·7 vs 0·2 per 100 000 person-days) against severe or critical COVID-19-related hospitalisation, and 96·7% (96·0–97·3; 0·6 vs 0·1 per 100 000 person-days) against COVID-19-related death. In all age groups, as vaccine coverage increased, the incidence of SARS-CoV-2 outcomes declined. 8006 of 8472 samples tested showed a spike gene target failure, giving an estimated prevalence of the B.1.1.7 variant of 94·5% among SARS-CoV-2 infections.InterpretationTwo doses of BNT162b2 are highly effective across all age groups (≥16 years, including older adults aged ≥85 years) in preventing symptomatic and asymptomatic SARS-CoV-2 infections and COVID-19-related hospitalisations, severe disease, and death, including those caused by the B.1.1.7 SARS-CoV-2 variant. There were marked and sustained declines in SARS-CoV-2 incidence corresponding to increasing vaccine coverage. These findings suggest that COVID-19 vaccination can help to control the pandemic.FundingNone.

Development of a method for the analysis of the lists of medicines and its application for the analysis of the lists of medicines in Russia, England, and Italy

Objective: the development and approbation of the method for comparative analysis of the lists of medicines in different countries and systems of healthcare.Material and methods. Based on the open-access data on the lists of medicines published on official websites of the authorized regulators, the authors selected the national lists of medicines of Russia, England, and Italy for the development and approbation of the method. It was proposed to use three parameters: the absolute number of medicines by international nonproprietary name (INN); the structure of the lists based on anatomical therapeutic chemical (ATC) classification; and the coverage of the indications based on the International Classification of Diseases, 10th edition (ICD-10). The results of the analysis provided grounds for the review of the approaches to the formation of the lists of medicines required for medical help in Russia, England, and Italy and reimbursed from the state budget.Results. The number of medicines by INN in the national lists of England and Italy exceeds the total number of drugs included in the list of vital essential and desirable (VED) in Russia. All the analyzed lists were characterized by an uneven distribution of medicines within the lists by the ATC groups. The lists of medicines in England and Italy significantly exceed the list of VED by the number of the included medicines by all ATC groups excluding groups J and H in comparison with Italy, and groups J and V in comparison with England. At the same time, the list of VED significantly exceeds the list in England by the number of covered indications from the ATC L group. During the approbation, the method showed to be effective and can be used for further comparative studies of the national lists of medicines.Conclusion. Non-uniform lists of medicines by ATC-codes show that each country has priority areas in their healthcare systems. The list of VED can be shorter by the absolute number of the included medicines in England and Italy but it can exceed them by the coverage of indications due to peculiarities of the procedure of the list formation (reimbursement of medicines by all the registered indications). The results of the study with the proposed method can serve for the optimization of the VED list and the analysis of therapeutic areas that are undercovered.

Analysis of acquisition and the monthly cost of antihypertensive therapy with modern fixed-dose combinations in the Far Eastern Federal District

Objective: analyzing the acquisition and monthly costs for patients on modern fixed-dose antihypertensive combinations in three regions of the Far Eastern Federal District.Material and methods. Intra-group analysis of retail of antihypertensive drugs for 2019 in drugstores of the Khabarovsk Region, Sakhalin Region, Amur Region (n=100) was carried out. The calculation of the monthly cost of therapy was performed and total sales indicators were identified. Statistical analysis: dispersion analysis, Spearman's rank correlation coefficient, Kruskal–Wallis test.Results. The maximum demand in patients among combinations of -blockers in the price range of 100-500 rubles: atenolol+chlortalidone; bisoprolol+amlodipine. In the grope of combinations of angiotensin-converting enzyme inhibitors with diuretics/calcium channel blockers, the most often acquired were: perindopril/ramipril+indapamide/amlodipine, enalapril+hydrochlorothiazide – in the price segment of 500–1000 rubles. Preferences for the use of combinations of angiotensin II receptor blockers+diuretic/calcium channel blockers: valsartan+amlodipine with a monthly cost of therapy of 300–500 rubles; losartan+hydrochlorothiazide – 100–500 rubles and azilsartan+chlortalidonee – 500–1000 rubles. The most popular three-component drugs were valsartan+amlodipine+hydrochlorothiazide, perindopril+amlodipine+indapamide with a monthly cost over 500 rubles. Differences in the acquisition structure of fixed-dose antihypertensive combinations between regions were statistically significant.Conclusion. The share of sales of combined antihypertensive drugs remains insignificant. The main selection criteria within an international nonproprietary name are affordability or trust in a brand. The presence of a reliable correlation of the acquisition structure with the region proves the influence of regional preferences of specialists in drug prescribing.

PRESCRIPTION AUDIT IN OUTPATIENT DEPARTMENTS OF TERTIARY CARE HOSPITALS; FACTS AND RECOMMENDATIONS

Objective: To evaluate written prescriptions according to a checklist based on WHO guidelines (prescription audit). To compare prescriptions of senior and junior physicians and to provide data and recommendations.
 Study Design: Cross-sectional, analytic study.
 Place and Duration of Study: Pak Emirates Military Hospital, and Combined Military Hospital, Rawalpindi Pakistan, from March to Aug 2018.
 Methodology: A total of 205 prescriptions using convenient sampling technique were analyzed according to a checklist based on WHO guidelines for standard prescription writing. Data was analyzed using SPSS-22.
 Results: Out of total 205 prescriptions, 83 (40%) prescriptions belong to senior and 122 (60%) to junior physicians. Fifty (25%) prescriptions lacked patient name, 49 (24%) lacked age. Gender was mentioned in only 117 (57%) prescriptions. Date, diagnosis and dosage of drug were written in 170 (83%), 172 (84%) and 177 (86%) respectively while dosage form and route of administration were mentioned in 144 (70%) and 102 (50%) respectively. Generic name was written in only 75 (37%) prescriptions. Name and stamp of the doctor were available on 135 (66%) and 125 (61%) prescriptions respectively. A statistically significant association was observed between senior and junior physicians in terms of error in name of patient and dosage form (p=0.002& 0.005 respectively).
 Conclusions: Prescriptions were mainly deficient in the generic names of drugs. Route of administration was missing in half of the prescriptions. None of the parameters was totally accurate. Prescriptions from junior physicians had more errors.

DRUG UTILIZATION REVIEW OF FLUOROQUINOLONES ANTIBIOTICS BY USING PRESCRIBING INDICATORS & COMPARISON OF DEFINE DAILY DOSE & PRESCRIBED DAILY DOSE IN OUTPATIENTS

Background: The increase in antibiotic resistance is new developing threat to healthcare system. Irrational drug use, polypharmacy and the current epidemic of bacterial resistance is attributed to the increase in use of antibiotics. The aim of the current study is to evaluate the difference between defined daily dose and prescribed daily dose of fluoroquinolones antibiotics.
 Methodology: Quantitative observational, retrospective study was carried out to measure the use of antibiotics, specifically Fluoroquinolones at northern region of Punjab, Nowshera Virkan, Tehsil of Gujranwala District, Pakistan. Total 300 patients were enrolled in this study. Data were collected from the patients of all age from either sex, by prescription review. Data included the drug name, strength and quantity.
 Results: 300 prescriptions were reviewed to evaluate the prescription pattern of fluoroquinolones in outpatients. Among the prescribing indicators, the average number of drugs per prescription was 4.5. Out of 300 prescriptions maximum number of drugs per prescription was 8 in only one prescription and minimum one drug was prescribed in 28(9.3) prescriptions. The number of prescriptions that contains the drugs without generic were 71(23.7) and which contains one drug with generic were 203(67.7). Encounter with antibiotic prescribed were 79.3%. Encounter with injection prescribed was 5.3%. All drugs were prescribed from Essential drug list (EDL). Ciprofloxacin was the most commonly prescribed followed by Levofloxacin and Moxifloxacin. Defined daily dose and prescribed daily dose of Ciprofloxacin were same (1) but the prescribed daily dose of levofloxacin (0.5) was higher than the Defined Daily Dose (1).
 Conclusion: Irrational use of drugs, polypharmacy, over prescribing of antibiotics and brand prescribing were observed during the study. Lack of knowledge and nonadherence to the prescribing indicators are the major factors that contribute towards the irrational drug prescribing that ultimately lead towards the antibiotic resistance.

P131 Defining refractory disease in RA and polyarticular JIA: a systematic review

Abstract Background/Aims A systematic approach to define patients with rheumatoid arthritis (RA) or polyarticular juvenile idiopathic arthritis (PolyJIA) who do not adequately respond to treatment and experience persistent symptoms (refractory disease) is absent. The objective of the systematic review was to identify how refractory disease (or relevant terminology variations) in RA/PolyJIA is defined and establish the key components/constructs of such definitions. Methods Searches were undertaken of English language articles within six medical databases, including manual searching, from January 1998 to March 2020 (PROSPERO: CRD42019127142). Articles were included if they incorporated a definition of refractory disease, or non-response, in RA/PolyJIA, with clear components to the description (e.g. disease activity assessment specified, patient perspective, number of drugs to classify non-response). A narrative synthesis mapping of the definitions was undertaken to describe refractory disease in RA/PolyJIA and classify each component within each definition through a qualitative content analysis. Results Of 6,251 studies screened, 646 studies met the inclusion criteria; 581 reported non-response criteria and 65 reported refractory disease definitions/descriptions. From the non-response studies, 39 different components included various disease activity measures, emphasising persistent disease activity and symptoms, despite treatment with at least one bDMARD. Of the papers with clear definitions for Refractory disease, 41 components were identified and categorised into three key themes: Resistance to multiple drugs/regimes with different mechanisms of action: descriptions of drugs/regimes failed, not tolerated, discontinued/switched, by specifying name, number or class of drugs failed (range 1-8 but typically ≥2 bDMARDs) and duration of treatment, and steroid use/dependency.Persistency of physical symptoms and disease activity: range of various disease activity criteria (including not achieving remission), descriptions of other patient-reported outcomes or symptoms e.g. patient global or pain VAS, presence or absence of inflammation, disease severity including new joint activity, damage or replacements.Other contributing factors: biomechanical or degenerative drivers, adverse event, co-morbidities or extra-articular manifestations, serology (RF Status) or anti-bodies (anti-CCP) and incorrect diagnosis or not relevant treatment. The most common labels were “Refractory” (80%), of which 32.7% used the term “Refractory RA” and 13.5% stating “Refractory to (drug name/class)”. “Difficult-to-treat RA” (23.1%) and “Treatment Resistant RA” (15.4%) were the most popular from remaining terms (20%). Only the minority (16.9%) reported explicitly how their definition was generated e.g. clinical experience or statistical methods. Conclusion Refractory disease can be defined as resistance to multiple drugs/regimes with different mechanisms of action as evidenced by persistency of physical symptoms and high disease activity, including contributing factors. There is a need for a clear unifying definition as the plethora of different definitions makes both study comparisons and appropriate identification of patients difficult. Disclosure H. Chaplin: None. L. Carpenter: None. A. Raz: None. E. Nikiphorou: None. H. Lempp: None. S. Norton: None.

The analysis of the range of sugar-reducing medicines presented on the pharmaceutical market of the republic of Tajikistan

The diabetes is one of the most pressing medical and social problems in the health care system of most countries, including Tajikistan. According to experts from the International Health Organization, this disease is a problem for all segments of the population and age groups. In this regard, the modernization of the price regulation system in order to provide consumers with highly effective, harmless and affordable antidiabetic drugs is an urgent task of the health care and public protection system of the Republic of Tajikistan.
 The aim of the work is to study the range of drugs registered in the Republic of Tajikistan for the treatment of diabetes. The object of the study were scientific sources, statistics, price indicators, official websites of authorized publications on registered medicines. The research was conducted using methods of analysis, systematization and generalization, mathematical and statistical calculations.
 The range of oral hypoglycemic drugs presented on the pharmaceutical market of the Republic of Tajikistan was studied and the analysis of the pharmaceutical market of oral antidiabetic drugs by countries-manufacturers, dosage forms, groups of anatomical-therapeutic-chemical (ATC) classification was carried out. On March 1, 2021, 70 trade names of oral hypoglycemic drugs were registered. The range of drugs is mainly represented by drugs from the group of sulfanylurea derivatives (21 trade names of drugs or 30% of the total number of drugs in this group), as well as drugs from the group of biguanide derivatives (17 trade names of drugs or 24.28% of their total quantity). In the structure of deliveries of oral hypoglycemic drugs the leading positions are occupied by India – 31.25% (15 LP), Pakistan – 22.91% (11 LP), Ukraine – 14.58% (7 LP), Belarus and Germany – 6.25% each. (3 LP each). Registered 8 names of insulin preparations for injection in the form of vials (5 ml and 10 ml) and cartridges made in Ukraine («Farmak», «Indar») and India («Wockhardt Limited») and in pre-filled syringe pens produced by the company «Indar», Ukraine.

What's in a Name? Drug Nomenclature and Medicinal Chemistry Trends using INN Publications.

The World Health Organization assigns international nonproprietary names (INN), also known as common names, to compounds upon request from drug developers. Structures of INNs are publicly available and represent a source, albeit underused, to understand trends in drug research and development. Here, we explain how a common drug name is composed and analyze chemical entities from 2000 to 2021. In the analysis, we describe some changes that intertwine chemical structure, newer therapeutic targets (e.g., kinases), including a significant increase in the use of fluorine and of heterocycles, and some other evolutionary modifications, such as the progressive increase in molecular weight. Alongside these, small signs of change can be spotted, such as the rise in spirocyclic scaffolds and small rings and the emergence of unconventional structural moieties that might forecast the future to come.

Feasibility of an experimental search for a resonance of a pion and a light nucleus

Abstract A hypothesis is proposed herein, suggesting that a pion-nuclear resonance may be observed in the $\alpha+d\to{}^6\mathrm{Li}(3.563)+\pi^0$ reaction. The resonance has a $\pi NN\alpha$ structure, containing $\alpha NN$ and $\pi NN$ subsystems. The former corresponds to the $A=6$ isotriplet $^6\mathrm{He}_\text{g.s.}$, $^6\mathrm{Li}(3.563)$, $^6\mathrm{Be}_\text{g.s.}$, whereas the latter is a hypothetical $NN$-decoupled dibaryon. We propose an experiment to search for this resonance using the $^7\mathrm{Li}(p,d)$ reaction.

Dispensing Errors in Hospital Pharmacies in Yemen: An Exploratory Study

Aims. This study aimed to describe the dispensing errors that occurred during the dispensing process in selected hospital pharmacies in Sana'a, Yemen, and to describe their types and causes. Methodology. A prospective study was carried out in selected hospital pharmacies in Yemen over 40 days using a validated tool. Results. A total of 9000 dispensed prescriptions were evaluated for the dispensing errors, and 2.13% dispensing errors were identified. Wrong dosage form (134/192), incorrect strength (24/192), wrong drug (18/192), incorrect quantity, wrong instructions written and drug available in the pharmacy but not given (6/192) and dispensing expired drugs (3/192) were the dispensing errors reported in this study. Poor handwriting, similar drug names, similar drug packaging, fatigue, heavy work, workforce issues, and poor communication were the most commonly reported causes of dispensing errors. Conclusion. There is a wide variation in the rates of prevalence of medication errors observed during this prospective study. Dispensing errors were the most common. This variation may be attributed to the nature and heterogeneity of the prescription’s sources. Study results indicate that medication errors imposed an extraordinary challenge to the healthcare system in Yemen and post significant potential harm to the patient in light of the current economic, social and security conditions. Well-designed nationwide future studies aimed at investigating the causes of medication errors to guide the design of interventions aimed at reducing their burden on the national healthcare system is highly recommended.

Generic Prescribing: The Egyptian semblance

Generic prescribing is prescribing medicines by the prescriber using the international non-proprietary name, leaving the choice to the pharmacist to either dispense the brand or its generic counterpart. Generic prescribing allows any suitable generic drug rather than a brand drug to be dispensed, reduces delays in supplying medicines to the patient and leads to cost savings. Several countries have issued regulatory policies for the use of generic medicines to facilitate the access of medicines and for cost savings purpose to decrease the rapid growth of spending in the healthcare system. The aim of this current review is to highlight the current status of generic prescribing and prescribing practices in Egypt, regulatory policies as well as the perceptions of the physicians, pharmacists and patients' towards generic prescribing and its economic impact.

The use of big data in psychiatry – the role of pharmacy registries

IntroductionAdministrative databases (AD) are repositories of administrative and clinical data related to patient contact episodes with all sorts of health facilities (primary care, hospitals, pharmacies,…).The large number of patients/contact episodes with pharmaceutical facilities available, the systematic and broad register and the fact that AD provides Real-world data are some of the pros in using AD data.ObjectivesTo perform a narrative review on the role of Big Data pharmaceutical registries in Mental Health research.MethodsWe conducted a narrative review using MEDLINE and Google Scholar databases in order to analyse current literature regarding the role of BigData pharmaceutical registries in Mental Health Research.ResultsAdministrative variables like drug names and prices may be used and linked to other clinical variables such as patients disease, in-hospital mortality, length of stay,(…). The use of electronic medical records may also contribute to systematic surveillance approaches like local or national pharmacovigilance strategies, identification of patients at risk of developing complications and software pop-up warnings related to medication dosage, duplication and lateral effects. The use of Big Data pharmaceutical registries allows to create predictive epidemiological models regarding drugs lateral effects or interactions and may help to perform pharmacovigilance phase 4 clinical trials. Its use may be applied to the optimization of clinical decision, monitoring of drug adverse events, drug cost and administrative monitoring and as surrogate measures of quality care indicators.ConclusionsBig Data use in pharmaceutical registries allows to collect large and important clinical and administrative data that may be later used in Mental Health care and research.DisclosureNo significant relationships.

Disease-Modifying Antirheumatic Drugs (DMARDs) and drug interactions in dentistry.

Rheumatoid arthritis is a chronic autoimmune disease. Treatment aims to reduce and improve its signs and symptoms. Hence, Disease-Modifying Antirheumatic Drugs (DMARDs) are the treatment of choice. The objective of this study was to identify potential interactions between DMARDs and the drugs most frequently prescribed in dentistry in order to avoid adverse reactions. This literature review sets out to define possible adverse reactions provoked by pharmacological interactions between DMARDs and the drugs commonly prescribed in dentistry. A search was conducted in PubMed by searching the names of drugs used in dentistry, "drug interactions," "rheumatoid arthritis," and "dentistry", "hydroxychloroquine", "leflunomide", "methotrexate", "sulfasalazine", "adalimumab", "anakinra", "etanercept", "abatacept", "infliximab" and "rituximab". It was found that most DMARDs show potential interactions with many drugs used in dentistry, including various antibiotics, analgesics, anesthetics, antifungals, and corticosteroids. It is clinically important for oral health clinicians to be aware of possible drug interactions between DMARDs and the drugs commonly prescribed in dentistry to prevent potential adverse reactions and avoid endangering the patient.

Safety and Efficacy of Remdesivir for the Treatment of Covid-19: A Rapid Review of Available Evidence

Context: Remdesivir is an antiviral drug manufactured by Gilead Sciences, Inc., in which in-vitro studies have been shown to work in COVID-19 patients. Although it’s not approved by pharmaceutical authorities and has not passed the first and second phases of clinical trials, it is prescribed on a trial basis for patients with Covid-19. In more than 20 countries, researchers are monitoring the results of using Remdesivir in clinical settings to see if it can be prescribed for larger populations if patients respond positively. Methods: This is a rapid review of the evidence for the potential effects of Remdesivir, which intended to create a policy guide. To do so, health technology assessment studies indexed in MEDLINE and Cochrane Library databases were searched using the keywords, including drug name and disease name, on April 21, 2020. In addition, references of retrieved studies were checked to ensure throughout the capture of the literature. Studies on the safety and efficacy of Remdesivir in Covid-19 patients, both in Persian or English, were included. To identify ongoing clinical trials in Iran and some countries, clinical trial registration systems were also searched. Results: In total 90 titles were identified, which after removing duplicates and applying inclusion criteria, 32 were included, all of which were published in 2020. 25 of them were review studies, mostly on treating Covid-19 disease, and some of them were dedicated to the effects of Remdesivir in treating the disease. However, no systematic review was found. Of the remaining studies, three were finished clinical trials, two of which evaluated the safety and efficacy of Remdesivir on mild, moderate, and severe Covid-19 compared to a placebo, and the third study compared Remdesivir with routine treatment. A cohort study on the efficacy of Remdesivir in compassionate use was also found. Also, two case reports of patients receiving Remdesivir and a letter-to- editor describing Remdesivir as an appropriate treatment for Covid-19 were identified. Moreover, registered clinical trials with different designs intended to investigate the safety and efficacy of Remdesivir in treating Covid-19 were extracted from clinical trial registration systems (Table 3). In total 15 protocols were found, which 13 were in primary stages. The other two were in phase three of clinical trials and aimed to investigate the effect of Remdesivir in treating patients with severe, moderate, or mild Covid-19. In the clinical trial registration system, it is mentioned that the first study is stopped prematurely due to the lack of a sufficient number of patients, and the second study is also suspended. Conclusions: Evidence on the safety and efficacy of Remdesivir in treating Covid-19 are very limited to make a decision. However, if registered trials are completed, enough evidence would be available to decide whether to accept or reject the Remdesivir. Since the effectiveness of Remdesivir is not clear yet, its prescription for Covid-19 patients has so far been limited to clinical trials, compassionate use, or emergency use.

STRENGTHENING LEGALITY IN THE LAW ENFORCEMENT AGENCIES FUNCTIONING AT THE STAGE OF INSTITUTING CRIMINAL PROCEEDINGS AS A MEANS OF PROTECTING THE RIGHTS OF CITIZENS

In the article the author examines the issues related to the improvement of legislation in the functioning of law enforcement agencies, in particular that on their counteraction to organized drug crime. We are talking about the amendment to Article 146 of the Criminal Procedure Code of the Russian Federation, according to which criminal proceedings on crimes under Articles 228.1 and 228.4 of the Criminal Code of the Russian Federation on the fact of illegal drugs dealing cannot be initiated in the absence of data on the type, weight and name of drugs, as well as sufficient evidence indicating their transfer to other persons. The law-in-draft is aimed, on the one hand, at protecting citizens, on the other – at increasing the exactingness to law enforcement agencies at the initial stage of criminal – proceedings related to drug crime. The grounds for instituting a criminal proceeding for illegal drug dealing should be the facts of drug transfer to another person, as well as an expert opinion determining their mass, type and name.

The Impact of a Bedside Medication Scanning Device on Administration Errors in the Hospital Setting: A Prospective Observational Study

IntroductionThe medication administration process is complex and influenced by interruptions, multi-tasking and responding to patient’s needs and is consequently prone to errors.1 Over half (54.4%) of the 237 million medication errors estimated to have occurred in England each year were found to have taken place at the administration stage and 7.6% were associated with moderate or severe harm. The implementation of a Closed Loop Medication Administration solution aims to reduce medication administration errors and prevent patient harm.AimWe conducted the first evaluation to assess the impact of a novel optical medication scanning device, MedEye, on the rate of medication administration errors in solid oral dosage forms.MethodsWe performed a before and after study on one ward at a tertiary-care teaching hospital that used a commercial electronic prescribing and medication administration system and was implementing MedEye (a bedside tool for stopping and preventing medication administration errors). Pre-MedEye data collection occurred between Aug-Nov 2019 and post-MedEye data collection occurred between Feb-Mar 2020. We conducted direct observations of nursing drug administration rounds before and after the MedEye implementation. Observers recorded what they observed being administered (e.g., drug name, form, strength and quantity) and compared this to what was prescribed. Errors were classified as either a ‘timing’ error, ‘omission’ error or ‘other’ error. We calculated the rate and type of medication administration errors (MAEs) before and after the MedEye implementation. A sample size calculation suggested that approximately 10,000 medication administrations were needed. Data collection was reduced due to the COVID 19 pandemic and implementation delays.ResultsTrained pharmacists or nurses observed a total of 1,069 administrations of solid oral dosage forms before and 432 after the MedEye intervention was implemented. The percentage of MAEs pre-MedEye (69.1%) and post-MedEye (69.9%) remained almost the same. Non-timing errors (combination of ‘omission’ + ‘other’ errors) reduced from 51 (4.77%) to 11 (2.55%), which had borderline significance (p=0.05) however after adjusting for confounders, significance was lost. We also saw a non-significant reduction in ‘other’ error types (e.g., dose and documentation errors) following the implementation of MedEye from 34 (3.2%) to 7 (1.62%). An observer witnessed a nurse dispense the wrong medication (prednisolone) instead of the intended medication (furosemide) in the post-MedEye period. After receiving a notification from MedEye that an unexpected medication had been dispensed, the nurse corrected the dose thus preventing an error. We also identified one instance where the nurse correctly dispensed a prescribed medication (amlodipine) but this was mistakenly identified by the MedEye scanner as another prescribed medication (metoclopramide).ConclusionsThis is the first evaluation of a novel optical medication scanning device, MedEye on the rate of MAEs in one of the largest NHS trusts in England. We found a non-statistically significant reduction in non-timing error rates. This was notable because incidents within this category e.g., dose errors, are more likely to be associated with harm compared to timing errors.2 However, further research is needed to investigate the impact of MedEye on a larger sample size and range of medications.

A cross-sectional study on current prescription trends and errors in outpatient department of a Bangladeshi secondary care district hospital.

Context:The rational prescription leads to a healthy and good-quality life of a patient. Irrational, inappropriate, and unnecessary prescriptions are major therapeutic issues in Bangladesh, which can cause severe consequences.Aim:This cross-sectional study was conducted to evaluate the prescription patterns and errors as well as to review the most frequently prescribed drug classes among outpatients at a secondary hospital in Pabna, a district of Bangladesh.Methods:A total of 400 prescriptions were reviewed from March 2019 to May 2019. In this study, statistical data analysis was implemented by IBM SPSS Statistics V22 and data revealed in frequencies, mean, and percentage. Spearman's rank correlation coefficient was calculated to show the correlation between bivariate coded variables.Results:The results revealed that majority of the prescription were prescribed for females (73.5%) where proton-pump inhibitors (PPIs), analgesics, vitamins, and single antibiotics were most frequently prescribed medicine for the female patients compared to male patients. Almost half of the collected prescription contained four medicines (47%). Maximum number of prescriptions contained two (30.5%) essential drugs and among 1402 medicines of 400 prescriptions, antiulcerants were most frequently prescribed medicine (23.32%) where esomeprazole was highly prescribed generic drug (44.75%). Moreover, Spearman's rank correlation coefficient suggested that PPIs and analgesics were frequently prescribed medicines at a time for the patients (0.182). According to the age group, the study also got some significant variations in prescribing pattern. However, most common prescription errors were prescriber's name not mentioned (100%), diagnosis not mentioned (96.75%), dose not indicated (15.41%), and wrong drug name (0.36%).Conclusion:Findings of the current study represent the existing prescribing trends of different therapeutic classes of drugs and common prescription errors in a secondary health facility of Bangladesh. From this study, it is observed that physicians prescribed rationally in some cases but need to ensure rationality in all prescriptions. Continuous monitoring of drug use, development of prescribing guidelines, and training are recommended to ensure and implement good-quality prescribing practices for promoting the rational and cost-effective use of drugs.

NLM-Chem, a new resource for chemical entity recognition in PubMed full text literature

Automatically identifying chemical and drug names in scientific publications advances information access for this important class of entities in a variety of biomedical disciplines by enabling improved retrieval and linkage to related concepts. While current methods for tagging chemical entities were developed for the article title and abstract, their performance in the full article text is substantially lower. However, the full text frequently contains more detailed chemical information, such as the properties of chemical compounds, their biological effects and interactions with diseases, genes and other chemicals. We therefore present the NLM-Chem corpus, a full-text resource to support the development and evaluation of automated chemical entity taggers. The NLM-Chem corpus consists of 150 full-text articles, doubly annotated by ten expert NLM indexers, with ~5000 unique chemical name annotations, mapped to ~2000 MeSH identifiers. We also describe a substantially improved chemical entity tagger, with automated annotations for all of PubMed and PMC freely accessible through the PubTator web-based interface and API. The NLM-Chem corpus is freely available.