Misuse Of Medicines Research Articles

Abuse of Medicines For Performance Enhancement in Sport: Why Is This A Problem For The Pharmaceutical Industry?

The misuse of medicines for performance enhancement in sport (doping) is not approved by regulatory agencies, and is illegal in many countries. In addition to the 'traditional' doping agents such as steroids, β-blockers and blood transfusions, the list of agents and techniques used in doping is increasing and now includes newer medicines such as erythropoiesis-stimulating agents and growth hormones. Innovative new medicines are of particular interest as would-be dopers may believe them to be undetectable by current methods. Close collaboration between the biopharmaceutical industry and anti-doping agencies such as the World Anti-Doping Agency is critical to a successful anti-doping strategy. Industry is ideally placed to identify the doping potential of new medicines at early stages and to support early development of detection assays. A strong, united front between the biopharmaceutical industry and anti-doping agencies is essential to counter the misuse of medicines for performance enhancement, as well as to promote fair play and clean sport.

Prescription Opioid Deaths: A Preventable Epidemic

Prescription Opioid Deaths: A Preventable Epidemic

Is There Evidence for Evidence-Based Medical Imaging?: TABLE 1

See Pages [64S][1] and [77S][2] > ΓNΩΘI ΣAYTON − Know thyself > > Inscription at the Apollo temple in Delphi ( 1 ) In this supplement to The Journal of Nuclear Medicine, Ware and Hicks provide scathing criticism of the misuse of evidence-based medicine in health technology assessments ([2

Research progress of Chinese herbal medicine and traditional Chinese medicine resulting in liver injury

The adverse reactions caused by Chinese herbal medicine and traditional Chinese medicine are reported increased in recent years, among which the acute liver injury caused by Chinese herbal medicine accounts for 21.5% of total liver injuries. Despite the misuse of traditional Chinese medicine not in accordance with differentiation of symptoms and signs, the adverse reaction of Chinese herbal medicine itself can't be little to these adverse events. The paper summarizes the most common categories of traditional Chinese medicine resulting in liver injury, the mechanism, pathological characteristics, clinical symptom of liver injury, the reasons of the reaction and how to prevent. The research aims to enhance the clinical physician recognition of liver injury caused by Chinese herbal medicine, in order to ensure the safe and rational usage of traditional Chinese medicine.

Limits of Autonomy in Biomedical Ethics? Conceptual Clarifications

In biomedical ethics the principle of autonomy is closely connected with the moral and legal claim to informed consent. After World War II and the dramatic misuse of medicine in Nazi Germany, informed consent regulations were expected to help avoid similar misuse in the future, to help overcome the traditional medical paternalism, and to advance the liberty rights of patients and human subjects of research. With the rise of the new field of bioethics in the 1970s, the traditional beneficence-based model of medical ethics shifted in the direction of an individual autonomy model.

Public knowledge, attitude and perception of over the counter medicines:Case study in Dar es Salaam region, Tanzania.

The purpose of this study was to investigate on misuse, abuse and the general public opinion as well as perception of OTC medicines. Data were collected, by face-to-face interview guided with a semi-structured questionnaire. The key questions focused on community attitude towards retail pharmacy, use of OTC medicines, views on OTC in terms of safety and effectiveness and knowledge and opinion on misuse and abuse of OTC medicines. The collected data were coded and statistically analyzed using EPI-Info version 6 database. Out of 270 interviewees, 50% admitted to have had visited retail pharmacies at least once per month. More than half of the participants (64.1%) reported to having been buying OTC medicines at least once in a month and 55.7% used the medicines as per containers label or leaflets' instructions The public demonstrated high awareness on the potential misuse of OTC medicines. The study revealed a high level of awareness on the potential abuse of OTC medicines and positive perception with regard to safety and effectiveness of OTC medicines. From these findings, it shows those pharmacists need to be more proactive in the management of inappropriate OTC drug use.

Surveillance of community antimicrobial use in resource‐constrained settings – experience from five pilot projects

To investigate the feasibility of surveillance of antimicrobial use in the community in resource-constrained settings. Overuse and misuse of antimicrobial medicines is contributing to the development of resistance. The WHO Global Strategy for Containment of Antimicrobial Resistance recommends surveillance of use at all levels of the health sector but this is not done in most low and middle income countries. Pilot projects were established in three sites in India (Delhi, Mumbai and Vellore) and 2 in South Africa (Brits and Durban). Antimicrobial use data were collected monthly from both public and private facilities. Each pilot site sought to document 30 patient encounters where antimicrobials were provided from 7 to 30 facilities per month. Antimicrobial use was expressed as the percentage of patients receiving a specific antimicrobial and as the number of defined daily doses of each specific antibiotic per 100 patients attending the facility per month. In all sites, there was extensive use of antimicrobials, with older agents being used more in the public sector and newer agents in the private sector. Although methodological differences limit the comparability of data, use appeared to be higher in India than in South Africa. Expressing antimicrobial use as the percentage of patients receiving a specific antimicrobial was more easily computed. Defined daily dose measure was useful in demonstrating differences in dosing and duration. All pilot sites provided data on antimicrobial use but also raised several issues related to methodology and logistics of long-term surveillance in community settings under resource constraints. Use measured as percentage of prescriptions is easier and more reliable in these settings.

Toxicological Risks of Chinese Herbs

As traditional Chinese medicine (TCM) has become more popular there have been increasing concerns about safety and potential toxicity of the Chinese materia medica (CMM) comprising plants, animal parts and minerals. The potential toxicity of many CMM is well recognised in TCM and to reduce risks use of some herbs is restricted whilst specific processing methods have been developed to modify the activities/toxicity of others. However adverse reactions have been reported, many of these are due misuse or abuse of Chinese medicine. The main problem remains products adulterated with pharmaceuticals for weight loss or erectile dysfunction. But some herbs have narrow therapeutic ranges (e.g., Aconitum species) so toxic effects are frequently reported. Toxic effects from chronic or cumulative dosing are difficult to detect in the traditional setting and recent reports have demonstrated the health problems from Aristolochia species. Despite safety concerns, Chinese medicine appears to be relatively safe with comparatively few reports of adverse reactions compared with overall drug reports. The wealth of information in the Chinese literature needs to be more widely available. As TCM is widely used by patients, improved pharmacovigilance and pharmacoepidemiology can contribute valuable safety information, relevant to clinical use.

Healthcare-seeking strategies among displaced children in war-ridden northern Uganda: the case of malaria

A field study was performed to examine suffering and treatment seeking from the perspective of children aged 8-16 years living in war-affected northern Uganda. Various techniques for collecting qualitative and quantitative data were used, including a semi-structured questionnaire about illness experiences and medicine use over a 1-month recall period. The 165 children who were interviewed were attending primary schools for displaced children and/or commuters' night shelters. The children frequently attributed their common febrile ailments to malaria and used a variety of pharmaceuticals and herbal remedies, as self-medication, for their self-diagnosed malarial episodes. Misdiagnosis of febrile illnesses by the children (as well as by the local healthcare providers) and frequent misuse of medicines in the treatment of these illnesses appeared to be very common. Improvement of the health conditions of these children requires a change of focus. Firstly, children above the age of 5 years who are not under adult care and who are often no longer welcome in the local hospital's paediatric ward need to be accepted at the outpatient clinics currently intended for adults. Secondly, the local diagnostic system needs to be improved, not only so that malaria can be reliably diagnosed but also so that alternative diagnoses can be confirmed or rejected, otherwise the current over-consumption of antimalarial drugs may simply be replaced with an over-consumption of antibiotics.

Medicine Safety Among Children and Adolescents

An increasing number of studies have documented problems with the safe use of prescription and nonprescription or over-the-counter (OTC) medicines among children and adolescents. Specifically, risks include potential errors by caretakers in administering prescription and OTC medicines to children,1,2 as well as unintended exposure of children and teens to medicines that are not intended for them.3 Children 18 years of age and younger make over 70 000 emergency visits each year for medication overdoses4 whereas adolescents are vulnerable to harm from both unintended and deliberate misuse of medicines.

Medicine or ecstasy? The importance of the logo

Some pharmaceutical tablets have an appearance that resembles that of ecstasy (a logo and often a name referring to it, a given shape and/or a colour). These are sometimes sold in the street as 'ecstasy'. In order to assess the knowledge of this phenomenon, surveys were conducted among designer drug users (DDUsers), pharmacists and pharmaceutical firms. Three surveys were conducted: the first one was conducted among DDUsers by means of an anonymous questionnaire; the second one consisted of a 1-month postal survey within a network of 155 community pharmacies in the Aquitaine region, Southwestern France and the third one consisted of a postal questionnaire sent to 71 pharmaceutical firms. Nineteen users, 77 pharmacists and 25 pharmaceutical firms participated in the surveys. All DDUsers knew the existence of what they call ecstasy 'swindles', but less than one quarter of the pharmacists and one third of pharmaceutical firms were aware of the potential recreational and involuntary misuse of medicines. The phenomenon of 'swindle' in the illicit market is not new. However, the sale of medicines because of their appearance or logo seems to be quite rare. In order to limit this diversion, prevention should be reinforced. In addition, recommendations on the appearance of medicine tablets should be set up by regulatory agencies in charge of medicine approval.

Analysis of Consumers' Attitudes toward Traceability System on Dairy Products in China

Research background Dairy industry has a large potential in China. The production and consumption of milk in China have increased dramatically especially since 2000. However, recent food safety problems occurred in the livestock sector in China have somehow negatively affected consumers’ confidence in purchasing foods. Food safety problems in dairy industry have created lack of confidence among the public in buying dairy products. The new approach (A traceability system) to ensure the food safety is concerned by the government, producers and even consumers. Traceability system could be a new way to respect consumers’ right to choose safe and high quality food, and to provide production information to consumers, which may help consumers to have the confidence on the food they consume. Basically, one of the functions of traceability system is to monitor food producers in order to avoid food safety problems such as misuse of veterinary medicines and so on. In China, traceability system is been in the processing of introduction, which initially focused on the food safety during the Olympic Game 2008 but not only for Olympic Game (Fig. 1) At present, the traceability system can be found in some supermarkets and hyper marts in China, which mainly used on vegetable (Fig. 2). Analysis of Consumers’ Attitudes toward Traceability System on Dairy Products in China

Rational use of medicines: Achievements and challenges

Rational use of medicines: Achievements and challenges

Les traitements de substitution aux opiacés en France

France has been implementing a harm reduction based policy toward drug users, mainly based on opiate replacement therapy. The opiate substitution treatment appeared at the beginning of 1990's and was implemented at a large scale to avoid the spread of HIV among injecting drug users and to reduce the large number of drug abuse related deaths. The 15-year experience is conclusive when access to health care had been greatly improved. Moreover, this policy has made a considerable impact on substance users' health in general. It has contributed to the reduction of fatal overdoses, almost brought an end to HIV transmission through needle-sharing; the numbers of offenders for heroine use dramatically decreased. In the same way, adverse consequences occurred, mainly linked to the misuse of buprenorphine. Policy measures have been set up at the end of the consensus conference on June 2004: a national health insurance action plan - aiming at reducing the volume of diverted medicines -, a working group dedicated to opiate replacement therapy on behalf of the Ministry of Health (commission on addiction), regulatory measures to reduce the misuse of opiate maintenance medicines, risk management plan of the French Medicines Agency. The Government Action Plan 2008-11 on drugs and drug addiction provides for proposals aiming at reducing the diversion and the misuse of medicines and protecting their therapeutic value. French advocacy in favour of opiate replacement therapy remains a national and international priority.

Compliance packaging for over-the-counter drug products

In view of the serious health risks and high costs to the health-care system of misuse and abuse of over-the-counter (OTC) analgesics, this article describes a rationale and prototype for new safety or compliance packaging for OTC drug products that are sold in pill form (e.g., tablets, caplets and gelcaps) inside blister packs. The proposed packaging is not simply promoting the use of blister packs for pills; that utility is already well known. It is an integrated system in which blister packs of pills can, themselves, be packaged, labeled and sold, offering a dose-directed unit-of-use design with enhanced warnings and directions to help prevent consumers from taking more than the instructed dose of pill-form medicines. Literature and information searches were conducted in publicly available databases and websites to (1) assess safety problems (serious adverse events and fatalities) associated with OTC analgesics and (2) determine public perceptions and knowledge about their use. Each year in the US, there are an estimated 100,000 hospitalizations and 16,500 deaths due to NSAID overdosing, and 26,000 hospitalizations and 1,600 acute liver failure cases due to acetaminophen poisoning. Many adults take more than the recommended dose and in some cases use multiple products containing acetaminophen and ibuprofen. Risk factors, such as alcohol use or pre-existing liver disease, exacerbate problems associated with acetaminophen misuse and abuse. In pediatric cases, dosing errors are often related to confusion over different product formulations, dosing strengths, and the use of inappropriate dosing devices. Consumers are often unaware of the active ingredients in, and correct doses of, drugs they are taking; they underestimate the risks associated with misuse of OTC medicines, and they frequently discard the packaging on which the drug’s directions, warnings and dosing instructions are located. Optimal compliance packaging should (1) keep the instructions, warnings and dosing directions attached to the blister card of pills at all times, thus avoiding the problem of cartons and package inserts being thrown away once the package is opened; (2) increase the surface area of the packaging, without adding bulk, to provide space for the use of larger font sizes and enhanced directions and warnings that are more conspicuous, explicit and memorable; (3) organize the pills into logical, unit-of-use (per-dose maximum and per-day maximum) sets or rows; (4) limit the number of pills in a unit-of-use package to coincide with the instructed maximum dose and maximum days of use for a specific product.

Prescription Opiate Medications: Clinical Assessment and Treatment of Addiction, Tolerance, and Dependence

<p>The 2003 National Survey on Drug Abuse and Health (NSDUH) demonstrated that 2.6 million people in the United States misused pain relievers, including hydrocodone and oxycodone. The misuse of prescription medicines affects a broad range of users, particularly older adults, adolescents, and women. There has been a sharp increase in new users of prescription drugs for nonmedical purposes, particularly painkillers, among teenagers and young adults, including both 12- to 17-year-olds (2.9% increase) and 18- to 25-year-olds (3.7% increase).</p> <h4>ABOUT THE AUTHOR</h4> <p>Dr. Miller is clinical professor, Department of Medicine, Michigan State University, East Lansing, MI. </p> <p>Address reprint requests to: Norman S. Miller, MD, JD, 321 Woodland Pass, Suite 300, East Lansing, MI 48823; or e-mail <a href="mailto:norman.miller@hc.msu.edu">norman.miller@hc.msu.edu</a>.</p> <p>Dr. Miller disclosed no relevant financial relationships.</p>

Surveillance of suspect animal toxicoses with potential food safety implications in England and Wales between 1990 and 2002

The potential chemical contamination incidents investigated by the Veterinary Laboratories Agency (VLA) between 1990 and 2002 are reviewed. Incidents were identified in the course of the VLA’s surveillance of food...

Treatment of Dependence on Opiate Medications

Scope of Dependence on Opiate Medications The National Household Survey on Drug Abuse demonstrates that 2.6 million people misuse pain relievers, including hydrocodone and oxycodone. This misuse of prescription medicines affects many people, particularly older adults, adolescents, and women. There has been a sharp increase in new users of prescription drugs for nonmedical purposes, particularly painkillers, among teenagers and young adults 12 to 17 years old (2.9 percent increase), and 18 to 25 years old (3.7 percent increase).

Sustainable veterinary medicine for the new era.

Sustainability aims to harmonise life on Earth without compromising the essential natural resources that should be the birthright of future generations. 'Sustainable medicine' (SM) is just one component of the wide range of possible sustainable approaches to peaceful co-existence. Sustainable medicine envisions an uncomplicated system of maintaining the health of people and animals, both now and for many years to come. This type of medicine is based on ancient wisdom, knowledge and healing arts, combined with the advantages and technical achievements of modern science and other areas of medicine; it is an integrated approach to preventive, safe and affordable healing. The term sustainable medicine also implies that the main therapeutic materials used in the course of practising this type of medicine can be replaced or replenished with minimal environmental damage after harvesting. The aim of sustainable medicine is to maintain the balance of nature, allowing an estimated 7 to 100 million species of life forms to co-exist and reproduce, and to sustain the long-term future of this planet. The world is in the midst of an environmental crisis: anthropogenic environmental damage in the last century was greater than in any previous century. One of the major concerns is the misuse of medicines, and the resulting immune depletion in people and animals. Many traditional medical systems have taught that appropriate adaptation by, and of, an effective defence system is the key to health and survival. This is only possible if priority is given to a preventive rather than a curative approach to health care; the very same approach that is advocated by proponents of SM: an approach based on proper diagnosis and the use of personalised, tailor-made medicine. The authors propose SM (the combination of the advantages of modern, traditional and complementary medical systems) as the best approach to providing better health care services for people and animals. The article presents a brief history of traditional medicines and outlines strategies for developing SM. The authors highlight some important factors in the development of SM in animal health care and attempt to encourage veterinarians to adopt a sustainable approach to treating animals.

Over-the-counter and prescription medicine misuse in Cape Town--findings from specialist treatment centres.

To provide community-level public health surveillance information on over-the-counter (OTC) and prescription medicine misuse. A retrospective study of OTC and prescription medicine misuse among 9,063 patients from 23 specialist substance abuse treatment centres in Cape Town, South Africa, between 1998 and 2000. OTC and prescription medicine misuse places a burden on health and social services in South Africa. This is evidenced through the constant demand for treatment for OTC/prescription medicine misuse. Benzodiazepines are the class of medicines for which users most often receive treatment, followed by analgesics. Analgesic misuse is most often accounted for by the use of codeine-containing medicines, many of which are available over the counter. Patients using OTC/prescription medicines as their primary drug of abuse are significantly more likely to be female, and aged over 40 years. In contrast, patients using OTC/prescription medicine as an additional drug of abuse tend to be male and over 40 years of age. This study points to the need to develop primary health care protocols for detection, management and referral of patients misusing OTC/prescription drugs and the need to debate the re-scheduling of codeine as a prescription-only substance. The study also points to the need for further community-based research on the nature and extent of OTC/prescription drug misuse among the general population.