Specific Types Of Medication Research Articles

Knowledge, Attitudes, and Practices Toward Self-Medicating Eye Symptoms in Jazan Region

Background: Self-medication with ophthalmic medications is a common practice; however, it raises concerns about the safety and appropriateness of treatment. Therefore, the current study aims to evaluate the knowledge, attitudes, and approaches toward self-medicating eye symptoms in the Jazan region. Methods: An observational cross-sectional study on the population comprises all individuals (aged 18 and up) who can read and write who were now taking or had previously used ophthalmic medicines. Following IRB approval, the questionnaire was distributed on social media to evaluate the aim of the study. Results: The majority of self-medicating ophthalmic medication users were male and aged between 18 and 29. 97.6% of self-medicators admitted to the practice; however, only 24.1% knew the specific type of medication they used. Lubricant eye drops were the most used medication. Eye dryness and redness were the most common symptoms leading to self-medication, with repeated symptoms and the perception of a simple condition being the most common reasons. Conclusion: Self-medication with ophthalmic medications is widespread in the studied population; nevertheless, there needs to be more knowledge about the specific medications used. Symptoms such as eye dryness and redness are common reasons for self-medication, driven by the perception of simplicity and repeated occurrence. Keywords: Self-medication; Eye symptoms; Blurred vision; Eye redness; Eye pain ; Jazan

CONSIDERATIONS OF AGE-FRIENDLY 4M PRINCIPLES IN DEPRESCRIBING INTERVENTIONS: A SCOPING REVIEW

Abstract The 4Ms – Medication, Mentation, Mobility, and What Matters - represent the key components in the Age-Friendly Health Systems initiative and provide a conceptual framework for research in the older adult population. Over 40% of older adults experience polypharmacy, which can be addressed by deprescribing unnecessary medications. This review aimed to assess the degree to which the 4Ms were considered in intervention design, sample selection, and outcome assessment in deprescribing trials by keyword search in six databases and snowballing. Thirty-seven of the 564 trials identified met the review eligibility criteria. Imbalanced consideration of 4Ms in the deprescribing trials was observed. Intervention design: “Medication” was considered in all trials; “Mentation” was considered in 8 trials; “Mobility” (n=2) and “What Matters” (n=6) was less often considered. By targeting providers, most of the trials lacked consideration of patient-centeredness - aligning what matters most to older adults and their families with deprescribing decision making and implementation. Sample selection: “Medication” was considered in 15 trials (e.g., samples including patients taking ≥ 5 medications or specific types of medications), whereas “Mentation” (n=6), “Mobility” (n=6) and “What Matters” (n=0) were less often considered. Outcome assessment: “Medication” was the most commonly assessed outcomes (n=33), followed by “Mobility” (n=13) and “Mentation” (n=10) outcomes, with no study examining “What Matters” outcomes. 4Ms were not purposefully considered in the intervention design, sample selection, and outcome measurement of existing deprescribing trials. Future deprescribing trials need a more balanced and complete consideration of the 4Ms in the trial design and implementation.

Management of Oral Pyogenic Granuloma: A Case Report

Granuloma pyogenicum, also referred to as a pyogenic granuloma, is a typical, acquired, benign vascular tumor that develops in tissues like the skin and mucous membranes. The correct term is lobular capillary hemangioma. Is typically brought on by a variety of stimuli, including mild local irritation, acute damage, hormonal variables, or specific types of medications. Pyogenic granuloma often do not develop when the base and the causes of it are removed. The case of pyogenic granulomas treated surgically as well as electro cautery are presented in this paper.

Association of antiherpetic medication with incident dementia in Denmark, Wales, Germany and Scotland

AbstractBackgroundSeveral epidemiological studies from Taiwan, all using the same data resource, found significant associations between herpes virus infection, antiherpetic medication and dementia. We conducted a multicenter observational cohort study using health registry data from Wales, Germany, Scotland, and Denmark to investigate potential associations between antiherpetic medication and incident dementia, and also to comprehensively investigate such associations broken down according to medication type and dose, type of herpes virus, and dementia subtype.Method2.5 million people aged 65 and older were followed up using routinely collected linked electronic health records in four separate national observational cohort studies. Exposure and outcome were classified using coded data from prescriptions and from primary and secondary care. Data were analyzed using survival analysis with time‐dependent covariates. Confounders were age, year, sex, socioeconomic status, and comorbidities.ResultResults were heterogenous across cohorts (Figure 1), with a tendency for decreased dementia risk in people exposed to antiherpetic medication (Wales: HR 0.91, 95% CI 0.86 to 0.97; Denmark: HR 0.91 (0.89 to 0.93); Germany: HR 1.08 (0.98 to 1.20); Scotland: HR 0.98 (0.64 to 1.49). Associations were not affected by number of treatments, herpes diagnosis, type of dementia, or specific type of medication. People diagnosed with herpes but not exposed to antiherpetic medication were at higher dementia risk in the German cohort (HR: 1.18; 1.09 to 1.28) but not in the Welsh cohort (HR: 0.95; 0.88 to 1.02).ConclusionResults from the four large cohorts allow us to exclude any major association of short‐term exposure to antiherpetic medication with dementia. Because neither type of dementia nor type of herpes infection modified the association, the small but significant decrease in dementia incidence with antiherpetic administration mayeflect unmeasured confounding and misclassification.

For which patient subgroups are there positive outcomes from a medication review? A systematic review.

Background:A medication review is a possibility to assess and optimise a patient’s medicine. A model that includes a medication review and a follow-up seem to provide the best results. However, it is not known whether specific subgroups of patients benefit more from a medication review than others.Objective:This literature review summarises the evidence that is available on which patient subgroups exist positive outcomes from a medication review carried out in a primary care setting.Methods:We performed a PICO analysis to identify keywords for setting, medication review and effect. We then conducted a search using the PubMed database (2004 to 2019) to identify studies relevant for our investigation. A screening process was carried out based on either title or abstract, and any study that matched the aim and inclusion criteria was included. All matching studies were obtained and read, and were included if they met predefined criteria such as study design, medication review and primary care. The studies were divided into subgroups. First, each subgroup was divided according to the studies’ own definition. Secondly, each subgroup was allocated as either risk patients if the subgroup described a specific patient subgroup or risk medication, if the subgroup was defined as using a specific type of medication. This was done after discussion in the author group.Results:28 studies from a total of 935 studies were included. Identified studies were divided into either risk patients; frail, recently discharged or multimorbid patients, or risk medication; heart medication, antithrombotic medication, blood pressure lowering medication, antidiabetic medication, anti-Parkinson medication or medication increasing the risk of falls. The subgroups identified from a medication review in primary care were defined as being frail, recently discharged from hospital or multimorbid (risk patients), or defined as patients using anticoagulant or blood pressure lowering medication (risk medication). Most of the medication reviews in the studies that showed an economic effect included at least one follow-up and were delivered by a pharmacist.Conclusions:The literature review demonstrates that medication reviews delivered by pharmacists to specific subgroups of patients are a way of optimising the economic effect of medication reviews in primary care. This is obtained by reducing health-related costs or the number of contacts with primary or secondary health care services.

Cognitive Burden of Common Non-antiretroviral Medications in HIV-Infected Women.

The aging HIV population has increased comorbidity burden and consequently non-antiretroviral medication utilization. Many non-antiretroviral medications have known neurocognitive-adverse effects ("NC-AE medications"). We assessed the cognitive effects of NC-AE medications in HIV+ and HIV- women. One thousand five hundred fifty-eight participants (1037 HIV+; mean age 46) from the Women's Interagency HIV Study completed a neuropsychological test battery between 2009 and 2011. The total number of NC-AE medications and subgroups (eg, anticholinergics) were calculated based on self-report. Generalized linear models for non-normal data were used to examine the cognitive burden of medications and factors that exacerbate these effects. HIV+ women reported taking more NC-AE medications vs. HIV- women (P < 0.05). NC-AE medication use altogether was not associated with cognitive performance. However, among NC-AE medication subgroups, anticholinergic-acting medications, but not opioids or anxiolytics/anticonvulsants, were negatively associated with performance. HIV status moderated the association between these NC-AE medication subgroups and performance (P's < 0.05). HIV-serostatus differences (HIV- < HIV+) in global, learning, fluency, and motor function were greatest among women taking >1 anticholinergic medications. HIV-serostatus differences in performance on learning and psychomotor speed were also greatest among women taking 1 or more anxiolytics/anticonvulsants and 1 or more opioids, respectively. HIV+ women have increased cognitive vulnerabilities to anticholinergic, anxiolytic/anticonvulsant, and opioid medications. Potential synergy between these medications and HIV may explain some HIV-related cognitive impairments. It may be important clinically to consider these specific types of medications as a contributor to impaired cognitive performance in HIV+ women and assess the cost/benefit of treatment dosage for underlying conditions.

Diagnosis and physical therapy evaluation of cervical radiculopathy

In Denmark, physical therapists are usually the first healthcare professionals to evaluate a patient suffering from radiating arm symptoms. A subgroup of these patients will suffer from cervical radiculopathy. Since cervical radiculopathy may respond well to certain exercises, specific types of medication and some of them will need surgery to improve. It is important to identify this subgroup. In this presentation, I will demonstrate the clinical examination procedures, and clinical reasoning, used by physical therapists in Denmark, to identify cervical radiculopathy, and to select relevant exercises for reducing symptoms, improving the patient's functional level, and to support the benign natural course of cervical radiculopathy. In terms of exercise selection, and evaluation of the individual patient's recovery, I discriminate between pain caused by a lack of space in the neural foramina, pain caused by pulling the nerve root, and pain caused by immature healing. Practical consequences and clinical use of this mechanical discrimination model will be explained.

Brain imaging biomarkers in personalizing pharmacotherapy of suicidal depressed patients

BackgroundNew knowledge has emerged about decision-making, mood regulation, social distortions and learning that is relevant for the diathesis for suicidal behavior. All four domains have identified underlying neural circuits and for decision-making and mood regulation also specific neurotransmitter systems.MethodsWe have conducted PET studies of the serotonergic system and CSF studies of the serotonin, norepinephrine and dopamine neurotransmitter systems in patients surviving suicide attempts to determine whether they have neurotransmitter abnormalities that resemble those found in the brain after suicide. We found alterations in the serotonin transporter and the 5-HT1A receptor that are similar to those seen in suicides and moreover the severity of the abnormality in 5-HT1A binding is correlated with the lethality of suicidal behavior. Other studies examining CSF levels of 5-HIAA are consistent with imaging data and extend the findings to the noradrenergic and dopaminergic systems. Finally, we will present data on use of these biomarkers to predict treatment outcome. Abnormal decision-making and mood regulation in suicidal patients is linked to abnormal brain biology and has direct implications for clinical practice in terms of selecting specific types of medication and how these may be best combined with psychotherapies.Disclosure of interestThe author has not supplied his declaration of competing interest.

Exposure to systemic antibacterial medications during pregnancy and risk of childhood cancer.

Up to one-third of women receive prescriptions for systemic antibacterial medications during pregnancy. This paper looks at the association between maternal use of systemic antibacterial medications during pregnancy and childhood cancer risk in the offspring using the prospective data on medication. A population-based follow-up study was carried out using Danish and Swedish register data. Exposure was maternal redemption of a prescription for a systemic antibacterial in the 3 months prior to pregnancy and during pregnancy (exposure window) documented in the national prescription registers, and offspring were followed up from birth to a cancer diagnosis, death, emigration, day before 15th birthday or end of follow-up, whichever came first. Timing, dosage, specific medication types and types of childhood cancer were also considered. Mothers of 35.1% (n = 506,194) of the children filled at least one prescription for systemic antibacterials during the exposure window. Exposed children had a hazard ratio of 1.08 (95% confidence interval: 0.97, 1.20) compared with unexposed children. Statistically significant results were found for some specific medications (for example, 'other antibacterials'/Anatomical Therapeutic Chemical code J01X) and combinations of cancer types and specific medications (leukaemia and other antibacterials, and hepatic cancers and tetracyclines). The results of this study indicate that most antibacterial drugs used during pregnancy were not related to childhood cancer risk in the offspring. However, some may be associated with the development of some specific types of childhood cancers. Our findings need to be replicated in an independent data source.

Type 2 diabetes mellitus: prevention of macrovascular complications

Type 2 diabetes mellitus is a disease that affects a rapidly increasing number of patients. Most patients with Type 2 diabetes will develop vascular complications. This may be microvascular disease, such as nephropathy, retinopathy or polyneuropathy, and also macrovascular disease, such as coronary heart disease, stroke or peripheral artery disease. Optimal control of elevated blood glucose levels will reduce the symptoms of hyperglycemia and help to prevent the development of complications. In addition, treatment of hypertension and lipid disturbances has been shown to reduce the incidence and severity of vascular complications significantly. The current treatment goals focus on adequate and aggressive treatment of these three risk factors. The central dogma for treatment of blood glucose, blood pressure and cholesterol levels is ‘the lower the better’. Ongoing trials evaluate the effect of further lowering these treatment goals and of specific types of medication on cardiovascular events.

Constrictive bronchiolitis obliterans: the fibrotic airway disorder

Constrictive bronchiolitis obliterans is an important respiratory illness because of its underlying irreversible fibrotic process, and is defined as concentric fibrosis in the bronchiolar submucosal layer with continual external circular scarring. The fibrotic and destructive nature of this lesion is the defining characteristic. Although patchy, the airway may become slit-like or obliterated from this fibrotic process, resulting in bronchiolitis obliterans. Constrictive bronchiolitis is limited to the bronchioles and does not extend into the alveoli. The clinical features of constrictive bronchiolitis consist of a chest radiograph that is often normal, early inspiratory crackles and irreversible airflow obstruction by pulmonary function testing. Chest CT scans show a mosaic pattern, air trapping by the expiratory film, bronchiolectasis and thickened small airway walls. Although idiopathic constrictive bronchiolitis is rare, the lesion is common among lung-transplant recipients. The lesion also occurs from certain types of toxic fumes, some of the connective tissue diseases, specific types of medications and post respiratory infection. Unusual exposures have also been described as a cause of constrictive bronchiolitis, such as consumption of the leafy vegetable Sauropus androgynus in far eastern Asia and from inhaling diacetyl, the ketone butter flavoring used in microwave popcorn production. Empirical treatment consists of corticosteroid and immunosuppressive agents. Antifibrotic agents may be successful in the future. This is generally a nonsteroid-responsive lesion and for disabling disease, lung transplantation can be a successful option.

Reflux symptoms are associated with psychiatric disease

To evaluate the frequency of reflux symptoms in patients with a diagnosed psychiatric disorder and to assess potential risk factors for symptom occurrence. The presence of reflux symptoms was compared between a case population of 94 psychiatric patients and a control population of 198 non-psychiatric patients. Heartburn, exercise-induced heartburn, cough and dysphagia were all reported significantly more frequently by subjects with psychiatric disorders than by control subjects. The presence of any psychiatric diagnosis exerted an increased risk for both heartburn (odds ratio, 2.71; 95% confidence interval, 1.01-7.30) and exercise-induced heartburn (3.34; 1.12-9.96). The type of psychiatric disorder, the type of psychotropic medication and the lifestyle did not influence the presence of reflux symptoms. Reflux symptoms occur more frequently in patients with than without a diagnosed psychiatric disorder. The reflux symptoms are not associated with any specific type of medication and may reflect a generally reduced threshold for or distorted perception of symptoms.

Oncologic pharmacology: selected topics for critical care nurses.

Administration of multiple and complex medications is common in the intensive care setting, but the response of a patient with cancer to medications and the specific types of medications is a unique specialty practice. In this article, the author provides the experienced critical care nurse with a condensed overview of the most important nursing issues in pharmacologic therapy for patients with cancer. There is a discussion of physiologic variables that influence how patients with cancer respond to pharmaceutical agents. This is followed with detailed information about cancer chemotherapy, biotherapy, and antiemetic practices.