Use Of Injectable Medications Research Articles

Determinants of vaccine adherence among non-dialysis chronic kidney disease patients in Qatar.

Chronic kidney disease (CKD) is a global health problem. Reduced innate and adaptive immunological responses predispose CKD patients to infections. Despite the clinical and epidemiological importance of CKD and the great value of vaccination as a prophylactic measure, the utilization of recommended vaccines in Qatar has not yet been evaluated. We conducted a cross-sectional study to estimate the level of influenza, pneumococcal, and hepatitis B vaccination and the predictors of adherence to these recommended vaccines among non-dialysis CKD patients receiving renal ambulatory care in Qatar from 1 September 2020 to 30 April 2021. Complete vaccination was defined as receiving the three vaccines, and partial vaccination was defined as receiving one or two vaccines. The full and partial vaccination predictors were assessed using multivariate logistic regression and reported as odds ratio (OR) with p<0.05 indicating statistical significance. 416 non-dialysis CKD patients were included in our analysis. 73% were males; the mean age was 56 ± 15 years. More than 50% of the patients were from the Middle East, followed by 36% from Asia. Most patients had concurrent hypertension, concurrent diabetes mellitus, and were stage V CKD. Only 12% of the patients were fully vaccinated, while 73% received partial vaccination. The predictors of vaccination included age, gender, Asian origin, employment, living conditions, concurrent medical conditions, CKD stage, allergy to medications, and use of injectable medications. Only stage V CKD positively predicted adherence to full and partial vaccinations in non-dialysis CKD patients. There is very low adherence to the recommended vaccines in CKD patients, with a prevalence of complete vaccination of 12% only. Increased public awareness about the importance of vaccination in CKD may improve the adherence rates among these patients in Qatar.

A population-based study of self-reported adverse drug events among Lebanese outpatients

There is a limited number of studies assessing the epidemiology of Adverse Drug Events (ADEs) in the outpatient setting, especially those that do not result in healthcare use. The primary objective of this study was to assess the prevalence and determinants of self-reported ADEs among Lebanese outpatients. It was a cross-sectional observational study performed among Lebanese outpatients visiting community pharmacies across Lebanon. A questionnaire was designed to elicit patients’ relevant information. The association between categorical variables were evaluated using Pearson χ2 test or Fisher's exact test. Binary logistic regression was performed to identify factors that affect the experience of self-reported ADEs. The study comprised 3148 patients. Around 37% of patients reported experiencing an ADE in the previous year. When ADEs occur, 70.5% of the respondents reported informing their physicians. Increasing number of medications per patient, use of injectable medication, and inquiring about potential drug-drug interactions were associated with higher experience of ADEs (p = 0.049; p = 0.003; and p = 0.009 respectively). Patients who received hospital discharge counseling reported experiencing less ADEs (p = 0.002). Our study showed prevalence of ADEs among Lebanese outpatients especially patients with polypharmacy, and highlighted the need to educate patients about the importance of reporting ADEs to their physicians.

Injectable Ketorolac and Corticosteroid Use in Athletes: A Systematic Review.

The use of injectable medications to help athletes quickly return to the field of play after injury is common. Understanding the effects and risks of these medications will help providers make informed decisions regarding their use in this patient population. To evaluate the utilization, efficacy, and adverse effects of injectable ketorolac and corticosteroids in athletes. This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic search of the literature was performed using multiple databases (PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov). Secondary references were appraised for relevant articles. No randomized controlled trials or other prospective studies were identified. Articles included retrospective database reviews and physician survey studies. A total of 6 studies met the inclusion and exclusion criteria and were reviewed by 2 independent reviewers with a third consulted in the case of disagreement, which was not needed. Systematic review. Level 5. Two reviewers recorded rate of use, effectiveness of treatment, and reported side effect data. Most studies centered around the football athlete, either professional or collegiate. Professional football game day use of intramuscular ketorolac declined from 93.3% (28/30) in 2002 to 48% in 2016. Collegiate football game day use of intramuscular ketorolac declined from 62% in 2008 to 26% in 2016. Game day corticosteroid injection was far lower than ketorolac usage. Both medications were reported to be effective with few adverse events. Use of injectable ketorolac is common but declining in professional and college football. Pain control efficacy is good, and risk of adverse events is low. The incidence of injectable corticosteroid use in athletes is unknown. Use of injectable corticosteroids in athletes allows for early return to sport activities with no reported complications.

Efficacy and safety of chloral hydrate sedation in infants for pulmonary function tests

ObjectiveTo describe the efficacy and safety of chloral hydrate sedation in infants for pulmonary function tests. MethodsAll sedation attempts for pulmonary function tests in infants carried out between June 2007 and August 2014 were evaluated. Obstructive sleep apnea and heart disease were contraindications to the exams. Anthropometric data, exam indication, used dose, outcomes of sedation and clinical events were recorded and described. ResultsThe sedation attempts in 277 infants (165 boys) with a median age of 51.5 weeks of life (14–182 weeks) were evaluated. The main indication for the tests was recurrent wheezing (56%) and the chloral hydrate dose ranged from 50 to 80mg/kg (orally). Eighteen (6.5%) infants had some type of clinical complication, with the most frequent being cough and/or airway secretion (1.8%); respiratory distress (1.4%) and vomiting (1.1%). A preterm infant had bradycardia for approximately 15 minutes, which was responsive to tactile stimulation. All observed adverse effects were transient and there was no need for resuscitation or use of injectable medications. ConclusionsThe data demonstrated that chloral hydrate at the employed doses is a safe and effective medicament for sedation during short procedures in infants, such as pulmonary function tests. Because of the possibility of severe adverse events, recommendations on doses and contraindications should be strictly followed and infants should be monitored by trained staff.

Epidemiology of hepatitis B virus in the cities of the northern region of Espírito Santo, Brazil

The World Health Organization (WHO) estimates that approximately 2 billion people worldwide have already had contact with hepatitis B virus (HBV) and 373 million have become chronic carriers. Hepatitis B is a major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma, leading to a large number of deaths annually. Both viral factors and the host immune response have been implicated in the pathogenesis and clinical result of HBV infection. Many Brazilian cities, including the cities of the northern region of the state of Espírito Santo are located in regions with little health infrastructure. Our study performed an epidemiological analysis of cases of Hepatitis B in São Mateus, using methodology of Geographic Information System (GIS), aiming to raise the number of disease cases, establishing preventive measures to control the disease, improving the quality of life of people affected by this pathology. The city of São Mateus had the largest number of reported cases of hepatitis B northern region of Espírito Santo. The age group with the highest number of hepatitis B notifications was 20-49 years, mostly females. The major forms of contact with HBV in these cities were dental treatment, use of injectable medications, surgical procedures and multiple sexual partners.

Antipsychotic prescribing and its correlates in New Zealand.

Antipsychotics are the cornerstone of schizophrenia management. There is substantial literature on their efficacy and optimal use. Doubts remain, however, regarding the translation of this knowledge into day-to-day practice. This study aimed to investigate antipsychotic prescribing in three New Zealand regions and its relationship to clinical guidelines and patient characteristics. We studied 451 patients discharged from inpatient units with a diagnosis of schizophrenia or a related disorder (International Classification of Disease, version 10) between July 2009 and December 2011. Available information included patient demography, legal status, prescribed medications, duration of index admission and prescriber's country of postgraduate training and years of postgraduate experience. There was a high rate (33.7%) of multiple antipsychotic prescription, and lower than expected clozapine use (20%); Maori were prescribed clozapine more frequently than non-Maori (24% vs. 13%, respectively). Compulsory treatment was associated with more use of injectable medication and increased length of stay in hospital. Clinician characteristics did not significantly influence prescribing. Observed prescribing practice aligned with existing guidelines except for antipsychotic polypharmacy and clozapine under-utilisation.

Eficácia e segurança do hidrato de cloral na sedação de lactentes para testes de função pulmonar

ObjectiveTo describe the efficacy and safety of chloral hydrate sedation in infants for pulmonary function tests. MethodsAll sedation attempts for pulmonary function tests in infants carried out between June 2007 and August 2014 were evaluated. Obstructive sleep apnea and heart disease were contraindications to the exams. Anthropometric data, exam indication, used dose, outcomes of sedation and clinical events were recorded and described. ResultsThe sedation attempts in 277 infants (165 boys) with a median age of 51.5 weeks of life (14 to 182 weeks) were evaluated. The main indication for the tests was recurrent wheezing (56%) and the chloral hydrate dose ranged from 50 to 80mg/kg (orally). Eighteen (6.5%) infants had some type of clinical complication, with the most frequent being cough and/or airway secretion (1.8%); respiratory distress (1.4%) and vomiting (1.1%). A preterm infant had bradycardia for approximately 15 minutes, which was responsive to tactile stimulation. All observed adverse effects were transient and there was no need for resuscitation or use of injectable medications. ConclusionsThe data demonstrated that chloral hydrate at the employed doses is a safe and effective medicament for sedation during short procedures in infants, such as pulmonary function tests. Because of the possibility of severe adverse events, recommendations on doses and contraindications should be strictly followed and infants should be monitored by trained staff.

Accuracy of self-reported survey data on assisted reproductive technology treatment parameters and reproductive history

It is unknown whether data obtained from maternal self-report for assisted reproductive technology treatment parameters and reproductive history are accurate for use in research studies. We evaluated the accuracy of self-reported in assisted reproductive technology treatment and reproductive history from the UpstateKIDS study in comparison with clinical data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Upstate KIDS maternal questionnaire data from deliveries between 2008 and 2010 were linked to data reported to Society for Assisted Reproductive Technology Clinic Outcome Reporting System. The 617 index deliveries were compared as to treatment type (frozen embryo transfer and donor egg or sperm) and use of intracytoplasmic sperm injection and assisted hatching. Use of injectable medications, self-report for assisted reproductive technology, or frozen embryo transfer prior to the index deliveries were also compared. We report agreement in which both sources had yes or both no and sensitivity of maternal report using Society for Assisted Reproductive Technology Clinic Outcome Reporting System as the gold standard. Significance was determined using χ(2) at P < 0.05. Universal agreement was not reached on any parameter but was best for treatment type of frozen embryo transfer (agreement, 96%; sensitivity, 93%) and use of donor eggs (agreement, 97%; sensitivity, 82%) or sperm (agreement, 98%; sensitivity, 82%). Use of intracytoplasmic sperm injection (agreement, 78%: sensitivity, 78%) and assisted hatching (agreement, 57%; sensitivity, 38%) agreed less well with self-reported use (P < .0001). Invitro fertilization (agreement, 82%) and frozen embryo transfer (agreement, 90%) prior to the index delivery were more consistently reported than was use of injectable medication (agreement, 76%) (P < .0001). Women accurately report invitro fertilization treatment but are less accurate about procedures handled in the laboratory (intracytoplasmic sperm injection or assisted hatching). Clinics might better communicate with patients on the use of these procedures, and researchers should use caution when using self-reported treatment data.

Has dialysis payment reform led to initial racial disparities in anemia and mineral metabolism management?

Implementation of the Medicare ESRD prospective payment system (PPS) and changes to dosing guidelines for erythropoiesis-stimulating agents (ESAs) in 2011 appear to have influenced use of injectable medications among dialysis patients. Given historically higher ESA and vitamin D use among black patients, we assessed the effect of these policy changes on racial disparities in the management of anemia and mineral metabolism. Analyses used cross-sectional monthly cohorts for a period-prevalent sample of 7384 maintenance hemodialysis patients at 132 facilities from the Dialysis Outcomes and Practice Patterns Study (DOPPS) Practice Monitor. Linear splines with knots at each policy change were used in survey-weighted regressions to estimate time trends in hemoglobin (Hgb), erythropoietin (EPO) dose, intravenous (IV) iron dose, ferritin, transferrin saturation (TSAT) concentration, parathyroid hormone (PTH), IV vitamin D dose, cinacalcet use, and phosphate binder use. From August 2010 to December 2011, mean Hgb declined from 11.5 to 11.0 g/dl (P<0.001), mean EPO dose declined from 20,506 to 14,777 U/wk (P<0.001), and mean serum PTH increased from 340 to 435 pg/ml (P<0.001). No meaningful differences by race were observed regarding the rates of change of management practices or laboratory measures (all P>0.21). Mean EPO and vitamin D dose and serum PTH levels remained higher in blacks. Despite evidence that anemia and mineral metabolism management practices have changed significantly over time, there was no immediate indication of racial disparities resulting from implementation of the PPS or ESA label change. Further studies are needed to examine effects among patient and facility subgroups.

Practical strategies for improving adherence to medication and outcomes

Practical strategies for improving adherence to medication and outcomes

1518 – Demographic and epidemiological profile of outpatients with mental disorders on depot medication in a mental health teaching hospital clinic of marilia/sp/brazil

Schizophrenia is the most severe mental disorder that may affect the individual. Among the proposed treatments it is included the use of medication for symptom control in addition to other therapies and psychoeducation. Often, individuals with schizophrenia suffer numerous hospitalizations when not adhering to the treatment proposed, in these cases depot antipsychotic injections are indicated. The objective of this study was to investigate the demographic and epidemiological profile of outpatients taking antipsychotic injections in a mental health clinic of a teaching hospital in Mar¡lia - SP, Brazil. It is a documentary research with a quantitative approach approved by the Ethics Committee in Research of the institution studied. It was observed that most of these individuals are male, young, white, education level less than 8 years, Catholic, single, unemployed. The drug of choice for treating most of these individuals was the haloperidol decanoate, and only one of the 26 patients studied showed extrapyramidal symptoms, who was also treated with biperiden injections. After the introduction of the treatment with depot medication there was a decrease in the number of rehospitalizations, shorter hospitalizations and bigger spacing between one hospitalization and another after the use of injectable medication. We conclude that these changes provide positive consequences for the patient, family and health sector in the country.

P-629 - Demographic and epidemiological profile of people with psychiatric disorder on medication to deposit an outpatient psychiatry

Schizophrenia is a severe mental disorder that may affect the individual. Among the proposed treatments include the use of medication for symptom control in addition to other therapies and psychoeducation. Often, individuals with schizophrenia suffer numerous hospital when not adhering to treatment proposed, and used the injectable depot antipsychotics to control symptoms. The objective of this study was to investigate the demographic and epidemiological profile of people taking antipsychotics injecting a mental health outpatient clinic in Marilia/Brazil. It is a documental research with a quantitative approach approved by the Ethics Committee in Research of the institution studied. It was observed that most of these individuals are male, young, white, education level less than 8 years, Catholic, single, unemployed. The drug of choice for treating most of these individuals was the haloperidol decanoate, and of the 28 patients studied only one individual showed signs of impregnation, the treatment being relocated with the introduction of biperiden. After the introduction of treatment with depot medication was noted decrease in the number of hospital admissions, decreased length of stay in hospital and increased time between one hospital and another after the use of injectable medication. We conclude that these changes entail positive consequences for the patient, family and health sector in the country.

P-1303 - Demographic and epidemiological profile of people with psychiatric disorder on medication to deposit an outpatient psychiatry

Schizophrenia is a severe mental disorder that may affect the individual. Among the proposed treatments include the use of medication for symptom control in addition to other therapies and psychoeducation. Often, individuals with schizophrenia suffer numerous hospital when not adhering to treatment proposed, and used the injectable depot antipsychotics to control symptoms. The objective of this study was to investigate the demographic and epidemiological profile of people taking antipsychotics injecting a mental health outpatient clinic in Marília / Brazil. It is a documental research with a quantitative approach approved by the Ethics Committee in Research of the institution studied. It was observed that most of these individuals are male, young, white, education level less than 8 years, Catholic, single, unemployed. The drug of choice for treating most of these individuals was the haloperidol decanoate, and of the 28 patients studied only one individual showed signs of impregnation, the treatment being relocated with the introduction of biperiden. After the introduction of treatment with depot medication was noted decrease in the number of hospital admissions, decreased length of stay in hospital and increased time between one hospital and another after the use of injectable medication. We conclude that these changes entail positive consequences for the patient, family and health sector in the country.

Pegaptanib octasodium for the treatment of diabetic macular edema

Introduction: The treatment of diabetic macular edema has evolved into the common use of injectable medications that block the pathogenic pathways that lead to vascular exudation, the most important of which is vascular endothelial growth factor (VEGF). Pegaptanib is an important medication that has been used clinically in the treatment of diabetic macular edema.Areas covered: A literature search was done on Medline using the terms ‘diabetic macular edema’, ‘diabetic retinopathy’, ‘vascular endothelial growth factor’ and ‘pegaptanib’. The relevant papers and citations were then reviewed.Expert opinion: Diabetic macular edema is the most common cause of visual loss in working-age people. Thus it is important to identify treatments that will allow a more prompt and complete improvement of visual function. Pegaptanib has many advantages in the treatment of diabetic macular edema. It may be more effective than laser therapy alone for center-involving edema and may have a better safety profile than pan-VEGF blocking agents.

Epidemiology of Hepatitis C Virus in Bangladeshi General Population

Background: Hepatitis C virus is encountered sporadically in Bangladesh. It results in a wide range liver diseases, with asymptomatic acute hepatitis rarely at one end to HCC at the other end of the spectrum. Methods: 1018 individuals of different age groups and sex with varied religious, educational and social backgrounds were tested for anti-HCV by ELISA. Before testing, blood samples were preserved at -20°C. The study was conducted in a semi-urban location on the outskirts of Dhaka. Results: 0.88% tested positive for anti HCV. None of them tested positive for HBsAg. There was a male predominance and those who tested positive were mostly between 17 and 50 years of age. Major risk factors for exposure to HBV appeared to be injudicious use of injectable medications, treatment by unqualified, traditional practitioners, mass-vaccination against cholera and smallpox, barbers and body piercing. Conclusion: HCV remains an important cause of morbidity and mortality in Bangladesh. Key words: HCV; prevalence; general population; Bangladesh. DOI: 10.3329/bsmmuj.v2i1.3705 BSMMU J 2009; 2(1): 14-17

Injections and return to play

The use of analgesic and anti-inflammatory injections in athletics has a long and sometimes controversial history. They have been and will continue to be utilized to decrease inflammation and pain, improve healing time, and ultimately decrease the amount of time missed from sports competition. Several authors have evaluated both the positive and negative aspects of various injectable medicines. Many questions still remain with regard to safety, tolerability, risks, complications, and side effects of these injectable medicines. This paper reviews some of the current trends regarding the use of injectable medications in athletic medicine.

Injections and return to play

The use of analgesic and anti-inflammatory injections in athletics has a long and sometimes controversial history. They have been and will continue to be utilized to decrease inflammation and pain, improve healing time, and ultimately decrease the amount of time missed from sports competition. Several authors have evaluated both the positive and negative aspects of various injectable medicines. Many questions still remain with regard to safety, tolerability, risks, complications, and side effects of these injectable medicines. This paper reviews some of the current trends regarding the use of injectable medications in athletic medicine.

Home medication injection among Latina women in Los Angeles: Implications for health education and prevention

Reuse of needles and syringes after home injection of medications and vitamins may be a risk for transmission of HIV. An exploratory study was done to determine (1) how commonly injectable medications were used in the home; (2) whether needles and syringes were reused; and (3) common practices for cleaning needles and syringes. A survey was conducted of low income Latina women (n = 216) who were attending a Public Health Foundation nutrition programme for women, infants and children (WIC) in Los Angeles. To clarify and expand on the survey findings, focus group interviews were done with an additional 55 women attending WIC. Quantitative data were analysed using descriptive and comparative statistics. Qualitative data were subjected to content analysis. The use of injectable medications purchased in Mexico was fairly common (43.5%); reuse of disposable needles and syringes (48%) and sharing (36%) among injectors were also common. Methods of cleaning needles and syringes were inadequate to CDC recommended guidelines. Injectors and non-injectors differed significantly in ethnicity, religion, and marital status. The only significant predictor of medication injection was educational level. Analysis of qualitative data revealed the reasons that Latina subjects were injecting medication; how they were transporting medicines from Mexico; and how they were cleaning their equipment. The practical implications for health education and prevention programmes should include an awareness that home use and reuse of needles for injection of medications may be common in some social groups and that knowledge of the potential dangers in reuse and sharing of needles may not extend to home medication injection.