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Prescribing Pattern of Analgesic Drugs at Boru Meda Hospital, North East, Amhara, Ethiopia

Pain Studies and Treatment 2017年第4期5卷 37-43页

作者： Abebaw Tegegne Wondesen Gashaw Dawit Kidane Pharmacy Department Dessie Health Science College Amhara Ethiopia Pharmacy Department Boru Meda Primary Hospital Amhara Ethiopia Boru Meda Primary Hospital Amhara Ethiopia

Introduction: Pain is the sensory and emotional experience, which altered human health and well-being. When pain does not resolve, it may be associated with a serious disease, condition, or injury that needs timely medical care and also irrational prescribing of analgesics, which is possible to lead to unwanted side effects. Therefore, this study has been intended to evaluate the prescribing pattern of analgesics drugs at Boru Meda Hospital. Method: A retrospective cross sectional descriptive study was conducted. A total of 200 prescriptions containing analgesic were systematically collected by using well designed and pretested Data collection format. The necessary information was extracted from the prescription sheets by trained pharmacists and later analyzed using SPSS version 20 software. Result: Regarding prescribed analgesic acetaminophen 115 (36.9%) was the most prescribed, and then followed diclofenac 83 (26.6%) and Ibuprofen 64 (20.5%). The maximum number of analgesic drugs was administered to patients by oral rout (75%), which is followed by parenteral (19%). About dosing approach 94% acetaminophen prescribed as needed (PRN) based, whereas ibuprofen 59.4% and tramadol 40% were prescribed as twice a day (bid) based. Acute fibril illness (13.6%) was the highest reason for prescribing analgesics. Conclusion: Majority of the prescription analgesics drugs were prescribed as PRN dosing approaches with a very large percentage of oral medications. Some of the prescriptions revealed irrational prescribing of analgesics, in accordance of clinical indication, frequency of administration and combination of analgesic.

关键词： analgesics Boru Meda Hospital Opioids NSAIDS

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Importance of Pharmacotherapeutic Follow-Up in Odontopediatrics

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Open Journal of Stomatology 2021年第1期11卷 1-13页

作者： Cristina Janeth Montañez-Sosa César Gaitán-Fonseca María Argelia López-Luna Carlos Bermúdez-Jiménez Jesús Luego-Ferreira Silverio Frausto-Esparza Luis Alejandro Aguilera-Galavíz Especialidad de Odontopediatría (CLIO) de la Unidad Académica de Odontología Universidad Autónoma de Zacatecas (UAO/UAZ) Zacatecas Mexico Unidad Académica de Ciencias Químicas-QFB Universidad Autónoma de Zacatecas Zacatecas Mexico

The most common cause of admission to the Pediatric Dentistry service is dental pain, active deafness and an oppressive sensation that is sometimes throbbing and burning. Pharmacotherapy in Pediatric Dentistry must be effective, safe, and rational in neonates, infants, and children. The pharmacotherapeutic follow-up of pediatric patients from Integral Clinic of the Odontopediatric Specialty (CLIO) and Kindergarten Clinic (CLIJANI), Autonomous University of Zacatecas (UAZ) was carried out. Through an observational, exploratory, and cross-sectional study, 23 patients from the Pediatric Dentistry Specialty Clinic (CLIO/UAO/UAZ) and 35 clinical records of patients from CLIJANI, from August 2019-2020, were analyzed. Prior authorization for the patient, an interview, and pharmacotherapeutic follow-up were performed, recording data on the indicated drug, the dose, and the schedule of use. On carrying out the interview on pharmacotherapy with the parents or guardians who accompany the patient, 91.3% of the pediatric patients were not administered pharmacological treatment. It was observed that there is no adequate adherence to the pharmacological treatment in pediatric patients.

关键词： Tooth Pain analgesics Antimicrobial Therapy

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Perioperative Local Cooling Reduce Significantly Early Pain after Open Inguinal Hernia Repair:A Prospective Randomized Study

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Pain Studies and Treatment 2014年第3期2卷 113-120页

作者： Gerard Champault Luca Paolino Antonio Valenti Christophe Barrat Department of Digestive and Metabolic Surgery Hopital Jean VerdierBondyFrance Pole de Coeliochirurgie Hopital Joseph DucuingToulouseFrance

Pain and local complications are the major determinants of outcome after inguinal hernia repair. To evaluate the respective impact of peri-operative cooling of surgical site and usual care after open inguinal hernia repair, we performed a prospective randomized study. Methods: One hundred and eight consecutive patients with primary unilateral inguinal hernia were included the study. Repair was performed by local direct access during ambulatory surgery. The first study group underwent standard pre- and postoperative local care (control group). In the second group (cold compress group), a single-use disposable sterile cold compress was applied on the surgical site for at least 30 minutes before and 2 hours after surgery. Primary endpoints were immediate postoperative pain using a visual analogue scale, and local complications. Secondary endpoints included: analgesic drug consumption, length of hospital stay, delay to return to normal activity and patient satisfaction. Results: There was no difference concerning operative time (36.3 ± 14.0 vs 39.6 ± 7.2 minutes) and early (one-week) complications, although there was a non significant reduced incidence of hematoma and ecchymosis (0/54 versus 4/54) for the cold compress group. Analgesic drug consumption was significantly (p = 0.01) reduced. During the day of surgery and the first postoperative day, the visual analogue scale was significantly lower after cooling. There was a non-significant reduction in length of hospital stay (150 ± 37 versus 210 ± 47 min), and time to return to normal activity was shorter in the cold compress group. Conclusion: For open inguinal hernia repair, immediate pre- and post operative surgical site cooling, targeting a controlled temperature between 12?C and 15?C significantly reduced postoperative pain, analgesic drug consumption and resulted in improved immediate outcomes. This technique is safe, simple, easy to use, inexpensive and well tolerated by the patient.

关键词： Inguinal Hernia Repair Cooling Ambulatory Surgery Pain analgesics

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Should Propofol and Alfentanil Be Combined in Patient-Controlled Sedation? A Randomised Controlled Trial Using Pharmacokinetic Simulation

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Open Journal of Anesthesiology 2015年第6期5卷 122-129页

作者： Andreas Nilsson Lena Nilsson Thomas Schnider Eva Uustal Folke Sjoberg Department of Medical and Health Sciences Linkoping UniversityLinkopingSweden Department of Anesthesiology and Intensive Care County Council of OstergotlandLinkopingSweden Institute of Anaesthesiology Kantonsspital St.GallenSt.GallenSwitzerland Departmentof Obstetrics and Gynecology Linkoping UniversityLinkopingSweden Department of Clinical and Experimental Medicine Linkoping UniversityLinkopingSweden

Background: Patient-controlled sedation (PCS) is increasingly used for moderate sedation. Detailed understanding is essential for maintaining safety and giving the most benefit. We wanted to explore the associations between patients’ characteristics, perioperative pain and anxiety, the procedure, and the calculated concentrations at the effect site (Ce) of propofol. We also wanted to analyse the pharmacokinetic profiles of propofol and alfentanil during PCS, and their association with respiratory complications. Methods: 155 patients were double-blinded and randomised to have propofol or propofol and alfentanil for PCS during gynaecological surgery. Pharmacokinetic simulation of Ce and multiple regressions aided the search for correlations between explanatory variables and concentrations of drugs. Results: In group propofol, treatment for incontinence, anterior repair, and the patient’s weight correlated the best (B-coef = 0.20, 0.20 and 0.01;r = 0.69;r² = 0.48). When alfentanil was added, alfentanil and the patient’s weight were associated with Ce of propofol (B-coef = ǂ.40 and 0.01;r = 0.70;r² = 0.43). Logistic regression indicated that age and Ce of drugs were related to ten cases of respiratory complications. Conclusions: Patients’ weights and the type of surgery performed were associated with the Ce of propofol;this knowledge could be used for refinement of the doses given during PCS. Because the pharmacokinetic profiles of propofol and alfentanil are different, the alfentanil effect becomes predominant during the time course of sedation. In order to reduce the risk of early and late respiratory depression, alfentanil should not be added to propofol in the same syringe.

关键词： Anaesthetics Intravenous Propofol analgesics Opioids Alfentanil Sedation

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Regional anesthesia for acute pain management in elderly patients

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World Journal of Anesthesiology 2014年第1期3卷 82-95页

作者： Jinlei Li Thomas M Halaszynski Department of Anesthesiology Yale University School of Medicine and Yale-New Haven Hospital New Haven CT 06520-8051United States

Normal aging is a process that involves loss of functional reserve of most organ systems of the human body, most significantly: cardiovascular, pulmonary, renal and nervous systems. Advancements in both surgery and anesthesia have made it possible to operate more safely on the elderly population and those older patients with multiple severe co-morbidities that were not routinely possible in the recent past. Regional anesthesiologist have proven to be instrumental in this regard as regional anesthetic/analgesic techniques may now permit surgeons to operate on the elderly who were not ideal surgical candidates or unable to tolerate general anesthesia. In addition, regional techniques provide alternatives that may optimize acute pain control and reduce the incidence of devastating side effects during the perioperative period such as: myocardial infarction, pulmonary embolism, pneumonia, and also increases the opportunity to allow for early ambulation and shorter hospital stays. These anesthetic options now provide the elderly patient with better medical care alternatives, but also can show a significant financial impact on health care system resources. Further understanding on aging molecular biology, physiology and pathophysiology, together with technical improvements of regional anesthetic techniques will continue to make it safer and more efficacious to operate on the elderly population with evidence of reduced morbidity and mortality. Although there is only anecdotal evidence that regional anesthesia(RA) improves survival, there is little doubt that RA plays an important role in perioperative optimization of pain control and decreases pain management complications as well as a reduction in healthcare costs. Beyond traditional operating rooms, elderly patients may increasingly benefit from RA and acute pain management in Emergency Rooms, medical clinics and even within a patient's home. Therefore, the focus of this review is directed toward geriatric patients and beneficial effects of RA on outcomes in the elderl

关键词： Regional anesthesia Elderly patients Pain management Local anesthetics Opioid analgesics Multi-modal Cognitive impairment Organ systems Procedure-and patient-specific

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Pain Management in a Parturient with Presacral Mass

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Open Journal of Anesthesiology 2017年第11期7卷 364-370页

作者： Tan Yan Ru John Paul Lew Ong Yee Yian Antonia Zeng Singapore General Hospital Singapore Singapore

Presacral masses are rare lesions and due to obscure anatomic location and etiological heterogeneity, they pose a diagnostic and therapeutic challenge. Literature is limited on the pain management of a parturient with presacral mass. We describe here a parturient in her second trimester with severe pain from a presacral mass. A high clinical acumen with early multidisciplinary involvement are needed to establish a diagnosis and provide treatment options for the well-being of the patient, minimize fetal teratogenicity, avoid chronic symptoms and long-term disability.

关键词： Presacral Mass Pregnancy Pain Management analgesics

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Characterization of Veterans’ Poisoning Events in the State of Florida

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Occupational Diseases and Environmental Medicine 2015年第2期3卷 17-23页

作者： G. T. Johnson J. White C. Younger P. Xu A. Abrittis U. Desai S. Morris R. D. Harbison Center for Environmental and Occupational Risk Analysis and Management University of South Florida Tampa USA Florida Poison Control Information Network Tampa USA College of Nursing University of South Florida Tampa USA

Increasing numbers of veterans are returning home with chronic pain and mental health disorders. Pharmacological treatments may be effective, but may also be increasing the incidence of poisonings among younger as well as older veterans, requiring greater resource expenditures at Veterans Administration (VA) facilities. Our objective was to characterize patterns of the poisoning among the veterans in Florida, using data obtained from the Florida Poisoning Control Information Network (FPCIN). We evaluated retrospective cohort data from 2005 to 2009 of 601 poisoning cases treated at Florida VA medical facilities with consultations from FPCIN. Intentional (suspected suicide) was the most common reason. Major adverse clinical outcomes were associated with the use of NSAIDs or alcohol. Antidepressants and anti-anxiolytics had the strongest association with intentional self-poisoning. Since medications are the major substances for the poisoning among the veterans, our study suggests that pharmaceutical treatments of veterans should include stronger prescribing guidelines and consideration of alternative therapies.

关键词： Poison Veterans FPCIN Suicide Opioids Opioid analgesics Antidepressants Chronic Pain PTSD TBI OIF OEF

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Opioid misuse in Canada and critical appraisal of aberrant behavior screening tools

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World Journal of Anesthesiology 2014年第1期3卷 61-70页

作者： Grace EC Frankel Howard Intrater Malcolm Doupe Michael Namaka Faculty of Pharmacy University of ManitobaManitoba R3E 0T5Canada

The incidence of prescription opioid misuse in Canada is increasing. Initiatives for safe prescribing practices for opioid medications include risk assessment for current and future opioid misuse. A clinical screening tool that can be universally applied to all patient populations is currently not available. Our objective was to provide a brief narrative review on opioid misuse from a Canadian perspective as well as a critical appraisal of the available clinical screening tools for detecting aberrant behaviors associated with opioid misuse. The Drug Abuse Screening Test, Addiction Behaviors Checklist, Diagnosis, Intractability, Risk and Efficacy Inventory, Pain Assessment and Documentation Tool, Prescription Drug Use Questionnaire, Prescription Opioid therapy Questionnaire, Screener and Opioid Assessment for Patients with Pain(SOAPP), Revised SOAPP, Pain Medication Questionnaire, Opioid Risk Tool and Current Opioid Misuse Measure were included in the following review. Overall, a wide variability in quality, sensitivity and specificity was observed between screening tools. There is an overall lack of applicability to diverse patient populations as the majority of screening tools have been validated in pain clinic populations only. To conclude, there is a great need for a validated and convenient aberrant behaviors risk assessment tool that can be applied to a diverse patient population in a clinical setting.

关键词： Opioid analgesics Opioid-related disorders Prescription drug misuse Risk assessment Drug-seeking behavior Canada

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Improved Hemodynamics with the Use of Prophylactic Infusion of Epinephrine and/or Norepinephrine during Transcatheter Aortic Valve Replacement (TAVR)

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Open Journal of Anesthesiology 2015年第6期5卷 130-134页

作者： Walter Bethune Steven Konstadt Giuseppe Trunfio Lynn Belliveau Mark Kronenfeld Charles Keilin Dennis E. Feierman Department of Anesthesiology Maimonides Medical Center Brooklyn USA

Background: Transcatheter Aortic Valve Replacement (TAVR) is a new minimally-invasive surgical procedure in which a bioprosthetic aortic valve is placed via a small skin incision in the groin, over either the left or right iliac artery. TAVR was recently approved by the FDA as a treatment option for aortic stenosis in patients who may be too frail to undergo open heart surgery. Anesthetic management of TAVR is complicated by the fact that rapid left ventricular pacing (to at least 180 beats per minute) is required at multiple points throughout the procedure. Aim: This rapid pacing creates a profound pathophysiologic stress on the heart, sometimes leading to severe left ventricular dysfunction and resultant complete hemodynamic collapse. We report that the use of prophylactic infusion of epinephrine and/or norepinephrine in patients undergoing TAVR results in improved recovery from rapid pacing as reflected by intraoperative trends in systolic systemic blood pressure and systolic pulmonary arterial pressure. Cases: Here we report three cases. During the first of these, we reacted to intraoperative hemodynamic changes by administering boluses of vasoactive medications as needed. During the other two cases, we preemptively infused vasopressors to facilitate a more rapid recovery from some of the hemodynamic disturbance associated with either TAVR or rapid pacing. Conclusion: The two patients in this series who were managed with a preemptive strategy had higher ratios of systemic systolic blood pressure to pulmonary arterial systolic blood pressure at the end of the case than did the patient who was managed reactively. This suggests that the preemptive strategy may lead to decreased left ventricular impairment and improved overall cardiac function after TAVR.

关键词： Anaesthetics Intravenous Propofol analgesics Opioids Alfentanil Sedation

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Total synthesis and determination of the absolute configuration of a natural analgesic: crotonine

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Natural Products and Bioprospecting 2013年第6期3卷 288-294页

作者： Yang YANG State Key Laboratory of Phytochemistry and Plant Resources in West China Kunming Institute of BotanyChinese Academy of SciencesKunming 650201China Graduate University of Chinese Academy of Sciences Beijing 100049China

We report the first total synthesis of four possible absolute configurations and four other regional isomers of a naturally occurring alkaloid crotonine,which was isolated from Croton tiglium L.(Euphoriaceae)without elucidation of its absolute configuration.The concise five-step route with a chirally poor and regioselective strategy starting from monosaccharides was established,and the absolute structure of the natural crotonine was determined by comparison of the NMR spectra and optical rotations of the synthetic products.

关键词： total synthesis crotonine 2-(furan-2-yl)-5-(2,3,4-trihydroxy-butyl)-1,4-diazine Croton tiglium L.(Euphoriaceae) analgesics

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