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Restless Legs
Published in Charles Theisler, Adjuvant Medical Care, 2023
Selenium: Sixty patients with primary RLS were enrolled in a clinical trial. It was based on three periods of drug prescription with a one month wash-out period. As a placebo, 50 and 200 Fig of selenium were administered in each separated month. Improvement was significantly higher in the selenium (50 and 200 μg) group than in the placebo group. The authors concluded that selenium prescription in a daily recommended dose of 50 μg instead of a dopamine agonist would be an alternative treatment for improvement of RLS symptoms.12
Introduction to the management station
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
This is a potentially serious clinical incident that has put the patient at risk, since they are not receiving the advised treatment. I would clarify the events and ensure I was reading the correct patient’s drug chart and that I had understood the changes that had been made to the prescription. I would read the patient’s notes to see if there was any documentation from any member of the team looking after the patient that may explain the circumstances. I would also seek to speak to the nursing staff, especially the nurse who had allegedly changed the drug prescription, and confirm this was how the prescription had been changed. Once I had clarified the situation, I would then ensure the patient was safe and attend to him/her first. I would make any safe changes to rectify their treatment plan and review their progress. Finally, I would document this incident in the notes and seek to escalate the incident by informing a senior member of the team and on-call line at the earliest opportunity.
Challenges Facing the American Healthcare System
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
Specialty pharmacies, in order to offer a full range of clinical and operational services that enhance the safety, quality, and affordability of specialty medications for patients, perform a variety of management functions. They include providing access to specially trained pharmacists, nurses, and clinicians, direct consultation with physicians to deal with concerns about side effects of specialty drugs on patients including adverse reaction and non-compliance, performing disease and drug-specific patient care management services to ensure patient safety, collecting data and tracking outcomes for specific patients, ensuring that patients adhere to drug prescription regimens, ensuring adherence to rigorous storage, shipping, and handling standards for specialty drugs, coordinating patient care with other healthcare providers, navigating on behalf of patients with insurance companies, managing formularies, i.e., continually updating lists of prescription drugs approved for reimbursement by PBMs, utilization management such as prior-authorization and quantity limits, encouraging use of preferred products by patients, and cost management (Academy of Managed Care Pharmacy 2006; National Pharmaceutical Services 2018; Pharmaceutical Care Management Association 2016).
Developing A Rapid Transfer from Opioid Full Agonist to Buprenorphine: “Ultrarapid Micro-Dosing” Proof of Concept
Published in Journal of Psychoactive Drugs, 2023
Pouya Azar, Nickie Mathew, Daljeet Mahal, James S.H. Wong, Jean N. Westenberg, Christian G. Schütz, Mark K. Greenwald
Urine analysis was positive for cannabinoids, benzodiazepines, fentanyl, and opiates (morphine, codeine and/or heroin). The patient’s medication history revealed recent methadone prescription (30 mg/day), and slow-release oral morphine prescription about 6 months prior (500 mg/day). According to the drug prescription monitoring program in British Columbia (Pharmanet), the patient last refilled methadone 3 days before admission. This was confirmed by the patient who stated no longer taking prescription medication and reported using $10 fentanyl thrice daily. During admission, the patient received morphine and hydromorphone for pain, craving and withdrawal symptoms. This was done in the emergency department to avoid the patient leaving AMA before being seen by a physician specializing in psychiatry and addiction medicine. Once transferred to the medicine unit, CPAS was consulted for management of OUD, at which point she expressed interest in starting opioid agonist treatment (OAT) and was assessed to be a candidate for buprenorphine/naloxone.
The financial burden of treating patients presenting with acute and chronic cough
Published in Current Medical Research and Opinion, 2021
Surinder S. Birring, Craig J. Currie, Sarah E. Holden, Sara Jenkins-Jones, Ellen R. Berni, Bethan Jones, Thomas R. Berni, Haya Langerman
The most common drug prescription in the 56 days following an incident CC episode that was not prescribed in the preceding 56 days was for an antibiotic, whether for the incident episode (3344 episodes, 47% of episodes and patients) or a subsequent episode (281 episodes in 275 patients, 47% of patients). For incident episodes, 12,872 prescriptions were prescribed over the follow-up period, a rate of 4.0 prescriptions ppy. For subsequent CC episodes, there were 1380 antibiotic prescriptions, a rate of 5.6 prescriptions ppy. For both incident and subsequent CC episodes, the most frequently prescribed antibiotics were amoxicillin, clarithromycin and doxycycline. Respiratory medicines were the next most frequently prescribed drug category in 19% of patients. The most frequently prescribed for both incident and subsequent CC episodes were salbutamol and prednisolone; beclomethasone was also frequently prescribed for incident episodes. Medicines for GORD were initiated by 565 (8%) patients (2,838 prescriptions, 5.2 ppy) for incident CC episodes and by 43 (7%) patients in 43 subsequent episodes (180 prescriptions, 4.0 ppy). Omeprazole was the most frequently prescribed drug. Other drugs prescribed at incident and subsequent CC episodes were: nasal corticosteroids (436, 6% and 29, 5%), cough remedies (410, 6% and 41, 7%), antihistamines (226, 3% and 30, 5%), and drugs for the treatment of cough hypersensitivity, mainly codeine and amitriptyline (63, 0.9% and ≤5).
Differences between the quality aspects of various generic and branded docetaxel formulations
Published in Current Medical Research and Opinion, 2021
The use of generic anticancer drugs is associated with lesser cost than their branded counterparts but comparable in dosage form, route of administration, strength of dose, performance and quality characteristics, and intended use of drug1. The global oncology drug market reached $97,401 million in 2017 and is estimated to outreach $176,509 million by 2025 with the Asia-Pacific region expecting to exhibit the highest compound annual growth rate (CAGR) of 9.5% during 2018–20252. With respect to the global generic drugs market, the sales value reached US$367 billion in 2019, recording a 5.7% CAGR during 2014–20193. Owing to lower market value and comparable quality, generic medications are used to strengthen effectiveness of drug prescription and minimize expenditure4.