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1

Methadone and prescription drug overdose.  

PubMed

(1) Methadone accounted for 2 percent of painkiller prescriptions and more than 30 percent of prescription painkiller deaths in 2009. (2) Data suggest that the rise in deaths from methadone overdose is not related to its use in treating drug abuse but, rather, to its use for pain management. (3) Preferred drug lists in most Medicaid programs identify methadone as a preferred drug for managing chronic pain, but most experts do no recommend it as a first choice. PMID:25556261

Hendrikson, Hollie; Hansen, Melissa

2014-12-01

2

Prescription Drugs  

MedlinePLUS

... at once. This effect increases the risk for addiction and overdose. Side effects. Prescription drugs are designed ... of these types of medications can lead to addiction. And, abusing any type of drug that causes ...

3

Factors associated with history of non-fatal overdose among young nonmedical users of prescription drugs  

PubMed Central

Objectives The current study examines the prevalence and correlates of lifetime non-fatal overdose (OD) involving the nonmedical use of prescription opioids and tranquilizers among a sample of high-risk young adults in New York, NY and Los Angeles, CA. Methods Data were derived from a cross-sectional study of 16–25 year old nonmedical users of prescription drugs (n = 596). Unadjusted associations between OD history and socio-demographic and drug use variables were investigated in bivariate logistic regression models. Multivariate logistic regression models identified correlates of non-fatal OD. Results Lifetime prevalence of non-fatal overdose involving prescription opioids and/or tranquilizers was 23.6%. Factors associated with increased risk of non-fatal overdose included lower social class while growing up (OR: 1.81, 95% CI: [1.15, 2.83], p < 0.01), having ever received care at a psychiatric hospital (OR: 1.79,95% CI: [1.12,2.85], p <0.05), ever witnessing a family member OD on drugs (OR: 1.59,95% CI: [1.02,2.50], p < 0.05), being prescribed tranquilizers (OR: 2.07,95% CI: [1.29,4.27], p < 0.01), ever snorting or sniffing opioids (OR: 2.51,95% CI: [1.48,4.27], p < 0.001), injecting tranquilizers (OR: 3.09,95% CI: [1.61, 5.93],p< 0.001), and past 90-day injection drug use (OR: 1.68, 95% CI: [1.03, 2.74], p < 0.05). Participants who reported past 90-day stimulant misuse had lower odds of reporting OD compared to those who were not recent stimulant users (OR: 0.60,95% CI: [0.38–0.96], p < 0.05). Conclusions This study documents the high prevalence of experiencing non-fatal overdose among young nonmedical users of prescription drugs. Results could inform overdose prevention efforts throughout the U.S. PMID:22974490

Silva, Karol; Schrager, Sheree M.; Kecojevic, Aleksandar; Lankenau, Stephen E.

2014-01-01

4

Associations among Pain, Non-Medical Prescription Opioid Use, and Drug Overdose History  

PubMed Central

Background and Objective Recently, use of prescription opioids (POs) has increased; non-medical PO (NMPO) use is linked to overdose. NMPO use is common among individuals prescribed opioids for pain, and those in Substance Use Disorder (SUD) treatment with pain could be at increased risk for unintentional overdose due to NMPO use. We examined associations between pain, NMPO use, and overdose among SUD treatment patients. Methods Among 342 patients at a residential SUD treatment center, logistic regression examined the association of overdose with pain, adjusting for substance use, suicide attempts, and demographics. Results Pain was positively related to NMPO use. Heroin use, suicide attempts, pain, and NMPO use were positively associated with overdose; but NMPO use attenuated the pain-overdose relationship. Conclusions The relationship between pain and overdose among substance users may be, in part, explained by the association between pain and heavy NMPO use. PMID:24313240

Bonar, Erin E.; Ilgen, Mark A.; Walton, Maureen; Bohnert, Amy S.B.

2014-01-01

5

Drug Overdose Deaths, Hospitalizations,  

E-print Network

Drug Overdose Deaths, Hospitalizations, and Emergency Department Visits in Kentucky, 2000 - 2012 #12; Kentucky Injury Preven on and Research Center Drug Overdose Deaths, Hospitaliza ons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Drug overdose deaths, 20002012

MacAdam, Keith

6

Media's Positive and Negative Frames in Reporting Celebrity Deaths From Illegal Drug Overdoses Versus Prescription Drug Overdoses  

E-print Network

to the field of mass media through his study of advertisements. He posited that women in advertisements reinforced how women are framed in daily life (Goffman, 1979). As the theory was adapted to journalism (Tuchman, 1978; Gitlin, 1980), such research revealed...” because it focuses on illicit drugs, such as cocaine, heroin, and ecstasy, as the drugs contributing the most to the “drug problem,” while rarely mentioning alcohol and tobacco as part of the problem (Murji, 1998). Therefore, the media conditions “public...

Wood, Michelle

2011-12-31

7

CDC Vital Signs: Prescription Painkiller Overdoses  

MedlinePLUS

... Compartir Prescription Painkiller Overdoses Use and Abuse of Methadone as a Painkiller July 2012 1 in 3 ... oxycodone), Opana (oxymorphone), and methadone. Issue Details Problem Methadone use poses risks Methadone is frequently prescribed for ...

8

Prescription Drug Abuse  

MedlinePLUS

... and drugs > Prescription drug abuse Overview FAQ Prescription drug abuse Sometimes you may need prescription drugs to treat ... medicine given by a health care provider . Prescription drug abuse is when you use a prescription drug in ...

9

Prescription Drug Abuse  

MedlinePLUS

... reported past-year nonmedical use of the prescription pain reliever Vicodin in 2010, and 1 in 20 reported ... an urgent one: unintentional overdose deaths involving opioid pain relievers have quadrupled since 1999, and by 2007, outnumbered ...

10

Overdose prevention for injection drug users: Lessons learned from naloxone training and distribution programs in New York City  

Microsoft Academic Search

BACKGROUND: Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs). Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United

Tinka Markham Piper; Sasha Rudenstine; Sharon Stancliff; Susan Sherman; Vijay Nandi; Allan Clear; Sandro Galea

2007-01-01

11

Prescription Drug Abuse  

MedlinePLUS

... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that was ... prescription drugs can lead to addiction. These include narcotic painkillers, sedatives, tranquilizers, and stimulants. Every medicine has ...

12

Prescription Drug Abuse  

MedlinePLUS

... more dangerous than people think. In fact, it's drug abuse. And it's just as illegal as taking street ... on the street like other illegal drugs. Prescription drug abuse continues to rise. In 2012, 24% of teens ...

13

Prescription Drug Monitoring Programs: Examining Limitations and Future Approaches  

PubMed Central

Prescription drug abuse is a leading cause of accidental death in the United States. Prescription drug monitoring programs (PDMPs) are a popular initiative among policy makers and a key tool to combat the prescription drug epidemic. This editorial discusses the limitations of PDMPs, future approaches needed to improve the effectiveness of PDMPs, and other approaches essential to curbing the rise of drug abuse and overdose.

Griggs, Christopher A.; Weiner, Scott G.; Feldman, James A.

2015-01-01

14

Decline in drug overdose deaths after state policy changes - Florida, 2010-2012.  

PubMed

During 2003-2009, the number of deaths caused by drug overdose in Florida increased 61.0%, from 1,804 to 2,905, with especially large increases in deaths caused by the opioid pain reliever oxycodone and the benzodiazepine alprazolam. In response, Florida implemented various laws and enforcement actions as part of a comprehensive effort to reverse the trend. This report describes changes in overdose deaths for prescription and illicit drugs and changes in the prescribing of drugs frequently associated with these deaths in Florida after these policy changes. During 2010-2012, the number of drug overdose deaths decreased 16.7%, from 3,201 to 2,666, and the deaths per 100,000 persons decreased 17.7%, from 17.0 to 14.0. Death rates for prescription drugs overall decreased 23.2%, from 14.5 to 11.1 per 100,000 persons. The decline in the overdose deaths from oxycodone (52.1%) exceeded the decline for other opioid pain relievers, and the decline in deaths for alprazolam (35.6%) exceeded the decline for other benzodiazepines. Similar declines occurred in prescribing rates for these drugs during this period. The temporal association between the legislative and enforcement actions and the substantial declines in prescribing and overdose deaths, especially for drugs favored by pain clinics, suggests that the initiatives in Florida reduced prescription drug overdose fatalities. PMID:24990490

Johnson, Hal; Paulozzi, Leonard; Porucznik, Christina; Mack, Karin; Herter, Blake

2014-07-01

15

Prescription Painkillers Fueling Overdose Cases in ERs, Study Finds  

MedlinePLUS

... class of medications that includes illegal drugs like heroin along with prescription painkillers like Percocet and Oxycontin. ... in 3 percent of cases in the study. Heroin alone was responsible for 16 percent of the ...

16

Prescription Drug Costs  

MedlinePLUS Videos and Cool Tools

A service of the U.S. National Library of Medicine National Institutes of Health Home About MedlinePlus Site ... 2015 Related MedlinePlus Pages Financial Assistance Health Insurance Medicines Transcript Prescriptions drugs can cost a lot, even ...

17

Injection drug users trained by overdose prevention programs: Responses to witnessed overdoses  

PubMed Central

In response to the growing public health problem of drug overdose, community-based organizations have initiated overdose prevention programs (OPP), which distribute naloxone, an opioid antagonist, and teach overdose response techniques. Injection drug users (IDUs) have been targeted for this intervention due to their high risk for drug overdose. Limited research attention has focused on factors that may inhibit or prevent IDUs who have been trained by OPPs to undertake recommended response techniques when responding to a drug overdose. IDUs (n=30) trained by two OPPs in Los Angeles were interviewed in 2010–11 about responses to their most recently witnessed drug overdose using an instrument containing both open and closed-ended questions. Among the 30 witnessed overdose events, the victim recovered in 29 cases while the outcome was unknown in one case. Participants responded to overdoses using a variety of techniques taught by OPP. Injecting the victim with naloxone was the most common recommended response while other recommended responses included stimulating the victim with knuckles, calling 911, and giving rescue breathing. Barriers preventing participants from employing recommended response techniques in certain circumstances included prior successes using folk remedies to revive a victim, concerns over attracting police to the scene, and issues surrounding access to or use of naloxone. Practical solutions, such as developing booster sessions to augment OPP, are encouraged to increase the likelihood that trained participants respond to a drug overdose with the full range of recommended techniques. PMID:22847602

Lankenau, Stephen E.; Wagner, Karla D.; Silva, Karol; Kecojevic, Aleksander; Iverson, Ellen; McNeely, Miles; Kral, Alex H.

2012-01-01

18

[Prescription drug monitoring programs in the United States of America].  

PubMed

Since the late 1990s, the number of opioid analgesic overdose deaths has quadrupled in the United States of America (from 4 030 deaths in 1999 to 16 651 in 2010). The objectives of this article are to provide an overview of the problem of prescription drug overdose in the United States and to discuss actions that could help reduce the problem, with particular attention to the characteristics of prescription drug monitoring programs (PDMPs). These programs consist of state-level databases that monitor controlled substances. The information compiled in the databases is at the disposal of authorized persons (e.g., physicians, pharmacists, and other health-care providers) and may be used only for professional purposes. Suppliers can use such information to prevent interaction with other drugs or therapeutic duplication, or to identify drug-search behavior. Law enforcement agencies can use these programs to identify improper drug prescription or dispensing patterns, or drug diversion. PMID:25563153

El Burai Félix, Sausan; Mack, Karin

2014-10-01

19

Trends in Prescription Drug Abuse  

MedlinePLUS

... prescription drugs? Adolescents and young adults Older adults Gender differences How many people suffer adverse health consequences from ... prescription drugs? Adolescents and young adults Older adults Gender differences How many people suffer adverse health consequences from ...

20

Overdose  

MedlinePLUS

... on purpose, it is called an intentional or deliberate overdose. If the overdose happens by mistake, it ... J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice . 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006: ...

21

Prescription Drugs and Cold Medicines  

MedlinePLUS

... treatment options available for those struggling with heroin addiction. En Español Prescription Drug Abuse (Research Reports) Published ... their use and the prevention and treatment of addiction. En Español Prescription and Over-the-Counter Medications ( ...

22

Diclofenac sodium overdose  

MedlinePLUS

Diclofenac sodium is a prescription medicine used to relieve pain and swelling. It is a nonsteroidal anti-inflammatory drug (NSAID). Diclofenac sodium overdose occurs when someone accidentally or intentionally ...

23

What Are Some Commonly Abused Prescription Drugs?  

MedlinePLUS

... some of the commonly abused prescription drugs? Prescription Drug Abuse Email Facebook Twitter What are some of the ... 2014 Contents From the Director What is prescription drug abuse? What are some of the commonly abused prescription ...

24

Adolescent Nonmedical Prescription Drug Use  

ERIC Educational Resources Information Center

For many adolescents today, the most common form of substance use is nonmedical prescription drug use. Fittingly, many researchers, policy makers, and people who work with youth are concerned about the serious problems associated with nonmedical prescription drug use (NMPDU). In this article, authors Jason Ford and William Watkins provide an…

Ford, Jason A.; Watkins, William C.

2012-01-01

25

Popping Pills: Prescription Drug Abuse in America  

MedlinePLUS

... Prescription Drug Abuse in America Popping Pills: Prescription Drug Abuse in America Email Facebook Twitter NIDA recently challenged ... Infographics that present current scientific information about prescription drug abuse in interesting, novel, and creative ways to help ...

26

Preliminary Evidence of Health Care Provider Support for Naloxone Prescription as Overdose Fatality Prevention Strategy in New York City  

Microsoft Academic Search

Preliminary research suggests that naloxone (Narcan), a short-acting opiate antagonist, could be provided by prescription or distribution to heroin users to reduce the likelihood of fatality from overdose. We conducted a random postal survey of 1,100 prescription-authorized health care providers in New York City to determine willingness to prescribe naloxone to patients at risk of an opiate overdose. Among 363

Phillip O. Coffin; Crystal Fuller; Liza Vadnai; Shannon Blaney; Sandro Galea; David Vlahov

27

Preliminary evidence of health care provider support for naloxone prescription as overdose fatality prevention strategy in New York City  

Microsoft Academic Search

Preliminary research suggests that naloxone (Narcan), a short-acting opiate antagonist, could be provided by prescription\\u000a or distribution to heroin users to reduce the likelihood of fatality from overdose. We conducted a random postal survey of\\u000a 1.100 prescription-authorized health care providers in New York City to determine willingness to prescribe naloxone to patients\\u000a at risk of an opiate overdose. Among 363

Phillip O. Coffin; Crystal Fuller; Liza Vadnai; Shannon Blaney; Sandro Galea; David Vlahov

2003-01-01

28

Prescription and over-the-counter medication in deliberate self-poisoning and accidental overdosing--preliminary study.  

PubMed

186 case records of patients who overdosed pharmaceuticals (confirmed by toxicological lab analysis) hospitalized at the Department of Clinical Toxicology during three months of 2000 were analyzed for age, sex, type of medication, reason for poisoning (intentional or accidental overdosing). Patients poisoned with prescription medication (Rx group) were compared with those who overdosed nonprescription (OTC-group) medications (alone or combined with Rx). Relative frequency of medication drug poisoning was highest in the 40-49 age group (28.5%) and was followed by the group of young adults (20-29 years; 24.2%). The lowest frequency (2.2%) was noted in the 60-69 age group. Of 186 cases analyzed, in 163 (87.6%) prescription medication (Rx) and in 23 (12.4%) OTC alone or co-ingested with Rx were involved (chi2 = 63.9; p < 0.001). The Rx and OTC groups were not significantly different as to reason for poisoning (chi2 = 0.7; p = 0.792) with significant overrepresentation of deliberate ingestion in both the group analysed (chi2 = 114.39; p < 0.001 for Rx, and chi2 = 13.49; p = 0.002 for OTC). Most adults attempting suicide used Rx with the highest incidence in the 40-49 age group (31.1%). Adolescents (14-19 years) with female over-representation ingested rather OTC pharmaceuticals (40.9%). Acetaminophen (alone or combined with benzodiazepines or/and ethanol) and nonsteroidal anti-inflammatory drugs (NSAIDs) were the most common OTC medications used for deliberate self-poisoning. PMID:16225126

Szkolnicka, Beata

2005-01-01

29

Initiation into Prescription Opioid Misuse among Young Injection Drug Users  

PubMed Central

Background Prescription opioids are the most frequently misused class of prescription drugs among young adults. Initiation into prescription opioid misuse is an important public health concern since opioids are increasingly associated with drug dependence and fatal overdose. Descriptive data about initiation into prescription opioid misuse among young injection drug users (IDUs) are scarce. Methods An exploratory qualitative study was undertaken to describe patterns of initiation into prescription opioid misuse among IDUs aged 16 to 25 years. Those young IDUs who had misused a prescription drug at least three times in the past three months were recruited during 2008 and 2009 in Los Angeles (n=25) and New York (n=25). Informed by an ethno-epidemiological approach, descriptive data from a semi-structured interview guide were analysed both quantitatively and qualitatively. Results Initiation into prescription opioid misuse was facilitated by easy access to opioids via participant’s own prescription, family, or friends, and occurred earlier than misuse of other illicit drugs, such as heroin. Nearly all transitioned into sniffing opioids, most injected opioids, and many initiated injection drug use with an opioid. Motives for transitions to sniffing and injecting opioids included obtaining a more potent high and/or substituting for heroin; access to multiple sources of opioids was common among those who progressed to sniffing and injecting opioids. Conclusion Prescription opioid misuse was a key feature of trajectories into injection drug use and/or heroin use among this sample of young IDUs. A new pattern of drug use may be emerging whereby IDUs initiate prescription opioid misuse before using heroin. PMID:21689917

Lankenau, Stephen E.; Teti, Michelle; Silva, Karol; Bloom, Jennifer Jackson; Harocopos, Alex; Treese, Meghan

2011-01-01

30

Preventing and Recognizing Prescription Drug Abuse  

MedlinePLUS

... counter medications—with their doctors. The risks for addiction to prescription drugs increase when they are used ... of prescription drugs and prevent the escalation to addiction. By asking about all drugs, physicians can help ...

31

Overdose with antiepileptic drugs: the efficacy of extracorporeal removal techniques.  

PubMed

Drug overdose is a growing problem among adolescents. Clinical severity depends on the drug and ingested amount, which in some cases may be life-threatening. We present a clinical case of a previously healthy teenage girl who ingested 16.4?g of carbamazepine and 14.5?g of valproic acid. She presented with profound disturbance of consciousness and toxic levels of both drugs, raised in the first hours after the ingestion. She was successfully treated with charcoal haemoperfusion followed by continuous venovenous hemodiafiltration. Overdose with the two drugs separately is common, but there are no reports of intoxication by simultaneous ingestion. High levels of carbamazepine and valproic acid can lead to severe systemic effects and management is made difficult by the absence of specific antidotes. Extracorporeal removal techniques are a good therapeutic option in these cases as they enhance the clearance by reducing the half-life of both drugs thereby preventing serious complications. PMID:25422348

Moinho, Rita; Dias, Andrea; Estanqueiro, Paula; Farela Neves, José

2014-01-01

32

“I Felt Like a Superhero”: The Experience of Responding to Drug Overdose Among Individuals Trained in Overdose Prevention  

PubMed Central

Background Overdose prevention programs (OPPs) train people who inject drugs and other community members to prevent, recognise and respond to opioid overdose. However, little is known about the experience of taking up the role of an “overdose responder” for the participants. Methods We present findings from qualitative interviews with 30 participants from two OPPs in Los Angeles, CA, USA from 2010–2011 who had responded to at least one overdose since being trained in overdose prevention and response. Results Being trained by an OPP and responding to overdoses had both positive and negative effects for trained “responders”. Positive effects include an increased sense of control and confidence, feelings of heroism and pride, and a recognition and appreciation of one’s expertise. Negative effects include a sense of burden, regret, fear, and anger, which sometimes led to cutting social ties, but might also be mitigated by the increased empowerment associated with the positive effects. Conclusion Findings suggest that becoming an overdose responder can involve taking up a new social role that has positive effects, but also confers some stress that may require additional support. OPPs should provide flexible opportunities for social support to individuals making the transition to this new and critical social role. Equipping individuals with the skills, technology, and support they need to respond to drug overdose has the potential to confer both individual and community-wide benefits. PMID:23932166

Wagner, Karla D.; Davidson, Peter J.; Iverson, Ellen; Washburn, Rachel; Burke, Emily; Kral, Alex H.; McNeeley, Miles; Bloom, Jennifer Jackson; Lankenau, Stephen E.

2013-01-01

33

Introducing Medicare's New Coverage for Prescription Drugs  

E-print Network

-of-pocket spending on drugs has increased dramatically. In order to get this prescription coverage, you must chooseIntroducing Medicare's New Coverage for Prescription Drugs CENTERS FOR MEDICARE & MEDICAID SERVICES #12;Starting January 1, 2006 Medicare will soon be offering insurance coverage for prescription drugs

Goodman, Robert M.

34

Prescription Drug Abuse and Youth. Information Brief.  

ERIC Educational Resources Information Center

Prescription drugs, a category of psychotherapeutics that comprises prescription-type pain relievers, tranquilizers, stimulants, and sedatives, are among the substances most commonly abused by young people in the United States. Prescription drugs are readily available and can easily be obtained by teenagers who abuse these drugs to experience a…

Department of Justice, Washington, DC. National Drug Intelligence Center.

35

Prescriptions, Over-the-Counter Drugs, Supplements and Herbal Products  

MedlinePLUS

... acid Warfarin (Coumadin® and Jantoven® ) What is prescription drug abuse? Prescription drug abuse is when you use a prescription drug in ... than ordered by a health care provider. Prescription drug abuse is a serious and growing problem. Nearly 1 ...

36

Your Guide to Medicare Prescription Drug Coverage  

MedlinePLUS

... a plan that has a coverage gap: Ms. Smith joined the ABC Prescription Drug Plan. Her coverage ... card when she buys prescriptions. Monthly premium—Ms. Smith pays a monthly premium throughout the year. 1. ...

37

The “Black Box” of Prescription Drug Diversion  

Microsoft Academic Search

A variety of surveys and studies are examined in an effort to better understand the scope of prescription drug diversion and to determine whether there are consistent patterns of diversion among various populations of prescription drug abusers. Data are drawn from the RADARS System, the National Survey of Drug Use and Health, the Delaware School Survey, and a series of

James A. Inciardi; Hilary L. Surratt; Theodore J. Cicero; Steven P. Kurtz; Steven S. Martin; Mark W. Parrino

2009-01-01

38

Underrepresentation of heroin involvement in unintentional drug overdose deaths in Allegheny County, PA.  

PubMed

Drugs contributing to overdose deaths are listed on death certificates, but their validity is rarely studied. To assess the accuracy of "morphine" and "codeine" listings on death certificates for unintentional overdose deaths in Allegheny County, PA, investigative and laboratory reports were reviewed. Deaths were reclassified as heroin-related if documentation showed 6-monoacetylmorphine in blood or urine, "stamp bags" or drug paraphernalia at scene, history of heroin use, or track marks. Deaths were considered morphine-related if notes indicated morphine use, prescription, or morphine at scene, or codeine-related if the codeine blood level exceeded morphine. Of 112 deaths with morphine but not heroin listed on the death certificate, 74 met heroin criteria and 21 morphine criteria. Of 20 deaths with both morphine and heroin listed, only one met morphine criteria. Of 34 deaths with codeine listed, only five were attributed to codeine. Consideration of patient history, death scene evidence, and expanded toxicology testing may improve the accuracy of death certificate drug listings. PMID:25041514

Mertz, Kristen J; Janssen, Jennifer K; Williams, Karl E

2014-11-01

39

Developing Performance Measures for Prescription Drug Management  

PubMed Central

Prescription drug management plans are outpatient drug benefit programs that strive to manage the cost effective and clinically appropriate delivery of prescription drugs to beneficiaries. The demand for accountability and a means to evaluate performance of drug benefit management programs is growing; nevertheless, a set of valid, standardized indicators for evaluating performance does not exist. We review drug management program activities and identify available measures for assessing performance. Additionally, we note recent efforts to develop performance indicators for prescription drug management. We conclude by raising key questions that should be addressed before a comprehensive set of performance measures can be implemented. PMID:25372960

Chawla, Anita J.; Hatzmann, Marjorie R.; Long, Stacey R.

2001-01-01

40

Pharmacokinetic strategies for treatment of drug overdose and addiction  

PubMed Central

The pharmacokinetic treatment strategy targets the drug molecule itself, aiming to reduce drug concentration at the site of action, thereby minimizing any pharmacodynamic effect. This approach might be useful in the treatment of acute drug toxicity/overdose and in the long-term treatment of addiction. Phase IIa controlled clinical trials with anticocaine and antinicotine vaccines have shown good tolerability and some efficacy, but Phase IIb and III trials have been disappointing because of the failure to generate adequate antibody titers in most participants. Monoclonal antibodies against cocaine, methamphetamine and phencyclidine have shown promise in animal studies, as has enhancing cocaine metabolism with genetic variants of human butyrylcholinesterase, with a bacterial esterase, and with catalytic monoclonal antibodies. Pharmacokinetic treatments offer potential advantages in terms of patient adherence, absence of medication interactions and benefit for patients who cannot take standard medications. PMID:22300100

Gorelick, David A

2012-01-01

41

How patients understand the term ‘nonmedical use’ of prescription drugs: insights from cognitive interviews  

PubMed Central

Background With rising rates of prescription drug abuse and associated overdose deaths, there is great interest in having accurate and efficient screening tools that identify nonmedical use of prescription drugs in health care settings. We sought to gain a better understanding of how patients interpret questions about misuse of prescription drugs, with the goal of improving the accuracy and acceptability of instruments intended for use in primary care. Methods A total of 27 English speaking adult patients were recruited from an urban safety net primary care clinic to complete a cognitive interview about a four-item screening questionnaire for tobacco, alcohol, illicit drugs, and misuse of prescription drugs. Detailed field notes were analyzed for overall comprehension of the screening items on illicit drug use and prescription drug misuse, the accuracy with which participants classified drugs into these categories, and whether the screening response correctly captured the participant’s substance use behavior. Results Based on initial responses to the screening items, 6 (22%) participants screened positive for past year prescription drug misuse, and 8 (30%) for illicit drug use. The majority (26/27) of participants correctly interpreted the item on illicit drug use, and appropriately classified drugs in this category. Eleven (41%) participants had errors in their understanding of the prescription drug misuse item. The most common error was including use of medications without abuse potential as misuse. All cases of misunderstanding prescription drug misuse occurred among participants who screened negative for illicit drug use. Conclusions Our results suggest that terminology used to describe misuse of prescription medications may be misunderstood by many primary care patients, particularly those who do not use illicit drugs. Failure to improve upon the language used to describe prescription drug misuse in screening questionnaires intended for use in medical settings could potentially lead to high rates of false positive results. PMID:24588288

Halkitis, Perry N.; Horton, Ariana; Khan, Rubina; Gourevitch, Marc N.

2013-01-01

42

State System of Higher Education Prescription Drug Card Program*  

E-print Network

prescription order or refill order. 2. Charges for a prescription drug when such drug or medication is used-medicinal substances); 12. Any drugs that can be purchased without a prescription order; 13. Any Prescription DrugState System of Higher Education Prescription Drug Card Program* Effective January 1, 2008 Benefits

Hardy, Christopher R.

43

76 FR 51245 - Branded Prescription Drug Fee  

Federal Register 2010, 2011, 2012, 2013

...RIN 1545-BK34 Branded Prescription Drug Fee AGENCY: Internal Revenue Service (IRS...regulations that provide guidance on the annual fee imposed on covered entities engaged in the...importing branded prescription drugs. This fee was enacted by section 9008 of the...

2011-08-18

44

Psychosocial and contextual correlates of opioid overdose risk among drug users in St. Petersburg, Russia  

PubMed Central

Background Opioid overdose in Russia is a problem that has grown more severe as heroin abuse expanded over the past decade, yet few studies have explored it in detail. In order to gain a clearer understanding of the situation, 60 drug users, both in and out of drug treatment in St. Petersburg, were interviewed concerning their overdose experience and knowledge about overdose recognition and prevention. Methods Using a semi-structured interview, we sought to identify and describe local attitudes, knowledge and experience (both self-sustained and witnessed) of opioid overdose. Bi-variate and multiple logistic regressions were performed in order to identify the relationship between overdose experience and sociodemographic factors, risk behaviors, and clinical psychiatric measures. Results We found that having experienced or witnessed an opioid overdose within the previous year was common, overdose knowledge was generally high, but nearly half the participants reported low self-efficacy for effectively intervening in an overdose situation. In bivariate analyses, self-reported family problems (i.e., perceived problematic family interactions) were positively associated with both experiencing (t56 = 2.49; p < 0.05) and with witnessing a greater number of overdoses in the previous year (rhos = 0.31; p < 0.05). Having previously overdosed [Adjusted Risk Ratio (ARR) 1.7, 95% Confidence Interval (CI) 1.1–2.6] and higher SCL-90-R somatization scores (ARR 1.2, 95% CI 0.96 – 1.5) were independently associated in multivariable analyses with self-sustained overdose experience in the past year. Greater perceived likelihood of experiencing a future overdose and concern about medical problems were independently associated with witnessing a higher number of overdoses within the previous year. Over two thirds of the participants expressed interest in receiving training in overdose prevention and response. Conclusion Opioid overdose experience is very common among drug users in St. Petersburg, Russia, and interest in receiving training for overdose recognition and prevention was high. Future research should target the development of effective overdose recognition and prevention interventions, especially ones that include naloxone distribution and involve drug users' families. PMID:19630963

Grau, Lauretta E; Green, Traci C; Torban, Mikhail; Blinnikova, Ksenia; Krupitsky, Evgeny; Ilyuk, Ruslan; Kozlov, Andrei P; Heimer, Robert

2009-01-01

45

The “Black Box” of Prescription Drug Diversion  

PubMed Central

A variety of surveys and studies are examined in an effort to better understand the scope of prescription drug diversion and to determine if there are consistent patterns of diversion among various populations of prescription drug abusers. Data are drawn from the RADARS® System, the National Survey of Drug Use and Health (NSDUH), the Delaware School Survey, and a series of quantitative and qualitative studies conducted in Miami, Florida. The data suggest that the major sources of diversion include drug dealers, friends and relatives, smugglers, pain patients, and the elderly, but these vary by the population being targeted. In all of the studies examined, the use of the Internet as a source for prescription drugs is insignificant. Little is known about where drug dealers are obtaining their supplies, and as such, prescription drug diversion is a “black box” requiring concentrated systematic study. PMID:20155603

Inciardi, James A.; Surratt, Hilary L.; Cicero, Theodore J.; Kurtz, Steven P.; Martin, Steven S.; Parrino, Mark W.

2009-01-01

46

Prescription errors. Legibility and drug name confusion.  

PubMed

Inadvertent drug substitution occurred in several instances in our practices due to the combination of the physician's illegible handwriting on prescriptions and the pharmacist's misinterpretation of subtle clues, which might have prevented the errors. The literature on the legibility of physician handwriting is reviewed. Our specific recommendations include using preprinted prescription pads, training staff assistants who write prescriptions, printing complete directions on each prescription, and aggressively educating each patient about the name and purpose of all drugs being prescribed. Patients are encouraged to bring their medications to each office visit to identify potential errors. PMID:9161359

Brodell, R T; Helms, S E; KrishnaRao, I; Bredle, D L

1997-01-01

47

Retained drugs in the gastrointestinal tracts of deceased victims of oral drug overdose.  

PubMed

Abstract Context. The extent of non-absorbed drug burden in the GI tract following overdose is unknown. Patients who present with clinical signs of toxicity may not undergo decontamination due to assumption that the drug has already been completely absorbed and because of limited scientific evidence of benefit for routine GI decontamination in poisoned patients. Objective. The goal of this study was to assess whether people who die of an oral overdose have unabsorbed drug present in the GI tract. The secondary goal was to analyze pharmacologic characteristics of retained drugs when present. Materials and methods. Retrospective review of autopsy reports from 2008 to 2010, whose cause of death was determined as "intoxication" or "overdose, was performed at the Office of Chief Medical Examiner of the City of New York (OCME NYC)." Decedents of all ages were identified via electronic OCME database. Inclusion criteria were as follows: 1) cause of death "intoxication" or "overdose" noted by forensic autopsy, 2) ingestion of a solid drug formulation. Results. 92 out of 1038 autopsies (9%) that met inclusion criteria had documentation of retained pill fragments, granules, paste, sludge, slurry, or whole pills in the GI tract. The most common drugs found were opioids and anticholinergics. Ninety-eight percent (98%) of the retained drugs were either modified-release preparations or drugs known to slow GI transit. Most decedents were dead on arrival; there were twelve in-hospital deaths and eleven patients died in the Emergency Department. Bupropion and venlafaxine were responsible for four deaths in those who received medical care. One person died in the ICU following bupropion ingestion. Discussion and conclusion. Overdose of an oral drug that either has modified-release properties or slows GI tract motility may result in substantial unabsorbed drug burden remaining in the GI tract. PMID:25547175

Livshits, Z; Sampson, B A; Howland, M A; Hoffman, R S; Nelson, L S

2015-02-01

48

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2012 CFR

...HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions....

2012-10-01

49

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2011 CFR

...OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions....

2011-10-01

50

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2013 CFR

...HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions....

2013-10-01

51

42 CFR 423.159 - Electronic prescription drug program.  

...HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.159 Electronic prescription drug program. (a) Definitions....

2014-10-01

52

Prescription drug diversion control and medical practice.  

PubMed

Concern about the role of prescription drug diversion in drug abuse has led to demands for more stringent regulation and for better ways to detect prescription drug diversion. Advances in technology now allow point-of-sale computer systems to report prescriptions filled by pharmacies to state agencies rapidly and possibly more economically. However, the advantages of more comprehensive control systems must be balanced against their possible effects on medical practice and patient care. Our limited knowledge about prescription drug diversion and the impact of diversion control systems on medical practice is summarized. Needed research is outlined together with the components of a diversion control program that balances reducing drug diversion with minimizing adverse effects on medical practice and patient care. We stress the need for broadly defined practice parameters and peer review by medical experts thoroughly familiar with the complexities of medical practice. PMID:1507377

Cooper, J R; Czechowicz, D J; Petersen, R C; Molinari, S P

1992-09-01

53

Emergency department visits involving nonmedical use of selected prescription drugs in the United States, 2004-2008.  

PubMed

This report, adapted from the lead article in the June 10, 2010, issue of Morbidity and Mortality Weekly Reports, describes the alarming increase in overdose deaths involving prescription drugs. Oxycodone, hydrocodone, and methadone were the drugs most highly implicated. Data were derived from the federal Drug Abuse Warning Network (Dawn). Other drugs commonly used in managing pain patients, including benzodiazepines and muscle relaxants, also were implicated. PMID:20718652

Cai, R; Crane, E; Poneleit, K; Paulozzi, L

2010-09-01

54

Closing the Prescription Drug Coverage Gap  

MedlinePLUS

... about the closing of the coverage gap. TTY users should call 1-877-486-2048. You can also contact your plan. • For general information about Medicare prescription drug coverage, visit Medicare.gov. • ...

55

NonNon--medical Use of Prescription Drugsmedical Use of Prescription Drugs on College Campuseson College Campuses  

E-print Network

NonNon--medical Use of Prescription Drugsmedical Use of Prescription Drugs on College CampusesonNationally, there has been a rise in college students using prescription drugs,students using prescription drugsNon--medical Use of Prescription Drugs on College Campusesmedical Use of Prescription Drugs on College Campuses #12

New Hampshire, University of

56

The street value of prescription drugs  

PubMed Central

BACKGROUND: Although most physicians are aware of the potential for abuse and resale of prescribed medications, little has been done to document it. The purpose of this study was to determine which prescription drugs have street value, what that value is and why these drugs are used. METHODS: A descriptive cross-sectional survey using a semistructured interview technique was carried out on 2 weekdays (Mar. 10 and Apr. 1, 1997) in Vancouver's Downtown Eastside. A total of 58 users and dealers of prescription sedative/hypnotic and narcotic drugs were approached. Information collected included the demographic characteristics of those interviewed, the common street names of the drugs of interest, and their value and method of use. RESULTS: Thirty-two people agreed to participate in the study (participation rate 55%), 7 of whom were dealers. The range in price of sedative/hypnotic drugs was $0.10 to $2. For narcotic drugs the range was much greater, at $0.25 to $75. Descriptive analysis identified the minimum and maximum price and the mode of each preparation. Among the weak narcotic drugs the index drug (highest in demand on the street) was Tylenol No. 3 and among the more potent narcotics, MS Contin 30 mg. INTERPRETATION: A wide variety of prescription sedative/hypnotic and narcotic drugs are available on the street. The mark-up from pharmacy cost can be considerable. Factors influencing pricing include the relative inexperience of the buyer, the availability of illicit narcotics, the current street supply of prescription medications and the time of the month (before or after issue of social assistance cheques). PMID:9700324

Sajan, A; Corneil, T; Grzybowski, S

1998-01-01

57

Get the Facts: Prescription Drug Abuse on College Campuses  

MedlinePLUS

... or get “high” is an example of prescription drug abuse . Someone who abuses prescription medications is also likely ... illegal. a Slippery Slope: the dangerS of preSCription drug abuSe Many students mistakenly believe prescription medications are safe ...

58

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2013 CFR

... false Requirements for wholesale distribution of prescription drugs. 203.50...PRESCRIPTION DRUG MARKETING Wholesale Distribution § 203.50 Requirements for wholesale distribution of prescription drugs. (a)...

2013-04-01

59

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2012 CFR

... false Requirements for wholesale distribution of prescription drugs. 203.50...PRESCRIPTION DRUG MARKETING Wholesale Distribution § 203.50 Requirements for wholesale distribution of prescription drugs. (a)...

2012-04-01

60

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2010 CFR

... false Requirements for wholesale distribution of prescription drugs. 203.50...PRESCRIPTION DRUG MARKETING Wholesale Distribution § 203.50 Requirements for wholesale distribution of prescription drugs. (a)...

2010-04-01

61

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

Code of Federal Regulations, 2011 CFR

... false Requirements for wholesale distribution of prescription drugs. 203.50...PRESCRIPTION DRUG MARKETING Wholesale Distribution § 203.50 Requirements for wholesale distribution of prescription drugs. (a)...

2011-04-01

62

21 CFR 203.50 - Requirements for wholesale distribution of prescription drugs.  

... false Requirements for wholesale distribution of prescription drugs. 203.50...PRESCRIPTION DRUG MARKETING Wholesale Distribution § 203.50 Requirements for wholesale distribution of prescription drugs. (a)...

2014-04-01

63

Information on Your Prescription Drug Benefit Starting this year, your prescription drug benefit is provided by your medical plan.  

E-print Network

to provide mail order drugs to their plan participants. If you are enrolled in either of these plans and haveInformation on Your Prescription Drug Benefit Starting this year, your prescription drug benefit is provided by your medical plan. Here are some important things to know about getting your prescription drugs

Wechsler, Risa H.

64

Phencyclidine overdose  

MedlinePLUS

... is an illegal street drug that can cause hallucinations and severe agitation. This article discusses overdose due ... does not talk, move, or react) Coma Convulsions Hallucinations High blood pressure Nystagmus (side-to-side eye ...

65

Cost Overdose: Growth in Drug Spending for the Elderly, 1992-2010  

NSDL National Science Digital Library

Posted in July by Families USA (see the December 1, 1995 Scout Report), this report is billed as "the first study to both analyze the increase in prescription drug spending for the elderly from 1992 to 2000 and to project further increases over the next 10 years." The report gives data on average expenditures on prescription drugs for seniors, average number of prescriptions, average out-of-pocket costs, total expenditures on health care and prescription drugs for seniors, and more. Among the significant findings: "Annual spending on prescription drugs per elderly American will grow from $559 in 1992 to an estimated $1,205 in 2000, an increase of 116 percent."

2000-01-01

66

Resonant Messages to Prevent Prescription Drug Misuse by Teens  

ERIC Educational Resources Information Center

Prescription drug misuse is a major health problem, particularly among teens. A key step in curbing misuse is the development of effective prescription drug prevention messages. This paper explores the elements of prescription drug misuse prevention messages that resonate with teens using data from focus groups with seventh and eighth grade…

Twombly, Eric C.; Holtz, Kristen D.; Agnew, Christine B.

2011-01-01

67

Correlates of non-medical prescription drug use among a cohort of injection drug users in Baltimore City.  

PubMed

Despite reports of increasing non-medical prescription drug use, relatively few studies have systematically evaluated the prevalence and correlates of non-medical prescription drug use, particularly in populations that might be especially vulnerable (e.g., injection drug users [IDUs]). We examined factors associated with non-medical prescription drug use among a community-based cohort of current and former IDUs in Baltimore (The ALIVE Study). We conducted a cross-sectional analysis of data from cohort participants that responded to a survey that included questions on non-medical prescription drug use between 2005-06 (n=1320). Non-medical prescription drug use was considered to be use of any of the following: Opiates (Oxycontin, Percocet), Benzodiazepines or Clonidine, purchased on the street and taken orally within the last six months. Data on other covariates of interest (e.g., demographics, substance use, general health) was obtained through a standardized interview. The median age was 46 years; 66% were male, 85% were African-American. Twenty one percent reported any non-medical prescription drug use; 12% reported using more than one drug. Non-medical use of opiates was most common (17%). In multivariate analysis, non-medical prescription drug use was significantly associated with Caucasian race (prevalence ratio [PR]: 1.79), self-reported bodily pain (PR: 1.58), hazardous alcohol use (PR: 1.47), marijuana use (PR: 1.65), non-injection cocaine/heroin use (PR: 1.70), diverted use of buprenorphine (PR: 1.51) or methadone (PR: 2.51), and active injection drug use (PR: 3.50; p<0.05 for all). The association between bodily pain and non-medical prescription drug use was stronger among persons that were not using substances (marijuana, injecting drugs, snorting/smoking heroin, cocaine, using crack) as compared to those using these substances. The high prevalence of non-medical prescription drug use among this population warrants further research and action. Information on the risks of nonmedical prescription drug use especially overdose, should be incorporated into interventions targeted at IDUs. PMID:21868170

Khosla, Nidhi; Juon, Hee Soon; Kirk, Gregory D; Astemborski, Jacqueline; Mehta, Shruti H

2011-12-01

68

Temporal differences in gamma-hydroxybutyrate overdoses involving injecting drug users versus recreational drug users in Helsinki: a retrospective study  

PubMed Central

Background Gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL) have been profiled as 'party drugs' used mainly at dance parties and in nightclubs on weekend nights. The purpose of this study was to examine the frequency of injecting drug use among GHB/GBL overdose patients and whether there are temporal differences in the occurrence of GHB/GBL overdoses of injecting drug and recreational drug users. Methods In this retrospective study, the ambulance and hospital records of suspected GHB- and GBL overdose patients treated by the Helsinki Emergency Medical Service from January 1st 2006 to December 31st 2007 were reviewed. According to the temporal occurrence of the overdose, patients were divided in two groups. In group A, the overdose occurred on a Friday-Saturday or Saturday-Sunday night between 11 pm-6 am. Group B consisted of overdoses occurring on outside this time frame. Results Group A consisted of 39 patient contacts and the remaining 61 patient contacts were in group B. There were statistically significant differences between the two groups in (group A vs. B, respectively): history of injecting drug abuse (33% vs. 59%, p = 0.012), reported polydrug and ethanol use (80% vs. 62%, p = 0.028), the location where the patients were encountered (private or public indoors or outdoors, 10%, 41%, 41% vs. 25%, 18%, 53%, p = 0.019) and how the knowledge of GHB/GBL use was obtained (reported by patient/bystanders or clinical suspicion, 72%, 28% vs. 85%, 10%, p = 0.023). Practically all (99%) patients were transported to emergency department after prehospital care. Conclusion There appears to be at least two distinct groups of GHB/GBL users. Injecting drug users represent the majority of GHB/GBL overdose patients outside weekend nights. PMID:22296777

2012-01-01

69

Prescription drug advertising: Trends and implications  

Microsoft Academic Search

Prescription drug advertisements which appeared in two leading American medical journals in 1972, 1977 and 1982 were analyzed to discover possible trends in advertising. The 5016 ads examined showed that ads for the diuretic-cardiovasculars, especially the beta-adrenergic blocking agents and the slow channel inhibitors, as well as the analgesics, had increased, while ads for the anti-infectives and tranquilizers had diminished.

Lawrence R. Krupka; Arthur M. Vener

1985-01-01

70

Alcohol and prescription drug safety in older adults  

PubMed Central

Background The objectives of this study were to investigate older adults’ knowledge of prescription drug safety and interactions with alcohol, and to identify pharmacists’ willingness to disseminate prescription drug safety information to older adults. Methods The convenience sample consisted of 48 older adults aged 54–89 years who were recruited from a local pharmacy and who completed surveys addressing their alcohol consumption, understanding of alcohol and prescription drug interactions, and willingness to change habits regarding alcohol consumption and prescription drugs. To address pharmacist willingness, 90 pharmacists from local pharmacies volunteered and answered questions regarding their willingness to convey prescription drug safety information to older adults. Results Older adults reported low knowledge of alcohol and prescription drug safety, with women tending to be slightly more knowledgeable. More importantly, those who drank in the previous few months were less willing to talk to family and friends about how alcohol can have harmful interactions with prescription drugs, or to be an advocate for safe alcohol and prescription drug use than those who had not had a drink recently. Pharmacists reported that they were willing to convey prescription drug safety information to older adults via a variety of formats, including displaying or distributing a flyer, and directly administering a brief intervention. Conclusion In this study, older adults were found to have inadequate knowledge of prescription drug safety and interactions with alcohol, but pharmacists who regularly come in contact with older adults indicated that they were ready and willing to talk to older adults about prescription drug safety. Future research should focus on interventions whereby pharmacists disseminate prescription drug safety information to older adults in order to improve healthy prescription drug and alcohol behavior and reduce medical and health costs associated with interactions between alcohol and prescription drugs. PMID:23467625

Zanjani, Faika; Hoogland, Aasha I; Downer, Brian G

2013-01-01

71

Non-fatal overdose among a cohort of active injection drug users recruited from a supervised injection facility.  

PubMed

Non-fatal overdose among injection drug users (IDU) is a source of significant morbidity. Since it has been suggested that supervised injecting facilities (SIF) may increase risk for overdose, we sought to evaluate patterns of non-fatal overdose among a cohort of SIF users. We examined recent non-fatal overdose experiences among participants enrolled in a prospective study of IDU recruited from within North America's first medically supervised safer injecting facility. Correlates of recent non-fatal overdoses were identified using generalized estimating equations (GEE). There were 1,090 individuals recruited during the study period of which 317 (29.08%) were female. At baseline, 638 (58.53%) reported a history of non-fatal overdose and 97 (8.90%) reported at least one non-fatal overdose in the last six months. This proportion remained approximately constant throughout the study period. In the multivariate GEE analysis, factors associated with recent non-fatal overdose included: sex-trade involvement (Adjusted Odds Ratio [AOR]: 1.45 [95% Confidence Interval [CI] 1.07-1.99], p = 0.02) and public drug use (AOR: 1.50 [95% CI 1.09-2.06]; p = 0.01). Using the SIF for >or= 75% of injections was not associated with recent non-fatal overdose in univariate (Odds Ratio: 1.05, p = 0.73) or multivariate analyses (AOR: 1.01, p = 0.96). The proportion of individuals reporting recent non-fatal overdose did not change over the study period. Our findings indicate that a sub-population of IDU might benefit from overdose prevention interventions. Our findings refute the suggestion that the SIF may increase the likelihood of overdose. PMID:18584579

Milloy, M-J S; Kerr, Thomas; Mathias, Richard; Zhang, Ruth; Montaner, Julio S; Tyndall, Mark; Wood, Evan

2008-01-01

72

Eugenol oil overdose  

MedlinePLUS

Clove oil overdose ... Maypole J, Woolf AD. Essential oils. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose . 4th ed. Philadelphia, ...

73

Strategies used by adults to reduce their prescription drug costs.  

PubMed

In 2011, Americans spent $45 billion out-of-pocket on retail prescription drugs (1). Some adults reduce prescription drug costs by skipping doses and delaying filling prescriptions (2). Some cost-reduction strategies used by adults have been associated with negative health outcomes. For example, adults who do not take prescription medication as prescribed have been shown to have poorer health status and increased emergency room use, hospitalizations, and cardiovascular events (3,4). This report analyzes different strategies used by U.S. adults to reduce their prescription drug costs, by age, health insurance status, and poverty status, using data from the 2011 National Health Interview Survey (NHIS). PMID:23742848

Cohen, Robin A; Kirzinger, Whitney K; Gindi, Renee M

2013-04-01

74

Prescription drug abuse among ecstasy users in Miami.  

PubMed

This study examines the nature, extent and consequences of prescription drug abuse among 143 ecstasy users in Miami. Participants were recruited through nightclub and college campus outreach, and through respondent referrals. Instrumentation included the Risk Behavior Assessment, Substance Abuse Module and Center for Epidemiological Studies Depression Scale. Median age was 23, 42% were female and 50% Hispanic. An arrest history was reported by 44%, and 33% reported prior drug/alcohol treatment. Prescription drug abuse was reported by 87%; alprazolam (57%), oxycodone (36%), hydrocodone (32%) and diazepam (30%) were cited most often. Prescription drug abusers were more likely to report polydrug use, drug treatment histories, risky drug use behaviors, and symptoms of depression. They also reported numerous physical, psychological and social consequences of prescription drug abuse. Additional studies among larger samples are needed to understand the processes of prescription drug access and the extent of integration in club drug using cultures. PMID:16368653

Kurtz, Steven P; Inciardi, James A; Surratt, Hilary L; Cottler, Linda

2005-01-01

75

76 FR 59897 - Branded Prescription Drug Fee; Correction  

Federal Register 2010, 2011, 2012, 2013

...Sec. 51.2T Explanation of terms (temporary). * * * * * (k) Orphan drugs--(1) In general. Except as provided in paragraph (k)(2) of this section, the term orphan drug means any branded prescription drug for which any person...

2011-09-28

76

Prescription drug advertising: trends and implications.  

PubMed

Prescription drug advertisements which appeared in two leading American medical journals in 1972, 1977 and 1982 were analyzed to discover possible trends in advertising. The 5016 ads examined showed that ads for the diuretic-cardiovasculars, especially the beta-adrenergic blocking agents and the slow channel inhibitors, as well as the analgesics, had increased, while ads for the anti-infectives and tranquilizers had diminished. The average amount of space allocated for each ad had increased. On the average, most ads (69%) depicted neither male nor female patients in their graphics, and a trend of increased neutrality was observed. When the hormones were excluded, an average of 21% of the ads showed male patients and 10% showed females. Since a relationship was discerned between the leading drugs advertised and the leading prescriptions filled, it was concluded that advertising does have some effect on the prescribing behavior of practitioners. The findings suggest that great investment in advertising is necessary in order to achieve high levels of sales for such drugs as Valium (diazepam) which do not have a clear-cut ameliorative effect on a specific physiological condition. On the other hand, it was suggested that saturation advertising would not significantly enhance the sales of such drugs as Dyazide (triamterene and hydrochlorothiazide) because of its well established therapeutic value in the control of hypertension. Ten advertising companies, on the average, had purchased 67% of all advertising space and five had purchased almost half (47%). The same two pharmaceutical companies were among the top five advertisers and the same five were among the top ten for the three years studied. PMID:3975684

Krupka, L R; Vener, A M

1985-01-01

77

75 FR 33312 - Indexing Structured Product Labeling for Human Prescription Drug and Biological Products; Request...  

Federal Register 2010, 2011, 2012, 2013

...staff ``Labeling for Human Prescription Drugs and...associated with approved human prescription drug and...Representatives of the human prescription drug and...adverse reactions, drug interactions, pediatric, or pregnancy...available for uploading into computer systems for sorting...

2010-06-11

78

Acetaminophen and codeine overdose  

MedlinePLUS

Acetaminophen (Tylenol) and codeine is a prescription pain medicine. It is a narcotic, which means it has ... to relieve pain while making you feel sleepy. Acetaminophen and codeine overdose occurs when someone accidentally or ...

79

Amitriptyline hydrochloride overdose  

MedlinePLUS

Amitriptyline hydrochloride is a type of prescription medicine called a tricyclic antidepressant. Amitriptyline hydrochloride overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication. ...

80

Teens and Prescription Drugs: An Analysis of Recent Trends on the Emerging Drug Threat  

ERIC Educational Resources Information Center

This report synthesizes a number of national studies that show the intentional abuse of prescription drugs to get high is a growing concern, particularly among teens. The analysis shows that teens are turning away from street drugs and using prescription drugs to get high. New users of prescription drugs have caught up with new users of marijuana.…

Office of National Drug Control Policy, 2007

2007-01-01

81

Prescription Drug Abuse & Diversion: Role of the Pain Clinic  

PubMed Central

The goal of this research is to better understand the role that South Florida pain management clinics may be playing in the abuse and diversion of prescription drugs. This study explores 1) the characteristics and practices of pain clinics that may be facilitating the drug-seeking endeavors of prescription drug abusers and 2) the drug-seeking behaviors of prescription drug abusers who use pain clinics as a primary source for drugs. Thirty in-depth interviews were conducted with prescription drug abusers in South Florida. Interviews were transcribed verbatim and codes were generated based on thematic analyses of the data. Using grounded theory strategies, the analysis revealed six main themes: “pill mills”, on-site pharmacies, liberal prescribing habits, “sponsoring” drug diversion, pain doctor/pharmacy shopping, and faking symptoms/documentation. These findings should provide insights for law enforcement, regulatory agencies, and industry as they attempt to develop appropriate policy initiatives and recommendations for best practices. PMID:21278927

Rigg, Khary K.; March, Samantha J.; Inciardi, James A.

2010-01-01

82

Influences of motivational contexts on prescription drug misuse and related drug problems.  

PubMed

Prescription drug misuse has emerged as a significant problem among young adults. While the effects of motivational contexts have been demonstrated for illicit drugs, the role of motivational contexts in prescription drug misuse remains understudied. Using data from 400 young adults recruited via time-space sampling, we examined the role of motivational contexts in the frequency of misuse of three prescription drug types as well as drug-related problems and symptoms of dependency. Both negative and positive motivations to use drugs are associated with increases in prescription drug misuse frequency. Only negative motivations are associated directly with drug problems and drug dependence, as well as indirectly via prescription pain killer misuse. Addressing positive and negative motivational contexts of prescription drug misuse may not only provide a means to reduce misuse and implement harm reduction measures, but may also inform the content of treatment plans for young adults with prescription drug misuse problems. PMID:25115134

Kelly, Brian C; Rendina, H Jonathon; Vuolo, Mike; Wells, Brooke E; Parsons, Jeffrey T

2015-01-01

83

Medicare prescription drug coverage: preparing for January 1, 2006.  

PubMed

After many years of effort by health advocates, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (called the MMA) in December 2003. The law updates the benefits provided to Medicare beneficiaries by adding coverage for prescription drugs beginning January 1, 2006. Prescription drugs play a central role in modern health care, and extending drug coverage to Medicare beneficiaries is an important goal. The way in which Congress tackled this problem, however, has been highly contentious. This article will describe the law as it was passed, the issues that remain to be resolved, and what ia all means for people with HIV/AIDS. PMID:16124121

Crowley, Jeffrey S

2005-01-01

84

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2010 CFR

...standard prescription drug coverage for a given...standard prescription drug coverage under Part D in effect either at the start of...the coverage limits in effect at the beginning of...standard prescription drug coverage under Part...

2010-10-01

85

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

Code of Federal Regulations, 2012 CFR

...creditable status of prescription drug coverage. (a) Definition. Creditable prescription drug coverage means any of the...defined standard prescription drug coverage under Part D in effect at the start of such plan...

2012-10-01

86

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

...creditable status of prescription drug coverage. (a) Definition. Creditable prescription drug coverage means any of the...defined standard prescription drug coverage under Part D in effect at the start of such plan...

2014-10-01

87

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

...defined standard prescription drug coverage for a given plan year...defined standard prescription drug coverage under Part D in effect at the start of such plan year...sponsor's retiree prescription drug plan operates under a plan...

2014-10-01

88

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2013 CFR

...defined standard prescription drug coverage for a given plan year...defined standard prescription drug coverage under Part D in effect at the start of such plan year...sponsor's retiree prescription drug plan operates under a plan...

2013-10-01

89

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

Code of Federal Regulations, 2013 CFR

...creditable status of prescription drug coverage. (a) Definition. Creditable prescription drug coverage means any of the...defined standard prescription drug coverage under Part D in effect at the start of such plan...

2013-10-01

90

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2012 CFR

...defined standard prescription drug coverage for a given plan year...defined standard prescription drug coverage under Part D in effect at the start of such plan year...sponsor's retiree prescription drug plan operates under a plan...

2012-10-01

91

42 CFR 423.884 - Requirements for qualified retiree prescription drug plans.  

Code of Federal Regulations, 2011 CFR

...defined standard prescription drug coverage for a given plan year...defined standard prescription drug coverage under Part D in effect at the start of such plan year...sponsor's retiree prescription drug plan operates under a plan...

2011-10-01

92

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...Requirements related to qualified prescription drug coverage. 423.104 Section 423...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Benefits and Beneficiary Protections...Requirements related to qualified prescription drug coverage. (a) General....

2010-10-01

93

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

...benefits with other providers of prescription drug coverage. 423.464 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2014-10-01

94

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2012 CFR

...Requirements related to qualified prescription drug coverage. 423.104 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Benefits and Beneficiary Protections...Requirements related to qualified prescription drug coverage. (a) General....

2012-10-01

95

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2012 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2012-10-01

96

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2011 CFR

...Requirements related to qualified prescription drug coverage. 423.104 Section 423...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Benefits and Beneficiary Protections...Requirements related to qualified prescription drug coverage. (a) General....

2011-10-01

97

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

...Requirements related to qualified prescription drug coverage. 423.104 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Benefits and Beneficiary Protections...Requirements related to qualified prescription drug coverage. (a) General....

2014-10-01

98

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2011 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2011-10-01

99

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2010-10-01

100

42 CFR 423.104 - Requirements related to qualified prescription drug coverage.  

Code of Federal Regulations, 2013 CFR

...Requirements related to qualified prescription drug coverage. 423.104 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Benefits and Beneficiary Protections...Requirements related to qualified prescription drug coverage. (a) General....

2013-10-01

101

42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.  

Code of Federal Regulations, 2013 CFR

...benefits with other providers of prescription drug coverage. 423.464 Section 423...CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D Plans With Other Prescription Drug Coverage § 423.464...

2013-10-01

102

42 CFR 423.56 - Procedures to determine and document creditable status of prescription drug coverage.  

Code of Federal Regulations, 2010 CFR

...document creditable status of prescription drug coverage. 423.56 Section 423.56...PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Eligibility and Enrollment...document creditable status of prescription drug coverage. (a) Definition....

2010-10-01

103

76 FR 41434 - Removal of Certain Requirements Related to the Prescription Drug Marketing Act; Opportunity for...  

Federal Register 2010, 2011, 2012, 2013

...Requirements Related to the Prescription Drug Marketing Act; Opportunity for Public Comment...remove a section of the Prescription Drug Marketing Act (PDMA) regulations requiring that...various aspects of human prescription drug marketing and distribution. The primary...

2011-07-14

104

Patterns of prescription medication diversion among drug dealers  

PubMed Central

This research examined the following questions: (1) how do drug dealers acquire their inventories of prescription medications? and (2) which types of prescription medications do dealers most commonly sell? Data are drawn from a National Institute on Drug Abuse-funded research study that examined prescription drug diversion and abuse in South Florida. In-depth semi-structured interviews (n = 50) were conducted with an ethnically diverse sample of prescription drug dealers from a variety of milieus to assess patterns of diversion. Audiotapes of the interviews were transcribed, coded, and thematically analysed using the NVivo 8 software program. Dealers relied on a wide array of diversion methods including visiting multiple pain clinics, working with pharmacy employees to steal medications from pharmacies, and purchasing medications from indigent patients. The type of medication most commonly sold by dealers was prescription opioid analgesics, and to a lesser extent benzodiazepines such as alprazolam. These findings inform public health policy makers, criminal justice officials, the pharmaceutical industry and government regulatory agencies in their efforts to reduce the availability of diverted prescription drugs in the illicit market. Specifically, these data support the need for statewide prescription drug monitoring programs and increased training for healthcare workers who have access to controlled medications. PMID:22665955

Rigg, Khary K.; Kurtz, Steven P.; Surratt, Hilary L.

2012-01-01

105

Abuse of Prescription (Rx) Drugs Affects Young Adults Most  

MedlinePLUS

... Adults Most Email Facebook Twitter Text Description of Infographic Young adults (age 18 to 25) are the ... 2014 Monitoring the Future Survey ( December 2014 ) Tags Infographics Prescription Drugs Trends and Statistics This page was ...

106

Essays on prescription drug benefits in Medicare managed care  

E-print Network

In this thesis, I estimate a structural demand model for prescription drug benefits by Medicare beneficiaries using data from the Medicare HMO program. I then use the utility parameter estimates to explore other questions ...

Hall, Anne Elizabeth, 1971-

2005-01-01

107

How Can I End a Prescription Drug Habit Safely?  

MedlinePLUS

... have been changed to protect user privacy. For Teens For Kids For Parents MORE ON THIS TOPIC Dealing With Addiction Prescription Drug Abuse Alcohol School Counselors Talking to Your Doctor Talking to ...

108

21 CFR 310.201 - Exemption for certain drugs limited by new-drug applications to prescription sale.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Exemption for certain drugs limited by new-drug applications to prescription sale. 310.201...AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS New Drugs Exempted From Prescription-Dispensing...

2010-04-01

109

21 CFR 310.201 - Exemption for certain drugs limited by new-drug applications to prescription sale.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Exemption for certain drugs limited by new-drug applications to prescription sale. 310.201...AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS New Drugs Exempted From Prescription-Dispensing...

2011-04-01

110

Law enforcement attitudes toward overdose prevention and response  

PubMed Central

Background Law enforcement is often the first to respond to medical emergencies in the community, including overdose. Due to the nature of their job, officers have also witnessed first-hand the changing demographic of drug users and devastating effects on their community associated with the epidemic of nonmedical prescription opioid use in the United States. Despite this seminal role, little data exist on law enforcement attitudes toward overdose prevention and response. Methods We conducted key informant interviews as part of a 12-week Rapid Assessment and Response (RAR) process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in locations in Connecticut and Rhode Island experiencing overdose “outbreaks.” Interviews with 13 law enforcement officials across three study sites were analyzed to uncover themes on overdose prevention and naloxone. Results Findings indicated support for law enforcement involvement in overdose prevention. Hesitancy around naloxone administration by laypersons was evident. Interview themes highlighted officers’ feelings of futility and frustration with their current overdose response options, the lack of accessible local drug treatment, the cycle of addiction, and the pervasiveness of easily accessible prescription opioid medications in their communities. Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police-community relations. Conclusion Emerging trends, such as existing law enforcement medical interventions and Good Samaritan Laws, suggest the need for broader law enforcement engagement around this pressing public health crisis, even in suburban and small town locations, to promote public safety. PMID:24051061

Green, Traci C.; Zaller, Nickolas; Palacios, Wilson R.; Bowman, Sarah E.; Ray, Madeline; Heimer, Robert; Case, Patricia

2014-01-01

111

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2010 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2010-04-01

112

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2011 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2011-04-01

113

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2012 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2012-04-01

114

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2014-04-01

115

21 CFR 250.100 - Amyl nitrite inhalant as a prescription drug for human use.  

Code of Federal Regulations, 2013 CFR

...nitrite inhalant as a prescription drug for human use. 250.100 Section 250.100...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS New Drug or Prescription...

2013-04-01

116

‘It’s more about the heroin’: Injection drug users’ response to an overdose warning campaign in a Canadian setting  

PubMed Central

Aims To assess heroin injectors’ perceptions of and responses to a warning issued by public health officials regarding high-potency heroin and increases in fatal overdoses. Design Semi-structured qualitative interviews Setting Vancouver, Canada. Participants Eighteen active heroin injectors Measurements Semi-structured interview guide focussing on heroin injectors’ perceptions of and responses to the overdose warning, including reasons for failing to adhere to risk reduction recommendations. Findings Although nearly all participants were aware of the warning, their recollections of the message and the timing of its release were obscured by on-going social interactions within the drug scene focussed on heroin quality. Many injection drug users reported seeking the high potency heroin and nearly all reported no change in overdose risk behaviours. Responses to the warning were shaped by various social, economic and structural forces that interacted with individual behaviour and undermined efforts to promote behavioural change, including sales tactics employed by dealers, poverty, the high cost and shifting quality of available heroin, and risks associated with income-generating activities. Individual-level factors, including emotional suffering, withdrawal, entrenched injecting routines, perceived invincibility and the desire for intense intoxication also undermined risk reduction messages. Conclusions Among heroin injectors in British Columbia, a 2011 overdose warning campaign appeared to be of limited effectiveness and also produced unintended negative consequences that exacerbated overdose risk. PMID:23551565

Kerr, Thomas; Small, Will; Hyshka, Elaine; Maher, Lisa; Shannon, Kate

2014-01-01

117

The role of depression and social support in non-fatal drug overdose among a cohort of injection drug users in a Canadian setting  

PubMed Central

Objectives Non-fatal overdose remains a significant source of morbidity among people who inject drugs (IDU). Although depression and social support are important in shaping the health of IDU, little is known about the relationship between these factors and overdose. Therefore, we sought to determine whether depressive symptoms and social support predicted non-fatal overdose among IDU in a Canadian setting. Methods Data were derived from three prospective cohorts of people who use drugs: the Vancouver Injection Drug Users Study (VIDUS), the ACCESS Cohort, and the At-Risk Youth Study (ARYS). Multilevel modeling was used to determine if depression and social support were significant predictors of non-fatal overdose across time. Analyses were stratified by sex. Results There were 1,931 participants included in this analysis, including 653 (33.8%) females and 69 (3.6%) youth 20 years old or younger. Depressed men (Adjusted odds ratio [AOR] =1.53, 95% confidence intervals [CI] =1.25, 1.87) and women (Adjusted odds ratio [AOR] =2.23, 95% confidence intervals [CI] =1.65, 3.00) were more likely to experience a non-fatal overdose. Further, among women, those who reported having 3 or more persons they could rely upon for social support were less likely to experience a non-fatal overdose (AOR=0.54, 95% 0.31, 0.93). Conclusion Although depression was a significant predictor of non-fatal drug overdose, social support was a significant predictor among women only. Possible strategies to prevent non-fatal overdose may include identifying IDU experiencing severe depressive symptoms and providing targeted mental health treatments and mobilizing interpersonal social support among IDU, especially among women. PMID:23647731

Pabayo, Roman; Alcantara, Carmela; Kawachi, Ichiro; Wood, Evan; Kerr, Thomas

2013-01-01

118

Intravenous lipids: antidotal therapy for drug overdose and toxic effects of local anesthetics.  

PubMed

Intravenous lipid emulsion is an accepted therapy for the treatment of severe cardiac toxic effects caused by local anesthetics. Lipid emulsion therapy has also been used successfully to treat cardiac arrest and intractable arrhythmias caused by overdoses of antiepileptic drugs, cardiovascular drugs, and psychotropic medications, but experience with intravenous lipids as antidotal therapy in these clinical situations is limited. However, intravenous lipids are relatively safe, widely available, and easy to administer, and many published case reports document their dramatic effectiveness. Patients who have not responded to standard therapies have been quickly revived by administration of intravenous lipids. Use of lipids most likely will increase, and critical care nurses should be familiar with lipid therapy. PMID:25274765

Bartlett, Dana

2014-10-01

119

Are You Shopping Smart for Prescription Drugs?  

MedlinePLUS

... work well for them through the CR Best Buy Drugs program. Photo courtesy of Sara Jorde Photography ... National Library of Medicine, the Consumer Reports Best Buy Drugs program helps consumers discuss drug choices with ...

120

Prevalence of the Prescription of Potentially Interacting Drugs  

PubMed Central

The use of multiple medications is becoming more common, with a correspondingly increased risk of untoward effects and drug-related morbidity and mortality. We aimed at estimating the prevalence of prescription of relevant potentially interacting drugs and at evaluating possible predictors of potentially interacting drug exposure. We retrospectively analyzed data on prescriptions dispensed from January 2004 to August 2005 to individuals of two Italian regions with a population of almost 2.1 million individuals. We identified 27 pairs of potentially interacting drugs by examining clinical relevance, documentation, and volume of use in Italy. Subjects who received at least one prescription of both drugs were selected. Co-prescribing denotes “two prescriptions in the same day”, and concomitant medication “the prescription of two drugs with overlapping coverage”. A logistic regression analysis was conducted to examine the predictors of potential Drug-Drug Interaction (pDDIs). 957,553 subjects (45.3% of study population) were exposed to at least one of the drugs/classes of the 27 pairs. Overall, pDDIs occurred 2,465,819 times. The highest rates of concomitant prescription and of co-prescription were for ACE inhibitors+NSAIDs (6,253 and 4,621/100,000 plan participants). Considering concomitance, the male/female ratio was <1 in 17/27 pairs (from 0.31 for NSAIDs-ASA+SSRI to 0.74 for omeprazole+clopidogrel). The mean age was lowest for methotrexate pairs (+omeprazole, 59.9 years; +NSAIDs-ASA, 59.1 years) and highest for digoxin+verapamil (75.4 years). In 13/27 pairs, the mean ages were ?70 years. On average, subjects involved in pDDIs received ?10 drugs. The odds of exposure were more frequently higher for age ?65 years, males, and those taking a large number of drugs. A substantial number of clinically important pDDIs were observed, particularly among warfarin users. Awareness of the most prevalent pDDIs could help practitioners in preventing concomitant use, resulting in a better quality of drug prescription and potentially avoiding unwanted side effects. PMID:24147143

Tragni, Elena; Casula, Manuela; Pieri, Vasco; Favato, Giampiero; Marcobelli, Alberico; Trotta, Maria Giovanna; Catapano, Alberico Luigi

2013-01-01

121

Americans' access to prescription drugs stabilizes, 2007-2010.  

PubMed

Despite the weak economy and more people lacking health insurance, the proportion of Americans reporting problems affording prescription drugs remained level between 2007 and 2010, with more than one in eight going without a prescribed drug in 2010, according to a new national study from the Center for Studying Health System Change (HSC). While remaining stable overall, access to prescription drugs improved for working-age, uninsured people, likely reflecting a decline in visits to health care providers, as well as changes in the composition of the uninsured population. Likewise, elderly people eligible for both Medicare and Medicaid saw a sharp drop in prescription drug access problems. The most vulnerable people--the uninsured, those with low incomes, people in fair or poor health, and those with multiple chronic conditions--continued to face the most unmet prescription needs. For example, 48 percent of uninsured people in fair or poor health went without a prescription drug because of cost concerns in 2010, almost double the rate of insured people with the same reported health status. PMID:22180943

Boukus, Ellyn R; Carrier, Emily R

2011-12-01

122

Psychosocial modifiers of drug prescription: the hidden face of pharmacology?  

PubMed

Apart from placebo, there is scant medical knowledge regarding the influence of psychosocial effect modifiers in pharmacology. Phenomena such as the nocebo, Hawthorne, Oedipus and complacency effects have been previously described as sources of bias in clinical trials; however, the effects related to prescription patterns have been widely ignored to date. Under certain circumstances, psychosocial effects may even be catalysts for changes in the official regulations on drug prescription--changes often lacking an adequate scientific basis--and, subsequently, induce major changes in drug use worldwide. In spite of this, the study of psychosocial effects in pharmacology has been confined to anecdotal reports. The present overview of this topic is aimed at encouraging the identification of psychosocial effects in pharmacology. It also suggests that commercial case studies of drugs are a suitable method for studying prescription and effect modifiers. Triazolam's commercial history provides a good example of this approach. A better knowledge of these effects may contribute to a better understanding of the prescription habits observed in clinical practice. It may also prevent paradoxical changes in prescription patterns or in drug regulations. PMID:15073743

Salvador-Carulla, L; Rodríguez-Blázquez, C

1998-01-01

123

Fatal heroin 'overdose': a review  

Microsoft Academic Search

The current paper examines critically the literature on deaths attributed to heroin overdose, and examines the characteristics and circumstances of such deaths. In particular, the dominance of the widely held belief that heroin-related fatalities are a consequence of overdose is challenged. Deaths attributed to overdose represented in the literature are typically older, heroin-dependent males not in drug treatment at the

SHANE DARKE; DEBORAH ZADOR

1996-01-01

124

Antidepressant Overdose: Symptoms and Treatment  

Microsoft Academic Search

In recent years, an increased use of antidepressant medications has resulted in a heightened incidence of drug overdose. Because of this increased use, more types of antidepressant agents have become available. Therefore, emergency-room physicians not only have to recognize the overdose patient (often unwilling or unable to communicate with the physician), but also, identify the overdose agents if possible, and

Donald M. Gallant

1987-01-01

125

Long day's journey into night: women and prescription drug abuse.  

PubMed

Standard explanatory models of addiction are reviewed, including personality theory, locus of control, behaviorist theory, social learning, biochemical and socioeconomic theories, in the context of understanding the female preponderance in prescription drug addiction. Alexander and Hadaway's "adaptive" model of addiction is presented as a more comprehensive model of female prescription drug addiction, encompassing relevant and therapeutically useful aspects of earlier models. It also permits both the individualization of the model to each woman's particular situation, and also the incorporation of common themes stemming from sex-role stereotyping, low status in the society, and the power dynamic of the male physician-female patient interaction. PMID:2874664

Ogur, B

1986-01-01

126

A New Prescription for Fighting Drug Abuse  

ERIC Educational Resources Information Center

It's a drug prevention conversation--and program--that was largely missing as recently as a decade ago in most middle and high schools. In those days, the principal concern of health educators and disciplinarians alike was to keep students from misusing alcohol and illegal street drugs such as ecstasy, cocaine and even heroine. But driven by the…

Schachter, Ron

2012-01-01

127

Prescription and Over-the-Counter Drug Abuse Prevention. Prevention Update  

ERIC Educational Resources Information Center

According to the White House Office of National Drug Control Policy, "abuse of prescription drugs to get high has become increasingly prevalent among teens and young adults. Past year abuse of prescription pain killers now ranks second--only behind marijuana--as the Nation's most prevalent illegal drug problem." Use of prescription drugs without a…

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2010

2010-01-01

128

Rural Adolescents' Nonmedical Prescription Drug Use: Implications for Intervention  

ERIC Educational Resources Information Center

Rural communities often have distinct contextual factors that impact residents' substance abuse behavior. However, most studies to date have focused either exclusively on urban populations or neglected to analyze data in a way that allows any rural/urban comparison. This is especially true for research examining nonmedical prescription drug use…

Young, April M.; Glover, Natalie; Havens, Jennifer R.

2012-01-01

129

A Political History of Medicare and Prescription Drug Coverage  

PubMed Central

This article examines the history of efforts to add prescription drug coverage to the Medicare program. It identifies several important patterns in policymaking over four decades. First, prescription drug coverage has usually been tied to the fate of broader proposals for Medicare reform. Second, action has been hampered by divided government, federal budget deficits, and ideological conflict between those seeking to expand the traditional Medicare program and those preferring a greater role for private health care companies. Third, the provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 reflect earlier missed opportunities. Policymakers concluded from past episodes that participation in the new program should be voluntary, with Medicare beneficiaries and taxpayers sharing the costs. They ignored lessons from past episodes, however, about the need to match expanded benefits with adequate mechanisms for cost containment. Based on several new circumstances in 2003, the article demonstrates why there was a historic opportunity to add a Medicare prescription drug benefit and identify challenges to implementing an effective policy. PMID:15225331

Oliver, Thomas R; Lee, Philip R; Lipton, Helene L

2004-01-01

130

An integrated drug prescription and distribution system: challenges and opportunities.  

PubMed

Using the hospital's drug prescription and distribution system as a guide, benefits and drawbacks of a medical activity management system that is tightly integrated with the supply chain management of a hospital will be discussed from the point of view of various participating healthcare actors. PMID:15058416

Lanssiers, R; Everaert, E; De Win, M; Van De Velde, R; De Clercq, H

2002-01-01

131

State prescription drug price Web sites: how useful to consumers?  

PubMed

To aid consumers in comparing prescription drug costs, many states have launched Web sites to publish drug prices offered by local retail pharmacies. The current push to make retail pharmacy prices accessible to consumers is part of a much broader movement to increase price transparency throughout the health-care sector. Efforts to encourage price-based shopping for hospital and physician services have encountered widespread concerns, both on grounds that prices for complex services are difficult to measure and compare accurately and that quality varies substantially across providers. Experts agree, however, that prescription drugs are much easier to shop for than other, more complex health services. However, extensive gaps in available price information--the result of relying on Medicaid data--seriously hamper the effectiveness of state drug price-comparison Web sites, according to a new study by the Center for Studying Health System Change (HSC). An alternative approach--requiring pharmacies to submit price lists to the states--would improve the usefulness of price information, but pharmacies typically oppose such a mandate. Another limitation of most state Web sites is that price information is restricted to local pharmacies, when online pharmacies, both U.S. and foreign, often sell prescription drugs at substantially lower prices. To further enhance consumer shopping tools, states might consider expanding the types of information provided, including online pharmacy comparison tools, lists of deeply discounted generic drugs offered by discount retailers, and lists of local pharmacies offering price matches. PMID:18494180

Tu, Ha T; Corey, Catherine G

2008-02-01

132

Withholding Medicare Prescription Drug Premium from Your 2014 Social Security Payment  

MedlinePLUS

... 2014 Withholding Medicare Prescription Drug Premium from Your 2015 Social Security Payment Each year, Medicare Prescription Drug ... up. 2 I chose a different plan for 2015 with a different premium but the plan is ...

133

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

Code of Federal Regulations, 2013 CFR

...standing technical advisory committees for human prescription drugs. 14.160 Section...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC HEARING BEFORE...ADVISORY COMMITTEE Advisory Committees for Human Prescription Drugs § 14.160...

2013-04-01

134

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

Code of Federal Regulations, 2011 CFR

...standing technical advisory committees for human prescription drugs. 14.160 Section...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC HEARING BEFORE...ADVISORY COMMITTEE Advisory Committees for Human Prescription Drugs § 14.160...

2011-04-01

135

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

...standing technical advisory committees for human prescription drugs. 14.160 Section...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC HEARING BEFORE...ADVISORY COMMITTEE Advisory Committees for Human Prescription Drugs § 14.160...

2014-04-01

136

21 CFR 14.160 - Establishment of standing technical advisory committees for human prescription drugs.  

Code of Federal Regulations, 2010 CFR

...standing technical advisory committees for human prescription drugs. 14.160 Section...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PUBLIC HEARING BEFORE...ADVISORY COMMITTEE Advisory Committees for Human Prescription Drugs § 14.160...

2010-04-01

137

Psychiatric and pain characteristics of prescription drug abusers entering drug rehabilitation.  

PubMed

There has been intense interest in the problem of prescription drug abuse on the parts of health professionals, law enforcement, the media, and the general public. Clinicians not only need to know how to assess risk but also what drugs are being diverted most in their region. We conducted a prospective survey of prescription drug abusers entering a treatment facility in central Kentucky. Participants (n = 109) were enrolled and completed a structured clinical interview and prescription drug abuse survey. The prescription drug abusers assessed in the study had a mean age of 30.95 years (SD = 10.21), were comprised of 75 men (69%) and 34 women (31%), and were mostly Caucasian (98%). The majority (84%) stated that they had legitimately been given a prescription for opioids for pain at some point from a physician and 61% reported chronic pain concerns. The most commonly abused drugs were hydrocodone-containing formulations (78%) and oxycodone-containing products (69%), while products containing methadone (23%) or fentanyl (7%) were abused much less frequently. Most respondents (91%) stated that they had purchased prescription opioids from a street dealer at least once and the majority (80%) had altered the delivery system of the prescription drug by chewing, snorting, or using i.v. administration. Implications for pain management are discussed, focusing on the need for clinicians treating chronic pain to more thoroughly assess patients for their risk of abuse and addiction before starting an opioid regimen. PMID:16702131

Passik, Steven D; Hays, Lon; Eisner, Nina; Kirsh, Kenneth L

2006-01-01

138

75 FR 46952 - Prescription Drug User Fee Rates for Fiscal Year 2011  

Federal Register 2010, 2011, 2012, 2013

...FDA-2010-N-0390] Prescription Drug User Fee Rates for Fiscal Year 2011 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2011. The Federal...as amended by the Prescription Drug User Fee Amendments of 2007 (Title 1 of the...

2010-08-04

139

77 FR 45639 - Prescription Drug User Fee Rates for Fiscal Year 2013  

Federal Register 2010, 2011, 2012, 2013

...FDA-2012-N-0007] Prescription Drug User Fee Rates for Fiscal Year 2013 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2013. The Federal...as amended by the Prescription Drug User Fee Amendments of 2012 (Title 1 of the...

2012-08-01

140

76 FR 45831 - Prescription Drug User Fee Rates for Fiscal Year 2012  

Federal Register 2010, 2011, 2012, 2013

...FDA-2011-N-0559] Prescription Drug User Fee Rates for Fiscal Year 2012 AGENCY: Food...announcing the rates for prescription drug user fees for fiscal year (FY) 2012. The Federal...as amended by the Prescription Drug User Fee Amendments of 2007 (Title 1 of the...

2011-08-01

141

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2013 CFR

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2013-04-01

142

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2012 CFR

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2012-04-01

143

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2010 CFR

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2010-04-01

144

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

Code of Federal Regulations, 2011 CFR

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2011-04-01

145

21 CFR 300.50 - Fixed-combination prescription drugs for humans.  

... Fixed-combination prescription drugs for humans. 300.50 Section 300.50 Food and Drugs...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE GENERAL Combination Drugs §...

2014-04-01

146

H2 receptor antagonists overdose  

MedlinePLUS

... Ranitidine overdose; Zantac overdose; Famotidine overdose; Pepcid overdose; Nizatidine overdose; Axid overdose ... Cimetidine Ranitidine Famotidine Nizatidine Note: This list may not be all-inclusive.

147

21 CFR 310.305 - Records and reports concerning adverse drug experiences on marketed prescription drugs for human...  

Code of Federal Regulations, 2011 CFR

...prescription drugs for human use without approved new drug applications. 310.305 Section...SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS Records and Reports § 310.305...prescription drugs for human use without approved new drug applications. (a) Scope....

2011-04-01

148

21 CFR 310.305 - Records and reports concerning adverse drug experiences on marketed prescription drugs for human...  

Code of Federal Regulations, 2010 CFR

...prescription drugs for human use without approved new drug applications. 310.305 Section...SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS Records and Reports § 310.305...prescription drugs for human use without approved new drug applications. (a) Scope....

2010-04-01

149

21 CFR 310.305 - Records and reports concerning adverse drug experiences on marketed prescription drugs for human...  

Code of Federal Regulations, 2012 CFR

...experiences on marketed prescription drugs for human use without approved new drug applications...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS Records and Reports §...

2012-04-01

150

21 CFR 310.305 - Records and reports concerning adverse drug experiences on marketed prescription drugs for human...  

...experiences on marketed prescription drugs for human use without approved new drug applications...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS Records and Reports §...

2014-04-01

151

21 CFR 310.305 - Records and reports concerning adverse drug experiences on marketed prescription drugs for human...  

Code of Federal Regulations, 2013 CFR

...experiences on marketed prescription drugs for human use without approved new drug applications...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE NEW DRUGS Records and Reports §...

2013-04-01

152

Redressing the Epidemics of Opioid Overdose and HIV among People who Inject Drugs in Central Asia: The Need for a Syndemic Approach  

PubMed Central

Background Accumulating evidence suggests that opioid overdose and HIV infection are burgeoning intertwined epidemics among people who inject drugs (PWID) in Central Asia. To date, however, research on overdose and its associations with HIV risks among PWID in Central Asia remains virtually absent. This paper aims to provide a regional overview of the hidden epidemic of overdose and how it is linked to HIV among PWID in Central Asia, using a syndemic framework that is guided by risk environment research. Methods We conducted a comprehensive literature search of peer-reviewed publications and grey literature on opioid overdose and its associations with HIV in five countries of Central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan) as well as on policies and programs that address these co-occurring epidemics. Results Regional data indicate high rates of fatal and non-fatal overdose among PWID. Evidence suggests mortality rates from overdose exceed HIV/AIDS as the leading cause of death among PWID. The syndemic framework suggests multiple macro-level and micro-level environmental risk factors that drive the co-occurring epidemics of HIV and overdose. This framework identifies several interacting biological and behavioral risks that result in additive effects for HIV and overdose. Conclusion The high rates of overdose and its associations with HIV underscore the need for a syndemic approach that considers overdose on parity with HIV. Such an approach should focus on the biological, behavioral and structural interactions between these epidemics to reduce social suffering, morbidity and mortality among PWID in Central Asia. PMID:23954070

Gilbert, Louisa; Primbetova, Sholpan; Nikitin, Danil; Hunt, Timothy; Terlikbayeva, Assel; Momenghalibaf, Azzi; Ruziev, Murodali; El-Bassel, Nabila

2013-01-01

153

Medical cost offsets from prescription drug utilization among medicare beneficiaries.  

PubMed

This brief commentary extends earlier work on the value of adherence to derive medical cost offset estimates from prescription drug utilization. Among seniors with chronic vascular disease, 1% increases in condition-specific medication use were associated with significant (P? less than ?0.001) reductions in gross nonpharmacy medical costs in the amounts of 0.63% for dyslipidemia, 0.77% for congestive heart failure, 0.83% for diabetes, and 1.17% for hypertension. PMID:25278321

Roebuck, M Christopher

2014-10-01

154

The Effect of Prescription Drug Advertising on Doctor Visits  

Microsoft Academic Search

The dramatic increase of direct-to-consumer advertising (DTCA) of prescription drugs created intensive debates on its effects on patient and doctor behaviors. Combining 1994–2000 DTCA data with the 1995–2000 National Ambulatory Medical Care Surveys, we examine the effect of DTCA on doctor visits. Consistent with the proponents' claim, we find that higher DTCA expenditures are associated with increased doctor visits, especially

Toshiaki Iizuka; Ginger Zhe Jin

2005-01-01

155

Prescription drug misuse, illicit drug use, and their potential risk and protective correlates in a Hispanic college student sample.  

PubMed

Illicit substance use has increased in Hispanics. Recent trends also warrant focus on prescription drug misuse, given its increased prevalence among college students. The aims of this study were to assess prescription drug misuse and illicit drug use in Hispanic students, as well as potential theoretically and empirically based risk and protective factors. Hispanic students (n = 435; 59% female) from a U.S. university located on the border with México completed a sociodemographic survey, licit, illicit, and prescription drug use frequency questionnaires, an attitudes and beliefs about prescription drugs survey, the Short Acculturation Scale for Hispanics, the Depression, Anxiety, and Stress Scales, the Collectivist Coping Styles Measure, and the Multidimensional Scale of Perceived Social Support. A hierarchical logistic regression assessed prescription drug misuse predictors including demographics, licit/illicit substance use, attitudes toward prescription drug use, acculturation, distress symptoms, coping style, perceived social support, and the interaction between distress symptoms and acculturation. A negative binomial regression assessed predictors of past 30-day illegal drug use (the same predictors as the previous model except illicit drug use). Results indicated that positive attitudes toward prescription drugs, higher anxiety, and lower depressive symptomatology increased the odds of prescription drug misuse. Past 30-day alcohol use, positive attitudes toward prescription drugs, and higher acculturation predicted past 30-day illicit drug use. Prescription drug misuse was differentially associated with distress symptoms, whereas the convergence model of acculturation was supported regarding illegal drug use. Inconsistent with hypotheses, protective factors were not significantly associated with substance use. PMID:23750694

Cabriales, José Alonso; Cooper, Theodore V; Taylor, Thom

2013-06-01

156

Evaluation of an Overdose Prevention and Response Training Programme for Injection Drug Users in the Skid Row Area of Los Angeles, California  

PubMed Central

Background Fatal opioid overdose is a significant cause of mortality among injection drug users (IDUs). Methods We evaluated an overdose prevention and response training programme for IDUs implemented by a community-based organization in Los Angeles, California. During a 1-hour training session participants learned skills to prevent, recognize, and respond to opioid overdoses, including: calling for emergency services, performing rescue breathing, and administering an intramuscular injection of naloxone (an opioid antagonist). Ninety-three IDUs were trained from September 2006 to January 2008. Of those, 66 (71%) enrolled in the evaluation study. In total, 47 of 66 participants (71%) completed both a baseline interview and three-month follow-up interview. Results Participants were 21% female, 42% White, 29% African American, and 18% Latino. Most were homeless and reported living predominantly in the street (44%), temporary housing such as hotels or motels (15%), or shelters (14%). Significant increases were found in overdose knowledge, driven largely by increase in knowledge about the appropriate use of naloxone. Twenty-two participants witnessed and responded to 35 overdoses during the follow-up period. Twenty-six overdose victims were reported to have recovered, four died, and the outcome of five cases was unknown. The most commonly reported response techniques included: staying with the victim (85%), administering naloxone (80%), providing rescue breathing (66%), and calling emergency services (60%). The average number of appropriate response techniques used by participants increased significantly from baseline to follow-up (p<0.05). Half (53%) of programme participants reported that their drug use decreased at follow-up. Conclusion Results suggest that overdose prevention and response training programmes may be associated with improvements in knowledge and overdose response behaviour among IDUs, with few adverse consequences and some unforeseen benefits, such as reductions in drug use. PMID:19268564

Wagner, Karla D.; Valente, Thomas W.; Casanova, Mark; Partovi, Susan M.; Mendenhall, Brett M.; Hundley, James H.; Gonzalez, Mario; Unger, Jennifer B.

2014-01-01

157

How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan  

MedlinePLUS

How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan Revised April 2014 Medicare offers prescription ... MA-PDs.” You’ll get all of your Medicare coverage including Part A (Hospital Insurance), Part B ( ...

158

Prescription drug advertising trends: a study of oral hypoglycemics.  

PubMed

A content analysis of oral hypoglycemic drug advertisements was performed in selected medical journals published in the United States from 1963 to 1986. The 665 advertisements subsequently examined were studied for certain predetermined parameters in order to indicate trends. The trend results may be summarized as follows. As an extension of prescription drug advertising trends in general, oral hypoglycemic drug advertising showed an increasing length along with a subsequent decrease in the amount of space devoted to the copy portion of the advertisement. They also showed a decrease in the use of statistical information and rarely made references to competitors. Nongender specific, colored advertisements with product and use related appeals have become more common with the passage of time. Although the rationale and purpose behind advertising is unchanged, the format has changed considerably. These changes are primarily due to the enhancement of print technology and to some extent, the changing social environment. PMID:2799427

Mehta, K K; Sorofman, B A; Rowland, C R

1989-01-01

159

Computer-aided auditing of prescription drug claims.  

PubMed

We describe a methodology for identifying and ranking candidate audit targets from a database of prescription drug claims. The relevant audit targets may include various entities such as prescribers, patients and pharmacies, who exhibit certain statistical behavior indicative of potential fraud and abuse over the prescription claims during a specified period of interest. Our overall approach is consistent with related work in statistical methods for detection of fraud and abuse, but has a relative emphasis on three specific aspects: first, based on the assessment of domain experts, certain focus areas are selected and data elements pertinent to the audit analysis in each focus area are identified; second, specialized statistical models are developed to characterize the normalized baseline behavior in each focus area; and third, statistical hypothesis testing is used to identify entities that diverge significantly from their expected behavior according to the relevant baseline model. The application of this overall methodology to a prescription claims database from a large health plan is considered in detail. PMID:23821344

Iyengar, Vijay S; Hermiz, Keith B; Natarajan, Ramesh

2014-09-01

160

HOW PARENTS OF TEENS STORE AND MONITOR PRESCRIPTION DRUGS IN THE HOME*  

PubMed Central

Qualitative interviews were conducted with parents of teens to explore how parents store and monitor prescription drugs in the home. Most parents had prescription drugs in the house, but took few precautions against teens accessing these drugs. Strategies for monitoring included moving the drugs to different locations, remembering how many pills were left, and how medication containers were positioned. Reasons given for not securing drugs were that parents did not think that their teens would be interested in their prescription drugs and did not believe that they could be used to get high. This study highlights the need for parents to be educated about securing prescription drugs, the dangers of non-medical prescription drug use by teens, and which drugs might be used for non-medical purposes. PMID:25429166

FRIESE, BETTINA; MOORE, ROLAND S.; GRUBE, JOEL W.; JENNINGS, VANESSA K.

2014-01-01

161

A free market solution for prescription drug crises.  

PubMed

The cost of prescription drugs is imposing an ever greater burden on families and varying levels of government. The vast majority of this cost is attributable to patent protection, since most drugs are actually relatively cheap to produce. The temporary monopolies provided by patent protection have been the main mechanism through which corporations have financed their drug research. This article examines the efficiency of publicly supported drug research relative to the current patent system. The author shows that even if publicly funded research were considerably less efficient on a dollar-per-dollar basis than patent-supported research, there would still be enormous gains from switching to a system of publicly supported research. The main reason for this conclusion is that patent monopolies lead to enormous economic distortions, including expensive sales promotion efforts, research into "copycat drugs," incentives to conceal unfavorable research findings, and other inefficiencies that economic theory predicts would result from a government-created monopoly. The gains from publicly supported research, coupled with a free market in the production of drugs, could reach into several hundred billion dollars annually within a decade. PMID:15346683

Baker, Dean

2004-01-01

162

Heroin overdose: Research and evidence-based intervention  

Microsoft Academic Search

Drug overdose is a major cause of premature death and morbidity among heroin users. This article examines recent research\\u000a into heroin overdose to inform interventions that will reduce the rate of overdose death. The demographic characteristics\\u000a of overdose cases are discussed, including factors associated with overdose: polydrug use, drug purity, drug tolerance, routes\\u000a of administration, and suicide. Responses by heroin

Shane Darke; Wayne Hall

2003-01-01

163

76 FR 79194 - Agency Information Collection Activities; Proposed Collection; Comment Request; Prescription Drug...  

Federal Register 2010, 2011, 2012, 2013

...Medication Guides, for certain prescription human drug and biological products used primarily on an...effectively. Included is information such as the drug's approved uses, contraindications, adverse drug reactions, and cautions for specific...

2011-12-21

164

HOW CLINICIANS USE PRESCRIPTION DRUG MONITORING PROGRAMS: A QUALITATIVE INQUIRY  

PubMed Central

Objectives Prescription drug monitoring programs (PDMP) are now active in most states to assist clinicians in identifying potential controlled drug misuse, diversion or excessive prescribing. Little is still known about the ways in which they are incorporated into workflow and clinical decision making, what barriers continue to exist, and how clinicians are sharing PDMP results with their patients. Design Qualitative data were collected through online focus groups and telephone interviews Setting Clinicians from pain management, emergency and family medicine, psychiatry/behavioral health, rehabilitation medicine, internal medicine and dentistry. Subjects 35 clinicians from 9 states participated. Methods We conducted two online focus groups and seven telephone interviews. A multidisciplinary team then used a grounded theory approach coupled with an immersion-crystallization strategy for identifying key themes in the resulting transcripts. Results Some participants, mainly from pain clinics, reported checking the PDMP with every patient, every time. Others checked only for new patients, for new opioid prescriptions, or for patients for whom they suspected abuse. Participants described varied approaches to sharing PDMP information with patients, including openly discussing potential addiction or safety concerns; avoiding discussion altogether; and approaching discussion confrontationally. Participants described patient anger or denial as a common response and noted the role of patient satisfaction surveys as an influence on prescribing. Conclusion Routines for accessing PDMP data and how clinicians respond to it vary widely. As PDMP use becomes more widespread, it will be important to understand what approaches are most effective for identifying and addressing unsafe medication use. PMID:24833113

Hildebran, Christi; Cohen, Deborah J.; Irvine, Jessica M.; Foley, Carol; O’Kane, Nicole; Beran, Todd; Deyo, Richard A.

2014-01-01

165

Mechanisms of Prescription Drug Diversion Among Drug-Involved Club- and Street-Based Populations  

PubMed Central

Objective Prescription drug diversion involves the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace, and can occur along all points in the drug delivery process, from the original manufacturing site to the wholesale distributor, the physician's office, the retail pharmacy, or the patient. However, empirical data on diversion are limited. Method In an attempt to develop a better understanding of how specific drug-using populations are diverting prescription opioids and other medications, or obtaining controlled drugs that have already been diverted, qualitative interviews and focus group data were collected on four separate populations of prescription drug abusers in Miami, Florida—club drug users, street-based illicit drug users, methadone maintenance patients, and HIV positive individuals who abuse and/or divert drugs. Results Sources of abused prescription drugs cited by focus group participants were extremely diverse, including their physicians and pharmacists; parents and relatives; “doctor shopping”; leftover supplies following an illness or injury; personal visits to Mexico, South America and the Caribbean; prescriptions intended for the treatment of mental illness; direct sales on the street and in nightclubs; pharmacy and hospital theft; through friends or acquaintances; under-the-door apartment flyers advertising telephone numbers to call; and “stealing from grandma's medicine cabinet.” Conclusion While doctor shoppers, physicians and the Internet receive much of the attention regarding diversion, the data reported in this paper suggest that there are numerous active street markets involving patients, Medicaid recipients and pharmacies as well. In addition, there are other data which suggest that the contributions of residential burglaries, pharmacy robberies and thefts, and “sneak thefts” to the diversion problem may be understated. PMID:17305688

Inciardi, James A.; Surratt, Hilary L.; Kurtz, Steven P.; Cicero, Theodore J.

2010-01-01

166

Nonmedical Prescription Drug Use among Adolescents: The Influence of Bonds to Family and School  

ERIC Educational Resources Information Center

There has been a tremendous increase in the prevalence of nonmedical prescription drug use among adolescents in recent years. Research now indicates that the prevalence of nonmedical prescription drug use is greater than the prevalence of other illicit drug use, excluding marijuana. Despite these recent trends, there is a dearth of research in the…

Ford, Jason A.

2009-01-01

167

77 FR 4273 - Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in...  

Federal Register 2010, 2011, 2012, 2013

...advertisements relating to the side effects and contraindications of an advertised prescription drug intended for use by humans...A) of the Food and Drug Administration Amendments...advertisements relating to the side effects and contraindications of an advertised prescription drug intended for use by...

2012-01-27

168

77 FR 16973 - Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in...  

Federal Register 2010, 2011, 2012, 2013

...advertisements relating to the side effects and contraindications of an advertised prescription drug intended for use by humans...A) of the Food and Drug Administration Amendments...advertisements relating to the side effects and contraindications of an advertised prescription drug intended for use by...

2012-03-23

169

75 FR 4973 - Registration Requirements for Importers and Manufacturers of Prescription Drug Products...  

Federal Register 2010, 2011, 2012, 2013

...Prescription Drug Products Containing Ephedrine, Pseudoephedrine, or Phenylpropanolamine...is obtained for every location where ephedrine, pseudoephedrine, or phenylpropanolamine...provisions related to importation of ephedrine, pseudoephedrine, and...

2010-02-01

170

21 CFR 201.80 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2013 CFR

...requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...requirements on content and format of labeling for human prescription drug and biological...

2013-04-01

171

21 CFR 201.80 - Specific requirements on content and format of labeling for human prescription drug and...  

...requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...requirements on content and format of labeling for human prescription drug and biological...

2014-04-01

172

21 CFR 201.56 - Requirements on content and format of labeling for human prescription drug and biological products.  

Code of Federal Regulations, 2010 CFR

...Requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...Requirements on content and format of labeling for human prescription drug and biological...

2010-04-01

173

21 CFR 201.56 - Requirements on content and format of labeling for human prescription drug and biological products.  

...Requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...Requirements on content and format of labeling for human prescription drug and biological...

2014-04-01

174

21 CFR 201.56 - Requirements on content and format of labeling for human prescription drug and biological products.  

Code of Federal Regulations, 2013 CFR

...Requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...Requirements on content and format of labeling for human prescription drug and biological...

2013-04-01

175

21 CFR 201.80 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2011 CFR

...requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...requirements on content and format of labeling for human prescription drug and biological...

2011-04-01

176

21 CFR 201.56 - Requirements on content and format of labeling for human prescription drug and biological products.  

Code of Federal Regulations, 2011 CFR

...Requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...Requirements on content and format of labeling for human prescription drug and biological...

2011-04-01

177

21 CFR 201.56 - Requirements on content and format of labeling for human prescription drug and biological products.  

Code of Federal Regulations, 2012 CFR

...Requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...Requirements on content and format of labeling for human prescription drug and biological...

2012-04-01

178

21 CFR 201.80 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2012 CFR

...requirements on content and format of labeling for human prescription drug and biological products...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL...requirements on content and format of labeling for human prescription drug and biological...

2012-04-01

179

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

21 Food and Drugs 4 2014-04-01 2014-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2014-04-01

180

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2011 CFR

21 Food and Drugs 4 2011-04-01 2011-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2011-04-01

181

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2013 CFR

21 Food and Drugs 4 2013-04-01 2013-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2013-04-01

182

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2012 CFR

21 Food and Drugs 4 2012-04-01 2012-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2012-04-01

183

21 CFR 205.50 - Minimum requirements for the storage and handling of prescription drugs and for the establishment...  

Code of Federal Regulations, 2010 CFR

21 Food and Drugs 4 2010-04-01 2010-04-01 false ...requirements for the storage and handling of prescription drugs and for the establishment and maintenance of prescription drug distribution records. 205.50 Section...

2010-04-01

184

Perception of Generic Prescription Drugs and Utilization of Generic Drug Discount Programs  

PubMed Central

Objective Our study aimed to assess patient’s perceptions of generic drugs and utilization of generic drug discount programs. Design, Setting and Participants A survey was administered to adult participants at community health centers and community-based organizations in Houston, Texas, USA (n=525). Main Outcome Measures Multivariate logistic regression was used to quantify the strength of association between generic drug perception and utilization of generic drug discount programs. Results Respondents who agreed that “Generic prescription drugs are as effective as brand name prescription drugs,” were 3 times as likely to utilize generic drug discount programs (AOR: 3.0, 95% CI: 1.8–4.8, P<.001). Compared to non-Hispanic Whites, African Americans (OR: 10.2; 95% CI: 1.4–76.4) and Hispanics (OR: 10.3; 95% CI: 1.3–79.4) were 10 times as likely to agree that generic drugs have more side effects than brand name drugs. Conclusion Race/ethnicity had no impact in utilization of generic drug discount programs, despite racial disparities in perception toward generic drugs’ side effects and generic drugs being inferior to brand name drugs. PMID:23140080

Omojasola, Anthony; Hernandez, Mike; Sansgiry, Sujit; Jones, Lovell

2012-01-01

185

An Exploration of Social Circles and Prescription Drug Abuse Through Twitter  

PubMed Central

Background Prescription drug abuse has become a major public health problem. Relationships and social context are important contributing factors. Social media provides online channels for people to build relationships that may influence attitudes and behaviors. Objective To determine whether people who show signs of prescription drug abuse connect online with others who reinforce this behavior, and to observe the conversation and engagement of these networks with regard to prescription drug abuse. Methods Twitter statuses mentioning prescription drugs were collected from November 2011 to November 2012. From this set, 25 Twitter users were selected who discussed topics indicative of prescription drug abuse. Social circles of 100 people were discovered around each of these Twitter users; the tweets of the Twitter users in these networks were collected and analyzed according to prescription drug abuse discussion and interaction with other users about the topic. Results From November 2011 to November 2012, 3,389,771 mentions of prescription drug terms were observed. For the 25 social circles (n=100 for each circle), on average 53.96% (SD 24.3) of the Twitter users used prescription drug terms at least once in their posts, and 37.76% (SD 20.8) mentioned another Twitter user by name in a post with a prescription drug term. Strong correlation was found between the kinds of drugs mentioned by the index user and his or her network (mean r=0.73), and between the amount of interaction about prescription drugs and a level of abusiveness shown by the network (r=0.85, P<.001). Conclusions Twitter users who discuss prescription drug abuse online are surrounded by others who also discuss it—potentially reinforcing a negative behavior and social norm. PMID:24014109

2013-01-01

186

Motivations for Non-Medical Prescription Drug Use: A Mixed Methods Analysis  

PubMed Central

Despite a dramatic increase in the non-medical use of prescription drugs among illicit drug users, their motives for abusing prescription drugs are still largely unknown. The objective of this study was to 1) determine the motivations for engaging in the non-medical use of prescription opioids and sedatives among street-based illicit drug users, methadone maintenance patients, and residential drug treatment clients, 2) examine associations between prescription drug abuse motivations and gender, age, race/ethnicity, and user group, and 3) examine associations between specific motivations and prescription drug abuse patterns. Quantitative surveys (n = 684) and in-depth interviews (n = 45) were conducted with a diverse sample of prescription drug abusers in South Florida between March 2008 and November 2009. The three most common motivations reported were “to get high”, “to sleep”, and “for anxiety/stress”. There were age, race/ethnicity, and gender differences by motives. Prescription drug abuse patterns were also found to be associated with specific motivations. While additional research is needed, these findings serve to inform appropriate prevention and treatment initiatives for prescription drug abusers. PMID:20667680

Rigg, Khary K.; Ibañez, Gladys E.

2010-01-01

187

Use of Drugs Subject to Controlled Prescriptions: a Retrospective Analysis  

PubMed Central

Objective: Use of drugs that may lead to abuse or dependence are subject to controlled prescriptions (CPs) in many countries, and these are closely monitored by health authorities. According to national regulations in Turkey, CPs may be red coloured (RCPs) or green coloured (GCPs). The aim of this study was to evaluate the use of such drugs in Istanbul. Study Design: Retrospective case-control study. Material and Methods: During the study period (01/01-31/12 2009), 502874 CPs were reported. Among these, 4000 CPs each month were randomly selected and evaluated. Results: The majority of GCPs were issued to women (55.6%), while the majority of RCPs were issued to men (68.4%). GCPs were most frequently prescribed by physicians working in private hospitals (33.6%) while RCPs by physicians working in university hospitals (39.7%). GCPs were mostly prescribed by psychiatrists (37.6%) while for RCPs were child and adolescent psychiatrists (35.9%). Psycholeptics (ATC code N05) were the most prescribed controlled drugs (CDs) (43.8%). Methylphenidate (53.9%) was the mostly prescribed on RCPs and alprazolam (39.6%) was on GCPs. Conclusion: We demonstrate that utilization of CDs shows demographical and institutional differences. These data could be of help to improve surveillance of CDs as well as to train prescribers and patients. PMID:25207068

Demircan, Dilek; Gülmez, Sinem Ezgi; Dönerta?, Ba?ak; Topcu, ?brahim; Y?lmaz, Hüseyin; Berkman, Kemal; Ak?c?, Ahmet

2013-01-01

188

Prescription Drug Misuse among University Staff and Students: A Survey of Motives, Nature and Extent  

ERIC Educational Resources Information Center

Aims: To determine the prevalence and nature of prescription drug misuse among university staff and students in the UK. Methods: In 2009, an online questionnaire regarding non-medical use of prescription drugs was completed by 1614 students and 489 staff registered at a large university in Wales. The sample data were weighted to match the…

Holloway, Katy; Bennett, Trevor

2012-01-01

189

An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs  

ERIC Educational Resources Information Center

This study examines patterns of use of prescription drugs and methamphetamine. We drew our sample from a study about 130 active and inactive methamphetamine users and focused on 16 participants with a recent history of methamphetamine and prescription drug use. We collected in-depth interviews to explore relationships in use trajectory patterns.…

Lamonica, Aukje K.; Boeri, Miriam

2012-01-01

190

76 FR 58020 - Prescription Drug User Fee Act IV Information Technology Plan  

Federal Register 2010, 2011, 2012, 2013

...Prescription Drug User Fee Act IV Information Technology Plan AGENCY: Food and Drug Administration...the availability of an updated information technology (IT) plan entitled ``PDUFA IV Information Technology Plan'' (updated plan) to...

2011-09-19

191

Prescription Drug Abuse: A Fast-Growing Problem | NIH MedlinePlus the Magazine  

MedlinePLUS

... turn Javascript on. Feature: Preventing Drug Abuse and Addiction Prescription Drug Abuse: A Fast-Growing Problem Past ... approach do you suggest I take for my addiction or substance abuse? Do I need to see ...

192

Intentional bupropion overdoses  

Microsoft Academic Search

Bupropion is an antidepressant that has recently seen increased usage in smoking cessation. This increased usage, along with its potential for causing seizures, has renewed interest among clinicians about the effects of this drug. The purpose of this study is to describe the clinical course of intentional bupropion overdoses in adults and adolescents. This study is a retrospective review of

Greene Shepherd; Larissa I Velez; Daniel C Keyes

2004-01-01

193

Bacitracin zinc overdose  

MedlinePLUS

... Small amounts of bacitracin zinc are dissolved in petroleum jelly to create antibiotic ointments. Bacitracin zinc overdose ... 1-800-222-1222. See also: Bacitracin overdose Petroleum jelly overdose Zinc oxide overdose

194

Which psychoactive prescription drugs are illegally obtained and through which ways of acquisition? About OPPIDUM survey.  

PubMed

The objective of the study was to determine which psychoactive prescription drugs are illegally obtained and through which ways of acquisition. OPPIDUM is an annual national study. It is based on specialized care centers that included subjects presenting a drug dependency or under opiate maintenance treatment. All their psychoactive substances consumed are reported. This work focuses on the different ways of acquisition specially the illegal ways of acquisition (bought on the street, forged prescription, stolen, given, internet). For each medication illegally obtained, a ratio has been calculated (number of illegal acquisitions divided by the number of described acquisitions). In 2008, 5542 subjects have been included and have described the consumption of 11 027 substances including 63.8% of prescription drugs. Among them, 11% were illegally obtained. The different illegal acquisition ways were 'street market' (77.6%), 'gift' (16.6%), 'theft' (2.3%), 'forged prescription' (2.3%), and 'internet' (0.7%). The third first drugs illegally obtained were high dosage buprenorphine, methadone, and clonazepam. Some prescription drugs, less consumed, have an important ratio of illegal acquisition like ketamine, flunitrazepam, morphine, trihexyphenidyl, or methylphenidate. This study confirms that theft, forged prescription and internet are few used and permits to highlight diversion of prescription drugs. It is important to inform healthcare professionals on the different prescription drugs that are illegally obtained. PMID:21564282

Frauger, Elisabeth; Nordmann, Sandra; Orleans, Veronica; Pradel, Vincent; Pauly, Vanessa; Thirion, Xavier; Micallef, Joëlle

2012-08-01

195

An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions  

PubMed Central

Background In an effort to control non-medical use and/or medical abuse of prescription drugs, particularly prescription opioids, electronic prescription drug monitoring programs (PDMP) have been introduced in North-American countries, Australia and some parts of Europe. Paradoxically, there are simultaneous pressures to increase opioid prescribing for the benefit of individual patients and to reduce it for the sake of public health, and this pressure warrants a delicate balance of appropriate therapeutic uses of these drugs with the risk of developing dependence. This article discusses pros and cons of PDMP in reducing diversion of prescription opioids, without hampering access to those medications for those with genuine needs, and highlights tensions around PDMP implementation. Discussion PDMPs may help alleviate diversion, over-prescription and fraudulent prescribing/dispensing; prompt drug treatment referrals; avoid awkward drug urine test; and inform spatial changes in prescribing practices and help designing tailored interventions. Fear of legal retribution, privacy and data security, potential confusion about addiction and pseudo-addiction, and potential undue pressure of detecting misuse/diversion - are the major problems. There are tensions about unintended consequence of excessive regulatory enforcements, corresponding collateral damages particularly about inadequate prescribing for patients with genuine needs, and mandatory consultation requirements of PDMP. Summary In this era of information technology PDMP is likely to flourish and remain with us for a long time. A clear standard of practice against which physicians’ care will be judged may expedite the utilisation of PDMP. In addition, adequate training on addiction and pain management along with public awareness, point-of-supply data entry from pharmacy, point-of-care real-time access to data, increasing access to addiction treatment and appropriate regulatory enforcement preferably through healthcare administration, together, may help remove barriers to PDMP use. PMID:25127880

2014-01-01

196

Prescription drug insurance coverage and patient health outcomes: a systematic review.  

PubMed

Previous reviews have shown that changes in prescription drug insurance benefits can affect medication use and adherence. We conducted a systematic review of the literature to identify studies addressing the association between prescription drug coverage and health outcomes. Studies were included if they collected empirical data on expansions or restrictions of prescription drug coverage and if they reported clinical outcomes. We found 23 studies demonstrating that broader prescription drug insurance reduces use of other health care services and has a positive impact on patient outcomes. Coverage gaps or caps on drug insurance generally led to worse outcomes. States should consider implementing the Affordable Care Act expansions in drug coverage to improve the health of low-income patients receiving state-based health insurance. PMID:25521879

Kesselheim, Aaron S; Huybrechts, Krista F; Choudhry, Niteesh K; Fulchino, Lisa A; Isaman, Danielle L; Kowal, Mary K; Brennan, Troyen A

2015-02-01

197

Riskier Than We Think? The Relationship Between Risk Statement Completeness and Perceptions of Direct to Consumer Advertised Prescription Drugs  

Microsoft Academic Search

Direct to consumer (DTC) prescription drug advertising is one of the fastest growing categories of advertising. Expenditures have increased from about $25 million in 1992 to nearly $2 billion in 1999. Given strong evidence of consumer driven demand for advertised prescription drugs, research was conducted to assess the extent to which DTC prescription drug advertising provides consumers with the information

Joel J. Davis

2000-01-01

198

Prescription and over-the-counter drug treatment admissions to the California public treatment system  

PubMed Central

Prescription and over-the-counter (OTC) drug abuse has become a focal point of public health policy, prevention, and control efforts. Adolescents represent one of the fastest growing segments of the general population abusing prescription and OTC drugs as represented by national surveys. This article reports on treatment admission data to the California addiction public system for prescription and OTC drugs among two age subgroups: adolescents 12–17 years and adults 18 years and older. Of the 6,841 admissions for primary abuse of prescription and OTC drugs in California (during 2006–2007), most adolescent admissions (12–17) were for stimulant prescription and OTC drugs (45.3% and 32.1%, respectively), whereas opioid prescription drugs (88.9%) were most common for adults 18 years and older. Differences in psychosocial, treatment, and substance use characteristics between these two age subgroups are described. Results from this study offer useful treatment admission information about prescription and OTC drug abuse within the California public addiction treatment system. PMID:21193282

Gonzales, Rachel; Brecht, Mary-Lynn; Mooney, Larissa; Rawson, Richard A.

2014-01-01

199

[Prescriptions for anorectic psychotropic drugs in the municipality of Juiz de Fora, Minas Gerais, Brazil].  

PubMed

Obesity is a serious public health issue of epidemic proportions. Although drug therapy is one of the therapeutic approaches, it should be preceded by a change in eating habits along with regular exercise. This study assessed prescription of such drugs in 2009, in Juiz de Fora, Minas Gerais, Brazil. Data were collected from consumption bulletins sent monthly to the municipal sanitary surveillance agency (VISA), and from the Brazilian National Management System of Controlled Products. Of the 7,759 notifications assessed, 93.3% were dispensed by prescription pharmacies and 6.7% by drugstores. Of that total, 55.4% were for amphepramone, 33.1% for femproporex, and 11.5% for mazindol. The three drugs had a larger consumption rate in the municipality (daily defined dose/1,000 inhabitants/day) than in the country as a whole, during the period under study. The professional with the highest prescription rate was responsible for 3,535 prescriptions. All of these were dispensed by prescription pharmacies, a single outlet being responsible for 99.5% of these prescriptions. This scenario shows that anorectic psychotropic drug prescription is a relevant public health issue and the criteria for monitoring the prescription and consumption of these drugs should be re-evaluated. PMID:23175409

Martins, Eduardo Luiz Mendonça; do Amaral, Maria da Penha Henriques; Ferreira, Maria Beatriz Cardoso; de Mendonça, Alessandra Ésther; Pereira, Mônica Cecília Santana; Pereira, Denise Campos; Ribeiro, Paula Maria; Brumano, Larissa Pereira

2012-12-01

200

NATIONAL SURVEY OF PRESCRIPTION DRUG INFORMATION PROVIDED TO PATIENTS (NSPDIPP)  

EPA Science Inventory

National telephone surveys were conducted in 1992, 1994, 1996, and 1998 to determine how much prescription medicine information consumers receive and through which sources. Approximately 1,000 U.S. consumers who received a new prescription for themselves or a family member at a r...

201

Understanding Nonprescription and Prescription Drug Misuse in Late Adolescence/Young Adulthood  

PubMed Central

This study explored the extent to which nonprescription and prescription drugs misuse among adolescents/young adults are related to their perception that it is safer than illicit drugs, ease of access, and lower societal stigma. Adolescents/young adults (N = 465; Mage = 18.57, SD = 0.86) completed an online survey about their nonprescription and prescription drug misuse, other substance use, and correlates of use. Perceived risk, societal stigma, and access to nonprescription and prescription drugs were predictive of misuse. Results support program planners working towards targeting perceived risk and societal stigma in reducing misuse and the need to restrict and monitor access to nonprescription and prescription drugs for adolescents/young adults. PMID:24826368

Fleary, Sasha A.; Heffer, Robert W.; McKyer, E. Lisako J.

2013-01-01

202

The relationship between source of diversion and prescription drug misuse, abuse, and dependence.  

PubMed

The current research examines the relationship between how people obtain prescription drugs (source of diversion) and how people misuse prescription drugs (i.e., frequency, abuse, and dependence). We analyzed data from the 2008 National Survey on Drug Use and Health public use file, a sample of 68,736 persons aged 12 and older that is generalizable to the noninstitutionalized population of the United States. A number of regression models were estimated, and findings indicate that source of diversion was significantly correlated to frequency of prescription drug misuse, abuse, and dependence. Given these findings, we believe any attempt to classify prescription drug misusers based on certain characteristics should include source of diversion. PMID:21174499

Ford, Jason A; Lacerenza, Christina

2011-01-01

203

Income and the Use of Prescription Drugs by the Elderly: Evidence from the Notch Cohorts  

ERIC Educational Resources Information Center

We use exogenous variation in Social Security payments created by the Social Security benefits notch to estimate how retirees' use of prescription medications responds to changes in their incomes. Using data from the 1993 Wave of the AHEAD, we obtain instrumental variables estimates of the income elasticity of prescription drug use that are…

Moran, John R.; Simon, Kosali Ilayperuma

2006-01-01

204

42 CFR 410.30 - Prescription drugs used in immunosuppressive therapy.  

Code of Federal Regulations, 2010 CFR

...only for prescription drugs used in immunosuppressive therapy, furnished to an individual who received an organ or tissue transplant for which Medicare payment is made, provided the individual is eligible to receive Medicare Part B benefits. (c)...

2010-10-01

205

42 CFR 410.30 - Prescription drugs used in immunosuppressive therapy.  

...only for prescription drugs used in immunosuppressive therapy, furnished to an individual who received an organ or tissue transplant for which Medicare payment is made, provided the individual is eligible to receive Medicare Part B benefits. (c)...

2014-10-01

206

42 CFR 410.30 - Prescription drugs used in immunosuppressive therapy.  

Code of Federal Regulations, 2013 CFR

...only for prescription drugs used in immunosuppressive therapy, furnished to an individual who received an organ or tissue transplant for which Medicare payment is made, provided the individual is eligible to receive Medicare Part B benefits. (c)...

2013-10-01

207

45 CFR 156.295 - Prescription drug distribution and cost reporting.  

Code of Federal Regulations, 2012 CFR

...that were provided under the QHP through retail pharmacies compared to mail order pharmacies, and the percentage of prescriptions for which...compared to all drugs dispensed, broken down by pharmacy type, which includes an independent...

2012-10-01

208

45 CFR 156.295 - Prescription drug distribution and cost reporting.  

...that were provided under the QHP through retail pharmacies compared to mail order pharmacies, and the percentage of prescriptions for which...compared to all drugs dispensed, broken down by pharmacy type, which includes an independent...

2014-10-01

209

45 CFR 156.295 - Prescription drug distribution and cost reporting.  

Code of Federal Regulations, 2013 CFR

...that were provided under the QHP through retail pharmacies compared to mail order pharmacies, and the percentage of prescriptions for which...compared to all drugs dispensed, broken down by pharmacy type, which includes an independent...

2013-10-01

210

78 FR 78367 - Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment  

Federal Register 2010, 2011, 2012, 2013

...Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment...for public comment of the draft information technology (IT) plan entitled ``PDUFA V Information Technology Plan.'' This plan is...

2013-12-26

211

Measures Such As Interstate Cooperation Would Improve The Efficacy Of Programs To Track Controlled Drug Prescriptions  

PubMed Central

In response to increasing abuse of prescription drugs, 44 states have implemented -- and five more states will soon adopt -- monitoring programs to track prescriptions of controlled medications. Although these programs are primarily designed to help law enforcement officials and regulatory agencies spot possible illegal activity, health care providers have begun to use data from them to help improve patient safety and quality of care. We reviewed government documents, expert white papers, articles from the peer reviewed medical literature, and reports of the experiences of local health officials. Although we found some evidence that prescription drug monitoring programs are a benefit to both law enforcement and health care delivery, the programs have strengths and weaknesses, and their overall impact on drug abuse and illegal activity remains unclear. We believe that improving the efficacy of prescription drug monitoring programs will require such changes as more standardization and interstate cooperation, better training of providers, more secure funding, and further evaluation. PMID:23406570

Deyo, Richard A.; Irvine, Jessica; Millet, Lisa; Beran, Todd; O'Kane, Nicole; Wright, Dagan; McCarty, Dennis

2013-01-01

212

Pricing of prescription drugs and its impact on physicians’ choice behavior  

Microsoft Academic Search

This research presents an analysis of Taiwan’s health care market with the focus on the pricing of prescription drugs and\\u000a its impact on physicians’ choice behavior. Since the advent of Taiwan’s national health insurance, with the competent authority\\u000a being Bureau of National Health Insurance (BNHI), hospitals are allowed to sell prescription drugs to patients at prices above\\u000a the purchasing prices,

Chen Miao-Sheng; Shih Yu-Ti

2008-01-01

213

Evaluating Prescription Drugs Used to Treat Overactive Bladder  

MedlinePLUS

... We chose the following as Consumer Reports Best Buy Drugs to treat overactive bladder—if you and ... Overactive Bladder: Drug Comparison Chart* Consumer Reports Best Buy Drugs are in blue. We recommend these drugs ...

214

The Drug Facts Box: Improving the communication of prescription drug information.  

PubMed

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label--the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing--may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and "spinning" unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies--including national randomized trials--demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3-5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information. PMID:23942130

Schwartz, Lisa M; Woloshin, Steven

2013-08-20

215

The Drug Facts Box: Improving the communication of prescription drug information  

PubMed Central

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label—the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing—may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and “spinning” unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies—including national randomized trials—demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3–5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information. PMID:23942130

Schwartz, Lisa M.; Woloshin, Steven

2013-01-01

216

Medical and Nonmedical Users of Prescription Drugs among College Students  

ERIC Educational Resources Information Center

Objectives: To examine medical and nonmedical users of prescription opioids, central nervous system depressants, and stimulants taken individually and in combination. Participants: Undergraduates at an urban mid-Atlantic university with 12,000 students. Methods: A questionnaire administered in classes provided 413 responses, with a usable response…

Rozenbroek, Katelyn; Rothstein, William G.

2011-01-01

217

Characteristics of Recipients of Free Prescription Drug Samples: A Nationally Representative Analysis  

Microsoft Academic Search

Objectives. Free prescription drug samples are used widely in the United States. We sought to examine characteristics of free drug sample recipients nationwide. Methods. We analyzed data on 32 681 US residents from the 2003 Medical Ex- penditure Panel Survey (MEPS), a nationally representative survey. Results. In 2003, 12% of Americans received at least 1 free sample. A higher pro-

Sarah L. Cutrona; Steffie Woolhandler; Karen E. Lasser; David H. Bor; Danny McCormick; David U. Himmelstein

218

Prescription Drug (Rx) and DEA Controlled Substance Order Worksheet PI/Researcher Name: Date of Order  

E-print Network

Prescription Drug (Rx) and DEA Controlled Substance Order Worksheet PI/Researcher Name: Date or in the "comments section" so it will appear on the Purchase Order. DEA Schedule I or II drugs: Create a note of Order: Budget Information: Vendor Name: (See below for vendor address) Rx/DEA Item Name: Rx/DEA Item

Sura, Philip

219

Ephemeral profiles of prescription drug and formulation tampering: Evolving pseudoscience on the Internet  

Microsoft Academic Search

The magnitude of non-therapeutic use, or misuse of prescription pharmaceuticals now rivals that of illicit drug abuse. Drug and formulation tampering enables misusers to administer higher doses by intended and non-intended routes. Perceived motives appear to be a combination of interests in achieving a faster onset and enhancing psychoactive effects. Narcotic analgesics, stimulants, and depressants are widely sought, examined, and

Edward J. Cone

2006-01-01

220

Direct-to-Consumer Promotion of Prescription Drugs: Economic Implications for Patients, Payers and Providers  

Microsoft Academic Search

Spending on outpatient prescription drugs in the US is accelerating rapidly. Although numerous factors are driving this trend, attention has recently focused on the role played by the marketing, promotion and advertising of pharmaceuticals, in particular direct-to-consumer (DTC) advertising. In 1997, the US Food and Drug Administration (FDA) issued a `guidance' on such mass media promotion. The guidance altered existing

Steven D. Findlay

2001-01-01

221

Preventing drug interactions by online prescription screening in community pharmacies and medical practices  

Microsoft Academic Search

Background: Drug interactions have been shown to be preventable by computerized prescription entry and screening only in hospitals and not in community-based practice.Methods: We retrospectively evaluated the effect of online prescription screening in community pharmacies and physician offices of one health maintenance organization, phased in during 3 consecutive 6-month periods in 1998 to 1999 (period I, system active only in

Hillel Halkin; Itzhak Katzir; Irena Kurman; Joseph Jan; Becky Ben-Oz Malkin

2001-01-01

222

Classification of drug-related problems with new prescriptions using a modified PCNE classification system  

Microsoft Academic Search

Objectives To explore and classify drug-related problems (DRPs) with new prescriptions detected in community pharmacies using a modified\\u000a PCNE (Pharmaceutical Care Network Europe) classification system. Setting Sixty-four Swiss community pharmacies offering internships for pharmacy students. Main outcome measures Occurrence, nature and pharmacist’s management of DRPs. Methods Fifth-year pharmacy students collected consecutively hospital discharge and primary care prescriptions. After training, they

Patrick M. Eichenberger; Markus L. Lampert; Irene Vogel Kahmann; J. W. Foppe van Mil; Kurt E. Hersberger

2010-01-01

223

Comparative study of paediatric prescription drug utilization between the spanish and immigrant population  

PubMed Central

Background The immigrant population has increased greatly in Spain in recent years to the point where immigrants made up 12% of the infant population in 2008. There is little information available on the profile of this group with regard to prescription drug utilization in universal public health care systems such as that operating in Spain. This work studies the overall and specific differences in prescription drug utilization between the immigrant and Spanish population. Methods Use was made of the Aragonese Health Service databases for 2006. The studied population comprises 159,908 children aged 0-14 years, 13.6% of whom are foreign nationals. Different utilization variables were calculated for each group. Prescription-drug consumption is measured in Defined Daily Doses (DDD) and DDD/1000 persons/day/(DID). Results A total of 833,223 prescriptions were studied. Utilization is lower for immigrant children than in Spanish children for both DID (66.27 v. 113.67) and average annual expense (€21.55 v. €41.14). Immigrant children consume fewer prescription drugs than Spanish children in all of the therapy groups, with the most prescribed (in DID) being: respiratory system, anti-infectives for systemic use, nervous system, sensory organs. Significant differences were observed in relation to the type of drugs and the geographical background of immigrants. Conclusion Prescription drug utilization is much greater in Spanish children than in immigrant children, particularly with reference to bronchodilators (montelukast and terbutaline) and attention-disorder hyperactivity drugs such as methylphenidate. There are important differences regarding drug type and depending on immigrants' geographical backgrounds that suggest there are social, cultural and access factors underlying these disparities. PMID:19995453

2009-01-01

224

Fluoride overdose  

MedlinePLUS

... counter and prescription products, including: Certain mouthwashes and toothpastes Certain vitamins (Tri-Vi-Flor, Poly-Vi-Flor, ... for recovery. The amount of fluoride found in toothpaste is usually not swallowed in large enough amounts ...

225

Medicare program; Medicare prescription drug discount card; revision of marketing rules for endorsed drug card sponsors. Final rule.  

PubMed

This final rule will revise the current limitations prohibiting an endorsed drug card sponsor from marketing its Part D plans to its drug card enrollees. This revised rule will give the current drug card sponsors the ability to market to their enrollees Part D plans that are either offered by the same endorsed drug card sponsor or an affiliated organization of the same endorsed drug card sponsor. We are making these changes after considering the public comments received regarding the need to ensure a smooth transition from the drug card to the Medicare Prescription Drug Benefit. PMID:16138430

2005-09-01

226

Treatment of hydroxychloroquine overdose.  

PubMed

Hydroxychloroquine overdoses are rarely reported with 7 previous cases found in the English medical literature. We report a case and review the literature. A 16-year-old girl ingested a handful of hydroxychloroquine 200mg, 30 minutes before presentation and presented with tachycardia (heart rate 110 beats/min), hypotension (systolic blood pressure 63 mm Hg), central nervous system depression, conduction defects (QRS = 0.14 msec), and hypokalemia (K = 2.1 meq/L). She was treated with fluid boluses and dopamine, oxygen, and potassium supplementation. Toxicologic tests confirmed the presence of hydroxychloroquine. The patient's hypotension resolved within 4.5 hours, serum potassium stabilized in 24 hours, and tachycardia gradually decreased over 3 days. Although hydroxychloroquine overdoses are very rare, life-threatening hypotension, conduction problems, and hypokalemia can occur within 30 minutes of ingestion. Symptoms are similar to chloroquine and treatment must be implemented quickly and should be modeled after experience with chloroquine overdoses. Treatment modalities need further study, but current recommendations are: (1) diazepam for seizures and sedation; (2) early intubation and mechanical ventilation; (3) epinephrine for treatment of vasodilation and myocardial depression; (4) potassium replacement with close monitoring of levels; (5) charcoal for gastrointestinal decontamination if ingestion occurred within an hour; (6) high dose diazepam for life-threatening symptoms, until more information becomes available. No value was found for serum alkalinization or extracorporeal methods of drug removal. PMID:11555803

Marquardt, K; Albertson, T E

2001-09-01

227

Branded prescription drug fee. Final regulations, temporary regulations, and removal of temporary regulations.  

PubMed

This document contains final regulations that provide guidance on the annual fee imposed on covered entities engaged in the business of manufacturing or importing branded prescription drugs. This fee was enacted by section 9008 of the Patient Protection and Affordable Care Act, as amended by section 1404 of the Health Care and Education Reconciliation Act of 2010. This document also withdraws the Branded Prescription Drug Fee temporary regulations and contains new temporary regulations regarding the definition of controlled group that apply beginning on January 1, 2015. The final regulations and the new temporary regulations affect persons engaged in the business of manufacturing or importing certain branded prescription drugs. The text of the temporary regulations in this document also serves as the text of proposed regulations set forth in a notice of proposed rulemaking (REG-123286-14) on this subject in the Proposed Rules section in this issue of the Federal Register. PMID:25118373

2014-07-28

228

Prescription Drug Abuse: Epidemiology, Regulatory Issues, Chronic Pain Management with Narcotic Analgesics  

PubMed Central

Synopsis The epidemic of prescription drug abuse has reached a critical level, which has received national attention. Physicians must learn strategies to effectively treat chronic pain, and help reduce the rates of prescription drug abuse. This chapter will provide insight into the epidemiology of prescription drug abuse, explain regulatory issues, and provide guidelines for the assessment and management of pain, particularly with chronic opioid therapy. The use of informed consent forms, treatment agreements, risk documentation tools, and regular monitoring of the 4 “A's” helps to educate patients, as well as guide management based on treatment goals. By using universal precautions, and being aware of aberrant behaviors, physicians may feel more confident in identifying and addressing problematic behaviors. PMID:21356422

Manubay, Jeanne M.; Muchow, Carrie; Sullivan, Maria A.

2012-01-01

229

Insurance Coverage of Prescription Drugs and the Rural Elderly  

ERIC Educational Resources Information Center

Rural impacts of a Medicare drug benefit will ultimately depend on the number of elderly who are currently without drug coverage, new demand by those currently without coverage, the nature of the new benefit relative to current benefits, and benefit design. Purpose: To enhance understanding of drug coverage among rural elderly Medicare…

Mueller, Curt; Schur, Claudia

2004-01-01

230

21 CFR 201.100 - Prescription drugs for human use.  

Code of Federal Regulations, 2011 CFR

...which it is possible to determine the complete manufacturing history of the package of the drug. (7) A statement directed...the labeling claims for the drug by the National Academy of Sciences/National Research Council (NAS/NRC), Drug Efficacy...

2011-04-01

231

76 FR 56201 - Prescription Drug User Fee Act; Public Meeting  

Federal Register 2010, 2011, 2012, 2013

...implemented other important drug safety initiatives under...the safety of marketed drugs 18 months after approval...regular screening of the adverse event reporting system...potential to decrease drug development time by helping...who are predisposed to adverse events. FDA...

2011-09-12

232

75 FR 12555 - Prescription Drug User Fee Act; Public Meeting  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration...collect user fees to fund the human drug review process. Section...better understand the history and evolution of the PDUFA program and its...marketing applications for certain human drug and biological...

2010-03-16

233

Prescription Drugs Associated with Reports of Violence Towards Others  

PubMed Central

Context Violence towards others is a seldom-studied adverse drug event and an atypical one because the risk of injury extends to others. Objective To identify the primary suspects in adverse drug event reports describing thoughts or acts of violence towards others, and assess the strength of the association. Methodology From the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) data, we extracted all serious adverse event reports for drugs with 200 or more cases received from 2004 through September 2009. We identified any case report indicating homicide, homicidal ideation, physical assault, physical abuse or violence related symptoms. Main Outcome Measures Disproportionality in reporting was defined as a) 5 or more violence case reports, b) at least twice the number of reports expected given the volume of overall reports for that drug, c) a ?2 statistic indicating the violence cases were unlikely to have occurred by chance (p<0.01). Results We identified 1527 cases of violence disproportionally reported for 31 drugs. Primary suspect drugs included varenicline (an aid to smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3 drugs for attention deficit hyperactivity disorder. The evidence of an association was weaker and mixed for antipsychotic drugs and absent for all but 1 anticonvulsant/mood stabilizer. Two or fewer violence cases were reported for 435/484 (84.7%) of all evaluable drugs suggesting that an association with this adverse event is unlikely for these drugs. Conclusions Acts of violence towards others are a genuine and serious adverse drug event associated with a relatively small group of drugs. Varenicline, which increases the availability of dopamine, and antidepressants with serotonergic effects were the most strongly and consistently implicated drugs. Prospective studies to evaluate systematically this side effect are needed to establish the incidence, confirm differences among drugs and identify additional common features. PMID:21179515

Moore, Thomas J.; Glenmullen, Joseph; Furberg, Curt D.

2010-01-01

234

A prescription for unemployment? Recessions and the demand for mental health drugs.  

PubMed

We estimate the relationship between mental health drug prescriptions and the level of labor market activity in the USA. Based on monthly data from the National Ambulatory Medical Care Survey of physicians and aggregated by US census regions, we find that the number of mental health drug prescriptions (those aimed at alleviating depression and anxiety) rises by about 10% when employment falls by 1% and when unemployment rises by 100 basis points, but only for patients in the Northeast region. This paper is one of the first to look at compensatory health behavior in response to the business cycle. PMID:23956154

Bradford, W David; Lastrapes, William D

2014-11-01

235

Utility of the Electrocardiogram in Drug Overdose and Poisoning: Theoretical Considerations and Clinical Implications  

PubMed Central

The ECG is a rapidly available clinical tool that can help clinicians manage poisoned patients. Specific myocardial effects of cardiotoxic drugs have well-described electrocardiographic manifestations. In the practice of clinical toxicology, classic ECG changes may hint at blockade of ion channels, alterations of adrenergic tone, or dysfunctional metabolic activity of the myocardium. This review will offer a structured approach to ECG interpretation in poisoned patients with a focus on clinical implications and ECG-based management recommendations in the initial evaluation of patients with acute cardiotoxicity. PMID:22708912

Yates, Christopher; Manini, Alex F

2012-01-01

236

[Evaluation of electronic drug prescriptions at a university hospital].  

PubMed

The medical orders have an important role in the prevention of medication errors. The objective of this study is to identify and to analyse the causal factors of error in the medication related to electronic prescription in two different clinics of a university hospital of the interior of the state of São Paulo. A questionnaire related to the advantages and disadvantages of electronic prescription was applied to the professionals of these clinics. The data collected was grouped in accordance with the similarity of the answers. These professionals identified causal factors of errors in the medical orders, but they also mentioned the advantages of it when compared to the manual order, such as bigger readability, rapidity and organization of the first one. As we can see, the computerized system of medical order represents a great advance considering strategies to minimize errors from orders badly formulated. However, it does not eliminate the possibility of occurrence of causal factors of errors in the medication, which asks for some modifications in the system. PMID:12817533

Cassiani, Sílvia Helena; Gimenes, Fernanda Raphael; Freire, Cláudia Câmara

2002-01-01

237

Prescription drug abuse: what is being done to address this new drug epidemic? Testimony before the Subcommittee on Criminal Justice, Drug Policy and Human Resources.  

PubMed

This comprehensive health policy review of the prescription drug abuse epidemic is based on the written and oral testimony of witnesses at a July 26, 2006 Congressional Hearing, including that of Laxmaiah Manchikanti, MD, the chief executive officer of the American Society of Interventional Pain Physicians and additions from review of the literature. Honorable Mark E. Souder, chairman of the Subcommittee on Criminal Justice, Drug Policy, and Human Resources, introduced the issue as follows: "Prescription drug abuse today is second only to marijuana abuse. In the most recent household survey, initiates to drug abuse started with prescription drugs (especially pain medications) more often than with marijuana. The abuse of prescription drugs is facilitated by easy access (via physicians, the Internet, and the medicine cabinet) and a perception of safety (since the drugs are FDA approved). In addition to the personal toll of drug abuse using prescription drugs, indirect costs associated with prescription drug abuse and diversion include product theft, commission of other crimes to support addiction, law enforcement costs, and encouraging the practice of defensive medicine." The Administration witnesses, Bertha Madras, Nora D. Volkow, MD, Sandra Kweder, MD, and Joe Rannazzisi reviewed the problem of drug abuse and discussed what is being done at the present time as well as future strategies to combat drug abuse, including prescription drug monitoring programs, reducing malprescriptions, public education, eliminating Internet drug pharmacies, and the development of future drugs which are not only tamper-resistant but also non-addictive. The second panel, consisting of consumers and advocates, included Misty Fetco, Linda Surks, and Barbara van Rooyan, all of whom lost their children to drugs, presented their stories and strategies to prevent drug abuse, focusing on education at all levels, development of resistant drugs, and non-opioid treatment of chronic pain. Mathea Falco, JD, and Stephen E. Johnson presented issues related to drug abuse and measures to curb drug abuse by various means. Stephen J. Pasierb presented startling statistics on teen drug abuse and various educational programs to deter abuse. Laxmaiah Manchikanti, MD presented an overview of prescription drug abuse, strategies to prevent drug abuse, including immediate funding and rapid implementation of NASPER, education at all levels and improving relations with the DEA and the provider community. PMID:17066115

Manchikanti, Laxmaiah

2006-10-01

238

Structure-based discovery of prescription drugs that interact with the norepinephrine transporter, NET.  

PubMed

The norepinephrine transporter (NET) transports norepinephrine from the synapse into presynaptic neurons, where norepinephrine regulates signaling pathways associated with cardiovascular effects and behavioral traits via binding to various receptors (e.g., ?2-adrenergic receptor). NET is a known target for a variety of prescription drugs, including antidepressants and psychostimulants, and may mediate off-target effects of other prescription drugs. Here, we identify prescription drugs that bind NET, using virtual ligand screening followed by experimental validation of predicted ligands. We began by constructing a comparative structural model of NET based on its alignment to the atomic structure of a prokaryotic NET homolog, the leucine transporter LeuT. The modeled binding site was validated by confirming that known NET ligands can be docked favorably compared to nonbinding molecules. We then computationally screened 6,436 drugs from the Kyoto Encyclopedia of Genes and Genomes (KEGG DRUG) against the NET model. Ten of the 18 high-scoring drugs tested experimentally were found to be NET inhibitors; five of these were chemically novel ligands of NET. These results may rationalize the efficacy of several sympathetic (tuaminoheptane) and antidepressant (tranylcypromine) drugs, as well as side effects of diabetes (phenformin) and Alzheimer's (talsaclidine) drugs. The observations highlight the utility of virtual screening against a comparative model, even when the target shares less than 30% sequence identity with its template structure and no known ligands in the primary binding site. PMID:21885739

Schlessinger, Avner; Geier, Ethan; Fan, Hao; Irwin, John J; Shoichet, Brian K; Giacomini, Kathleen M; Sali, Andrej

2011-09-20

239

Use of Antipsychotic Drugs in Individuals with Intellectual Disability (ID) in the Netherlands: Prevalence and Reasons for Prescription  

ERIC Educational Resources Information Center

Background: We investigated antipsychotic drug prescription practice of Dutch ID physicians, studying prevalence of antipsychotic drug use, reasons for prescription and the relationship between these reasons and patient characteristics. Methods: A cross-sectional study of medical and pharmaceutical records in a population living in residential…

de Kuijper, G.; Hoekstra, P.; Visser, F.; Scholte, F. A.; Penning, C.; Evenhuis, H.

2010-01-01

240

Understanding the Extra Help with Your Medicare Prescription Drug Plan  

MedlinePLUS

... advances and refunds related to earned income tax credits and child tax credits; —Compensation you receive as a crime victim; and — ... treatment and drugs; • Disaster assistance; • Earned income tax credit payments; • Assistance from others to pay your household ...

241

Strategies Used by Adults to Reduce Their Prescription Drug Costs  

MedlinePLUS

... drug costs, by age, health insurance status, and poverty status, using data from the 2011 National Health ... in the past 12 months, by age and poverty status: United States, 2011 1 Significantly different from ...

242

42 CFR 423.159 - Electronic prescription drug program.  

Code of Federal Regulations, 2010 CFR

...MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...pharmacy benefit manager, or health plan, either directly or...medication history, or related health or drug information for Part...standards are effective. (d) Promotion of electronic prescribing...

2010-10-01

243

The demand for prescription drugs as a function of cost-sharing  

Microsoft Academic Search

This paper estimates how cost-sharing affects the use of prescription drugs. The data for this analysis are derived from the Rand Health Insurance Experiment (HIE), a randomized controlled trial that randomly assigned participants to insurance plans with varying coinsurance rates and deductibles. Therefore, the cost-sharing they faced was independent of their health and demographic characteristics. The paper used HIE data

Arleen Leibowitz; Willard G. Manning; Joseph P. Newhouse

1985-01-01

244

Not a good buy: value for money of prescription drugs sold on the internet.  

PubMed

In this note we study the value for money of purchases of fluoxetine made through on-line pharmacies without prescription. We show that this channel is not good value from an economic point of view and that it can be dangerous in medical terms because of the poor quality of the drugs received and the lack of prescribing instructions. PMID:22694971

Levaggi, Rosella; Marcantoni, Claudio; Filippucci, Laura; Gelatti, Umberto

2012-08-01

245

The Relationship between Health Professionals and the Elderly Patient Facing Drug Prescription: A Qualitative Approach  

ERIC Educational Resources Information Center

Aiming at identifying the relationship between the elderly patient facing drug prescription and health professionals, an exploratory and descriptive study of a qualitative cut was carried out using semi-structured interviews. To this end, the Collective Subject Discourse analysis technique was employed. Thirty elderly patients living in the urban…

Lefevre, Fernando; Teixeira, Jorge Juarez Vieira; Lefevre, Ana Maria Cavalcanti; de Castro, Lia Lusitana Cardozo; Spinola, Aracy Witt de Pinho

2004-01-01

246

Misuse of Prescription and Illicit Drugs Among High-risk Young Adults in Los Angeles and New York  

PubMed Central

Background Prescription drug misuse among young adults is increasingly viewed as a public health concern, yet most research has focused on student populations and excluded high-risk groups. Furthermore, research on populations who report recent prescription drug misuse is limited. This study examined patterns of prescription drug misuse among high-risk young adults in Los Angeles (LA) and New York (NY), which represent different local markets for illicit and prescription drugs. Design and Methods Between 2009 and 2011, 596 young adults (16 to 25 years old) who had misused prescription drugs within the past 90 days were interviewed in Los Angeles and New York. Sampling was stratified to enroll three groups of high-risk young adults: injection drug users (IDUs); homeless persons; and polydrug users. Results In both sites, lifetime history of receiving a prescription for an opioid, tranquilizer, or stimulant was high and commonly preceded misuse. Moreover, initiation of opioids occurred before heroin and initiation of prescription stimulants happened prior to illicit stimulants. NY participants more frequently misused oxycodone, heroin, and cocaine, and LA participants more frequently misused codeine, marijuana, and methamphetamine. Combining prescription and illicit drugs during drug using events was commonly reported in both sites. Opioids and tranquilizers were used as substitutes for other drugs, e.g., heroin, when these drugs were not available. Conclusion Patterns of drug use among high-risk young adults in Los Angeles and New York appear to be linked to differences in local markets in each city for illicit drugs and diverted prescription drugs. PMID:22798990

Lankenau, Stephen E.; Schrager, Sheree M.; Silva, Karol; Kecojevic, Alex; Bloom, Jennifer Jackson; Wong, Carolyn; Iverson, Ellen

2012-01-01

247

Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: retrospective cohort study  

PubMed Central

Objective To test the hypothesis that people taking anxiolytic and hypnotic drugs are at increased risk of premature mortality, using primary care prescription records and after adjusting for a wide range of potential confounders. Design Retrospective cohort study. Setting 273 UK primary care practices contributing data to the General Practice Research Database. Participants 34?727 patients aged 16 years and older first prescribed anxiolytic or hypnotic drugs, or both, between 1998 and 2001, and 69?418 patients with no prescriptions for such drugs (controls) matched by age, sex, and practice. Patients were followed-up for a mean of 7.6 years (range 0.1-13.4 years). Main outcome All cause mortality ascertained from practice records. Results Physical and psychiatric comorbidities and prescribing of non-study drugs were significantly more prevalent among those prescribed study drugs than among controls. The age adjusted hazard ratio for mortality during the whole follow-up period for use of any study drug in the first year after recruitment was 3.46 (95% confidence interval 3.34 to 3.59) and 3.32 (3.19 to 3.45) after adjusting for other potential confounders. Dose-response associations were found for all three classes of study drugs (benzodiazepines, Z drugs (zaleplon, zolpidem, and zopiclone), and other drugs). After excluding deaths in the first year, there were approximately four excess deaths linked to drug use per 100 people followed for an average of 7.6 years after their first prescription. Conclusions In this large cohort of patients attending UK primary care, anxiolytic and hypnotic drugs were associated with significantly increased risk of mortality over a seven year period, after adjusting for a range of potential confounders. As with all observational findings, however, these results are prone to bias arising from unmeasured and residual confounding. PMID:24647164

2014-01-01

248

Forces Pushing Prescription Psychotropic Drugs in College Mental Health  

ERIC Educational Resources Information Center

A complex of forceful influences is greatly accelerating the use of what are usually referred to as "psychiatric drugs," although most prescribing is not done by psychiatrists. Many other clinicians, including other kinds of physicians, and recently psychologists, prescribe these medications. The influences contributing to this dramatic surge…

Whitaker, Leighton C.

2007-01-01

249

Audit of Psychoactive Drug Prescriptions in Group Homes.  

ERIC Educational Resources Information Center

The survey found that of the 1,389 mentally retarded persons living in community supervised residential settings in Southwestern Ontario, 49 percent received some type of psychoactive drug. Specifically, 23 percent received anticonvulsants; 14 percent, neuroleptics; 5 percent, sedative/hypnotics; 3 percent, antidepressants; 3 percent,…

Gowdey, Charles W.; And Others

1987-01-01

250

Treatment outcomes for prescription drug misusers: the negative effect of geographic discordance.  

PubMed

This is the first known study to examine geographic discordance (traveling from one's home residence to a county with a different socio-cultural context to receive substance abuse treatment) as a predictor of clinical and social functioning treatment outcomes (i.e., relapse, self-help attendance, anxiety, and incarceration) among a sample of prescription drug misusers. Treatment entry and 12-month follow-up client-level survey data were collected from 187 clients who misused prescription drugs, and center-level survey data were collected from the supervisors at treatment centers attended by the clients. Multivariate models reveal that geographic discordance significantly increased the odds that prescription drug misusers would report relapse to prescription opioid misuse, anxiety, and any incarceration at follow-up. Moreover, geographically discordant clients were significantly less likely to have attended a self-help group, net of the effect of other individual- and center-level factors. Implications for clinical practice and substance abuse treatment policy are provided. PMID:25200740

Oser, Carrie B; Harp, Kathi L H

2015-01-01

251

What impact do prescription drug charges have on efficiency and equity? Evidence from high-income countries  

PubMed Central

As pharmaceutical expenditure continues to rise, third-party payers in most high-income countries have increasingly shifted the burden of payment for prescription drugs to patients. A large body of literature has examined the relationship between prescription charges and outcomes such as expenditure, use, and health, but few reviews explicitly link cost sharing for prescription drugs to efficiency and equity. This article reviews 173 studies from 15 high-income countries and discusses their implications for important issues sometimes ignored in the literature; in particular, the extent to which prescription charges contain health care costs and enhance efficiency without lowering equity of access to care. PMID:18454849

Gemmill, Marin C; Thomson, Sarah; Mossialos, Elias

2008-01-01

252

PRESCRIPTION DRUG CLAIM FORM In order to process your claim(s), you must provide all information requested below. Submit the completed form with the original pharmacy  

E-print Network

Page - 1 PRESCRIPTION DRUG CLAIM FORM In order to process your claim(s), you must provide all #Prescription Details Drug Name & Strength or NDC # Quantity and Day Supply Dispensed Member Paid Expense 1) Rx

Devoto, Stephen H.

253

Prescription of nonsteroidal anti-inflammatory drugs for elderly people in Alberta.  

PubMed Central

OBJECTIVE: To examine the extent prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) are used by elderly people in Alberta as well as the degree of concurrent use of multiple NSAIDs, of peptic ulcer medications and of certain medications known to have clinically significant adverse interactions with NSAIDs. DESIGN: Retrospective analysis of the Alberta Blue Cross database. SETTING: Alberta. PATIENTS: All people 65 years of age and older using the subsidized drug benefit plan for whom prescription claims were submitted for reimbursement between Jan. 1 and June 30, 1991. OUTCOME MEASURES: Number of people who received one or more prescriptions for NSAIDs, rates of prescribing peptic ulcer medications and drugs with the potential for clinically significant interactions with NSAIDs among NSAID users and non-NSAID users, and rate of prescribing more than one NSAID concurrently. RESULTS: Of the Albertan population 65 years of age and over 61,601 (26.7%) received at least one prescription for an NSAID during the study period. In decreasing order, the five most commonly prescribed NSAIDs were acetylsalicylic acid, diclofenac, naproxen, indomethacin and ibuprofen. The total cost of NSAID therapy was $5,415,974. Of the people prescribed an NSAID 25.8% were also prescribed a peptic ulcer medication, as compared with 10.5% of the non-NSAID users. There was a significant relation between the increasing number of NSAID prescriptions and the likelihood of receiving a peptic ulcer medication. Those who received a prescription for an NSAID were more likely than non-NSAID users to have been prescribed coumarin anticoagulants, diuretics, angiotensin-converting-enzyme inhibitors, beta-blockers, oral corticosteroids, methotrexate and lithium, all of which are known to have possible adverse interactions with NSAIDs. A total of 2,631 people had two or more prescriptions for NSAIDs filled on the same day. CONCLUSIONS: NSAIDs are prescribed frequently for elderly people and are associated with an increased likelihood of concurrent prescription of peptic ulcer medication and medications that could have adverse drug interactions with NSAIDs. Additional study is required to evaluate the appropriateness of NSAID use in elderly patients, to determine the degree of actual patient consumption of these medications, to document the true prevalence of clinically significant drug interactions and to formulate educational strategies to reach physicians with this information. PMID:8039085

Hogan, D B; Campbell, N R; Crutcher, R; Jennett, P; MacLeod, N

1994-01-01

254

Evaluation of the community pharmacist’s behavior towards a prescription of antidiabetic and antiasthma drugs  

PubMed Central

Objective The objective of this study is to assess the performance of community pharmacist towards antidiabetic and antiasthma prescriptions, and also to assess the lack of information provided by community pharmacists regarding patient counseling and missing data, using a simulated patient technique. Methods A prescription including antidiabetic and antiasthma drugs was used by simulated patient to assess community pharmacist’s performance in 194 pharmacies. A performance assessment sheet was used to measure the patient counseling process. A quantitative descriptive and comparative analysis was done for the collected data. Pearson chi-square test (crosstabs) was used with a level of significance 95%). Results The analysis of the 194 pharmacies visited revealed that most of the pharmacists were male (61%), Arabs (35%) and Indians (55%) with some other nationalities. The dispensing time in the pharmacy ranged between 2 to 10 minutes. Spending time with patients was not affected by gender (p-value 0.087), slightly affected by nationality (p-value 0.04), and highly affected by age (p-value 0.002) leaning towards older pharmacists who spent more time with patients than younger pharmacists. Most pharmacists (90%) started preparing the prescription once they received the prescription with no actual prescription screening. fifty five percent of the pharmacists asked about the duration of the treatment after preparing the prescription. ninety six percent did not counsel patients about diet, exercise and lifestyle changes. Less than 40% asked if the prescription was intended to be used for the same patient. Conclusion This study recommends that health authorities consider follow up plans in order to ensure the best pharmaceutical care is provided by community pharmacies. PMID:25132888

Alomar, Muaed J.; Qandil, Shareef; Al-Hilwani, Hanan M.A.; Malkat, Dima M.; Caroline, Claire

2010-01-01

255

Quality of Online Pharmacies and Websites Selling Prescription Drugs: A Systematic Review  

PubMed Central

Background Online pharmacies are companies that sell pharmaceutical preparations, including prescription-only drugs, on the Internet. Very little is known about this phenomenon because many online pharmacies operate from remote countries, where legal bases and business practices are largely inaccessible to international research. Objective The aim of the study was to perform an up-to-date and comprehensive review of the scientific literature focusing on the broader picture of online pharmacies by scanning several scientific and institutional databases, with no publication time limits. Methods We searched 4 electronic databases up to January 2011 and the gray literature on the Internet using the Google search engine and its tool Google Scholar. We also investigated the official websites of institutional agencies (World Health Organization, and US and European centers for disease control and drug regulation authorities). We focused specifically on online pharmacies offering prescription-only drugs. We decided to analyze and report only articles with original data, in order to review all the available data regarding online pharmacies and their usage. Results We selected 193 relevant articles: 76 articles with original data, and 117 articles without original data (editorials, regulation articles, or the like) including 5 reviews. The articles with original data cover samples of online pharmacies in 47 cases, online drug purchases in 13, consumer characteristics in 15, and case reports on adverse effects of online drugs in 12. The studies show that random samples with no specific limits to prescription requirements found that at least some websites sold drugs without a prescription and that an online questionnaire was a frequent tool to replace prescription. Data about geographical characteristics show that this information can be concealed in many websites. The analysis of drug offer showed that online a consumer can get virtually everything. Regarding quality of drugs, researchers very often found inappropriate packaging and labeling, whereas the chemical composition usually was not as expected in a minority of the studies’ samples. Regarding consumers, the majority of studies found that not more than 6% of the samples had bought drugs online. Conclusions Online pharmacies are an important phenomenon that is continuing to spread, despite partial regulation, due to intrinsic difficulties linked to the impalpable and evanescent nature of the Web and its global dimension. To enhance the benefits and minimize the risks of online pharmacies, a 2-level approach could be adopted. The first level should focus on policy, with laws regulating the phenomenon at an international level. The second level needs to focus on the individual. This approach should aim to increase health literacy, required for making appropriate health choices, recognizing risks and making the most of the multitude of opportunities offered by the world of medicine 2.0. PMID:21965220

Merla, Anna; Schulz, Peter J; Gelatti, Umberto

2011-01-01

256

Medicare Part D and Its Effect on the Use of Prescription Drugs and Use of Other Health Care Services of the Elderly  

ERIC Educational Resources Information Center

We examine the effect of gaining prescription drug insurance, as a result of Medicare Part D, on use of prescription drugs and other medical services for a nationally representative sample of Medicare beneficiaries. Given the heightened importance of prescription drugs for those with chronic illness, we provide separate estimates for elderly in…

Kaestner, Robert; Nasreen Khan,

2012-01-01

257

Is Access Sufficient?: An Examination of the Effects of the MedShare Program to Expand Access to Prescription Drugs for Indigent Populations  

ERIC Educational Resources Information Center

We conduct an evaluation of MedShare, a program designed to enhance access to prescription drugs for indigent patients in the Greater Cincinnati area. The program expands access to drugs by providing subsidies to reduce the costs paid by patients for their prescriptions. The assumption is that by expanding access to prescription drugs, participant…

Shaw, Thomas; Carrozza, Mark

2008-01-01

258

Potential drug interactions and duplicate prescriptions among ambulatory cancer patients: a prevalence study using an advanced screening method  

Microsoft Academic Search

BACKGROUND: The pharmacotherapeutic treatment of patients with cancer is generally associated with multiple side-effects. Drug interactions and duplicate prescriptions between anti-cancer drugs or interactions with medication to treat comorbidity can reinforce or intensify side-effects. The aim of the present study is to gain more insight into the prevalence of drug interactions and duplicate prescriptions among patients being treated in the

Roelof WF van Leeuwen; Eleonora L Swart; Frits A Boom; Martin S Schuitenmaker; Jacqueline G Hugtenburg

2010-01-01

259

Researching Prescription Drug Misuse among First Nations in Canada: Starting from a Health Promotion Framework  

PubMed Central

The intentional misuse of psychotropic drugs is recognized as a significant public health concern in Canada, although there is a lack of empirical research detailing this. Even less research has been documented on the misuse of prescription drugs among First Nations in Canada. In the past, Western biomedical and individual-based approaches to researching Indigenous health have been applied, whereas First Nations’ understandings of health are founded on a holistic view of wellbeing. Recognition of this disjuncture, alongside the protective influence of First Nations traditional culture, is foundational to establishing an empirical understanding of and comprehensive response to prescription drug misuse. We propose health promotion as a framework from which to begin to explore this. Our work with a health promotion framework has conveyed its potential to support the consideration of Western and Indigenous worldviews together in an ‘ethical space’, with illustrations provided. Health promotion also allots for the consideration of Canada’s colonial history of knowledge production in public health and supports First Nations’ self-determination. Based on this, we recommend three immediate ways in which a health promotion framework can advance research on prescription drug misuse among First Nations in Canada. PMID:22879752

Dell, Colleen Anne; Roberts, Gary; Kilty, Jennifer; Taylor, Kelli; Daschuk, Mitch; Hopkins, Carol; Dell, Debra

2012-01-01

260

To Dope or Not to Dope: Neuroenhancement with Prescription Drugs and Drugs of Abuse among Swiss University Students  

PubMed Central

Background Neuroenhancement is the use of substances by healthy subjects to enhance mood or cognitive function. The prevalence of neuroenhancement among Swiss university students is unknown. Investigating the prevalence of neuroenhancement among students is important to monitor problematic use and evaluate the necessity of prevention programs. Study aim To describe the prevalence of the use of prescription medications and drugs of abuse for neuroenhancement among Swiss university students. Method In this cross-sectional study, students at the University of Zurich, University of Basel, and Swiss Federal Institute of Technology Zurich were invited via e-mail to participate in an online survey. Results A total of 28,118 students were contacted, and 6,275 students completed the survey. Across all of the institutions, 13.8% of the respondents indicated that they had used prescription drugs (7.6%) or drugs of abuse including alcohol (7.8%) at least once specifically for neuroenhancement. The most frequently used prescription drugs for neuroenhancement were methylphenidate (4.1%), sedatives (2.7%), and beta-blockers (1.2%). Alcohol was used for this purpose by 5.6% of the participants, followed by cannabis (2.5%), amphetamines (0.4%), and cocaine (0.2%). Arguments for neuroenhancement included increased learning (66.2%), relaxation or sleep improvement (51.2%), reduced nervousness (39.1%), coping with performance pressure (34.9%), increased performance (32.2%), and experimentation (20%). Neuroenhancement was significantly more prevalent among more senior students, students who reported higher levels of stress, and students who had previously used illicit drugs. Although “soft enhancers”, including coffee, energy drinks, vitamins, and tonics, were used daily in the month prior to an exam, prescription drugs or drugs of abuse were used much less frequently. Conclusions A significant proportion of Swiss university students across most academic disciplines reported neuroenhancement with prescription drugs and drugs of abuse. However, these substances are rarely used on a daily basis and more sporadically used prior to exams. PMID:24236008

Maier, Larissa J.; Liechti, Matthias E.; Herzig, Fiona; Schaub, Michael P.

2013-01-01

261

Doping in gymnasiums in Amman: the other side of prescription and nonprescription drug abuse.  

PubMed

This study investigated the abuse of over-the-counter (OTC) products (e.g., proteins, dietary supplements) and prescription drugs (e.g., hormones) in gymnasiums in Amman by random distribution of a structured questionnaire to 375 gym clients (November 2012-February 2013). Data were analyzed using SPSS for Windows (version 17.0). A total of 31 (8.8%) clients admitted to using 21 products (mentioned 71 times) of anabolic steroids and other hormones (e.g., growth hormone and thyroxine) to increase muscular power at the gym or build muscle mass. Abuse of different prescription and OTC drugs among gymnasium clients is present in Jordan, but current methods for controlling the problem are ineffective. Better methods should be developed. The study's limitations are noted. PMID:24611822

Wazaify, Mayyada; Bdair, Ahmad; Al-Hadidi, Kamal; Scott, Jenny

2014-08-01

262

Phenothiazine overdose  

MedlinePLUS

Seek immediate medical help. Do NOT make a person throw up unless told to do so by ... tracing) Intravenous (through the vein) fluids Laxative Medication (antidote) to reverse the effects of the drug Tube ...

263

College on Problems of Drug Dependence taskforce on prescription opioid non-medical use and abuse: position statement  

Microsoft Academic Search

This position paper from the College on Problems of Drug Dependence addresses the issues related to non-medical use and abuse of prescription opioids. A central theme throughout is the need to strike a balance between risk management strategies to prevent and deter prescription opioid abuse and the need for physicians and patients to have appropriate access to opioid pharmaceuticals for

James Zacny; George Bigelow; Peggy Compton; Kathleen Foley; Martin Iguchi; Christine Sannerud

2003-01-01

264

Perceived Harmfulness Predicts Nonmedical Use of Prescription Drugs Among College Students: Interactions with Sensation-Seeking  

Microsoft Academic Search

This study describes the level of perceived harmfulness of nonmedical prescription stimulant and analgesic use in a sample\\u000a of college students, and examines the prospective relationship between perceived harmfulness and subsequent nonmedical use.\\u000a In addition, we explore whether the association between perceived harmfulness and nonmedical use varies by level of sensation-seeking.\\u000a Personal interviews, including questions on sensation-seeking and drug use,

Amelia M. Arria; Kimberly M. Caldeira; Kathryn B. Vincent; Kevin E. O’Grady; Eric D. Wish

2008-01-01

265

A Content Analysis of Direct-to-Consumer Television Prescription Drug Advertisements  

Microsoft Academic Search

This article reports the results of a content analysis of 23 direct-to-consumer (DTC) product-specific television prescription drug advertisements broadcast during 2001. A majority of ads used both medical and lay terms to convey medical ideas. Most gave consumers somewhat more time to absorb facts about benefits than those about risks, which could have implications for the “fair balance” requirement. Complete

KIMBERLY A. KAPHINGST; WILLIAM DEJONG; RIMA E. RUDD; LAWREN H. DALTROY

2004-01-01

266

Financial Disparities In Prescription Drug Use Between Elderly And Nonelderly Americans Elderly people bear a disproportionately high out-of-pocket spending burden for prescription drugs, even at higher income levels  

Microsoft Academic Search

This study examines cross-sectional disparities in the financial burden of pre- scription drug use among U.S. elderly and nonelderly adult populations, using data from the 1998 Medical Expenditure Panel Survey. Out-of-pocket spending for prescriptions, copayment rates, and the proportion of family income spent on prescription drugs were ex- amined to compare elderly people with working-age adults. Even after utilization or

K. Tom Xu

267

The impact of increasing patient prescription drug cost sharing on therapeutic classes of drugs received and on the health status of elderly HMO members.  

PubMed Central

OBJECTIVE: To assess the impact of increased prescription drug copayments on the therapeutic classes of drugs received and health status of the elderly. HYPOTHESES TESTED: Increased prescription drug copayments will reduce the relative exposure to, annual days use of, and prescription drug costs for drugs used in self-limiting conditions, but will not affect drugs used in progressive chronic conditions and will not reduce health status. STUDY DESIGN: Each year over a three-year period, one or the other of two well-insured Medicare risk groups in an HMO setting had their copayments per dispensing increased. Sample sizes ranged from 6,704 to 7,962. DATA SOURCES/DATA COLLECTION: Automated administrative data systems of the HMO were used to determine HMO eligibility, prescription drug utilization, and health status. ANALYSIS DESIGN: Analysis of variance or covariance was employed to measure change in dependent variables. FINDINGS: Relative exposure, annual days of use, and prescription drug costs for drugs used in self-limiting conditions and in progressive chronic conditions were not affected in a consistent manner across years by increases in prescription drug copayment. Health status may have been adversely affected. Larger increases in copayments appeared to generate more changes. CONCLUSIONS: Small changes in copayments did not appear to substantially affect outcomes. Large changes in copayments need further examination. Images PMID:9108807

Johnson, R E; Goodman, M J; Hornbrook, M C; Eldredge, M B

1997-01-01

268

Prescription of drugs during pregnancy: a study using EFEMERIS, the new French database  

Microsoft Academic Search

Background  Because of the limited data concerning drug risks in pregnancy, health professionals are often deprived of relevant and sufficient\\u000a information related to prescribing or dispensing during pregnancy. However, previous studies have emphasised the widespread\\u000a French prescription of several drugs (sometimes “typically French”) which have not been assessed in pregnant women.\\u000a \\u000a \\u000a \\u000a Objectives  The aim of the present study was to create the

I. Lacroix; C. Hurault; M. F. Sarramon; C. Guitard; A. Berrebi; M. Grau; C. Albouy-Cossard; R. Bourrel; E. Elefant; J. L. Montastruc; C. Damase-Michel

2009-01-01

269

From Salt Injection to Naloxone: Accuracy and Myths in Peer Resuscitation Methods for Opiate Overdose  

Microsoft Academic Search

One hundred and eight opiate addicts attending an in-patient opiate treatment unit were interviewed, using a mixed quantitative–qualitative approach, to investigate their experiences of witnessing overdoses, the associated interpretations and perceived cause of the overdose. Poly drug use and frequency of witnessed overdose was high among the sample. Use of 14 different combinations of drugs were reported, 8 of which

Tracy Beswick; David Best; Jenny Bearn; Sian Rees; Michael Gossop; Ross Coomber; John Strang

2002-01-01

270

Serial monitoring of sedation scores in benzodiazepine overdose.  

PubMed

Benzodiazepines are widely used for many diseases, and benzodiazepine overdose is globally increasing in proportion to its prescriptions. Although most benzodiazepine overdoses are known to be safe and nonfatal without coingestions, morbidity or mortality after benzodiazepine overdose is closely related with the duration of unconsciousness or depth of compromised airway. Proper use of flumazenil, a potent antidote of benzodiazepine, seems to accelerate the recovery from the toxicity after benzodiazepine overdose.However, as the case we present demonstrates, careful attention and repetitive evaluations before and after use of flumazenil may be needed in benzodiazepine overdose because resedation occurs in approximately 30% of total flumazenil-treated cases, which suggests that the risk of aspiration or incidental death after administrating flumazenil might be significant without careful monitoring. PMID:24908447

Kyong, Yeon Young; Park, Jeng Tak; Choi, Kyoung Ho

2014-11-01

271

21 CFR 200.200 - Prescription drugs; reminder advertisements and reminder labeling to provide price information to...  

...or suggestion concerning the drug product's safety, effectiveness...limited to, the cost of the drug product, professional fees...if any. Mailing fees and delivery fees, if any, may be stated...applicable to all prescription drug reminder labeling and...

2014-04-01

272

21 CFR 200.200 - Prescription drugs; reminder advertisements and reminder labeling to provide price information to...  

Code of Federal Regulations, 2013 CFR

...or suggestion concerning the drug product's safety, effectiveness...limited to, the cost of the drug product, professional fees...if any. Mailing fees and delivery fees, if any, may be stated...applicable to all prescription drug reminder labeling and...

2013-04-01

273

21 CFR 200.200 - Prescription drugs; reminder advertisements and reminder labeling to provide price information to...  

Code of Federal Regulations, 2012 CFR

...or suggestion concerning the drug product's safety, effectiveness...limited to, the cost of the drug product, professional fees...if any. Mailing fees and delivery fees, if any, may be stated...applicable to all prescription drug reminder labeling and...

2012-04-01

274

21 CFR 200.200 - Prescription drugs; reminder advertisements and reminder labeling to provide price information to...  

Code of Federal Regulations, 2011 CFR

...or suggestion concerning the drug product's safety, effectiveness...limited to, the cost of the drug product, professional fees...if any. Mailing fees and delivery fees, if any, may be stated...applicable to all prescription drug reminder labeling and...

2011-04-01

275

21 CFR 200.200 - Prescription drugs; reminder advertisements and reminder labeling to provide price information to...  

Code of Federal Regulations, 2010 CFR

...or suggestion concerning the drug product's safety, effectiveness...limited to, the cost of the drug product, professional fees...if any. Mailing fees and delivery fees, if any, may be stated...applicable to all prescription drug reminder labeling and...

2010-04-01

276

Cop's Best Friend: Preventing the Illegal Distribution and Transportation of Prescription Drugs.  

PubMed

Law enforcement and the military have long relied on canines to provide protection of the handler and others involved in combating crime. One of the extremely important uses of canines is in the detection of illegal drugs, bombs, and other explosives to protect the President of the United States, other dignitaries, and the general public. This article discusses the details on a canine that was trained to detect major illicit pharmaceuticals. The efforts of this program were made easier with the help of a compounding pharmacist who willingly assisted the Warren County Drug Task Force in the Canine's detection training by preparing and individually labeling capsules that contained pure drug. Both parties share their experiences in this important endeavor to combat the illegal distribution and transportation of prescription drugs. PMID:23965423

Burke, John

277

'He was like a zombie': off-label prescription of antipsychotic drugs in dementia.  

PubMed

This paper explores the legal position of the off-label prescription of antipsychotic medications to people with dementia who experience behavioural and psychological symptoms of dementia (BPSD). Dementia is a challenging illness, and BPSD can be very difficult for carers to manage, with evidence that this contributes to carer strain and can result in the early institutionalisation of people with dementia. As a result, the prescription of antipsychotic and other neuroleptic medications to treat BPSD has become commonplace, in spite of these drugs being untested and unlicensed for use to treat older people with dementia. In recent years, it has become apparent through clinical trials that antipsychotic drugs increase the risk of cerebrovascular accident (stroke) and death in people with dementia. In addition, these types of medication also have other risk factors for people with dementia, including over-sedation and worsening of cognitive function. Drawing on recent questionnaire (n = 185), focus group (n = 15), and interview (n = 11) data with carers of people with dementia, this paper explores the law relating to off-label prescription, and the applicability of medical negligence law to cases where adverse events follow the use of antipsychotic medication. It is argued that the practice of off-label prescribing requires regulatory intervention in order to protect vulnerable patients. PMID:23047844

Harding, Rosie; Peel, Elizabeth

2013-03-01

278

Prediction and Prevention of Prescription Drug Abuse: Role of Preclinical Assessment of Substance Abuse Liability  

PubMed Central

In 2011, the prevalence of prescription drug abuse exceeded that of any other illicit drug except marijuana. Consequently, efforts to curtail abuse of new medications should begin during the drug development process, where abuse liability can be identified and addressed before a candidate medication has widespread use. The first step in this process is scheduling with the Drug Enforcement Agency so that legal access is appropriately restricted, dependent upon levels of abuse risk and medical benefit. To facilitate scheduling, the Food and Drug Administration (FDA) has published guidance for industry that describes assessment of abuse liability. The purpose of this paper is to review methods that may be used to satisfy the FDA’s regulatory requirements for animal behavioral and dependence pharmacology. Methods include psychomotor activity, self-administration (an animal model of the rewarding effects of a drug), drug discrimination (an animal model of the subjective effects of a drug), and evaluation of tolerance and dependence. Data from tests conducted at RTI with known drugs of abuse illustrate typical results, and demonstrate that RTI is capable of performing these tests. While using preclinical data to predict abuse liability is an imperfect process, it has substantial predictive validity. The ultimate goal is to increase consumer safety through appropriate scheduling of new medications. PMID:24008590

Marusich, Julie A.; Lefever, Timothy W.; Novak, Scott P.; Blough, Bruce E.; Wiley, Jenny L.

2013-01-01

279

Association of Income and Prescription Drug Coverage With Generic Medication Use among Older Adults with Hypertension  

PubMed Central

Objectives To assess the potential for generic cardiovascular drug (CVD) use and to determine whether low-income seniors and those without prescription drug coverage are more likely to use generic CVD than more affluent and better insured adults. Study Design Cross-sectional analysis. Methods We used data from the 2001 Medicare Current Beneficiary Survey. Analyses included non-institutionalized survey respondents over age 65 with hypertension who used ?1 multisource CVD (available in chemically equivalent brand name and generic versions) (n=1,710). We examined the association of income and prescription coverage on use of generic versions of multisource drugs from 5 classes: angiotensin converting enzyme (ACE) inhibitors, beta-adrenergic receptor antagonists (beta-blockers), calcium channel blockers, alpha1-adrenergic receptor antagonists (alpha-blockers), and thiazide diuretics. Results Among users of medications in each class, rates of generic medication use were, for beta-blockers, 88.5%; thiazides, 92.8%; calcium channel blockers, 58.7%; ACE-inhibitors, 60.7%; and alpha-blockers, 52.6%. In multivariate analysis of generic medication use aggregated across the 5 drug classes, individuals with incomes below 200% of poverty had modestly increased likelihoods of using generic medications compared to seniors with incomes >300% of poverty (e.g., for income between 150% to 199% of poverty vs. 300% or more, RR 1.40, 95% CI 1.03 to 1.83). Seniors who lacked prescription coverage were more likely to use generics compared to those with employer-sponsored coverage, though the association was of marginal statistical significance (RR 1.29, 1.00 to 1.60). Conclusions Brand name agents from 3 of the 5 cardiovascular drug classes studied were often used despite the availability of generic equivalents. Seniors with low incomes or no prescription coverage were only somewhat more likely to use generic cardiovascular drugs than higher income and insured seniors. These findings suggest that physicians and policy makers may be missing opportunities to reduce costs for Medicare and its economically disadvantaged beneficiaries. PMID:17026415

Federman, Alex D.; Halm, Ethan A.; Zhu, Carolyn; Hochman, Tsivia; Siu, Albert L.

2006-01-01

280

Calcium carbonate overdose  

MedlinePLUS

Calcium carbonate is an ingredient that is commonly found in antacids (for heartburn) and some dietary supplements. Calcium carbonate overdose occurs when someone accidentally or intentionally takes ...

281

Use of illicit and prescription drugs for cognitive or mood enhancement among surgeons  

PubMed Central

Background Surgeons are usually exposed to high workloads leading to fatigue and stress. This not only increases the likelihood of mistakes during surgery but also puts pressure on surgeons to use drugs to counteract fatigue, distress, concentration deficits, burnout or symptoms of depression. The prevalence of surgeons taking pharmacological cognitive enhancement (CE) or mood enhancement (ME) drugs has not been systematically assessed so far. Methods Surgeons who attended five international conferences in 2011 were surveyed with an anonymous self-report questionnaire (AQ) regarding the use of prescription or illicit drugs for CE and ME and factors associated with their use. The Randomized Response Technique (RRT) was used in addition. The RRT guarantees a high degree of anonymity and confidentiality when a person is asked about stigmatizing issues, such as drug abuse. Results A total of 3,306 questionnaires were distributed and 1,145 entered statistical analysis (response rate: 36.4%). According to the AQ, 8.9% of all surveyed surgeons confessed to having used a prescription or illicit drug exclusively for CE at least once during lifetime. As one would expect, the prevalence rate assessed by RRT was approximately 2.5-fold higher than that of the AQ (19.9%; 95% confidence interval (CI), 15.9% to 23.9%, N = 1,105). An even larger discrepancy between the RRT and AQ was observed for the use of antidepressants with a 6-fold higher prevalence (15.1%; 95% CI, 11.3% to 19.0%, N = 1,099) as compared to 2.4% with the AQ. Finally, logistic regression analysis revealed that pressure to perform at work (odds ratio (OR): 1.290; 95% CI, 1.000 to 1.666; P = 0.05) or in private life (OR: 1.266; 95% CI, 1.038 to 1.543; P = 0.02), and gross income (OR: 1.337; 95% CI, 1.091 to 1.640; P = 0.005), were positively associated with the use of drugs for CE or ME. Conclusions The use of illicit and prescription drugs for CE or ME is an underestimated phenomenon among surgeons which is generally attributable to high workload, perceived workload, and private stress. Such intake of drugs is associated with attempts to counteract fatigue and loss of concentration. However, drug use for CE may lead to addiction and to overestimation of one’s own capabilities, which can put patients at risk. Coping strategies should be taught during medical education. PMID:23570256

2013-01-01

282

Reducing Prescriptions of Long-Acting Benzodiazepine Drugs in Denmark: A Descriptive Analysis of Nationwide Prescriptions during a 10-Year Period.  

PubMed

Prolonged consumption of benzodiazepine drugs (BZD) and benzodiazepine receptor agonists (zolpidem, zaleplon, zopiclone; altogether Z drugs) is related to potential physiological and psychological dependence along with other adverse effects. This study aimed to analyse the prescribing of long-acting BZD (half-life >10 hr), compared to short-acting BZD in Denmark during a 10-year period. Descriptive analysis of total sales data from the Danish Register of Medicinal Product Statistics, to individuals in the primary healthcare sector, of all BZD and Z drugs in the period of 2003-2013. Prescription data derive from all community and hospital pharmacies in Denmark. The prescribing of long-acting BZD was reduced from 25.8 defined daily doses (DDD)/1000 inhabitants/day in 2003 to 8.8 DDD/1000 inhabitants/day in 2013, a relative reduction of 66%. The prescribing of short-acting BZD was reduced from 26.1 DDD/1000 inhabitants/day in 2003 to 16.4 DDD/1000 inhabitants/day in 2013, a relative reduction of 37%. Prescription data in this study did not include information about indications for initiating treatments. In addition, due to compliance problems, some of the prescribed drugs may not have been consumed according to the prescription. The observed reduction in BZD use was correlated to the introduction of new national guidelines on prescription of addictive drugs, but this study was not designed to detect a causal relationship. The prescribing of long-acting BZD decreased considerably more than the prescribing of short-acting BZD in the 10-year period. PMID:25382355

Eriksen, Sophie Isabel; Bjerrum, Lars

2014-11-10

283

Public/Private Partnerships for Prescription Drug Coverage: Policy Formulation and Outcomes in Quebec's Universal Drug Insurance Program, with Comparisons to the Medicare Prescription Drug Program in the United States  

PubMed Central

In January 1997, the government of Quebec, Canada, implemented a public/private prescription drug program that covered the entire population of the province. Under this program, the public sector collaborates with private insurers to protect all Quebecers from the high cost of drugs. This article outlines the principal features and history of the Quebec plan and draws parallels between the factors that led to its emergence and those that led to the passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) in the United States. It also discusses the challenges and similarities of both programs and analyzes Quebec's ten years of experience to identify adjustments that may help U.S. policymakers optimize the MMA. PMID:17718665

Pomey, Marie-Pascale; Forest, Pierre-Gerlier; Palley, Howard A; Martin, Elisabeth

2007-01-01

284

78 FR 8446 - Center for Drug Evaluation and Research; Prescription Drug Labeling Improvement and Enhancement...  

Federal Register 2010, 2011, 2012, 2013

...Center for Drug Evaluation and Research...facilitating optimal communication through labeling...Center for Drug Evaluation and Research...drug labeling as a communication tool and to discuss strategies for making it...

2013-02-06

285

CDC Vital Signs: Prescription Painkiller Overdoses  

MedlinePLUS

... Vital Signs™, enter your email address. What's this? Contact Us: Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30329- ... Using this Site Link to Us Social Media Contact CDC Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30329- ...

286

How Might the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Affect the Financial Viability of Rural Pharmacies? An Analysis of Preimplementation Prescription Volume and Payment Sources in Rural and Urban Areas  

ERIC Educational Resources Information Center

Passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) has created interest in how the legislation will affect access to prescription drugs among rural beneficiaries. Policy attention has focused to a much lesser degree on the implications of the MMA for the financial viability of rural pharmacies. This article…

Fraher, Erin P.; Slifkin, Rebecca T.; Smith, Laura; Randolph, Randy; Rudolf, Matthew; Holmes, George M.

2005-01-01

287

Policing and risk of overdose mortality in urban neighborhoods  

PubMed Central

Background Accidental drug overdose is a major cause of mortality among drug users. Fears of police arrest may deter witnesses of drug overdose from calling for medical help and may be a determinant of drug overdose mortality. To our knowledge, no studies have empirically assessed the relation between levels of policing and drug overdose mortality. We hypothesized that levels of police activity, congruent with fears of police arrest, are positively associated with drug overdose mortality. Methods We assembled cross-sectional time-series data for 74 New York City (NYC) police precincts over the period 1990–1999 using data collected from the Office of the Chief Medical Examiner of NYC, the NYC Police Department, and the US Census Bureau. Misdemeanor arrest rate—reflecting police activity—was our primary independent variable of interest, and overdose rate our primary dependent variable of interest. Results The mean overdose rate per 100,000 among police precincts in NYC between 1990 and 1999 was 10.8 (standard deviation = 10.0). In a Bayesian hierarchical model that included random spatial and temporal effects and a space-time interaction, the misdemeanor arrest rate per 1,000 was associated with higher overdose mortality (posterior median = 0.003, 95% Credible Interval = 0.001, 0.005) after adjustment for overall drug use in the precinct and demographic characteristics. Conclusions Levels of police activity in a precinct are associated with accidental drug overdose mortality. Future research should examine aspects of police-community interactions that contribute to higher overdose mortality. PMID:20727684

Bohnert, Amy S.B.; Nandi, Arijit; Tracy, Melissa; Cerdá, Magdalena; Tardiff, Kenneth J; Vlahov, David; Galea, Sandro

2010-01-01

288

Increases in heroin overdose deaths - 28 States, 2010 to 2012.  

PubMed

Nationally, death rates from prescription opioid pain reliever (OPR) overdoses quadrupled during 1999-2010, whereas rates from heroin overdoses increased by <50%. Individual states and cities have reported substantial increases in deaths from heroin overdose since 2010. CDC analyzed recent mortality data from 28 states to determine the scope of the heroin overdose death increase and to determine whether increases were associated with changes in OPR overdose death rates since 2010. This report summarizes the results of that analysis, which found that, from 2010 to 2012, the death rate from heroin overdose for the 28 states increased from 1.0 to 2.1 per 100,000, whereas the death rate from OPR overdose declined from 6.0 per 100,000 in 2010 to 5.6 per 100,000 in 2012. Heroin overdose death rates increased significantly for both sexes, all age groups, all census regions, and all racial/ethnic groups other than American Indians/Alaska Natives. OPR overdose mortality declined significantly among males, persons aged <45 years, persons in the South, and non-Hispanic whites. Five states had increases in the OPR death rate, seven states had decreases, and 16 states had no change. Of the 18 states with statistically reliable heroin overdose death rates (i.e., rates based on at least 20 deaths), 15 states reported increases. Decreases in OPR death rates were not associated with increases in heroin death rates. The findings indicate a need for intensified prevention efforts aimed at reducing overdose deaths from all types of opioids while recognizing the demographic differences between the heroin and OPR-using populations. Efforts to prevent expansion of the number of OPR users who might use heroin when it is available should continue. PMID:25275328

Rudd, Rose A; Paulozzi, Len J; Bauer, Michael J; Burleson, Richard W; Carlson, Rick E; Dao, Dan; Davis, James W; Dudek, Jennifer; Eichler, Beth Ann; Fernandes, Jessie C; Fondario, Anna; Gabella, Barbara; Hume, Beth; Huntamer, Theron; Kariisa, Mbabazi; Largo, Thomas W; Miles, JoAnne; Newmyer, Ashley; Nitcheva, Daniela; Perez, Beatriz E; Proescholdbell, Scott K; Sabel, Jennifer C; Skiba, Jessica; Slavova, Svetla; Stone, Kathy; Tharp, John M; Wendling, Tracy; Wright, Dagan; Zehner, Anne M

2014-10-01

289

Prescription drug coupons: evolution and need for regulation in direct-to-consumer advertising.  

PubMed

Pharmaceutical marketing in the United States had undergone a shift from largely exclusively targeting physicians to considerable efforts in targeting patients through various forms of direct-to-consumer advertising ("DTCA"). This includes the use of DTCA in prescription drug coupons ("PDCs"), a new form of DTCA that offers discounts and rebates directly to consumers to lower costs of drug purchasing. Our examination of PDCs reveals that the use and types of PDC programs is expanding and includes promotion of the vast majority of top grossing pharmaceuticals. However, controversy regarding this emerging form of DTCA has given rise to health policy concerns about their overall impact on prescription drug expenditures for consumers, payers, and the health care system, and whether they lead to optimal long-term utilization of pharmaceuticals. In response to these concerns and the growing popularity of PDCs, what we propose here are clearer regulation and regulatory guidance for PDC DTCA use. This would include review for appropriate disclosure of marketing claims, increased transparency in PDC use for pharmaceutical pricing, and leveraging potential positive benefits of PDC use for vulnerable or underserved patient populations. PMID:24120330

Mackey, Tim K; Yagi, Nozomi; Liang, Bryan A

2014-01-01

290

Analysis of clinical records of dental patients attending Jordan University Hospital: Documentation of drug prescriptions and local anesthetic injections  

PubMed Central

Objectives: The aim of this study was to analyze clinical records of dental patients attending the Dental Department at the University of Jordan Hospital: a teaching hospital in Jordan. Analysis aimed at determining whether dental specialists properly documented the drug prescriptions and local anesthetic injections given to their patients. Methods: Dental records of the Dental Department at the Jordan University Hospital were reviewed during the period from April 3rd until April 26th 2007 along with the issued prescriptions during that period. Results: A total of 1000 records were reviewed with a total of 53 prescriptions issued during that period. Thirty records documented the prescription by stating the category of the prescribed drug. Only 13 records stated the generic or the trade names of the prescribed drugs. Of these, 5 records contained the full elements of a prescription. As for local anesthetic injections, the term “LA used” was found in 22 records while the names and quantities of the local anesthetics used were documented in only 13 records. Only 5 records documented the full elements of a local anesthetic injection. Conclusion: The essential data of drug prescriptions and local anesthetic injections were poorly documented by the investigated group of dental specialists. It is recommended that the administration of the hospital and the dental department implement clear and firm guidelines for dental practitioners in particular to do the required documentation procedure. PMID:19209291

Dar-Odeh, Najla; Ryalat, Soukaina; Shayyab, Mohammad; Abu-Hammad, Osama

2008-01-01

291

Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access.  

PubMed

Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences. Naloxone dose and route of administration can produce variable intensity of potential adverse reactions and opioid withdrawal symptoms: intravenous administration and higher doses produce more adverse events and more severe withdrawal symptoms in those individuals who are opioid dependent. More serious adverse reactions after naloxone administration occur rarely and may be confounded by the effects of other co-intoxicants and the effects of prolonged hypoxia. One component of the new opioid harm reduction initiative is to expand naloxone access to high-risk individuals (addicts, abusers, or patients taking high-dose or extended-release opioids for pain) and their close family or household contacts. Patients or their close contacts receive a naloxone prescription to have the medication on their person or in the home for use during an emergency. Contacts are trained on overdose recognition, rescue breathing and administration of naloxone by intramuscular injection or nasal spraying of the injection prior to the arrival of emergency medical personnel. The safety profile of naloxone in traditional medical use must be considered in this new context of outpatient prescribing, dispensing and treatment of overdose prior to paramedic arrival. New naloxone delivery products are being developed for this prehospital application of naloxone in treatment of opioid overdose and prevention of opioid-induced mortality. PMID:25642320

Wermeling, Daniel P

2015-02-01

292

Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access  

PubMed Central

Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences. Naloxone dose and route of administration can produce variable intensity of potential adverse reactions and opioid withdrawal symptoms: intravenous administration and higher doses produce more adverse events and more severe withdrawal symptoms in those individuals who are opioid dependent. More serious adverse reactions after naloxone administration occur rarely and may be confounded by the effects of other co-intoxicants and the effects of prolonged hypoxia. One component of the new opioid harm reduction initiative is to expand naloxone access to high-risk individuals (addicts, abusers, or patients taking high-dose or extended-release opioids for pain) and their close family or household contacts. Patients or their close contacts receive a naloxone prescription to have the medication on their person or in the home for use during an emergency. Contacts are trained on overdose recognition, rescue breathing and administration of naloxone by intramuscular injection or nasal spraying of the injection prior to the arrival of emergency medical personnel. The safety profile of naloxone in traditional medical use must be considered in this new context of outpatient prescribing, dispensing and treatment of overdose prior to paramedic arrival. New naloxone delivery products are being developed for this prehospital application of naloxone in treatment of opioid overdose and prevention of opioid-induced mortality. PMID:25642320

2015-01-01

293

Association between prescription drug misuse and injection among runaway and homeless youth  

PubMed Central

Background The nonmedical use of prescription drugs is the fastest growing drug problem in the United States, disproportionately impacting youth. Furthermore, the population prevalence of injection drug use among youth is also on the rise. This short communication examines the association between current prescription drug misuse (PDM) and injection among runaway and homeless youth. Methods Homeless youth were surveyed between October, 2011 and February, 2012 at two drop-in service agencies in Los Angeles, CA. Prevalence ratios (PR) and 95% confidence intervals (CI) for the association between current PDM and injection behavior were estimated. The outcome of interest was use of a needle to inject any illegal drug into the body during the past 30 days. Results Of 380 homeless youth (median age, 21; IQR, 17-25; 72% male), 84 (22%) reported current PDM and 48 (13%) reported currently injecting. PDM during the past 30 days was associated with a 7.7 (95% CI: 4.4, 13.5) fold increase in the risk of injecting during that same time. Among those reporting current PDM with concurrent heroin, cocaine, and methamphetamine use, the PR with injection was 15.1 (95% CI: 8.5, 26.8). Conclusions Runaway and homeless youth are at increased risk for a myriad of negative outcomes. Our preliminary findings are among the first to show the strong association between current PDM and injection in this population. Our findings provide the basis for additional research to delineate specific patterns of PDM and factors that enable or inhibit transition to injection among homeless and runaway youth. PMID:24300900

Al-Tayyib, Alia A; Rice, Eric; Rhoades, Harmony; Riggs, Paula

2013-01-01

294

Demand for prescription drugs under non-linear pricing in Medicare Part D.  

PubMed

We estimate the price elasticity of prescription drug use in Medicare Part D, which features a non-linear price schedule due to a coverage gap. We analyze patterns of drug utilization prior to the coverage gap, where the "effective price" is higher than the actual copayment for drugs because consumers anticipate that more spending will make them more likely to reach the gap. We find that enrollees' total pre-gap drug spending is sensitive to their effective prices: the estimated price elasticity of drug spending ranges between [Formula: see text]0.14 and [Formula: see text]0.36. This finding suggests that filling in the coverage gap, as mandated by the health care reform legislation passed in 2010, will influence drug utilization prior to the gap. A simulation analysis indicates that closing the gap could increase Part D spending by a larger amount than projected, with additional pre-gap costs among those who do not hit the gap. PMID:24214101

Jung, Kyoungrae; Feldman, Roger; McBean, A Marshall

2014-03-01

295

Acute opiate overdose in Tehran: The forgotten role of opium  

Microsoft Academic Search

IntroductionThe global epidemic of opiate use continues to spread and is an increasing burden especially in developing countries. Acute opiate overdose (AOO) is one of the most dramatic complications of drug abuse. The purpose of this study is to examine the epidemiology of acute opiate overdose in a poisoning center in Tehran.

Mojgan Karbakhsh; Negar Salehian Zandi

2007-01-01

296

Extracorporeal circulation in the management of massive propranolol overdose.  

PubMed

A case of refractory hypotension following propranolol overdose is reported. Management included isoprenaline, glucagon and extracorporeal circulatory support using femoral vein-femoral artery bypass. The unreliability of neurological observations, especially unreactive pupils, in the presence of drug overdose is reiterated. PMID:1928675

McVey, F K; Corke, C F

1991-09-01

297

Excess drug prescriptions during influenza and RSV seasons in the Netherlands: potential implications for extended influenza vaccination.  

PubMed

Influenza and respiratory syncytial virus (RSV) infections are responsible for considerable morbidity, mortality and health-care resource use. For the Netherlands, we estimated age and risk-group specific numbers of antibiotics, otologicals and cardiovascular prescriptions per 10,000 person-years during periods with elevated activity of influenza or RSV, and compared these with peri-season rates. Data were taken from the University of Groningen in-house prescription database (www.iadb.nl) and virological surveillance for the period 1998-2006. During influenza and RSV periods excess antibiotic prescriptions were estimated for all age groups. In the age groups 0-1 and 2-4 years, excess antibiotic prescriptions during periods with elevated RSV activity (65% and 59% of peri-seasonal rates) exceeded the surpluses estimated during the influenza-activity periods (24% and 34% of peri-seasonal rates) while for otologicals excess prescriptions were higher for influenza (22% and 27%) than for RSV (14% and 17%). Among persons of 50 years and older, notably those without medical high-risk conditions, excess prescriptions for cardiovascular medications were estimated during the influenza periods at approximately 10% (this was also already seen in persons aged 45-49). Our results may have implications for influenza vaccination policies. In particular, extension of influenza vaccination to groups of non-elderly adults and young children may lower excess prescriptions during these influenza periods for all three types of drug prescriptions investigated. PMID:19071185

Assink, M D M; Kiewiet, J P; Rozenbaum, M H; Van den Berg, P B; Hak, E; Buskens, E J; Wilschut, J C; Kroes, A C M; Postma, M J

2009-02-11

298

The Demise of Oregon’s Medically Needy Program: Effects of Losing Prescription Drug Coverage  

PubMed Central

BACKGROUND In January 2003, people covered by Oregon’s Medically Needy program lost benefits owing to state budget shortfalls. The Medically Needy program is a federally matched optional Medicaid program. In Oregon, this program mainly provided prescription drug benefits. OBJECTIVE To describe the Medically Needy population and determine how benefit loss affected this population’s health and prescription use. DESIGN A 49-question telephone survey instrument created by the research team and administered by a research contractor. PARTICIPANTS A random sample of 1,269 eligible enrollees in Oregon’s Medically Needy Program. Response rate was 35% with 439 individuals, ages 21–91 and 64% women, completing the survey. MEASUREMENTS Demographics, health information, and medicatication use at the time of the survey obtained from the interview. Medication use during the program obtained from administrative data. RESULTS In the 6 months after the Medically Needy program ended, 75% had skipped or stopped medications. Sixty percent of the respondents had cut back on their food budget, 47% had borrowed money, and 49% had skipped paying other bills to pay for medications. By self-report, there was no significant difference in emergency department visits, but a significant decrease in hospitalizations comparing 6 months before and after losing the program. Two-thirds of respondents rated their current health as poor or fair. CONCLUSIONS The Medically Needy program provided coverage for a low-income, chronically ill population. Since its termination, enrollees have decreased prescription drug use and increased financial burden. As states make program changes and Medicare Part D evolves, effects on vulnerable populations must be considered. PMID:17380369

Edlund, Tina; Krois, Lisa; Smith, Jeanene

2007-01-01

299

Prescription Drug Misuse and Sexual Risk Behaviors Among Young Men Who have Sex with Men (YMSM) in Philadelphia.  

PubMed

This study examined the relationship between prescription drug misuse and sexual risk behaviors (i.e. unprotected sex, increased number of sex partners) in a sample of young men who have sex with men (YMSM) in Philadelphia. Data come from a cross-sectional study of 18-29 year old YMSM (N = 191) who misused prescription drugs in the past 6 months. Associations were investigated in two regression models: logistic models for unprotected anal intercourse (UAI) and zero-truncated Poisson regression model for number of sex partners. Of 177 participants engaging in anal intercourse in the past 6 months, 57.6 % engaged in UAI. After adjusting for socio-demographic variables and illicit drug use, misuse of prescription pain pills and muscle relaxants remained significantly associated with engaging in receptive UAI. No prescription drug class was associated with a high number of sex partners. This study provides additional evidence that some prescription drugs are associated with sexual risk behaviors among YMSM. PMID:25240627

Kecojevic, Aleksandar; Silva, Karol; Sell, Randall L; Lankenau, Stephen E

2014-09-21

300

Ephemeral profiles of prescription drug and formulation tampering: evolving pseudoscience on the Internet.  

PubMed

The magnitude of non-therapeutic use, or misuse of prescription pharmaceuticals now rivals that of illicit drug abuse. Drug and formulation tampering enables misusers to administer higher doses by intended and non-intended routes. Perceived motives appear to be a combination of interests in achieving a faster onset and enhancing psychoactive effects. Narcotic analgesics, stimulants, and depressants are widely sought, examined, and tampered with for recreational use. This review examines tampering methods reported on the Internet for selected pharmaceutical products. The Internet provides broad and varied guidance on tampering methods that are specific to drug classes and unique formulations. Instructions are available on crushing, separating, purifying and chemically altering specific formulations to allow changes in dosage, route of administration, and time course of effects. Many pharmaceutical formulations contain features that serve as "barriers" to tampering. The nature and effectiveness of formulation barriers vary widely with many being overcome by adventurous misusers. Examples of successes and failures in tampering attempts are frequently described on Internet sites that support recreational drug use. Successful tampering methods that have widespread appeal evolve into recipes and become archived on multiple websites. Examples of tampering methods include: (1) how to separate narcotic drugs (codeine, hydrocodone, oxycodone) from excipients and non-desirable actives (aspirin, acetaminophen, ibuprofen); (2) overcoming time-release formulations (beads, layers, matrices); (3) removal of active drug from high-dose formulations (patches, pills); (4) alteration of dosage forms for alternate routes of administration. The development of successful formulations that inhibit or prevent drug/formulation tampering with drugs of abuse should take into consideration the scope and practice of tampering methods available to recreational drug users on the Internet. PMID:16458455

Cone, Edward J

2006-06-01

301

Utilisation and Off-Label Prescriptions of Respiratory Drugs in Children  

PubMed Central

Respiratory drugs are widely used in children to treat labeled and non-labeled indications but only some data are available quantifying comprehensively off-label usage. Thus, we aim to analyse drug utilisation and off-label prescribing of respiratory drugs focusing on age- and indication-related off-label use. Patients aged ?18 years documented in the Bavarian Association of Statutory Health Insurance Physicians database (approx. 2 million children) between 2004 and 2008 were included in our study. Annual period prevalence rates (PPRs) per 10,000 children and the proportion of age- and indication-related off-label prescriptions were calculated and stratified by age and gender. Within the study period, highest PPRs were found for the fixed combination of clenbuterol/ambroxol (between 374–575 per 10,000 children) and the inhaled short acting beta-2-agonist salbutamol (between 378–527 per 10,000 children). Highest relative PPR increase was found for oral salbutamol (approx. 39-fold) whereas the most distinct decrease was found for oral long-acting beta-2-agonist clenbuterol (?97%). Compound classes most frequently involved in off-label prescribing were inhaled bronchodilative compounds (91,402; 37.3%) and oral beta-2-agonists (26,850; 22.5%). The highest absolute number of off-label prescriptions were found for inhaled salbutamol (n?=?67,084; 42.0%) and oral clenbuterol/ambroxol (fixed combination, n?=?18,897; 20.7%). Off-label prescribing due to indication was of much greater relevance than age-related off-label use. Most frequently, bronchodilative compounds were used off-label to treat respiratory tract infections. Highest off-label prescription rates were found in the youngest patients without relevant gender-related differences. Off-label prescribing of respiratory drugs is common especially in young children. Bronchodilative drugs were most frequently used off-label for treating acute bronchitis or upper respiratory tract infections underlining the essential need for a more rational prescribing in this area. PMID:25180704

Schmiedl, Sven; Fischer, Rainald; Ibáñez, Luisa; Fortuny, Joan; Klungel, Olaf H.; Reynolds, Robert; Gerlach, Roman; Tauscher, Martin; Thürmann, Petra; Hasford, Joerg; Rottenkolber, Marietta

2014-01-01

302

Age and the purchase of prescription drug insurance by older adults  

PubMed Central

The Medicare Part D Prescription Drug Program places an unprecedented degree of choice in the hands of older adults despite concerns over their ability to make effective decisions and desire to have extensive choice in this context. While previous research has compared older adults to younger adults along these dimensions, our study, in contrast, examines how likelihood to delay decision making and preferences for choice differ by age among older age cohorts. Our analysis is based on responses of older adults to a simulation of enrollment in Medicare Part D. We examine how age, numeracy, cognitive reflection, and the interaction between age and performance on these instruments are related to the decision to enroll in a Medicare prescription drug plan and preference for choice in this context. We find that numeracy and cognitive reflection are positively associated with enrollment likelihood and that they are more important determinants of enrollment than age. We also find that greater numeracy is associated with a lower willingness to pay for choice. Hence, our findings raise concern that older adults, and, in particular, those with poorer numerical processing skills, may need extra support in enrolling in the program: they are less likely to enroll than those with stronger numerical processing skills, even though they show greater willingness to pay for choice. PMID:21534689

Szrek, Helena; Bundorf, M. Kate

2011-01-01

303

Risk factors of ?-hydroxybutyrate overdosing.  

PubMed

The aim of this study was to identify in recreational drug users the factors which increase the risk of overdosing (OD) with ?-hydroxybutyrate (GHB). A purposive sample of 45 experienced GHB users was interviewed, equally divided into three groups (never OD, occasional OD, and repeat OD). The repeat OD group scored highest on many risk factors regarding GHB use, the occasional OD group scored intermediate, and the never OD group scored lowest. Participants, whether or not they had overdosed on GHB, most often perceived GHB use (e.g. using more GHB than usual, using GHB doses too closely together) as the main reason for GHB OD, and many participants who had overdosed on GHB reported that they had taken more GHB than usual at their most recent occasion of GHB OD. No significant differences in co-use of GHB with other substances were found between the three groups. Our findings indicate that using GHB in the company of groups of friends probably reduces, but does not eliminate, the risk of OD. PMID:24080792

Korf, Dirk J; Nabben, Ton; Benschop, Annemieke; Ribbink, Kim; van Amsterdam, Jan G C

2014-01-01

304

Associations between prescription opioid injection and Hepatitis C virus among young injection drug users  

PubMed Central

Objective Hepatitis C virus (HCV) incidence has been increasing among young injection drug users (IDUs). This analysis examined whether the emerging practice of prescription opioid (PO) injection is associated with self-reported HCV among young IDUs. Methods Young IDUs (n = 162) aged 18–25-years-old who indicated recent misuse of prescription drugs were sampled in New York and Los Angeles during 2009–2011. Participants reported lifetime PO injection history and results from their most recent HCV test as well as demographic characteristics and lifetime drug use. Bivariate analyses examined relationships between covariates and both lifetime PO injection and HCV positivity. Poisson regression examined the associations between lifetime PO injection, HCV positivity, and significant covariates. Results A majority reported lifetime PO injection (72.2%) and 30.9% self-reported being HCV positive. Lifetime PO injectors were nearly three times more likely to report being HCV positive than non-PO injectors (adjusted incidence rate ratio (AIRR): 2.69, p<0.05) after controlling for socio-demographic and other drug use variable. Additionally, substituting POs for heroin (AIRR: 2.27, p<0.05), growing up in a lower social class (AIRR: 1.67, p<0.05), age (AIRR: 1.12, p<0.05), age of injection initiation (AIRR: 0.87, p<0.001), and history of being prescribed stimulants (AIRR: 0.64, p<0.05) were independently associated with HCV positivity. Conclusions Findings suggest that PO injection should be given further consideration as a contributing factor to rising HCV infection among young adults in the US. PMID:25598589

Lankenau, Stephen E.; Kecojevic, Aleksandar; Silva, Karol

2014-01-01

305

Prescription drug use during pregnancy and risk of childhood cancer - Is there an association?  

PubMed

In economically developed countries up to 90% of women are prescribed medications, including vitamins and supplements, during pregnancy. Whilst a number of adverse health outcomes in their offspring have been related to prescription drug use, associations with childhood cancer are less clear and most investigations have been reliant on maternal self-report. With a view to providing new insight we investigated maternal prescription drug use and risk of childhood cancer primary care medical records collected as part of the United Kingdom Childhood Cancer Study, a national population-based case-control study conducted between 1991 and 1996. There was evidence that mothers of children with acute lymphoblastic leukaemia (OR 1.36, 95% CI 1.14-1.63), medulloblastoma (OR 1.79, 95% CI 1.00-3.22) and Wilms tumour (OR 1.79; 95% CI 1.05-3.04) were more likely to have been prescribed iron when compared to mothers of controls. In addition, systemic anti-infectives were positively associated with acute myeloid leukaemia (OR 1.58, 95% CI: 1.05-2.38) and rhabdomyosarcoma (OR 1.80, 95% CI 1.03-3.16), and analgesic use (NO2B) was positively associated with Hodgkin lymphoma (OR 5.02, 95% CI 2.16-11.82) and neuroblastoma (OR 1.99, 95% CI 1.07-3.69). Whilst our findings suggest that maternal use of antibiotics, iron, and nervous system drugs during pregnancy may be associated with some childhood cancer subtypes these associations need to be confirmed elsewhere. Unravelling the mechanisms that may underpin these associations is complex and research is needed to determine whether they are directly related to the drugs themselves, or the illnesses for which they were prescribed. PMID:25544150

Bonaventure, A; Simpson, J; Ansell, P; Roman, E; Lightfoot, T

2015-02-01

306

Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. Final rule.  

PubMed

The Food and Drug Administration (FDA) is amending its regulations governing the content and format of the "Pregnancy," "Labor and delivery," and "Nursing mothers" subsections of the "Use in Specific Populations" section of the labeling for human prescription drug and biological products. The final rule requires the removal of the pregnancy categories A, B, C, D, and X from all human prescription drug and biological product labeling. For human prescription drug and biological products subject to the Agency's 2006 Physician Labeling Rule, the final rule requires that the labeling include a summary of the risks of using a drug during pregnancy and lactation, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy and lactation. The final rule eliminates the "Labor and delivery" subsection because information about labor and delivery is included in the "Pregnancy" subsection. The final rule requires that the labeling include relevant information about pregnancy testing, contraception, and infertility for health care providers prescribing for females and males of reproductive potential. The final rule creates a consistent format for providing information about the risks and benefits of prescription drug and/or biological product use during pregnancy and lactation and by females and males of reproductive potential. These revisions will facilitate prescriber counseling for these populations. PMID:25509060

2014-12-01

307

A Database Developed with Information Extracted from Chemotherapy Drug Package Inserts to Enhance Future Prescriptions  

PubMed Central

Package inserts of Food and Drug Administration (FDA) approved prescription drugs, including chemotherapy drugs, must follow a specific format imposed by the FDA. These inserts are created by unrelated pharmaceutical companies and as a result tend to be very different in the way the required information is reported. Chemical and pharmacokinetic properties including absorption, distribution, metabolism, excretion, and toxicity (ADME/Tox) are crucial elements to a prescribing information packet and are often missing from the reported data. This undergraduate research project analyzes the information packets of 85 randomly chosen chemically diverse chemotherapy drugs for four parameters important to patient care; viz, volume of distribution (VD), elimination half-life (t1/2), bioavailability, and water solubility. The prescribing information from the package inserts of each was analyzed in detail and pertinent information was consequently tabulated into a database using a commercial informatics platform. Then using a substructure search-tool, sixty-five chemotherapy drugs containing a carbonyl group in their chemical structure were selected and as hypothesized, it was found that many of these packets were significantly lacking in the reporting of the four parameters of interest. To further enhance this cataloged data, a freely available online database was consequently developed (http://annotation.dbi.udel.edu/CancerDB/) with the intention that the chemical, biological, and clinical community will now add some of the missing parameters. PMID:25302340

Alabed, Ghada J.; Wheatley, Jordan M.; Veturi, Yogasudha; Bi, Xia; Continisio, Christopher Hart

2011-01-01

308

Characteristics of Recipients of Free Prescription Drug Samples: A Nationally Representative Analysis  

PubMed Central

Objectives. Free prescription drug samples are used widely in the United States. We sought to examine characteristics of free drug sample recipients nationwide. Methods. We analyzed data on 32681 US residents from the 2003 Medical Expenditure Panel Survey (MEPS), a nationally representative survey. Results. In 2003, 12% of Americans received at least 1 free sample. A higher proportion of persons who had continuous health insurance received a free sample (12.9%) than did persons who were uninsured for part or all of the year (9.9%; P<.001). The poorest third of respondents were less likely to receive free samples than were those with incomes at 400% of the federal poverty level or higher. After we controlled for demographic factors, we found that neither insurance status nor income were predictors of the receipt of drug samples. Persons who were uninsured all or part of the year were no more likely to receive free samples (odds ratio [OR]=0.98; 95% confidence interval [CI]=0.087, 1.11) than those who were continuously insured. Conclusions. Poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples. Our findings suggest that free drug samples serve as a marketing tool, not as a safety net. PMID:18172135

Cutrona, Sarah L.; Woolhandler, Steffie; Lasser, Karen E.; Bor, David H.; McCormick, Danny; Himmelstein, David U.

2008-01-01

309

Intertwined Epidemics: National Demographic Trends in Hospitalizations for Heroin- and Opioid-Related Overdoses, 1993–2009  

PubMed Central

The historical patterns of opiate use show that sources and methods of access greatly influence who is at risk. Today, there is evidence that an enormous increase in the availability of prescription opiates is fuelling a rise in addiction nationally, drawing in new initiates to these drugs and changing the geography of opiate overdoses. Recent efforts at supply-based reductions in prescription opiates may reduce harm, but addicted individuals may switch to other opiates such as heroin. In this analysis, we test the hypothesis that changes in the rates of Prescription Opiate Overdoses (POD) are correlated with changes in the rate of heroin overdoses (HOD). ICD9 codes from the Nationwide Inpatient Sample and population data from the Census were used to estimate overall and demographic specific rates of POD and HOD hospital admissions between 1993 and 2009. Regression models were used to test for linear trends and lagged negative binomial regression models were used to model the interrelationship between POD and HOD hospital admissions. Findings show that whites, women, and middle-aged individuals had the largest increase in POD and HOD rates over the study period and that HOD rates have increased in since 2007. The lagged models show that increases in a hospitals POD predict an increase in the subsequent years HOD admissions by a factor of 1.26 (p<0.001) and that each increase in HOD admissions increase the subsequent years POD by a factor of 1.57 (p<0.001). Our hypothesis of fungibility between prescription opiates and heroin was supported by these analyses. These findings suggest that focusing on supply-based interventions may simply lead to a shift in use to heroin rather minimizing the reduction in harm. The alternative approach of using drug abuse prevention resources on treatment and demand-side reduction is likely to be more productive at reducing opiate abuse related harm. PMID:23405084

Unick, George Jay; Rosenblum, Daniel; Mars, Sarah; Ciccarone, Daniel

2013-01-01

310

Describing Prescription Opioid Adherence among Individuals with Chronic Pain using Urine Drug Testing.  

PubMed

Adherence monitoring for prescription opioid use is a clinical imperative for individuals prescribed opioids for chronic pain. Urine drug testing (UDT) provides objective evidence for prescription opioid adherence, as recommended by national guidelines to be part of adherence monitoring. The aim of this study was to describe prescription opioid adherence using UDT results in chronic pain patients and to examine the association between demographic characteristics and adherence to their prescribed opiate regimens. We used a retrospective chart review of 120 consecutive patients at an urban pain management clinic. Data collected included UDT results, pain level, and demographic characteristics. Descriptive and correlational statistics were used for data analysis. About 54% of the individuals appeared nonadherent to their prescribed opiate regimen as defined by absence or inappropriate level of prescribed controlled medication, presence of additional nonprescribed controlled substance(s), presence of illicit substance(s), or presence of adulterant in the urine sample. Of the participants, 23% had absence of one or more of their prescribed controlled medications and 12.5% had presence of one or more other opioids. Marijuana was the main illicit substance used (24.2%), followed by cocaine (11.7%). Patients' age, pain level, sex, ethnicity, and injury compensation were not associated with UDT results. UDT results could be useful to educate and guide patients on the proper use of controlled medications. Results from UDT are highly contextual and easily misinterpreted, requiring comparison with a variety of clinical indicators over time before deciding if there is adherence to a prescribed opiate regimen for individuals with chronic pain. PMID:24939349

Matteliano, Deborah; Chang, Yu-Ping

2015-02-01

311

Zinc oxide overdose  

MedlinePLUS

Zinc oxide is an ingredient in many products, including certain creams and ointments used to prevent or treat minor skin burns and irritation. Zinc oxide overdose occurs when someone accidentally or intentionally ...

312

Sassafras oil overdose  

MedlinePLUS

... taken from the root bark of the sassafras tree. Sassafras oil overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this substance. This is for information only and not ...

313

Castor oil overdose  

MedlinePLUS

Castor oil is a yellowish liquid often used as a lubricant and in laxatives. This article discusses poisoning from swallowing a large amount (overdose) of castor oil. This is for information only and not for ...

314

Methyl salicylate overdose  

MedlinePLUS

Methyl salicylate is a wintergreen-scented chemical found in many over-the-counter products, including muscle ache creams. Methyl salicylate overdose occurs when someone accidentally or intentionally takes ...

315

Desipramine hydrochloride overdose  

MedlinePLUS

Desipramine hydrochloride is a type of medicine called a tricyclic antidepressant. Desipramine hydrochloride overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication. ...

316

Campho-Phenique overdose  

MedlinePLUS

Campho-Phenique contains both camphor and phenol. For information on products containing camphor alone, see camphor overdose . ... The combination of camphor and phenol is found in Campho-Phenique. ... camphor and phenol may be found separately in other products.)

317

Guide to drug porphyrogenicity prediction and drug prescription in the acute porphyrias  

PubMed Central

What is already known about this subject Many drug safety lists for acute porphyrias, largely based on anecdotal evidence, are put forward, but no methods or rationale for the risk estimates are given. Many unexplained discrepancies between the lists exist. What this study adds A standardized method for assessment of the risk that a certain drug may activate these diseases has been developed. It also allows risk assessments for drugs lacking porphyria related clinical experience. About one thousand therapeutic drugs have been classified with regard to porphyrogenicity by the proposed method, which is most valuable for the care of porphyria patients. Aims This paper addresses two common problems in the care of carriers of acute porphyria: the choice of safe drugs for pharmacotherapy and the strategy to apply when potentially unsafe drugs cannot be avoided. Methods and results A technique is presented for prediction of risk that a certain drug may activate the disease in a gene carrier for acute porphyria. It is based on a model explaining the clinical manifestations as a result of the acute overloading of a deficient enzyme within the hepatic heme biosynthetic chain. The capacity of the drug for induction of the rate-limiting enzyme in heme biosynthesis, e.g. housekeeping 5-aminolevulinate synthase (ALAS1), is assessed by critical appraisal of reports of the outcomes of clinical use of the drug, and by theoretical criteria. The assessment occurs within the frame of a flow-scheme employing variables of increasing specificity, i.e. endocrine properties of the drug, structure and metabolism pointing to affinity to cytochrome P450, hepatic load in therapeutic use, recognized affinity to major CYP species, capacity for CYP-induction or irreversible inhibition, and capacity to activate or modulate the transduction mechanisms of nuclear receptors affecting ALAS1-gene transcription. It is proposed that in the absence of a safer alternative, an urgently needed drug not should be withheld on the grounds of potential porphyrogenicity. After risk-benefit analysis it should be prescribed, but individualized preventive measures adapted to patient vulnerability may be needed. Conclusions About 1000 therapeutic drugs categorized with regard to porphyrogenicity by the technique proposed are presented on the internet (http://www.drugs-porphyria.org). PMID:17578481

Thunell, Stig; Pomp, Erik; Brun, Atle

2007-01-01

318

[Local straight line screening method for the detection of Chinese proprietary medicines containing undeclared prescription drugs].  

PubMed

The present paper constructs a new approach named local straight-line screening (LSLS) to detect Chinese proprietary medicines (CPM) containing undeclared prescription drugs (UPD). Different from traditional methods used in analysis of multi-component spectrum, LSLS is proposed according to the characteristics of original infrared spectra of the UPD and suspected CPM, without any pattern recognition or concentration model establishment. Spectrum-subtraction leads to the variance in local straight line, which serves as a key in discrimination of whether suspected CPD is adulterated or not. Sibutramine hydrochloride, fenfluramine hydrochloride, sildenafil citrate and lovastatin were used as reference substances of UPD to analyze 16 suspected CPM samples. The results show that LSLS can obtain an accurate quantitative and qualitative analysis of suspected CPM. It is possible for the method to be potentially used in the preliminary screening of CPM containing possible UPD. PMID:19445196

Li, Shu; Cao, Yan; Le, Jian; Chen, Gui-Liang; Chai, Yi-Feng; Lu, Feng

2009-02-01

319

The unlicensed lives of antidepressants in India: generic drugs, unqualified practitioners, and floating prescriptions.  

PubMed

Antidepressant uses have been rising rapidly over the past decades. Two main theories have been advanced to explain this. One claims that socio-economic change causes a global rise of depressive illness. The other holds that European and North American corporations are aggressively marketing antidepressants to expand their global reach. Both theories assume that multinational capitalism drives rising depression rates. Based on ethnographic data from India, this article shows that antidepressants are increasingly used in this country as well, but for reasons than have been little explored yet. Taking fluoxetine (Prozac) as the main example, it is argued that the spread of antidepressants in India is ;unlicensed' by Euro-American corporations in at least three ways: (i) drug marketing is driven by Indian generic producers; (ii) fluoxetine is given by practitioners who have no license to do so; and (iii) knowledge of fluoxetine is spread through unlicensed ;floating' prescriptions that patients take from one prescriber to another. PMID:19293281

Ecks, Stefan; Basu, Soumita

2009-03-01

320

Frequency of Prescription Drugs on Durable Medical Equipment Files by Brand Drug Name  

Cancer.gov

If a patient receives an oral chemotherapeutic agent that is equivalent to a chemotherapy administered intravenously, this agent may be captured in the Durable Medical Equipment (DME) file. Under most circumstances, CMS requires providers to use 11-digit National Drugs Codes (NDCs) when submitting DME claims for oral anti-cancer drugs. For patients in clinical trials, DME claims will be billed using HCPCS codes instead of DME codes.

321

The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.  

PubMed

The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142

Ung, Brian L; Mullins, C Daniel

2014-08-12

322

The Ohio State University Office of Human Resources Page 1 of 1 Prescription Drug Benefit Summary Edited 02/06/14  

E-print Network

-Formulary Brand Name Drug 50% coinsurance, no maximum 50% coinsurance, no maximum Infertility Medication Plan5 sheets, visit hr.osu.edu/benefits/hb_prescription. 5 The infertility treatment medical benefit includes The Prescription Drug Program annual out-of-pocket maximum does not apply to infertility medications. 7 Infertility

323

Exposure to Prescription Drugs Labeled for Risk of Adverse Effects of Suicidal Behavior or Ideation among 100 Air Force Personnel Who Died by Suicide, 2006-2009  

ERIC Educational Resources Information Center

Prescription drugs for many indications are labeled with warnings for potential risk of suicidal ideation or behavior. Exposures to prescription drugs labeled for adverse effects of suicidal behavior or ideation among 100 Air Force personnel who died by suicide between 2006 and 2009 are described. Air Force registry data were linked to…

Lavigne, Jill E.; McCarthy, Michael; Chapman, Richard; Petrilla, Allison; Knox, Kerry L.

2012-01-01

324

Effective August 12, 2013, if you are filing Form 843 in response to Letter 4658 (notice of branded prescription drug fee), note that the Mailstop  

E-print Network

is effective ONLY if you are filing Form 843 in response to Letter 4658 (notice of branded prescription drugAttention Effective August 12, 2013, if you are filing Form 843 in response to Letter 4658 (notice of branded prescription drug fee), note that the Mailstop number in the Where to File table on page 2

Gering, Jon C.

325

Reform of Prescription Drug Reimbursement and Pricing in the German Social Health Insurance Market: A Comparison of Three Scenarios  

Microsoft Academic Search

We review regulation of two important parameters for third-party payers and manufacturers of prescription drugs: regulation of reimbursement and pricing. We find that centralised regulation of reimbursement and pricing prevails in the 15 original EU member countries (EU-15) and in European Free Trade Association (EFTA) countries. Compared with countries such as Switzerland, The Netherlands, France and England, regulation in the

Stefan Gress; Dea Niebuhr; Uwe May

2007-01-01

326

Design, Development, and Evaluation of Visual Aids for Communicating Prescription Drug Instructions to Nonliterate Patients in Rural Cameroon.  

ERIC Educational Resources Information Center

Culturally sensitive visual aids designed to help convey drug information to nonliterate female adults requiring antibiotics were developed. Researchers conceptualized the messages, and a local artist produced the visual aids. Comprehension and compliance with prescription instructions were evaluated (N=78). Results and practical implications are…

Ngoh, Lucy N.; Shepherd, Marvin D.

1997-01-01

327

Non-Medical Use of Prescription Drugs among Youth in an Appalachian Population: Prevalence, Predictors, and Implications for Prevention  

ERIC Educational Resources Information Center

This article examines prevalence of non-medical use of prescription drugs (NMUPD) in a sample of elementary and high school students in an Appalachian Tennessee county. We found that lifetime prevalence of NMUPD (35%) was higher than prevalence of cigarette use (28%) and marijuana use (17%), but lower than lifetime prevalence of alcohol use (46%).…

Collins, David; Abadi, Melissa Harris; Johnson, Knowlton; Shamblen, Steve; Thompson, Kirsten

2011-01-01

328

Exploring the Use of Nonmedical Sources of Prescription Drugs among Immigrant Latinos in the Rural Southeastern USA  

ERIC Educational Resources Information Center

Background: Little is known about access to medicine among immigrant Latinos in the United States (US). This study explored access to, and use of, prescription drugs obtained from nonmedical sources among recently arrived, Spanish-speaking immigrant Latinos in rural North Carolina (NC). Methods: Our community-based participatory research…

Vissman, Aaron T.; Bloom, Fred R.; Leichliter, Jami S.; Bachmann, Laura H.; Montano, Jaime; Topmiller, Michael; Rhodes, Scott D.

2011-01-01

329

Prescription painkillers and controlled substances: an appraisal of drug information provided by six US pharmacies  

PubMed Central

Background Health literacy impacts health outcomes. Health literacy is a measure of a person’s competence to find, access, contextualize, and understand the information needed to make health decisions. Low levels of health literacy have been associated with poor health status. Health literacy can be enhanced by improving the readability of health literature. Misuse and abuse of prescription medicines and controlled substances is rising. It could be argued that improving the readability of the drug-information documents associated with these medicines could serve to alleviate this situation in a small, albeit incremental, manner. This paper provides a readability assessment of 71 such documents. Methods The readability of drug-information documents associated with 12 commonly misused and abused painkiller medicines and controlled substances published by the top six US pharmacies was assessed. The Flesch-Kincaid Grade Level, Flesch Reading Ease, and Simple Measure of Gobbledygook (SMOG) indices were used to assess the readability of these drug-information documents. One-way analysis of variance (ANOVA) was used to compare the readability of the documents. Results The average Flesch-Kincaid Grade Level index score was found to be 11.16. The average Flesch Reading Ease index score was found to be 45.94. The average SMOG index score was found to be 13.60. Pharmacies C and E had the best average readability scores, whereas pharmacies A and B had the worst average readability scores. Conclusion Access, contents, and formatting of the documents were qualitatively analyzed to make recommendations to improve readability. Pharmacies C and E were used as benchmarks to identify the seven best practices. Good drug-information documents should have: (1) clear purpose, (2) limited scope, (3) summary/brief review, (4) well-placed graphics, (5) informative illustrations, (6) clean layout and lucid formatting relevant to the media, and (7) focus on the intended users. PMID:23467668

Gill, Preetinder S

2013-01-01

330

[The experimental drug prescription program in Andalusia [PEPSA]: procedure for recruiting participants].  

PubMed

In this field note we describe the steps followed in the process of recruiting participants for the experimental drug prescription program in Andalusia (PEPSA). This trial is a comparative, randomized, open study of the difference between intravenous heroin treatment and oral methadone for socially excluded, opiate-dependent patients, in whom other available treatments have been unsuccessful. Because this is a hidden and hard-to-reach population, a specific approach was planned to put as many patients as possible in touch with the program. A previous study of the target population's distribution in the City of Granada was performed and the city was divided into three areas. Potential participants were interviewed in squares, soup kitchens and methadone dispensaries by outreach workers and peers, who suggested they make an appointment with a PEPSA physician. Peer-driven intervention was a crucial instrument in this recruitment procedure, allowing greater access to the target population. Furthermore, this approach allowed contact with drug users who do not attend health and social services. The work of the outreach team involved educating these users in harm reduction and offering them health and social alternatives beyond the clinical trial. PMID:15228924

March, Joan Carles; Oviedo-Joekes, Eugenia; Romero, Manuel; Gómez, Miguel; Rodríguez, Salvador; León, M Isabel; Rodríguez, Cristina

2004-01-01

331

Prescription trends of immunosuppressive drugs in post-heart transplant recipients in Taiwan, 2000–2009  

PubMed Central

Purpose Significantly increasing heart transplantations have been performed in Taiwan in the past decades, but the trends of maintenance immunosuppression for heart transplant recipients have not been well known. In this study, we aimed to explore the trends of maintenance immunosuppressive therapy and common complications for heart transplant recipients. Methods We retrospectively analyzed ambulatory prescriptions in 488 heart transplant recipients for the period 2000–2009. Patient complications after heart transplantation were also identified. Results The annual number of new heart transplant recipients ranged from 18 to 68. The 5-year survival rate was 77.9%. The total number of regimens was 10 in 2000, and increased to 28 in 2009. Most prescriptions were immunosuppressive combinations (95.5%–89.5%). The majority of immunosuppressive regimens were a triple regimen: cyclosporine, mycophenolic acid and corticosteroid in 2009. Cyclosporine was a predominant calcineurin inhibitor with a decreasing trend from 73.9% to 59.1%, whereas the use of tacrolimus significantly increased from 11.9% to 38.4%. Mycophenolic acid was the most frequently used antimetabolite (60.1%–80.3%), while the use of azathioprine was reduced (21.6%–2.3%). From 2008, the launch of everolimus initiated a new era in the utilization of mammalian target of rapamycin inhibitors for maintenance immunosuppression. Conclusions Cyclosporine remained the most frequently used calcineurin inhibitors, and tacrolimus increased gradually. Mycophenolic acid was the most popular antimetabolite rather than azathioprine. The rapidly increased everolimus combined regimen may change the patterns of maintenance immunosuppression. The increasing number of combination therapies indicates an active role of everolimus and a tendency of complex tailored individual therapies. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. PMID:25335855

Chou, Chia-Lin; Chou, Chia-Yu; Huang, Ying-Yu; Wu, Min-Shan; Hsu, Chia-Chen; Chou, Yueh-Ching

2014-01-01

332

Opposite Drug Prescription and Cost Trajectories following Integrative and Conventional Care for Pain – A Case-Control Study  

PubMed Central

Objectives Pharmacotherapy may have a limited role in long-term pain management. Comparative trajectories of drug prescriptions and costs, two quality-of-care indicators for pain conditions, are largely unknown subsequent to conventional or integrative care (IC) management. The objectives of this study were to compare prescribed defined daily doses (DDD) and cost of first line drugs for pain patients referred to conventional or anthroposophic IC in Stockholm County, Sweden. Methods In this retrospective high quality registry case-control study, IC and conventional care patients were identified through inpatient care registries and matched on pain diagnosis (ICD-10: M79), age, gender and socio-demographics. National drug registry data was used to investigate changes in DDD and costs from 90/180 days before, to 90/180 days after, index visits to IC and conventional care. The primary selected drug category was analgesics, complemented by musculo-skeletal system drugs (e.g. anti-inflammatories, muscle relaxants) and psycholeptics (e.g. hypnotics, sedatives). Results After index care visits, conventional care pain patients (n?=?1050) compared to IC patients (n?=?213), were prescribed significantly more analgesics. The average (95% CI) group difference was 15.2 (6.0 to 24.3), p?=?0.001, DDD/patient after 90 days; and 21.5 (7.4 to 35.6), p?=?0.003, DDD/patient after 180 days. The cost of the prescribed and sold analgesics was significantly higher for conventional care after 90 days: euro/patient 10.7 (1.3 to 20.0), p?=?0.025. Changes in drug prescription and costs for the other drug categories were not significantly different between groups. Conclusions Drug prescriptions and costs of analgesics increased following conventional care and decreased following IC, indicating potentially fewer adverse drug events and beneficial societal cost savings with IC. PMID:24827981

Sundberg, Tobias; Petzold, Max; Kohls, Niko; Falkenberg, Torkel

2014-01-01

333

Social and structural aspects of the overdose risk environment in St. Petersburg, Russia  

PubMed Central

Background While overdose is a common cause of mortality among opioid injectors worldwide, little information exists on opioid overdoses or how context may influence overdose risk in Russia. This study sought to uncover social and structural aspects contributing to fatal overdose risk in St. Petersburg and assess prevention intervention feasibility. Methods Twenty-one key informant interviews were conducted with drug users, treatment providers, toxicologists, police, and ambulance staff. Thematic coding of interview content was conducted to elucidate elements of the overdose risk environment. Results Several factors within St. Petersburg’s environment were identified as shaping illicit drug users’ risk behaviors and contributing to conditions of suboptimal response to overdose in the community. Most drug users live and experience overdoses at home, where family and home environment may mediate or moderate risk behaviors. The overdose risk environment is also worsened by inefficient emergency response infrastructure, insufficient cardiopulmonary or naloxone training resources, and the preponderance of abstinence-based treatment approaches to the exclusion of other treatment modalities. However, attitudes of drug users and law enforcement officials generally support overdose prevention intervention feasibility. Modifiable aspects of the risk environment suggest community-based and structural interventions, including overdose response training for drug users and professionals that encompasses naloxone distribution to the users and equipping more ambulances with naloxone. Conclusion Local social and structural elements influence risk environments for overdose. Interventions at the community and structural levels to prevent and respond to opioid overdoses are needed for and integral to reducing overdose mortality in St. Petersburg. PMID:18774283

Grau, Lauretta E.; Blinnikova, Ksenia N.; Torban, Mikhail; Krupitsky, Evgeny; Ilyuk, Ruslan; Kozlov, Andrei; Heimer, Robert

2009-01-01

334

What Matters Most? Assessing the Influence of Demographic Characteristics, College-Specific Risk Factors, and Poly-Drug Use on Nonmedical Prescription Drug Use  

ERIC Educational Resources Information Center

Objective: Although prior recent research has revealed a significant relationship between the nonmedical use of prescription drugs, demographic characteristics, college-specific risk factors, and other substance use among college students, there remains a need to conduct a comparative analysis on the differential impact these factors may have on…

Lanier, Christina; Farley, Erin J.

2011-01-01

335

Digital Social Media, Youth, and Nonmedical Use of Prescription Drugs: The Need for Reform  

PubMed Central

The tragic death of 18-year-old Ryan Haight highlighted the ethical, public health, and youth patient safety concerns posed by illicit online nonmedical use of prescription drugs (NUPM) sourcing, leading to a federal law in an effort to address this concern. Yet despite the tragedy and resulting law, the NUPM epidemic in the United States has continued to escalate and represents a dangerous and growing trend among youth and adolescents. A critical point of access associated with youth NUPM is the Internet. Internet use among this vulnerable patient group is ubiquitous and includes new, emerging, and rapidly developing technologies—particularly social media networking (eg, Facebook and Twitter). These unregulated technologies may pose a potential risk for enabling youth NUPM behavior. In order to address limitations of current regulations and promote online safety, we advocate for legislative reform to specifically address NUPM promotion via social media and other new online platforms. Using more comprehensive and modernized federal legislation that anticipates future online developments is critical in substantively addressing youth NUPM behavior occurring through the Internet. PMID:23892156

Liang, Bryan A; Strathdee, Steffanie A

2013-01-01

336

The United States wants to increase senior citizens' access to prescription drugs at a time when spending on drugs is soaring. Is a national list of essential medicines the answer? Many elderly people in the United States have no insurance cover for prescription drugs. Currently, one in four elderly people in the United States limit their drug use because of cost  

Microsoft Academic Search

1 The US Congress recently passed a bill that partially subsidises prescriptions for elderly and disabled people while promoting their use of private health insurance plans. Previous efforts to provide drug benefits to this population have been unsuccessful, however, largely because it would be hugely expensive. One way to extend access to drugs while containing costs is to establish a

Andrew Ellner

337

Alcohol-Related Problems among Younger Drinkers Who Misuse Prescription Drugs: Results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC)  

ERIC Educational Resources Information Center

The authors determined whether lifetime prescription drug misuse (PDM) associated with increased risks for alcohol-related problems among 18- to 34-year-old, NESARC respondents. Among 8222 "ever-drinkers," 15.4% reported ever "misusing sedatives, tranquilizers, painkillers or stimulants ... as prescriptions or from indirect sources." Outcomes were…

Hermos, J.; Winter, M.; Heeren, T.; Hingson, R.

2009-01-01

338

Longitudinal Effects of Universal Preventive Intervention on Prescription Drug Misuse: Three RCTs with Late Adolescents and Young Adults  

PubMed Central

Objectives Examine long-term prescription drug misuse outcomes from three RCTs of brief universal preventive interventions conducted during middle school. Methods Study 1 tested the Iowa Strengthening Families Program (ISFP); 22 schools participated, with pretesting at grade 6 (1993) and outcomes measured at age 25. Study 2 evaluated a revised ISFP, renamed Strengthening Families Program: For Parents and Youth 10–14—SFP 10–14, plus the school-based Life Skills Training (SFP 10–14 + LST); 24 schools participated, with pretesting at grade 7 (1998) and outcomes at ages 21–25. Study 3 examined SFP 10–14 plus one of three school-based interventions selected from a menu (SFP 10–14 + School Program); 28 schools participated, with pretesting at grade 6 (2002) and outcomes at 12th grade. Self-reported outcomes were Prescription Opioid Misuse (POM) and Lifetime Prescription Drug Misuse Overall (PDMO). Results Study 1: ISFP showed significant effects on POM and PDMO, Relative Reduction Rates (RRRs) of 65%, and comparable benefits for higher- and lower-risk subgroups. Study 2: SFP 10–14 + LST showed significant or marginally-significant effects on POM/PDMO across all ages; higher-risk participants showed stronger effects (RRRs 43–79%). Study 3: significant results were found for POM/PDMO (RRRs 20–21%); higher-risk and lower-risk participants showed comparable outcomes. Conclusions Brief universal interventions have potential for public health impact by reducing prescription drug misuse among adolescents and young adults. PMID:23409883

Spoth, Richard; Trudeau, Linda; Shin, Chungyeol; Ralston, Ekaterina; Redmond, Cleve; Greenberg, Mark; Feinberg, Mark

2013-01-01

339

Massive hydroxychloroquine overdose.  

PubMed

We report a case presenting with massive overdose of hydroxychloroquine who survived without any sequelae. A 17-year-old girl presented to the Emergency Department 45 min after the ingestion of 22 g of hydroxychloroquine in a suicide attempt. We believe this is highest dose yet reported in the medical literature. The patient developed hypotension, life-threatening ventricular arrhythmias and mild hypokalemia. She was managed with saline infusion and dopamine for hypotension, gastric lavage and activated charcoal for decontamination, lidocain, magnesium sulfate and defibrillation for pulseless ventricular tachycardia. Potassium replacement and bicarbonate administration were performed. Quick treatment of hypotension, gastric decontamination, continuous long-term cardiac monitoring, and treatment of arrhythmias are the cornerstones of hydroxychloroquine overdose management. PMID:14982575

Yanturali, S; Aksay, E; Demir, O F; Atilla, R

2004-03-01

340

Prescription opioid misuse in the United States and the United Kingdom: Cautionary lessons.  

PubMed

In the United States, opioid analgesics have increasingly been prescribed in the treatment of chronic pain, and this trend has accompanied increasing rates of misuse and overdose. Lawmakers have responded with myriad policies to curb the growing epidemic of opioid misuse, and a global alarm has been sounded among countries wishing to avoid this path. In the United Kingdom, a similar trend of increasing opioid consumption, albeit at lower levels, has been observed without an increase in reported misuse or drug-related deaths. The comparison between these two countries in opioid prescribing and opioid overdose mortality underscores important features of prescribing, culture, and health systems that may be permissive or protective in the development of a public health crisis. As access to opioid medications increases around the world, it becomes vitally important to understand the forces impacting opioid use and misuse. Trends in benzodiazepine and methadone use in the UK as well as structural elements of the National Health Service may serve to buffer opioid-related harms in the face of increasing prescriptions. In addition, the availability and price of heroin, as well as the ease of access to opioid agonist treatment in the UK may limit the growth of the illicit market for prescription opioids. The comparison between the US and the UK in opioid consumption and overdose rates should serve as a call to action for UK physicians and policymakers. Basic, proactive steps in the form of surveillance - of overdoses, marketing practices, prescribers, and patients - and education programs may help avert a public health crisis as opioid prescriptions increase. PMID:25190034

Weisberg, Daniel F; Becker, William C; Fiellin, David A; Stannard, Cathy

2014-11-01

341

Who are the opinion leaders? The physicians, pharmacists, patients, and direct-to-consumer prescription drug advertising.  

PubMed

A popular perception holds that physicians prescribe requested drugs to patients influenced by mass mediated direct-to-consumer prescription drug advertising. The phenomenon poses a serious challenge to the two-step flow model, which emphasizes the influence of opinion leaders on their followers and their legitimating power over the informing power of the mass media. This study investigates a 2002 Food and Drug Administration (FDA) survey and finds that patients searching for drug information through mass and hybrid media in newspapers and magazines' small print, the Internet, and toll-free numbers are more likely to seek information through interpersonal communication channels like health care providers. Patients using small print, toll-free numbers, one's own physician, and other physicians are associated with influencing their physicians with various drug-requesting behaviors. But physicians only prescribe requested drugs to patients who are influenced by other health care providers, such as pharmacists and other physicians, not the mass media. The influence of expert opinion leaders of drugs is so strong that the patients even would switch from their own unyielding physicians who do not prescribe drugs as advised by the pharmacists. Physicians and patients all are influenced more by other expert opinion leaders of drugs than by the mass media and therefore still uphold the basic tenet of the two-step model. PMID:20812124

Lee, Annisa Lai

2010-09-01

342

Design, development, and evaluation of visual aids for communicating prescription drug instructions to nonliterate patients in rural Cameroon.  

PubMed

In this study, culturally sensitive visual aids designed to help convey drug information to nonliterate female adults who had a prescription for a solid oral dosage form of antibiotic medications were developed and evaluated. The researchers conceptualized the educational messages while a local artist produced the visual aids. Seventy-eight female ambulatory patients were evaluated for comprehension and compliance with antibiotic prescription instructions. The study was conducted in three health centers in Cameroon, West Africa and followed a pre-test, post-test, and follow-up format for three groups: two experimental, and one control. All participants were randomly assigned to either experimental or control groups, 26 patients to each group. Subjects in the experimental groups received visual aids alone or visual aids plus an Advanced Organizer. A comparison of the three groups showed that subjects in the experimental groups scored significantly higher than the control group in both the comprehension and compliance measures. PMID:9104382

Ngoh, L N; Shepherd, M D

1997-03-01

343

Design, development, and evaluation of visual aids for communicating prescription drug instructions to nonliterate patients in rural Cameroon.  

PubMed

In this study, culturally sensitive visual aids designed to help convey drug information to nonliterate female adults who had a prescription for a solid oral dosage form of antibiotic medications were developed and evaluated. The researchers conceptualized the educational messages while a local artist produced the visual aids. Seventy-eight female ambulatory patients were evaluated for comprehension and compliance with antibiotic prescription instructions. The study was conducted in three health centers in Cameroon, West Africa and followed a pre-test, post-test, and follow-up format for three groups: two experimental, and one control. All participants were randomly assigned to either experimental or control groups, 26 patients to each group. Subjects in the experimental groups received visual aids alone or visual aids plus an Advanced Organizer. A comparison of the three groups showed that subjects in the experimental groups scored significantly higher than the control group in both the comprehension and compliance measures. PMID:9277247

Ngoh, L N; Shepherd, M D

1997-07-01

344

[Long-term effects of prescription drugs in 174 patients treated for myocardial infarction, followed up from 4 to 5 years (the DEVENIR study)].  

PubMed

The aim of this study was to document changes in drug prescription after myocardial infarction. One hundred and seventy four men with typical myocardial infarction recensed by the Toulouse MONICA centre between 1989 and 1990 were followed up for 4.5 years. A copy of their drug prescription was obtained during the acute phase of infarction, at the time of discharge from hospital or clinic, after 6 months, and finally, after 4.5 years after infarction. During the acute phase, the majority of patients received nitrate derivatives, platelet antiaggregants, calcium antagonists, betablockers and antiarrhythmics. Between hospital discharge and the sixth month, the prescription of lipid lowering drugs quadrupled (from 8 to 33%; p < 0.00001) and those of platelet anti-aggregants decreased (from 82 to 70%; p < 0.01). The prescriptions of other drugs remained relatively stable. Between the 6th month and the 4th year of follow-up the only prescription to increase significantly was that of ACE inhibitors (from 14 to 23%; p < 0.03). The other prescriptions were maintained: platelet anti-aggregants (70% at 6 months vs 75% at 4.5 years), nitrate derivatives (59 vs 51%), betablockers (51 vs 52%), calcium antagonists (51 vs 48%), lipid lowering drugs (33 vs 42%), diuretics (3 vs 6%) and inotropic agents (2 vs 2%). Overall analysis showed an increase in the prescriptions of lipid-lowering agents (p < 0.00001) and ACE inhibitors (p < 0.002). On the other hand, the prescriptions of calcium antagonists and nitrate derivatives tended to decrease. These results show that the treatment of patients with coronary artery disease is based on drugs of proven efficacy, reflecting the impact of large scale therapeutic trials on everyday medical practice. PMID:8678736

Graille, V; Ferrières, J; Marques-Vidal, P; Ruidavets, J B; Rodier, P; Cambou, J P

1996-01-01

345

Can gender difference in prescription drug use be explained by gender-related morbidity?: a study on a Swedish population during 2006  

PubMed Central

Background It has been reported that there is a difference in drug prescription between males and females. Even after adjustment for multi-morbidity, females tend to use more prescription drugs compared to males. In this study, we wanted to analyse whether the gender difference in drug treatment could be explained by gender-related morbidity. Methods Data was collected on all individuals 20 years and older in the county of Östergötland in Sweden. The Johns Hopkins ACG Case-Mix System was used to calculate individual level of multi-morbidity. A report from the Swedish National Institute of Public Health using the WHO term DALY was the basis for gender-related morbidity. Prescription drugs used to treat diseases that mainly affect females were excluded from the analyses. Results The odds of having prescription drugs for males, compared to females, increased from 0.45 (95% confidence interval (CI) 0.44-0.46) to 0.82 (95% CI 0.81-0.83) after exclusion of prescription drugs that are used to treat diseases that mainly affect females. Conclusion Gender-related morbidity and the use of anti-conception drugs may explain a large part of the difference in prescription drug use between males and females but still there remains a difference between the genders at 18%. This implicates that it is of importance to take the gender-related morbidity into consideration, and to exclude anti-conception drugs, when performing studies regarding difference in drug use between the genders. PMID:24713023

2014-01-01

346

Prescription Drug Use During and Immediately Before Pregnancy in Hawai'i - Findings from the Hawai'i Pregnancy Risk Assessment Monitoring System, 2009-2011.  

PubMed

There are relatively few population-based studies on prescription drug use during pregnancy. Hawai'i Pregnancy Risk Assessment Monitoring System (PRAMS) survey data from 4,735 respondents were used to estimate statewide prevalence of overall non-vitamin prescription drug use during and in the month before pregnancy. Data were weighted to be representative of all pregnancies resulting in live births in Hawai'i in 2009-2011. Of women with recent live births in Hawai'i, 14.2% (95% CI: 13.0 - 15.5) reported prescription drug use before pregnancy and 17.6% (95% CI: 16.2 - 19.0) reported prescription drug use during pregnancy. Prevalence of prescription drug use both before and during pregnancy was highest among women who had a pre-pregnancy chronic disease, were White, and had a pregnancy-related medical problem. Pain relievers (2.82%; 95% CI: 2.28 - 3.47), psychiatric medications (2.34%; 95% CI: 1.85 - 2.95), and anti-infectives (1.91%; 95% CI: 1.46 - 2.48) were the most common types of medications used before pregnancy. The most commonly-reported prescription medication types taken during pregnancy were anti-infectives (4.00%; 95% CI: 3.34 - 4.79), pain relievers (3.18%; 95% CI: 2.56 - 3.94), and gastrointestinal drugs (3.08%; 95% CI: 2.47 - 3.83). Of women who reported prescription drug use during pregnancy and attended prenatal care, 10.3% (95% CI: 8.0 - 13.2) reported that their healthcare provider had not counseled them during prenatal care on which medicines are safe to use during pregnancy. PMID:25628970

Roberson, Emily K; Hurwitz, Eric L

2014-12-01

347

Prescription Drug Use During and Immediately Before Pregnancy in Hawai‘i — Findings from the Hawai‘i Pregnancy Risk Assessment Monitoring System, 2009–2011  

PubMed Central

There are relatively few population-based studies on prescription drug use during pregnancy. Hawai‘i Pregnancy Risk Assessment Monitoring System (PRAMS) survey data from 4,735 respondents were used to estimate statewide prevalence of overall non-vitamin prescription drug use during and in the month before pregnancy. Data were weighted to be representative of all pregnancies resulting in live births in Hawai‘i in 2009–2011. Of women with recent live births in Hawai‘i, 14.2% (95% CI: 13.0 – 15.5) reported prescription drug use before pregnancy and 17.6% (95% CI: 16.2 – 19.0) reported prescription drug use during pregnancy. Prevalence of prescription drug use both before and during pregnancy was highest among women who had a pre-pregnancy chronic disease, were White, and had a pregnancy-related medical problem. Pain relievers (2.82%; 95% CI: 2.28 – 3.47), psychiatric medications (2.34%; 95% CI: 1.85 – 2.95), and anti-infectives (1.91%; 95% CI: 1.46 – 2.48) were the most common types of medications used before pregnancy. The most commonly-reported prescription medication types taken during pregnancy were anti-infectives (4.00%; 95% CI: 3.34 – 4.79), pain relievers (3.18%; 95% CI: 2.56 – 3.94), and gastrointestinal drugs (3.08%; 95% CI: 2.47 – 3.83). Of women who reported prescription drug use during pregnancy and attended prenatal care, 10.3% (95% CI: 8.0 – 13.2) reported that their healthcare provider had not counseled them during prenatal care on which medicines are safe to use during pregnancy.

Hurwitz, Eric L

2014-01-01

348

Consumer Knowledge of the Impact of a Change in Prescription Drug Benefit Design  

Microsoft Academic Search

Background: Many employers are changing their pharmacy benefit designs to contain cost increases. The objective of this study was to evaluate employee awareness of the cost-saving potential of these changes in the context of one such employer initiative. Methods: We analyzed data from a survey of employees in 16 firms in Minneapolis, MN, USA. All of the firms offered prescription

Roger Feldman; Jean Abraham; Linda Davis; Caroline Carlin

2005-01-01

349

Reducing risk for illicit drug use and prescription drug misuse: High school gay-straight alliances and lesbian, gay, bisexual, and transgender youth.  

PubMed

Previous research suggests that lesbian, gay, bisexual, and transgender (LGBT) youth are at elevated risk for using illicit drugs and misusing prescription drugs relative to heterosexual youth. Previous research also indicates that LGBT youth who attend high schools with a gay-straight alliance (GSA) report having fewer alcohol problems and lower levels of cigarette smoking. The present study investigates whether the absence of a GSA is associated with risk for illicit drug use and prescription drug misuse in a sample of 475 LGBT high school students (M age=16.79) who completed an online survey. After controlling for demographic variables and risk factors associated with illicit drug use, the results of 12 logistic regression analyses revealed that LGBT youth attending a high school without a GSA evidenced increased risk for using cocaine (adjusted odds ratio [adjOR]=3.11; 95% confidence interval [95% CI]=1.23-7.86), hallucinogens (adjOR=2.59; 95% CI=1.18-5.70), and marijuana (adjOR=2.22; 95% CI=1.37-3.59) relative to peers attending a high school with a GSA. Youth without a GSA also evidenced increased risk for the misuse of ADHD medication (adjOR=2.00; 95% CI=1.02-3.92) and prescription pain medication (adjOR=2.00; 95% CI=1.10-3.65). These findings extend the research base related to GSAs and further demonstrate the importance of providing LGBT youth with opportunities for socialization and support within the school setting. Important limitations of the present study are reviewed. PMID:24531638

Heck, Nicholas C; Livingston, Nicholas A; Flentje, Annesa; Oost, Kathryn; Stewart, Brandon T; Cochran, Bryan N

2014-04-01

350

75 FR 12756 - Agency Information Collection Activities: Proposed Collection; Comment Request; Prescription Drug...  

Federal Register 2010, 2011, 2012, 2013

...the advertisements for the drug; and (3) the sponsor has...assuring that significant new adverse information about the drug that becomes known (i...to FDA for assuring that adverse informatio n about the drug will be...

2010-03-17

351

Original Investigation Use of antihypertensive drugs doi: 10.5455/medscience.2012.01.8047 Prescription pattern of antihypertensive drugs in Family Practice Clinics at Jordan University Hospital  

E-print Network

This study aims at assessing the prescription pattern of antihypertensive drugs in hypertensive patients attending the Family Practice Clinics at Jordan University Hospital in Amman, Jordan and evaluating their blood pressure control according to the international guidelines. The study sample involved 416 hypertensive Jordanian patients, 259 (62.3%) of them were females and 157 (37.7%) were males, with ages ranged from 18 to 94 years (mean ± SD 59.2 ± 10.2 years). Data was obtained from hypertensive patients by using patient's medical records and a designed questionnaire. Our results demonstrate that 192, 157, 52 and 13 patients were receiving one, two, three and more than three antihypertensive drugs, respectively. Only 2 patients were not receiving any therapy. Among the single prescriptions, angiotensin converting enzyme inhibitors were the most commonly prescribed, whereas diuretics were the most prescribed antihypertensive drugs in combined therapy. A significant reduction (p<0.0001) in systolic and diastolic blood pressures was observed. Means+ SD of systolic/diastolic blood pressure in the last and first visits were 133.4±18.4/ 83.2±10.1 and157.4±13.9/94.6 ±8.2, respectively. Despite the use of different antihypertensive drugs, most of the patients did not achieve recommended blood pressure control according to the international guidelines.

Essam Al-drabah; Yacoub Irshaid; Nada Yasein; Suheil Zmeili

352

Patient safety in drug therapy and the influence of the prescription in dose errors.  

PubMed

The aims of this study were to analyze the redaction of the prescription in dose errors that occurred in general medical units of five Brazilian hospitals and to identify the pharmacological classes involved in these errors. This was a descriptive study that used secondary data obtained from a multicenter study conducted in 2005. The population consisted of 1,425 medication errors and the sample of 215 dose errors. Of these, 44.2% occurred in hospital E. The presence of acronyms and/or abbreviations was verified in 96.3% of prescriptions; absence of the patient registration in 54.4%; absence of posology in 18.1%; and omission of date of 0.9%. With respect to medication type, 16.8% were bronchodilators; 16.3% were analgesics; 12.1%, antihypertensives; and 8.4% were antibiotics. The absence of posology in the prescriptions may facilitate the administration of the wrong dose, resulting in inefficiency of the treatment, compromising the quality of care provided to hospitalized patients. PMID:21340268

Gimenes, Fernanda Raphael Escobar; Mota, Maria Ludermiller Sabóia; Teixeira, Thalyta Cardoso Alux; Silva, Ana Elisa Bauer de Camargo; Opitz, Simone Perufo; Cassiani, Silvia Helena De Bortoli

2010-01-01

353

78 FR 15019 - Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for...  

Federal Register 2010, 2011, 2012, 2013

...Research (HFM-17), Food and Drug Administration...President signed into law the Food and Drug Administration...d) of the Federal Food, Drug, and Cosmetic...process for human drug and biological products. The reauthorization...nature and severity of the disease or condition that...

2013-03-08

354

3 CFR 13588 - Executive Order 13588 of October 31, 2011. Reducing Prescription Drug Shortages  

Code of Federal Regulations, 2012 CFR

...The affected medicines include cancer treatments, anesthesia drugs, and other drugs that are critical to the treatment and prevention of serious diseases...the use of sterile injectable cancer treatments has increased by...

2012-01-01

355

75 FR 69093 - Prescription Drug User Fee Act; Reopening of the Comment Period  

Federal Register 2010, 2011, 2012, 2013

...the recommendations for the human drug review program after negotiations...collect user fees to fund the human drug review process. Section...the recommendations for the human drug review program after negotiations...better understand the history and evolution of the PDUFA program and...

2010-11-10

356

The Burden of Nephrotoxic Drug Prescriptions in Patients with Chronic Kidney Disease: A Retrospective Population-Based Study in Southern Italy  

PubMed Central

Background The use of nephrotoxic drugs can further worsening renal function in chronic kidney disease (CKD) patients. It is therefore imperative to explore prescribing practices that can negatively affect CKD patients. Aim To analyze the use of nephrotoxic drugs in CKD patients in a general population of Southern Italy during the years 2006–2011. Methods The general practice “Arianna” database contains data from 158,510 persons, registered with 123 general practitioners (GPs) of Caserta. CKD patients were identified searching: CKD-related ICD-9 CM codes among causes of hospitalization; CKD-relevant procedures undergone in hospital (e.g. dialysis); drug prescriptions issued for a CKD-related indication. A list of nephrotoxic drugs was compiled and validated by pharmacologists and nephrologists. The summary of product characteristics was used to classify drugs as ‘contraindicated’ or ‘to be used with caution’ in renal diseases. Frequency of nephrotoxic drug use, overall, by drug class and single compounds, by GPs within one year prior or after first CKD diagnosis and within one year after dialysis entry was calculated. Results Overall, 1,989 CKD patients and 112 dialysed patients were identified. Among CKD patients, 49.8% and 45.2% received at least one prescription for a contraindicated nephrotoxic drug within one year prior or after first CKD diagnosis, respectively. In detail, 1,119 CKD patients (56.3%) had at least one nonsteroidal anti-inflammatory drugs (NSAIDs) prescription between CKD diagnosis and end of follow-up. A large proportion of CKD patients (35.6%) were treated with NSAIDs for periods exceeding 90 days. Contraindicated nephrotoxic drugs were used commonly in CKD, with nimesulide (16.6%) and diclofenac (11.0%) being most frequently used. Conclusions Contraindicated nephrotoxic drugs were highly prescribed in CKD patients from a general population of Southern Italy. CKD diagnosis did not seem to reduce significantly the prescription of nephrotoxic drugs, which may increase the risk of preventable renal function deterioration. PMID:24558471

Ingrasciotta, Ylenia; Sultana, Janet; Giorgianni, Francesco; Caputi, Achille Patrizio; Arcoraci, Vincenzo; Tari, Daniele Ugo; Linguiti, Claudio; Perrotta, Margherita; Nucita, Andrea; Pellegrini, Fabio; Fontana, Andrea; Cavagna, Lorenzo; Santoro, Domenico; Trifirò, Gianluca

2014-01-01

357

Prescription of antiviral drugs during the 2009 influenza pandemic: an observational study using electronic medical files of general practitioners in the Netherlands  

PubMed Central

Background After the clinical impact of the A(H1N1) pdm09 virus was considered to be mild, treatment with antiviral drugs was recommended only to patients who were at risk for severe disease or who had a complicated course of influenza. We investigated to what extent antiviral prescriptions in primary care practices were in accordance with the recommendations, what proportion of patients diagnosed with influenza had been prescribed antiviral drugs, and to what extent prescriptions related to the stated indications for antiviral treatment. Methods We used data from routine electronic medical records of practices participating in the Netherlands Information Network of General Practice LINH in the period August - December 2009. We considered patient and practice characteristics, clinical diagnoses and drug prescriptions of all patients who contacted their general practitioner in the given period and who had been prescribed antiviral medication (n?=?351) or were diagnosed with influenza (n?=?3293). Results Of all antiviral prescriptions, 69% were in accordance with the recommendations. Only 5% of patients diagnosed with influenza were prescribed antiviral drugs. This percentage increased to 12% among influenza patients belonging to the designated high risk groups. On the other hand, 2.5% of influenza patients not at high risk of complications received antiviral treatment. In addition to the established high risk factors, the total number of drug prescriptions for a patient in this year was a determinant of antiviral prescriptions. Information on time since onset of symptoms and the clinical presentation of patients was not available. Conclusions General practitioners in the Netherlands have been restrictive in prescribing antiviral drugs during the influenza pandemic, even when patients met the criteria for antiviral treatment. PMID:24143932

2013-01-01

358

Calcium carbonate with magnesium overdose  

MedlinePLUS

The combination of calcium carbonate and magnesium is commonly found in antacids, which are medicines that provide heartburn relief. Calcium carbonate with magnesium overdose occurs when someone accidentally or ...

359

Enough to Make You Sick: Prescription Drug Prices for the Elderly  

NSDL National Science Digital Library

Released on June 12, 2001 by Families USA, a national, nonprofit organization that advocates high-quality, affordable health and long term care for all Americans, this study finds that "last year and during the past 5 years, the prices of the 50 drugs most commonly used by older Americans have increased considerably faster than inflation." The report also demonstrates that the most expensive drugs are among the most commonly prescribed and that generic drugs are generally rising in price at much slower rates than brand-name drugs. Users may read the full text of the report in .pdf format at the FamiliesUSA site.

2001-01-01

360

Standardized order form for investigational drugs: effect on completeness of the prescription  

Microsoft Academic Search

Aim: To compare completeness and quality of orders written before and after introduction of a preprinted medication order form for investigational drugs. Completeness of physician’s orders for investigational drugs was compared during two successive periods: before and after implementation of a preprinted form for these orders.

Valérie Ollivier; Chloë Thelcide; Claire Simon; Mireille Favier

2004-01-01

361

Colleague interactions and new drug prescribing behavior: the case of the initial prescription of antidepressants in Taiwanese medical centers.  

PubMed

This research explores the social factors influencing hospital physicians' initial adoption of duloxetine hydrochloride, with a focus on colleague interactions. The study analyzes archival data compiled by the National Health Insurance Research Database of Taiwan to examine how the prescribing decisions made by psychiatrists' colleagues influence the likelihood of the psychiatrists' initial prescription. The results show that the adoption ratio of a physician's colleagues in a medical center is positively associated with the likelihood of a physician's adoption of the new drug. Specifically, colleague groups with similar and longer tenure as well as similar and older age have significantly positive effects. Colleague groups with the same and different gender also have positive effects. In summary, tenure and age, rather than gender, are vital sources of heterogeneous colleague interactions. PMID:21962150

Lin, Shu-Jou; Jan, Kuan-An; Kao, Jen-Tse

2011-10-01

362

Marvelous medicines and dangerous drugs: the representation of prescription medicine in the UK newsprint media.  

PubMed

Using discourse analysis, this study examines the representation of prescription medicines in the UK newsprint media and, specifically, how the meaning and function of medicines are constructed. At the same time, it examines the extent to which the newsprint media represents a resource for health information, and considers how it may encourage or challenge faith in modern medicine and medical authority. As such, it extends analysis around concepts such as the informed patient and examines the representation of patients and doctors and the extent to which patient-doctor identities promoted in the newsprint media reflect a shift away from paternalism to negotiated encounters. Findings show the media constructs a discrete, contradictory, and frequently oversimplified set of characterizations about medicine. Moreover, it discursively constructs realities that justify and sustain medial dominance. Ideological paradigms in discourse assign patients as passive and disempowered while simultaneously privileging "expert" knowledge. This constructs a reality that marginalizes patients' participation in decision-making. PMID:20533792

Prosser, Helen

2010-01-01

363

Occurrence of Medication Errors and Comparison of Manual and Computerized Prescription Systems in Public Sector Hospitals in Lahore, Pakistan  

PubMed Central

The knowledge of medication errors is an essential prerequisite for better healthcare delivery. The present study investigated prescribing errors in prescriptions from outpatient departments (OPDs) and emergency wards of two public sector hospitals in Lahore, Pakistan. A manual prescription system was followed in Hospital A. Hospital B was running a semi-computerised prescription system in the OPD and a fully computerised prescription system in the emergency ward. A total of 510 prescriptions from both departments of these two hospitals were evaluated for patient characteristics, demographics and medication errors. The data was analysed using a chi square test for comparison of errors between both the hospitals. The medical departments in OPDs of both hospitals were the highest prescribers at 45%–60%. The age group receiving the most treatment in emergency wards of both the hospitals was 21–30 years (21%–24%). A trend of omitting patient addresses and diagnoses was observed in almost all prescriptions from both of the hospitals. Nevertheless, patient information such as name, age, gender and legibility of the prescriber’s signature were found in almost 100% of the electronic-prescriptions. In addition, no prescribing error was found pertaining to drug concentrations, quantity and rate of administration in e-prescriptions. The total prescribing errors in the OPD and emergency ward of Hospital A were found to be 44% and 60%, respectively. In hospital B, the OPD had 39% medication errors and the emergency department had 73.5% errors; this unexpected difference between the emergency ward and OPD of hospital B was mainly due to the inclusion of 69.4% omissions of route of administration in the prescriptions. The incidence of prescription overdose was approximately 7%–19% in the manual system and approximately 8% in semi and fully electronic system. The omission of information and incomplete information are contributors of prescribing errors in both manual and electronic prescriptions. PMID:25165851

Riaz, Muhammad Kashif; Hashmi, Furqan Khurshid; Bukhari, Nadeem Irfan; Riaz, Mohammad; Hussain, Khalid

2014-01-01

364

Getting Extra Help with Medicare Prescription Drug Plan Costs: Information for American Indians and Alaska Natives  

MedlinePLUS

... advances and refunds related to earned income tax credits and child tax credits; —Compensation you receive as a crime victim; and — ... treatment and drugs; • Disaster assistance; • Earned income tax credit payments; • Assistance from others to pay your household ...

365

ADVANCED TOOLS FOR ASSESSING SELECTED PRESCRIPTION AND ILLICIT DRUGS IN TREATED SEWAGE EFFLUENTS AND SOURCE WATERS  

EPA Science Inventory

The purpose of this poster is to present the application and assessment of advanced technologies in a real-world environment - wastewater effluent and source waters - for detecting six drugs (azithromycin, fluoxetine, omeprazole, levothyroxine, methamphetamine, and methylenedioxy...

366

Rational prescription of drugs within similar therapeutic or structural class for gastrointestinal disease treatment: Drug metabolism and its related interactions  

PubMed Central

AIM: To review and summarize drug metabolism and its related interactions in prescribing drugs within the similar therapeutic or structural class for gastrointestinal disease treatment so as to promote rational use of medicines in clinical practice. METHODS: Relevant literature was identified by performing MEDLINE/Pubmed searches covering the period from 1988 to 2006. RESULTS: Seven classes of drugs were chosen, including gastric proton pump inhibitors, histamine H2-receptor antagonists, benzamide-type gastroprokinetic agents, selective 5-HT3 receptor antagonists, fluoroquinolones, macrolide antibiotics and azole antifungals. They showed significant differences in metabolic profile (i.e., the fraction of drug metabolized by cytochrome P450 (CYP), CYP reaction phenotype, impact of CYP genotype on interindividual pharmacokinetics variability and CYP-mediated drug-drug interaction potential). Many events of severe adverse drug reactions and treatment failures were closely related to the ignorance of the above issues. CONCLUSION: Clinicians should acquaint themselves with what kind of drug has less interpatient variability in clearance and whether to perform CYP genotyping prior to initiation of therapy. The relevant CYP knowledge helps clinicians to enhance the management of patients with gastrointestinal disease who may require treatment with polytherapeutic regimens. PMID:17948937

Zhou, Quan; Yan, Xiao-Feng; Zhang, Zhong-Miao; Pan, Wen-Sheng; Zeng, Su

2007-01-01

367

The Role of Traumatic Event History in Non-Medical Use of Prescription Drugs among a Nationally Representative Sample of US Adolescents  

ERIC Educational Resources Information Center

Background: Building on previous research with adolescents that examined demographic variables and other forms of substance abuse in relation to non-medical use of prescription drugs (NMUPD), the current study examined potentially traumatic events, depression, posttraumatic stress disorder (PTSD), other substance use, and delinquent behavior as…

McCauley, Jenna L.; Danielson, Carla Kmett; Amstadter, Ananda B.; Ruggiero, Kenneth J.; Resnick, Heidi S.; Hanson, Rochelle F.; Smith, Daniel W.; Saunders, Benjamin E.; Kilpatrick, Dean G.

2010-01-01

368

Characterization of Adolescent Prescription Drug Abuse and Misuse Using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R]) System  

ERIC Educational Resources Information Center

Objective: To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R])) System. Method: Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all…

Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick

2013-01-01

369

Long-term, high-dose benzodiazepine prescriptions in veteran patients with PTSD: influence of preexisting alcoholism and drug-abuse diagnoses.  

PubMed

Databases from the New England Veterans Integrated Service Network were analyzed to determine factors associated with long-term, high-dose anxiolytic benzodiazepine prescriptions dispensed to patients with posttraumatic stress disorder (PTSD) and existing alcoholism and/or drug abuse diagnoses. Among 2,183 PTSD patients, 234 received the highest 10% average daily doses for alprazolam, clonazepam, diazepam, or lorazepam, doses above those typically recommended. Highest doses were more commonly prescribed to patients with existing drug abuse diagnoses. Among patients with PTSD and alcoholism, younger age, drug abuse, and concurrent prescriptions for another benzodiazepine and oxycodone/acetaminophen independently predicted high doses. Results indicate that for veteran patients with PTSD, alcoholism alone is not associated with high-dose benzodiazepines, but existing drug abuse diagnoses do increase that risk. PMID:17955537

Hermos, John A; Young, Melissa M; Lawler, Elizabeth V; Rosenbloom, David; Fiore, Louis D

2007-10-01

370

Recent advances in opioid prescription for chronic non-cancer pain.  

PubMed

Chronic pain is pain that persists past the normal time of healing, and is seen as a common problem with a significant socioeconomic impact. Pharmacological management for chronic non-cancer pain also involves the prescription of opioids, with the aim of an improved quality of life for the patient. New guidelines have been published to aid prescribing clinicians improve opioid safety and patient care, and include recommendations on when to refer patients to a pain specialist. In recent years there has been a rapid increase in opioid prescription in the UK and USA, prompting further concern regarding opioid abuse and side effects. Opioid use may also result in physical dependence and tolerance. Earlier recognition and diagnosis of unwanted effects of long-term opioid use is needed, such as opioid induced suppression of the hypothalamic-pituitary-gonadal axis, and opioid induced immunosuppression. Patients may themselves discontinue opioids, however, due to minor side effects. Recent advances in opioid prescription include the increasing use of transdermal preparations and extended release, oral, once daily preparations. New formulations of existing drugs have been developed, as well as a new chemical entity. Abuse deterrent formulations and delivery systems may prevent the artificial acceleration of drug delivery and reduce the potential for opioid addiction. Overdose concerns and the potential for fatal overdose may necessitate mandatory training for all clinicians who prescribe opioids. Despite the widespread use of opioids in the management of chronic non-cancer pain, significant research gaps remain. An improvement in the evidence base for its prescription is required. PMID:21725034

Snidvongs, Saowarat; Mehta, Vivek

2012-02-01

371

76 FR 2691 - Prescription Drug Products Containing Acetaminophen; Actions To Reduce Liver Injury From...  

Federal Register 2010, 2011, 2012, 2013

...products in the United States. (The remaining 80...products in the United States, and for many years...nonsteroidal anti-inflammatory drugs (NSAIDS) such...from ALF in the United States (Refs. 2, 3, and...some people may have increased risk for liver...

2011-01-14

372

ADVANCED TOOLS FOR ASSESSING SELECTED PRESCRIPTION AND ILLICIT DRUGS IN TREATED SEWAGE EFFLUENTS AND SOURCE WATERS  

EPA Science Inventory

The purpose of this poster is to present the application and assessment of advanced state-of-the-art technologies in a real-world environment - wastewater effluent and source waters - for detecting six drugs [azithromycin, fluoxetine, omeprazole, levothyroxine, methamphetamine, m...

373

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Amphetamine and methamphetamine inhalers regarded...Status of Specific Drugs § 250.101 Amphetamine and methamphetamine inhalers regarded...contain is being used as a substitute for amphetamine tablets. Amphetamine tablets and...

2010-04-01

374

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Amphetamine and methamphetamine inhalers regarded...Status of Specific Drugs § 250.101 Amphetamine and methamphetamine inhalers regarded...contain is being used as a substitute for amphetamine tablets. Amphetamine tablets and...

2013-04-01

375

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

...2014-04-01 2014-04-01 false Amphetamine and methamphetamine inhalers regarded...Status of Specific Drugs § 250.101 Amphetamine and methamphetamine inhalers regarded...contain is being used as a substitute for amphetamine tablets. Amphetamine tablets and...

2014-04-01

376

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Amphetamine and methamphetamine inhalers regarded...Status of Specific Drugs § 250.101 Amphetamine and methamphetamine inhalers regarded...contain is being used as a substitute for amphetamine tablets. Amphetamine tablets and...

2012-04-01

377

21 CFR 250.101 - Amphetamine and methamphetamine inhalers regarded as prescription drugs.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Amphetamine and methamphetamine inhalers regarded...Status of Specific Drugs § 250.101 Amphetamine and methamphetamine inhalers regarded...contain is being used as a substitute for amphetamine tablets. Amphetamine tablets and...

2011-04-01

378

The endogenous modeling of the effect of direct-to-consumer advertising in prescription drugs  

Microsoft Academic Search

Purpose – The purpose of this paper is to study two major research objectives. The first objective is to investigate the effect of direct-to-consumer advertising (DTCA) on market share in the pharmaceutical drugs industry by modeling advertising decision of the firm as an endogenous decision. The second objective is to examine and determine whether there is any empirical support for

G. K. Kalyanaram

2009-01-01

379

Drugs, athletes, and family physicians. When to withhold medications and when to document prescriptions.  

PubMed Central

Sport governing bodies restrict drug use by athletes. Family physicians need to know which common medications are banned or restricted, and what documentation of treatment is necessary. The formidable list of banned and restricted substances and methods can be distilled to manageable guidelines for situations often faced by family physicians treating patient-athletes. Images p1954-a PMID:8894242

Olson, R.

1996-01-01

380

Everyday drug diversions: A qualitative study of the illicit exchange and non-medical use of prescription stimulants on a university campus.  

PubMed

This article investigates everyday experiences and practises that are associated with processes of pharmaceuticalization and with practices of 'drug diversion'-that is, the illicit exchange and non-medical use of prescription drugs. It reports results from a qualitative study that was designed to examine the everyday dimensions of non-medical prescription stimulant use among students on an American university campus, which involved 38 semi-structured interviews with individuals who used prescription stimulants as a means of improving academic performance. While discussions of drug diversion are often framed in terms of broad, population-level patterns and demographic trends, the present analysis provides a complementary sociocultural perspective that is attuned to the local and everyday phenomena. Results are reported in relation to the acquisition of supplies of medications intended for nonmedical use. An analysis is provided which identifies four different sources of diverted medications (friends; family members; black-market vendors; deceived clinicians), and describes particular sets of understandings, practices and experiences that arise in relation to each different source. Findings suggest that at the level of everyday experience and practice, the phenomenon of prescription stimulant diversion is characterised by a significant degree of complexity and heterogeneity. PMID:25455480

Vrecko, Scott

2014-10-01

381

Charcoal hemoperfusion in bupropion overdose.  

PubMed

Bupropion is a relatively new and popular medication for depression, with seizures as its major side effect. In the literature, there are insufficient data about hemodialysis following bupropion overdose. A 23-year-old female patient was brought to our emergency department with acute change in mental status and seizure after deliberate self-poisoning with approximately 25-30 tablets of bupropion hydrochloride. Her Glasgow coma scale score was 8/15. The patient underwent hemodialysis about 4 hours later. After 4 hours of extracorporeal treatment, she became conscious and was extubated. We present a case of full recovery after charcoal hemoperfusion following a bupropion overdose. PMID:24636552

Akdemir, H?z?r Ufuk; Cal??kan, Fatih; Duran, Latif; Kat?, Celal; Güngörer, Bülent; Ocak, Metin

2014-10-01

382

Bad medicine: prescription drugs, preemption, and the potential for a no-fault fix.  

PubMed

For decades, federal regulation of pharmaceutical drugs and medical devices has worked hand in hand with state tort claims to protect the health and safety of the American public. Now, a new trend toward preemption endangers this scheme. In recent years, the Supreme Court has given increasing deference to agency assertions about their preemptive authority and has found preemption in an increasing number of cases. In the process, the Supreme Court has preempted claims for medical device injuries and left claims for pharmaceutical harms in a precarious position. The elimination of common law claims for drug and device harms will leave holes in the FDA's regulatory scheme, endangering the health and safety of Americans. It will also prevent ordinary Americans from seeking compensation for their injuries--even those injuries caused by manufacturer malfeasance. This Article proposes that Congress create a no-fault compensation scheme for drugs and medical devices to close these gaps. Such a scheme could be both practical and politically possible, satisfying manufacturers, tort reformers, patients, and plaintiffs' lawyers alike. PMID:22363960

Smirniotopoulos, Amalea

2012-01-01

383

Study of Natural Health Product Adverse Reactions (SONAR): Active Surveillance of Adverse Events Following Concurrent Natural Health Product and Prescription Drug Use in Community Pharmacies  

PubMed Central

Background Many consumers use natural health products (NHPs) concurrently with prescription medications. As NHP-related harms are under-reported through passive surveillance, the safety of concurrent NHP-drug use remains unknown. To conduct active surveillance in participating community pharmacies to identify adverse events related to concurrent NHP-prescription drug use. Methodology/Principal Findings Participating pharmacists asked individuals collecting prescription medications about (i) concurrent NHP/drug use in the previous three months and (ii) experiences of adverse events. If an adverse event was identified and if the patient provided written consent, a research pharmacist conducted a guided telephone interview to gather additional information after obtaining additional verbal consent and documenting so within the interview form. Over a total of 112 pharmacy weeks, 2615 patients were screened, of which 1037 (39.7%; 95% CI: 37.8% to 41.5%) reported concurrent NHP and prescription medication use. A total of 77 patients reported a possible AE (2.94%; 95% CI: 2.4% to 3.7%), which represents 7.4% of those using NHPs and prescription medications concurrently (95%CI: 6.0% to 9.2%). Of 15 patients available for an interview, 4 (26.7%: 95% CI: 4.3% to 49.0%) reported an AE that was determined to be “probably” due to NHP use. Conclusions/Significance Active surveillance markedly improves identification and reporting of adverse events associated with concurrent NHP-drug use. Although not without challenges, active surveillance is feasible and can generate adverse event data of sufficient quality to allow for meaningful adjudication to assess potential harms. PMID:23028841

Vohra, Sunita; Cvijovic, Kosta; Boon, Heather; Foster, Brian C.; Jaeger, Walter; LeGatt, Don; Cembrowski, George; Murty, Mano; Tsuyuki, Ross T.; Barnes, Joanne; Charrois, Theresa L.; Arnason, John T.; Necyk, Candace; Ware, Mark; Rosychuk, Rhonda J.

2012-01-01

384

Oral hypoglycemics overdose  

MedlinePLUS

... hypoglycemics. The poisonous ingredient depends on the specific drug. The main (active) ingredient in sulfonylurea-based oral hypoglycemics stimulates cells in the pancreas to produce more insulin.

385

Immunopharmacotherapeutic Manifolds and Modulation of Cocaine Overdose  

PubMed Central

Cocaine achieves its psychostimulant, reinforcing properties through selectively blocking dopamine transporters, and this neurobiological mechanism impedes the use of classical receptor-antagonist pharmacotherapies to outcompete cocaine at CNS sites. Passive immunization with monoclonal antibodies (mAb) specific for cocaine circumvents this problem as drug is sequestered in the periphery prior to entry into the brain. To optimize an immunopharmacotherapeutic strategy for reversing severe cocaine toxicity, the therapeutic properties of mAb GNC92H2 IgG were compared to those of its engineered formats in a mouse overdose model. Whereas the extended half-life of an IgG justifies its application to the prophylactic treatment of addiction, the rapid, thorough biodistribution of mAb-based fragments, including F(ab')2, Fab and scFv, may correlate to accelerated scavenging of cocaine and reversal of toxicity. To test this hypothesis, mice were administered the anti-cocaine IgG (180 mg/kg, i.v.) or GNC92H2-based agent after receiving an LD50 cocaine dose (93 mg/kg, i.p.), and the timeline of overdose symptoms was recorded. All formats lowered the rate of lethality despite the >100-fold molar excess of drug to antibody binding capacity. However, only F(ab')2-92H2 and Fab-92H2 significantly attenuated the progression of premorbid behaviors, and Fab-92H2 prevented seizure generation in a percentage of mice. The calculation of serum half-life of each format demonstrated that the pharmacokinetic profile of Fab-92H2 (elimination half-life, t1/2 ? 100 minutes) best approximated that of cocaine. These results not only confirm the importance of highly specific and tight drug binding by the mAb, but also highlight the benefit of aligning the pharmacokinetic and pharmacodynamic properties of the immunopharmacotherapeutic with the targeted drug. PMID:21356233

Treweek, Jennifer B.; Roberts, Amanda J.; Janda, Kim D.

2011-01-01

386

Analysis of Medication Use Patterns: Apparent Overuse of Antibiotics and Underuse of Prescription Drugs for Asthma, Depression, and CHF  

Microsoft Academic Search

OBJECTIVE: To assess the appropriateness of prescription medication use based upon widely accepted treatment guidelines. RESULTS: During the study period, only 27.5% of antidepressant users received the recommended 6 months of continuous therapy, only 49.0% of diagnosed asthma patients received at least one inhaled corticosteroid prescription (com- pared to 67.1% who received at least one inhaled beta-agonist prescription), and only

KAREN GILBERG; MARIANNE LAOURI; SALLY WADE; SHARON ISONAKA

2003-01-01

387

Concealed paracetamol overdose treated as HELLP syndrome in the presence of postpartum liver dysfunction.  

PubMed

Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We report a case that was erroneously managed as HELLP syndrome before a paracetamol overdose was diagnosed. This case highlights current practice in managing paracetamol overdose and focuses on the importance of addressing mental health issues to mitigate the risk of self-harm in pregnancy. PMID:24631060

Mills, A T; Davidson, M E; Young, P

2014-05-01

388

Prescription opioid injection and risk of hepatitis C in relation to traditional drugs of misuse in a prospective cohort of street youth  

PubMed Central

Objective Despite dramatic increases in the misuse of prescription opioids, the extent to which their intravenous injection places drug users at risk of acquiring hepatitis C virus (HCV) remains unclear. We sought to compare risk of HCV acquisition from injection of prescription opioids to that from other street drugs among high-risk street youth. Design Prospective cohort study. Setting Vancouver, British Columbia, Canada from September 2005 to November 2011. Participants The At-Risk Youth Study (ARYS) is a prospective cohort of drug-using adolescents and young adults aged 14–26?years. Participants were recruited through street-based outreach and snowball sampling. Primary outcome measure HCV antibody seroconversion, measured every 6?months during follow-up. Risk for seroconversion from injection of prescription opioids was compared with injection of other street drugs of misuse, including heroin, cocaine or crystal methamphetamine, using Cox proportional hazards regression controlling for age, gender and syringe sharing. Results Baseline HCV seropositivity was 10.6%. Among 512 HCV-seronegative youth contributing 860.2 person-years of follow-up, 56 (10.9%) seroconverted, resulting in an incidence density of 6.5/100 person-years. In bivariate analyses, prescription opioid injection (HR=3.48; 95% CI 1.57 to 7.70) predicted HCV seroconversion. However, in multivariate modelling, only injection of heroin (adjusted HR=4.56; 95% CI 2.39 to 8.70), cocaine (adjusted HR=1.88; 95% CI 1.00 to 3.54) and crystal methamphetamine (adjusted HR=2.91; 95% CI 1.57 to 5.38) remained independently associated with HCV seroconversion, whereas injection of prescription opioids did not (adjusted HR=0.94; 95% CI 0.40 to 2.21). Conclusions Although misuse of prescription opioids is on the rise, traditional street drugs still posed the greatest threat of HCV transmission in this setting. Nonetheless, the high prevalence and incidence of HCV among Canadian street youth underscore the need for evidence-based drug prevention, treatment and harm reduction interventions targeting this vulnerable population. PMID:25052173

Hadland, Scott E; DeBeck, Kora; Kerr, Thomas; Feng, Cindy; Montaner, Julio S; Wood, Evan

2014-01-01

389

CDC Vital Signs: Prescription Painkiller Overdoses in the US  

MedlinePLUS

... version SOURCES: National Vital Statistics System, 1999-2008; Automation of Reports and Consolidated Orders System (ARCOS) of ... 10,000 people (2010) Read text version SOURCE: Automation of Reports and Consolidated Orders System (ARCOS) of ...

390

Prescription diets for rabbits.  

PubMed

Dietary management can be used with drug therapy for the successful treatment of many diseases. Therapeutic nutrition is well-recognized in dogs and cats and is beginning to increase among other pet species, including rabbits. The nutritional component of some rabbit diseases (eg, urolithiasis) is not completely understood, and the clinician should evaluate the use of prescription diets based on the scientific literature and individual needs. Long-term feeding trials are needed to further evaluate the efficacy of prescription diets in rabbits. Prescription diets are available for selected diseases in rabbits, including diets for immediate-term, short-term, and long-term management. PMID:25155667

Proença, Laila Maftoum; Mayer, Jörg

2014-09-01

391

Mirtazapine overdose is unlikely to cause major toxicity  

PubMed Central

Objective. There is limited information on mirtazapine overdose, but cases of severe effects (seizures, serotonin toxicity and coma) have been reported. We aimed to investigate the clinical effects and complications of mirtazapine overdose. Methods. This was an observational case series of mirtazapine overdoses (> 120 mg) identified from admissions to a toxicology unit between January 1987 and August 2013. Demographic information, details of ingestion, clinical effects, ECG parameters (HR, QT and QRS), and length of stay were extracted from a clinical database. Results. From 267 mirtazapine overdoses, there were 89 single-agent mirtazapine ingestions and 178 cases where mirtazapine was taken with at least one other drug. The median age of the 89 single-agent mirtazapine ingestions was 36 years [interquartile range (IQR): 26–49 years; Range: 15–81 years]; 45 were female (51%). The median ingested dose was 420 mg (IQR: 270–750 mg; Range: 150–1350 mg) and 41 patients (46%) had a Glasgow coma score (GCS) < 15, but the minimum GCS was 10. There were no seizures, serotonin toxicity or delirium. Tachycardia occurred in 29 patients (33%) and hypertension in 32 patients (36%). The median QRS was 80 ms (Range: 80–120 ms) and there were no cases with QT prolongation. There were no arrhythmias and no deaths. The median length of stay was 14 h (IQR: 8.8–18.2 h; Range:2.2–75 h). No single-agent mirtazapine patient was admitted to intensive care. The 178 patients taking co-ingestants had more severe toxicity depending on the co-ingested drug. Conclusion. Mirtazapine appears to be relatively benign in overdose, associated with tachycardia, mild hypertension and mild CNS depression not requiring intervention. PMID:24228948

2014-01-01

392

Microemulsion formulation for enhanced absorption of poorly soluble drugs. I. Prescription design.  

PubMed

Microemulsion formulations, which can be used to improve the bioavailability of poorly soluble drugs, were designed using only pharmaceutical excipients. Several types of oils and surfactants were tested and it was found that propyleneglycol monoalkyl ester and glycerol monoalkyl ester were solubilized easily in an aqueous medium by various types of surfactants. Although propyleneglycol dialkyl ester was difficult to be solubilized, the solubility was significantly enhanced by mixing it with glycerol monoalkyl ester at the ratio of 1:1. The most suitable surfactants for preparing microemulsion formulations were HCO-40, HCO-60, Tween 80, BL-9EX and Pluronic P84. The use of additional surfactants such as sodium dodecyl sulfate or sodium deoxycholate significantly improved the solubilization capacity of the oils, although formulations free of these surfactants were also available. These microemulsion formulations can be administered as a form of water-in-oil microemulsion or surfactant-oil mixture, and are expected to convert to oil-in-water microemulsion in the small intestine. PMID:11992679

Kawakami, Kohsaku; Yoshikawa, Takayoshi; Moroto, Yasushi; Kanaoka, Eri; Takahashi, Koji; Nishihara, Yoshitaka; Masuda, Kazuyoshi

2002-05-17

393

Two cases of intranasal naloxone self-administration in opioid overdose  

PubMed Central

Background Overdose is a leading cause of death for former prisoners, exacting its greatest toll during the first 2 weeks post-release. Protective effects have been observed with training individuals at high risk of overdose and prescribing them naloxone, an opioid antagonist that reverses the effects of the opioid-induced respiratory depression that causes death. Cases We report two people with opiate use histories who self-administered intranasal naloxone to treat their own heroin overdoses following release from prison. Patient A is a 34-year-old male, who reported having experienced an overdose on heroin the day after he was released from incarceration. Patient B is a 29-year-old female, who reported an overdose on her first injection of heroin, 17 days post release from incarceration. Both patients self-administered the medication but were assisted at some point during the injury by a witness whom they had personally instructed in how to prepare and administer the medication. Neither patient experienced withdrawal symptoms following exposure to naloxone. Discussion Self-administration of naloxone should not be a goal of overdose death prevention training. A safer, more reliable approach is to prescribe naloxone to at-risk patients and train and also equip members of their household and social or drug using networks in overdose prevention and response. PMID:24821348

Green, Traci C.; Ray, Madeline; Bowman, Sarah E.; McKenzie, Michelle; Rich, Josiah D.

2013-01-01

394

Potential of prescription registries to capture individual-level use of aspirin and other nonsteroidal anti-inflammatory drugs in Denmark: trends in utilization 1999–2012  

PubMed Central

Background Due to over-the-counter availability, no consensus exists on whether adequate information on nonsteroidal anti-inflammatory drug (NSAID) use can be obtained from prescription registries. Objectives To examine utilization of aspirin and nonaspirin NSAIDs in Denmark between 1999 and 2012 and to quantify the proportion of total sales that was sold on prescription. Method Based on nationwide data from the Danish Serum Institute and the Danish National Prescription Registry, we retrieved sales statistics for the Danish primary health care sector to calculate 1-year prevalences of prescription users of aspirin or nonaspirin NSAIDs, and to estimate the corresponding proportions of total sales dispensed on prescription. Results Both low-dose aspirin and nonaspirin NSAIDs were commonly used in the Danish population between 1999 and 2012, particularly among elderly individuals. The 1-year prevalence of prescribed low-dose aspirin increased throughout the study period, notably among men. Nonaspirin NSAID use was frequent in all age groups above 15 years and showed a female preponderance. Overall, the prevalence of prescribed nonaspirin NSAIDs decreased moderately after 2004, but substantial variation according to NSAID subtype was observed; ibuprofen use increased, use of all newer selective cyclooxygenase-2 inhibitors nearly ceased after 2004, diclofenac use decreased by nearly 50% after 2008, and naproxen use remained stable. As of 2012, the prescribed proportion of individual-level NSAID sales was 92% for low-dose aspirin, 66% for ibuprofen, and 100% for all other NSAIDs. Conclusion The potential for identifying NSAID use from prescription registries in Denmark is high. Low-dose aspirin and nonaspirin NSAID use varied substantially between 1999 and 2012. Notably, use of cyclooxygenase-2 inhibitors nearly ceased, use of diclofenac decreased markedly, and naproxen use remained unaltered. PMID:24872722

Schmidt, Morten; Hallas, Jesper; Friis, Søren

2014-01-01

395

Amendments to regulations regarding eligibility for a Medicare prescription drug subsidy. Interim final rule with request for comments.  

PubMed

We are revising our regulations to incorporate changes to the Medicare prescription drug coverage low-income subsidy (Extra Help) program made by the Affordable Care Act which was enacted on March 23, 2010. Under our interpretation of section 3304 of the Affordable Care Act and this interim final rule, if the death of a beneficiary's spouse would decrease or eliminate the subsidy provided by the Extra Help program, we will, based on a determination, or redetermination, extend the effective period of eligibility for the most recent determination or redetermination until 1 year after the month following the month we are notified of the death of the spouse. These regulatory changes will allow us to implement this provision of the Affordable Care Act when it goes into effect on January 1, 2011. We are also revising our regulations to incorporate changes made by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), which affect the way we account for income and resources when determining eligibility for the Extra Help program. The statute provides that we no longer count as a resource the value of any life insurance policy for Extra Help applications filed, or redeterminations that are effective, on or after January 1, 2010. In addition, we will no longer count as income the help a beneficiary receives when someone else provides food and shelter, or pays household bills for food, mortgage, rent, electricity, water, property taxes, or heating fuel or gas. These revisions will update our rules to reflect these statutory changes. PMID:21261125

2010-12-29

396

anthem.com/ca Anthem Blue Cross/Anthem Blue Cross Life and Health Insurance Company (P-NP) LR2027 Effective 11/2009 Printed 6/7/2010 Prescription Drug Benefits  

E-print Network

anthem.com/ca Anthem Blue Cross/Anthem Blue Cross Life and Health Insurance Company (P-NP) LR2027 to consumer advertising. With prescription drug costs increasing at twice the rate of medical care, we

Gleeson, Joseph G.

397

anthem.com/ca Anthem Blue Cross/Anthem Blue Cross Life and Health Insurance Company (P-NP) LR2027 Effective 11/2009 Printed 6/21/2010 Prescription Drug Benefits  

E-print Network

anthem.com/ca Anthem Blue Cross/Anthem Blue Cross Life and Health Insurance Company (P-NP) LR2027 advertising. With prescription drug costs increasing at twice the rate of medical care, we developed ways

Gleeson, Joseph G.

398

The Source of Methadone in Overdose Deaths in Western Virginia in 2004  

PubMed Central

Objectives Methadone-related overdose deaths increased in the United States by 468% from 1999 to 2005. Current studies associate the nonmedical use of methadone with methadone-related deaths. This study describes medical examiner cases in rural Virginia in 2004 with methadone identified by toxicology and compares cases according to source of methadone. Methods In 2004, all intentional and unintentional poisoning deaths from the Office of The Chief Medical Examiner, Western District of Virginia, were reviewed to identify cases in which methadone was a direct or contributing cause of death. The Virginia Prescription Monitoring Program was reviewed for prescription opioids in the name of these identified decedents. Decedent participation in local opioid treatment programs (OTP) was also assessed. Results The source of methadone in the 61 methadone-related overdose deaths was mostly nonprescribed (67%), although 28% of decedents were prescribed methadone for analgesia. Only 5% of decedents were actively enrolled in an OTP. The majority of deaths were attributed to polysubstance overdose. Conclusions The majority of methadone overdose deaths in this study were related to illicit methadone use, rather than prescribed or OTP uses. Interventions to decrease methadone-related deaths should focus on reduction of nonprescription use of methadone. PMID:21844834

Weimer, Melissa B.; Korthuis, P. Todd; Behonick, George S.; Wunsch, Martha J.

2011-01-01

399

76 FR 17137 - Pregnancy and Prescription Medication Use Symposium  

Federal Register 2010, 2011, 2012, 2013

...Docket No. FDA-2011-N-0002] Pregnancy and Prescription Medication Use Symposium...is announcing the following meeting: Pregnancy and Prescription Medication Use Symposium...discussed is ``Prescription Drug Use in Pregnancy.'' Date and Time: The meeting...

2011-03-28

400

Multiple episodes of aspirin overdose in an individual patient: a case report  

PubMed Central

Introduction Aspirin overdose, though now infrequently encountered, nevertheless continues to contribute to significant morbidity and mortality. The patient described in this case report intentionally ingested overdoses of aspirin on repeated occasions. The case provided an unusual and possibly one-of-a-kind opportunity to focus on the variability in the time course of plasma salicylate concentrations with current treatment modalities of aspirin overdose in an individual patient. Case presentation A 75-year-old Caucasian man who weighed 45kg and had an extensive history of various drug overdoses and stage 3 chronic kidney disease presented to a tertiary university hospital on three occasions within 2 months after successive overdoses of aspirin. During his third admission, he overdosed with aspirin, while on the ward recovering from the previous aspirin overdose. The overdoses were categorized as “potentially lethal” on two occasions and as “serious” in the other two, based on the alleged dose of aspirin ingested (over 500mg/kg in the first two overdoses, and 320mg/kg and 498mg/kg in the other two, respectively). However, as assessed by the observed salicylate concentrations, the ingestions would more appropriately have been categorized as being of “moderate” severity for the first and second overdose and “mild” severity for each of the others. This categorization was more consistent with the clinical severity of his admissions. A single dose of activated charcoal was administered only after the second overdose. On each occasion, he was given intravenous fluid with the aim of achieving euvolemia. Urinary alkalization was not attempted during the first admission, which was associated with the longest apparent elimination half-life of salicylate (30 hours). A plasma potassium concentration of approximately 4mmol/L appeared to be needed for adequate urinary alkalization. Conclusion In a patient with impaired renal function, intravenous fluid and urinary alkalization are the mainstays of treatment of aspirin overdose. Correction of hypokalemia is recommended. Repeated doses of charcoal may be a worthwhile intervention when there is no risk of aspiration. Our experience in this case also revealed considerable unexplained variation in management despite the availability of guidelines. It is, therefore, important to monitor the implementation of available guidelines. PMID:25406385

2014-01-01

401

Hypoglycemia - A rare complication of carbamazepine overdose  

PubMed Central

Carbamazepine overdose usually presents with neurological manifestations such as ataxia, seizures and altered sensorium or cardiac manifestations that include tachycardia, hypotension and ventricular extra-systoles. We report a patient with carbamazepine overdose who manifested recurrent hypoglycemia on the third and fourth day following ingestion that resolved with supportive therapy.

Jha, Avanish; Abhilash, Kundavaram Paul Prabhakar; Bandhyopadhyay, Rini; Victor, Peter John

2014-01-01

402

Hypoglycemia - A rare complication of carbamazepine overdose.  

PubMed

Carbamazepine overdose usually presents with neurological manifestations such as ataxia, seizures and altered sensorium or cardiac manifestations that include tachycardia, hypotension and ventricular extra-systoles. We report a patient with carbamazepine overdose who manifested recurrent hypoglycemia on the third and fourth day following ingestion that resolved with supportive therapy. PMID:25538340

Jha, Avanish; Abhilash, Kundavaram Paul Prabhakar; Bandhyopadhyay, Rini; Victor, Peter John

2014-11-01

403

Unintentional prescription drug non-compliance for financial reasons in families with a child with a limiting health condition.  

PubMed

Area probability sampling via U.S. postal addresses was used to select households from seven high poverty U.S. metropolitan areas. In person and telephone interviews with one adult household member were used to determine the odds of delaying or failing to fill a needed prescription for families with a child member with a limiting health condition. Logistic models indicate families with a child with a limiting health condition are 1.57 times more likely to delay or fail to fill a needed prescription, and families with more than one child with a limiting condition are 1.85 times more likely. Implications are set forth. PMID:25674724

Stoddard-Dare, Patricia; DeRigne, LeaAnne; Mallett, Christopher; Quinn, Linda M

2015-02-01

404

Effects of wind-dispelling drugs and deficiency-nourishing drugs of Houshiheisan compound prescription on astrocyte activation and inflammatory factor expression in the corpus striatum of cerebral ischemia rats?  

PubMed Central

This study explored protective effects of Houshiheisan and its compound prescription of wind-dispelling drugs and deficiency-nourishing drugs on cerebral ischemia in terms of astrocyte activation and inflammatory factor expression. Results suggested that Houshiheisan lessened neuronal degeneration in the corpus striatum on the ischemic side of rats following cerebral ischemia/reperfusion injury, contributed to astrocyte activation and glial fibrillary acidic protein expression in the corpus striatum and decreased the levels of interleukin-2, interleukin-6, interleukin-1? and tumor necrosis factor-?. Factor analysis results demonstrated that deficiency-nourishing drugs were more beneficial in protecting neurons and upregulating glial fibrillary acidic protein expression than wind-dispelling drugs. However, wind-dispelling drugs were more effective in increasing the number of glial fibrillary acidic protein-positive cells and reducing inflammatory factor expression than deficiency-nourishing drugs. These indicate that different ingredients of Houshiheisan suppress cerebral ischemic injury by promoting astrocyte activation and diminishing inflammatory factor expression.

Zhang, Qiuxia; Zhao, Hui; Wang, Lei; Zhang, Qi; Wang, Haizheng

2012-01-01

405

Do Motives Matter?: Nonmedical Use of Prescription Medications among Adolescents  

ERIC Educational Resources Information Center

Adolescents' motives for engaging in nonmedical prescription drug use is somewhat different than their reasons for using other drugs, such as marijuana. For some youth, nonmedical prescription drug use is an attempt to self-treat a medical condition, for others it is an effort to get high, and some youth misuse prescription drugs for both reasons.…

McCabe, Sean Esteban; Boyd, Carol J.

2012-01-01

406

Nonmedical prescription drug users in private vs. public substance abuse treatment: a cross sectional comparison of demographic and HIV risk behavior profiles  

PubMed Central

Background Little is known regarding the demographic and behavioral characteristics of nonmedical prescription drug users (NMPDUs) entering substance abuse treatment settings, and information on the HIV-related risk profiles of NMPDUs is especially lacking. Participation in substance abuse treatment provides a critical opportunity for HIV prevention and intervention, but successful initiatives will require services appropriately tailored for the needs of NMPDUs. Methods This paper compares the HIV risk profiles of NMPDUs in public (n?=?246) and private (n?=?249) treatment facilities. Participants included in the analysis reported five or more recent episodes of nonmedical prescription drug use, a prior HIV negative test result, and current enrollment in a substance abuse treatment facility. A standardized questionnaire was administered by trained interviewers with questions about demographics, HIV risk, and substance use. Results Private treatment clients were more likely to be non-Hispanic White, younger, and opioid and heroin users. Injection drug use was higher among private treatment clients, whereas public clients reported higher likelihood of trading or selling sex. Public treatment clients reported higher rates of HIV testing and availability at their treatment facilities compared to private clients. Conclusions Findings suggest differing demographics, substance use patterns, profiles of HIV risk and access to HIV testing between the two treatment samples. Population tailored HIV interventions, and increased access to HIV testing in both public and private substance treatment centers, appear to be warranted. PMID:24495784

2014-01-01

407

Discovery of Potent, Selective Multidrug And Toxin Extrusion Transporter 1 (MATE1, SLC47A1) Inhibitors Through Prescription Drug Profiling and Computational Modeling  

PubMed Central

The human multidrug and toxin extrusion (MATE) transporter 1 contributes to the tissue distribution and excretion of many drugs. Inhibition of MATE1 may result in potential drug-drug interactions (DDIs) and alterations in drug exposure and accumulation in various tissues. The primary goals of this project were to identify MATE1 inhibitors with clinical importance or in vitro utility and to elucidate the physicochemical properties that differ between MATE1 and OCT2 inhibitors. Using a fluorescence assay of ASP+ uptake in cells stably expressing MATE1, over 900 prescription drugs were screened and 84 potential MATE1 inhibitors were found. We identified several MATE1 selective inhibitors including four FDA-approved medications that may be clinically relevant MATE1 inhibitors and could cause a clinical DDI. In parallel, a QSAR model identified distinct molecular properties of MATE1 versus OCT2 inhibitors and was used to screen the DrugBank in silico library for new hits in a larger chemical space. PMID:23241029

Kido, Yasuto; Kosaka, Alan; Zhang, Xuexiang; Morrissey, Kari M.; Sali, Andrej; Huang, Yong; Giacomini, Kathleen M.

2014-01-01

408

A Response to the Opioid Overdose Epidemic: Naloxone Nasal Spray  

PubMed Central

Opioid overdose morbidity and mortality is recognized to have epidemic proportions. Medical and public health agencies are adopting opioid harm reduction strategies to reduce the morbidity and mortality associated with overdose. One strategy developed by emergency medical services and public health agencies is to deliver the opioid antidote naloxone injection intranasally to reverse the effects of opioids. Paramedics have used this route to quickly administer naloxone in a needle-free system and avoiding needle-stick injuries and contracting a blood-born pathogen disease such as hepatitis or human immunodeficiency virus. Public health officials advocate broader lay person access since civilians are likely witnesses or first responders to an opioid overdose in a time-acute setting. The barrier to greater use of naloxone is that a suitable and optimized needlefree drug delivery system is unavailable. The scientific basis for design and study of an intranasal naloxone product is described. Lessons from nasal delivery of opioid analgesics are applied to the consideration of naloxone nasal spray. PMID:23734342

Wermeling, Daniel P.

2012-01-01

409

Misuse of Prescription Pain Relievers: The Buzz Takes Your Breath Away. Permanently.  

MedlinePLUS

... Misuse of Prescription Pain Relievers Misuse of Prescription Pain Relievers: The Buzz Takes Your Breath Away . . . Permanently (PDF ... drugs have real potential for harm - even prescription pain relievers. When abused alone, or taken with other drugs, ...

410

Medicare program; revisions to the Medicare Advantage and Part D prescription drug contract determinations, appeals, and intermediate sanctions processes. Final rule with comment period.  

PubMed

This rule with comment period finalizes the Medicare program provisions relating to contract determinations involving Medicare Advantage (MA) organizations and Medicare Part D prescription drug plan sponsors, including eliminating the reconsideration process for review of contract determinations, revising the provisions related to appeals of contract determinations, and clarifying the process for MA organizations and Part D plan sponsors to complete corrective action plans. In this final rule with comment period, we also clarify the intermediate sanction and civil money penalty (CMP) provisions that apply to MA organizations and Medicare Part D prescription drug plan sponsors, modify elements of their compliance plans, retain voluntary self-reporting for Part D sponsors and implement a voluntary self-reporting recommendation for MA organizations, and revise provisions to ensure HHS has access to the books and records of MA organizations and Part D plan sponsors' first tier, downstream, and related entities. Although we have decided not to finalize the mandatory self-reporting provisions that we proposed, CMS remains committed to adopting a mandatory self-reporting requirement. To that end, we are requesting comments that will assist CMS in crafting a future proposed regulation for a mandatory self-reporting requirement. PMID:18064773

2007-12-01

411

78 FR 69992 - Withdrawal of Approval of New Animal Drug Applications; Carbarsone; Roxarsone  

Federal Register 2010, 2011, 2012, 2013

...pigmentation. as sole source of organic arsenic; drug overdose or lack of water may result...source of improved pigmentation; organic arsenic; drug and for control of overdose or...source of improved pigmentation; organic arsenic; drug and for control of overdose...

2013-11-22

412

Rebound of overdose mortality in the European Union 2003-2005: findings from the 2008 EMCDDA Annual Report.  

PubMed

Drug overdose is an important cause of death among young adults in Europe. According to data reported by Member States to the EMCDDA, many of the European Union countries reported a rebound in the numbers of overdose deaths in 2003-2005, following decreases in almost all reporting countries in previous years (2000 to 2003). Further investigations are needed in order to clarify the factor driving these increases and inform policies and interventions aimed at reducing these deaths. PMID:19161718

Vicente, J; Giraudon, Isabelle; Matias, J; Hedrich, D; Wiessing, L

2009-01-15

413

prescription drug program highlights retail pharmacy prescriptions  

E-print Network

or administration. Examples of chronic conditions include multiple sclerosis, rheumatoid arthritis, cancer provides patient training, encourages patient compliance with the prescribed treatment plan and their family and helps reduce complications to promote the best treatment outcome. Welcome to the SHIP

Scharer, John E.

414

Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths - United States, 2010.  

PubMed

The abuse of prescription drugs has led to a significant increase in emergency department (ED) visits and drug-related deaths over the past decade. Opioid pain relievers (OPRs) and benzodiazepines are the prescription drugs most commonly involved in these events. Excessive alcohol consumption also accounts for a significant health burden and is common among groups that report high rates of prescription drug abuse. When taken with OPRs or benzodiazepines, alcohol increases central nervous system depression and the risk for overdose. Data describing alcohol involvement in OPR or benzodiazepine abuse are limited. To quantify alcohol involvement in OPR and benzodiazepine abuse and drug-related deaths and to inform prevention efforts, the Food and Drug Administration (FDA) and CDC analyzed 2010 data for drug abuse-related ED visits in the United States and drug-related deaths that involved OPRs and alcohol or benzodiazepines and alcohol in 13 states. The analyses showed alcohol was involved in 18.5% of OPR and 27.2% of benzodiazepine drug abuse-related ED visits and 22.1% of OPR and 21.4% of benzodiazepine drug-related deaths. These findings indicate that alcohol plays a significant role in OPR and benzodiazepine abuse. Interventions to reduce the abuse of alcohol and these drugs alone and in combination are needed. PMID:25299603

Jones, Christopher M; Paulozzi, Leonard J; Mack, Karin A

2014-10-10

415

Overdose effect of aconite containing Ayurvedic Medicine (‘Mahashankha Vati’)  

PubMed Central

There are chances that the use of larger than recommended dose of Ayurvedic medicines containing aconite can produce drug reactions. Vatsanabha (Aconitum ferox Wall.) is a very well-known ingredient of Ayurvedic formulations and is prescribed as an antipyretic, analgesic, anti-rheumatic, appetizer and digestive. The recommended dose of purified Vatsanabha (A. ferox Wall.) root is 15 mg. We present a case of hypotension and bradycardia due to aconite poisoning caused by overdosing of an Ayurvedic medicine (Mahashankha Vati), which was primarily managed by Ayurvedic treatment. PMID:21170213

Panda, Ashok Kumar; Debnath, Saroj Kumar

2010-01-01

416

Extreme ?-butyrolactone overdose with severe metabolic acidosis requiring hemodialysis.  

PubMed

?-Hydroxybutyrate (GHB) and its precursor ?-butyrolactone (GBL) are commonly abused drugs with a narrow therapeutic index. Therefore, overdoses occur readily with recreational use, and severe poisoning can occur after deliberate self-poisoning. We report the sequelae in a patient who ingested a massive dose of GBL, with suicidal intent. Severe metabolic acidosis and an asystolic cardiac arrest were successfully treated with standard resuscitation, supportive care, and continuous venovenous hemodiafiltration. Plasma GHB concentrations were the highest reported to date. The acidosis was attributed to rapid systemic absorption of GBL, followed by rapid metabolism to GHB. PMID:21435738

Roberts, Darren M; Smith, Myles W H; Gopalakrishnan, Manivannan; Whittaker, Geoffrey; Day, Richard O

2011-07-01

417

How do prescription opioid users differ from users of heroin or other drugs in psychopathology: Results from the National Epidemiologic Survey on Alcohol and Related Conditions  

PubMed Central

Objectives To study substance use and psychiatric disorders among prescription opioid users, heroin users, and non-opioid drug users in a national sample of adults. Methods Analyses of data from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (N=43,093). Results Four groups were identified among 9140 illicit or non-prescribed drug users: heroin-other opioid users (1.0%; used heroin and other opioids), other opioid-only users (19.8%; used other opioids but never heroin), heroin-only users (0.5%; used heroin but never other opioids), and non-opioid drug users (78.7%; used drugs but never heroin or other opioids). After adjusting for variations in socioeconomic characteristics, history of substance abuse treatment, and familial substance abuse, heroin-other opioid users had greater odds of several substance use disorders (cocaine, hallucinogen, sedative, amphetamine, and tranquilizer) as compared with the other groups; heroin-only users had reduced odds of sedative and tranquilizer use disorders as compared with other opioid-only users. Non-opioid drug users had reduced odds of all substance use disorders and other mental disorders (mood, anxiety, pathological gambling, and personality) as compared with other opioid-only users. Past-year other opioid-only users also reported slightly lower scores on quality of life than past-year non-opioid drug users. Conclusions All opioid use groups had higher rates of substance use disorders than non-opioid drug users, and these rates were particularly elevated among heroin-other opioid users. Findings suggest the need to distinguish between these four groups in research and treatment as they may have different natural histories and treatment needs. PMID:21532972

Wu, Li-Tzy; Woody, George E.; Yang, Chongming; Blazer, Dan G.

2010-01-01

418

A case of fatal felodipine overdose.  

PubMed

A 54 year gentleman was admitted to hospital within four hours of taking an overdose of modified release felodipine tablets, with a total dose of approximately 250 mg. The initial management comprised fluid resuscitation, calcium chloride and glucagon. He remained hypotensive and was commenced on hyperinsulinaemia-euglycaemic therapy. Hypotension persisted with the development of progressive metabolic acidosis despite increasing inotropic support, haemofiltration and high dose insulin-dextrose infusions. The patient died 60 hours post overdose. The case highlights the profound, refractory circulatory collapse and lethal consequences of significant calcium channel blocker overdose and also reviews potential management strategies to attempt to reverse these changes. Despite the lack of evidence of whole bowel irrigation in overdose per se, its role in the removal of modified release compounds has not been studied. We would strongly urge emergency departments to consider this therapeutic modality, especially in overdoses involving delayed release preparations of calcium channel blockers, which are extremely toxic in overdose and are associated with very high mortality. PMID:21607228

Lota, Harpreet; Powell, Nick; Negus, Rupert; Leonard, Richard; Manikon, Maribel

2008-01-01

419

Psychotropic drug prescribing in an Australian specialist child and adolescent eating disorder service: a retrospective study  

PubMed Central

Background To describe the rates, indications, and adverse effects of psychotropic drug prescription in a specialist tertiary hospital child and adolescent eating disorder service. Methods Retrospective case note study of all active eating disorder patients (N?=?115) over the period of treatment from referral to time of study (M?=?2 years), covering patient demographics, clinical characteristics, drug prescriptions, indications, and adverse effects. Results Psychotropic drugs were prescribed in 45% of cases, most commonly antidepressants (41%), followed by anxiolytics (29%) and antipsychotics (22%), with 8% initiated before referral to the specialist eating disorder program. Common indications were depressed mood, agitation, anxiety, and insomnia. Patient clinical severity and complexity was associated with prescribing. Adverse effects, mostly minor, were recorded in 23% of antidepressant prescriptions, 39% of antipsychotic prescriptions, and 13% of anxiolytic prescriptions. Second generation antipsychotic prescription was associated with subsequent new onset binge eating, in this preliminary observational study. Self-harm by overdose of psychotropics occurred in 11% of patients prescribed medication. Conclusions Psychotropic medications were frequently prescribed to adolescent eating disorder patients to treat distressing symptoms. Prospective randomised controlled trials to clarify efficacy and safety are needed. Given the difficulties of conducting clinical trials in this population, services are encouraged to monitor and audit medication safety and efficacy in everyday practice, and to report their findings. PMID:24999406

2013-01-01

420

Ginseng in Traditional Herbal Prescriptions  

PubMed Central

Panax ginseng Meyer has been widely used as a tonic in traditional Korean, Chinese, and Japanese herbal medicines and in Western herbal preparations for thousands of years. In the past, ginseng was very rare and was considered to have mysterious powers. Today, the efficacy of drugs must be tested through well-designed clinical trials or meta-analyses, and ginseng is no exception. In the present review, we discuss the functions of ginseng described in historical documents and describe how these functions are taken into account in herbal prescriptions. We also discuss the findings of experimental pharmacological research on the functions of ginseng in ginseng-containing prescriptions and how these prescriptions have been applied in modern therapeutic interventions. The present review on the functions of ginseng in traditional prescriptions helps to demystify ginseng and, as a result, may contribute to expanding the use of ginseng or ginseng-containing prescriptions. PMID:23717123

Park, Ho Jae; Kim, Dong Hyun; Park, Se Jin; Kim, Jong Min; Ryu, Jong Hoon

2012-01-01

421

Overdose during chemical restraint in a black rhinoceros (Diceros bicornis).  

PubMed

A juvenile female black rhinoceros (Diceros bicornis) was successfully treated after overdose of drugs used for chemical restraint. Subsequent general anaesthesia for surgical reduction of a recurrent rectal prolapse was uneventful. Over a 25-minute period before transportation to the veterinary hospital, the animal received a total dose of 1.225 mg etorphine, 30 mg acepromazine and 30 mg detomidine. Based on an estimated mass of 200 kg, these corresponded to doses of 6.1 microg kg(-1) etorphine, 150 microg kg(-1) acepromazine, and 150 microg kg(-1) detomidine which constitutes considerable overdose for each drug given separately, notwithstanding the synergy that probably resulted when the three drugs were present concurrently. The estimated body mass may have substantially overestimated the actual body mass and exacerbated overdosage. The animal was recumbent and apnoeic on arrival at the hospital. Heart sounds were auscultated and a weak peripheral pulse was palpated; no pulse deficits were detected, although the heart rate was low. The trachea was intubated, inspired breath was enriched with oxygen and the lungs ventilated manually. Diprenorphine (1.5 mg) was given intravenously and spontaneous breathing resumed 11 minutes later. After induction of general anaesthesia using isoflurane, emergency surgery for correction of rectal prolapse was performed, from which the animal recovered uneventfully. The case highlights some of the practical problems that may be encountered in dealing with dangerous and unfamiliar species. PMID:15663740

Adams, Wendy A; Robinson, Kerry J; Jones, Ronald S; Edwards, G Barrie

2005-01-01

422

Cardiotoxicity Associated with an Intentional Overdose of Maprotiline and Perphenazine: A Case Report  

PubMed Central

Cardiotoxicity is a life-threatening complication of an intentional overdose of cyclic antidepressant and phenothiazine drugs. This case report illustrates the severe conduction abnormalities that can accompany a massive ingestion of maprotiline and perphenazine. The patient's condition was further complicated by the unexpected finding of hypothermia. PMID:21264008

Jolly, Donald T.; Stiell, Ian G.

1987-01-01

423

Prescription Medications for the Treatment of Obesity  

MedlinePLUS

... How do these drugs work? Who may use obesity medications? Health care providers often use the body ... prescription drugs do doctors use "off-label" for obesity treatment? What is "off-label" use? Health care ...

424

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2010 CFR

...categorized by body system, by severity...description of the human studies. If animal...drug's action in humans at various levels...organ, whole body). If the mechanism...of the drug in humans that is not incorporated...implanted in the body). (15)...

2010-04-01

425

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2013 CFR

...categorized by body system, by severity...description of the human studies. If animal...drug's action in humans at various levels...organ, whole body). If the mechanism...of the drug in humans that is not incorporated...implanted in the body). (15)...

2013-04-01

426

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2012 CFR

...categorized by body system, by severity...description of the human studies. If animal...drug's action in humans at various levels...organ, whole body). If the mechanism...of the drug in humans that is not incorporated...implanted in the body). (15)...

2012-04-01

427

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2011 CFR

...categorized by body system, by severity...description of the human studies. If animal...drug's action in humans at various levels...organ, whole body). If the mechanism...of the drug in humans that is not incorporated...implanted in the body). (15)...

2011-04-01

428

21 CFR 201.57 - Specific requirements on content and format of labeling for human prescription drug and...  

...categorized by body system, by severity...description of the human studies. If animal...drug's action in humans at various levels...organ, whole body). If the mechanism...of the drug in humans that is not incorporated...implanted in the body). (15)...

2014-04-01

429

Can access limits on sales representatives to physicians affect clinical prescription decisions? A study of recent events with diabetes and lipid drugs.  

PubMed

The authors explored to what extent important medical decisions by practitioners can be influenced by pharmaceutical representatives and, in particular, whether restricting such access could delay appropriate changes in clinical practice. Medical practices were divided into four categories based on the degree of sales representative access to clinicians: very low, low, medium, and high from a database compiled by ZS Associates called AccessMonitor (Evanston, IL) used extensively by many pharmaceutical companies. Clinical decisions of 58,647 to 72,114 physicians were statistically analyzed using prescription data from IMS Health (Danbury, CT) in three critical areas: an innovative drug for type 2 diabetes (sitagliptin), an older diabetes drug with a new Food and Drug Administration-required black box warning for cardiovascular safety (rosiglitazone), and a combination lipid therapy that had reported negative outcomes in a clinical trial (simvastatin+ezetimbe). For the uptake of the new diabetes agent, the authors found that physicians with very low access to representatives had the lowest adoption of this new therapy and took 1.4 and 4.6 times longer to adopt than physicians in the low- and medium-access restriction categories, respectively. In responding to the black box warning for rosiglitazone, the authors found that physicians with very low access were?4.0 times slower to reduce their use of this treatment than those with low access. Likewise, there was significantly less response in terms of changing prescribing to the negative news with the lipid therapy for physicians in more access-restricted offices. Overall, cardiologists were the most responsive to information changes relative to primary care physicians. These findings emphasize that limiting access to pharmaceutical representatives can have the unintended effect of reducing appropriate responses to negative information about drugs just as much as responses to positive information about innovative drugs. PMID:22747616

Chressanthis, George A; Khedkar, Pratap; Jain, Nitin; Poddar, Prashant; Seiders, Michael G

2012-07-01

430

75 FR 61621 - Charges Billed to Third Parties for Prescription Drugs Furnished by VA to a Veteran for a...  

Federal Register 2010, 2011, 2012, 2013

...Claims, Day care, Dental health, Drug abuse, Foreign relations...contracts, Grant programs--health, Grant programs--veterans, Health care, Health facilities...professions, Health records, Homeless, Medical and dental...

2010-10-06

431

Overdose rescues by trained and untrained participants and change in opioid use among substance-using participants in overdose education and naloxone distribution programs: a retrospective cohort study  

PubMed Central

Background One approach to preventing opioid overdose, a leading cause of premature, preventable mortality, is to provide overdose education and naloxone distribution (OEND). Two outstanding issues for OEND implementation include 1) the dissemination of OEND training from trained to untrained community members; and 2) the concern that OEND provides active substance users with a false sense of security resulting in increased opioid use. Methods To compare overdose rescue behaviors between trained and untrained rescuers among people reporting naloxone rescue kit use; and determine whether heroin use changed after OEND, we conducted a retrospective cohort study among substance users in the Massachusetts OEND program from 2006 to 2010. We used chi square and t-test statistics to compare the differences in overdose management characteristics among overdoses managed by trained versus untrained participants. We employed Wilcoxon signed rank test to compare median difference among two repeated measures of substance use among participants with drug use information collected more than once. Results Among 4,926 substance-using participants, 295 trained and 78 untrained participants reported one or more rescues, resulting in 599 rescue reports. We found no statistically significant differences in help-seeking (p =?0.41), rescue breathing (p =?0.54), staying with the victim (p =?0.84) or in the success of naloxone administration (p =?0.69) by trained versus untrained rescuers. We identified 325 OEND participants who had drug use information collected more than once. We found no significant overall change in the number of days using heroin in past 30 days (decreased 38%, increased 35%, did not change 27%, p =?0.52). Conclusion Among 4926 substance users who participated in OEND, 373(7.6%) reported administering naloxone during an overdose rescue. We found few differences in behavior between trained and untrained overdose rescuers. Prospective studies will be needed to determine the optimal level of training and whether naloxone rescue kits can meet an over-the-counter standard. With no clear evidence of increased heroin use, this concern should not impede expansion of OEND programs or policies that support them. PMID:24684801

2014-01-01

432

CETA and pharmaceuticals: impact of the trade agreement between Europe and Canada on the costs of prescription drugs.  

PubMed

On a per capita basis, Canadian drug costs are already the second highest in the world after the United States and are among the fastest rising in the Organization for Economic Co-Operation and Development. The Comprehensive Economic and Trade Agreement (CETA) between the European Union (EU) and Canada will further exacerbate the rise in costs by: ?Committing Canada to creating a new system of patent term restoration thereby delaying entry of generic medicines by up to two years; Locking in Canada's current term of data protection, and creating barriers for future governments wanting to reverse it; ?Implementing a new right of appeal under the patent linkage system that will create further delays for the entry of generics.CETA will only affect intellectual property rights in Canada-not the EU. This analysis estimates that CETA's provisions will increase Canadian drug costs by between 6.2% and 12.9% starting in 2023. The Canadian government committed to compensating provinces for the rise in costs for their public drug plans. Importantly, this means that people paying out-of-pocket for their drugs or receiving them through private insurance, will be charged twice: once through higher drug costs and once more through their federal taxes.As drug costs continue to grow, there are limited options available for provincial/territorial governments: restrict the choice of medicines in public drug plans; transfer costs to patients who typically are either elderly or sick; or take money from other places in the health system, and threaten the viability of Canada's single payer system. CETA will therefore negatively impact the ability of Canada to offer quality health care. PMID:24885309

Lexchin, Joel; Gagnon, Marc-André

2014-01-01

433

Completeness, Accuracy and Presentation of Information on Interactions Between Prescription Drugs and Alternative Medicines: An Internet Review  

PubMed Central

Background As the use of the Internet continues to increase across all age groups and education levels, with usage in the US around 78%, consumers are increasingly turning to the Internet for health related information. Objective To assess the completeness, accuracy, and consumer friendliness of information on the Internet pertaining to drug-Complementary and Alternative Medicine (CAM) interactions with cardiac drugs. Methods A review of online information was performed across three search engines and ten drug-CAM pairs. Results Overall, the quality of the drug-CAM interaction information available online to consumers is fairly poor. Only one site contained an interaction checker that provided interaction information for all ten pairs, but with an accuracy rate of 50%. Reading levels ranged from 10.5–23.5, with a mean of 16.7. A value greater than 22 indicates a graduate level reading skill. Conclusion Web site developers should be cautious in presenting drug-CAM interaction information unless it is comprehensive and regularly maintained. Consumers should also know how to evaluate sites before trusting the content where the consequences are potentially severe. PMID:23920676

Scarton, Lou Ann; Del Fiol, Guilherme; Treitler-Zeng, Qing

2014-01-01

434

Consumer-directed health plans reduce the long-term use of outpatient physician visits and prescription drugs.  

PubMed

Consumer-directed health plans (CDHPs) are designed to make employees more cost- and health-conscious by exposing them more directly to the costs of their care, which should lower demand for care and, in turn, control premium growth. These features have made consumer-directed plans increasingly attractive to employers. We explored effects of consumer-directed health plans on health care and preventive care use, using data from two large employers-one that adopted a CDHP in 2007 and another with no CDHP. Our study had mixed results relative to expectations. After four years under the CDHP, there were 0.26 fewer physician office visits per enrollee per year and 0.85 fewer prescriptions filled, but there were 0.018 more emergency department visits. Also, the likelihood of receiving recommended cancer screenings was lower under the CDHP after one year and, even after recovering somewhat, still lower than baseline at the study's conclusion. If CDHPs succeed in getting people to make more cost-sensitive decisions, plan sponsors will have to design plans to incentivize primary care and prevention and educate members about what the plan covers. PMID:23733988

Fronstin, Paul; Sepúlveda, Martín J; Roebuck, M Christopher

2013-06-01

435

Management of calcium channel blocker overdoses.  

PubMed

Calcium channel blockers (CCBs) are some of the most commonly used medications in clinical practice to treat hypertension, angina, cardiac arrhythmias, and some cases of heart failure. Recent data show that CCBs are the most common of the cardiovascular medications noted in intentional or unintentional overdoses.(1) Novel treatment approaches in the form of glucagon, high-dose insulin therapy, and intravenous lipid emulsion therapies have been tried and have been successful. However, the evidence for these are limited to case reports and case series. We take this opportunity to review the various treatment options in the management of CCB overdoses with a special focus on high-dose insulin therapy as the emerging choice for initial therapy in severe overdoses. PMID:25066023

Shenoy, Sundeep; Lankala, Shilpa; Adigopula, Sasikanth

2014-10-01

436

Ensuring safe access to medication for palliative care while preventing prescription drug abuse: innovations for American inner cities, rural areas, and communities overwhelmed by addiction.  

PubMed

This article proposes and develops novel components of community-oriented programs for creating and affording access to safe medication dispensing centers in existing retail pharmacies and in permanent or travelling pharmacy clinics that are guarded by assigned or off-duty police officers. Pharmacists at these centers would work with police, medical providers, social workers, hospital administrators, and other professionals in: planning and overseeing the safe storage of controlled substance medications in off-site community safe-deposit boxes; strengthening communication and cooperation with the prescribing medical provider; assisting the prescribing medical provider in patient monitoring (checking the state prescription registry, providing pill counts and urine samples); expanding access to lower-cost, and in some cases, abuse-resistant formulations of controlled substance medications; improving transportation access for underserved patients and caregivers to obtain prescriptions; and integrating community agencies and social networks as resources for patient support and monitoring. Novel components of two related community-oriented programs, which may be hosted outside of safe medication dispensing centers, are also suggested and described: (1) developing medication purchasing cooperatives (ie, to help patients, families, and health institutions afford the costs of medications, including tamper-or abuse-resistant/deterrent drug formulations); and (2) expanding the role of inner-city methadone maintenance treatment programs in palliative care (ie, to provide additional patient monitoring from a second treatment team focusing on narcotics addiction, and potentially, to serve as an untapped source of opioid medication for pain that is less subject to abuse, misuse, or diversion). PMID:22312232

Francoeur, Richard B

2011-01-01

437

21 CFR 201.80 - Specific requirements on content and format of labeling for human prescription drug and...  

Code of Federal Regulations, 2010 CFR

...to a pregnant woman or can affect reproduction capacity. (Name...effects in the fetus or newborn infant (for example, withdrawal...and effects on the nursing infant. Pertinent adverse effects...adverse reactions in nursing infants from (name of drug )...

2010-04-01

438

Dirt Cheap and Without Prescription: How Susceptible are Young US Consumers to Purchasing Drugs From Rogue Internet Pharmacies?  

PubMed Central

Background Websites of many rogue sellers of medications are accessible through links in email spam messages or via web search engines. This study examined how well students enrolled in a U.S. higher education institution could identify clearly unsafe pharmacies. Objective The aim is to estimate these health consumers´ vulnerability to fraud by illegitimate Internet pharmacies. Methods Two Internet pharmacy websites, created specifically for this study, displayed multiple untrustworthy features modeled after five actual Internet drug sellers which the authors considered to be potentially dangerous to consumers. The websites had none of the safe pharmacy signs and nearly all of the danger signs specified in the Food and Drug Administration´s (FDA´s) guide to consumers. Participants were told that a neighborhood pharmacy charged US$165 for a one-month supply of Beozine, a bogus drug to ensure no pre-existing knowledge. After checking its price at two Internet pharmacies—$37.99 in pharmacy A and $57.60 in pharmacy B—the respondents were asked to indicate if each seller was a good place to buy the drug. Responses came from 1,914 undergraduate students who completed an online eHealth literacy assessment in 2005-2008. Participation rate was 78%. Results In response to "On a scale from 0-10, how good is this pharmacy as a place for buying Beozine?" many respondents gave favorable ratings. Specifically, 50% of students who reviewed pharmacy A and 37% of students who reviewed pharmacy B chose a rating above the scale midpoint. When explaining a low drug cost, these raters related it to low operation costs, ad revenue, pressure to lower costs due to comparison shopping, and/or high sales volume. Those who said that pharmacy A or B was "a very bad place" for purchasing the drug (25%), as defined by a score of 1 or less, related low drug cost to lack of regulation, low drug quality, and/or customer information sales. About 16% of students thought that people should be advised to buy cheaper drugs at pharmacies such as these but the majority (62%) suggested that people should be warned against buying drugs from such internet sellers. Over 22% of respondents would recommend pharmacy A to friends and family (10% pharmacy B). One-third of participants supplied online health information to others for decision-making purposes. After controlling for the effects of education, health major, and age, these respondents had significantly worse judgment of Internet pharmacies than those who did not act as information suppliers. Conclusions At least a quarter of students, including those in health programs, cannot see multiple signs of danger displayed by rogue Internet pharmacies. Many more are likely to be misled by online sellers that use professional design, veil untrustworthy features, and mimic reputable websites. Online health information consumers would benefit from education initiatives that (1) communicate why it can be dangerous to buy medications online and that (2) develop their information evaluation skills. This study highlights the importance of regulating rogue Internet pharmacies and curbing the danger they pose to consumers. PMID:20439253

Brookins-Fisher, Jodi; O´Boyle, Irene; Vibbert, Danielle; Erofeev, Dmitry; Fulton, Lawrence

2010-01-01

439

Overuse of prescription and OTC non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis and osteoarthritis.  

PubMed

Non-steroidal anti-inflammatory drugs (NSAIDs) have been demonstrated to have significant cardiovascular and gastrointestinal toxicity; high dose of intake and concomitant use of multiple compounds or corticosteroids are factors that increase the risk of NSAID toxicity. In this paper we described our experience on NSAIDs misuse (both prescribing and OTC formulations), particularly relevant in the setting of rheumatoid arthritis (39.5 percent of patients) and osteoarthritis (47 percent of patients). We also evaluated causes underlying NSAIDs misuse (e.g. not satisfactory pain control, other painful conditions, etc). PMID:23527735

Cavagna, L; Caporali, R; Trifiro, G; Arcoraci, V; Rossi, S; Montecucco, C

2013-01-01

440

Now you see it. Now you don't: fair balance and adequate provision in advertisements for drugs before and after the switch from prescription to over-the-counter.  

PubMed

The objective of this study was to measure differences in fair balance (benefit and risk statements) and adequate provision (toll-free numbers, Internet URLs, print ad references, and medical professional references) in advertising content for drugs that have switched from prescription to over-the-counter (OTC). The Vanderbilt TV News Archive was used to select products to study, to measure the frequency and placement of ads for those products, and to view advertising content for those products. Unique advertisements (n?=?108) for loratadine (Claritin), citirizine (Zyrtec), and omeprazole (Prilosec) were analyzed for the presence of adequate provision statements and for the frequency of benefit, risk, and other statements. OTC ads were shorter than prescription ads by 10.6 seconds but contained the same total number of statements. Most prescription ads (n (RX)?=?31) contained toll-free numbers (97%), Internet URLs (94%), medical professional references (100%) and print ad references (68%). Few OTC ads (n (OTC)?=?77) contained adequate provision statements: 4% contained toll-free numbers and 10% contained Internet URLs. Prescription ads had similar numbers of benefits (1.5) and risks (1.8) per 30 seconds of ad time, and OTC ads had more benefits (6.6) than risks (1.2) per 30 seconds of ad time. Prescription drug ads contained risk statements that listed specific side effects and explicit harms from taking the product, but OTC ads contained nonspecific risk information and statements that implied risk rather than directly identifying risk. Differences in the Food and Drug Administration (FDA) and Federal Trade Commission (FTC) regulation of advertising affected the balance of risk and benefit information that appeared and the specificity of risk information available. PMID:21745037

Faerber, Adrienne E; Kreling, David H

2012-01-01

441

Prescription and illicit psychoactive drugs in oral fluid--LC-MS/MS method development and analysis of samples from Brazilian drivers.  

PubMed

This study is part of a larger project designed to investigate the prevalence of psychoactive drug (PAD) use among Brazilian drivers. In this paper we describe the development and validation of an analytical method to analyze 32 prescription and illicit PADs (amphetamines, benzodiazepines, cocaine, cannabis, opioids, ketamine and m-CPP) and metabolites in oral fluid samples collected with a Quantisal™ device. Samples were extracted with ethyl acetate:hexane and analyzed by LC-MS/MS. Instrumental LOD ranged from 0.26 to 0.65 ng/mL. Mean procedural recoveries at 1.3 ng/mL (LLOQ) ranged from 50% to 120% for 24 compounds. Recoveries were concentration independent, with the exception of femproporex, heroin and ecgonine methyl-ester (EME) for which the recovery decreased significantly at higher levels (13 and 52 ng/mL). RSD was <20% for all compounds at all spiking levels. Ion suppression due to the matrix was <20% for most compounds, and higher than 60% for EME and diethylpropion. Analysis was performed against a in-matrix standard curve. About 10% of the 2235 oral fluid samples collected from drivers on Brazilian Federal highways were positive (?LOD) for at least one analyte investigated. Alone or in combination with other drugs, cocaine/metabolites were the analytes most detected in the samples (129; 5.8%), followed by amphetamines/metabolite (69; 3.1%), benzodiazepines (28; 1.2%), cannabinoids (23; 1.1%) and opioids (8; 0.4%). Detection of at least two PADs from different classes accounted for 9.3% of the 236 positive samples. Cocaine was found at higher levels in the samples (up to 1165 ng/mL). Preventive measures aimed at reducing the use of PADs by drivers in Brazil will certainly contribute to decrease the country's highway death rates. PMID:23000138

Zancanaro, Ivomar; Limberger, Renata Pereira; Bohel, Paula O; dos Santos, Maíra Kerpel; De Boni, Raquel B; Pechansky, Flavio; Caldas, Eloisa Dutra

2012-11-30

442

21 CFR 1311.120 - Electronic prescription application requirements.  

Code of Federal Regulations, 2012 CFR

21 Food and Drugs 9 2012-04-01 2012-04-01...120 Section 1311.120 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE REQUIREMENTS FOR ELECTRONIC ORDERS AND PRESCRIPTIONS Electronic...

2012-04-01

443

21 CFR 1311.120 - Electronic prescription application requirements.  

Code of Federal Regulations, 2013 CFR

21 Food and Drugs 9 2013-04-01 2013-04-01...120 Section 1311.120 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE REQUIREMENTS FOR ELECTRONIC ORDERS AND PRESCRIPTIONS Electronic...

2013-04-01

444

Potential effects of the new Medicare Prospective Payment System on drug prescription in end-stage renal disease care.  

PubMed

The Centers for Medicaid and Medicare Services have announced a new Prospective Payment System to reimburse the care furnished by dialysis centers to patients with end-stage renal disease (ESRD). As of January 2011, most aspects of the outpatient treatment of patients with ESRD will be included in a single payment. In addition to the items previously included in the Composite Rate, injectable drugs and their oral equivalents will be included in this new capitation payment, as will the laboratory tests required for monitoring maintenance dialysis. As of January 2014, oral-only medications will also be included. Physician payments and payments for inpatient care, as well as for care not directly related to ESRD care will continue to be reimbursed separately. Patterns of medication treatment of ESRD patients will likely be revisited, and one can expect pronounced adjustments. Treatment of anemia will likely shift towards less use of erythropoiesis-stimulating agents and somewhat towards higher use of intravenous iron supplements. Average hemoglobin concentrations will decline. Use of intravenous vitamin D analogues will likely be reduced and substituted with their oral equivalents in many patients. One can also expect a temporary trend towards higher use of calcimetics, since their inclusion in the payment bundle is deferred until 2014. Treatment of problems with vascular access patency and of access infections will likely shift to the inpatient setting, and there may be reluctance to quickly accept recovering patients back to the outpatient setting after vascular access intervention. On aggregate, these changes have the potential to alter patient outcomes, but it is currently unclear how these will be and can be monitored. PMID:21228569

Winkelmayer, Wolfgang C

2011-01-01

445

Lithium overdose: Early hemodialysis is the key!  

PubMed

A 65-year-old gentleman was referred to our hospital with encephalopathy and renal failure. His medications included lithium for the treatment of bipolar disorder. The clinical examination and the laboratory investigations that followed revealed findings classical of lithium overdose. The patient was successfully managed and discharged from the hospital on Day 9 of admission. Clinicians should be aware of this rather unusual and relatively rare differential cause of acute on chronic renal failure with encephalopathy. PMID:25579730

Goel, Sachin; Nasa, Prashant; Gupta, Ankur; Gupta, Rajiva; Taneja, Saurabh

2015-01-01

446

Understanding Medicare Prescription Drug Coverage  

MedlinePLUS

... I get help? State Health Insurance Assistance Programs (SHIP) are a good place to get help. Call ... 4227) to get the number for your local SHIP. Local community groups can also help people pick ...

447

Is 50 cent the price of the optimal copayment? - a qualitative study of patient opinions and attitudes in response to a 50 cent charge on prescription drugs in a publicly funded health system in Ireland  

PubMed Central

Background A 50 cent prescription levy was introduced in 2010 on the General Medical Services (GMS) scheme (Irish public health insurance). This study sought to examine patient attitudes and opinions surrounding the 50 cent copayment. Given the small momentary value of the prescription fee, these results are of interest to policymakers internationally who wish to reduce copayments rather than abolish them. Methods A qualitative research design was used; semi structured interviews were carried out. Twenty four GMS eligible participants were interviewed in 23 interviews. Fifteen females and 9 males took part. Ages varied from 31- >70?years. Patients were invited to be interviewed in both independent and chain community pharmacies in three types of setting; 1) a socially deprived urban area, 2) a suburban affluent area and 3) a rural area. The Framework method was used for data management and analysis using QSR International’s NVivo 9.2 qualitative data analysis software. The “Francis method” was used to test for data saturation. Results Results are of interest to the Irish context and also at a broader international level. Patients were mostly accepting of the prescription levy with some reservations concerning an increased price and the way in which generated revenue would be used by government. Participants identified waste of prescription drugs at the hand of patients (moral hazard), but there was discordant opinion on whether the 50 cent copayment would halt this moral hazard. Interviewees felt the levy was affordable, albeit some may suffer a financial impact more than others. Conclusions This qualitative study gives important insights into the experiences of GMS patients with regard to the prescription levy. Information regarding the appropriateness of a 50 cent copayment as a symbolic copayment needs to be confirmed by quantitative analysis. Further insight is required from a younger population. PMID:23305316

2013-01-01

448

Identifying Errors in Handwritten Outpatient Prescriptions in Oman  

PubMed Central

To evaluate and analyze the handwritten outpatient prescriptions and associated error of omissions from four different hospitals in Oman. The study designed was an observational, retrospective and analysis of prescriptions was carried out by table and chart method. A total of 900 prescriptions were collected between April 2009 to July 2010. The type of error of omissions considered in this analysis includes all three important parts of prescriptions, i.e. superscription, inscription, and subscription. The most common type of superscription error of omission was found to be age (72.44%) and gender (32.66%). More than 46% of prescriptions were incomplete on direction for use, more than 22% of prescriptions were not having the information on dose, and more than 23% of prescriptions omitted the dosage forms of prescribed drugs. The date of dispensing of medications was omitted in all the prescriptions and more than 44% of prescriptions were missing the signature of dispenser. It was also found that more than 4% of prescriptions omitted the prescriber's signature and more than 18% of prescriptions omitted the date of prescription. We conclude from this study that the handwritten prescriptions were associated with significant frequency of minor and major prescription error of omissions. PMID:23492857

Al Shahaibi, Nadiya MS; Al Said, Lamya S; Kini, TG; Chitme, HR

2012-01-01

449

Heroin Addicts Reporting Previous Heroin Overdoses Also Report Suicide Attempts  

ERIC Educational Resources Information Center

Nonfatal heroin overdoses and suicide attempts are both common among heroin addicts, but there is limited knowledge about the association between them. The sample in the present study consisted of 149 regular heroin users in Malmo, Sweden. Out of these 98 had taken an unintentional heroin overdose at some time and 51 had made at least one attempt…

Bradvik, Louise; Frank, Arne; Hulenvik, Per; Medvedeo, Alvaro; Berglund, Mats

2007-01-01

450

Prescription Analysis of Pediatric Outpatient Practice in Nagpur City  

PubMed Central

Background: Medication errors are probably one of the most common types of medical errors, as medication is the most common health-care intervention. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors. Objective: To study prescribing patterns and errors in pediatric OPD prescriptions presenting to four community pharmacies across Nagpur city and to compare the prescription error rates across prescriber profiles. Materials and Methods: The study sample included 1376 valid pediatric OPD prescriptions presenting to four randomly selected community pharmacies in Nagpur, collected over a period of 2 months. Confirmed errors in the prescriptions were reviewed and analyzed. The core indicators for drug utilization studies, mentioned by WHO, were used to define errors. Results: The 1376 prescriptions included in the study were for a total of 3435 drugs, prescribed by 41 doctors. Fixed dose formulations dominated the prescribing pattern, many of which were irrational. Prescribing by market name was almost universal and generic prescriptions were for merely 254 (7.4%) drugs. The prescribing pattern also indicated polypharmacy with the average number of drugs per encounter of 2.5. Antibiotics were included in 1087 (79%) prescriptions, while injectable drugs were prescribed in 22 (1.6%) prescriptions. The prescription error score varied significantly across prescriber profiles. Conclusion: The findings of our study highlight the continuing crisis of the irrational drug prescribing in the country. PMID:20606924

Pandey, Anuja A; Thakre, Subhash B; Bhatkule, Prakash R

2010-01-01

451

[Analysis on composition principles of prescriptions for stranguria in dictionary of traditional Chinese medicine prescription].  

PubMed

By using traditional Chinese medicine inheritance support system to analyze the dominant experience and recessive principles of the prescriptions for stranguria in the dictionary of traditional Chinese medicine prescription (DCMP), we aim to define the medication pattern and rule and to acquire new prescriptions. In dominant experience analysis, we were able to find 22 drugs used over 50 times, including drugs of clearing heat, diuresis and relieving stranguria which are the most used and drugs of clearing heat, cooling blood, benefiting Qi and nourishing Yin. In addition, drugs of activating Qi and Xue, eliminating phlegm and removing toxic are often used, including 34 herb pairs and 5 combinations of three-taste drugs are used more than 35 times. These results fully reflect the composition principles and compatibility characteristic of prescriptions for treating stranguria in DCMP. Thirteen new prescriptions by way of recessive principle excavating were acquired. These new prescriptions might be suitable to clinical treatments of variable syndromes. This article provides an useful clue to research and produce new drugs. PMID:24956864

Sun, Jing-Chang; Wang, Miao-Miao

2014-03-01

452

A Combined Analysis of 48 Type 2 Diabetes Genetic Risk Variants Shows No Discriminative Value to Predict Time to First Prescription of a Glucose Lowering Drug in Danish Patients with Screen Detected Type 2 Diabetes  

PubMed Central

Objective To investigate the genetic influence of 48 type 2 diabetes susceptibility variants on disease progression measured as risk of early prescription redemption of glucose lowering drugs in screen-detected patients with type 2 diabetes. Methods We studied type 2 diabetes progression in 1,480 patients with screen-detected type 2 diabetes from the ADDITION-Denmark study using information of redeemed prescriptions from the Register of Medicinal Products Statistics from 2001–2009 in Denmark. Patients were cluster randomized by general practitioners, who were randomized to treat type 2 diabetes according to either a conventional or a multifactorial intensive treatment algorithm. We investigated the genetic influence on diabetes progression by constructing a genetic risk score (GRS) of all 48 validated type 2 diabetes susceptibility variants, a GRS of 11 variants linked to ?-cell function and a GRS of 3 variants linked to insulin sensitivity and assessed the association between number of risk alleles and time from diagnosis until first redeemed prescription of either any glucose lowering drug or an insulin drug. Results The GRS linked to insulin sensitivity only nominally increased the risk of an early prescription redemption with an insulin drug by 39% (HR [95% C.I.]?=?1.39 [1.09–1.77], p?=?0.009] in patients randomized to the intensive treatment group. Furthermore, the strongest univariate predictors of diabetes progression for the intensive treatment group (measured as time to first insulin) were younger age (HR [95% C.I.]?=?0.96 [0.93–0.99]), increased BMI (1.05 [1.01–1.09]), increased HbA1c (1.50 [1.36–.66]), increased TG (1.24 [1.11–1.39]) and reduced fasting serum HDL (0.37 [0.17–0.80]) at baseline. Similar results were obtained for the conventional treatment group. Conclusion Higher levels of HbA1c, fasting circulating levels of triglyceride, lower HDL, larger BMI and younger age are significant determinants of early pharmacological intervention in type 2 diabetes. However, known common type 2 diabetes-associated gene variants do not appear to significantly affect disease progression. PMID:25157406

Hornbak, Malene; Allin, Kristine Højgaard; Jensen, Majken Linnemann; Lau, Cathrine Juel; Witte, Daniel; Jørgensen, Marit Eika; Sandbæk, Annelli; Lauritzen, Torsten; Andersson, Åsa; Pedersen, Oluf; Hansen, Torben

2014-01-01

453

A Prescription Management System The goal is to construct an information system to assist a pharmacist in filling and  

E-print Network

a pharmacist in filling and refilling prescriptions. A prescription is a dated, written order for a drug, age, a list of known allergies to prescription drugs, one or physicians and an affiliation that identifies an allergic reaction to a drug or family of drugs. Customer allergies are identified by a pharmacy

Browne, James C.

454

Prescription Stimulants Are "A Okay": Applying Neutralization Theory to College Students' Nonmedical Prescription Stimulant Use  

ERIC Educational Resources Information Center

Objective: National college health data indicate that prescription stimulants are the most widely misused prescription drugs among college students, with 9% admitting to nonmedical use within the past year. Although motivations for the nonmedical use of these drugs have been explored, scant attention has been paid to justifications for nonmedical…

Cutler, Kristin A.

2014-01-01

455

Evolving Electrocardiographic Changes in Lamotrigine Overdose: A Case Report and Literature Review.  

PubMed

Lamotrigine overdose usually follows a benign pattern, and the majority of cases reported involve a co-ingestant. Prior reports have suggested the possible use of intravenous lipid emulsion in cases of severe sodium channel blockade. We describe the electrocardiographic changes in a massive lamotrigine overdose treated with intravenous lipid emulsion. A 36-year-old male with bipolar disorder ingested 13.5 g of lamotrigine in a suicidal attempt. The lamotrigine level was 78.0 ?g/mL. Comprehensive drug screen was negative for all screened compounds. The electrocardiogram demonstrated a prolonged QRS complex and signs suggestive of sodium channel blockade. Refractory to treatment with sodium bicarbonate was treated with intravenous lipid emulsion, with immediate resolution of the electrocardiographic changes. Lamotrigine inhibits the voltage-gated sodium channel opening, attenuating the release of excitatory neurotransmitters. Cardiac intraventricular conduction could be delayed in cases of lamotrigine overdose resulting in QRS and QTc prolongation and R waves >3 mm in leads I and aVR. A potential role for intravenous lipid emulsion therapy has been described in patients with toxic levels of lamotrigine and electrocardiographic changes refractory to the treatment with sodium bicarbonate. Intravenous lipid emulsion has been successfully used in the treatment of lamotrigine cardiac toxicity. PMID:25448877

Chavez, Patricia; Casso Dominguez, Abel; Herzog, Eyal

2014-12-01

456

21 CFR 290.2 - Exemption from prescription requirements.  

Code of Federal Regulations, 2010 CFR

21 ? Food and Drugs ? 4 ? 2010-04-01 ? 2010-04-01 ? false ? Exemption from prescription requirements. ? 290.2 ? Section 290.2 ? Food and Drugs ? FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ? DRUGS: GENERAL ? CONTROLLED DRUGS ? General Provisions ? § 290.2...

2010-04-01

457

A radiation overdose incident: Initial data  

SciTech Connect

The purpose of this investigation was to estimate tolerance limits for irradiated human tissues by evaluating reactions observed in 426 patients who had received significant overdoses from an improperly calibrated cobalt unit. A data file was designed to store essential technical and dosimetric information sufficient to analyze the response, estimate complication rates, and derive dose-response functions, using hierarchical region, system, and organ coding protocols. A total of 795 discrete target tissues had been irradiated in 426 evaluable subjects studied. In 183 patients who survived beyond 1 year, there were 62 (34%) with immediate severe complications in 386 irradiated sites including brain, spinal cord, skin, oropharyngeal mucosa, colon, and rectum. This unique data set includes responses to high doses and unusual fractionation beyond the range of conventional clinical experience. It provides a resource for estimating human tissue tolerance limits, for testing clinically relevant radiobiological models and for developing new optimization algorithms. 4 refs., 7 figs., 5 tabs.

Cohen, L. [Univ. of Chicago, IL (United States)] [Univ. of Chicago, IL (United States); Schultheiss, T.E. [Fox Chase Cancer Center, Philadelphia, PA (United States)] [Fox Chase Cancer Center, Philadelphia, PA (United States); Kennaugh, R.C. [Riverside Methodist Hospital, Columbus, OH (United States)] [Riverside Methodist Hospital, Columbus, OH (United States)

1995-08-30

458

Some notes on prescriptions.  

PubMed

Two separate surveys of prescriptions and prescription habits have been performed. In a survey in one pharmacy in Tamworth, 16 out of 750 prescriptions had to be returned to the doctor for correction. The most common problem was illegible handwriting. Another survey to determine the competence of script writing amongst 12 interns at Tamworth Base Hospital revealed a certain lack in their basic training. PMID:994933

Burke, R F; Fahy, F G; Widolf, G A

1976-09-18

459

Alcohol Overdose: The Dangers of Drinking Too Much  

MedlinePLUS

Alcohol Overdose: The Dangers of Drinking Too Much Celebrating at parties, cheering a favorite sports team, and ... excess. And the results can be deadly. Identifying Alcohol Poisoning Critical Signs and Symptoms of Alcohol Poisoning ...

460

Tricyclic antidepressant overdose in a toddler treated with intravenous lipid emulsion.  

PubMed

We report a case that involves the use of intravenous lipid emulsion as an antidote for a drug overdose involving a 20-month-old girl who had ingested a potentially lethal amount of the tricyclic antidepressant (TCA) dothiepin. The patient's condition continued to deteriorate despite implementation of standard pediatric treatment recommendations for TCA toxicity. Administration of intravenous lipid emulsion in addition to standard therapy (including sodium bicarbonate) and direct-current cardioversion for ventricular arrhythmia led to a successful outcome. The case report is followed by a review of the current evidence underlying this novel therapy and the background on its use. TCA toxicity is addressed specifically. PMID:22065274

Hendron, David; Menagh, Gareth; Sandilands, Euan A; Scullion, Damian

2011-12-01

461

Type B Lactic Acidosis Associated With Venlafaxine Overdose.  

PubMed

Lactic acidosis that is not secondary to tissue hypoperfusion or hypoxemia (type B lactic acidosis) is a rare but potentially fatal condition that has been associated with drugs like metformin, linezolid, and nucleoside reverse-transcriptase inhibitors in patients with HIV. We report the first case of type B lactic acidosis caused by overdose of the serotonin-norepinephrine reuptake inhibitor, venlafaxine. A 55-year-old man with no significant medical history was brought to the emergency department after intentional ingestion of around 80 capsules of venlafaxine (a total dose of over 6000 mg) in an attempt to commit suicide. Complete blood count and comprehensive metabolic panel were unremarkable except for a bicarbonate level of 13 mEq/L and an anion gap of 22 mEq/L. An arterial blood gas revealed a pH of 7.39, partial pressure of CO2 of 19 mm Hg, calculated bicarbonate of 11.5 mEq/L, and a lactate level of 8.6 mmol/L. The patient was started on aggressive intravenous hydration with normal saline along with oral activated charcoal with sorbitol. Repeat laboratory work after 4 hours showed an improvement in anion gap (15 mEq/L) and serum lactate (5.6 mmol/L). The patient remained stable throughout the hospital stay and lactic acidosis resolved in 24 hours. In the absence of hypotension, hypoxemia, kidney or liver dysfunction, myopathy, malignancy, or use of other medications, venlafaxine was the most likely cause of lactic acidosis in our case. Rapid improvement of acidosis was probably related to clearance of the drug. PMID:25405896

Iragavarapu, Chaitanya; Gupta, Tanush; Chugh, Savneek S; Aronow, Wilbert S; Frishman, William H

2014-11-17

462

Analysis of Multiple End Points in Consumer Research in Support of Switching Drugs From Prescription to Over-the-Counter Status: The Concept of End-Point Hierarchies  

Microsoft Academic Search

Clinical and regulatory decision making concerning over-the-counter (OTC) drugs requires research designed to understand how consumers will self-manage treatment using the candidate OTC drug. Consumer research for an OTC drug may include studies of label comprehension, self-selection, and actual use. Definition and analysis of end points for these trials have varied in the absence of consensus on optimal approaches. Research

EP Brass; LE Shay; A Leonard-Segal

2009-01-01

463

Office of National Drug Control Policy  

MedlinePLUS

... its consequences in America. Read more Topics Prescription Drug Abuse Prescription drug abuse is the Nation's fastest-growing drug problem and ... being taken b