Design of the functional requirements of a smartphone app for patients receiving oral antineoplastic agents: The e-OncoSalud® app

2019 ◽  
Vol 26 (1) ◽  
pp. 105-115 ◽  
Author(s):  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Almudena Ribed ◽  
Helena Anglada-Martínez ◽  
Maite Martín-Conde ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
Antineoplastic Agents ◽  
Relevant Information ◽  
Mobile App ◽  
Smartphone App ◽  
Functional Requirements ◽  
Healthcare Organizations ◽  
Multidisciplinary Working ◽  
Monitoring Treatment

Objective To design a mobile app based on the needs of the onco-hematological patient receiving oral antineoplastic agents. Methods A multidisciplinary working group (pharmacy–oncology–hematology) was created to design the app. The study was developed in three phases: first, we analyzed the features of patients receiving oral antineoplastic agents. We then analyzed available apps for cancer patients. Finally, we designed the app's functionalities. Results We included 51 patients with middle-advanced age (68.7 years (SD=10.7)). They were polymedicated (mean: 5.3 (SD = 2.7), with numerous drug–drug interactions and adverse effects (all patients presented adverse effects). We then analyzed 166 apps. Most apps had more than one use, the most frequent being information (39.8%) and diagnosis (38.6%). Ten apps (6%) were for registering and monitoring treatment and adverse effects. Almost half of the apps (48.8%) were developed by healthcare organizations. Finally, we designed an app (e-OncoSalud®) with the following functionalities: (a) agenda; (b) treatment and drug interactions checker; (c) continuous recording of self-controls (weight, blood pressure, general condition) and adverse effects. The management of the adverse effects are based on an algorithm which provides different recommendations according to the adverse effects severity; (d) patient–pharmacist messaging in real-time; (e) education. Conclusions After analysis of the main problems affecting these patients and the needs not covered by the existing apps, we designed e-OncoSalud®. It integrates relevant information about their treatment, focused on drug interactions identification and the prevention, and management of adverse effects.

Design of the functional requirements of a smartphone app for patients receiving oral antineoplastic agents: the e-oncohealth� app.

2018 ◽  
Author(s):  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Almudena Ribed ◽  
Helena Anglada-Mart�nez ◽  
Maite Mart�n-Conde ◽  
...  
Keyword(s):  
Antineoplastic Agents ◽  
Smartphone App ◽  
Functional Requirements

Characteristics of the Analgesic Effects and Drug Interactions of Intrathecal Carbachol in Rats

1995 ◽  
Vol 83 (4) ◽  
pp. 844-849. ◽  
Author(s):  
Stephen E. Abram ◽  
Therese C. O'Connor
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
Stimulus Intensity ◽  
Hind Limb ◽  
Intrathecal Morphine ◽  
Radiant Heat ◽  
Limb Weakness ◽  
Analgesic Effects ◽  
Low Intensity ◽  
Significant Difference

Background Intrathecal carbachol produces consistent analgesia in animals without appreciable adverse effects. Little is known about the ability of this drug to provide analgesia as stimulus intensity is increased. Likewise, there are few data regarding interactions between carbachol and other intrathecal analgesics. Methods Using two different noxious radiant heat intensities, one applied to each hind limb, analgesic effects of 1, 3, 10, and 30 micrograms intrathecal carbachol on paw withdrawal latencies were measured. Similar testing was done for intrathecal morphine and clonidine. ED50 fractions (1/2, 1/4, 1/8, 1/16) of drug combinations of carbachol-morphine and carbachol-clonidine were administered, responses to the low intensity stimulus were recorded, and the ED50 of each combination was established and isobolographic analysis of the drug interactions was carried out. Results The 30-micrograms dose of carbachol was associated with transient agitation, salivation, and hind limb weakness. No other adverse effects were noted. The ED50 (95% confidence interval) of intrathecal carbachol was 2.34 micrograms (1.34-4.04) for low intensity stimulation and 12.64 micrograms (4.18-38.25) for high intensity. There was no significant difference between high- and low-intensity ED50 values for intrathecal morphine and clonidine. The analgesic effect of the carbachol-morphine and carbachol-clonidine combinations were significantly greater than the calculated additive effects. The ED50 for the carbachol-morphine combination was 12% of the expected additive value and the ED50 for the carbachol-clonidine combination was 30% of the expected additive value. Conclusions Intrathecal carbachol provides analgesia to noxious thermal stimulation of the hind paw in rats. It is relatively less effective at providing analgesia than intrathecal morphine or clonidine when stimulus intensity is raised. Intrathecal carbachol is synergistic when combined with intrathecal morphine or clonidine.

Oral Terbinafine: A New Antifungal Agent

1997 ◽  
Vol 31 (4) ◽  
pp. 445-456 ◽  
Author(s):  
Susan M Abdel-Rahman ◽  
Milap C Nahata
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
Fungal Infections ◽  
Case Reports ◽  
Current Standard ◽  
Open Label ◽  
Double Blind ◽  
Pathogenic Yeast

Objective To review the pharmacology, pharmacokinetics, efficacy, adverse effects, drug interactions, and dosage guidelines of terbinafine. Available comparative data of terbinafine and other antimycotic agents are described for understanding the potential role of terbinafine in patient care. Data Sources A MEDLINE search restricted to English language during 1966–1996 and extensive review of journals was conducted to prepare this article. MeSH headings included allylamines, terbinafine, SF 86–327, dermatophytosis, dermatomycosis. Data Extraction The data on pharmacokinetics, adverse effects, and drug interactions were obtained from open-label and controlled studies and case reports. Controlled single- or double-blind studies were evaluated to describe the efficacy of terbinafine in the treatment of various fungal infections. Data Synthesis Terbinafine is the first oral antimycotic in the allylamines class: a fungicidal agent that inhibits ergosterol synthesis at the stage of squalene epoxidation. Terbinafine demonstrates excellent in vitro activity against the majority of dermatophyte species including Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum; less activity is seen against Dematiaceae and the filamentous fungi. It is least active against the pathogenic yeast and this correlates with the relatively poor efficacy against these organisms in vivo. High concentrations of terbinafine are achieved in keratinous tissues, the site of superficial infections, and these concentrations are maintained for up to 3 months. The clinical efficacy of terbinafine against a number of dermatophyte infections exceeds that of the current standard of therapy, griseofulvin. The efficacy of terbinafine may be as good or better than that of the azole antifungals. Additional studies are required to confirm these observations. Terbinafine demonstrates a good safety profile, and relatively few drug interactions have been identified. Conclusions Terbinafine is more effective than the gold standard, griseofulvin, in the treatment of tinea pedis and tinea unguinum, with considerably shorter treatment duration in the latter. It has been proven as effective as griseofulvin in the treatment of tinea capitis, tinea corporis, and tinea cruris. Terbinafine does not appear to offer any advantage in the treatment of nondermatophyte infections; its utility in the treatment of systemic infections has yet to be established. Depending on individual institutional costs, terbinafine may be a front-line drug for some superficial infections responding poorly to the current standard of therapy.

scholarly journals Developing a Theory-Informed Smartphone App for Early Psychosis: Learning Points From a Multidisciplinary Collaboration

2020 ◽  
Vol 11 ◽  
Author(s):  
Natalie Berry ◽  
Matthew Machin ◽  
John Ainsworth ◽  
Katherine Berry ◽  
Dawn Edge ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Reference Group ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Smartphone App ◽  
Proof Of Concept ◽  
Randomized Controlled ◽  
Multidisciplinary Working ◽  
Software Engineers ◽  
Learning Points

Background: Actissist is a smartphone app designed to deliver an intervention grounded in cognitive behavior therapy for early psychosis. Actissist was developed by a multidisciplinary team of academics, clinicians, experts by experience and software engineers. Actissist has been tested in two trials, the first a proof-of-concept trial where Actissist was safe, acceptable and feasible, the second, a powered randomized controlled trial.Objective: This article describes how our multidisciplinary team designed and developed Actissist. This article describes: (i) how Actissist was informed by initial qualitative interviews and focus groups and an expert reference group; (ii) refinements made to the app based on ongoing user feedback; (iii) successes and challenges encountered; and (iv) learning points and recommendations for involving stakeholders in digital health interventions.Methods: Expert reference group meetings informed the development of Actissist and design of subsequent trials, which included individuals with lived experience of psychosis, clinicians, academics, computer scientists and software engineers. Person-centered stakeholder involvement was promoted using focus groups and qualitative interviews prior to the development of the app, which informed version one of Actissist. Interviews were carried out with participants who had used Actissist. Two further versions of Actissist were developed following additional rounds of testing.Results: Multidisciplinary working throughout the Actissist project led to the development, inclusion and improvement of the app design and content. These changes and features included non-directive and compassionate content, co-designed recovery videos, relaxation exercises, psychoeducation material, ability to “favorite” areas of the app that users found helpful, and goal-setting. Challenges to collaborative working included discrepancies between what stakeholders want and what is technically possible to deliver, resource pressures, trying to deliver desired features within the boundaries of fundamental trial design considerations, and power imbalances associated with multidisciplinary working.Conclusions: The involvement of stakeholders in the design and development and delivery of Actissist has been fundamental to our development approach. Through this collaborative process, we have identified different perspectives and ideas that would have not been generated by the research team alone.Clinical Trial Registrations: Proof-of-concept trial: http://www.isrctn.com/ISRCTN34966555Fully-powered randomized controlled trial: https://www.isrctn.com/ISRCTN76986679

Nimesulide – A Drug to be Banned completely

2021 ◽  
pp. 132-137
Author(s):  
C. Muralikrishna Goud ◽  
Syeda Mariya Ghazanfar
Keyword(s):  
United States ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Acute Hepatitis ◽  
Family Welfare ◽  
Over The Counter ◽  
High Court ◽  
Human Use ◽  
The Government ◽  
Pediatric Use

The Aim of present work is to report Nimesulide a Nonsteroildal Anti Inflammatory Drug is being sold as over the counter drug has to banned completely due to occurrence of Nimesulide induced acute hepatitis. On February 12, 2011, the Union Ministry of Health and Family Welfare finally had decided to suspend the pediatric use of the Nimesulide suspension. From 10 March 2011 Nimesulide formulations are not indicated for human use in children below 12 years of age. On September 13, 2011 Madras High Court revoked a suspension on manufacture and sale of pediatric drugs Nimesulide and phenylpropanolamine (PPA). Though the government of India has banned the pediatric use of Nimesulide for common fever and pain due to its adverse effects on the liver, its usage by adults is being increased everyday without any prescription. The drug was banned in 2000 in various countries like Switzerland, Spain, United states etc, whereas in India it was banned in 2011 which was too late to be banned and still available in India for adult use despite of its hepatotoxicity and possible drug interactions.

Medication Safety in Obstetrics and Gynecology Ward in Jayanagar General Hospital, Bangalore, India

2021 ◽  
Vol 15 (5) ◽  
pp. 1270-1275
Author(s):  
S. Ferdousmakan ◽  
Namitha K.B ◽  
M. Etesami
Keyword(s):  
Diabetes Mellitus ◽  
Folic Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Drug Interactions ◽  
General Hospital ◽  
Medication Safety ◽  
Relevant Information ◽  
Obstetrics And Gynecology ◽  
Iron Folic Acid

Objective: The present study is aimed at Medication Safety in Obstetrics and Gynecology Ward in Jayanagar General Hospital, Bangalore, India Methodology: It is a prospective observational study, conducted in the inpatient obstetrics and gynecology ward in Jayanagar General Hospital. The study was conducted for 6 months. CRF (Case record form) was designed to record the clinical profile and treatment pattern which contains patient demography, family history, past medication history, obstetric history and follow up and further medication safety was assessed in the patient according to WHO and US-FDA guidelines. The patient demographics and all medically relevant information were noted in a predefined data collection form. Alternatively, these case charts were reviewed for prescription legibility and completeness, unaccepted abbreviations, the capture of relevant information in case sheets, contraindication, drug interactions, and adverse drug events. Result: The data of 150 pregnant women admitted to obstetrics and gynecology ward for delivery related care during the period October 2018 to April 2019 were analyzed. It was observed that 20.67% had Hypertension, 14.67% had Gestational diabetes mellitus, and 8.67% had urinary tract infections as major comorbidities. Among the study population most of them 20.67% had oligohydramnios as a major pregnancy risk factor followed by 12% of preeclampsia and 3.33% of small for gestational age. A total of 1950 drugs were prescribed, and thus the average number of drugs per patient was 13.28. Iron, folic acid, calcium, and vitamins were the most frequently used drugs during the pregnancy. Category A drug constituted 623(54.50%) followed by category B drug 398(34.82%) out of 1950 drugs used in pregnant subjects. Another category C, D and X were 6.99%, 3.5% and 0.1% respectively. The most common drug interaction was found to be between Metronidazole and ondansetron, which may be due to high usage of tramadol and metoclopramide in pregnancy. Conclusion: Among the study patients most them 75.33% were in the age group of 21-30 years. Most of the 20.67% and 14.67% had hypertension and gestational diabetes mellitus as co- morbidities. On the review of 150 prescriptions, the average number of drugs prescribed was found to be 7.62. Iron, folic acid, calcium, and vitamins were the most frequently used drugs during the pregnancy. Most of the used drugs were from Category A (54.50%). Only 0.1% of the drug were from Category X. There were 183 possible risks of major potential drug interactions. The most common interaction was between Metronidazole and ondansetron. The majority of the drugs were prescribed as per FDA category A, the safest category during pregnancy. Keywords: Medication Safety, Obstetrics, Gynecology, pregnancy

Non-Steroidal Anti-Inflammatory Drugs: Usage and Co-prescription with Other Potentially Interacting Drugs in Elderly: a Cross-sectional Study

2019 ◽  
Author(s):  
Nuru Abdu ◽  
Samuel Teweldemedhin ◽  
Asmerom Mosazghi ◽  
Luwam Asfaha ◽  
Makda Teshale ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Protective Agents ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Introduction: Globally, non-steroidal anti-inflammatory drugs (NSAIDs) usage in the elderly with chronic pain has been reported as frequent. Though it is fundamental in maintaining their quality of life, the risk of polypharmacy, drug interactions and adverse effects is of paramount importance as the elderly usually require multiple medications for their co-morbidities. If prescriptions are not appropriately monitored and managed, they are likely to expose patients to serious drug interactions and potentially fatal adverse effects. Thus, the objective of the study was to assess the appropriateness of NSAIDs use and incidence of NSAIDs related potential interactions in elderly. Methods: A descriptive cross-sectional study was conducted among elderly out-patients (aged 60 and above) who visited three hospitals in Asmara between August 22 and September 29, 2018. The sampling design was two-stage random sampling and data was collected using a questionnaire, exit interview and by abstracting information from patients’ clinical cards. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS. Results: A total of 285 elderly respondents were enrolled in the study with similar male to female ratio. One in four of all respondents were chronic NSAIDs users, of which 74.6% were not prescribed prophylactic gastro-protective agents (GPAs). About 20% of the elderly were involved in polypharmacy and nearly all of the encountered potential NSAIDs related interactions (n=322) with prescribed drugs were moderate. Diabetes and hypertension were significantly associated with chronic NSAIDs use (OR=3, 95% CI: 1.54, 5.84; OR=9.99, 95% CI: 4.46, 22.38) and incidence of drug interactions (OR=3.95, 95%CI: 1.92, 8.13; OR=3.12, 95%CI: 1.81, 5.33) while diabetes and cardiac problem were significantly associated with incidence of polypharmacy (OR=4.33, 95% CI: 2.36, 7.96; OR=3.56, 95% CI: 1.05, 12.11). Conclusion: Though the overall reflection of prescription pattern of NSAIDs during the study period was almost satisfactory, gastro-protective agents were poorly prescribed as a prophylaxis.

Herbal Drug Interactions

2017 ◽  
pp. 201-231 ◽  
Author(s):  
Mymoona Akhter
Keyword(s):  
Drug Interaction ◽  
Side Effects ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Herbal Drugs ◽  
Herbal Drug ◽  
Herbal Therapy ◽  
Alternative Medicines ◽  
Regulatory Bodies

Use of complementary and alternative medicines (CAM) for preventive and therapeutic purposes has increased tremendously in the last two decades internationally. The manufacturers of these products are not required to submit proof of safety or efficacy to the Food and Drug Administration. As a result, the adverse effects and drug interactions associated with them are largely unknown. In this chapter, the author presents interactions of herbal medicines with other medicines (herbal or non-herbal). A large number of herbal drugs, including from single drug to a variety of mixtures have been used to treat kidney disorders. Herb-herb or herb drug interaction has been reported intensively during last decade, therefore it becomes important to keep an eye on the use of combination herbal therapy in order to avoid serious results because of interactions with each other. Due to the growing awareness about the interactions and side effects of herbal drugs/supplements over the past few years, regulatory bodies are working on these issues and pharmacopoeias are being developed for reference.

Sign in / Sign up

Export Citation Format

Share Document