Analysis of effectiveness and drug related problems of pain reliever for knee osteoarthritis: weighing clinical risk and benefit

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Junaidi Khotib ◽  
Henny Utami Setiawan ◽  
Ahmad Dzulfikri Nurhan ◽  
Erreza Rahadiansyah ◽  
Chrismawan Ardianto ◽  
...  
Keyword(s):  
Side Effects ◽  
Drug Interactions ◽  
Adverse Drug Events ◽  
Laboratory Data ◽  
Age Distribution ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Drug Related Problems ◽  
Pain Reliever ◽  
Pain Medications

AbstractBackgroundOsteoarthritis (OA) is a chronic degenerative joint disease, characterized by physiological disorders, such as cartilage degradation, bone remodeling, osteophyte formation, and joint inflammation, which results in pain. Several studies have reported problems with the use of pain medications in OA, such as the use of a combination of many drugs and their long-term use. Therefore, this study was designed to evaluate the use of pain medications in OA patients. The study focused on the analysis of effectiveness and drug related problems (DRPs) with the category of drug interactions and adverse drug events (ADEs) in knee OA patients in Orthopedic and Traumatology Clinic, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia.MethodsThe study used a retrospective approach through tracking and recording of the medical data from the period of 1st January to 30th June, 2018. The potential of drug interactions was determined by analyzing data based on literature. The actual side effects of the drug were identified based on the patient’s medical record through clinical data, laboratory data, and therapeutic data received by the patient. The study involved 143 subjects who met the inclusion criteria of 871 visits to the hospital.ResultsThe results showed that women as much as 80.42% with an age distribution of at most 46–65 years are the most affected by OA cases. The predominant history of illness and comorbidities in OA patients was hypertension in 58.74% of patients. The use of analgesic meloxicam had a percentage of 26.06%, sodium diclofenac 20.21%, mefenamic acid 4.36% and paracetamol 4.25%. The effectiveness of the use of pain reliever was characterized by a decrease in VAS in each patient at the beginning and at the end of the study, where a decrease in pain intensity occurred in 79.72% of patients who received pain medications. Based on drug interactions, we were able to identify pharmacodynamic interactions of 43 events (4.94%) and onine events of pharmacokinetic interactions (1.03%), with a minor severity of 7 events (0.80%),44 moderate events (5.05%), and one major event (0.11%). Mostly identified side effects of the drugs were those due to the use of non-steroid anti inflammatory drugs, which occurred in 42 events (4.82%).ConclusionsIt can be concluded that OA therapy with a number of pain relievers shows an adequate therapeutic response with some side effects and interactions both pharmacokinetically and pharmacodynamically.

Piroxicam in the Treatment of Osteoarthrosis: A Multicentre Study in General Practice Involving 1218 Patients

1979 ◽  
Vol 7 (5) ◽  
pp. 335-343 ◽  
Author(s):  
P Dessain ◽  
T F Estabrooks ◽  
A J Gordon
Keyword(s):  
General Practice ◽  
Side Effects ◽  
Treatment Period ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Global Evaluation ◽  
Self Assessment ◽  
Once Daily ◽  
Prior Therapy ◽  
Epigastric Distress

A non-comparative multicentre trial was conducted by 156 general practitioners with 1218 patients in eight European countries to assess the efficacy and toleration of once daily doses of piroxicam in the treatment of osteoarthrosis (degenerative joint disease). Drug was taken for an average of 2.5 months with more than 75% on piroxicam for 7 weeks or more. The maintenance dose in 81% of all patients was the same as the recommended starting dose of 20 mg, taken once daily after breakfast. Although more than 40% of patients received concurrent analgesic/anti-inflammatory drug(s) at the beginning of the trial, only 10% to 15% took such therapy by the end of their treatment period. Most patients had moderate or severe involvement in one or more of knee, spine, hip, digit, or shoulder joints. From 75% to 80% of patients reported marked or moderate improvement in ability to move and use joints and their general overall feeling (‘quality of life’ measurement). Patients' self-assessment of joint pain and stiffness showed from 25% to 30% reduction after 2 weeks on drug and up to 60% reduction by the end of the treatment period. Onset of morning pain at baseline occurred within 1 to 2 hours after waking, but by final evaluation, the average time had risen to 6 hours in those patients still experiencing pain. Side-effects definitely attributed to piroxicam were reported by 13% of all patients; there were sixty discontinuations (5%) due to drug. The majority of side-effects were upper gastro-intestinal in origin, primarily epigastric distress, nausea, and indigestion. Most side-effects were mild or moderate and were experienced without incident within the first three weeks on drug. In their global evaluation, investigators judged the efficacy of piroxicam as marked or moderate in 82% of patients while toleration was considered excellent or good in 92% of cases. In comparison to a patient's prior therapy, investigators considered piroxicam better in its overall effect in 72% of the cases. In summary, the data show that once-daily doses of piroxicam, mostly 20 mg, can provide very favourable efficacy and toleration in the treatment of osteoarthritis in general practice.

scholarly journals ANALISA DRUG RELATED PROBLEMS (DRPS) PASIEN GAGAL GINJAL DENGAN KOMPLIKASI DIABETES MELLITUS DI RSUD X

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Siti Pandanwangi ◽  
Ahmad Azrul Zuniarto ◽  
Husni Mubarok
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Drug Therapy ◽  
Side Effects ◽  
Drug Interactions ◽  
Kidney Failure ◽  
Diabetic Patients ◽  
Drug Side Effects ◽  
Drug Related Problems ◽  
Selection Of

ABSTRAK Drug Related Problems (DRPs) merupakan suatu kejadian yang tidak diinginkan atau yang timbul dari suatu terapi pengobatan terhadap pasien. DRPs dapat berupa, ketidaktepatan dosis (lebih tinggi atau lebih rendah dari yang dibutuhkan), interaksi obat DM dengan obat lain, pemilihan jenis obat DM yang kurang tepat, adanya indikasi DM namun tidak mendapatkan terapi obat DM, efek samping obat yang timbul, gagal dalam menerima terapi obat (kepatuhan pasien dll). Berdasarkan hal tersebut, penulis merasa tertarik untuk mengambil judul “Analisa Drug Related Problems (DRPs) Pasien Gagal Ginjal dengan Komplikasi Diabetes Mellitus di RSUD X ”. Jenis penelitian yang digunakan dalam penelitian ini adalah metode analisis deskritif yaitu metode penelitian yang bertujuan mengetahui gambaran Drug Related Problems (DRPs) dari pengobatan injeksi insulin dan Obat Anti Diabetik Oral (OADO) terhadap penurunan fungsi ginjal. Berdasarkan penelitian yang telah dilakukan pada pasien Nefropati Diabetik yang sedang menjalani terapi hemodialisa di RSUD X pada periode bulan januari 2017 sampai dengan bulan mei 2017 diperoleh kesimpulan sebagai berikut :Terdapat 2 (94 %) pasien yang tidak memperoleh obat gagal ginjal dan 3 (81 %) pasien tidak mendapatkan obat DM dari total peresepan yang diterima, hal ini bisa disebabkan tidak terkontrolnya data pasien sebelumnya sehingga terputus pada saat pemeriksaan selanjutnya, dari 16 sampel pasien yang diteliti terjadi 9 pasien mengalami ketidaktepatan pengobatan dengan prosentase 56 %. Ketidaktepatan ini berupa pemberian dosis yang sama pada pasien yang sudah ada perbaikan kadar gula darah, hal ini dapat menimbulkan resiko hipoglikemia pada pasien tersebut., hampir seluruh sampel pasien nefropati diabetik mendapatkan dosis berlebih (100%), hasil pengamatan efek samping obat pada pasien nefropati diabetik pasien mengalami keluhan mual (31 %), pusing (25%), lemas (94 %), nyeri badan(31 %) , gatal atau alergi (12.5 %), hasil pengamatan ketidaktepatan pemilihan jenis obat, terdapat 6 sampel pasien yang mengalami ketidaktepatan pemilihan jenis obat dengan prosentase 43,75 %. Ketidaktepatan pemilihan jenis obat ini dapat berpengaruh terhadap penurunan fungsi ginjal atau memperberat fungsi ginjal penderita nefropati diabetic, hasil pengamatan interaksi obat diperoleh data interaksi antagonis terjadi 95 % sedangkan untuk interaksi sinergis terjadi 81 %, hasil pengamatan pasien tidak menerima obat, diperoleh data bahwa semua pasien memperoleh obat sesuai dengan resep ( 100 %). Kata kunci: Drug Related Problems (DRPs), penderita nefropati diabetic, rumah sakit X ABSTRACT Drug Related Problems (DRPs) is an undesirable event or arising from a therapeutic treatment of a patient. DRPs may be, inaccurate doses (higher or lower than required), DM drug interactions with other drugs, inappropriate selection of DM drugs, presence of DM indications but not DM drug therapy, adverse drug side effects, failure in receiving drug therapy (patient compliance etc). Based on this, the authors feel interested to take the title "Analysis Drug Related Problems (DRPs) Patients Kidney Failure with Complications of Diabetes Mellitus in RSUD X". Type of research used in this research is descriptive analysis method that is research method which aim to know Drug Related Problems (DRPs) from insulin injection treatment and Oral Anti Diabetic Drug (OADO) to decrease kidney function. Based on the research that has been done on Diabetic Nephropathy patients who are undergoing hemodialysis therapy in RSUD X in the period of January 2017 up to May7 2017 obtained the following conclusion: There are 2 (94%) patients who do not get kidney failure drug and 3 (81% ) patients did not receive DM medication from total prescribed acceptance, this could be due to uncontrolled patient's previous data so disconnected during subsequent examination, from 16 samples of patients studied occurred 9 patients experiencing treatment inaccuracy with percentage of 56%. This inaccuracy in the form of giving the same dosage to an existing patient improves blood sugar levels, this can lead to the risk of hypoglycemia in these patients., Almost all diabetic nephropathy patients sample get overdose (100%), observed drug side effects in patients with nephropathy diabetic patients (31%), dizziness (25%), weakness (94%), body aches (31%), itching or allergies (12.5%), observation of inaccurate selection of drugs, 6 patients the inaccuracy of the selection of drugs with the percentage of 43.75%. Inaccurate selection of this type of drug may affect the decline in renal function or aggravate the function of kidney patients diabetic nephropathy, the observation of drug interactions obtained by antagonistic interaction data occurred 95% while for the synergistic interaction occurred 81%, the observation of patients did not receive the drug, obtained data that all patients get the medicine according to the prescription (100%). Keywords: Drug Related Problems (DRPs), diabetic nephropathy patients, hospital X

scholarly journals Intertarsal Joint Stabilization in a Bateleur Eagle (Terathopius ecaudatus) Using a Novel Application of a Braided Suture and Titanium Button System

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Jenessa Gjeltema ◽  
Ryan S. De Voe ◽  
Larry J. Minter ◽  
Brian J. Trumpatori
Keyword(s):  
Weight Bearing ◽  
Degenerative Joint Disease ◽  
Additional Treatment ◽  
Joint Disease ◽  
The Novel ◽  
Joint Stability ◽  
Pain Medications ◽  
Old Adult ◽  
History Of ◽  
Intertarsal Joint

A 32-year-old adult captive male bateleur eagle (Terathopius ecaudatus) with a history of laxity, degenerative joint disease, and varus deviation of the distal left hindlimb for several years was presented for evaluation of left hindlimb lameness and was diagnosed with chronic subluxation of the left intertarsal joint. After failing to improve with conservative management and pain medication, surgical stabilization of the joint was performed using a novel application of a braided suture and titanium button system. Unsatisfactory clinical improvement and postsurgical reevaluation indicated that the initial surgical stabilization was unsuccessful. The surgery was repeated, and the animal showed postsurgical improvement in intertarsal joint stability, weight-bearing, and lameness for a period of several years with use and adjustment of chronic pain medications. The novel surgical technique described in this case report represents an additional treatment option for management of avian intertarsal joint subluxations. Presurgical planning should consider the unique anatomic features and variability of the avian tarsometatarsus to avoid surgical complications.

Apportionment of Impairment from Meniscal Tears and Knee Arthritis

2013 ◽  
Vol 18 (5) ◽  
pp. 1-10 ◽  
Author(s):  
Charles N. Brooks ◽  
James B. Talmage
Keyword(s):  
Medial Meniscus ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Detailed Knowledge ◽  
Meniscal Tears ◽  
Knee Arthritis ◽  
Degenerative Arthritis ◽  
Study Results ◽  
Physical Findings ◽  
Causation Analysis

Abstract Meniscal tears and osteoarthritis (osteoarthrosis, degenerative arthritis, or degenerative joint disease) are two of the most common conditions involving the knee. This article includes definitions of apportionment and causes; presents a case report of initial and recurrent tears of the medial meniscus plus osteoarthritis (OA) in the medial compartment of the knee; and addresses questions regarding apportionment. The authors, experienced impairment raters who are knowledgeable regarding the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), show that, when instructions on impairment rating are incomplete, unclear, or inconsistent, interrater reliability diminishes (different physicians may derive different impairment estimates). Accurate apportionment of impairment is a demanding task that requires detailed knowledge of causation for the conditions in question; the mechanisms of injury or extent of exposures; prior and current symptoms, functional status, physical findings, and clinical study results; and use of the appropriate edition of the AMA Guides. Sometimes the available data are incomplete, requiring the rating physician to make assumptions. However, if those assumptions are reasonable and consistent with the medical literature and facts of the case, if the causation analysis is plausible, and if the examiner follows impairment rating instructions in the AMA Guides (or at least uses a rational and hence defensible method when instructions are suboptimal), the resulting apportionment should be credible.

3. Degenerative joint disease

2000 ◽  
Vol 81 (3B) ◽  
pp. s67-s72
Author(s):  
Victoria A. Brander ◽  
Darryl L. Kaelin ◽  
Terry H. Oh ◽  
Peter A.C. Lim
Keyword(s):  
Degenerative Joint Disease ◽  
Joint Disease

Osteotomy for Correction of Premature Growth Plate Closure in 24 Dogs

1994 ◽  
Vol 07 (03) ◽  
pp. 129-135 ◽  
Author(s):  
C.W. Miller ◽  
P.W. Morgan
Keyword(s):  
Corrective Osteotomy ◽  
Functional Results ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Angular Deformity ◽  
Dynamic Correction ◽  
Age At Surgery ◽  
Limb Deformities ◽  
The Mean ◽  
A Prospective Study

SummaryTwenty-four dogs (27 limbs) were evaluated after surgery for correction of forelimb angular limb deformities. Partial ulnar ostectomies or definitive corrective osteotomies were performed depending upon the age of the dog. According to owner assessment nine of fourteen limbs were considered functionally good, or excellent, after partial ulnar ostectomies. Younger dogs appeared to have better functional results after dynamic correction with the mean age at surgery of dogs with good to excellent results being 6.5 months contrasted to the mean age at surgery of dogs with fair to poor results being 9.75 months. Ten of fourteen limbs were considered functionally good or excellent after definitive corrective osteotomy. One dog had definitive osteotomy after partial ulnar ostectomy in order to further correct a residual angular deformity. However, 58% of the limbs with radiographic follow-up had signs of degenerative joint disease (DJD). There were not significant differences between neither degree of angulation remaining after surgery and the functional result nor the degree of angulation remaining after surgery and the development of DJD. A prospective study is warranted to more objectively assess the efficacy of surgical correction of angular limb deformities in dogs.Twenty-four dogs were evaluated after surgery for correction of forelimb angular limb deformities. The results are described.

Anticoagulant Properties of Three Mucopolysaccharides Used in Rheumatology

1983 ◽  
Vol 50 (03) ◽  
pp. 652-655 ◽  
Author(s):  
F Bauer ◽  
P Schulz ◽  
G Reber ◽  
C A Bouvier
Keyword(s):  
Factor Xa ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Thrombin Time ◽  
Coagulation Tests ◽  
Amplification System ◽  
Relative Potencies ◽  
In Vivo Administration

SummaryThree mucopolysaccharides (MPS) used in the treatment of degenerative joint disease were compared to heparin to establish their relative potencies on 3 coagulation tests, the aPTT, the antifactor X a activity and the dilute thrombin time. One of the compounds, Arteparon®, was one fourth as potent as heparin on the aPTT, but had little or no influence on the 2 other tests. Further in vitro studies suggested that Arteparon® acted at a higher level than factor Xa generation in the intrinsic amplification system and that its effect was independent of antithrombin III. In vivo administration of Arteparon® confirmed its anticoagulant properties, which raises the question of the clinical use of this MPS.

The Gut Microbiota of Rats under Experimental Osteoarthritis and Administration of Chondroitin Sulfate and Probiotic

2020 ◽  
Vol 82 (6) ◽  
pp. 64-73
Author(s):  
O.H. Korotkyi ◽  
◽  
T.V. Luhovska ◽  
T.M. Serhiychuk ◽  
K.O. Dvorshchenko ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Chondroitin Sulfate ◽  
Joint Inflammation ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Quantitative Composition ◽  
Combined Administration ◽  
Osteoarthritis Progression ◽  
Experimental Osteoarthritis ◽  
Gut Microbiota Composition

Osteoarthritis is a most widespread chronic degenerative joint disease that causes pain, cartilage deformation, and joint inflammation. Adverse alterations of intestinal microbiota like dysbiosis may lead to metabolic syndrome and inflammation, two important components of osteoarthritis progression. Aim. In this study we investigated the effect of chondroitin sulfate and probiotics on the gut microbiome in monoiodoacetate-induced osteoarthritis model in rats. Methods. The species and quantitative composition of feces were determined using diagnostic media with selective properties. Further identification of isolated microorganisms was carried out according to morphological, tinctorial, physiological and metabolic parameters. The results are presented in the form of lg CFU/g. Results. Induction of osteoarthritis caused significant increasing the number of opportunistic enterobacteria and lactose-negative Escherichia coli against the decreasing of lacto- and bifidobacteria that may indicate a dysbiotic condition. Coadministration of chondroitin sulfate and probiotic bacteria has led to improvement the quantitative composition of the gut microbiota in experimental animals, the numerous of Bifidobacterium, Lactobacillus were increasing against decreasing the quantitative composition of opportunistic microorganisms. Conclusions. Monoiodoacetate-induced osteoarthritis caused dysbiosis of gut in rat. We observed beneficial effect of combined administration of chondroitin sulfate and probiotics on gut microbiota composition in rats with experimental osteoarthritis. Thus, adding of supplements like probiotics to standard treatment of osteoarthritis may have potentials to prevent and treat this disease.

Allogenic Mesenchymal Stem Cells as a Treatment for Equine Degenerative Joint Disease: A Pilot Study

2014 ◽  
Vol 9 (6) ◽  
pp. 497-503 ◽  
Author(s):  
Sarah Broeckx ◽  
Marc Suls ◽  
Charlotte Beerts ◽  
Aurelie Vandenberghe ◽  
Bert Seys ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Pilot Study ◽  
Degenerative Joint Disease ◽  
Joint Disease
Sign in / Sign up

Export Citation Format

Share Document