scholarly journals The main complications of infusion therapy and methods to overcome them

2020 ◽  
pp. 57-59
Author(s):  
Ye.V. Hryzhymalskyi
Keyword(s):  
Anaphylactic Shock ◽  
Treatment Process ◽  
Healthcare Professionals ◽  
Muscle Relaxants ◽  
Infusion Therapy ◽  
Solution Preparation ◽  
Inflammatory Drugs ◽  
Safe Injection ◽  
Modern Treatment ◽  
Injection Safety

Background. Infusion therapy (IT) is an integral part of the modern treatment process and the most common method of inpatient treatment. Indications for the IT use include dehydration, changes in blood properties, intoxication, the impossibility or inexpediency of the drug administration in other ways, the impossibility of oral nutrition, and impaired immunity. Objective. To describe the main complications of IT and their treatment. Materials and methods. Analysis of literature data on this issue. Results and discussion. Before conducting IT, you should take into account all the indications and contraindications and carefully read the instructions for use of drugs. It is advisable to use several drugs to reduce the number and severity of side effects. The rate of administration is important: in most cases, the safe rate is 20-30 drops per minute. Accidental needle injuries (ANI) and blood contact are potential IT risks for healthcare professionals. The National Union of Nurses of Private Practice has launched a survey of health workers to reduce the prevalence of these injuries. There are three components to injection safety: safe solution preparation, safe injection, and safe disposal. IT via the needle has a number of disadvantages: complications due to frequent punctures, limited ability to conduct long-term IT, increased risk of ANI. The installation of a permanent venous catheter reduces the likelihood of these defects. After catheter placement, before and after infusion, it should be flushed with 0.9 % NaCl, heparin or Soda-Bufer solution (“Yuria-Pharm”). However, as the number of catheterizations increases, the number of catheter-associated infections increases too, ranking third among nosocomial infections and first among the causes of bacteremia. In general, the frequency of complications of venous catheterization is 15 %. Mechanical complications occur in 5-19 % of patients, infectious – in 5-26 %, thrombotic – in 2-26 %. Complications of IT are classified into the complications due to violation of the rules of administration (hematoma, tissue damage, thrombophlebitis (septic, mechanical and chemical), embolism) or blood composition disorders (acidosis, blood thinning), as well as overdose, and specific complications (anaphylactic shock, pulmonary edema, hyperthermia). Anaphylaxis most often accompanies the introduction of nonsteroidal anti-inflammatory drugs, antibiotics, muscle relaxants, radiocontrast, hypnotics, etc. The first line of treatment of anaphylactic shock involves drug discontinuation, intravenous adrenaline, 100 % oxygen, rapid intravenous infusion of crystalloids, in case of bronchospasm – 2-3 inhalations of salbutamol. Additionally, antihistamines and glucocorticoids may be prescribed. Conclusions. 1. IT is an integral part of the modern treatment process and the most common method of treatment in the hospital. 2. In IT, it is advisable to use several drugs, which reduces the number and severity of side effects. 3. Potential IT risks for healthcare professionals include ANI and blood contact. 4. Injection safety requires three components: safe solution preparation, safe injection, and safe disposal. 5. Complications of IT are divided into complications due to violations of the rules of installation or violation of blood composition, as well as overdose, and specific complications. 6. Anaphylaxis often accompanies the introduction of nonsteroidal anti-inflammatory drugs, antibiotics, muscle relaxants, radiocontrast, hypnotics, etc.

Confound it: latent lessons from the Mwanza trial of STD treatment to reduce HIV transmission

2003 ◽  
Vol 14 (3) ◽  
pp. 179-184 ◽  
Author(s):  
David Gisselquist ◽  
John J Potterat
Keyword(s):  
Sexually Transmitted Disease ◽  
Hiv Transmission ◽  
Additional Data ◽  
Transmitted Disease ◽  
Published Data ◽  
Hiv Incidence ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Safe Injection ◽  
Injection Safety

In 1995, an international team reported that improved syndromic management of sexually transmitted disease (STD) in Mwanza, Tanzania, had reduced HIV incidence by 38% in intervention compared to control communities. However, the team has not addressed confound: project interventions might have reduced HIV transmission during health care through provision of syringes and benzathine (replacing short acting) penicillin and through interactions with a coeval safe injection initiative. Mwanza's success in lowering HIV incidence is a puzzle, since it was achieved with only minor reductions in observed STD prevalence. Despite incomplete analyses, reports from Mwanza have encouraged expansion of STD treatment. However, should success be attributed to injection safety rather than to decreased STD prevalence — an hypothesis that fits published data — expanded STD treatment without attention to injection safety could, ironically, increase rather than decrease HIV incidence. To control for confound, additional data and analyses from the Mwanza study are warranted.

scholarly journals Current Drugs with Potential for Treatment of COVID-19: A Literature Review

2020 ◽  
Vol 23 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Md Insiat Islam Rabby
Keyword(s):  
Clinical Trial ◽  
Severe Acute Respiratory Syndrome ◽  
Laboratory Tests ◽  
Literature Search ◽  
Treatment Process ◽  
Clinical Use ◽  
Animal Trial ◽  
Chinese Drugs ◽  
Inflammatory Drugs ◽  
Traditional Chinese Drugs

Purpose: SARS-CoV-2 first emerged in China in December 2019 and rapidly spread worldwide. No vaccine or approved drug is available to eradicate the virus, however, some drugs that are indicated for other afflictions seems to be potentially beneficial to treat the infection albeit without unequivocal evidence.   The aim of this article is to review the published background on the effectiveness of these drugs against COVID-19 Methods: A thorough literature search was conducted on recently published studies which have published between January 1 to March 25, 2020. PubMed, Google Scholar and Science Direct databases were searched Results: A total 22 articles were found eligible. 8 discuss about treatment outcomes from their applied drugs during treatment of COVID-19 patients, 4 report laboratory tests, one report animal trial and other 9 articles discuss recommendations and suggestions based on the treatment process and clinical outcomes of other diseases such as malaria, ebola, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). The data and/or recommendations are categorized in 4 classes: (a) anti-viral and anti-inflammatory drugs, (b) anti-malaria drugs, (c) traditional Chinese drugs and (d) other treatments/drugs. Conclusion: All examined treatments, although potentiality effective against COVID-19, need either appropriate drug development or clinical trial to be suitable for clinical use.

scholarly journals Brief Report on Double-Chamber Syringes Patents and Implications for Infusion Therapy Safety and Efficiency

2020 ◽  
Vol 17 (21) ◽  
pp. 8209 ◽  
Author(s):  
Liliana B. Sousa ◽  
Paulo Santos-Costa ◽  
Inês A. Marques ◽  
Arménio Cruz ◽  
Anabela Salgueiro-Oliveira ◽  
...  
Keyword(s):  
Drug Administration ◽  
Data Extraction ◽  
Intravenous Drug ◽  
Standards Of Care ◽  
Infusion Therapy ◽  
Search Terms ◽  
Freeze Dried ◽  
Injection Safety ◽  
Current Standards ◽  
Double Chamber

This review aimed to map the existing patents of double-chamber syringes that can be used for intravenous drug administration and catheter flush. A search was conducted in the Google patents database for records published prior to 28 October 2020, using several search terms related to double-chamber syringes (DCS). Study eligibility and data extraction were performed by two independent reviewers. Of the initial 26,110 patents found, 24 were included in this review. The 24 DCS that were found display two or more independent chambers that allow for the administration of multiple solutions. While some of the DCS have designated one of the chambers as the flushing chamber, most patents only allow for the sequential use of the flushing chamber after intravenous drug administration. Most DCS were developed for drug reconstitution, usually with a freeze-dried drug in one chamber. Some patents were designed for safety purposes, with a parallel post-injection safety sheath chamber for enclosing a sharpened needle tip. None of the DCS found allow for a pre- and post-intravenous drug administration flush. Given the current standards of care in infusion therapy, future devices must allow for the sequential use of the flushing chamber to promote a pre-administration patency assessment and a post-administration device flush.

scholarly journals Factors influencing the efficacy of nonsteroidal anti-inflammatory drugs for acute low back pain. The results of the multicenter observational «CARAMBOL» (Clinical Analysis of Results of Analgesia by Meloxicam and its Safety in Acute Lumbodynia) study

2019 ◽  
Vol 13 (2) ◽  
pp. 31-37
Author(s):  
A. E. Karateev ◽  
A. M. Lila ◽  
E. Yu. Pogozheva ◽  
E. S. Filatova ◽  
V. N. Amirdzhanova
Keyword(s):  
Low Back Pain ◽  
Treatment Outcome ◽  
Pain Relief ◽  
Severe Pain ◽  
Muscle Relaxants ◽  
B Vitamins ◽  
Low Back ◽  
Factors Influencing ◽  
Inflammatory Drugs ◽  
Pain At Rest

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a main tool to treat acute nonspecific low back pain (NLBP). However, no factors that influence the efficacy of these drugs have been identified to the present day.Objective: to evaluate the therapeutic effect of and tolerance to NSAIDs (meloxicam) in treating acute NLBS and to identify the factors influencing the efficacy of this drug.Patients and methods. A study group consisted of 2078 patients (mean age 46.3±13.4 years; women 56.6%) with acute NLBS who had been treated in real clinical practice. The level of pain was estimated using a 0–10 point numerical rating scale (NRS). Initially, the pain level averaged 6.69±1.65 scores; 57.0% of patients were noted to have severe pain (≥7 NRS scores). Pain at rest persisted in 32.0% of patients; that at night was in 19.0%; sensation of stiffness in 60.7%, irradiation to the leg in 28.2%, and lumbar ischialgia in 9.6%. 70.2% of patients had been previously treated with NSAIDs for NLBS, while only 28.0% rated their efficacy as good. All the patients were prescribed meloxicam at a dose of 15 mg/day for a period of up to 2 weeks. 86.1% of the patients received meloxicam intramuscular for 2 days, then orally; 13.9% took the drug only orally. 52.3% of the patients also used muscle relaxants; 17.4% received oral or intramuscular B vitamins. The study estimated the rate of complete pain relief when NSAIDs were used for up to 2 weeks.Results and discussion. Complete pain relief was achieved in 75.2% of patients. 83.7% of patients rated the effect of treatment as good or excellent. Undesired drug reactions were recorded in 4.6% of patients. Female gender had no effect on treatment outcome (odds ratio (OR)=0.967; 95% confidence interval (CI), 0.795–1.177; p=0.763). Age over 65 years, the first NLBS episode, and a good NSAID effect in a history were associated with the best treatment result: OR=2.053 (95% CI, 1.5920–2.642), p<0.001; 1.415 (1.09–1.836), p=0.009; and 1.937 (1.513–2.481), p<0.001, respectively. Severe pain (≥7 NRS scores), persistent pain at rest and at night, and especially lumbar ischialgia indicated the worst result: OR=0.481 (95% CI, 0.393–0.588), p<0.001; 0.559 (0.441–0.709), p<0.001; 0.511 (0.413–0.631), p<0.001; and 0.346 (0.256–0.466), p<0.001, respectively. NSAIDs in combination with muscle relaxants and B vitamins versus NSAID monotherapy did not increase the likelihood of pain relief: OR=0.827 (95% CI, 0.594–0.889), p=0.02 and 0.917 (0.804–1.1201), p=0.452, respectively.Conclusion. Meloxicam at a dose of 15 mg/day is an effective and safe drug to treat acute NLBS. Patient gender has no effect on treatment outcome. Age over 65 years, the first NLBS episode, and a good response to NSAIDs in a history are associated with the best treatment results; and severe pain, persistent pain at rest and at night, irradiation to the leg, and lumbar ischialgia are related to the worst result. NSAIDs in combination with muscle relaxants and B vitamins did not improve treatment outcomes. 

scholarly journals Spinal pain: causes and treatment policy

2018 ◽  
Vol 12 (3) ◽  
pp. 53-60
Author(s):  
Yu. A. Olyunin
Keyword(s):  
Back Pain ◽  
Structural Changes ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Spinal Pain ◽  
Muscle Relaxants ◽  
Medical Problems ◽  
Relieve Pain ◽  
Inflammatory Drugs ◽  
Current Guidelines

Chronic pain in the spine is one of the most urgent medical problems. Clinical and instrumental studies fail to reveal that most patients with back pain have any structural changes that may contribute to its occurrence. It is considered that the pain may be caused by the strain of muscles and ligaments located in the lower back, by the overload of these segments, and by detraining. If the cause of the pain syndrome cannot be established, the pain in the spine is regarded as nonspecific. It is believed that behavioral, psychological, and social factors can play an important role in the development of pain. Therefore, current guidelines propose to apply a biopsychosocial approach in patients with back pain. At the same time, much attention is paid to patient self-treatment, exercise therapy, psychotherapy, and some other auxiliary methods. When nonpharmacological interventions are insufficiently effective, drug therapy is indicated. Nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, opioid analgesics, and muscle relaxants are used to treat nonspecific spinal pain. Pharmacotherapy is usually initiated with the use of NSAIDs. They can effectively relieve pain sndrome, but the possibilities of their use in a large proportion of patients are significantly limited due to adverse reactions (ARs). Gastrointestinal and cardiovascular ARs most commonly occur. The likelihood of ARs can be substantially reduced by the use of aceclofenac (AirtalR) that is characterized by a favorable gastrointestinal and cardiovascular safety profile. Paracetamol, opioid analgesics, and muscle relaxants are also used in the combination treatment of these patients.

scholarly journals Assessment of injection safety in Ha Dong General Hospital, Hanoi, in 2012

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1003 ◽  
Author(s):  
Phan Van Tuong ◽  
Tran Thi Minh Phuong ◽  
Bui Thi My Anh ◽  
Trang Huyen Thi Nguyen
Keyword(s):  
General Hospital ◽  
Target Population ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
The Body ◽  
Lower Amount ◽  
Cross Sectional ◽  
Injection Practice ◽  
Safe Injection ◽  
Injection Safety

Background: Injection is one of the most frequently used medical methods to introduce drugs or other substances into the body for purposes of treatment or prevention. Unsafe injection can cause adverse outcomes, such as abscess and anaphylactic shock, and increases the risk of blood-borne transmission of viruses to patients and health care workers, as well as the community. Recognizing the importance of injection safety, in 2000 the Vietnamese Ministry of Health (MOH) collaborated with the Vietnam Nurses Association to launch the “Safe injection” program throughout the country, including Hanoi. Methods: This cross-sectional study, combining quantitative and qualitative analysis, was conducted from February to August 2012 in Ha Dong General Hospital using a structured questionnaire and observation checklist. The target population of the study was 109 nurses working in clinical departments and 436 injections were observed. Results: The percentage of nurses who are familiar with injection safety standards was found to be 82.6%. The proportion of practical injections that met the 23 standards of injection safety set by the MOH amounted to 22.2%. The factors related to safe injection practice of nurses who are younger age group (OR=3.1; p<0.05) and lower amount of working years (OR=2.8; p<0.05). Conclusions: A low proportion of nurses performed correct safety injection practice, which raises the need for further training about this issue, especially among older nurses.

scholarly journals A study on assessment of safe injection practices among internees in government general hospital, Kakinada, Andhra Pradesh, India

2017 ◽  
Vol 4 (11) ◽  
pp. 4321
Author(s):  
Sujatha Peethala ◽  
Sridevi Garapati
Keyword(s):  
General Hospital ◽  
Andhra Pradesh ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Safe Disposal ◽  
Safe Injection ◽  
Unsafe Injection ◽  
Injection Safety ◽  
Injection Practices

Background: Injections are commonly used in healthcare settings for the prevention, diagnosis, and treatment of various illnesses. Unsafe injection practices put patients and healthcare providers at risk of infectious and non-infectious adverse events. Safe injection practices are part of standard precautions and are aimed at maintaining basic levels of patient safety and provider protections. Objectives of this study were to assess the knowledge and observe safety practices while giving the injections.Methods: A cross-sectional study conducted among 200 internees in Government General Hospital, Kakinada, Andhra Pradesh in the months of January and February 2010. Data was obtained by semi- structured questionnaire; analyzed by using SPSS software version16.0 at p<0.05 significance level.Results: In the present study, knowledge of internees was enquired into and practices were also observed in various aspects of injection safety. Knowledge on washing hands before giving injection was 64% but when it comes to practice, it was only 29%; knowledge on use of hub-cutter after giving injection was found to be 48% but in practice hub-cutter use was observed to be very less (5.5%); knowledge on safe disposal of used syringes was 42% but only 9.0% were practicing safe disposal. Similarly knowledge on use of color coded bags according to guidelines was 40.5% and in practice it was observed to be 14%.Conclusions: In the present study knowledge and practices on injection safety was found to be poor; dissemination of IEC, behavior change campaigns and continuing education on universal precautions and proper disposal of injection related waste was recommended. 

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