Diuretics: Is non-prescription leave possible?

Relevance. Diuretics currently play an important role in modern clinical practice. However, at present, diuretics are increasingly used and not “for medical purposes”: to reduce excess weight for cosmetic purposes or by people involved in sports, in those forms where weight categories are provided, or to reduce the concentration of a prohibited substance in urine. In this case, diuretic therapy is associated with the development of a large number of undesirable drug reactions, the likelihood of which increases with the “over-the-counter” dispensing of drugs and, accordingly, with their uncontrolled consumption. Aim. Using an anonymous questionnaire to reveal the demand for diuretics among the visitors of Tyumen pharmacies and the readiness of pharmacists for their over-the-counter dispensing. Materials and methods: analysis of the results of an anonymous survey, visitors and employees of the pharmacy chain (n = 70) in Tyumen. Results. In 42.9% of cases, respondents applied for “over-the-counter” purchase of diuretics (no hard copy). All non-prescription consumers were of working age: 70% were between the ages of 30 and 60, and 30% were under 30. In 20% of cases, over-the-counter dispensing of diuretic drugs was denied by pharmacy staff. 12.5% of non-prescription consumers reported adverse drug reactions to diuretics. An anonymous survey of “non-prescription respondents” under 30 revealed that in 50% of cases, diuretics were used to eliminate edema, in 25% of cases – for weight loss for cosmetic purposes, and in 25% – for weight loss by people involved in sports. In 37.5% of cases, respondents noted the development of unwanted drug reactions in the form of arterial hypotension, seizures, and decreased performance. Conclusion. Non-prescription leave dispensing of diuretics is noted in 42.9% of cases. The main consumers of non-prescription leave diuretics are people of working age. There is a low awareness of consumers about adverse drug reactions of diuretics, which requires not only to limit the over-the-counter dispensing of this group of drugs, but also to educate the population about the dangers of self-medication.

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Self-Medication With Over-the-counter Medicines Among the Working Age Population in Metropolitan Areas of Thailand

Frontiers in Pharmacology ◽

10.3389/fphar.2021.726643 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sineenart Chautrakarn ◽

Waraporn Khumros ◽

Phanupong Phutrakool

Keyword(s):

Adverse Drug Reactions ◽

Metropolitan Areas ◽

Easy Access ◽

Drug Reactions ◽

Self Medication ◽

Over The Counter ◽

Medication Knowledge ◽

Antibiotic Drug ◽

Working Age ◽

Working Age Population

Background and Objectives: Self-medication with over-the-counter (OTC) medicines is becoming an increasingly popular practice around the world. The global prevalence rate of self-medication ranges from 11.2% to 93.7%, depending on the target population and country. However, there is a lack of data on the prevalence and practices of self-medication among the working-age population, particularly in Thailand metropolitan areas. The current study describes the prevalence of self-medication practices, adverse drug reactions and severity, reasons for self-medication, and basic medication knowledge among people of working age in metropolitan areas in Thailand.Methods: We conducted an online cross-sectional study between December 2020 and January 2021. Descriptive statistics were used to analyze self-medication data. A chi-square test was used to assess the association between self-medication and sociodemographic characteristics.Results: This study found high prevalence of self-medication among the working-age population in metropolitan areas of Thailand (88.2%). The most commonly used drug groups were NSAIDs (34.8%) and antibiotics (30.2%). Minor illness and easy access to pharmacies were the most common reasons for self-medication. Almost half of the participants&apos; illnesses (42.6%) for which they self-medicated were not always completely cured, necessitating treatment at a hospital or clinic. Although only a small number of participants (ranged from 0.6 to 6.6%) experienced adverse drug reactions as a result of self-medication, some had severe symptoms that disrupted their daily lives or required hospitalization. In terms of basic medication knowledge, we discovered that study participants misunderstood some antibiotic drug concepts.Conclusions: According to the study findings, it is recommended that more information about the risks of self-medication, drug adverse reactions, antibiotic stewardship, more supervision of the prohibition of over-the-counter drugs and selling practices, and adequate facilities for peoples access to medical services be provided at the policy level.

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Nimesulide induced toxic epidermal necrolysis: a rare case report

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20175223 ◽

2017 ◽

Vol 6 (12) ◽

pp. 2939

Author(s):

Vineet Kumar ◽

Manju Gari ◽

Kishor Chakraborty ◽

Ravi Ranjan ◽

Anshuman Chandra ◽

...

Keyword(s):

Toxic Epidermal Necrolysis ◽

Adverse Drug Reactions ◽

Drug Reactions ◽

Over The Counter ◽

Medical Practitioners ◽

Rare Case Report ◽

Prescribed Medicines ◽

Anti Fungal ◽

Possible Cause ◽

Antipyretic Action

Adverse drug reactions to the prescribed medicines are the major obstacles in continuation of drug treatment. Nimesulide, a selective cyclo-oxygenase (COX-2) inhibitor was first launched in Italy in 1985 and subsequently marketed in more than 50 countries including India. Due to its better and faster antipyretic action, it has gained popularity among physicians and paediatricians. Here, we report a case of 60 years old male patient who developed toxic epidermal necrolysis (TEN) following ingestion of tablet nimesulide. The patient was managed with parenteral corticosteroids, antibiotics, emollients, anti-fungal and supportive care. This case highlights the importance of nimesulide and other NSAIDs as possible cause of TEN. Nimesulide has never been approved in countries like USA, Canada, Britain, New Zealand, Australia. But in India it is available as over the counter drug and is used for various indications like fever, myalgia, arthralgia. Therefore, the drugs which are banned outside India should be used with caution and medical practitioners should report all the adverse drug reactions to such drugs.

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Diuretic Drug Utilization Study

Journal of Pharmacy Technology ◽

10.1177/875512259601200412 ◽

1996 ◽

Vol 12 (4) ◽

pp. 169-176

Author(s):

Jaime Torelló ◽

José A Durán ◽

María I Serrano

Keyword(s):

Adverse Drug Reactions ◽

Diuretic Therapy ◽

University Hospital ◽

World Health ◽

Drug Reactions ◽

Cardiac Symptoms ◽

Medicine Service ◽

Combined Use ◽

Health Organization ◽

The University

Objective: To evaluate the present use of diuretics in our institution, and determine the appropriateness of that use and the incidence of adverse reactions and interactions. Design: This retrospective study describes the indications for use of an identified drug or combination of drugs. By the time the data were collected, some patients had been discharged or had died. Setting: The study was carried out in a referral center, the University Hospital “Virgen Macarena,” Seville, Spain. Patients: All patients receiving diuretic therapy. Those undergoing hemodialysis or receiving home care were excluded from the study. Intervention: A therapeutic audit was performed using specific standards of reference. Two models were used — one for each of the most frequent indications, ascites and congestive heart failure (CHF). Main Outcome Measures: A structured protocol gathered data on (1) demographic characteristics, (2) causes of admission and pathologic antecedents, (3) diuretic treatment, (4) basic controls (24-h diuresis and daily basal weight), (5) clinical evolution, and (6) concurrent complementary studies. The protocol included a checklist of the most frequent adverse drug reactions and interactions whose degree of causality was determined by applying the modified algorithm of Karch-Lasagna, used in the World Health Organization voluntary reporting system of adverse drug reactions. Results: One hundred twenty-six patients (16% of total admissions) received diuretic therapy. Of these, 71% were analyzed; information in the medical records was incomplete for the rest (29%). Fifty-one percent of the patients were more than 60 years old. The most frequent admission diagnoses were cardiovascular (51.5%), followed by digestive (16.7%) diseases. A total of 134 cardiac symptoms was seen in 50 patients. The most notable were acute pulmonary edema (26%), ischemic cardiopathy (12%), and cardiogenic shock (8%). Most patients receiving diuretic therapy (47.3%) were admitted to the internal medicine service. The most-prescribed diuretic was furosemide (59%), followed by spironolactone (27%). The combined use of furosemide and spironolactone occurred in all but 1 of the patients with hepatic ascites (92%), whereas in those with CHF the figure for the combined use of furosemide and spironolactone fell to 38% (p = 0.001). In 63% of the patients with ascites, the spironolactone dosage was changed in the first 48 hours of treatment. There was a high percentage of deaths (21%) in the study patients. Conclusions: Therapeutic strategy often does not follow the guidelines laid down in the standards of reference on diuretic use in serious CHF and/or ascites in this institution.

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100TYPE A ADVERSE DRUG REACTIONS AND WEIGHT LOSS ARE CORRELATED IN IDIOPATHIC PARKINSON’S DISEASE IN SINGLE-CENTRE STUDY

Age and Ageing ◽

10.1093/ageing/afz064.01 ◽

2019 ◽

Vol 48 (Supplement_2) ◽

pp. ii30-ii30

Author(s):

B E Schroeder ◽

B Mohamed ◽

C Thomas

Keyword(s):

Parkinson’S Disease ◽

Weight Loss ◽

Parkinson's Disease ◽

Adverse Drug Reactions ◽

Idiopathic Parkinson’S Disease ◽

Drug Reactions ◽

Single Centre ◽

Centre Study ◽

Idiopathic Parkinson's Disease ◽

Single Centre Study

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Severe adverse drug reactions due to pseudoephedrine from over-the-counter medications

Contact Dermatitis ◽

10.1034/j.1600-0536.2002.470308_1.x ◽

2002 ◽

Vol 47 (3) ◽

pp. 165-182 ◽

Cited By ~ 14

Author(s):

H. Assier-Bonnet ◽

M. Viguier ◽

L. Dubertret ◽

J. Revuz ◽

J. C. Roujeau

Keyword(s):

Adverse Drug Reactions ◽

Drug Reactions ◽

Over The Counter

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Awareness of adverse drug reactions in third M.B.B.S students practicing self-medication

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20160127 ◽

2016 ◽

pp. 196-201

Author(s):

Shreyas Burute ◽

Ramchandra Burute ◽

Mangala Murthy ◽

Vitthal Karande ◽

Shraddha Pore ◽

...

Keyword(s):

Adverse Drug Reactions ◽

Drug Reactions ◽

Self Medication

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Adverse drug reactions and drug–drug interactions with over-the-counter NSAIDs

Therapeutics and Clinical Risk Management ◽

10.2147/tcrm.s79135 ◽

2015 ◽

pp. 1061 ◽

Cited By ~ 12

Author(s):

Nicholas Cooney ◽

Charles Pollack ◽

Paul Butkerait

Keyword(s):

Drug Interactions ◽

Adverse Drug Reactions ◽

Drug Reactions ◽

Over The Counter

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Frequency and Severity of Adverse Drug Reactions Due to Self-Medication: A Cross-Sectional Multicentre Survey in Emergency Departments

Drug Safety ◽

10.1007/s40264-013-0114-y ◽

2013 ◽

Vol 36 (12) ◽

pp. 1159-1168 ◽

Cited By ~ 25

Author(s):

Nathalie Asseray ◽

Françoise Ballereau ◽

Béatrice Trombert-Paviot ◽

Jacques Bouget ◽

Nadine Foucher ◽

...

Keyword(s):

Adverse Drug Reactions ◽

Emergency Departments ◽

Drug Reactions ◽

Self Medication ◽

Cross Sectional

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Nimesulide induced Stevens Johnson Syndrome: a case report

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20173303 ◽

2017 ◽

Vol 6 (8) ◽

pp. 2094

Author(s):

Shagupta A. Naikwadi ◽

Rupali B. Jadhav

Keyword(s):

Case Report ◽

Supportive Care ◽

Adverse Drug Reactions ◽

Stevens Johnson Syndrome ◽

Drug Reactions ◽

Over The Counter ◽

Johnson Syndrome ◽

Inflammatory Drugs ◽

Prescribed Medicines ◽

Possible Cause

Adverse drug reactions to the prescribed medicines are the major obstacles in continuation of drug treatment. Stevens- Johnson Syndrome (SJS) is a severe, episodic, acute mucocutaneous reaction which is most commonly elicited by drugs and occasionally by infections. Common drugs associated with SJS are sulphonamide antibiotics, anticonvulsants, non- steroidal anti-inflammatory drugs (NSAIDS) and allopurinol. Nimesulide is an NSAID with analgesic and antipyretic properties. Here, we report a case of 21 years old male patient who developed Stevens Johnson Syndrome following ingestion of tablet Nimesulide. The patient was managed with parenteral corticosteroids, antibiotics, emollients, and supportive care. This case highlights the importance of Nimesulide and other NSAIDs as possible cause of SJS. Nimesulide has never been approved in countries like USA, Canada, Australia. But in India it is available as over the counter drug and is used for various indications like fever, myalgia, arthralgia. Therefore, the drugs which are banned outside India should be used with caution and practitioners should report all the adverse drug reactions to such drugs.

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