scholarly journals Evaluation of the Medication Safety of Chemotherapy Drugs

2021 ◽  
Author(s):  
Sayna Jabalpeikar
Keyword(s):  
Bone Marrow ◽  
Side Effects ◽  
Medical Records ◽  
Medication Safety ◽  
Tertiary Care ◽  
Medication Administration ◽  
Chemotherapy Drugs ◽  
Prescription Errors ◽  
Total Percentage ◽  
Improvement Methodologies

To evaluate the medication safety of chemotherapy drugs at a tertiary care hospital, with complete reporting of prescription errors, classifying prescription errors, complete detailing of watched medication administration errors (MAEs) by nurses, ordering watched MAEs, and figuring improvement methodologies. Likewise, in relation to side effects, how to overcome side effects, which antiemetic treatments to use, how to survey the appropriateness of requesting and apportioning. An imminent, observational, non-interventional contemplate study was driven at the Oncology Department, Baptist Hospital, Bangalore for half a year. All the data was collected from patient medical records according to case record structure. An aggregate of 70 patients tolerating chemotherapy were observed for information on a sort of side effects, prescription missteps and other relevant information like demographic findings, treatments, and drugs used to manage the adverse effects (AEs) collected from the patient’s medical records. The data was characterized reliant on various parameters. The watched side effects according to different organ frameworks were orchestrated and appeared differently in relation to the distributed writing and bundle embeds. Among the 70 patients, 22 (31.4%) were males and 48 (68.57%) were females. Moreover, the age interval within these two groups was of 20–65. From the 70 patients, the number of chemotherapy cycles was of one for 14 (20%) patients, two for 16 (22.85%), three for 16 (22.85%), four for 5 (7.14%), five for 6 (8.57%), six for 9 (12.85%), and more than six for 4 (5.71%) patients, mostly due to maintenance chemotherapy. The evaluation of our information uncovered that the cancer with the most elevated predominance was breast cancer (24.28%), pursued by blood and bone marrow cancer (5.71%) in females, whereas in males were blood and bone marrow (4.28%), followed by lung cancer (2.85%), non-Hodgkin lymphoma (2.85%), and colon cancer (2.85%). The present study demonstrated that in both gender groups, the most influenced organ framework was gastro intestinal tract (GIT), trailed by skin and subcutaneous tissue, musculoskeletal, blood and nervous system. The most prescribed antiemetic drug was ondansetron (81.42%), and the normally endorsed chemotherapy agents in our setting were shown to be cisplatin (21.42%), carboplatin (17.14%), and paclitaxel (14.28%). The total percentage of errors on the 70 prescriptions was 24.28. Most of the errors were due to drug–drug interactions (10%). The total percentage of errors in drug administration performed by nurses was found to be 11.42%, out of which in 2.85% of the cases, it was used the wrong drug dose. The adverse impacts related with the usage of anticancer medication were surveyed for half a year. The AEs most commonly experienced suggest that for all intents and purposes, all the patients accepting cytotoxic drugs suffered at least one AE. The critical announced MAE rates on our hospital ward (0.04% of medication administration and 0.03% MAE/patient admission) send out an impression of being generally low due to the utilization of current security rules. Emphasize on deep understanding of MAE at individual foundations, is likely going to result in important procedure changes, improved effectiveness of MAE detailing, and various focal points.

Side Effects of Chemotherapy and Cancer Treatment in Tertiary Care Teaching Hospital

2016 ◽  
Vol 2 (1) ◽  
pp. 62-78
Author(s):  
. Hemraj ◽  
Raj Kumar ◽  
Sourabh Kosey ◽  
Amit Sharma ◽  
Nalini Negi
Keyword(s):  
Side Effects ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Informational Needs ◽  
Cross Sectional ◽  
Clinical Pharmacists ◽  
Medical College ◽  
Related Information ◽  
The Common ◽  
Chemotherapy Patients

To determine the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. This was a single center, observational cross-sectional study conducted at department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. A face to face interview was conducted. Information collected included chemotherapy related side effects after last chemotherapy experience, the most worrisome side effects, overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. In this study, hundred patients were enrolled out of them 48 were male and 52 were female. When differential calculations was done, common side effects or adverse effects of chemotherapy in the patients of breast, lung cancer, Ovarian Cancer, Colon cancer, Prostate cancer, Lymphoma Cancer, Cervix cancer where there is much irregular medicine intake 57.4% may be due to common problem of joint pain reported by all the patients under study, with the consecutive problem of nausea and vomiting. The high prevalence of chemotherapy related side effects among local patients is a major concern and findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists and physicians to help in side effect management. This study shows the common problems reported by the patients when they are suffering from cancer condition, according to their incidence perceptions as experienced by the patient, this will allow the physician and clinical pharmacist to effectively counsel and manage the common symptoms as reported prior to its occurrence in the patient, so that withdrawal can be checked.

Efficacy and safety of oral dapsone in acne vulgaris – experience of a tertiary care teaching hospital in central Lahore

2020 ◽  
Vol 14 (2) ◽  
pp. 87-90
Author(s):  
Sadaf Amin Chaudhry ◽  
Nadia Ali Zafar ◽  
Rabia Hayat ◽  
Ayesha Noreen ◽  
Gulnaz Ali ◽  
...  
Keyword(s):  
Side Effects ◽  
Therapeutic Option ◽  
Acne Vulgaris ◽  
Treatment Options ◽  
Tertiary Care ◽  
Poor Response ◽  
Global Assessment Scale ◽  
Severe Acne ◽  
Hematologic Profile

Background: Acne is the eighth most prevalent disease affecting 9.4% of the population worldwide and its prevalence in our country is estimated to be around 5%. Severe inflammatory acne is most likely to leave scars and in order to prevent facial disfigurement due to acne scarring, early treatment is desirable. Various treatment options have been formulated for acne, and are tailored according to the severity of the disease. Numerous clinical trials have been conducted till now, to determine the usefulness and side effect profile of such therapies, making acne treatment a highly studied area in dermatology. Objective of this study is to highlight the fact that oral Dapsone could be used as a cheaper alternate to isotretinoin in recalcitrant severe acne, especially in females where retinoids are sometimes contraindicated. Patients and methods: 51 patients, suffering from severe nodulocystic acne, fulfilling the criteria, were enrolled from the Department of Dermatology, Sir Ganga Ram Hospital, Lahore. All the study patients were given oral Dapsone 50mg for initial two weeks and then 100mg daily for the next 10 weeks along with oral cimetidine and topical clindamycin application twice daily. Investigator Global Assessment Scale (IGAS) was employed to measure effectiveness. The treatment was considered ʽeffectiveʹ if the patient achieves 2 or more than 2-grade improvement or almost clear or clear skin at the end of 12 weeks according to IGAS scale. The lesion counts were also done before the start of therapy (day 1) and at every two weeks follow up for 12 weeks. The change in lesion count observed between the baseline number and that seen at follow up visits was also used to evaluate the effectiveness of oral Dapsone. Safety was analyzed by fortnightly visits of the patients to look for any undesirable side effects and monitoring of the hematologic profile of the patients. Final follow up was done at the end of 16 weeks. Results: The study was conducted on 51 patients, with a ratio of 1:3 for males and females and a mean age of 25.2 years (SD ±5.81). At 12th week, patients had significant reduction in their acne lesions; with 7 patients (13.7%) showing completely clear skin, 17 patients (33.3%) had almost clear skin, 5 patients (9.8%) had 3-grade improvement. Twelve patients (23.5%) had 2-grade improvement from baseline score and only 2 patients (3.9%) had 1-grade improvement from baseline. Based on percentage reduction of lesions, excellent response was seen in 32 patients (62.7%), good response in 9 patients (17.6%), moderate response in 2 patients (3.9%), while no patient showed poor response. Dapsone was discontinued in 8 patients due to derangement of hematologic profile. Conclusion: Oral Dapsone, when given carefully, is a very effective therapeutic option in severe recalcitrant acne, with limited side effects.

Chemo-prophylaxis of COVID-19 with hydroxychloroquine: a study of health care workers attitude, adherence to regime and toxicities/side effects (Preprint)

2020 ◽  
Author(s):  
Debajyoti Bhattacharyya ◽  
Neeraj Raizada ◽  
Bharathnag Nagappa ◽  
Arvind Tomar ◽  
Prateek Maurya ◽  
...  
Keyword(s):  
Side Effects ◽  
Health Care Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perceived Threat ◽  
Care Hospital ◽  
Care Workers ◽  
Perceived Danger ◽  
Structured Questionnaire

BACKGROUND There are apprehensions among healthcare worker (HCWs) about COVID-19. The HCWs have been given hydroxychloroquine (HCQ) chemo-prophylaxis for seven weeks as per Government of India guidelines. OBJECTIVE To assess the apprehensions among HCWs about COVID-19 and to document accessibility, adherence and side effects related to HCQ prophylaxis in HCWs. METHODS A longitudinal follow up study was conducted in a tertiary care hospital. HCQ was given in the dose of 400 mg twice on day one, and then 400 mg weekly for seven weeks. 391 HCWs were interviewed using semi structured questionnaire. RESULTS 62.2% HCWs expressed perceived danger posted by COVID-19 infection. Doctors (54%) showed least acceptance and paramedics (88%) showed highest acceptance to chemo-prophylaxis. 17.5% participants developed at least one of the side effects to HCQ. Females and nursing profession were significantly associated with adverse effects. Common side effects were gastro-intestinal symptoms, headache and abnormal mood change. Most of these were mild, not requiring any intervention. Gender, professions and perceived threat of COVID-19 were significantly associated with acceptance and adherence to HCQ prophylaxis. CONCLUSIONS Two third of HCWs had perceived danger due to COVID-19. Three fourth of the HCWs accepted chemo-prophylaxis and four out of five who accepted had complete adherence to prophylaxis schedule. One out of five had developed at least one of side effects; however, most of these were mild not requiring any intervention.

scholarly journals The critical role of T cells in glucocorticoid-induced osteoporosis

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Lin Song ◽  
Lijuan Cao ◽  
Rui Liu ◽  
Hui Ma ◽  
Yanan Li ◽  
...  
Keyword(s):  
Bone Marrow ◽  
T Cells ◽  
Steady State ◽  
Side Effects ◽  
Critical Role ◽  
Wild Type ◽  
Receptor Activator ◽  
Steady State Levels ◽  
Induced Apoptosis

AbstractGlucocorticoids (GC) are widely used clinically, despite the presence of significant side effects, including glucocorticoid-induced osteoporosis (GIOP). While GC are believed to act directly on osteoblasts and osteoclasts to promote osteoporosis, the detailed underlying molecular mechanism of GC-induced osteoporosis is still not fully elucidated. Here, we show that lymphocytes play a pivotal role in regulating GC-induced osteoporosis. We show that GIOP could not be induced in SCID mice that lack T cells, but it could be re-established by adoptive transfer of splenic T cells from wild-type mice. As expected, T cells in the periphery are greatly reduced by GC; instead, they accumulate in the bone marrow where they are protected from GC-induced apoptosis. These bone marrow T cells in GC-treated mice express high steady-state levels of NF-κB receptor activator ligand (RANKL), which promotes the formation and maturation of osteoclasts and induces osteoporosis. Taken together, these findings reveal a critical role for T cells in GIOP.

scholarly journals Medical Trainee Continuity of Care Following Emergency Department Consultations in a Pediatric Hospital

2016 ◽  
Vol 8 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Kim Bjorklund ◽  
Emily A. Eismann ◽  
Roger Cornwall
Keyword(s):  
Emergency Department ◽  
Continuity Of Care ◽  
Broad Spectrum ◽  
Medical Records ◽  
Care Center ◽  
Tertiary Care ◽  
Well Being ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Medical Trainee

ABSTRACT Background The importance of continuity of care in training is widely recognized; however, a broad-spectrum assessment across all specialties has not been performed. Objective We assessed the continuity of care provided by trainees, following patient consultations in the emergency department (ED) across all specialties at a large pediatric tertiary care center. Methods Medical records were reviewed to identify patients seen in consultation by a resident or fellow trainee in the ED over a 1-year period, and to determine if the patient followed up with the same trainee for the same condition during the next 6 months. Results Resident and fellow trainees from 33 specialties participated in 3400 ED consultations. Approximately 50% (1718 of 3400) of the patients seen in consultation by a trainee in the ED followed up with the same specialty within 6 months, but only 4.1% (70 of 1718) followed up with the same trainee for the same condition. Trainee continuity of care ranged from 0% to 21% among specialties, where specialties with resident clinics (14.4%) have a greater continuity of care than specialties without resident clinics (2.7%, P < .001). Continuity of care did not differ between fellows (4.2%) and residents (4.0%, P = .87), but did differ between postgraduate years for residents (P < .001). Conclusions Trainee continuity of care for ED consultations was low across all specialties and levels of training. If continuity of care is important for patient well-being and trainee education, efforts to improve continuity for trainees must be undertaken.

scholarly journals A Preclinical Evaluation of the Antitumor Activities of Edible and Medicinal Mushrooms: A Molecular Insight

2017 ◽  
Vol 17 (2) ◽  
pp. 200-209 ◽  
Author(s):  
Thomson Patrick Joseph ◽  
Warren Chanda ◽  
Arshad Ahmed Padhiar ◽  
Samana Batool ◽  
Shao LiQun ◽  
...  
Keyword(s):  
Side Effects ◽  
Biological Activities ◽  
Genetic Alterations ◽  
In Vivo Models ◽  
Medicinal Mushrooms ◽  
Chemotherapy Drugs ◽  
Development Of Resistance ◽  
Preclinical And Clinical Studies

Cancer is the leading cause of morbidity and mortality around the globe. For certain types of cancer, chemotherapy drugs have been extensively used for treatment. However, severe side effects and the development of resistance are the drawbacks of these agents. Therefore, development of new agents with no or minimal side effects is of utmost importance. In this regard, natural compounds are well recognized as drugs in several human ailments, including cancer. One class of fungi, “mushrooms,” contains numerous compounds that exhibit interesting biological activities, including antitumor activity. Many researchers, including our own group, are focusing on the anticancer potential of different mushrooms and the underlying molecular mechanism behind their action. The aim of this review is to discuss PI3K/AKT, Wnt-CTNNB1, and NF-κB signaling pathways, the occurrence of genetic alterations in them, the association of these aberrations with different human cancers and how different nodes of these pathways are targeted by various substances of mushroom origin. We have given evidence to propose the therapeutic attributes and possible mode of molecular actions of various mushroom-originated compounds. However, anticancer effects were typically demonstrated in in vitro and in vivo models and very limited number of studies have been conducted in the human population. It is our belief that this review will help the research community in designing concrete preclinical and clinical studies to test the anticancer potential of mushroom-originated compounds on different cancers harboring particular genetic alteration(s).

1128 Total body irradiation (TBI) before bone marrow grafting (BMG): Analysis of late side effects

1995 ◽  
Vol 31 ◽  
pp. S236
Author(s):  
V. Fayrel ◽  
Th. Schmitt ◽  
J.L. Stephan ◽  
D. Guyotat ◽  
G. Puel ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Side Effects ◽  
Total Body Irradiation ◽  
Late Side Effects ◽  
Total Body ◽  
Bone Marrow Grafting ◽  
Late Side

scholarly journals Medication safety knowledge, attitude, and practice among hospital pharmacists in tertiary care hospitals in Saudi Arabia: a multi-center study

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Azizah AL-Mutairi ◽  
Isamme AlFayyad ◽  
Youssef Altannir ◽  
Mohamad Al-Tannir
Keyword(s):  
Saudi Arabia ◽  
Medication Safety ◽  
Positive Attitude ◽  
Health Care Systems ◽  
Tertiary Care ◽  
World Health ◽  
Cross Sectional ◽  
Hospital Pharmacists ◽  
Adr Reporting ◽  
Tertiary Care Centers

Abstract Background Pharmacovigilance (PV) demarcates all actions involving the detection and prevention of adverse drug reactions (ADR) for marketed drugs. However, ADRs are considerably underreported worldwide and continue to be a major concern to health care systems. This study aims to assess the knowledge, attitude, and perception of hospital pharmacists regarding medication safety concerning PV and ADRs across multiple tertiary care centers around Saudi Arabia. Methods This cross-sectional study was conducted between July 2019 and January 2020. Pharmacists working in the tertiary care centers of Riyadh City, Saudi Arabia were asked to participate in the study. A self-administered questionnaire was used to conduct this study, it consisted of: 63 questions out of which 19 questions were knowledge-based, 15 were attitude-based, and 29 were practice-based questions. Results A total of 350 pharmacists were distributed and 289 agreed to participate, giving a response rate of 82.6%. Most pharmacists were aware of the concept of VP and its functions (96.5%) and (87.2%), respectively. Moreover, 90% said that ADR can be preventable and non-preventable. However, the findings revealed inadequate knowledge about the overall PV field, where the majority of the pharmacists failed to correctly answer questions related to independent ADRs treatment, Augmented drug reaction, the international location of ADR, and the World Health Organization “online database” for reporting ADRs. Moreover, incomplete and/or wrong answers were recorded for questions that included single or multiple correct answers. Regarding the participants” attitude, 96.9% were interested in ADR reporting, agreeing that ADR is important to enable safe drug usage. Although a general positive attitude was recorded, pharmacists have stated that the three main barriers that hinder reporting ADRs are: unavailability of information about ADRs, lack of awareness about the need to report ADRs, and lack of time. Concerning practice, 69.2% said they received training in ADRs reporting, and 70% have reported ADRs more than once a week. Conclusion Surveyed pharmacists from Riyadh hospitals showed narrow knowledge of the PV field. However, a positive attitude and satisfactory practice was observed among pharmacists. These findings warrant the need for educational programs and an encouraging environment for ADR reporting to increase ADR reporting rates and support PV activities in Saudi Arabia.

scholarly journals Pictograms for Safer Medication Management by Health Care Workers

2016 ◽  
Vol 69 (4) ◽  
Author(s):  
Régis Vaillancourt ◽  
Annie Pouliot ◽  
Kim Streitenberger ◽  
Sylvia Hyland ◽  
Pierre Thabet
Keyword(s):  
Health Care ◽  
Medication Safety ◽  
Medication Management ◽  
Medication Administration ◽  
Delphi Process ◽  
Semiotic Analysis ◽  
Safety Issues ◽  
Personnel Infirmier ◽  
Nurses And Physicians ◽  
Pharmacy Technicians

<p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Inherent risks are associated with the preparation and administration of medications. As such, a key aspect of medication safety is to ensure safe medication management practices.</p><p><strong>Objective:</strong> To identify key medication safety issues and high-alert drug classes that might benefit from implementation of pictograms, for use by health care providers, to enhance medication administration safety. This study was the first step in the development of such pictograms.</p><p><strong>Methods:</strong> Self-identified medication management experts participated in a modified Delphi process to achieve consensus on situations where safety pictograms are required for labelling to optimize safe medication management. The study was divided into 3 phases: issue generation, issue reduction, and issue selection. Issues achieving at least 80% consensus and deemed most essential were selected for future studies. Retained issues were subjected to semiotic analysis, and preliminary pictograms were developed.</p><p><strong>Results:</strong> Of the 87 health care professionals (pharmacists, pharmacy technicians, nurses, and physicians) invited to participate in the Delphi process, 30 participated in all 3 phases. A total of 55 situations that could potentially benefit from safety pictograms were generated initially. Through the Delphi process, these were narrowed down to 10 situations where medication safety might be increased with the use of safety pictograms. For most of the retained issues, between 3 and 6 pictograms were designed, based on the results of the semiotic analysis.</p><p><strong>Conclusions:</strong> The pharmacists, pharmacy technicians, nurses, and physicians participating in this study reached consensus and identified 10 medication administration safety issues that might benefit from the development and implementation of safety pictograms. Pictograms were developed for a total of 9 issues. In follow-up studies, these pictograms will be validated for comprehension and evaluated for effectiveness.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte :</strong> Il y a des risques inhérents associés à la préparation et à l’administration de médicaments. Pour cette raison, l’un des principaux aspects de la sécurité des médicaments est d’assurer des pratiques de gestion des médicaments sécuritaires.</p><p><strong>Objectif :</strong> Déterminer les principales questions de sécurité des médicaments et les classes de médicaments de niveau d’alerte élevé pour lesquelles l’ajout de pictogrammes, destinés aux fournisseurs de soins de santé, permettrait de rendre l’administration de médicaments plus sécuritaire. La présente étude représentait la première étape dans l’élaboration de ces pictogrammes.</p><p><strong>Méthodes :</strong> Des professionnels qui se définissaient comme experts en gestion de médicaments ont participé à un processus Delphi modifié dans le but d’arriver à un consensus à propos des situations où des pictogrammes de sécurité doivent être ajoutés à l’étiquette afin d’optimiser la gestion sécuritaire des médicaments. L’étude a été divisée en trois phases : génération de questions de sécurité, élimination de questions de sécurité et sélection de questions de sécurité. Les questions qui atteignaient un consensus d’au moins 80 % et qui étaient considérées comme les plus essentielles ont été retenues pour des études ultérieures. Les questions de sécurité retenues ont été soumises à une analyse sémiotique, puis des ébauches de pictogrammes ont été créées.</p><p><strong>Résultats :</strong> Parmi les 87 professionnels de la santé (notamment des pharmaciens, des techniciens en pharmacie, du personnel infirmier et des médecins) invités à participer au processus Delphi, 30 ont pris part aux trois étapes. Au total, 55 situations pour lesquelles il pourrait être avantageux d’utiliser des pictogrammes de sécurité ont été générées au départ. Grâce au processus Delphi, ce nombre a été réduit à 10 situations pour lesquelles la sécurité des médicaments pourrait être accrue à l’aide de pictogrammes de sécurité. Pour la plupart des questions retenues, entre trois et six pictogrammes ont été conçus à l’aide des résultats de l’analyse sémiotique.</p><p><strong>Conclusion :</strong> Les pharmaciens, les techniciens en pharmacie, le personnel infirmier et les médecins qui ont participé à l’étude ont atteint un consensus sur dix questions au sujet de l’administration sécuritaire des médicaments pour lesquelles l’élaboration et la mise en place de pictogrammes de sécurité pourraient être avantageuses. Ensuite, des pictogrammes ont été conçus pour neuf questions au total. Dans les études ultérieures, il faudra évaluer l’efficacité des pictogrammes et s’assurer qu’ils sont interprétés correctement.</p>

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