Analysis of Influencing Factors of Acute Medication Poisoning in Adults in Emergency Department of Our Hospital from 2016 to 2019 and Observation of Curative Effect of Optimizing Emergency Procedures

Objective. This study analyzed the influencing factors of acute medication poisoning in adults in the emergency department of our hospital from January 2016 to December 2019 and observed the curative effect of optimizing emergency procedures on adult acute medication poisoning. Our results showed that, among all acute drug poisoning patients, the most common poisoning drug was sleeping pills (24.22%), followed by painkillers (20.31%) and antipsychotics (16.41%). Education level, drug category, drug source, drug dosage, unknown drug composition, and medication side effect were all influencing factors of acute drug poisoning. High school education level or below, self-purchasing medicine, medication overdose, unknown drug composition, and medication side effect were the risk factors of acute medication poisoning. In addition, after the nursing management of optimizing emergency procedures for this type of patients, the rescue time, observation time, and hospital stay of the patients had been shortened, the incidence of complications was low, the rescue success rate was high, and the clinical application effect was good.

Tolerance of aromatase inhibitors in post-menopausal patients with early-stage hormone receptor positive (HR+) breast cancer: A real-world retrospective analysis in a large oncotype database.

e12532 Background: Aromatase inhibitors (AIs) compose the backbone of adjuvant endocrine therapy for early-stage HR+ breast cancer. Prior studies have demonstrated equivalence in efficacy between aromatase inhibitors in current clinical use. Thus choice of aromatase inhibitors is initially influenced by provider patterns and tailored based on adverse side effects. This study retrospectively evaluates the prevalence of intolerance to AIs warranting a change in therapy. Methods: We identified 181 post-menopausal patients with early-stage, HR+ breast cancer within a database of women who underwent oncotype testing at a large, urban medical center, with 167 (92%) receiving an AI. Patients were excluded if they had received chemotherapy. The Kaplan-Meier method was used to estimate median duration of endocrine therapy (ET). The Fisher’s exact test was used to compare proportions of patients requiring a switch in adjuvant AI and the Wilcoxon rank-sum test was used to compare age distributions. Results: Of the patients identified, 153 (90%) had stage IA disease with a median oncotype RS of 19. 167 (92%) patients received an AI as adjuvant therapy. Median duration of endocrine therapy (ET) was 83.5 months, with over 90% of patients on ET more than 5 years. Among the 152 patients with available data on ET interruptions, 52 (34%) patients had a change or interruption in their ET of these 40 (77%) were attributed to a medication side effect. The AI prescribed most frequently as initial therapy was anastrozole 138/165 (84%). 33 (24%) of patients who received anastrozole required a drug switch within the class, (no sig difference based on initial adjuvant therapy; p=0.4281). 12 (7%) patients required a switch from an AI to tamoxifen at some point during therapy. Changes in AI adjuvant therapy were most commonly attributed to joint pains 24 (46%), followed by hot flashes 2 (4%) and weight gain, 2 (4%). There was no statistically significant difference in median age between patients who interrupted ET due to medication side effect or other reason; p=0.2906. Conclusions: This study enforces previous findings that a significant proportion of women require a change in their adjuvant ET, most commonly due to adverse medication effects such as joint pain. The majority of the women in this database were initiated on anastrozole as initial adjuvant ET of whom 24% required a drug switch.[Table: see text]

Portable Wireless Drowsiness Detector

Excess sleep results in drowsiness that's not the underlying disease.Drowsiness may cause additional symptoms, like forgetfulness or falling asleep at inappropriate times. The common examples are Sleep deprivation, alcohol or drug use, medication side -effect, an outsized meal or caffeine withdrawal. A number of the causes of the drowsiness are Lifestyle factors, psychological state, Medical Condition, Medications, Sleeping disorders. The prevailing method uses the photo-PLETHYSMOGRAPHY method. In our project we are going to detect the drowsiness, this we will detect the waveforms and transform the waveforms using ARDUINO software and determine the speed of drowsiness. Using GSM, just in case of drowsiness the notification or call is shipped to the respective registered number. The developed low-cost device could avoid complicated procedures and provides continuous monitoring of the drowsiness.

A case report of sweating caused by hydromorphone

Thermoregulatory control of shivering and sweating is a complex process that can be affected by centrally acting medications. Opioids, in particular fentanyl and methadone, have been associated with sweating, but it remains a relatively rare occurrence in clinical practice. Under-recognition of this medication side-effect may lead to patient discomfort as well as a potentially unnecessary work-up to determine the etiology of the sweating. Here, we discuss severe sweating caused by hydromorphone that resolved upon the medication's discontinuation.

PERCEPTION OF SUPERVISOR TAKING MEDICINE ABOUT THE SIDE EFFECT OF TUBERCULOSIS MEDICATION FOR PATIENTS

DOTS strategy is a short-term treatment guide with direct supervision by supervisor taking medicine for tuberculosis patients. Supervisors should know, understand, and be able to distinguish between mild and severe side effects of anti-tuberculosis drugs. The failure of Tb treatment depends on supervisor taking medicine. Currently, never been known the perception of supervisor taking medicine about tuberculosis medication side effect. The purpose of the research was to know the perception of the supervisor taking medicine about side effects for clients’ Tb treatment program in Blitar City. The research design used a descriptive. The result showed the perception of supervisor taking medicine about the side effects was as much as 54.5% in the right category and as much as 45.5% in the wrong category. The right category perception may be the supervisor taking medicine ever receive information of tuberculosis medication side effect at the public health center while take a drug. Recommendations for health workers are providing appropriate information to the supervisor taking medicine can be improved with technique of counseling and training so it can improve knowledge and expertise in the management of medication side effects.Key words: perceptions, supervisor taking medicine, Tuberculosis

Case Report: Non-infectious causes of palmoplantar rashes, what to consider

Background: Palm and sole skin eruptions have a broad differential diagnosis. It is particularly important to recognize common causes as well as their association with certain chemotherapy regimens such as Capecitabine. Case report: A 79-year-old woman presented with a painful rash on her hands and feet for 1 week. She had metastatic colon cancer and was in her third week of treatment with capecitabine. Her diagnosis was a medication side-effect from chemotherapy. Capecitabine was stopped and she had some clinical improvement over the next two days. She was discharged with oncology follow up for resumption of Capecitabine at a lower dose with improvement in her rash 3 weeks later. Discussion: Skin rashes are a commonly encountered complaint in patients in the inpatient and outpatient setting. It is important to maintain a broad differential diagnosis in those with rashes of the palmoplantar surfaces of the hands and feet. Recognizing skin changes as a possible manifestation of underlying malignancy or a medication side-effect is key in appropriate diagnosis and treatment.