Pattern of triptan use and cardiovascular coprescription: a pharmacoepidemiological study in Italy

Purpose  

We evaluated the incidence, prevalence, and patterns of triptan use with a special focus on patients who also received cardiovascular drugs, considered as a deviation from appropriate triptan use.     

Managing hypertension among nursing-home residents and community-dwelling elderly in Germany: a comparative pharmacoepidemiological study

Purpose  

The purpose of this study was to investigate the adequacy of hypertension management in hypertensive elderly living in long-term-care facilities compared with home-living elderly.     

The use of a large pharmacoepidemiological database to study exposure to oral corticosteroids and risk of fractures: validation of study population and results

Purpose — The objective of this study was an evaluation of the sensitivity of findings of the relationship between oral corticosteroid use and the risk of fracture. We found in earlier work that the risk of fracture was significantly higher during oral corticosteroid treatment, with increases of 61% in hip and 160% in vertebral fractures. Methods — Information was obtained from the General Practice Research Database which contains medical records of general practitioners in the UK. The study included 244,235 oral corticosteroid users and 244,235 controls. Results — The validation of fracture cases showed that the hip fractures, as recorded in the GPRD, were confirmed by the GP on the questionnaire in 90.7% of the cases and by discharge summary in 86.5%. The relative rate of non‐vertebral fracture during oral corticosteroid use did not vary substantially between patients with different diseases, age, or gender. The sensitivity analysis, modifying the type of analysis or inclusion of patients, did not materially change the findings. Conclusions — We found a high level of validity of the GPRD with respect to hip and vertebral fractures. The sensitivity analysis indicated internal validity and consistency of the findings on fracture risks of oral corticosteroid therapy. Copyright © 2000 John Wiley & Sons, Ltd.     

Use of reboxetine in bulimia nervosa: a pilot study

The pharmacological approach to bulimia nervosa is mainly based (BN) on selective serotonin reuptake inhibitors, but many elements suggest the possible involvement of the noradrenergic system in this disorder. The aim of the study was to assess the efficacy of reboxetine--a selective norepinephrine uptake inhibitor--in a sample of bulimic outpatients, after 3 months of treatment. Twenty-eight of 77 consecutively admitted patients with a DSM-IV diagnosis of BN (without Axis I comorbidity) received reboxetine. All patients were assessed at baseline (T0), and after 1 month (T1) and 3 months (T3), respectively, of treatment with reboxetine 4 mg/day. The subjects were administered the following questionnaires: Hamilton Rating Scale for Anxiety (HAM-A) and for Depression (HAM-D), Global Assessment Functioning (GAF), Eating Disorder Inventory-2 (EDI-2) and Body Shape Questionnaire (BSQ). Sixty percent of the patients were responsive to treatment(evaluated as a 50% decrease of bulimic behaviours). After 3 months of treatment, a significant reduction emerged in the scores of various EDI-2 subscales (Bulimia, Drive for Thinness, Body Dissatisfaction, Social Insecurity, Interpersonal Distrust, etc.) and in the BSQ total score. Moreover, depressive symptoms (HAM-D) and Global Functioning (GAF) scores showed a significant improvement. These data support a fast and favourable effect of reboxetine in the treatment of BN, both on symptoms and psychopathological features. Moreover, the specific and strong action of reboxetine on improvement of social functioning is also supported in this disorder.     

The impact of antidepressant use on social functioning: reboxetine versus fluoxetine

Depression compromises affected individuals' functional well-being and impairs their level of social and workplace performance. Improved social functioning in depressed patients may improve their work productivity. This study evaluated the differential effects of two antidepressants on social functioning outcomes for patients with major depression comparing reboxetine, a non-tricyclic, selective noradrenaline reuptake inhibitor and fluoxetine, a commonly prescribed selective serotonin reuptake inhibitor. A model using data from 284 depressed patients (138 reboxetine, 146 fluoxetine) in two 8-week clinical trials was developed to predict the percentage change over time in continuous outcome assessments as measured by a 21-item self-rating scale called the Social Adaptation Self-evaluation Scale (SASS). The percentage change from baseline SASS score was modelled as a function of both time-invariant and time-varying covariates. Results suggest that, by mid-study, the more severely ill subjects benefitted more from reboxetine treatment in terms of the outcome improvement rate and, by study-end, this effect also extended into the less severely ill population. In addition, a significant relationship was identified between the change in depression symptom severity as measured by the standard Hamilton Depression Rating Scale score and the change in social functioning per the SASS.     

Profound weight loss associated with reboxetine use in a 44-year-old woman

We report a case of significant weight loss experienced by a 44-year-old Caucasian woman treated with reboxetine. She was treated with this drug at 12 mg daily for a total duration of 11 months. During the corresponding period her body mass index (BMI) decreased from a baseline of 21.4 kg m(-2) to a low of 16.8 kg m(-2). Withdrawal of the drug led to a full recovery of her BMI. The strongest evidence linking reboxetine to this woman's weight loss laid in the fact that the re-introduction of the drug subsequently caused a similar negative impact in her BMI.     

Pregnancy outcomes following use of escitalopram: a prospective comparative cohort study

Escitalopram is a serotonin reuptake inhibitor prescribed for depression and anxiety. There is a paucity of information regarding safety in pregnancy. The objective of this study was to determine whether escitalopram is associated with an increased risk for major malformations or other adverse outcomes following use in pregnancy. The authors analyzed pregnancy outcomes in women exposed to escitalopram (n = 212) versus other antidepressants (n = 212) versus nonteratogenic exposures (n = 212) and compared the outcomes. Among the escitalopram exposures were 172 (81%) live births, 32 (15%) spontaneous abortions, 6 (2.8%) therapeutic abortions, 3 stillbirths (1.7%), and 3 major malformations (1.7%). The only significant differences among groups was the rate of low birth weight (<2500 g) and overall mean birth weight (P = .225). However, spontaneous abortion rates were higher in both antidepressant groups (15% and 16%) compared with controls (8.5%; P = .066). There were lower rates of live births (P = .006), lower overall birth weight (P < .001), and increased rates of low birth weight (<2500 g; P = .009) with escitalopram. Spontaneous abortion rates were nearly double in both antidepressant groups (15% and 16%) compared with controls (8.5%) but not significant (P = .066). Escitalopram does not appear to be associated with an increased risk for major malformations but appears to increase the risk for low birth weight, which was correlated with the increase in infants weighing <2500 g. In addition, the higher rates of spontaneous abortions in both antidepressant groups confirmed previous findings.     

Patterns of systemic antibiotic use in a tertiary hospital in Israel in the years 1998-2000

OBJECTIVES: To investigate the pattern of antibiotic use in the hospital over a 3-year period according to individual drugs and hospital departments. SETTING: 335 adult beds of a tertiary hospital in Northern Israel during the years 1998-2000. An antibiotic control policy restricts the use of the most expensive antibiotics and those with broad spectrum of activity and a major impact on bacterial resistance. METHODS: The ATC/DDD and DU 90% methodologies were used. The use of antibiotics was expressed as the number of defined daily doses (DDD) per 100 bed-days. RESULTS: The total antibiotic use varied during the study period from 93.7-101.0 DDD/100 bed-days (p < 0.1). Thirteen drugs accounted for 90% of the total volume. The use of broad spectrum penicillins was the highest of all drugs followed by cephalosporins and oral quinolones. The highest rates of antibiotic use were found in the departments of ENT, urology, gynecology and orthopedics and in the intensive care unit (ICU). The total restricted antibiotics use was 7.2 DDD/100 bed-days and was the highest in the ICU. CONCLUSIONS: The ATC/DDD methodology provided delineation and interpretation of antibiotic usage patterns in the hospital. Although the overall use is higher then that found in several reports from European hospitals, stratification by individual drugs and by hospital department yielded similar trends.     

A comparative trial use of sulpiride and risperidone in Huntington's disease: a pilot study

Sulpiride and risperidone treatment significantly improved the abnormal involuntary movements of two patients with Huntington's disease on both actometer and clinical assessments. However, treatment with risperidone, but not sulpiride, significantly improved the functional activities as assessed by the Functional Disability Scale. To the best of our knowledge this is the first report of the successful treatment of Huntington's disease with risperidone.     

2002-2006年我院麻醉药品应用分析

目的 评价我院麻醉药品的应用现状,为临床合理用药提供参考.方法 对我院2002-2006年门诊、住院药房麻醉药品的应用数据进行统计、分析.结果 麻醉药品用量及销售金额逐年上升,其中芬太尼透皮贴的用量及销售金额最大呈逐年上升趋势:哌替啶注射液用量逐年下降,结论我院麻醉药品使用基本合理,麻醉药品口服剂型和透皮贴剂将成为用药主流.