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PubMed · 16566332

A quick fix?

Elizabeth Lynch
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Abstract

Recommendations from the National Institute for Health and Clinical Excellence say more people with high cholesterol levels should be prescribed statins. But some professionals have reservations. Currently 2 million people in England and Wales take statins. This figure will rise to 3.3 million with the change in threshold for statin treatment. The threshold for considering statin use has changed from a 30 per cent ten-year risk of developing cardiovascular disease to a 20 per cent or more risk. Statins in low dosage are available over the counter.

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Drug UtilizationEnglandHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaNonprescription DrugsPatient SelectionPractice Guidelines as TopicPractice Patterns, Physicians'Primary PreventionRisk FactorsWalesJournal Article

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Elizabeth Lynch. A quick fix?. https://doi.org/10.7748/ns.20.27.20.s27

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PubMed2006

[Determinants of diphemanil methylsulfate (Prantal) utilization: a survey of practice in the French neonatal and intensive care units].

UNLABELLED: Diphemanil methylsulfate (Prantal) is a quaternary ammonium with parasympathicolytic properties. It is used in premature and term neonates with bradycardias related to vagal hyper reflectivity (HRV). OBJECTIVES: To assess the use of Prantal in the French neonatal and intensive care units: its indications, its modalities of use, its side effects and the number of patients treated during 1 year (2004) in France. METHODS: A questionnaire was electronically sent to all neonatology units and all neonatal intensive care units in France. RESULTS: Among 202 units, 121 (60%) answered the questionnaire. Prantal was reported to be used in 51 (42.1%) units. Among them, 38 (31.4%) actually treated 169 patients in 2004 with a mean number of patients treated by unit of 4. The diagnostic of HRV was supported by: a history of malaise (84.3%), bradycardia (94.1%), oculocardiac reflex (74.5%), cardiac Holter (76.4%), cardiorespirographic recording (19.6%), esophageal pHmetry (35.2%) and esophageal fibroscopy (21.5%). The mean starting dosing was 4.7 mg/kg/d, the mean maximal dosing was 9 mg/kg/d and the mean daily intakes were initially 2.3 and secondary 2.9. Prantal dosing was adjusted to weight in 54.9%, every month in 85.7%. Treatment was stopped at the mean post-natal age of 6 months, mostly in a progressive manner and without monitoring help. CONCLUSION: Prantal was seldom used in 2004 in France for different reasons: HRV is an uncertain entity, the efficacy of Prantal has not been validated and atropinic side effects can be encountered.

Drug Utilization↗
PubMed2006

Changing patterns of drug utilization in a neonatal intensive care population.

Newborns in the neonatal intensive care unit (NICU) typically are exposed to a large number of drugs and are especially vulnerable to adverse drug reactions. It is important to review changes in drug use patterns periodically in the NICU to identify newly introduced drugs as well as drugs with increasing use. The objective of this study was to determine the changes in drug utilization patterns over a 7-year period in an NICU population. Drug utilization of 2332 neonates treated at an intramural NICU between January 1, 1997 and December 31, 1998, and 2691 neonates between January 1, 2001 and June 30, 2004 was analyzed using chi-square tests, T tests, and linear regression. There was an increased utilization of antibiotics, central nervous system drugs, endocrine agents, cardiovascular and gastrointestinal drugs, and a decreased utilization of ophthalmic drugs. No changes in nutritional, biological, renal, and pulmonary drugs were observed. Some individual drug changes include an increased use of vancomycin, cefepime, caffeine, and a decreased use of morphine. Significant changes in drug utilization patterns in an NICU were observed during a 7-year period. These data are useful in monitoring drug resistance patterns, adverse drug reactions, and prioritizing areas of relevant therapeutic research and educational programs.

Drug Utilization↗