International journal of clinical pharmacy
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BACKGROUND National guidelines in Australia advise that patients should be stabilised on both individual antihypertensive medicines before initiating a fixed-dose combination (FDC) product. ⋯ A minority of patients initiated combination products after being stabilised on both individual medicines. Significant number had no prior history of antihypertensive use. One-third of FDC initiators still required additional antihypertensive medication concurrently with the FDC product at 12 months post initiation.
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When patients are admitted to, and discharged from hospital there is a high chance of discrepancies and errors occurring during the transfer of patients' medication information. This often causes drug related problems. Correct and fast communication of patients' medication information between community pharmacy and hospital is necessary. ⋯ Many discrepancies were found between different information sources at patient discharge from hospital. A majority of the discrepancies had their origin in hospital information. The number of medicines after discharge was related to the number of discrepancies found. The medication reconciliation process took an average of 45 minutes per patient.
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Prescribing errors are common in hospital inpatients. However, the literature suggests that doctors are often unaware of their errors as they are not always informed of them. It has been suggested that providing more feedback to prescribers may reduce subsequent error rates. Only few studies have investigated the views of prescribers towards receiving such feedback, or the views of hospital pharmacists as potential feedback providers. ⋯ Feedback on prescribing errors was valued and acceptable to both professional groups. From the results, several suggested methods of providing feedback on prescribing errors emerged. Addressing barriers such as the identification of individual prescribers would facilitate feedback in practice. Research investigating whether or not feedback reduces the subsequent error rate is now needed.
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Comparative Study
Evaluation of unlicensed and off-label antiepileptic drugs prescribed to children: Brazilian Regulatory Agency versus FDA.
Epileptic seizures are neurological disorders common in children; 4 to 10% of under 16-year olds have suffered at least one seizure. Antiepileptic drugs represent the basis of treatment for the majority of patients, but many of the drugs prescribed to pediatrics are used unlicensed and off-label. ⋯ Old-generation antiepileptic drugs are widely prescribed to children. The results found for the use of off-label drugs demonstrate the absence of uniformity in action between the agencies and a lack of integration between the studies carried out. Although legislation on the licensing of drugs aims to protect the patients from drugs that have not been scientifically evaluated, the scarcity of data about the safety of the therapeutic resources obliges the doctors to prescribe unlicensed and off-label antiepileptic drugs to the pediatric population.
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Case Reports Comparative Study
Unusual drug reaction between valproate sodium and meropenem.
We describe here a rare case in which valproic acid (VPA) levels were affected by ertapenem but not by meropenem even though ertapenem and meropenem are in the same carbapenem class. A 68-year-old Filipino male treated with valproate for epilepsy and ertapenem for an infectious disease had decreased VPA levels during the first day of ertapenem therapy. His VPA level increased soon after terminating ertapenem therapy. Two types of carbapenems had different drug reactions with concomitant use of VPA in this patient. ⋯ Closer monitoring of VPA concentrations are necessitated using carbapenems for treating infection in patients being administered VPA. Another option is the use of anti-epileptic drugs other than VPA if concomitant use with a carbapenem is warranted.