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Perception towards Insulin Therapy and Factors Related to Insulin Refusal among Insulin Naive Type 2 Diabetes Mellitus Patients in Primary Care Clinics PKD Lipis 初级保健诊所首次使用胰岛素的2型糖尿病患者对胰岛素治疗的认知及胰岛素拒绝的相关因素
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2021-07-31 DOI: 10.31436/JOP.V1I2.52
N. Zakaria, Narasimman Baskaran, Wan Lin Lim
Introduction: Insulin is one of the suggested treatments to prevent and reduce long-term diabetes complications. However, due to many factors such as socio-demographic factors, many Type 2 diabetes mellitus patients refuse this treatment. This study aimed to determine perception towards insulin among naive Type 2 diabetes mellitus patients, to calculate the prevalence of rejecting insulin therapy, and to find out factors related to the refusal.Materials and methods: This cross-sectional study involved 188 insulin naive Type 2 diabetes mellitus patients attending five primary health clinics in Lipis district, Pahang from October to November 2017. A five-point Likert Scale was used to determine perception towards insulin therapy and the Chi-square test was used to assess the proportion of acceptance of the therapy. Simple and multiple logistic regressions were utilised to study the associated factor(s).Results: Mean score of 60.5 ± 8.2 pointed towards a negative appraisal of insulin therapy. Embarrassment to inject in public (69.1%) and concern of frequent hypoglycaemia (52.7%) were the most common perception. Nearly half of the respondents (46.3%) refused insulin therapy upon suggestion. After adjusting the variables using multiple logistic regressions, only gender (Adjusted OR=0.20, 95% CI=0.10-0.40, p<0.001), educational level (Adjusted OR=0.17, 95% CI=0.06-0.50, p=0.001), age (Adjusted OR=1.04, 95% CI=1.01-1.08, p=0.012) and glycated haemoglobin level (Adjusted OR=1.33, 95% CI=1.07-1.67, p=0.013) remained significant.Conclusion: In conclusion, insulin refusal among insulin naive patients was common in Lipis with an overall negative perception towards therapy. By tailoring strategies according to the patient’s factors such as gender, educational level, age, and glycated haemoglobin level, the insulin refusal rate might decrease in the future.
胰岛素是预防和减少长期糖尿病并发症的建议治疗方法之一。然而,由于社会人口因素等诸多因素,许多2型糖尿病患者拒绝这种治疗。本研究旨在了解初发型2型糖尿病患者对胰岛素的认知,计算排斥胰岛素治疗的患病率,并找出排斥的相关因素。材料和方法:本横断面研究纳入了2017年10月至11月在彭亨州利皮斯区5个初级卫生诊所就诊的188名胰岛素初始型2型糖尿病患者。采用李克特五点量表来确定对胰岛素治疗的认知,采用卡方检验来评估接受治疗的比例。使用简单和多元逻辑回归来研究相关因素。结果:平均得分为60.5±8.2分,对胰岛素治疗评价为阴性。在公共场所注射时感到尴尬(69.1%)和担心经常出现低血糖(52.7%)是最常见的感受。近一半(46.3%)的受访者拒绝接受胰岛素治疗。在使用多元logistic回归调整变量后,只有性别(调整后OR=0.20, 95% CI=0.10-0.40, p<0.001)、教育程度(调整后OR=0.17, 95% CI=0.06-0.50, p=0.001)、年龄(调整后OR=1.04, 95% CI=1.01-1.08, p=0.012)和糖化血红蛋白水平(调整后OR=1.33, 95% CI=1.07-1.67, p=0.013)仍然具有显著性。结论:胰岛素初治患者中胰岛素拒绝在Lipis患者中普遍存在,且对治疗总体持负面看法。通过根据患者的性别、教育程度、年龄、糖化血红蛋白水平等因素来调整策略,胰岛素拒绝率可能在未来有所下降。
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引用次数: 0
Treatment of Chronic Refractory Cough in Adults: Focus on Neuromodulators and Other Therapeutic Modalities 成人慢性难治性咳嗽的治疗:关注神经调节剂和其他治疗方式
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-09-17 DOI: 10.1177/8755122520954866
C. O’Hare, Tashrique Rahman, N. Williams
Objective: To evaluate the literature and educate health care professionals about the different management options for chronic refractory cough (CRC). Data Sources: Searches were performed through MEDLINE (1966 to July 2020) using OVID and EBSCOhost and EMBASE (1947 to July 2020) using OVID. Search terms included chronic cough, neurogenic cough, neuromodulators, chronic cough management, and chronic cough treatment. References of all relevant articles were further used to obtain additional articles. Study Selection and Data Extraction: This review includes articles in the English language and human trial literature. Twenty-three trials explored the use of oral neuromodulators in the management of CRC. Data Synthesis: CRC is a poorly understood disease that may have a complex neuropathic etiology. Oral neuromodulators, such as amitriptyline, baclofen, gabapentin, and pregabalin, continue to be the most commonly used agents for the management of CRC. Alternative pharmacological therapies such as botulinum toxin, anesthetic agents (benzonatate, lidocaine), and narcotic agents have efficacy data, and further research into effective doses and routes of administration is warranted. Alternative nonpharmacologic therapies more commonly used included speech pathology treatment. Conclusion: Several medication and alternative treatment interventions may be effective in managing CRC. Current studies used wide dosing and titration strategies, making it challenging to standardize therapy. No consistent method of assessing cough reflex was used between studies, as well as a lack of consistent randomization and small sample sizes. Additional research is needed to standardize treatment durations, optimum doses, and place in therapy of the available interventions in the management of CRC.
目的:评价文献资料,教育卫生保健专业人员关于慢性难治性咳嗽(CRC)的不同治疗方案。数据来源:通过使用OVID的MEDLINE(1966年至2020年7月)和EBSCOhost和使用OVID的EMBASE(1947年至2020年7月)进行搜索。搜索词包括慢性咳嗽,神经源性咳嗽,神经调节剂,慢性咳嗽管理和慢性咳嗽治疗。进一步使用所有相关文章的参考文献来获取其他文章。研究选择和数据提取:本综述包括英文文章和人体试验文献。23项试验探讨了口服神经调节剂在结直肠癌治疗中的应用。资料综合:结直肠癌是一种鲜为人知的疾病,可能具有复杂的神经病变病因。口服神经调节剂,如阿米替林、巴氯芬、加巴喷丁和普瑞巴林,仍然是治疗结直肠癌最常用的药物。替代药物治疗,如肉毒杆菌毒素、麻醉剂(苯甲酸酯、利多卡因)和麻醉药有疗效数据,对有效剂量和给药途径的进一步研究是必要的。替代的非药物治疗更常用包括言语病理治疗。结论:几种药物和替代治疗干预措施可能有效地控制结直肠癌。目前的研究使用了广泛的剂量和滴定策略,使其标准化治疗具有挑战性。研究之间没有使用一致的评估咳嗽反射的方法,也缺乏一致的随机化和小样本量。需要进一步的研究来规范治疗时间,最佳剂量,以及在CRC管理中现有干预措施的治疗位置。
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引用次数: 2
Exploration of Body Habitus and Fluid Overload in Critically Ill Patients 危重病人体质与体液超载的探讨
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-09-11 DOI: 10.1177/8755122520957629
Peyton E. Moon, A. Newsome, W. Hawkins, Maitri Patel, S. Smith
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引用次数: 0
Increasing Naloxone Knowledge and Use Through Direct-to-Patient Education 通过直接对患者的教育增加纳洛酮的知识和使用
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-09-11 DOI: 10.1177/8755122520954218
Kathryn Litten, Lucas G. Hill, Aida Garza, M. Srinivasa
Background: In the United States, opioid overdoses account for 130 deaths daily. Barriers to obtaining naloxone, the drug-of-choice for opioid overdose reversal, include limited education, access, and perceptions of provider judgement. Objectives: This study aimed to assess the efficacy of mailed education about naloxone, with or without a live teaching seminar, to patients at risk for opioid overdose. Methods: This observational study was conducted in a federally qualified health system. A phone presurvey was administered to patients on long-term opioid therapy or with a diagnosis of opioid use disorder to assess opioid overdose-related knowledge. Subjects were mailed a handout about naloxone and an invitation to receive naloxone at no cost at a seminar. Three-month phone postsurveys were conducted. The primary outcome was change in mean knowledge score from presurvey to postsurvey. Secondary outcomes included scores on individual survey items, naloxone prescriptions provided, and overdose reversals reported. Results: Ninety-four patients received mailed education. Sixty-two subjects took presurveys and 23 took 3-month follow-up surveys. Five subjects attended the live seminar. The mean cumulative knowledge score improved by 8.7% from the presurvey to the postsurvey. During the study period, one new naloxone prescription was written and one overdose reversal was reported. Conclusion: Direct-to-patient mailed education slightly improved knowledge regarding naloxone and opioid overdose response, and it may have led to one successful overdose reversal. Mailing education to a larger population of patients at risk for opioid overdose may be necessary to observe a substantial clinical impact.
背景:在美国,阿片类药物过量每天导致130人死亡。获得纳洛酮(逆转阿片类药物过量的首选药物)的障碍包括教育、获取和对提供者判断的认知有限。目的:本研究旨在评估有或没有现场教学研讨会的邮寄纳洛酮教育对阿片类药物过量风险患者的疗效。方法:本观察性研究在联邦合格的卫生系统中进行。对长期接受阿片类药物治疗或诊断为阿片类药物使用障碍的患者进行电话调查,以评估阿片类药物过量相关知识。研究对象邮寄了一份关于纳洛酮的讲义,并邀请他们在研讨会上免费接受纳洛酮。进行了为期三个月的电话后调查。主要观察指标为调查前后平均知识得分的变化。次要结果包括个别调查项目的得分、提供的纳洛酮处方和报告的过量逆转。结果:94例患者接受了邮寄教育。62名受试者进行了问卷调查,23名受试者进行了为期3个月的随访调查。五名受试者参加了现场研讨会。平均累积知识得分从调查前到调查后提高了8.7%。在研究期间,新开了一张纳洛酮处方,并报告了一次过量用药逆转。结论:直接对患者进行邮寄教育,可以略微提高对纳洛酮和阿片类药物过量反应的认识,并可能导致一次成功的过量逆转。邮寄教育给更多有阿片类药物过量风险的患者可能是必要的,以观察实质性的临床影响。
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引用次数: 1
Assessing the Quality of Life in Patients With Polyarthralgia Based on 25-Hydroxycholecalciferol Levels 基于25-羟基胆骨化醇水平评估多关节痛患者的生活质量
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-08-25 DOI: 10.1177/8755122520952048
T. Baral, D. Laxmi, Mounika Pedada, N. Ganta, Wasim Feroz
Background Vitamin D deficiency is widespread, yet it is the most underdiagnosed and undertreated nutritional deficiency and has a very crucial clinical importance in today’s medical field. Objective To assess quality of life in patients with polyarthralgia based on 25-hydroxycholecalciferol (25-(OH)D) levels, which will help understand the importance of vitamin D in a broader sense. Methodology Our panel study was carried out in the department of orthopedics of a tertiary care hospital in southern India between October 1, 2018, and February 28, 2019. A total of 114 patients with polyarthralgia from the outpatient department were included in the study. Results In our study, there was a predominance of female patients (77.2%). Overall, 92.10% of our study population were aged between 21 and 60 years. The highest percentage of low vitamin D status was detected in unexplained polyarthralgia cases (52.63%), who did not have any comorbid condition except a low serum level of 25-(OH)D level. There was a strong association between quality of life, before and after supplementation of vitamin D (P < .0001), for every domain of the 36-item Short Form Survey. Conclusion The 36-item Short Form Survey analysis showed that the patients with polyarthralgia whose serum level of 25-(OH)D was found below the optimal range had dramatic improvement in their symptoms after vitamin D supplementation. Based on the findings of our study, we strongly recommend screening for vitamin D deficiency in those who are at risk, as features of low vitamin D are mostly reversible with proper supplementation.
维生素D缺乏症很普遍,但它是最未被充分诊断和治疗的营养缺乏症,在当今的医学领域具有非常重要的临床意义。目的评价25-羟基胆钙化醇(25-(OH)D)水平对多关节痛患者生活质量的影响,有助于从更广泛的意义上理解维生素D的重要性。我们的小组研究于2018年10月1日至2019年2月28日在印度南部一家三级医院的骨科进行。114例门诊就诊的多关节痛患者被纳入研究。结果本组以女性患者为主(77.2%)。总体而言,92.10%的研究人群年龄在21 - 60岁之间。原因不明的多关节痛患者中维生素D含量低的比例最高(52.63%),除血清25-(OH)D水平低外,无其他合并症。在36项简短调查的每个领域中,补充维生素D前后的生活质量之间存在很强的关联(P < 0.0001)。结论36项问卷调查分析表明,血清25-(OH)D水平低于最佳范围的多关节痛患者在补充维生素D后症状明显改善。根据我们的研究结果,我们强烈建议对那些有维生素D缺乏症风险的人进行筛查,因为维生素D不足的特征在适当的补充下大多是可逆的。
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引用次数: 0
Implications of Glycopeptide and Lipopeptide Antibiotics on Asthma Exacerbations in a Patient With Hyper-IgE Syndrome and Chronic Severe Asthma: A Case Report 糖肽类和脂肽类抗生素对高ige综合征合并慢性严重哮喘患者哮喘加重的影响:1例报告
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-08-14 DOI: 10.1177/8755122520949589
Justin P. Reinert, Kevin J. Burnham
Objective: To review and consider the immunomodulatory ramifications of glycopeptide and lipopeptide antibiotics in a patient with severe asthma, hyper-immunoglobulin E (IgE) syndrome, and osteonecrosis of the jaw. Case Summary: A 36-year-old male patient with a pertinent past medical history of hyper-IgE syndrome, severe asthma, and osteonecrosis of the jaw attributed to steroid use initially presented to the emergency department, where imaging of the jaw suggested an infectious process. Following months of vancomycin therapy as an outpatient, the patient was switched to daptomycin to facilitate once-daily infusions. Following this change, the patient experienced significantly less asthma exacerbations and fewer admissions to the hospital for asthma-related issues. Discussion: Though daptomycin is associated with eosinophilia, and this patient’s eosinophil counts did increase while on the drug, an inverse relationship developed concerning the number of hospital admissions for asthma exacerbations. A review of the literature indicates that select glycopeptides, such as vancomycin, have pro-inflammatory effects, while other related drugs, such as the lipopeptide daptomycin, may not result in clinical manifestations of an inflammatory process. Tumor necrosis factor-α, interleukin-1β, and interleukin-6 have been implicated in this process. This patient may have been particularly susceptible to the effects of the glycopeptides due to his diagnosis of hyper-IgE syndrome, which has been independently associated with reactive airway diseases. Conclusion: Cytokine migration and activation by select glycopeptide and lipopeptide antibiotics warrant consideration from clinicians when determining the most appropriate treatment regimens. Further research is required to elucidate whether the pro-inflammatory properties of vancomycin warrant a change in first-line therapy to daptomycin in select cases.
目的:回顾和考虑糖肽和脂肽抗生素对严重哮喘、高免疫球蛋白E (IgE)综合征和颌骨骨坏死患者的免疫调节作用。病例总结:一名36岁男性患者,既往有高ige综合征、严重哮喘和因使用类固醇引起的颌骨骨坏死病史,最初被送到急诊科,在那里颌骨成像显示有感染过程。在门诊接受了几个月的万古霉素治疗后,患者改用达托霉素,以便每天输注一次。随着这一变化,患者的哮喘发作明显减少,因哮喘相关问题入院的人数也减少。讨论:尽管达托霉素与嗜酸性粒细胞增多有关,并且该患者的嗜酸性粒细胞计数确实在用药期间增加,但与哮喘加重住院次数呈反比关系。文献综述表明,某些糖肽如万古霉素具有促炎作用,而其他相关药物如脂肽达托霉素可能不会导致炎症过程的临床表现。肿瘤坏死因子-α、白细胞介素-1β和白细胞介素-6参与了这一过程。由于诊断为高ige综合征,该患者可能特别容易受到糖肽的影响,而高ige综合征与反应性气道疾病独立相关。结论:糖肽类和脂肽类抗生素对细胞因子迁移和激活的影响值得临床医生在确定最合适的治疗方案时加以考虑。需要进一步的研究来阐明万古霉素的促炎特性是否需要在特定病例中将一线治疗改为达托霉素。
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引用次数: 1
Ervebo (Ebola Zaire Vaccine, Live/rVSVΔG-ZEBOV-GP): The First Licensed Vaccine for the Prevention of Ebola Virus Disease Ervebo(埃博拉扎伊尔活疫苗/rVSVΔG-ZEBOV-GP):第一个获得许可的预防埃博拉病毒病的疫苗
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-08-14 DOI: 10.1177/8755122520950692
Chris Piszczatoski, J. Gums
Objective: To review the clinical data regarding the safety and efficacy of the Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) vaccine for the prevention of the Ebola virus disease. Data Sources: A literature search through PubMed, MEDLINE, and Cochrane Library was conducted for clinical trials published between January 2014 and June 2020 in the English language using the keywords Ervebo, rVSVΔG-ZEBOV, rVSVΔG-ZEBOV-GP, Ebola Zaire, and vaccine. Study Selection and Data Extraction: Articles were selected if they were related to the Food and Drug Administration (FDA) approval of Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) or provided novel data regarding this entity. Twelve articles noted in the FDA approval were chosen, along with 2 additional articles identified as providing novel information. Data Synthesis: The findings of the review show that Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) is a safe, immunogenic, and likely effective vaccine for the prevention of Ebola virus disease. Relevance to Patient Care and Clinical Practice: Ebola virus disease is highly infectious and often fatal. There have been multiple large outbreaks in the past 5 years, with no licensed treatments or vaccines. An effective vaccine could largely curtail current outbreaks and prevent further ones. Conclusion: The recent FDA approval of Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) offers the first approved vaccine for the prevention of Ebola virus disease. It has been shown to be safe, immunogenic, and likely effective for use in real-world applications for those at risk of contracting the disease.
目的:综述Ervebo(埃博拉扎伊尔活疫苗,rVSVΔG-ZEBOV-GP)疫苗预防埃博拉病毒病的安全性和有效性的临床资料。数据来源:通过PubMed、MEDLINE和Cochrane图书馆进行文献检索,检索2014年1月至2020年6月期间以英语发表的临床试验,检索关键词为Ervebo、rVSVΔG-ZEBOV、rVSVΔG-ZEBOV-GP、埃博拉扎伊尔和疫苗。研究选择和数据提取:选择与美国食品和药物管理局(FDA)批准的Ervebo(埃博拉扎伊尔疫苗,活疫苗/rVSVΔG-ZEBOV-GP)相关的文章,或提供有关该实体的新数据。FDA批准的12篇文章被选中,另外2篇文章被认为提供了新的信息。数据综合:审查结果表明,Ervebo(埃博拉扎伊尔活疫苗,rVSVΔG-ZEBOV-GP)是一种安全、具有免疫原性且可能有效的埃博拉病毒病预防疫苗。与病人护理和临床实践的相关性:埃博拉病毒病具有高度传染性,往往是致命的。在过去5年里发生了多次大规模疫情,没有获得许可的治疗方法或疫苗。一种有效的疫苗可以在很大程度上遏制目前的疫情,并防止进一步爆发。结论:最近FDA批准了Ervebo(埃博拉扎伊尔活疫苗,rVSVΔG-ZEBOV-GP),这是第一个被批准用于预防埃博拉病毒病的疫苗。它已被证明是安全的,免疫原性的,并且可能对那些有感染疾病风险的人在现实世界中的应用有效。
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引用次数: 12
Defining the Role of the Advanced Pharmacy Technician: Perspective Dissonance 定义高级药学技术人员的角色:视角失调
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-08-08 DOI: 10.1177/8755122520947637
Allison M. Dering-Anderson, Madeline Blaha, J. Neville
Background: Pharmacy technicians serve as pharmacist extenders. Attempts at advancing their practice have not been as rapid as the profession would prefer. We postulated that a barrier to this advancement is lack of agreement between pharmacists and technicians on how advancement should occur and on what it means. Objective: The objectives were to evaluate the differences in definitions and expectations of “technician advancement” between pharmacists and pharmacy technicians as potential impediments to advancement. Methods: Multimodal: An initial questionnaire for pharmacy technicians was collected during the American Association of Pharmacy Technicians Annual Convention to identify major topics for further survey. From those data, a survey was developed to ask pharmacists and pharmacy technicians about “technician advancement.” Surveys were provided to technicians in seminar settings; to members of the Nebraska Pharmacists Association; and via online platforms such as Facebook. Additionally, face-to-face targeted interviews were conducted with pharmacy technicians attending American Association of Pharmacy Technicians conventions and with the pharmacy technician and pharmacist leaders at the Nebraska Pharmacists Association. Results: Responses show that pharmacists’ expectations for advancing the practice of pharmacy technicians and the expectations of the technicians themselves vary widely. A notable finding is that 96% of all technicians responding see technician payment as a significant issue in advancement, while less than 4% of pharmacists commented on rate of pay. Conclusion: While both pharmacists and pharmacy technicians are hopeful for pharmacy technician role advancement, there is substantial disagreement about the definition of advancement that may be a barrier to the process.
背景:药学技术人员是药剂师的延伸者。推进他们的实践的努力并没有像业内人士所希望的那样迅速。我们假设这种进步的障碍是药剂师和技术人员之间缺乏关于进步应该如何发生以及它意味着什么的协议。目的:评价药师和药学技术人员对“技术人员晋升”的定义和期望的差异。方法:多模式:在美国药学技术人员协会年会上收集药学技术人员的初步问卷,以确定进一步调查的主要主题。根据这些数据,研究人员开展了一项调查,询问药剂师和药学技术人员关于“技术进步”的问题。在讨论会中向技术人员提供了调查;内布拉斯加州药剂师协会会员;以及通过Facebook等在线平台。此外,对参加美国药学技术人员协会会议的药学技术人员以及内布拉斯加州药剂师协会的药学技术人员和药剂师领导进行了面对面的有针对性的访谈。结果:调查结果显示,药师对推进药学技术人员实践的期望与药学技术人员自身的期望差异较大。一个值得注意的发现是,96%的技术人员认为技术人员的薪酬是晋升的重要问题,而不到4%的药剂师对薪酬率发表了评论。结论:药师和药学技术人员都对药学技术人员角色提升抱有希望,但对角色提升的定义存在重大分歧,这可能成为阻碍药学技术人员角色提升的障碍。
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引用次数: 0
Evaluation of the Safety and Efficacy of Metformin Use in Hospitalized, Non–Critically Ill Patients 二甲双胍在住院非危重患者中的安全性和有效性评价
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-03-13 DOI: 10.1177/8755122520911689
Tahnia Alauddin, Sarah E. Petite
Background: Contraindications and precautions to metformin have limited inpatient use, and limited evidence exists evaluating metformin in hospitalized patients. Objective: This study aimed to determine the safety and efficacy of inpatient metformin use. Methods: This study was an observational, retrospective, cohort study at an academic medical center between June 1, 2016, and May 31, 2018. Hospitalized adults with type 2 diabetes mellitus receiving at least 1 metformin dose were included. The primary endpoint was to identify hospitalized patients using metformin with at least 1 contraindication or precautionary warning against use. Secondary endpoints included assessing metformin efficacy with glycemic control, characterizing adverse outcomes of inpatient metformin, and comparing the efficacy of metformin-containing regimens. Results: Two hundred patients were included. There were 126 incidences of potentially unsafe use identified in 111 patients (55.5%). The most common reasons were age ≥65 years (47%), heart failure diagnosis (7.5%), and metformin within 48 hours of contrast (6%). Metformin was contraindicated in 2 patients (1%) with an estimated glomerular filtration rate ≤30 mL/min/1.73 m2. The overall median daily blood glucose was 146 mg/dL (interquartile range [IQR] = 122-181). Patients were divided into 3 groups: metformin monotherapy, metformin plus oral antihyperglycemic therapy, and metformin plus insulin. The median daily blood glucoses were 129 mg/dL (IQR = 110-152), 154 mg/dL (IQR = 133-178), and 174 mg/dL (IQR = 142-203; P < .001), respectively. Two patients (1%) developed acute kidney injury, and no patients developed lactic acidosis. Conclusions: Metformin was associated with goal glycemic levels in hospitalized patients with no adverse outcomes. These results suggest the potential for metformin use in hospitalized, non–critically ill patients.
背景:二甲双胍的禁忌症和注意事项限制了住院患者的使用,并且评估二甲双胍在住院患者中的应用证据有限。目的:本研究旨在确定住院患者使用二甲双胍的安全性和有效性。方法:本研究是一项观察性、回顾性、队列研究,于2016年6月1日至2018年5月31日在某学术医学中心进行。接受至少1剂二甲双胍治疗的住院成人2型糖尿病患者被纳入研究。主要终点是确定住院患者使用二甲双胍至少有一个禁忌症或预防性警告。次要终点包括评估二甲双胍与血糖控制的疗效,表征住院二甲双胍的不良结局,以及比较含二甲双胍方案的疗效。结果:纳入200例患者。111例患者中发现126例潜在不安全用药(55.5%)。最常见的原因是年龄≥65岁(47%)、心衰诊断(7.5%)和48小时内使用二甲双胍(6%)。2例(1%)估计肾小球滤过率≤30ml /min/1.73 m2的患者禁用二甲双胍。总体每日血糖中位数为146 mg/dL(四分位数范围[IQR] = 122-181)。患者分为3组:单用二甲双胍治疗、口服二甲双胍联合降糖治疗、二甲双胍联合胰岛素治疗。中位日血糖分别为129 mg/dL (IQR = 110-152)、154 mg/dL (IQR = 133-178)和174 mg/dL (IQR = 142-203;P < 0.001)。2例(1%)患者发生急性肾损伤,无患者发生乳酸酸中毒。结论:二甲双胍与住院患者的目标血糖水平相关,且无不良结局。这些结果提示二甲双胍在住院非危重患者中的应用潜力。
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引用次数: 1
The Efficacy of Flow Restrictors on Children’s Liquid Acetaminophen Products 流量限制器对儿童液体对乙酰氨基酚产品的影响
IF 1 Q4 PHARMACOLOGY & PHARMACY Pub Date : 2020-03-13 DOI: 10.1177/8755122520911208
Jacob Budnitz, Stephanie L Hon, J. Punzi
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引用次数: 1
期刊
Journal of Pharmacy Technology
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