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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 44 (1993), S. 589-591 
    ISSN: 1432-1041
    Keywords: Metformin ; Lactic acidosis ; adverse drug reactions ; spontaneous reporting
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Since the withdrawal of phenformin in 1978, the use of metformin has increased from 13,500 to 22,00 patient years/year. During the period 1977–91 a total of 18 cases of metformin — associated acidosis was reported, of which 16 had lactic acidosis. The incidence of reported acidosis and lactic acidosis decreased from 1.50 cases per 10,000 patient years in 1977–81 to 0.24 cases per 10,000 patient years 1987–91, probably due to lower doses doses and reduced usage in the very old. All the reports described patients with several other concomitant diseases, mainly cardiovascular and renal, when the acidosis was diagnosed. It is important continuously to re-evaluate metformin therapy and to stop treatment at the onset of impaired renal or cardiovascular function.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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  • 2
    ISSN: 1432-1041
    Keywords: Post-marketing surveillance ; oral contraceptives ; record-linkage ; epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The Department of Drugs of the Swedish National Board of Health and Welfare undertook a study of the possibilities of a new scheme for post-marketing surveillance by means of prescription and register based epidemiological studies, primarily of combined oral contraceptives (COC). Based on available data on COC usage patterns and incidence rates of the disease at study, it was estimated that study periods, including the necessary time periods for disease development and generation of a sufficient number of cases, would amount to at least 1 to 13 years for cardiovascular outcomes and 8 to 17 years for reproductive cancers. Prospective and unbiased exposure ascertainment would be the most important advantage. However, delay in follow up, the need for extensive individual questionnaire probing and fear of violation of personal integrity could adversely affect the feasibility of the scheme. Chiefly on the grounds of the extended study periods and magnitude of the necessary infrastructure, it was not judged cost-effective to pursue such a scheme for COC exposure only. It was, however, suggested that it would be considered for epidemiological surveillance of other drugs that are commonly used and for which short term and frequent serious side effects are expected, as for instance lipid lowering compounds, beta-blockers, bensodiazepines and other psychotropic drugs.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 43 (1992), S. 211-214 
    ISSN: 1432-1041
    Keywords: Agranulocytosis ; Sulphasalazine ; Trimethoprimsulphamethoxazole ; case-control study ; drug monitoring system ; risk estimates ; sales and prescription data
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary A comparison has been made of risk estimates for agranulocytosis connected with sulphasalazine and trimethoprim-sulphamethoxazole (T-SM) therapy calculated from data in the Swedish Drug Monitoring System (“spontaneous” reports, sales and prescription information) and a population based case-control study (the IAAAS). The relative risk for agranulocytosis during sulphasalazine treatment was calculated to be 107 and 123 by the spontaneous reporting system and the case-control study, respectively. The corresponding excess risk in both systems was 1.5. For T-SM the relative risk was 17 in the spontaneous reporting system and 12 in the case-control study, while the excess risk calculated for 3 days of treatment was 0.9 in the spontaneous reporting system, and 1.6 for 3 or more days of treatment in the case-control study. It is concluded that the Swedish Drug Monitoring System gives an appropriate estimate of the risk of developing agranulocytosis in association with the two drugs studied.
    Type of Medium: Electronic Resource
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