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  • 1
    ISSN: 1432-1041
    Keywords: Key words Chloroquine ; Malaria ; Pregnancy; blood pharmacokinetics ; prophylaxis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: Routine malaria prophylaxis with chloroquine (CQ) is recommended to pregnant semi-immune women in several countries in Africa. The dosage is empirically based. We investigated whether blood CQ concentrations and apparent oral blood clearance (CL/F) change during the course of pregnancy. We also studied whether malaria parasites could be detected together with low CQ blood levels. Methods: Forty nine semi-immune Tanzanian women were recruited in the 16th week of pregnancy. They were given 310 mg oral CQ base once per week as prophylaxis during the whole pregnancy. Capillary blood samples were taken for analysis of CQ before treatment and at weeks 26 and 36. Blood samples were dried on filter paper and analysed by HPLC. Blood was also drawn to detect occurrence of malaria parasites. Results: A total of 25 women fulfilled the sampling schedule. CL/F increased significantly from 160 ml ·  min−1 at week 26 to 180 ml · min−1 at week 36. In 7 of 25 women, CL/F increased 〉20%. Trough blood CQ concentrations, determined on four occasions at week 26 and at week 36 varied between 200 and 900 nmol · l−1. No statistically significant differences between occasions were seen. Malaria parasites were seen in two individuals early in pregnancy. Conclusion: Blood CQ CL/F showed a small increase during the course of pregnancy. The estimated mean blood CL/F values of 160 and 180 ml · min−1 (week 26 and 36, respectively) were higher than the mean CL/F of 125 ml · min−1 in non-pregnant individuals, published previously. Efficacy of higher dosages of CQ in malaria prophylaxis in pregnant women could, therefore, be evaluated in controlled trials in high-risk malaria areas.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 39 (1990), S. 463-467 
    ISSN: 1432-1041
    Keywords: Drug utilization ; prescribing practices ; inpatients ; placebo ; treatment perceptions ; Sri Lanka
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Few drug utilization studies have been conducted in Sri Lanka and they were register based. We wished to combine records with interviews to study drug use before hospital admission and drug prescribing in wards among 850 randomly chosen inpatients. Four institutions representing different levels of health care were studied. At the end of the study, all 25 practitioners involved were interviewed about how they perceived their prescribing practices. During the 48 h before admission drugs were used by 84% of the patients, of whom 73% took Western and 29% Ayurvedic drugs; combinations were common. The drugs most commonly named were aspirin and paracetamol. The medical records were an unreliable source of information in this respect. Infectious and parasitic disorders, together with respiratory diseases, constituted 40% of the diagnoses. The total number of prescriptions was 3,226. The number of drugs prescribed per patient varied between the institutions, the two extremes being the University (2.7) and the peripheral unit (5.1). Analgesics — antipyretics was the most commonly prescribed class at all institutions, 45.7% and 86%, respectively, of the patients being exposed to these drugs at the two institutions. The prescribing of antibiotics (53%) and antihistamines (65%) was considerably more common in the peripheral unit. The most commonly prescribed single drug products were paracetamol (31.3%), aspirin (20.9%), diazepam (21.8%), chloroquine (14.5%), ampicillin and multivitamins (both 12.6%). Most practitioners indicated deliberate use of active drugs as placebos, one drug chosen being vitamine. They were aware of the need for drug information from sources other than the industry. At the three large hospitals, generic prescribing and, with a few exceptions, the use of ‘essential drugs’ prevailed, as well as a low degree of polypharmacy.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 39 (1990), S. 469-473 
    ISSN: 1432-1041
    Keywords: children ; prescribing ; drug utilization ; developing countries ; drug policy ; antibiotics ; Sri Lanka
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Few drug utilization studies have been focused on children in developing countries, where they constitute a large part of the total population. The present study describes prescribing in 5 outpatient departments (15 practitioners) in an area of Sri Lanka over a period of seven months. It includes a random sample of 2484 paediatric consultations. On average, 2.7 drugs were prescribed per patient. With a few exceptions generic prescribing of oral drugs prevailed, and only 1% of the children were given injections. In all, 107 different products were used. Antipyretics, antihistamines, antibiotics and sulphonamides were the most commonly used classes of drugs, being prescribed for 40–50% of the children. Penicillin V represented 43% of the total antibiotic prescribing. Only 1.2% of the children and 0.5% of the infants were given tetracycline. Paracetamol was the preferred antipyretic drug in infants. The use of injectables and tetracycline in children has been reported to be common in other developing countries. The practitioners in Sri Lanka showed a more rational prescribing pattern with the exception of the frequent use of antihistamines, cough medicine and an antiflatulent. The need to develop a paediatric drug policy is discussed.
    Type of Medium: Electronic Resource
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