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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 18 (1980), S. 9-15 
    ISSN: 1432-1041
    Keywords: fetus ; neonate ; oxazepam ; pethidine ; acetaminophen (paracetamol) ; glucuronides ; sulfates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Drug oxidations are catalyzed by the liver microsomal fraction of human fetuses but not by fetal livers from most experimental animals. In contrast, glucuronidation of some substrates is catalyzed by the rat fetal liver in late gestation but not in the human fetal liver. The deficient human fetal glucuronidation seems to be compensated for by early development of sulfation activity. The inconsistency of the results from animal fetuses and human fetuses shows that animal data have little relevance for the human fetus. No generalized statements can be made about drug disposition in the newborn infant as compared to adults. Although most drugs that are oxidized have prolonged plasma half-lives in the neonatal period there are examples of drugs with half-lives similar to, or even shorter than, the average half-lives in adults. Oxazepam is conjugated with glucuronic acid in adults. The neonatal plasma half-life of this drug is considerably prolonged. This is true also for its conjugate as would be expected from the immature renal function in newborns. Adequate pharmacokinetic information is a prerequisite for rational and safe drug treatment in the neonatal period.
    Type of Medium: Electronic Resource
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  • 3
    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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  • 4
    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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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 43 (1992), S. 413-415 
    ISSN: 1432-1041
    Keywords: Drug utilisation ; prescribing habits, developing countries, antimicrobials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Primary health centres provide health care to the majority of the population in developing countries. A drug utilization study was conducted for 1 y at two primary health centres in Pondicherry, India. Information on complaints, diagnosis and drugs prescribed was collected. From the 2953 prescriptions studied, it was found that on an average each patient received 2.71 drugs. Vitamins, antibiotics, analgesics and antihistamines were the most commonly used, accounting for more than 80% of the drugs prescribed. The antimicrobials which constituted one fourth of the drug consumption, comprised sulphonamides, tetracycline and cotrimoxazole. About half of the patients received injections, particularly of the vitamin B Complex and antibiotics. The results will be used to plan intervention strategies for the promotion of rational drug use.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 0952-6862
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Seeks to identify physicians' perceptions of possibilities and obstacles prior to implementing a computerised drug prescribing support system. Details a descriptive, qualitative study, with semi-structured individual interviews of 21 physicians in the Accident and Emergency Department of South Stockholm General Hospital. Identifies four descriptive categories for possibilities and obstacles. Concludes that gaining access to patient drug history enables physicians to carry out work in a professional way - a need the computerised prescription support system was not developed for and thus cannot fulfil. Alerts and producer-independent drug information are valuable in reducing workload. However, technical prerequisites form the base for a successful implementation. Time must be given to adapt to new ways of working.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Social Science & Medicine 31 (1990), S. 737-741 
    ISSN: 0277-9536
    Keywords: IFPMA code ; WHO guidelines ; advertisements ; developing country ; drug information ; drug utilization
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Social Science & Medicine 34 (1992), S. 307-315 
    ISSN: 0277-9536
    Keywords: Ayurvedic theory ; Western medicines ; compliance/non-compliance ; consultation ; culture ; drug utilization
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1573-8205
    Source: Springer Online Journal Archives 1860-2000
    Topics: Energy, Environment Protection, Nuclear Power Engineering , Physics
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1041
    Keywords: Key words Asthma ; General practice ; Educational in-tervenction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: To assess the effect of an intervention on general practitioners' (GPs) knowledge about the diagnosis and treatment of asthma, including the prescribing of anti-asthmatic drugs, and asthmatic patients' knowledge about their disease. Methods: The study took place in the south-west region of Stockholm County. In the area where the intervention took place (area 1), 44 GPs at 21 health centres were visited by a clinical pharmacologist and a pharmacist presenting oral and written information. The basic messages were: (1) the central role of inhaled glucocorticoids; (2) the use of peak expiratory flow (PEF) meters; and (3) the use of reversibility tests. In the control area (area 2), there were 19 GPs at nine health centres. The GPs knowledge about the intervention message was evaluated by a questionnaire pre- and post-intervention. The ratios of prescribed inhaled be β-adrenoceptor agonists to inhaled glucocorticoids were determined. At the 26 local pharmacies, all asthmatic patients who presented a prescription for anti-asthmatic drugs, issued at the 30 health centres, were given a questionnaire before and after the intervention regarding their knowledge of asthma and its treatment. Results: GPs in area 1 showed significantly more knowledge about item numbers 2 and 3 in the above-described intervention message than did the GPs in the control area 2. The data on prescriptions showed lower ratios of β-adrenoceptor agonists to glucocorticoids in area 1 than in area 2. The difference, however, between area 1 and area 2 was not significant. After the GP intervention, the patients' knowledge about asthma had increased in area 1, as assessed by the questionnaire filled in by the patients. However, there was no significant difference from that in area 2. Conclusions: The study shows differences between the intervention and control areas regarding the knowledge and practice of GPs after the intervention. We found changes in knowledge, attitudes and actual practice, the latter being measured by the prescriptions.
    Type of Medium: Electronic Resource
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