DOCSLIB.ORG

The Long-Term Prescription of Benzodiazepines, Psychotropic Agents, to the Elderly at a University Hospital in Japan

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Long-Term Prescription of Benzodiazepines, Psychotropic Agents, to the Elderly at a University Hospital in Japan Tohoku J. Exp. Med., 2007,The 212Long-Term, 239-246 Benzodiazepine Prescription in the Elderly 239 The Long-Term Prescription of Benzodiazepines, Psychotropic Agents, to the Elderly at a University Hospital in Japan KYOKO NOMURA, MUTSUHIRO NAKAO, MIKIYA SATO and EIJI YANO Department of Hygiene and Public Health, School of Medicine, Teikyo University, Tokyo, Japan NOMURA, K., NAKAO, M., SATO, M. and YANO, E. The Long-Term Prescription of Benzodiazepines, Psychotropic Agents, to the Elderly at a University Hospital in Japan. Tohoku J. Exp. Med., 2007, 212 (3), 239-246 ── Benzodiazepines are useful and effec- tive psychotropic agents used worldwide. However, the long term use of the drugs can lead to serious adverse health effects such as psychomotor and cognitive impairment, espe- cially in the elderly. In Japan, there are very few reports concerning long-term use of ben- zodiazepines, and no countermeasures have been instituted. Thus, this study assessed the characteristics of long-term prescription of benzodiazepines at a university hospital in Japan. A cross-sectional study using the database of a computer ordering system examined 4,239 adult outpatients who were prescribed benzodiazepines at a university teaching hos- pital between July 2002 and June 2003. The patients were divided into two groups: those with long-term (≧ 3 months) and short-term (≦ 2 months) prescriptions. A logistic regression model was used to analyze the effect of patient age on long-term benzodiaze- pine prescription. Adjusting for patient gender, pharmacological half-life of the drug, and department group, a logistic regression model showed that long-term benzodiazepine pre- scription occurred more frequently in older patients (p < 0.0001 in trend tests) and varied according to the physician’s specialty (p < 0.0001). Benzodiazepines were more frequent- ly prescribed for long term in the elderly by internal medicine group (p = 0.003). Of the patients older than 71 years (n = 1,105), 86% were assigned to the long-term group and were more likely to have been prescribed benzodiazepines by an internist than a surgeon (p < 0.0001). The appropriate prescription of benzodiazepines in the elderly should be included in the educational programs at teaching hospitals, and rational prescribing needs to be monitored carefully. ──── benzodiazepine; computer ordering system; elderly; long-term prescription; university hospital © 2007 Tohoku University Medical Press Benzodiazepines are useful and effective are less toxic than barbiturates when they are used psychotropic agents used worldwide. Their thera- in overdose and have thus become one of the most peutic actions as anxiolytics, sedative hypnotics, prescribed classes of drugs. A literature (Woods anticonvulsants, and muscle relaxants have led to et al. 1992) reported that about 2% of the adult their use as first-line treatments. In addition, they populations in the United States (4 million peo- Received March 7, 2007; revision accepted for publication May 12, 2007. Correspondence: Kyoko Nomura, M.D., M.P.H., Ph.D., Department of Hygiene and Public Health, School of Medicine, Teikyo University, 2-11-1, Kaga, Itabashi, Tokyo 173-8605, Japan. e-mail: [email protected] 239 240 K. Nomura et al. The Long-Term Benzodiazepine Prescription in the Elderly 241 ple) and United Kingdom (1 million people) were is unclear if previous risk profiles are being con- prescribed benzodiazepines as hypnotics or tran- sidered in light of the long-term prescription of quilizers. In Japan, benzodiazepines are quite these drugs to this age group. Therefore, we popular in clinical practice, although a population- investigated long-term benzodiazepine prescrip- based survey needs to be conducted to determine tions especially to the elderly at a university the prevalence of benzodiazepine use in the gen- teaching hospital in Japan. eral population (Yamawaki 1999). In 1999, the Teikyo University School of Despite their usefulness, benzodiazepines Medicine installed a computer ordering system have serious adverse effects, including sedation, (COS), which has been used to monitor drug pre- psychomotor and cognitive impairment, and scriptions in every clinical department at the hos- memory loss, and they induce withdrawal reac- pital. Using data available through the COS, the tions and physical dependence (Nelson and university has launched several research projects Chouinard 1999). Hence, it has been recom- to study evidence-based health care services at the mended that their use be limited to short interven- hospital (Nakao et al. 2007). This study was part tions (Committee on Safety of Medicine 1988; of a project to assist physicians in developing Royal College of Psychiatrists 1988; Fick et al. more rational protocols for appropriate drug pre- 2003; Ashton 2005). Nevertheless, many epide- scription. miological studies (Magrini et al. 1996; Simon et al. 1996; Egan et al. 2000a, b; Gray et al. 2003; MATERIALS AND METHODS Fialova et al. 2005; Voyer et al. 2006) in Europe, Data set the United States, and Canada, have reported that We created a new data set of patient information benzodiazepines are prescribed for the long term, using Access 2000 (Microsoft Japan, Tokyo) based on especially to the elderly, women with psychologi- the original COS database accumulated at Teikyo cal problems and chronic physical diseases, and University Itabashi Hospital, Tokyo, Japan (1,154 hospi- users of long-acting type benzodiazepines. Of tal beds). This university teaching hospital has 19 these three types of users, the elderly constitute department clinics, with approximately 60,000 outpa- the most vulnerable population because the long- tients visiting annually. The variables retrieved from the term use of benzodiazepines increases the risks of COS database were patient gender and age, prescribing falls and fractures (Pierfitte et al. 2001; Wagner et department, benzodiazepine pharmacological half-life, al. 2004), and cognitive and memory changes and the date of benzodiazepine prescription. (Paterniti et al. 2002; Barker et al. 2004) that could dramatically decrease their quality of life. Patients Therefore, although the high prevalence of use Fig. 1 is a flow chart of our study subjects. The among the elderly has been reported repeatedly, it subjects consisted of 5,959 adult outpatients who had Fig. 1. A flow chart of the study subjects. 240 K. Nomura et al. The Long-Term Benzodiazepine Prescription in the Elderly 241 visited the hospital and were prescribed benzodiazepines room, plastic surgery, and cardiovascular surgery. The by physicians between July 2002 and June 2003. After internal medicine group consisted of the general internal excluding 1,720 patients who were prescribed benzodi- medicine and neurology departments. The psychiatry azepines at two or more different clinics, 4,239 patients group was composed of the psychiatry and mind/body (59% female, mean age 57 years) receiving benzodiaze- medicine departments, and the “other” group included pines were selected for the analyses. The patients were the pediatrics, dermatology, radiology, anesthesiology, divided into two groups depending on the prescription and rehabilitation departments and the hemodialysis length based on previous studies (WHO Collaborating center. Centre for Drugs 1996; Zandstra et al. 2002) ; the long- Although the diagnostic information was prelimi- term group consisted of those with prescription periods nary during the study period (the annual report of the of 3 months or more (mean ± S.D.: 8.0 ± 2.7 months) and hospital, unpublished), the major ICD-10 diagnoses in the short-term group had prescription periods of 2 internal medicine were angina pectoris, followed by months or less (1.4 ± 0.5 months). In Japan, according to chronic renal failure, primary lung cancer, old myocardi- the Health Insurance Law, physicians can write a pre- al infarction, and hepatocellular carcinoma, while those scription for hypnotics for up to 14 days; hence, patients in surgery were inguinal hernia, followed by gastric can- who take the drug continuously have to see a physician cer, breast cancer, pancreatic cancer, and hepatocellular at least twice a month. The data set used in this study carcinoma. The total number of new outpatients in the contained the date of prescription, and we defined the psychiatry group was 1,549, of which 19.5% had depres- prescription time period based on this date. sive disorders. During the study period, the numbers of physicians employed in the aforementioned groups were Benzodiazepines 190 in the internal medicine group, 354 in the surgery Referring to the Anatomical Therapeutic Chemical group, 60 in the psychiatry group and 84 in the other Classification System (WHO Collaborating Centre for department group. Drugs 1996) index groups, including N05BA (N = ner- vous system, N05B = anxiolytics, 01 = diazepam, 02 = Statistical analysis medazepam, 04 = oxazolam, 06 = lorazepam, 08 = bro- Chi-square tests were used to compare patient mazepam, 12 = alprazolam, 18 = ethyl loflazepate, 19 = gender, department group, and pharmacological half-life etizolam, 21 = clotiazepam, 22 = cloxazolam, 23 = tofi- between the long- and short-term groups, and the t-test sopam), N05CD (N05C = hypnotics and sedatives, 01 = was applied to compare age between the two groups. To flurazepam, 02 = nitrazepam, 03 = flunitrazepam, 05 = clarify the patient characteristics in each age category, triazolam, 06 = lormetazepam, 09 = brotiazepam, 10 = patient age was transformed into four
Load more

Recommended publications
  • 124.210 Schedule IV — Substances Included. 1
    1 CONTROLLED SUBSTANCES, §124.210 124.210 Schedule IV — substances included. 1. Schedule IV shall consist of the drugs and other substances, by whatever official name, common or usual name, chemical name, or brand name designated, listed in this section. 2. Narcotic drugs. Unless specifically excepted or unless listed in another schedule, any material, compound, mixture, or preparation containing any of the following narcotic drugs, or their salts calculated as the free anhydrous base or alkaloid, in limited quantities as set forth below: a. Not more than one milligram of difenoxin and not less than twenty-five micrograms of atropine sulfate per dosage unit. b. Dextropropoxyphene (alpha-(+)-4-dimethylamino-1,2-diphenyl-3-methyl-2- propionoxybutane). c. 2-[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexanol, its salts, optical and geometric isomers and salts of these isomers (including tramadol). 3. Depressants. Unless specifically excepted or unless listed in another schedule, any material, compound, mixture, or preparation which contains any quantity of the following substances, including its salts, isomers, and salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible within the specific chemical designation: a. Alprazolam. b. Barbital. c. Bromazepam. d. Camazepam. e. Carisoprodol. f. Chloral betaine. g. Chloral hydrate. h. Chlordiazepoxide. i. Clobazam. j. Clonazepam. k. Clorazepate. l. Clotiazepam. m. Cloxazolam. n. Delorazepam. o. Diazepam. p. Dichloralphenazone. q. Estazolam. r. Ethchlorvynol. s. Ethinamate. t. Ethyl Loflazepate. u. Fludiazepam. v. Flunitrazepam. w. Flurazepam. x. Halazepam. y. Haloxazolam. z. Ketazolam. aa. Loprazolam. ab. Lorazepam. ac. Lormetazepam. ad. Mebutamate. ae. Medazepam. af. Meprobamate. ag. Methohexital. ah. Methylphenobarbital (mephobarbital).
    [Show full text]
  • Drug Screening: Actual Status, Pitfalls and Suggestions for Improvement Drogenscreening: Gegenwa¨ Rtiger Stand, Fehlermo¨ Glichkeiten Und Verbesserungsvorschla¨Ge
    J Lab Med 2004;28(4):317–325 ᮊ 2004 by Walter de Gruyter • Berlin • New York 2004/03304 Drug Monitoring und Toxikologie Redaktion: V. W. Armstrong Drug screening: Actual status, pitfalls and suggestions for improvement Drogenscreening: Gegenwa¨ rtiger Stand, Fehlermo¨ glichkeiten und Verbesserungsvorschla¨ge Wolf R. Ku¨ lpmann* pretierbar. In Wirklichkeit mu¨ ssen viele Aspekte beru¨ ck- sichtigt werden, um einen aussagekra¨ ftigen Befund zu Klinische Chemie, Medizinische Hochschule Hannover, erhalten, z.B. Pra¨ analytik, Spezifita¨ t und Empfindlichkeit Hannover, Germany des Verfahrens oder Qualita¨ tssicherung. Obwohl die Abstract mechanisierten Meßverfahren naturgema¨ ß quantitative Ergebnisse liefern, wird aufgezeigt, daß es sich in der Immunoassays for drug screening are often regarded as Regel empfiehlt, qualitative Befunde zu erstellen. Die procedures which are easily performed and interpreted. Verfahren erlauben aber im Gegensatz zu den auch fu¨r But in fact, many aspects have to be considered to diese Zwecke verwendeten Teststreifen die Entschei- obtain a meaningful result. Among these are sampling, dungsgrenze (cut-off) der jeweiligen Fragestellung anzu- specificity and sensitivity of assays, and quality assess- passen, z.B. bei akuter Intoxikation, chronischem Abusus ment. Although the mechanised procedures yield quan- oder U¨ berwachung des Drogenentzugs. titative results, there are good reasons to generally report Ein schwerwiegender Nachteil von Immunoassays zum qualitative findings. The mechanised procedures allow Nachweis von Amphetamin und a¨ hnlichen Substanzen, the adjustment of the cut-off concentration to the clinical Barbituraten, Benzodiazepinen und Opiaten besteht dar- setting, e.g. in the case of acute intoxication, chronic in, daß eine starke Kreuzreaktivita¨ t des Antiko¨ rpers abuse or drug withdrawal, an important advantage as gegenu¨ ber pharmakologisch wenig wirksamen Verbin- compared to test strips.
    [Show full text]
  • Introduced B.,Byhansen, 16
    LB301 LB301 2021 2021 LEGISLATURE OF NEBRASKA ONE HUNDRED SEVENTH LEGISLATURE FIRST SESSION LEGISLATIVE BILL 301 Introduced by Hansen, B., 16. Read first time January 12, 2021 Committee: Judiciary 1 A BILL FOR AN ACT relating to the Uniform Controlled Substances Act; to 2 amend sections 28-401, 28-405, and 28-416, Revised Statutes 3 Cumulative Supplement, 2020; to redefine terms; to change drug 4 schedules and adopt federal drug provisions; to change a penalty 5 provision; and to repeal the original sections. 6 Be it enacted by the people of the State of Nebraska, -1- LB301 LB301 2021 2021 1 Section 1. Section 28-401, Revised Statutes Cumulative Supplement, 2 2020, is amended to read: 3 28-401 As used in the Uniform Controlled Substances Act, unless the 4 context otherwise requires: 5 (1) Administer means to directly apply a controlled substance by 6 injection, inhalation, ingestion, or any other means to the body of a 7 patient or research subject; 8 (2) Agent means an authorized person who acts on behalf of or at the 9 direction of another person but does not include a common or contract 10 carrier, public warehouse keeper, or employee of a carrier or warehouse 11 keeper; 12 (3) Administration means the Drug Enforcement Administration of the 13 United States Department of Justice; 14 (4) Controlled substance means a drug, biological, substance, or 15 immediate precursor in Schedules I through V of section 28-405. 16 Controlled substance does not include distilled spirits, wine, malt 17 beverages, tobacco, hemp, or any nonnarcotic substance if such substance 18 may, under the Federal Food, Drug, and Cosmetic Act, 21 U.S.C.
    [Show full text]
  • Report on the Investigation Results
    Pharmaceuticals and Medical Devices Agency This English version is intended to be a reference material to provide convenience for users. In the event of inconsistency between the Japanese original and this English translation, the former shall prevail. Report on the Investigation Results February 28, 2017 Pharmaceuticals and Medical Devices Agency I. Overview of Product [Non-proprietary name] See Attachment 1 [Brand name] See Attachment 1 [Approval holder] See Attachment 1 [Indications] See Attachment 1 [Dosage and administration] See Attachment 1 [Investigating office] Office of Safety II 1 Pharmaceuticals and Medical Devices Agency This English version is intended to be a reference material to provide convenience for users. In the event of inconsistency between the Japanese original and this English translation, the former shall prevail. II. Background of the investigation 1. Status in Japan Hypnotics and anxiolytics are prescribed by various specialties and widely used in clinical practice. In particular, benzodiazepine (BZ) receptor agonists, which act on BZ receptors, bind to gamma-aminobutyric acid (GABA)A-BZ receptor complex and enhance the function of GABAA receptors. This promotes neurotransmission of inhibitory systems and demonstrates hypnotic/sedative effects, anxiolytic effects, muscle relaxant effects, and antispasmodic effects. Since the approval of chlordiazepoxide in March 1961, many BZ receptor agonists have been approved as hypnotics and anxiolytics. Currently, hypnotics and anxiolytics are causative agents of drug-related disorders such as drug dependence in Japanese clinical practice. Hypnotics and anxiolitics that rank high in causative agents are BZ receptor agonists for which high frequencies of high doses and multidrug prescriptions have been reported (Japanese Journal of Clinical Psychopharmacology 2013; 16(6): 803-812, Modern Physician 2014; 34(6): 653-656, etc.).
    [Show full text]
  • A Review of the Evidence of Use and Harms of Novel Benzodiazepines
    ACMD Advisory Council on the Misuse of Drugs Novel Benzodiazepines A review of the evidence of use and harms of Novel Benzodiazepines April 2020 1 Contents 1. Introduction ................................................................................................................................. 4 2. Legal control of benzodiazepines .......................................................................................... 4 3. Benzodiazepine chemistry and pharmacology .................................................................. 6 4. Benzodiazepine misuse............................................................................................................ 7 Benzodiazepine use with opioids ................................................................................................... 9 Social harms of benzodiazepine use .......................................................................................... 10 Suicide ............................................................................................................................................. 11 5. Prevalence and harm summaries of Novel Benzodiazepines ...................................... 11 1. Flualprazolam ......................................................................................................................... 11 2. Norfludiazepam ....................................................................................................................... 13 3. Flunitrazolam ..........................................................................................................................
    [Show full text]
  • II.3.4 Benzodiazepines by Hiroshi Seno and Hideki Hattori
    3.4 II.3.4 Benzodiazepines by Hiroshi Seno and Hideki Hattori Introduction Benzodiazepines show antianxiety, hypnotic, anticonvulsant and muscle-relaxant eff ects. Th is group of drugs has wide safety dose ranges; it means that the ratio of the LD50 to the ED50 (therapeutic index) is high. Because of its safety, benzodiazepines are being widely used in the world. Some of benzodiazepines are also being abused or used for so-called “ drug facilitated sexual assault”, and thus they are under the control of the Narcotics and Psychotropics Control Law; in Japan, triazolam abuse has become one of the serious social problems. In this chapter, a GC/MS method for simultaneous analysis of 22 kinds of benzodiazepines listed in > Table 4.1 is described. In addition, the LC/MS analysis of triazolam, and its metabolites 4-hydroxy- triazolam and α-hydroxytriazolam is also presented. GC/MS analysis of benzodiazepines in blood and urine Reagents and their preparation • Th e pure powder of the 22 kinds of benzodiazepines was donated by each pharmaceutical manufacturers according to the authors’ request a (some of benzodiazepines now obtaina- ble from Sigma, St. Louis, MO, USA). • 1 M Sodium bicarbonate solution: a 8.4-g aliquot of sodium bicarbonate is dissolved in distilled water to prepare 100 mL solution. • 2 M Sodium acetate solution: a 27.5-g aliquot of sodium acetate is dissolved in distilled water to prepare 100 mL solution. GC/MS conditions Column: a DB-5 fused silica capillary column (30 m × 0.25 mm i.d., fi lm thickness 0.25 µm, J & W Scientifi c, Folsom, CA, USA).
    [Show full text]
  • Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DIX to the HTSUS—Continued
    20558 Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DEPARMENT OF THE TREASURY Services, U.S. Customs Service, 1301 TABLE 1.ÐPHARMACEUTICAL APPEN- Constitution Avenue NW, Washington, DIX TO THE HTSUSÐContinued Customs Service D.C. 20229 at (202) 927±1060. CAS No. Pharmaceutical [T.D. 95±33] Dated: April 14, 1995. 52±78±8 ..................... NORETHANDROLONE. A. W. Tennant, 52±86±8 ..................... HALOPERIDOL. Pharmaceutical Tables 1 and 3 of the Director, Office of Laboratories and Scientific 52±88±0 ..................... ATROPINE METHONITRATE. HTSUS 52±90±4 ..................... CYSTEINE. Services. 53±03±2 ..................... PREDNISONE. 53±06±5 ..................... CORTISONE. AGENCY: Customs Service, Department TABLE 1.ÐPHARMACEUTICAL 53±10±1 ..................... HYDROXYDIONE SODIUM SUCCI- of the Treasury. NATE. APPENDIX TO THE HTSUS 53±16±7 ..................... ESTRONE. ACTION: Listing of the products found in 53±18±9 ..................... BIETASERPINE. Table 1 and Table 3 of the CAS No. Pharmaceutical 53±19±0 ..................... MITOTANE. 53±31±6 ..................... MEDIBAZINE. Pharmaceutical Appendix to the N/A ............................. ACTAGARDIN. 53±33±8 ..................... PARAMETHASONE. Harmonized Tariff Schedule of the N/A ............................. ARDACIN. 53±34±9 ..................... FLUPREDNISOLONE. N/A ............................. BICIROMAB. 53±39±4 ..................... OXANDROLONE. United States of America in Chemical N/A ............................. CELUCLORAL. 53±43±0
    [Show full text]
  • Title Continuation and Discontinuation of Benzodiazepine Prescriptions: A
    Continuation and discontinuation of benzodiazepine Title prescriptions: A cohort study based on a large claims database in Japan( Dissertation_全文 ) Author(s) Takeshima, Nozomi Citation 京都大学 Issue Date 2016-05-23 URL https://doi.org/10.14989/doctor.k19890 Right Type Thesis or Dissertation Textversion ETD Kyoto University Psychiatry Research ∎ (∎∎∎∎) ∎∎∎–∎∎∎ Contents lists available at ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres Continuation and discontinuation of benzodiazepine prescriptions: A cohort study based on A large claims database in Japan Nozomi Takeshima, Yusuke Ogawa, Yu Hayasaka, Toshi A Furukawa n Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan article info abstract Article history: Although benzodiazepines (BZDs) are often prescribed to treat a wide range of psychiatric and neuro- Received 29 March 2015 logical conditions, they are also associated with various harms and risks including dependence. However Received in revised form the frequency of its continued use in the real world has not been well studied, especially at longer follow- 15 October 2015 ups. The aim of this study was to clarify the frequency of long-term BZD use among new BZD users over Accepted 15 January 2016 longer follow-ups and to identify its predictors. We conducted a cohort study to examine how frequently new BZD users became chronic users, based on a large claims database in Japan from January 2005 to Keywords: June 2014. We used Cox proportional hazards models to identify potential predictors. A total 84,412 Benzodiazepine patients with new BZD prescriptions were included in our cohort.
    [Show full text]
  • PMDA Alert for Proper Use of Drugs When Using Benzodiazepine
    ■ PMDA Alert for Proper Use of Drugs https://www.pmda.go.jp/english/safety/info-services/drugs/properly- No. 11 March 2017 use-alert/0001.html PMDA Alert for Proper Use of Drugs Pharmaceuticals and Medical Devices Agency No. 11 March 2017 Dependence associated with Benzodiazepine Receptor Agonists [To Patients] This document is for healthcare professionals. If taking the drug, please consult with your physicians or pharmacists. Please don’t reduce the dosage or stop taking the drug on self-judgment. Benzodiazepine receptor agonists have a characteristic of developing physical dependence with long-term use even within an approved dose range, leading to various withdrawal symptoms on dose reduction or discontinuation. <Major withdrawal symptoms> insomnia, anxiety, feeling irritated, headache, queasy/vomiting, delirium, tremor, seizure, etc. Please pay careful attention to the following when using benzodiazepine receptor agonists as hypnotics-sedatives and anxiolytics. Healthcare professionals should avoid long-term use with chronic administration. - Dependence may occur with long-term use even within an approved dose range. - Therapeutic necessity should be carefully considered when continuing administration of the drug. Healthcare professionals should adhere to the dosage and confirm that there is no multiple prescription of similar drugs. - Long-term administration, high-dose administration, or multiple medications increase the risk of developing dependence. - Healthcare professionals should confirm that similar drugs are not prescribed by other medical institutions. Healthcare professionals should reduce the dose or discontinue carefully such as by gradual dose reduction or alternate-days administration when discontinuing the administration. - Sudden discontinuation will develop serious withdrawal symptoms in addition to aggravate primary diseases.
    [Show full text]
  • Association Between Benzodiazepine Use and Dementia: Data Mining of Different Medical Databases Mitsutaka Takada , Mai Fujimoto, Kouichi Hosomi
    Int. J. Med. Sci. 2016, Vol. 13 825 Ivyspring International Publisher International Journal of Medical Sciences 2016; 13(11): 825-834. doi: 10.7150/ijms.16185 Research Paper Association between Benzodiazepine Use and Dementia: Data Mining of Different Medical Databases Mitsutaka Takada , Mai Fujimoto, Kouichi Hosomi Division of Clinical Drug Informatics, School of Pharmacy, Kinkai University, Higashi-osaka, Osaka, 577-8502, Japan. Corresponding author: Mitsutaka Takada, PhD. Division of Clinical Drug Informatics, School of Pharmacy, Kindai University, 577-8502, 3-4-1, Kowakae, Higashi-osaka, Osaka, 577-8502, Japan. Telephone number: +81-6-6721-2332 Fax number: +81-6-6730-1394. E-mail address: [email protected] © Ivyspring International Publisher. Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited. See http://ivyspring.com/terms for terms and conditions. Received: 2016.05.16; Accepted: 2016.09.27; Published: 2016.10.18 Abstract Purpose: Some studies have suggested that the use of benzodiazepines in the elderly is associated with an increased risk of dementia. However, this association might be due to confounding by indication and reverse causation. To examine the association between benzodiazepine anxiolytic drug use and the risk of dementia, we conducted data mining of a spontaneous reporting database and a large organized database of prescriptions. Methods: Data from the US Food and Drug Administration Adverse Event Reporting System (FAERS) from the first quarter of 2004 through the end of 2013 and data from the Canada Vigilance Adverse Reaction Online Database from the first quarter of 1965 through the end of 2013 were used for the analyses.
    [Show full text]
  • Enrolled Copy SB 170 1 PHARMACY AND
    Enrolled Copy S.B. 170 1 PHARMACY AND PHARMACEUTICALS AMENDMENTS 2 2019 GENERAL SESSION 3 STATE OF UTAH 4 Chief Sponsor: Evan J. Vickers 5 House Sponsor: Brad M. Daw 6 7 LONG TITLE 8 General Description: 9 This bill amends provisions relating to the practice of pharmacy. 10 Highlighted Provisions: 11 This bill: 12 < amends the definition of "closed door pharmacy" and "practice as a licensed 13 pharmacy technician"; 14 < changes the requirements for certain supervising pharmacists; 15 < adds a drug to the list of long-acting injectable drug therapies that can be 16 administered by certain pharmacists; 17 < adds certain board certified urologists to the list of individuals who are qualified to 18 be a dispensing medical practitioner; and 19 < reschedules certain drugs that are approved by the United States Food and Drug 20 Administration and contain a component of cannabis. 21 Money Appropriated in this Bill: 22 None 23 Other Special Clauses: 24 None 25 Utah Code Sections Affected: 26 AMENDS: 27 58-17b-102, as last amended by Laws of Utah 2018, Chapter 295 28 58-17b-612, as last amended by Laws of Utah 2014, Chapter 72 29 58-17b-625, as enacted by Laws of Utah 2017, Chapter 384 S.B. 170 Enrolled Copy 30 58-17b-805, as enacted by Laws of Utah 2014, Chapter 72 31 58-37-4, as last amended by Laws of Utah 2018, Chapter 146 32 33 Be it enacted by the Legislature of the state of Utah: 34 Section 1. Section 58-17b-102 is amended to read: 35 58-17b-102.
    [Show full text]
  • SB0170S01* Money Appropriated in This Bill: Other Special Clauses: Utah Code Sections Af AMENDS: Administration and Contain a Component of Cannabis
    LEGISLATIVE GENERAL COUNSEL S.B. 170 6 Approved for Filing: D.M. Cheung 6 1st Sub. (Green) 6 02-19-19 8:19 AM 6 Senator Evan J. Vickers proposes the following substitute bill: 1 PHARMACY AND PHARMACEUTICALS AMENDMENTS 2 2019 GENERAL SESSION 3 STATE OF UTAH 4 Chief Sponsor: Evan J. Vickers 5 House Sponsor: Brad M. Daw 6 7 LONG TITLE 8 General Description: 9 This bill amends provisions relating to the practice of pharmacy. 10 Highlighted Provisions: 11 This bill: 12 < amends the definition of º "closed door pharmacy" and » "practice as a licensed 12a pharmacy technician"; 13 < adds a drug to the list of long-acting injectable drug therapies that can be 14 administered by certain pharmacists; 15 < changes the requirements for certain supervising pharmacists; 16 < adds certain board certified urologists to the list of individuals who are qualified to 17 be a dispensing medical practitioner; and 18 < reschedules certain drugs that are approved by the United States Food and Drug 1 19 Administration and contain a component of cannabis. s t 20 Money Appropriated in this Bill: S 21 None u b 22 Other Special Clauses: . S 23 None . B 24 Utah Code Sections Affected: . 25 AMENDS: 1 7 0 *SB0170S01* - 1 - House Committee Amendments 3-5-2019 pf/dc 1st Sub. (Green) S.B. 170 02-19-19 8:19 AM 26 58-17b-102, as last amended by Laws of Utah 2018, Chapter 295 27 58-17b-612, as last amended by Laws of Utah 2014, Chapter 72 28 58-17b-625, as enacted by Laws of Utah 2017, Chapter 384 29 58-17b-805, as enacted by Laws of Utah 2014, Chapter 72 30 58-37-4, as last amended by Laws of Utah 2018, Chapter 146 31 32 Be it enacted by the Legislature of the state of Utah: 33 Section 1.
    [Show full text]