DOCSLIB.ORG

Drugs-Induced Pathological Gambling: an Analysis of Italian Spontaneous Reporting System

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Drugs-Induced Pathological Gambling: an Analysis of Italian Spontaneous Reporting System Journal of Gambling Studies https://doi.org/10.1007/s10899-019-09828-1 ORIGINAL PAPER Drugs‑Induced Pathological Gambling: An Analysis of Italian Spontaneous Reporting System Cristina Scavone1 · Barbara Stelitano1 · Concetta Rafaniello1 · Francesco Rossi1 · Liberata Sportiello1 · Annalisa Capuano1 © The Author(s) 2019 Abstract Pathological gambling has been reported as a direct complication of Parkinson’s disease and its pharmacological treatment based on dopamine agonists. Moreover, further medica- tions (not dopamine agonists) were associated to the occurrence of gambling disorder. We aim to analyze the spontaneous reports of gambling disorder on the whole Italian terri- tory with a focus on Campania Region (Southern Italy) from January 1st 2002 to July 31st 2018. We analyzed gambling disorder’s reports across the 2002–2018 period in the Italian spontaneous reporting database (Rete Nazionale di Farmacovigilanza—RNF), with a focus on Campania region. 94 suspected cases of gambling disorder associated to apomorphine, aripiprazole, cabergoline, levodopa, levodopa and derivatives in association with entaca- pone/benserazide and carbidopa, pergolide, pramipexole, ropinirole, and rotigotine were reported into the RNF. Of these cases, two related to pramipexole and one to aripiprazole were sent to Campania Pharmacovigilance Regional Centre. Although it is widely recog- nized that dopamine agonists may induce behavioral disorders, Parkinson’s disease is itself associated to pathological gambling, compulsive shopping and eating. Since our results could not clarify the correlation between Parkinson’s disease, its pharmacological treat- ment and pathological gambling, in order to better defne this correlation there is a need to conduct further ad hoc observational studies. Keywords Pathological gambling · Pharmacovigilance · Italian spontaneous reporting system · RNF Liberata Sportiello, Annalisa Capuano both are lead authors. * Cristina Scavone [email protected] 1 Department of Experimental Medicine Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Via Costantinopoli 16, 80138 Naples, Italy Vol.:(0123456789)1 3 Journal of Gambling Studies Introduction During the last few years, the availability of legal gambling has abruptly increased lead- ing to a huge intensifcation in pathological gambling (Potenza et al. 2002). Among European countries, Italy holds the absolute record for gambling related receipt. In 2016 the gaming sector has brought almost 10 billion euros, equal to 0.6% of the Italian gross domestic product (Fisco, entrate record dal gioco d’azzardo: in Europa nessuno come noi. Available at: http://www.today .it/econo mia/getti to-fsca le-gioch i-scomm esse-itali a-dati.html). According to the ffth edition of the Diagnostic and Statistical Manual (DSM- 5), gambling disorder is defned as a persistent and recurrent behavior leading to clini- cally signifcant impairment or distress. Patients afected by gambling disorder present at least four of the following attitudes or feelings: they need to gamble with increasing amounts of money; they present restlessness or irritability when stop or reduce gam- bling; they have made several failed eforts to control or stop gambling; they are wor- ried about gambling; they gamble during anxious or depressed situations; they gamble despite loss of money; they lie about the extent of involvement with gambling; they usu- ally lost any relationship, job, or career opportunity due to gambling; they rely on others to provide money (DSM-5 Diagnostic Criteria: Gambling Disorder. Available at: http:// www.ncpga mblin g.org/wp-conte nt/uploa ds/2014/08/DSM-5-Diagn ostic -Crite ria-Gambl ing-Disor der.pdf). Several risk factors have been identifed in inducing gambling disor- ders, including biological ones, such as changes in dopamine and serotonin neurotrans- mission, genetic, psychological and social factors (Fong 2005; Comings et al. 1996). In recent years, pathological gambling has also been reported as a direct complication of Parkinson’s disease and its pharmacological treatment based on dopamine agonists (Seedat et al. 2000; Weintraub and Claassen 2017). Following an evaluation performed by the EU Pharmacovigilance Working Party, the Italian Medicine Agency (AIFA) released a public statement in which announced an increased risk of impulse control disorders, including pathological gambling, increased libido, compulsive buying and eating, in patients treated with dopamine agonists for Parkinson’s disease, restless legs syndrome and endocrine disorders (Agenzia Italiana del Farmaco. Importanti informazi- oni sulla sicurezza riguardanti i farmaci dopamino agonisti. Available at: http://www. agenz iafar maco.gov.it/wscs_rende r_attac hment _by_id/111.71353 .11724 88155 7268b 10.pdf?id=111.71359 .11724 88156 158; PhVWP monthly report on safety concerns, guidelines and general matters. http://www.ema.europ a.eu/docs/en_GB/docum ent_libra ry/Repor t/2012/07/WC500 13039 1.pdf). On the basis of new evidence, sections “Special warnings and precautions for use” and “Adverse efects” of the Summary of product Characteristics (SPCs) of apomorphine, bromocriptine, cabergoline, alpha-dihydroer- gocryptine, lisuride, pergolide, piribedil, pramipexole, quinagolide, ropinirole, levodopa and derivatives in association with entacapone/benserazide and carbidopa, were modi- fed highlighting the new risk of impulse control disorders (Peterson and Forlano 2017; Mété et al. 2016). Moreover, further medications, including aripiprazole, modafnil, rotigotine, sertraline, citalopram, and lamotrigine, were associated to the occurrence of gambling disorder (George et al. 2015; Schreglmann et al. 2012; Ramasubbu 2004). Given the clinical relevance of pathological gambling, the safety warning issued by European regulatory agencies about the increased risk of this adverse drug reaction (ADR) in patients treated with dopamine agonists and the literature data that suggested the same risk also with further medications, we aim to analyze the spontaneous reports 1 3 Journal of Gambling Studies of gambling disorder on the whole Italian territory with a focus on Campania Region from January 1st 2002 to July 31st 2018. Methods Data Source The Italian Pharmacovigilance System is coordinated by the AIFA, that established in 2001 a National Pharmacovigilance Network (Rete Nazionale di Farmacovigilanza, RNF) for the collection of individual case safety reports (ICSRs). The AIFA works in collaboration with Pharmacovigilance Regional Centers (Mazzitello et al. 2013), which are involved in the evalu- ation of ICSRs, in terms of quality of data, evaluation of causality assessment for each drug- vaccine/ADR couple, and participation to signal analysis on drugs and vaccines. In accordance with Italian pharmacovigilance regulations, ICSRs entry into the RNF at national level can be shared only as pooled data through the RAM system, while ICSRs entry into the RNF at regional level are accessible to the Pharmacovigilance Regional Center of competence directly through the RNF. Information are more refned in the latter case. For the purpose of this study, we retrieved from the RAM system (for Italian safety data) and the RNF (for regional safety data) all ICSRs that reported gambling disorder as ADR and apomorphine, bromocriptine, cabergoline, alpha-dihydroergocryptine, lisuride, pergolide, pir- ibedil, pramipexole, quinagolide, ropinirole, levodopa and derivatives in association with enta- capone/benserazide and carbidopa, aripiprazole, modafnil, rotigotine, sertraline, citalopram or lamotrigine as the suspected drug. Descriptive Analysis and Case‑Series All ICSRs, reported from January 1st 2002 to July 31st 2018, that described the occurrence of gambling disorder related to the previous mentioned suspected drugs were selected. For ICSRs reported on the whole Italian territory we performed a descriptive analysis in terms of number of gambling disorder’s reports. For ICSRs reported in Campania region, we performed a descriptive analysis of gambling disorder’s reports, stratifying by suspected drug (s), concomitant drug (s), age, gender, seriousness and outcome degrees, and causality assess- ment. Regarding to the seriousness degree, ADRs are classifed as serious, when they induce death, hospitalization or prolongation of hospitalization, severe or permanent disability, life- threat, congenital abnormalities/birth defcits, or if they were considered clinically relevant, or not serious. The outcome is categorized as: completely resolved, resolved with sequelae, improved, unchanged and unavailable (Sessa et al. 2016a, b). The causality assessment was performed through Naranjo algorithm (Naranjo et al. 1981; Mascolo et al. 2017) in order to establish the strength of relationship between the drug and the ADR. All scores ranged between possible and certain reports were considered reasonable for causality. Compliance with Ethical Standards Safety data deriving from the Italian spontaneous reporting system are anonymous and in compliance with ethical standard. Therefore, no further ethical measures were required. 1 3 Journal of Gambling Studies Results Gambling Disorder in Italy From January 1st 2002 to July 31st 2018, 94 suspected cases of gambling disorder asso- ciated to apomorphine, aripiprazole, cabergoline, levodopa, levodopa and derivatives in association with entacapone/benserazide and carbidopa, pergolide, pramipexole, ropin-
Load more

Recommended publications
  • Diplomarbeit/Diploma Thesis
    DIPLOMARBEIT/DIPLOMA THESIS Titel der Diplomarbeit / Title of the Diploma Thesis “An evaluation of the accuracy of drug – related InChI & InChIKey on ChemSpider, DrugBank, PharmXplorer, PubChem and Wikipedia“ verfasst von / submitted by Joachim Tscherny angestrebter akademischer Grad / in partial fulfilment of the requirements for the degree of Magister der Pharmazie (Mag.pharm.) Wien, 2018 / Vienna, 2018 Studienkennzahl lt. Studienblatt / A 449 degree programme code as it appears on the student record sheet: Studienrichtung lt. Studienblatt / Diplomstudium Pharmazie degree programme as it appears on the student record sheet: Betreut von / Supervisor: Univ.-Prof. Mag. Dr. Gerhard Ecker II Acknowledgments Foremost, I would like to thank my supervisor Gerhard Ecker for the opportunity for realizing this project. Through these thesis, I was able to expand my knowledge extensively. Furthermore, I would like to thank Daniela Digles, who especially supported me at the beginning of my work with the Knime Analytics Platform. I would also like to express my gratitude to Norbert Haider, who provided the data from PharmXplorer. I would like to express my appreciation to the developers of the KNIME Analytical Platform – I could not have carried out the type of computational work without access to this software. I would like to take this opportunity to thank my family, especially Mom, Dad and my sister Katharina, for the continuous and unconditional support they have given me throughout my duration of study. And finally, I extend my personal gratitude to Martina for all the love, patience, and guidance she has given me during the last years. “lucundi acti labores” (Marcus Tullius Cicero, Brutus 70) III IV Abstract Freely available online resources such as ChemSpider, DrugBank, PubChem, and Wikipedia are widely used for obtaining information on drugs.
    [Show full text]
  • Public Assessment Report Scientific Discussion Normodiab Tablets 80 Mg Gliclazide IS/H/0145/001/DC
    Public Assessment Report Scientific discussion Normodiab tablets 80 mg Gliclazide IS/H/0145/001/DC This module reflects the scientific discussion for the approval of Nemodiab. The procedure was finalised at 13 December 2009. For information on changes after this date please refer to the module ‘Update’. I. INTRODUCTION Based on the review of the quality, safety and efficacy data, the Member States have granted a marketing authorisation for Normodiab tablets 80 mg from Actavis. The product is indicated for non- insulin dependent diabetes mellitus. A comprehensive description of the indications and posology is given in the SmPC. The marketing authorisation has been granted pursuant to Article 10(1) of Directive 2001/83/EC. Gliclazide is a second-generation sulphonylurea compound that is used in the treatment of non- Insulin-Dependent Diabetes Mellitus (NIDDM) where dietary regulation is insufficient. The primary effect of sulphonylurea-like drugs is to potentiate glucose-stimulated insulin release from functioning pancreatic islet-ß-cells by induction of a decrease in potassium efflux from these cells. ATC code: A 10 BB 09. Gliclazide is indicated for the treatment of non insulin-dependent diabetes (type 2) in adults when dietary measures, physical exercise and weight loss alone are not sufficient to control blood glucose. No discussions were held with CMDh during the procedure. II. QUALITY ASPECTS II.1 Introduction The drug product is a conventional tablet with 80 mg of the active substance gliclazide. The tablets are white, flat, round, bevelled-edged and with score on both faces. The tablet diameter is 8.0 mm and "GZ" is engraved in either side of a central break line on one face.
    [Show full text]
  • Pharmacoepidemiological Profile and Polypharmacy Indicators in Elderly Outpatients
    Brazilian Journal of Pharmaceutical Sciences vol. 49, n. 3, jul./sep., 2013 Article Pharmacoepidemiological profile and polypharmacy indicators in elderly outpatients André de Oliveira Baldoni1,*, Lorena Rocha Ayres1, Edson Zangiacomi Martinez2, Nathalie de Lourdes Sousa Dewulf3, Vânia dos Santos4, Paulo Roque Obreli-Neto5, Leonardo Régis Leira Pereira1 1Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil, 2Department of Social Medicine, School of Medicine Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil, 3School of Farmacy, Federal University of Goiás, Goiânia, GO, Brazil, 4Department of Clinical, Toxicological and Bromatological Analyses, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil, 5Department of Pharmacology and Therapeutics, State University of Maringá, Maringá, PR, Brazil This cross-sectional study was carried out with 1000 elderly outpatients assisted by a Basic Health District Unit (UBDS) from the Brazilian Public Health System (SUS) in the municipality of Ribeirão Preto. We analyzed the clinical, socioeconomic and pharmacoepidemiological profile of the elderly patients in order to identify factors associated with polypharmacy amongst this population. We used a truncated negative binomial model to examine the association of polypharmacy with the independent variables of the study. The software SAS was used for the statistical analysis and the significance level adopted was 0.05. The most prevalent drugs were those for the cardiovascular system (83.4%). There was a mean use of seven drugs per patient and 47.9% of the interviewees used ≥7 drugs. The variables that showed association with polypharmacy (P value < 0.01) were female gender, age >75 years, self-medication, number of health problems, number of medical appointments, presence of adverse drug events, use of over-the-counter drugs, use of psychotropic drugs, lack of physical exercise and use of sweeteners.
    [Show full text]
  • Dropizol Summary of Product Characteristics
    DROPIZOL SUMMARY OF PRODUCT CHARACTERISTICS 1 1. NAME OF THE MEDICINAL PRODUCT Dropizol 10 mg/ml oral drops, solution 2. QUALITATIVE AND QUANTITATIVE COMPOSITION 1 ml of oral liquid contains 1 ml of tincture from Papaver somniferum L., succus siccus (Opium, raw) corresponding to 10 mg of morphine. 1 drop contains 50 mg opium tincture corresponding to 0.5 mg (10 mg/ml) anhydrous morphine 1 ml = 20 drops Extraction solvent: 33 % ethanol (V/V) Excipients with known effect: 33 % ethanol (V/V) For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Oral drops, solution Appearance: dark, reddish brown liquid. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Symptomatic treatment of severe diarrhoea in adults, when use of other anti-diarrhoea treatments have not given sufficient effect. 4.2 Posology and method of administration Posology Usual starting dose in adults: 5–10 drops, 2–3 times daily. Individual doses should not exceed 1 ml, and the total daily dose should not exceed 6 ml The posology should be individualized to use the lowest effective dose for the shortest duration of time taking into account the patient’s general condition, the patient’s age, weight, and medical history (see sections 4.3 and 4.4). Paediatric population Dropizol should not be used in children and adolescents aged below 18 years for safety reasons, see section 5.1. Treatment should be initiated and supervised by a specialist, i.e. oncologist or gastroenterologist. Particular caution should be exercised when prescribing this drug due to its morphine content. The treatment period should be as short as possible.
    [Show full text]
  • Availability of Medicines in the European Union: Results from the EURO-Medicines Project
    Eur J Clin Pharmacol 02001) 57: 441±446 DOI 10.1007/s002280100345 SPECIAL ARTICLE P. Folino-Gallo á T. Walley á J.C. Frolich á A. Carvajal I.R. Edwards Availability of medicines in the European Union: results from the EURO-Medicines project Received: 3 May 2001 / Accepted in revised form: 26June 2001 / Published online: 2 August 2001 Ó Springer-Verlag 2001 Abstract Objective: There is at present no comprehen- cardiovascular 0ATC code C, maximum 269, minimum sive directory of medicines available in European 112). Only 7% of all the active ingredients were available countries. Such a directory would be valuable to policy in all the countries studied. The Scandinavian countries analysts, clinicians, regulatory agencies, pharmaceutical had the greatest proportion of active ingredients 060%) companies and consumer groups. The aim of this project available in all other countries. Each country had a was to compile such a directory of all medicines mar- number of active ingredients available only in that keted in each of the European Union member countries. country ± Italy had the largest number of these. Methods: Lists of medicines for each country, compiled Conclusions: The directory illustrates the wide variations from several national sources, classi®ed by Anatomical- in the availability of medicines across the European Chemical-Therapeutic 0ATC) code. Census date was late Union. The range of drugs available in each country 1998. represents dierences in regulatory and market policies, Results: A comprehensive directory was created using as well as cultural and historic dierences. This directory data from 14 of the 15 European Union countries. lends itself to many further analyses.
    [Show full text]
  • Organizational, Legal and Marketing Characteristics of Domestic Medicines for Pharmaceutical Provision to Victims Suffered From
    The Pharma Innovation Journal 2018; 7(6): 586-589 ISSN (E): 2277- 7695 ISSN (P): 2349-8242 NAAS Rating: 5.03 Organizational, legal and marketing characteristics of TPI 2018; 7(6): 586-589 © 2018 TPI domestic medicines for pharmaceutical provision to www.thepharmajournal.com Received: 14-04-2018 victims suffered from emergency situations in Ukraine Accepted: 17-05-2018 Valentyn Shapovalov Valentyn Shapovalov, Andriy Gudzneko, Valeriy Shapovalov and a) Medical and Pharmaceutical Law, General and Clinical Viktoriya Shapovalova Pharmacy Department, Kharkiv Medical Academy of Abstract Postgraduate Education A question of proper level of pharmaceutical provision to victims suffered from emergency situation in Kharkiv, 61176, Ukraine Ukraine becomes more and more actual over the past years, as quantity of persons suffered from b) Advocates company emergency situations grew up at a high rate. It becomes even more important to provide patients suffered “Apotheosis” Kharkiv, 61195, Ukraine from emergency situations with effective and cheap domestic medications. That is why this study concerning organizational, legal and marketing characteristics of domestic medicines to patients was Andriy Gudzneko conducted. Medical and Pharmaceutical Law, General and Clinical Keywords: Pharmaceutical law, pharmaceutical provision, emergency situation, domestic medicine Pharmacy Department, Kharkiv Medical Academy of 1. Introduction. Previous studies have proven the importance of forensic and pharmaceutical Postgraduate Education researches in study of pharmaceutical
    [Show full text]
  • ATC Code a ALIMENTARY TRACT and METABOLISM -- A01
    ATC code A ALIMENTARY TRACT AND METABOLISM -- A01 STOMATOLOGICAL PREPARATIONS Mar A02 DRUGS FOR ACID RELATED DISORDERS Mar A03 DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS Mar A04AA ANTIEMETICS AND ANTINAUSEANTS, Serotonin (5HT3) antagonists Nov A04AD ANTIEMETICS AND ANTINAUSEANTS, Other antiemetics Mar A05 BILE AND LIVER THERAPY Mar A06 DRUGS FOR CONSTIPATION Mar A07 ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS Mar A08 ANTIOBESITY PREPARATIONS, EXCL. DIET PRODUCTS Sep A09 DIGESTIVES, INCL. ENZYMES Mar A10 DRUGS USED IN DIABETES Sep A11 VITAMINS Sep A12 MINERAL SUPPLEMENTS Sep A13 TONICS Sep A14 ANABOLIC AGENTS FOR SYSTEMIC USE Sep A15 APPETITE STIMULANTS Mar A16 OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS ＊ B BLOOD AND BLOOD FORMING ORGANS -- B01 ANTITHROMBOTIC AGENTS Jan B01AD12 PROTEIN C May B02 ANTIHEMORRHAGICS Nov B03 ANTIANEMIC PREPARATIONS Nov B05 BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS Nov B06 OTHER HEMATOLOGICAL AGENTS Nov C CARDIOVASCULAR SYSTEM -- C01 CARDIAC THERAPY Jan C02 ANTIHYPERTENSIVES Jan C03 DIURETICS Jan C04 PERIPHERAL VASODILATORS Jan C05 VASOPROTECTIVES Jan C07 BETA BLOCKING AGENTS Jan C08 CALCIUM CHANNEL BLOCKERS Jan C09 AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM Jan C10 LIPID MODIFYING AGENTS Jan D DERMATOLOGICALS -- D01 ANTIFUNGALS FOR DERMATOLOGICAL USE Mar D02 EMOLLIENTS AND PROTECTIVES Mar D03 PREPARATIONS FOR TREATMENT OF WOUNDS AND ULCERS Mar D04 ANTIPRURITICS, INCL. ANTIHISTAMINES, ANESTHETICS, ETC. Mar D05 ANTIPSORIATICS Mar D06 ANTIBIOTICS AND CHEMOTHERAPEUTICS FOR DERMATOLOGICAL USE Mar D07 CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS Mar D08 ANTISEPTICS AND DISINFECTANTS Mar D09 MEDICATED DRESSINGS Mar D10 ANTI-ACNE PREPARATIONS Mar D11 OTHER DERMATOLOGICAL PREPARATIONS Mar G GENITO URINARY SYSTEM AND SEX HORMONES -- G01 GYNECOLOGICAL ANTIINFECTIVES AND ANTISEPTICS May G02 OTHER GYNECOLOGICALS Mar G03 SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM Sep G04 UROLOGICALS Mar H SYSTEMIC HORMONAL PREPARATIONS, EXCL.
    [Show full text]
  • Evaluation of Carcinogenicity Studies of Medicinal Products for Human Use Authorised Via the European Centralised Procedure
    Regulatory Toxicology and Pharmacology xxx (2011) xxx–xxx Contents lists available at ScienceDirect Regulatory Toxicology and Pharmacology journal homepage: www.elsevier.com/locate/yrtph Evaluation of carcinogenicity studies of medicinal products for human use authorised via the European centralised procedure (1995–2009) ⇑ Anita Friedrich a, , Klaus Olejniczak b a Granzer Regulatory Consulting and Services, Zielstattstrasse 44, 81379 Munich, Germany b Federal Institute for Drugs and Medical Devices, Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany article info abstract Article history: Carcinogenicity data of medicinal products for human use that have been authorised via the European Received 25 October 2010 centralised procedure (CP) between 1995 and 2009 were evaluated. Carcinogenicity data, either from Available online xxxx long-term rodent carcinogenicity studies, transgenic mouse studies or repeat-dose toxicity studies were available for 144 active substances contained in 159 medicinal products. Out of these compounds, 94 Keywords: (65%) were positive in at least one long-term carcinogenicity study or in repeat-dose toxicity studies. Medicinal products Fifty compounds (35%) showed no evidence of a carcinogenic potential. Out of the 94 compounds with Carcinogenicity positive findings in either carcinogenicity or repeat-dose toxicity studies, 33 were positive in both mice Rodents and rats, 40 were positive in rats only, and 21 were positive exclusively in mice. Long-term carcinogenic- ity studies in two rodent species were available for 116 compounds. Data from one long-term carcinoge- nicity study in rats and a transgenic mouse model were available for eight compounds. For 13 compounds, carcinogenicity data were generated in only one rodent species. One compound was exclu- sively tested in a transgenic mouse model.
    [Show full text]
  • Drug Prescription Appropriateness in the Elderly: an Italian Study
    Journal name: Clinical Interventions in Aging Article Designation: Original Research Year: 2017 Volume: 12 Clinical Interventions in Aging Dovepress Running head verso: Allegri et al Running head recto: Drug appropriateness in the elderly open access to scientific and medical research DOI: http://dx.doi.org/10.2147/CIA.S109125 Open Access Full Text Article ORIGINAL RESEARCH Drug prescription appropriateness in the elderly: an Italian study Nicola Allegri1 Purpose: Correct drug prescription in the elderly is a difficult task that requires careful survey Federica Rossi2 of the current pharmacological therapies. In this article, we reviewed the drug prescriptions Federica Del Signore2 provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy. Paolo Bertazzoni3 Methods: Subjects were recruited from a local nursing home, the Pavia and Vigevano Neu- Roberto Bellazzi4 ropsychological Center for Alzheimer’s Disease, general practitioners’ offices, and the local Giorgio Sandrini5 University of the Third Age. For each patient, the amount of potentially inappropriate pre- scriptions (PIPs), sedative and anticholinergic load (SL and AL, respectively), and drug–drug Tomaso Vecchi1 interactions were evaluated. Davide Liccione1 Results: Widespread polypharmacy, giving rise to 10.06% of PIPs in the whole collection of 6 Alessia Pascale prescriptions, was observed. In particular, PIPs mainly concern drugs acting at the central nervous 6 Stefano Govoni system level, mostly benzodiazepines and antipsychotics. Moreover, approximately one-fourth of 1 For personal use only. Department of Brain and Behavioral the subjects had an elevated SL and approximately one-tenth a high AL. Drug–drug interactions 2 Sciences, University of Pavia, Pavia were frequent (266 requiring medical attention), up to five for each single patient.
    [Show full text]
  • Statistics on Local Drug Sales: a Tool to Identify Problem Areas and to Follow Effects of Education on Drug Use
    Statistics on local drug sales: A tool to identify problem areas and to follow effects of education on drug use Ekedahl, Anders 2002 Link to publication Citation for published version (APA): Ekedahl, A. (2002). Statistics on local drug sales: A tool to identify problem areas and to follow effects of education on drug use. Anders Ekedahl, SMI Universitetssjukhuset MAS (MFC), Ingång 59, SE-205 02 Malmö, Sweden,. Total number of authors: 1 General rights Unless other specific re-use rights are stated the following general rights apply: Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Read more about Creative commons licenses: https://creativecommons.org/licenses/ Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. LUND UNIVERSITY PO Box 117 221 00 Lund +46 46-222 00 00 From Department of Community Medicine Malmö University Hospital Lund University, Sweden Statistics on local drug sales: A tool to identify problem areas and to follow effects of education on drug use Anders Ekedahl Malmö 2002 Anders Ekedahl Abstract Aims: 1) To assess if drug sales data indicate differences in morbidity, mortality, socio-economic conditions and deviating prescribing habits among physicians; 2) to identify areas for educational interventions and to analyse changes in prescribing after educational activities.
    [Show full text]
  • Pharmaceutical Residues in Senior Residences Wastewaters: High Loads, Emerging Risks
    molecules Article Pharmaceutical Residues in Senior Residences Wastewaters: High Loads, Emerging Risks Silvia Lacorte 1,*, Cristian Gómez-Canela 2 and Carole Calas-Blanchard 3,4 1 Department of Environmental Chemistry, IDAEA-CSIC, Jordi Girona 18-26, 08034 Barcelona, Catalonia, Spain 2 Department of Analytical Chemistry and Applied (Chromatography Section), School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Via Augusta 390, 08017 Barcelona, Spain; [email protected] 3 Biocapteurs-Analyses-Environnement, Université de Perpignan Via Domitia, 52 Av. Paul Alduy, CEDEX, 66860 Perpignan, France; [email protected] 4 Laboratoire de Biodiversité et Biotechnologies Microbiennes, USR 3579 Sorbonne Universités (UPMC) Paris 6 et CNRS Observatoire Océanologique, 66650 Banyuls-sur-Mer, France * Correspondence: [email protected] or [email protected] Abstract: Senior residences are health-care facilities that are socially-accepted for the assistance of elderly people. Since the elderly account for the foremost pharmaceutical-consuming age-group, senior residences become a hot-spot for pharmaceuticals discharge to the sewage grid. The objectives of the present study were to identify the bioactive pharmaceuticals in sewage waters from senior residences and to propose an on-site monitoring strategy for their control. In this study, we have studied the presence of 43 pharmaceuticals highly consumed by the elderly population in six senior residences located in Spain, France and Portugal. Wastewater was sampled directly from the water- chest in each residence during different times of the day throughout one week. Main compounds detected at the high µg L−1 level were analgesic and antipyretic drugs such as acetylsalicylic acid, Citation: Lacorte, S.; Gómez-Canela, paracetamol, ibuprofen; antibiotics such as amoxicillin and sulfamethoxazole; compounds for the C.; Calas-Blanchard, C.
    [Show full text]
  • Mcgarry, Kenneth and Assamoha, Ennock (2017) Data Integration with Self-Organising Neural Network Reveals Chemical Structure and Therapeutic Effects of Drug ATC Codes
    McGarry, Kenneth and Assamoha, Ennock (2017) Data integration with self-organising neural network reveals chemical structure and therapeutic effects of drug ATC codes. In: The 17th Annual UK Workshop on Computational Intelligence (UKCI- 2017), 6-8 Sep 2017, Cardiff. Downloaded from: http://sure.sunderland.ac.uk/id/eprint/7533/ Usage guidelines Please refer to the usage guidelines at http://sure.sunderland.ac.uk/policies.html or alternatively contact [email protected]. Data integration with self-organising neural network reveals chemical structure and therapeutic effects of drug ATC codes Ken McGarry1 and Ennock Assamoha1 School of Pharmacy and Pharmaceutical Sciences, Faculty of Health Sciences and Wellbeing, University of Sunderland, City Campus, UK. [email protected] Abstract. Anatomical Therapeutic Codes (ATC) are a drug classification sys- tem which is extensively used in the field of drug development research. There are many drugs and medical compounds that as yet do not have ATC codes, it would be useful to have codes automatically assigned to them by computational methods. Our initial work involved building feedforward multi-layer perceptron models (MLP) but the classification accuracy was poor. To gain insights into the problem we used the Kohonen self-organizing neural network to visualize the relationship between the class labels and the independent variables. The informa- tion gained from the learned internal clusters gave a deeper insight into the map- ping process. The ability to accurately predict ATC codes was unbalanced due to over and under representation of some ATC classes. Further difficulties arise because many drugs have several, quite different ATC codes because they have many therapeutic uses.
    [Show full text]