جستجوی مقالات مرتبط با کلیدواژه « عوارض دارویی » در نشریات گروه « پزشکی »

Seizure is a common neurological disease with many therapies, especially antiepileptic drugs being used to treat it. Any adverse effects caused by taking antiepileptic drugs are called antiepileptic side effects. The purpose of this study was to evaluate the side effects of antiepileptic drugs in patients admitted to Shahid Motahari Hospital of Urmia from 2010 until the end of 2016.

This descriptive study was conducted after the approval of the Ethics Committee of Urmia University of Medical Sciences. In this study, 100 epileptic children with complications of antiepileptic drugs admitted to Motahari Pediatric Hospital of Urmia from 2010 to 2016 were studied. The sampling method was census using the keyword drug reaction in patient files. The information was collected through a checklist, which was completed by the project manager based on the information in the patientchr('39')s file. The checklist consisted of 3 sections. The first part included demographic information of patients including age and sex; the second part included targeted information including the number of seizures, type of anticonvulsant drug used; and the third part included targeted information including drug side effects in these patients.

The mean weight SD of the studied patients was 40.09 /1 1.94 kg with a median of 41.50 kg. Most of the adverse events observed in the studied patients were related to skin complications with the frequency of 52 patients (52%). The most common adverse events observed were within the age range of 9 to 10 years with a frequency of 16 patients (16%). Also, there was no significant relationship between the side effects of epileptic drugs and the age of the patients (p = 0.844).

The renal side effects of antiepileptic drugs in males were higher than females, and the skin and liver complications were higher in females, and the most common side effects were observed within the age range of 9 to 10 years. It also has a direct relationship with the duration of drug side effects. Compared to sodium valproate, Phenobarbital has more side effects in children.

About 6% of all hospital admissions are due to adverse drug reactions, the most important determinants in reporting adverse drug reactions is knowledge of health care workers about drug side effects. Since the nurses have an important role in medication orders, this study was conducted with aim to assess the knowledge of neonatal unit nurses about adverse drug reactions at East Azarbaijan province.
This descriptive and cross-sectional study was conducted in neonatal units of East Azarbaijan province in 2014. The participants surveyed in this study were 200 nurses who were invited by cluster randomization sampling method. A researcher prepared a questionnaire that investigated the knowledge of participants about adverse drug reactions and was used after approving its validity and reliability. The quantitative analysis of this study used SPSS version 13 by descriptive and inferential statistics. For multivariable explanation of nurses’ knowledge based on independent variables multiple linear regression was used
The mean score of nurses’ knowledge was moderate(12.35±2.36). The highest score was for serum therapy domain and the lowest score was for side effects in oral drugs’s domain. Statistically significant correlation was found between the mean knowledge score with age and work experience (p According to the average level of neonatal nurses’s knowledge about the pharmacology, it is recommended continuing education courses, preparation of facilities for quick access to information about the side effects and drug interactions, as well as providing access to clinical pharmacologists in neonatal units. Also, more experienced nurses should be employed in neonatal units.

Drug misuse is defined as inappropriate administration or usage of drug which can be preventable. The aim of study was to identify the consistency rate of drug record information between cardex and patients medical cards in teaching hospitals of Yasuj، Iran The present descriptive sectional study was conducted in teaching hospitals of Yasuj in 2012. Case Sampling was convenience sampling. A number of 400 patient’s charts were selected and drug orders were compared with cardex and drug patient’s cards. Statistical analysis was performed by SPSS software and descriptive tests. Of 400 charts، only 1670 charts had drug orders and there were a total 337 of drug errors in cardex and drug cards. The highest rate of inconsistency of drug details was related to entering drug routes into cradex and drug cards that were reported 41% and 43. 2 % respectively. In addition about 5% and 23. 4% of administrated drugs were not recorded in cardex and drug cards. It is also indicated that 1% and 2. 5 % of deleted drug orders in the chart were not deleted in cardex and drug cards. There are relatively large numbers of inconsistency cases of drug details between cardex، drug cards and patient’s charts. It is necessary to clarify the issue، and also performed new methods of drug registration in the hospitals.

Tuberculosis is an emerging and reemerging disease and standard tre-atments are used to control this disease all around the world these days. If TB trea-tment side effects are not early diagnosed, these side effects can be costly and very dangerous. The aim of this study was the assessment of TB treatment side effects and its determining factors.

This study is desc-riptive-analytical and cross-sectional. Do-cuments of all patients diagnosed with TB were used from the beginning of April 2005 to the end of the September 2012 in Kh-uzestan province. The instruments for data collection included a checklist and demo-graphic variables for collecting the required data. The collected data was analyzed thr-ough SPSS-16 software by Chi-square, Ind-ependent t and Kruskal-Wallis tests.

The overall 6363 TB patients with the mean age of 18±39.3 years were identified and studied. Side effects in 106 (1.66%) patients were associated with TB treatment during the treatment period. The most common complication was Hepatitis in 52 cases (49.05%). Side effects incidence had a significant relationship with gender, kind of disease, HIV infection, and result of chest radiography (P˂0.05). Discussion &

High incidence of complications in TB treatment among patients with over 65 years age and less than 4 years age and HIV infection cause disorder in TB controlling. Thus, training and protective measures and periodical as-sessment is recommended.

Medication errors are the most common medical errors which, due to their high prevalence and potential risks to patients, are used as indicators for patients’ safety measures in hospitals. This cross-sectional study was conducted on 97 nurses working in Taleghani and Valiasr hospitals in Abadan and Khorramshahr cities. Nurses were selected by census method and a questionnaire was used to ask their opinions about key factors affecting medication errors. Response categories including none, low, average, and high were scored 0 to 30 in order to determine the importance of each factor. The data were analyzed using SPSS 17.0. Based on the findings of this study, factors such as work-related fatigue (63.9%), lack of sufficient time and opportunity (61.9%), shortage of nurses compared to the patients in ward (58.1%), nurse's lack of drug-related knowledge (48.9%), increasing workload (45.4%) and illegible physicians’ prescriptions in patients’ records (40.2%) were reported as the most important factors in the incidence of medication errors. Also, factors such as morning shift (49.5%), putting pharmaceutical drugs on pharmacy shelves (42.3%) and medication room (41.2%) were reported as the least important factors in in medication errors. According to the results it is recommended to employ effective management, motivate nurses, and also upgrade their scientific and clinical skills in performing pharmaceutical prescriptions in order to prevent medication errors in various sectors.

An optimal regimen for treatment of Helicobacter pylori should have high efficacy، tolerable side effects، easy administration and should be economical. Intensive efforts are being made to identify such an optimal regimen، but there are many obstacles hindering the achievement of this goal. This study aimed at comparing the rate of HP eradication by examining quadruple regimens in dyspeptic patients. In this open-label randomized clinical trial، 270 patients with positive Urease test were randomly assigned into four groups to receive one of the following treatment protocols. (group A: omeprazole+ amoxicillin+ bismuth subcitrate+clarithromycin for 2 weeks (73 patients)، group B: omeprazole+tetracycline+bismuth subcitrate+metronidazole for 2 weeks (46 patients)، group C: omeprazole+amoxicillin+bismuth subcitrate+furazolidone for 2 weeks (64 patients)، groupD: omeprazole+amoxicillin+bismuth subcitrate+furazolidone/metronidazole interchangeably each one for one week (87 patients). Six weeks after the treatment، the compliance، eradication and complication rates were evaluated in each group. Helicobacter pylori eradication rates were، 96. 3%، 87%، 79. 7%، and 79. 3 % in groups A، B، C and D respectively (p=0. 506). The overall complication rate was 37%، 63%، 32. 8% and 28. 7% in groups A، B، C and D respectively. This rate was significantly higher in group B than other groups (p=0. 01). The compliance rate was “complete”، ‘good” or “poor”. Accordingly the compliance rate in group A was 83. 6%، 11% and 5. 5%، in group B، 87%، 6. 5% and 6. 5%، in group C. 90. 6%، 4. 7% and 4. 7%، and in group D 86. 2%، 11. 5% and 2. 3%، respectively (p=0. 683). Abdominal pain and vomiting was significantly more frequent in groups B and C compared to the other groups. The other complications were not significantly different in the groups. The rate of compliance and HP eradication was similar in quadruple regimens; however، due to difference in the rate of complications، regimens of groups A or D are recommended.

Nicolau Syndrome (NS) is a rare but severe localized adverse reaction at the site of intramuscular drug injection. The typical presentation is intense pain around the injection site soon after injection، followed by erythema، purplish network discolouration of the skin (livido reticularis)، haemorrhagic patch، and finally tissue necrosis. Here in، we report a 7years old boy، the forth Nicolau Syndrome (NS) reported from Iran after a single intramuscular injection of penicillin.

There is increasing evidence that self-medication is a widely prevalent practice in many developing countries. It seems a special significance issues among medical students as they are the future medical practitioners. The objective of this study was to assess the level of self-medication and its related factors amongst medical students in Tehran University of Medical Sciences. A cross-sectional questionnaire-based study was conducted among the 600 students of Tehran University of medical science in 2011 year. The frequency of self-medication in students was 35.7 percent. This was more common in females rather than males. Some reasons for seeking self-medication included Previous illness experience (51/9%), easily access to medications (28/5%) and feeling not important of illness (22/9%). Our study shows that self-medication is common among medical students in Tehran. In this situation, it is necessary for faculties to create awareness and educate theses students regarding advantages and disadvantages of self-medication.

Acute myopia following use of some drugs is a relatively rare condition. Topiramate prescribed for seizure prophylaxis is one of these drugs. In this paper a case of acute transient myopia after taking topiramate is reported. The reported patient is a 28-year old woman who had no history of any eye disease. Following consumption of topiramate pill for one week، she had found blurred vision since one day prior to the admission. A complete ocular examinations revealed acute bilateral myopia. This disease was resolved about 48 hours after discontinuation of topiromate. Due to the wide spectrum of indications for the administration of Topiramate، neurologists and psychiatrists should be aware of its ocular side effects. In conclusion، ocular complications following this drug should be taken seriously and be subjected to ophthalmic counsaltation.

Epilepsy is one of the most important diseases of nervous system that involves 0.5-1% of the population. In spite of new developments in antiepileptic drugs, between 20-30% of epileptic patients can not be controlled and even those who are controlled with antiepileptic drugs suffer from their adverse events. Epileptic patients have different challenges in relation to the disease and its medications. This article has reviewed these challenges. The most common challenges are misdiagnosis of epilepsy or type of epilepsy resulting in wrong drug administration, noncompliance with antiepileptic drugs, adverse effects of antiepileptic drugs, drug resistance, non-pharmacological interventions and their limitations, photosensitivity, epilepsy problems in children and the elderly, pregnancy and epilepsy, driving and epilepsy and finally sudden death in epileptic patients.

Major beta thalassemia is the most common hereditary anemia in our country, especially in the shores of Caspian Sea, Oman and the Persian Gulf. Hearing impairment is one of its complications. This study was aimed to evaluate the hearing impairment in thalassemic patients in South Khorasan province.

This descriptive-analytic and cross sectional study was performed on the 32 major thalassemic patients in South Khorasan province in year 2007. Personal and clinical data were collected from the patient's file in the certain disease department of Valiasser Hospital. Clinical examination and hearing tests were done by an odiometrist and ENT specialist to evaluate the hearing status of the patients. Data were analyzed by means of SSPS (version 15)using independent Student-t test at the significant level of P<0.05.

The mean age of the studied patients was 9.3±1.4 years (range: 2-17.5 years). Fourteen patients were female. Abnormal audiogram, tympanogram and otoscopy were observed in 10.9%, 31.2% and 18.7% of the examined ears, respectively. Normal hearing, sensory neural hearing loss and conductive hearing loss were observed in 81.2%, 9.4% and 9.4% of patients, respectively. Overall, the prevalence of hearing impairment in this study was approximately 20%.

In order to prevent and to treat the hearing complications of thalassemia earlier regular and periodical monitoring of auditory function in all thalassemic patients is recommended.

Cutaneous drug reaction is a common side effect of antiepileptic drugs and a frequent cause of treatment discontinuation. These reactions ranges can be a mild maculopapular rash to Stevens-Johnson Syndrom and toxic epidermal necrolysis. Among the traditional anticonvulsant drugs the aromatic compounds Phenytoin, Phenobarbital and Carbamazepin have been associated with relatively higher incidences of cutaneous reactions which can hospitalized the patient. Some of the newer drugs also can induce this problem, especially lamotrigine. All records of patiens who were hospitalized at hospitals related to Islamic Azad as well as Rasol Akram hospital with a diagnosis of cutaneous drug reaction to anticonvulsant therapy in 8 years period were reviewed. The most common culprit was phenytoin (32%) and the least common drug was lamotrigin (3%). Cutaneous reaction to anticonvulsant drugs is common and sometimes may be life threatening which needs serious treatment options.

The major complication of radioiodine therapy for thyrotoxicosis is hypoth-yroidism, the long-term management of which is often problematic. In this study, the long-term effects of continuous methimazole (MMI) therapy are investigated.

One hundred and thirty-two patients, aged between 36-66 years, with Graves recurrence, were semi randomly randomized in 2 groups for continuous antithyroid and radioiodine treatment. The number of thyroid dysfunctions in each patient were recorded and serum TSH, FT4, Anti TPO, TRAb, FBS, HOMA IR, and lipid profiles were measured. Bone mineral density and echocar-diography were performed.

There was no significant differences in age, duration of symptoms and thyroid function between the 2 groups. No serious complications occurred in the MMI group and no difference in any of parameters was seen between groups 1 and 2. Goiter rate and anti TPO concentration were higher in group 1 than in group 2. Serum triglycerides and cholesterol were increased in group 2 as compared to group 1. Bone mineral density was more reduced in group 2, especially in the spine. Echocardiography showed diastolic dysfunction in group 2 as compared to group 1. Some parameters in neuro-pschyciatric evaluation were significantly better in the MMI group, as compared to the radioiodine one.

Considering it is a safe treatment and has fewer complications, methimazole is another option for patients with recurrent Graves', who do not wish to use radioiodine.

Chronic mental disorders are among the problems in psychiatrics. Atypical anti psychotic drugs are new effective medications to treat these disorders. Unfortunately these drugs lead to side effects such as increase in blood glocuse, weight gain and edema. This study aims to investigate adverse effects of Olanzapine and Rispridone on lipid level and blood glocuse and other complications in patients with psychotic disorders. This clinical trial-double blinded study, patients with psychotic disorders were randomly categorized into two groups. Group one treated with Olanzapine and other with Rispridone. All the subjects were initially assessed for blood sugar and lipids, and in the case of normal, they were randomly assigned to two groups in a double- blinded method to be treated with Olanzapine or Risperidone. Blood sugar and lipids tests were performed for all subjects at the 1st week and 3 months after initiation of therapy. Other complications were assessed too, then the data were analyzed using SPSS software. The results of the study indicated that the levels of cholesterol, triglycerides and blood suger rose significantly at the 1st week and third month after beginning the treatment. Increase of cholesterol and triglyceride in the Olanzapine and Risperidone groups was significant, while blood sugar level showed no significant difference in these two groups. Other side effects including restlessness, impotence, weight again, edema and drowsiness were significantly different between the two groups. Based on the findings of this study and the emphasis of other related studies on the metabolic changes of the body resulting from atypicad antipsychotic drugs, it is suggested that these drugs should be prescribed for high risk patients with great care and cautions.

To compare three different methods of signal detection applied to the Adverse Drug Reactions registered in the Iranian Pharmacovigilance database from 1998 to 2005. All Adverse Drug Reactions (ADRs) reported to Iranian Pharmacovigilance Center from March 1998 through January 2005, were included in the analysis. The data were analyzed based on three different signal detection methods including Reporting Odds Ratios (PRRs), Bayesian Propagation Neural Network (BCPNN) and Reporting Odds Ratios (RORs). Signals detected by each method were categorized based on the number of reports per drug-adverse event combination, severity of the event and labeled or unlabeled ADRs. The methods applied to signal detection were then compared in recognizing different types of adverse events. A total of 6353 cases of ADR reports, describing 11130 reactions, were reported to Iranian Pharmacovigilance Center (IPC) during the study period. The dataset involved 4975 drug-event combinations, which were assessed for detecting signals. The counts of drug-event combinations was 1, 2 and 3 or more for 3470, 727 and 779 combinations, respectively. There were 500 drug items responsible for 468 reaction terms in the database. According to PRR and 95% Confidence Interval, there were 2838, 872 and 488 drug-event combinations known as a signal for the pairs with the reporting frequency of ³1, ³2 and ³3 reports, respectively. The signals detected with the criteria of PRR³2, c2³4 were 2930, 872 and 480 for the pairs with the same reporting frequencies. Estimates of RORs and the 95% Confidence Interval showed that 2722, 862 and 481 drug-event combinations were detected to be signal for the pairs with the reporting frequency of ³1, ³2 and ³3 reports, respectively, while measuring IC and IC-2SD detected 1120, 378 and 235 cases for the same reporting frequencies. There were 234 signals detected by all three methods. Despite the similarities between data mining methodologies for signal detection, there are differences in the numbers of signals detected by each method. The study findings suggest that quantitative signal detection methods should be added to the routine Pharmacovigilance activities in Iran and the trends for quantitative measures over time should be monitored.

Metformin is usually using for glycemic control in type 2 diabetes mellitus. The drug is the first line for obese patients without renal or liver failure. Different pharmaceutical types of Metformin are available. As a clinical trial, we compared effects of Aria Metformin (product of Aria pharmaceutical company, Iran) with Merck Metformin or Glucophage (product of Merck pharmaceutical company, France), in diabetic patients. This double blind randomized clinical trial study performed with 60 non- pregnant diabetic patients, in order to comparison of therapeutic effects of combination therapy (Glibenclamide + Metformin "Aria or Merck") in a 12 weeks period. We evaluated FBS, BS 2hpp, HbA1c, lipid profile, liver function tests, weight, BMI and common or uncommon side effects. Not only each of two pharmaceutical types of Metformin had the same therapeutic effects for controlling of glycemia, lipid profile and weight, but also there were not difference between them in side effects. Distention was the most common side effects of two types products (33%). There is not significant difference between them in common side effects. 70% of patients were satisfied with each two kinds of Metformin. It seems, in view of beneficial therapeutic effects of Aria Metformin, low rate of side effects, and finally low cost, Aria Metformin is a good choice.