Prescription and Other Medication Use in Pregnancy.

OBJECTIVE: To characterize prescription and other medication use in a geographically and ethnically diverse cohort of women in their first pregnancy. METHODS: In a prospective, longitudinal cohort study of nulliparous women followed through pregnancy from the first trimester, medication use was chronicled longitudinally throughout pregnancy. Structured questions and aids were used to capture all medications taken as well as reasons they were taken. Total counts of all medications taken including number in each category and class were captured. Additionally, reasons the medications were taken were recorded. Trends in medications taken across pregnancy and in the first trimester were determined. RESULTS: Of the 9,546 study participants, 9,272 (97.1%) women took at least one medication during pregnancy with 9,139 (95.7%) taking a medication in the first trimester. Polypharmacy, defined as taking at least five medications, occurred in 2,915 (30.5%) women. Excluding vitamins, supplements, and vaccines, 73.4% of women took a medication during pregnancy with 55.1% taking one in the first trimester. The categories of drugs taken in pregnancy and in the first trimester include the following: gastrointestinal or antiemetic agents (34.3%, 19.5%), antibiotics (25.5%, 12.6%), and analgesics (23.7%, 15.6%, which includes 3.6%; 1.4% taking an opioid pain medication). CONCLUSION: In this geographically and ethnically diverse cohort of nulliparous pregnant women, medication use was nearly universal and polypharmacy was common. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01322529.

Review of Italian primary care paediatricians identifies 38 commonly prescribed drugs for children.

AIM: Most Italian children are cared for by a family paediatrician until they are 14 years old, and their duties include prescribing drugs recommended by specialists so that they are free. This study aimed to draw up a list of the drugs most commonly prescribed by family paediatricians. METHODS: We surveyed 64 experienced family paediatricians to find out what drugs they prescribed over an 8-week period, including those recommended by a specialist, using cartons of drugs as the unit of measurement. A list of commonly prescribed drugs was then drawn up. RESULTS: A total of 381 active substances were prescribed. The most commonly prescribed drugs were amoxicillin (25.8% of the cartons), amoxicillin clavulanate (9.2%) and cetirizine (9.0%). The most commonly prescribed drug classes were antibiotics (43.8%), anti-asthmatics (12.9%) and antihistamines (11.8%). A list of 38 commonly prescribed drugs belonging to 16 therapeutic subgroups and covering 83.1% of cartons was identified. Of these, 33 were prescribed by 50% or more of the paediatricians and five were mainly prescribed following the recommendation of a specialist. CONCLUSION: Our review of the prescribing habits of family paediatricians showed that 38 commonly prescribed drugs were sufficient to treat most common diseases in children under 15 years of age.

[Thinking about evaluation of proprietary Chinese medicines containing toxic herbs during switch process of non-prescription drugs].

To enhance the scientific and fair evaluation about proprietary Chinese medicines containing toxic herbs during the switch process of non-prescription drugs, and to ensure those medicines to be used safely by the public in their self-medication. Combined with current research status of toxic herbs, the experience and knowledge accumulated in the practical work of selection and switch of OTC Chinese medicines for years, thinking about the feasible standards about evaluation and management of proprietary Chinese medicines containing toxic herbs at this stage. Initially established ideas and methods about evaluation of proprietary Chinese medicines containing toxic herbs during the switch process of non-prescription drugs. Basically solved the main problem currently faced by toxic herbs during the OTC switch process of proprietary Chinese medicines, effectively promoted the work on OTC switch, and had the important significance in making consumers use non-prescription drugs conveniently and safely.

Self-medication: initial treatments used by patients seen in an ophthalmologic emergency room.

OBJECTIVE: This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients' use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS: We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS: The sample included 561 subjects, 51.3% males and 48.7% females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5% reported self-medicating; 29.4% used a homemade preparation (13.9% referred to an industrialized product like boric acid as a homemade preparation), and 11.1% used a manufactured product. The most frequently used products included a boric acid solution (53.3%), a normal saline solution (35.7%), herbal infusions (6.1%) and breast milk (4.8%). Viral conjunctivitis was the most frequent diagnosis (24.4%), followed by the presence of a corneal foreign body (7.4%). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION: Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries.

Medication use among senior Canadians.

Based on data from the 1996/1997 (institutional component) and 1998/1999 (household component) National Population Health Survey, seniors were major consumers of prescription medications, over-the-counter (OTC) products, and natural and alternative medicines. Almost all (97%) seniors living in long-term health care institutions were current medication users (medication use in the two days before their interview), as were 76% of those living in private households. Over half (53%) of seniors in institutions and 13% of those in private households used multiple medications (currently taking five or more different medications). Both medication and multiple medication use were associated with morbidity. Medications for the nervous system, the alimentary tract and metabolism, and the cardiovascular system were reported most frequently. Among seniors in institutions, those with Alzheimer's disease were less likely to take multiple medication than were those without this condition.

Self-medication: initial treatments used by patients seen in an ophthalmologic emergency room

OBJECTIVE: This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients' use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS: We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS: The sample included 561 subjects, 51.3 percent males and 48.7 percent females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5 percent reported self-medicating; 29.4 percent used a homemade preparation (13.9 percent referred to an industrialized product like boric acid as a homemade preparation), and 11.1 percent used a manufactured product. The most frequently used products included a boric acid solution (53.3 percent), a normal saline solution (35.7 percent), herbal infusions (6.1 percent) and breast milk (4.8 percent). Viral conjunctivitis was the most frequent diagnosis (24.4 percent), followed by the presence of a corneal foreign body (7.4 percent). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION: Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries.

Preparing botanical medicines.

Next to dose concerns, the subject of preparation may be the most misinterpreted area of modem botanical medicine. Yet it is one of the most important issues in clinical practice. In traditional medicine systems, any given herb would have been discovered to be effective in specific preparations. The "ideal" form and preparation varies from herb to herb, as well as from person to person. The most desirable preparation is usually defined as the way to get the most active ingredient out of the herb. However, in some cases, the proper preparation may be the only way to safely use the herb. The proper preparation may be dictated by the solubility of the constituents and may also be defined according to how the patient is practicably able to consume it. In today's market, most herbs can be found in most preparations, but that does not mean that every preparation will contain active constituents. The author makes the case that using traditional preparations from the ethnic system of the herb origin will be the most effective clinical course of action.

Usefulness of traditionally defined herbal properties for distinguishing prescriptions of traditional Chinese medicine from non-prescription recipes.

Traditional Chinese medicine (TCM) has been widely practiced and is considered as an attractive to conventional medicine. Multi-herb recipes have been routinely used in TCM. These have been formulated by using TCM-defined herbal properties (TCM-HPs), the scientific basis of which is unclear. The usefulness of TCM-HPs was evaluated by analyzing the distribution pattern of TCM-HPs of the constituent herbs in 1161 classical TCM prescriptions, which shows patterns of multi-herb correlation. Two artificial intelligence (AI) methods were used to examine whether TCM-HPs are capable of distinguishing TCM prescriptions from non-TCM recipes. Two AI systems were trained and tested by using 1161 TCM prescriptions, 11,202 non-TCM recipes, and two separate evaluation methods. These systems correctly classified 83.1-97.3% of the TCM prescriptions, 90.8-92.3% of the non-TCM recipes. These results suggest that TCM-HPs are capable of separating TCM prescriptions from non-TCM recipes, which are useful for formulating TCM prescriptions and consistent with the expected correlation between TCM-HPs and the physicochemical properties of herbal ingredients responsible for producing the collective pharmacological and other effects of specific TCM prescriptions.

Frequently asked questions (FAQ).

As Americans use botanical medicines in ever-increasing numbers, they are moving beyond capsules and tinctures, and turning to assorted preparations that will complete their herbal medicine chest. According to The Arthritis Foundation, almost 45% of patients apply ointments or rubs for osteoarthritis. Topical preparations have a long history in traditional herbal medicine systems, and make up a significant proportion of the armamentarium of indigenous practitioners. Although contemporary patients are often resistant to the inconvenience of topical preparations, they often will become compliant after a notable success. The nomenclature of these topical preparations, as one would expect, is murky. There are no clear and consistent definitions for the assorted terms, and different sources will use different terms for the same material or process.

Mexican migrant ethnopharmacology: pharmacopoeia, classification of medicines and explanations of efficacy.

This paper describes the ethnopharmacological knowledge of women in an urban Mexican migrant community in Athens, GA, USA. Data were collected using free-list, pile-sort and semi-structured interviews. The pharmacopoeia of this community includes herbal remedies, over-the-counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and prescription medicines. Multi-dimensional scaling analysis of pile-sort data revealed that Mexican women living in Athens classify medicines into four categories: herbal remedies, salves, pastillas (pills-both prescription and non-prescription) and other commercial preparations. Herbal remedies are viewed as natural and safe while pastillas are thought to be dangerous and potentially addictive. Comparisons of Mexican explanations for the actions of five medicines (Matricaria recutita L. [Asteraceae], Mentha spp. L. [Lamiaceae], Ruta spp. L. [Rutaceae], Ocimum basilicum L. [Lamiaceae] and paracetemol) with the pharmacological literature show several similarities and confirm that migrant women use these medicines effectively. Mexican migrant women use medicinal plants in combination with commercially produced medicines, but most have a strong preference for the herbal remedies that they make themselves, over drugs prescribed by physicians. Some of their descriptions of the actions of medicines are supported by the pharmacological literature, but ethnopharmacologists have not fully investigated all of the attributes that migrant women ascribe to them.

Non-prescription medicines: prescribing legislation.

This article discusses developments in prescribing legislation in relation to non-prescription medicines. The three supply categories are outlined: prescription only, general sale list, and pharmacy medicines. Changes in legislation towards increased availability of medicines that do not require prescription are covered and the implications for at-risk groups are discussed. A table of minor ailments and their principal treatments is provided.

Self-reported medication use among adolescents in Kuwait.

OBJECTIVE: The objectives of this study were to describe and examine the pattern of medication use, including age and gender differences among adolescents in Kuwait, and to establish the sources of information on medicines in this age group. SUBJECTS AND METHODS: A cross-sectional survey of 1,110 male and female students (14-21 years) from 10 randomly selected public schools in Kuwait was conducted. The prevalence of self-medication was estimated. RESULTS: The prevalence of self-medication among the high school students was 92%. The prevalence increased by age from 87% among 14-year-olds to 95% among 18-year-olds. Sixty-five percent of medicines used were for pain relief, 54% for respiratory conditions, 39% for allergic conditions, and 37% for dermatological conditions. Twenty-two percent of medicines were nutritional supplements and vitamins, 21% gastrointestinal products, 17% antidandruff products, 15% hair products, 13% for migraine while 8% were for athlete's foot. Pain relief, respiratory, dermatologic and hair products were more prevalent in female adolescents than in male while antidandruff and athlete's foot preparations were used more by male adolescents. The most common sources of information on medicines were parents. CONCLUSION: The prevalence of self-medication among adolescents in Kuwait is high. Self-medication tended to increase with age and differed between male and female students. Few students consulted pharmacists for information on drugs. There is need to promote the image of the pharmacist in Kuwait as a provider of medication information.