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Biomedical subjects

D L Kennedy

Publications and source records attributed to D L Kennedy.

At least 37 records · Page 2Linked to original sources
PubMed1988

Prescription drug use in 1984 and changes over time.

More than 1.5 billion prescriptions were dispensed from retail pharmacies in 1984 at a consumer cost of +18.4 billion. The number of prescriptions dispensed in 1984 equaled the previous record set in 1973. Over 40% of 1984 prescriptions were for four therapeutic classes: cardiovascular drugs, anti-infectives, psychotherapeutic drugs, and diuretics. Prescriptions for cardiovascular drugs and diuretics increased substantially from 1975 to 1984, while prescriptions for psychotherapeutic drugs decreased. Outpatient use of systemic antiinfectives remained fairly stable over the 10-year period. Trends in the use of specific drug categories within these broad therapeutic classes were variable, as were patient age and sex distributions.

Adult↗
PubMed1988

Prescribing of noncontraceptive estrogens and progestins in the United States, 1974-86.

This paper describes changes in the prescribing of noncontraceptive estrogens and progestins, using data from pharmaceutical marketing surveys. The number of estrogen prescriptions decreased from 1975 to 1980, and then increased through 1986. Progestin use has increased since 1982; concomitant use of estrogens and progestins increased over time and was common in 1986. The trends suggest that the use of estrogens, particularly the combined use of estrogens and progestins, will continue to increase.

Adult↗
PubMed1987

Prescription drug use before and during pregnancy in a Medicaid population.

This study describes prescription drug use before and during pregnancy and is based on data obtained from the paid Medicaid claims of 18,886 Michigan women aged 15 to 44 years who were delivered of a live infant. Rates of exposure to drugs within 15 therapeutic categories are presented for each of five 90-day periods preceding delivery. Overall dispensed drug use (excluding vitamins) decreased during pregnancy; however, there was still substantial exposure to drugs including drugs that are contraindicated during pregnancy. During the gestational period, study mothers received an average of 3.1 prescriptions for nonvitamin drugs. Black mothers received more exposure to drugs other than vitamins than did white mothers. Black mothers had higher rates of exposure to analgesics, ampicillin, codeine, and vaginal preparations. Similarities between black and white mothers in the use of vitamins with and without other drugs suggest there is no racial difference in attaining prenatal care within the Medicaid system, but that black mothers may have more medical problems that warrant the use of other medications in addition to vitamins during pregnancy.

Adolescent↗
PubMed1987

Oral contraceptives in the United States: trends in content and potency.

Data from the National Prescription Audit, a nationwide pharmaceutical marketing research data base, were reviewed to study changes in the type of oral contraceptives marketed in the US, their content and their relative oestrogen and progestin potency over the 21-year time period of 1964-84. Three major types and 42 brands of oral contraceptives were marketed in the US during this time period. All oral contraceptives dispensed in the US have contained one of nine different progestins and one of two oestrogens or, in the case of the progestin-only pills, no oestrogen at all. A comprehensive classification listing all 42 brands of oral contraceptives by content and strength is presented. Secular changes in oral contraceptive potency are described in terms of a categorization scheme which simultaneously ranks both the oestrogen and progestin potencies of each oral contraceptive. Over the time period studied, oral contraceptives have evolved from high strength, high potency drugs to much lower strength, lower potency drugs. The epidemiological implications of these shifts in oral contraceptive content and potency are discussed.

Contraceptives, Oral↗
PubMed1987

National patterns of aspirin use and Reye syndrome reporting, United States, 1980 to 1985.

The number of cases of Reye syndrome reported annually to the Centers for Disease Control declined markedly between 1980 and 1985. In this article, we present pharmaceutical marketing research data that suggest sharp decreases in the use and purchase of children's aspirin between 1980 and 1985. These trends appear to correspond to the decrease in reporting of Reye syndrome cases. Additionally, analysis of physician mentions of aspiring and acetaminophen for treating flu and chickenpox showed statistically significant trends toward decreasing recommendations for the use of aspirin and significant trends toward increasing recommendations for use of acetaminophen. Trends in wholesale purchases of aspirin and acetaminophen by drug stores from 1979 through 1985 demonstrated a significant decline for the 81-mg children's aspirin tablet and an increase in purchases of children's acetaminophen products. Many factors may influence physician and parents' choice of analgesic/antipyretic medication, including information about Reye syndrome. Data suggest that a continuing decline in the use of aspirin for children may be accompanied by a continuing decline in the reported number of Reye syndrome cases.

Acetaminophen↗
PubMed1985

Drug use and expenditures in 1982.

This article provides national estimates of drug use and drug expenditures in 1982. Total outpatient drug exposure increased 5% from 1981 to 1982 and 28% from 1971 to 1982. Hydrochlorothiazide was the most frequently dispensed drug chemical and was contained in more than 5% of all 1982 prescriptions. Sixteen major therapeutic classes accounted for about 80% of drugstore and hospital expenditures for ethical pharmaceuticals. Hospitals spent around +3.0 billion and a third of this total was for anti-infectives administered for systemic effects. The prescription drug component of the consumer price index increased 11.7% in 1982, and consumers spent about +14.5 billion on prescriptions from retail pharmacies alone.

Adolescent↗
PubMed1985

Utilization of nonsteroidal antiinflammatory drugs.

Information derived from pharmaceutical marketing databases on the use of 12 nonsteroidal antiinflammatory drugs in 1983 is presented. Estimates of population exposure, regularity of treatment, average daily dose, age and sex distributions of users, concomitant use of other drugs, associated diagnoses, and trends in use are provided. Utilization patterns were similar for 8 of the nonsteroidal antiinflammatory drugs, with differing patterns seen for mefenamic acid, oxyphenbutazone, phenylbutazone, and zomepirac.

Adolescent↗
PubMed1985

Noncontraceptive estrogens and progestins: use patterns over time.

The use of noncontraceptive estrogens and progestins, particularly in menopausal women, has been a subject of considerable controversy during the past decade. Reported is a review of overall trends in the use of these drugs from 1966 to 1983 and a more indepth qualitative and quantitative description of their use during 1983. The use of these estrogens and progestins appears to be increasing again. The estrogens are apparently being used at lower doses than in the past, and there is a trend toward using estrogens and progestins concomitantly. Exclusive of oral contraceptives, enough oral estrogen was purchased during 1983 to treat an average of 2.3 million people each day, while oral progestin purchases could have supplied 129,000 people daily.

Administration, Oral↗
PubMed1984

Drug use in the United States in 1981.

This study provides national estimates of outpatient prescription drug use based on pharmaceutical marketing data. An analysis of total outpatient exposure from 1971 through 1981, generated from data on population and prescription size as well as total prescriptions, indicated that overall drug use is increasing. Overall use was also analyzed by patient age and sex, geographic region, and physician specialty. Data are presented for the most frequently used drug categories and therapeutic classes. Ranking drug chemicals across different products and therapeutic indications, which is a more precise measure of population exposure, indicated that nearly one of every ten prescriptions in 1981 contained either hydrochlorothiazide or codeine.

Adult↗
PubMed1983

Predominant integration end products of infecting bacteriophage Mu DNA are simple insertions with no preference for integration of either Mu DNA strand.

The integration of 32P-labeled infecting Mu DNA into the Escherichia coli chromosome was investigated. Cleavage of the integrated Mu DNA with restriction endonuclease EcoRI, which cuts twice in the Mu genome, liberated the internal EcoRI fragment but not the left and right end fragments. The ends of the Mu genome became fused with host DNA at a variety of locations generating a smear of radioactive DNA fragments following cleavage with EcoRI. The predominant integration end products of infecting Mu DNA molecules are therefore generated by a mechanism which results in simple insertions and not cointegrates. Since predominantly simple insertions are found after infection (during lysogenization or lytic growth) but not after prophage induction, the transposition mode which is utilized appears to be a function of the source of the transposing DNA. Use of the integrated, 32P-labeled Mu DNA as a hybridization probe with the separated strands of Mu DNA or lambda phages carrying various regions of Mu showed no strand preference in the integration process. Both labeled DNA strands at both ends of the Mu genome were integrated. These results suggest the lack of a site-specific recombination site in the genome; the simple insertions which are the end products of Mu DNA integration following infection appear to be generated by a separate pathway rather than by the resolution of cointegrate structures.

Bacteriophage mu↗
PubMed1983

Relationship of oral contraceptive estrogen dose to age.

The authors analyzed extracts of the computerized Medicaid records of 81,968 patients with prescription billing claims for oral contraceptives from the states of Michigan and Minnesota in 1980. It was found that women aged 35-39 years were more than twice as likely to be recipients of high dose (over 50 micrograms) estrogen oral contraceptive preparations than women aged 15-19. There was an increase in the proportion of high dose estrogen recipients among oral contraceptive recipients for each successive five-year age group from 15-19 to 35-39 years in both states. These findings were similar to those from National Disease and Therapeutic Index data for the United States for 1980, and appear to indicate changing patterns of use in the past decade. The independent contributions of age and estrogen dose or their combined effect with respect to the risk for venous thrombosis, pulmonary embolism, or related diseases has not been assessed in prior studies. To the extent that current use of oral contraceptives with higher estrogen doses contributes to the age-related trend of morbidity and mortality rates among women aged 15-44 years, an opportunity for prevention exists by altering this pattern of use.

Adolescent↗
PubMed1982

Drug therapy for ambulatory pediatric patients in 1979.

Little data are available on the use of drugs in children on an outpatient basis. Therefore, the present study investigated national patterns in the prescribing of drugs for children by office-based physicians during 1979, in order to describe the most commonly encountered pediatric drug therapies. The data are presented as descriptive norms of drug therapy by office-based physicians in two pediatric subgroups, 0 to 2 years old and 3 to 9 years old. Anti-infective drugs and cough and cold preparations accounted for approximately 50% of drugs used. Tetracycline and its congeners continue to be used in pediatric patients. Despite apparent advantages of amoxicillin, ampicillin is still widely used.

Ambulatory Care↗
PubMed1980

The effects of dexamethasone on metabolic activity of hepatocytes in primary monolayer culture.

The effects of dexamethasone on multiple metabolic functions of adult rat hepatocytes in monolayer culture were studied. Adult rat liver parenchymal cells were isolated by collagenase perfusion and cultured as a primary monolayer in HI/WO/BA, a serum free, completely defined, synthetic culture medium. Cells inoculated into the culture medium formed a monolayer within 24 hr. Electron microscopy showed that the cells in primary culture had a fine structure identical to liver parenchymal cells in vivo, including the observation of desmosomes and bile canaliculi in intercellular space. There was significant gluconeogenesis by the cells 24 hr postinoculation but it had decreased markedly by 48 hr. There was a marked induction of tyrosine aminotransferase (TAT) by dexamethasone, which was maintained for up to 72 hr postinoculation of cells. The transport of alpha-aminoisobutyric acid into the cells in monolayer culture was stimulated by dexamethasone and was dependent on the concentration of dexamethasone. Albumin synthesis and secretion by the cells was measured by a quantitative electroimmunoassay. Albumin production was shown to increase linearly over an incubation period of 24 to 48 hr postinoculation. Dexamethasone depressed the albumin synthesis. The effects of dexamethasone are slow, and at times require more than 6 hr to show variation from the control, indicating that dexamethasone is not a single controlling hormone. Possibly it functions in a cooperative and coordinating role in the regulation of cell metabolism.

Albumins↗