Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PRESCRIPTIONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,621 records · Page 90Linked to original sources

[A new therapeutic approach: the behavioral prescription of anxiolytics].

Nowadays, two major therapeutic approaches (pharmacological and behavioural) have proven their efficiency and efficacy in the treatment of anxious disorders. These two methods have been used separately, alternatively or simultaneously. The prescription of benzodiazepines is necessary, because they are efficient and fast-acting. But this is not enough and may be hazardous for a prolonged period. Behavioural methodology and therapeutics improve the assessment of anxious disorders and offer a large variety of specific techniques to the physician. The innovative and integrative behavioural prescription (BP) is pragmatic and reliable. For instance, drugs are markers for assessment of anxious behaviours, in an agenda and may be used both to support functional analysis, and as agents of therapeutic contracts. The synergic action of behavioural prescription is clear in three dimensions: BP deepens muscle relaxation and gives better self-control and self-regulation of arousal level. BP alleviates social inhibition by developing social skills. BP modifies cognitions and affective disorders, which is necessary for permanent results and drug withdrawal. Other applications of BP will be considered in the future.

Anti-Anxiety Agents↗

[Treatment of operated late gastric carcinoma with prescription of strengthening the patient's resistance and dispelling the invading evil in combination with chemotherapy: follow-up study of 158 patients and experimental study in animals].

158 cases of late gastric carcinoma (11 males and 47 females, age 30-70 years) were treated postoperatively with TCM prescriptions of strengthening the patient's resistance and dispelling the invading evil in combination with chemotherapy. The main ingredients were Radix Codonopsis Pilosulae, Radix Astragali seu Hedysari, Rhizoma Atractylodes, Herba Solani Hyrati, Herba Oldenlandiae and Herba Salviae. The prescription was individualized by adding or subtracting some herbs according to TCM syndrome diagnosis at the time of patient's visit. The decoction was given daily for a long time, three to four years or even longer. It was given alone or together with regimes of chemotherapy at random. The average survival rates at 3 and 5 years were 41.07% and 30.36% respectively. Seven patients have lived for more than 11 years. 10 years survival rate was 12.5%. The combination of Chinese medicine with chemotherapy was better than chemotherapy regime alone (single 5-Fu or CCNU+5-Fu, MMF). Immunological studies of the survivors revealed an enhancement of both humoral and cellular immunity especially the function of peripheral NK cells. The decoction had been given to mice bearing Ehrlich ascites tumor. The amount of ascitic fluid was reduced and its cancer cell count decreased besides a significant increase in over-all survival rate of the animals. It suggested that the above prescription might have an inhibitory or even killing effect on tumor cells. T cell immunity of the treated mice was also improved as seen among patients.

Adult↗

Perception of prescription drug risks: a survey of patients with ankylosing spondylitis.

The ways in which patients perceive the risks of prescription drugs are likely to influence treatment preferences and compliance decisions. But very little is known about the perceived frequency of adverse drug reactions (ADR), their perceived causation and attitudes towards the safety regulation of prescription drugs. A sample of 1,034 patients with ankylosing spondylitis (AS) completed a postal questionnaire on the risks of medicines in general and nonsteroidal antiinflammatory drugs (NSAID) in particular. Serious ADR were perceived to be more frequent with NSAID than prescription drugs generally, and those who had experienced a previous ADR (47%) judged ADR to be more frequent (p less than 0.001). When asked to rate the likelihood that each of 7 reasons were causative of ADR, the most likely reason was perceived to be inadequate information to the patient about the drug, and secondly inadequate patient followup by the prescribing doctor. Responses to a hypothetical AS drug risk scenario indicated high safety expectations for antirheumatic agents; 61% thought that the government should take a drug off the market if there is any evidence of fatal ADR. The results of this survey suggest the need for greater patient information and education on the risks and benefits of medicines to modify perceptions and false expectations.

Adult↗

[Use of aminopenicillins: first cause of error in the prescription of antimicrobial agents at a hospital].

The patterns of use and quality of prescription of ampicillin and amoxycillin (A/A) as compared with the rest of antimicrobials (AM) was evaluated by means of the review of the therapeutic sheets of 4572 admitted patients, in coincidence with 5 calculations of prevalence in a university hospital. 25.7% of patients received AM. These were used in 865 instances, and 6% were disqualified. A/A participated in 57% of these errors (p = 0.002 as related with the rest of AM). 309 patients received AM as prophylactic drugs, and 70% of them did not comply with the standard rules. The election of A/A for prophylaxis was associated with 71% of these errors (p less than 0.0001). Nine out of every 10 prophylactic administrations of A/A were abnormal owing to incorrect indication (77%), dosage (10%), oral route (62%) or excessive duration (82%). The high prevalence of prescription of aminopenicillins (30%) was associated with 68% of the errors in the use of AM, owing, among other reasons, to the high resistance rates of the major recovered organisms excluding enterococci. The nonjustified overuse of aminopenicillins was the leading detected problem; it can be managed by a restrictive antibiotic policy and educational measures oriented to an adequate medical prescription.

Amoxicillin↗

Exercise prescription guidelines for normal and cardiac populations.

The basic components of aerobic exercise prescription include recommendations for optimal frequency, intensity, duration, mode, and progression of activity. The most effective program design involves the use of each of these components and incorporates specific coexistent medical problems and objective data derived from a multistage exercise tolerance test. In addition to the prescription of aerobic exercise, the use of circuit weight training and recreational activities has become accepted as an important part of a comprehensive exercise prescription. In effecting a well-designed and safe exercise program, the clinician must also be aware of environmental considerations and the effect of cardiac medications on the response to exercise.

Adrenergic beta-Antagonists↗

[Guidelines for prescription of the assay of digitalis glycosides by immunologic methods].

Digoxin, digitoxin and acetyldigitoxin are the most widely prescribed of cardiotonic glycosides. Analytical exploration can be performed by a single assay when only one compound is prescribed or by multiple assays in cases of imprecise prescription or when several glycosides are given concomitantly. In addition, the metabolic transformation of digitoxin into digoxin and the presence of endogenous "digitalis-like compounds" mean that a number of precautions must be taken during prescription. These examples underline the ambiguity of the so-called "digitalinaemia" prescriptions and the need for biologists to be supplied with maximum information by clinicians.

Acetyldigitoxins↗

Prescription diuretic abuse in patients with bulimia nervosa.

Bulimia nervosa, a common eating disorder usually characterized by binge eating and self-induced vomiting, may also involve abuse of prescription diuretics. This article describes four patients who abused prescription diuretics in large quantities (up to 2 g/d of furosemide) for extended periods of time. Physical examination and laboratory values provided few clues to the diagnosis of bulimia nervosa. Other eating-related behaviors previously linked to bulimia nervosa--including abuse of diet pills, illicit amphetamines, and laxatives, as well as withholding of insulin in one diabetic patient--were present in these cases. Usually the patients' primary physicians were not aware of these problems. Physicians should be aware that patients requesting prescription diuretics may have bulimia nervosa.

Adult↗

[Contraception and informatics. SELF, a system to aid medical decisions applied to the prescription of contraceptive methods].

SELF (systeme en logique floue = system in soft discware), developed by the Computer Sciences Laboratory of the Faculté de Médecine in Nancy, is, by comparison to many systems of assistance in medical decisions already existing, a comprehensive and simple unit enabling the construction and modification of basic knowledge as well as its questioning. The first application of SELF concerned the field of gynecology, by producing a system of assistance applied to the prescription of a contraceptive method. The systematic use of this computer program along with the traditional prescription of a contraceptive method, was tested for three months in the Regional Maternity Hospital by several physicians in the Gynecology Clinic. The system was extremely well accepted and the responses have generated numerous discussions between physicians leading to an improvement of SELF and a better rationalization of the prescription. The medical and paramedical personnel in training at the hospital found SELF to be a teaching tool which, on the basis of simulated cases, permits an easier and more concrete explanation of the practical management in advising or prescribing a contraceptive method.

Contraceptive Agents, Female↗

Exercise prescription for the cardiac patient: an update.

Exercise prescription for patients after myocardial infarction and for those after coronary artery bypass grafting is contrasted with prescription for healthy adults. Calculation of target training heart rate and the rating of perceived exertion scale for the cardiac patient are examined. The authors discuss in detail exercise prescription for the cardiac patient during in-patient, outpatient, and community-based programs. A well-rounded approach including flexibility, strength, and aerobic components is emphasized.

Adrenergic beta-Antagonists↗

Folic acid prescription in pregnancy.

We resolved to prescribe folic acid supplements for all women who attended this practice during the first twelve weeks of pregnancy. Six months after this decision a prescription was recorded in only 13% of cases: this compared with 18% during the two months immediately following the decision. It was resolved to improve this performance and observations six months later revealed a prescription recorded in 63% of cases. Subsequently a new form for recording an antenatal consultation was devised and six months after its implementation, 100% recording of folate prescription for appropriate cases was observed. It was concluded that these simple audit exercises prompted changes in practice which helped to improve standards of patient care.

Adolescent↗

[Evaluation of the impact of a care program for asthmatic children on the quality of anti-asthma drug prescriptions].

OBJECTIVE: To determine the influence of a programme of care for asthmatic children (CAC) on the quality of prescription of anti-asthmatic drugs. DESIGN: A controlled non-random intervention study. SETTING: Paediatric clinics operating before 1991 in Health Districts (HD) of Hospitalet. PARTICIPANTS: INTERVENTION GROUP: All the paediatricians ranked in the HD where the programme was set up (n = 3). CONTROL GROUP: All the paediatricians ranked in the rest of the HD (n = 9). INTERVENTION: In april 1992 the CAC programme, which included a pharmaco-therapeutic procedure, was set up in the HD. MEASUREMENTS AND MAIN RESULTS: Prescriptions were evaluated by looking at the billing data of the Catalan Health Service between january and april, 1991, 1992 and 1993. The following Quality Indicators were evaluated: 1. Percentage of dosage of beta 2 adrenergics inhaled as against the total of beta 2 (oral and inhaled). 2. Percentage of DHD of Nedocromil (NC) and Cromoglycate (CG) as against the total of preventive drugs (NC + CG + Ketotifen). 3. Number of packages of oral and/or rectal Theophyllines, counter-indicated combinations and anti-inflammatory drugs (Chromones and inhaled steroids). CONCLUSION: The influence of the programme can be considered very positive, since an increase in all the quality indicators of the prescription of anti-asthmatics was observed, something that did not occur in the Control Group.

Administration, Inhalation↗

Neuroleptic prescriptions for acutely ill geriatric patients.

BACKGROUND: Use of neuroleptic medication by the general population of acute care hospitals and in geriatric populations in long-term care has been described. This study examines the use of neuroleptics in acutely ill medical/surgical geriatric patients. METHODS: Chart review was performed for geriatric patients prescribed a neuroleptic drug during a 2-month study period. Patient characteristics, indications for drug use, and evaluations of cognitive or behavioral dysfunction were noted. For the patients who received only haloperidol, the type of order was described and prescription strategies were identified. RESULTS: Ninety-one (10.7%) of 848 patients received a neuroleptic order. They were older and stayed longer than the rest of the geriatric population. Fifty-eight percent were demented or delirious but 31.9% were simply described as agitated or had no reason identified for drug use. Haloperidol was the sole neuroleptic prescribed for 91.2% of patients. The rationale behind the strategies for drug prescription (loading, maintenance, sporadic) was not clear. CONCLUSION: This study raises concerns about the quality of documentation around drug use and the adequacy of diagnostic evaluation prior to drug prescription. The strategies of drug treatment do not consistently reflect a working knowledge of the pharmacology of the drug or a diagnosis-based plan of treatment. Future research should focus on physician education and the efficacy of diagnosis and management of the agitated elder.

Acute Disease↗

Thyroxine prescription in the community: serum thyroid stimulating hormone level assays as an indicator of undertreatment or overtreatment.

Examination of thyroxine usage in a study in the United States of America revealed that many patients were prescribed thyroxine for non-thyroid indications, such as obesity and fatigue. Many of those receiving thyroxine had high or low serum thyroid stimulating hormone levels, indicating prescription of incorrect doses or lack of patient compliance with therapy. Long term thyroxine therapy may have effects upon the risk of osteoporosis. The aims of this study were to investigate indications for thyroxine prescription in the United Kingdom and to examine the frequency of abnormal serum thyroid stimulating hormone concentrations in those prescribed thyroxine for hypothyroidism. This was in order to determine the relevance of measurement of thyroid stimulating hormone level in monitoring thyroxine therapy. Subjects receiving thyroxine were identified from the computerized prescribing records of four general practices in the West Midlands. Of 18,944 patients registered, 146 (0.8%) were being prescribed thyroxine; 134 of these had primary hypothyroidism and the remainder had other thyroid or pituitary diseases prior to treatment. Of the 97 patients with primary hypothyroidism who agreed to have their thyroid stimulating hormone level measured, abnormal serum levels were found in 48%, high levels in 27% and low levels in 21%. There was a significant relationship between prescribed thyroxine dose and median serum thyroid stimulating hormone level: high hormone levels were found in 47% of those prescribed less than 100 micrograms thyroxine per day, while low levels were found in 24% of those prescribed 100 micrograms or more. Thus, thyroxine prescription was common in the four practices sampled, although indications for its use were appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Use of second line drugs for the treatment of rheumatoid arthritis in Edmonton, Alberta. Patterns of prescription and longterm effectiveness.

OBJECTIVE: Our purpose was to compare the patterns of prescription of 2nd line drugs for the treatment of rheumatoid arthritis (RA) among rheumatologists in Edmonton, Alberta, and to examine the longterm effectiveness of these drugs. METHODS: A 1985 inception cohort of 128 patients with RA was assessed between 1991 and 1992, using measures of disease activity, radiological scores and physical functional status. Use of different therapies was retrieved from the medical charts. RESULTS: All patients had seen a rheumatologist at any time between January, 1985 and December, 1991, 88% within the first 3 years of disease. Most (85%) had received at least one 2nd line drug, the majority within the first 2 years. Overall, gold salts were the most frequently prescribed drugs. Patterns of prescription varied among different rheumatologists; some drugs were never prescribed by some and very often by others (e.g., auranofin). Terminations because of toxicity and lack of efficacy were high. Methotrexate (MTX) had the lowest termination rate and sulfasalazine the highest, mostly due to lack of efficacy. CONCLUSION: In this cohort, patients were treated early in the course of RA. Patterns of prescription of 2nd line drugs varied among rheumatologists. Termination rates were highest for sulfasalazine and lowest for MTX.

Adrenal Cortex Hormones↗

Antibiotics and respiratory infections: do antibiotic prescriptions improve outcomes?

BACKGROUND AND OBJECTIVES: Antibiotics are frequently prescribed for respiratory infections though most of these infections are viral. To determine whether this practice contributes to patient health and patient satisfaction, we studied the effect of antibiotic prescriptions on outcomes at 7 to 10 days. We also studied the effect of antibiotic prescriptions upon the accuracy of patients' beliefs about viruses. METHODS: One hundred thirteen patients with a respiratory infection completed questionnaires before and after their visit with their primary care doctor. A phone interview was completed 7 to 10 days later. Questions elicited their expectations for antibiotics, their beliefs about the efficacy of antibiotics, and satisfaction with the doctor. The phone interview asked whether they felt better, whether they had returned to the doctor about the same illness, satisfaction, and whether they would expect antibiotics for the same disease in the future. The doctors provided information about their diagnosis and treatment. RESULTS: No correlation was found between prescription of antibiotics and patient satisfaction, feeling better, return physician visits, or phone calls. Receiving antibiotics increased the likelihood the patients would expect antibiotics the next time they had an upper respiratory infection and made them more likely to have an inaccurate belief, that antibiotics kill viruses. CONCLUSIONS: The study found no evidence that antibiotics improve patient outcome in upper respiratory infections by making patients feel better at 7 to 10 days. Nor did it find evidence that antibiotics help physicians by reducing return visits or increasing patient satisfaction. Doctors are invited to reconsider their policies for prescribing antibiotics for upper respiratory infection.

Adolescent↗

[Evaluation of an intervention on the prescription and biological surveillance of low-molecular weight heparins in medicine].

OBJECTIVES: We evaluated the effect of oral recommendations documents distributed to prescribing physicians on the use of low-molecular weight heparin (LMWH) and laboratory test orders. METHODS: Prescription of LMWH over a 6 month period was left to the total discretion of the prescribing physician (observation period). An information session and recommendation documents were then proposed describing prophylactic use of LMWH and appropriate hemostasis monitoring tests for curative treatments. Prescriptions and laboratory test orders were then recorded for the next six months (intervention period). RESULTS: Diffusion of recommendation documents to prescribers led to a 50% decrease in the prescription of low-molecular weight heparin for prophylaxis and a significant drop in orders for anti-Xa and prothrombin. CONCLUSION: These results confirm the efficacity of informing prescribing physicians on the use of low-molecular weight heparins and underlines the need to validate methods used for the prevention of venous thrombosis.

Animals↗

An elevated ratio of measured to predicted creatinine production in CAPD patients is not a sensitive predictor of noncompliance with the dialysis prescription.

OBJECTIVE: To determine the effect a period of "intentional noncompliance" in stable continuous ambulatory peritoneal dialysis (CAPD) patients has on the ratio of measured to predicted creatinine generation. DESIGN: Prospective study that compares baseline to noncompliant periods in individual CAPD patients. PATIENTS: Nine chronic, stable CAPD patients. STUDY DESIGN: At baseline, measured creatinine production and adequacy parameters (KT/V, creatinine clearance, lean body mass, and protein equivalent of nitrogen appearance) were calculated from 24-hour collections of dialysate and urine while patients were performing their routine dialysis prescriptions. After three days of intentional noncompliance (one less exchange/day) the patients repeated their 24-hour collections, again performing their routine number of exchanges. Measured creatinine production and adequacy parameters were again calculated. Predicted creatinine production for each patient was calculated from standard equations. All parameters at baseline were compared to corresponding parameters after intentional noncompliance. RESULTS: In all patients, except one where there was no change, there was a statistically significant increase in not only the ratio of measured to predicted creatinine production but also all other parameters. CONCLUSION: As suspected by previous investigators, this study suggests that one cause of an elevated ratio of measured to predicted creatinine production may be a recent period of noncompliance with the patient's dialysis prescription. However, these data suggest that an isolated ratio of measured to predicted creatinine generation is not a sensitive predictor of noncompliance with the peritoneal dialysis prescription.

Adult↗

Variability in post-operative fluid and electrolyte prescription.

A four-week retrospective survey of intravenous fluid and electrolyte prescriptions on post-operative surgical patients revealed wide variability in fluid and electrolyte prescription by medical staff. Median volume of intravenous fluid prescribed was 3000 ml (range 1667-5000). Total sodium prescribed varied from 0 to 770, median 242 mmol/day), with potassium infrequently added (range 0-81, median 0 mmol/day). Patients undergoing emergency surgery were prescribed more sodium than those undergoing routine procedures (p = 0.0403); 0.9% saline was the most common fluid prescribed overall. There was poor correlation between serum electrolyte values and the amounts of electrolytes prescribed. Intravenous fluid prescription should take into account the post-operative stress response which reduces sodium requirements (unless there are other concomitant losses) and increases urinary potassium losses. A suitable post-operative 'maintenance' fluid is 4% dextrose/0.18% saline with 1-2 g potassium chloride, particularly if serum electrolyte levels are not known. Other fluid losses should be replaced with equivalent fluids.

Aged↗