To assess physician knowledge regarding acetaminophen dosing, toxicity, and recognition of acetaminophen-containing products and counseling practices when prescribing acetaminophen-containing medications.

METHODS:

Resident and faculty physicians at 1 internal medicine and 2 family medicine residency programs in Alabama were asked to participate in a voluntary survey. Participants completed a 7-item self-administered questionnaire. Questions were designed to assess physician knowledge of acetaminophen dosing and toxicity, recognition of prescription and over-the-counter products containing acetaminophen, and education provided to patients when prescribing acetaminophen-containing products. Questions were formatted as multiple choice, yes/no, true/false, and short answer. Certain items contained an answer choice of "unsure."

RESULTS:

Of the 76 physicians who completed the survey, only 76% were aware of the maximum daily dose of acetaminophen. Although 93% recognized Lortab and 90% Percocet as acetaminophen-containing products, only 83% identified Lorcet and 75% Darvocet. More than 90% of physicians correctly identified nonacetaminophen prescription medications with the exception of OxyContin (84%) and Ultram (79%). Knowledge of over-the-counter products was generally less accurate. Ninety-eight percent recognized hepatotoxicity as the primary toxicity. Although 72% of physicians stated they provide specific instructions to patients when prescribing acetaminophen-containing medications, the information provided was limited.

CONCLUSIONS:

Many physicians are unaware of acetaminophen dosing and toxicity issues and have some difficulty identifying acetaminophen-containing products. Information provided by physicians when prescribing acetaminophen products was limited. How this may contribute to unintentional acetaminophen overdose is unclear but should raise concern. These results reinforce the importance of public awareness, patient counseling, and physician education regarding acetaminophen toxicity issues.

2008-04-01·Drug and alcohol dependence2区 · 医学

Non-prescribed use of pain relievers among adolescents in the United States

2区 · 医学

Article

作者: Ashwin A. Patkar ; Li-Tzy Wu ; Daniel J. Pilowsky

BACKGROUND:

We examined gender-specific prevalences, patterns, and correlates of non-prescribed use of pain relievers - mainly opioids - in a representative sample of American adolescents (N=18,678).

METHODS:

Data were drawn from the public use data file of the 2005 U.S. National Survey on Drug Use and Health, a survey of non-institutionalized American household residents. The patterns of non-prescribed use of prescription pain relievers were examined, and logistic regression procedures were conducted to identify correlates of non-prescribed use.

RESULTS:

Approximately one in 10 adolescents aged 12-17 years reported non-prescribed use of pain relievers in their lifetime (9.3% in males and 10.3% in females). The mean age of first non-prescribed use was 13.3 years, which was similar to the mean age of first use of alcohol and marijuana but older than the age of first inhalant use. Among all non-prescribed users, 52% reported having used hydrocodone products (Vicodin, Lortab, Lorcet, and Lorcet Plus, and hydrocodone), 50% had used propoxyphene (Darvocet or Darvon) or codeine (Tylenol with codeine), and 24% had used oxycodone products (OxyContin, Percocet, Percodan, and Tylox). Approximately one quarter (26%) of all non-prescribed users had never used other non-prescribed or illicit drugs. There were gender variations in correlates of non-prescribed use.

CONCLUSIONS:

Use of non-prescribed pain relievers occurs early in adolescence. Research is needed to understand whether early use of non-prescribed pain relievers is related to later drug use.

2007-01-01·Journal of the American Pharmacists Association : JAPhA4区 · 医学

Knowledge of appropriate acetaminophen doses and potential toxicities in an adult clinic population

4区 · 医学

Article

作者: Janice L. Stumpf ; Steven R. Erickson ; Cesar Alaniz ; Amy J. Skyles

OBJECTIVE:

To evaluate the knowledge of appropriate doses and potential toxicities of acetaminophen and assess the ability to recognize products containing acetaminophen in an adult outpatient setting.

DESIGN:

Cross-sectional, prospective study.

SETTING:

University adult general internal medicine (AGIM) clinic.

PATIENTS:

104 adult patients presenting to the clinic over consecutive weekdays in December 2003.

INTERVENTIONS:

Three-page, written questionnaire.

MAIN OUTCOME MEASURES:

Ability of patients to identify maximum daily doses and potential toxicities of acetaminophen and recognize products that contain acetaminophen.

RESULTS:

A large percentage of participants (68.3%) reported pain on a daily or weekly basis, and 78.9% reported use of acetaminophen in the past 6 months. Only 2 patients correctly identified the maximum daily dose of regular acetaminophen, and just 3 correctly identified the maximum dose of extra-strength acetaminophen. Furthermore, 28 patients were unsure of the maximum dose of either product. Approximately 63% of participants either had not received or were unsure whether information on the possible danger of high doses of acetaminophen had been previously provided to them. When asked to identify potential problems associated with high doses of acetaminophen, 43.3% of patients noted the liver would be affected. The majority of the patients (71.2%) recognized Tylenol as containing acetaminophen, but fewer than 15% correctly identified Vicodin, Darvocet, Tylox, Percocet, and Lorcet as containing acetaminophen.

CONCLUSION:

Although nearly 80% of this AGIM population reported recent acetaminophen use, their knowledge of the maximum daily acetaminophen doses and potential toxicities associated with higher doses was poor and appeared to be independent of education level, age, and race. This indicates a need for educational efforts to all patients receiving acetaminophen-containing products, especially since the ability to recognize multi-ingredient products containing acetaminophen was likewise poor.

项与对乙酰氨基酚/盐酸右丙氧芬相关的新闻（医药）

2019-10-16

·BioSpace

6 Major Drug Recalls from the Past

Patients take a doctor's prescription, believing that their doctor knows best, and the vast majority of the time that is correct. So it can be quite a shock when a recall happens on well-known prescription drugs because of possible health issues. Zantac, a popular H2 receptor blcoker that treats extreme cases of heartburn or recurring acid reflux, was recently added to the list of products getting pulled off the shelf. Unfortunately, Zantac and similar drugs that block the production of acid in the stomach are showing a connection to the development of stomach cancer. GlaxoSmithKline has officially recalled Zantac as a "precaution." It’s always big news when popular drugs get pulled off the shelf. Here are six major recalls from the past worth noting: Valsartan, Losartan and Irbesartan It's technically three drugs, but all three are within the same family and serve the same function. Additionally, all three drugs were part of recalls for the same issue. These common blood pressure medications have had over 75 recalls in recent years because of impurities that could be cancer-causing. Valsartan, Irbesartan and Losartan aren't directly linked to cancer. However, during the refining process, each has produced batches with impurities that have led to cancer and numerous recall incidents. Accutane Accutane was widely prescribed to treat acne for roughly three decades. Then after thousands of lawsuits and millions paid out in verdicts, it was recalled. The recall cited several severe side effects. With the use of Accutane, patients were at risk of experiencing inflammatory bowel disease as well as suicidal tendencies. Anyone using Accutane when pregnant was in danger of miscarriage, premature birth and children at greater risk for congenital disabilities. As a result, production of this popular drug ended entirely by Roche. Generic variations still produced today but the use of them has significantly diminished. Vioxx Over a four and a half year span, Vioxx resulted in nearly 28,000 cardiac deaths or heart attacks. Vioxx was used by over 20 million people and even had Olympic athletes featured in ads for the pain medication. The average rate of heart attacks works out to about 4 per every 1,000 people who used the drug. The manufacturer, Merck, pulled the drug after identifying the substantially increased possibility of a stroke or heart attack. Raptiva Efalizumab or Raptiva was a psoriasis treatment that was eventually found to onset a brain infection called leukoencephalopathy. This brain infection is extremely rare but lethal. Essentially, leukoencephalopathy causes the white matter of the brain to become inflamed, resulting in damaged white matter and ultimately damage to the central nervous system. In early 2009 the FDA announced a Public Health Advisory, which notified the healthcare community of these risks associated with Raptiva. The manufacturer then voluntarily removed the product from the market. Darvocet and Darvon The Darvocet recall received quite a bit of publicity when the common pain treatment was found to lead to many serious heart rhythm risks. Heart rhythm abnormalities, which were not only severe but frequently fatal, caused Xanodyne Pharmaceuticals to pull the brand name opioid medication. The FDA requested the generic producers of the drug, Darvon, to follow Xanodyne's example and remove their products as well. At one point in time, Darvocet was among the most popular pain treatments in both Europe and the United States. Now it is completely banned throughout the U.S. and the U.K. Lipobay The direct competitor to Lipitor, Lipobay, treated high-cholesterol, and was meant to prevent heart disease. Bayer manufactured this drug through the late 1990s but ultimately pulled it in 2001. Lipobay presented the risk of rhabdomyolysis, which causes muscle breakdown. Then the deteriorated muscle tissue clogs the kidneys leading to renal failure. After 52 deaths connected with Lipobay, the drug was removed from the global market. Why Do Medication Recalls Happen? In some cases, such as Lipobay, the medications become available through surrogate endpoints. With surrogate endpoints, the new drug uses the clinical data of similar drugs to receive approval without clinical trials. Recalls for these drugs usually happen because of unexpected differences that change the outcome of use for patients. In other cases, new medication does go through extensive testing, research, development, and refinement. Recalls are still possible even after successful clinical trials. Zantac's recall, for instance, is happening because of an impurity in manufacturing, whereas the drug itself is not the problem.

100 项与对乙酰氨基酚/盐酸右丙氧芬相关的药物交易

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