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  • 1
    ISSN: 1432-1041
    Keywords: Drug use ; Complaint profiles ; Pregnancy ; pharmacoepidemiology ; pharmacy records
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary We have compared the reliability of the information about drug therapy and pregnancy retrieved by interviewing patients with that distilled from pharmacy records. In the initial phase of each interview we used the internationally accepted open-ended technique, and extended this with an indication-oriented set of questions and then a set of specific drug-oriented questions. These data were then compared with those from pharmacy records on dispensing for the same patients during their pregnancy. The results suggest that if drug consumption during pregnancy is evaluated by interview, one should not restrict oneself to open-ended questions but should include indication-oriented and, when appropriate, drug-oriented questions. Such specific questions offer the opportunity of detecting the use of over-the-counter medication and of constructing drug use/complaint profiles. By contrast, pharmacy records will give better information in case of long recall periods and in patients with multiple and/or repeated drug use. Investigators should use the complementary elements of both techniques where appropriate.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1041
    Keywords: Acitretine ; Psoriasis ; ad hoc cohort tracing ; pharmacoepidemiology ; postmarketing surveillance ; adverse reaction monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Etretinate has been detected in the blood of women taking acitretine. Because of the proven teratogenic effects of etretinate it was decided to try to trace all users of acitretine in The Netherlands via all drug dispensing outlets (1450 community pharmacies, 95 hospital pharmacies and 636 general practitioners). A request for information on the date of birth, sex, type of prescriber, and the number of capsules dispensed yielded a response rate of 87%. In 61% of all the responding dispensing outlets a prescription for acitretine had been filled. Of these 1153 outlets, 40% had dispensed acitretine to one patient and 52% had dispensed it to 2–5 patients. The 2717 patients comprised 1500 men (55%) and 1217 women, with mean ages of 48 and 53 y, respectively. As against 45% of all the male users, 31% of all the women were in the child-bearing age (15–45 y). The average numbers of dispensed capsules was 167 to users of 10 mg capsules, and 107 to users of the 25 mg capsules. In more than 80% of cases acitretine had been prescribed by dermatologists. Because the large majority of inhabitants in The Netherlands use one community pharmacy, and because most of them have automated records, it is possible to trace a cohort of users quickly and almost completely. Because most large-scale problems with adverse reactions are discovered within the first 2 years of marketing, at a time when exposure and morbidity registries are still collecting information, adhoc formation of a cohort in this way may be a useful resource for postmarketing surveillance.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Pharmacy world & science 14 (1992), S. 33-37 
    ISSN: 1573-739X
    Keywords: Acitretin ; Etretinate ; Metabolism ; Pharmacokinetics ; Retinoids ; Teratogens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Acitretin was introduced as a replacement for etretinate, the ethyl ester of acitretin. Acitretin is eliminated at a much faster rate than etretinate. Although both drugs are teratogens, the replacement was important especially as it allowed for a much shorter post-medication period in which pregnancy should be precluded. Recent findings showed the presence of etretinate in the plasma of acitretin-treated patients. This article gives a review of known metabolic pathways of the retinoids and tries to elucidate the possible conversion of acitretin into etretinate after acitretin ingestion.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Pharmacy world & science 14 (1992), S. 38-45 
    ISSN: 1573-739X
    Keywords: Analgesics ; Antibiotics ; Anticonvulsants ; Cardiovascular agents ; Drug utilization ; Pregnancy ; Prescriptions, drug ; Psychotropic drugs ; Teratogens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract The drug use of nearly 2,000 pregnant women was evaluated at the level of the individual patient for the drugs belonging to the Australian risk categories B3, C and D. The pattern of changes in the use of these drugs is studied in terms of women who discontinue (d), continue (c) or begin (b) using the drug during pregnancy. The ratios d/(c+b) and d/b were the highest for the drugs belonging to the high-risk groups and the lowest for drugs from the low-risk categories. This suggests a congruence between theoretical knowledge and daily practice. Patients who had already been using a drug for a long time before pregnancy, more frequently continued using that drug than patients who had been using the drug only incidentally before. The described daily dose for the riskful drugs was approximately 20% lower in patients who started to use a drug during pregnancy compared to those who continued drug use. The data from this analysis indicate that the prescribing physician is generally aware of the possible risks of drug use during pregnancy. The d/(b+c) and d/b ratios are shown to be a good measure of prescribing behaviour in relation to pregnancy and can be used to compare knowledge of theory and daily practice.
    Type of Medium: Electronic Resource
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