Discuss what drugs you couldn't do without in your practice and why.
Tuesday, July 3, 2018
The Return of Thalidomide
It is interesting that Thalidomide has been has been somewhat 'rehabilitated' since its devastating effect on the development of unborn babies in the 50's. For sufferers of conditions as various as arthritis, AIDS, MS and lymphoma it has become a 'wonder drug.'
Discuss what drugs you couldn't do without in your practice and why.
Discuss what drugs you couldn't do without in your practice and why.
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I do not have any experience for Thalidomide .In the past it use for their mother had been use combat nausea during pregnancy .In addition, many past years ago the test carried out on it were not strict enough and the same time we still do not know exactly how its work.In the contrast,it has many benefit for another disease.Despite its harmful side effects, thalidomide is FDA-approved for two uses today—the treatment of inflammation associated with Hansen’s disease (leprosy) and as a chemotherapeutic agent for patients with multiple myeloma, purposes for which it was originally prescribed off-label. Because of its known adverse effects on fetal development, the dispensing of thalidomide is regulated by the System for Thalidomide Education and Prescribing Safety (S.T.E.P.S.)(helix.northwestern,2018)
ReplyDeleteThanks for sharing this interesting information. What, in your opinion, is another 'wonder drug' you have come across?
DeleteI saw a child cadaver in Anatomy museum who has effected from Thalidomind. Reflected me that a danger of this durgs.
DeleteFantastic, I am interested information.
DeleteThank you for sharing your strong ideas.
DeleteThat is very important concern about drug use both in care giver and patient.
DeleteI do concern about the fetal side effect that may happen after using Thalidomide again.
DeleteIn Thailand, it has many drugs that a patient cannot buy from a clinic or a pharmacy store. Particularly, I will mention about an antitussive such as codeine.Many years ago, a youth who has addicted to drugs using the antitussive (TOCODYL) which was mixed with codeine for taking drugs. After that, FDA Thailand restricts to use this drugs except by a doctor prescription.
ReplyDeleteHave you found such antitussives as codeine effective in your practice?
DeleteI'm interested in your information. Drug using has to be careful and strict because a patient might has adverse effect from it.
DeleteI think so.
DeleteNowadays Thailand have a several problems about drugs using.
DeleteThank you for information and I don't know TOCODYL be fore.
DeleteAs drug addiction is very harmful, every potential addictive drug should be used and prescribed under restriction.
DeleteUsing in the wrong way make a problem with some people who necessary to use it.
Deleteummm, and right now the trend change to Tramadol drug abuse in teenager.
DeleteThank you for your story.In my opinion in the incidence a youth who has addicted to drugs using the antitussive (TOCODYL) which was mixed with codeine for taking drugs is very dangerous and effect for Digestive system: rarely - nausea, vomiting, and constipation.
DeleteCNS and peripheral nervous system: headache, drowsiness, when used in high doses or in sensitive patients may worsen the coordination of movements of the eyeballs with impaired vision, develop respiratory depression; rarely - increased tone of smooth muscles (at doses above 60 mg)good news for FDA Thailand restricts to use this drugs except by a doctor prescription.
The role of Thai nurses in providing medications to patients must be made under the guidance of a physician. Medications that can be administered to patients are available as basic medicines such as paracetamol and chlorpheniramine.
ReplyDeleteImportant drugs that nurse can not do with many independent functions. For example, drugs such as morphine used in patients with surgical pain or pain from cancer. The patient must report to the doctor and allow it to be available.
How effective do you think drugs such as morphine are? How helpful are they in curtailing patients' pain?
DeleteProviding medications is significant useful. Each case must to access patient`s health.
DeleteI think so, health care professionals have to administer drugs under guidelines and knowledge. If they do not know, they should confirm with experts, recheck guidelines and use pharmacopoeias.
DeleteThe morphine effective is drug addicted if you control by doctor.
DeleteThe problems of morphine use is that it is not enough dose for patients to control pain because some believes that a patient might be addicted morphine.
DeleteThe role of nurse is important give medicine to patients.
DeleteExactly,Thai nurses in providing medications to patients must be made under the guidance of a physician and awearness for 6R,such as ,side effect probably problem later.
DeleteMorphine is the effective for mu receptor and it is the medium strength but yes it's effective.
DeleteThere are many drugs which can be used or prescribed only by the physicians. Steroids , for example, are drug that might be misused and harm individuals healt if it is prescribed easily. As a pharmacy in Thailand, even though I can prescribe and give medicines to patients in pharmacy store, such drugs I cannot do. Due to its side effects: reduce immune, increase osteoporosis , steroids must be monitored carefully.
ReplyDeleteI understand some of the side effects that steroids have? Can you discuss some of their positive effects also. What are they good for?
DeleteI think a good think for limit of prescribed only by the physicians.
DeleteI have been using steroid for my self though, without it seborrheic dermatitis on my nose will be worse.
DeleteI think so, steroids are usually use in Thailand for autoimmune diseases such as SLE and Rheumatiod arthritis but it has more adverse effects especially bone marrow suppression so that we have to use it under guidelines.
DeleteThank you for sharing.
DeleteI total agree with you the medicine most common use is steroids.
DeleteSteroid has rapid effect on pain relieve, so patients want to use it but they don't aware of the serious side effects that may occur.
DeleteSteroids are bigger problems in Thai older people.
DeleteNurses play a role in administering medications to patients under the supervision of physicians. The method of administration of each medication is to instruct the patient. The nurse will administer each medication to the skin, subcutaneous, muscular and intravenous. Some drugs given to patients if they require special treatment. Nurses who give medications to patients must be trained in how to administer them. For example, administering chemotherapy to cancer patients. Nurses who have never been trained in chemotherapy will not be able to administer these drugs to patients because of the inadequate administration of medications, which can affect the patient, other patients, the person around them and nurses from the radiation of cancer drugs etc.
ReplyDeleteUnderstood. Administering certain medications is certainly a skilled procedure. What drugs, though, have you found to be wonder drugs in your experience?
DeleteWonder drugs in Thailand have a lot of number in each system.
DeleteI totally agree that only people who have been trained to administer particular drugs should be allowed to give them.
DeleteThat true.
DeleteYes, I agree that medicine for cancer need skills before giving to patients.
DeleteIn my experience, a drug that is necessary for use in patient but it has frequent side effects with patients, is prednisolone. It is use for reduce inflammation of the organ in the body.
DeleteIn my opinion recently health care provider warning about drug use in pregnancy and we must ask about allergy drug or pregnancy stage. In contrast miginalization some people use drug without knowleage or appeopriate conditions. They use because another people tell that good or it can help to release pain and they can work hard after that. This is a big problem in Thailand and we want to solve this problems. How to people awarenese when they use drug or how are they know about side effect when they take the medicine.
ReplyDeleteInteresting! I think a wider variety of medicines are available direct from the pharmacist in Thailand compared with NZ. Are you talking about such 'over the counter' drugs in your post?
DeleteThank a good ideas for pregnancy drugs.
Deleteno I am talking about steroid drug.
DeleteIn my opinion, all medicines that have effects to treat illness,have side effects. The poison is in the dose, and that we must weigh the benefits of any treatment against the risks. Doctors, pharmacists, nurses and patients have to know about its benefits and adverse effects because the health care providers have to evaluate its effects and monitor its unwanted effects when patients are in the hospital. After patients back home, they should know how to assess its side effect and they have to see the doctor when its adverse effects happen. For example, warfarin is an anticoagulant drug to prevent blood clots in a patient who has ischemic cardiovascular disease. It can increase risk of dangerous bleeding so that health professionals have to monitor coagulation test (prothrombin time)and a patient has to observe bleeding in his/her body such as bleeding per gum. If a patient has a prolonged prothrombin time and has bleeding tendency, warfarin should be stopped due to warfarin overdose.
ReplyDeleteWafarin is one of high alert drugs in the teriary hospital in UbonRatchathani,Thailand. My mother has taken this medicine at home and followed up every three month.However, it is a good efectiveness to treament a vivular heart disease but also often to advers side effect such as bleeding on skin.
DeleteWarfarin is a well-known drug isn't it! It can't be used for all though as you discuss. What drug would you label a 'wonder drug?'
DeleteThank you for your great ideas.
DeleteThe role of nurse in administering drugs to patients very important, especially for high risk patient such as newborn, children, pregnant women and elderly with underlying diseases. Nurses need to be aware of and take into account the side effects of each drug that will work better than the effects under close medical supervision.
ReplyDeleteAgreed! What drug would you though label as a 'wonder drug?'
DeleteIn my opionion I think wonder drug is Tramadol.
Delete
ReplyDeleteThe role of nurse in administering drugs to patients very important, especially for high risk patient such as newborn, children, pregnant women and elderly with underlying diseases. Nurses need to be aware of and take into account the side effects of each drug that will work better than the effects under close medical supervision.
The experience from read article Thalidomide lead to protection about side effect of drugs.I heard before another is Tetracycline used to treat a wide variety of infections,It do not use in pregnant women on child below 8 age because side effects of tetracycline on teeth. Therefore,health care provider use Drug careful especially pregnant women.
ReplyDeleteUnited states Food and Drug administration recommend that Pregnancy Safety Index Category: 5 Catagoty A,B,C,D and were as follows:
Category A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
Example drugs or substances: levothyroxine, folic acid, liothyronine
Category B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
Example drugs: metformin, hydrochlorothiazide, cyclobenzaprine, amoxicillin, pantoprazole
Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Example drugs: tramadol, gabapentin, amlodipine, trazodone
Category D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Example drugs: lisinopril, alprazolam, losartan, clonazepam, lorazepam
Category X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
Example drugs: atorvastatin, simvastatin, warfarin, methotrexate, finasteride
How interesting! Good to know that that pregnancy safety index is in place. What drugs would you consider 'wonder drugs?'
DeleteThank a good ideas for pregnancy drugs.
DeleteThank you very much for sharing. It is interesting information especially category X that we have to strict and careful.
DeleteOhh, I haven't given much thought for drugs I can't use before as in fact, in dentistry, we routinely only prescribe a few types; Paracetamol, Ibuprofen, Amoxicillin, Chlorhexidine gluconate, Metronidazole, Clindamycin and local anesthesia with epinephrine. These drugs have been used under certain international guidelines, therefor, we hardly ever misused or faced problems. I think all of these medicines had been experimented properly in animals and humans before announced to use generally.
ReplyDeleteSo would you classify any of them as 'wonder drugs?'
DeleteThank a good ideas for speacial drugs in dentist.
DeleteI would say "Metronidazole" is considered to be a wonder drug in dentistry due to its rapid affect and a wide range of cure, as it can kill almost any kind of dental abscesses.
DeleteI have no experience with Thalidomide, it is too dangerouse previously that what make all health professionals afraid of it. In my own opioin, paracetamol or acetaminophen and all kinds of NSAISs are medicines that I can not live without. Comminly I will catch a cold or pain, what is why it is important. There are a lot of medicines that need skill beforehand such as Warfarin, Steriod (oral and inhaler), antidote and High alert drugs. In Thai hospital, the high alert drug protocol helps health care providers to beware of the use of listed medicine and patient safety.
ReplyDeleteThanks for sharing the drugs you can't personally do without. What drugs can't you do without in your practice?
DeleteI agree with you about wonder drug is paracetamol drug.
DeleteNew answer after I understand the question.
ReplyDeleteI think Steroids are necessary drugs even they can cause many side effects that I mentioned on the previous post. For instance, prednisolone is widely used in various diseases namely asthma, rheumatoid, organ transplantation.