Aims To explore drug exposure, frequency of adverse drug reactions (ADRs), types of ADRs, predisposing risk factors and ADR-related excess hospital stay in medical inpatients. Methods Structured data regarding patient characteristics, 'events' (symptoms, laboratory results), diagnoses (ICD10) and drug therapy were collected using a computer-supported data entry system and an interface for data retrieval from electronic patient records. ADR data were collected by 'event monitoring' to minimize possible bias by the drug monitor. The causality of each event was assessed in relation to disease(s) and drug therapy. Results The analysis included 4331 (100%) hospitalizations. The median observation period was 8 days. The median number of different drugs administered per patient and day was 6 and varied between 4 (Q 1 ) and 9 (Q 3 ) different drugs in 50% of all hospital days. In 41% of all hospitalizations at least one disease-unrelated event could be possibly attributed to drug therapy. Clinically relevant ADRs occurred in 11% of all hospitalizations. In 3.3% of all hospitalizations ADRs were the cause of hospital admission. The incidence of possibly ADR-related deaths was 1.4‰. Factors predisposing for clinically relevant ADRs were female gender and polypharmacy. ADR-related excess hospital stay accounted for 8.6% of hospital days. Conclusions These data demonstrate the feasibility of the developed 'event monitoring' system for quantitative analysis of ADRs in medical inpatients. With increasing numbers of recorded patients the pharmacoepidemiological database provides a valuable tool to study specific questions regarding drug efficacy and safety in hospitalized patients.
Co-administration of lornoxicam at the upper limit of recommended doses does not alter the pharmocokinetics of the clinically relevant (R)-acenocoumarol or the anticoagulant activity of acenocoumarol. These data clearly differ from the results of previous studies, which showed clinically relevant influences of lornoxicam on warfarin kinetics and of piroxicam on acenocoumarol kinetics.
These results suggest that paracetamol co-administration at a dosage of 2000-2500 mg/day for 3 days has no clinically relevant effects on the anticoagulant effects of phenprocoumon.
Die Diagnose eines Karpaltunnelsyndroms beruht in der Regel auf klinischen Befunden und einer elektrophysiologischen Untersuchung. Im Frühstadium können Schienen oder Steroidinjektionen zur Beschwerdelinderung beitragen. Wenn die Symptome anhalten oder sich verschlechtern, ist aber eine Operation kaum zu umgehen. Wichtig ist, chirurgisch einzugreifen, ehe sich ein dauernder Nervenschaden eingestellt hat.
Escitalopram entspricht dem aktiven Enantiomer des bekannten Antidepressivums Citalopram und scheint nach bisherigem Wissen ungefähr dasselbe wie das Razemat zu erreichen. Das «neue» Mittel hat gegenüber dem Originalpräparat einen günstigeren Preis, weist aber sonst keine Vorteile auf.
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