ABSTRACT
Few pregnant women are prescribed oxycodone for cancer pain. Here, we report a case of neonatal abstinence syndrome in an infant born to a woman using oxycodone long term for cancer pain. During pregnancy, rather than the expected effects on pregnant women for oxycodone use, fetal growth was also favorable. However, the infant presented with respiratory failure after birth and required ventilator management. In addition, the infant required treatment for neonatal abstinence syndrome.
ABSTRACT
Background: Previous surveys have demonstrated that a significant proportion of inpatients did not receive adequate pain management at an acute care hospital in Japan. Aim: The aim of this study was to evaluate the usefulness of a hospital-wide audit for assessing pain management with opioids according to the electronic medical records (EMRs) Methods: The subjects of this audit were inpatients receiving strong opioids who had not been consulted by the pallia. tive care team (PCT). The PCT held a weekly pharmacist-led conference to evaluate the adequacy and appropriateness of analgesics, including opioids, as well as drugs administered for adverse effects according to information collected by the PCT pharmacists. The PCT subsequently recorded the advisory comments in the EMRs. Each week, the PCT monitored whether the suggestions had been accepted by primary physicians and whether the pain and/or adverse effects had improved. Results: Among a total of 4,978 cases evaluated during the 3-year survey period, 888 (17.8％) had inadequate pain and/or adverse effect management. Symptoms improved in 82.3％ of cases for which PCT proposals were accepted. Conclusion: The results suggest that this hospital-wide audit may be useful for improving pain management with opioids at an acute care hospital.
ABSTRACT
<b>Objective: </b>There are only a few studies evaluating the effects of drug information services on pharmacotherapy. We, therefore, studied the effects of providing drug information such as the effectiveness and safety of aliskiren on its pharmacotherapeutic efficacy by comparing before versus after drug information provision.<br><b>Methods: </b>Pharmacists provided drug information such as the effectiveness and safety of aliskiren coadministered with either ACE-I (angiotensin converting enzyme inhibitor) or ARB (angiotensin receptor blocker) to physicians and other healthcare professionals. We compared the number of patients for whom aliskiren was prescribed, the proportion of diabetic patients taking both aliskiren and ACE-I (or ARB), the proportion of patients with low eGFR (estimated glomerular filtration rate), and the proportion of patients with hyperkalemia and related conditions, before versus after providing the drug information to the healthcare professionals.<br><b>Results: </b>The number of patients for whom aliskiren was prescribed decreased. The proportion of patients taking both aliskiren and ACE-I (or ARB) decreased significantly after providing the drug information (<i>p</i>=0.007). The proportion of diabetic patients taking both aliskiren and ACE-I (or ARB), the proportion of patients with low eGFR, and the proportion of patients with hyperkalemia also decreased, after providing the drug information.<br><b>Conclusion: </b>This study showed the drug information service to be clinically beneficial, achieving better pharmacotherapy. Pharmacists should evaluate and provide information on the effectiveness and safety of drugs announced by authorities in a timely manner to achieve optimal patient care.