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Prescription Drugs Misuses

Globally, prescription drug diversion and misuse is a growing public health issue and its impact is associated with a high risk of poor healthcare outcomes, increased hospitalization and higher death rates.

Misuse of prescription drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain;  continues use of the medication even when asked to stop by a doctor, taking more than a recommended prescribed dose or taking a medication to feel euphoria. The term nonmedical use of prescription drugs also refers to these categories of misuse. The three classes of medication most commonly misused are:

Opioids. – Usually prescribed to treat pain in the central nervous system [CNS]

Depressants. This category includes tranquillizers, sedatives, and hypnoticsβ€”used to treat anxiety and sleep disorders

Stimulants. – Most often prescribed to treat attention-deficit hyperactivity disorder (ADHD)

Impact of inappropriate uses of medicines.

  • Reduce the quality of the treatment: will consequently lead to increase hospital stay, worsen the health conditions and may even lead to death.
  • Waste of Resources: will lead to reduced availability and increase the cost of the treatment
  • Risk of Unwanted side effects. Misuses of medications are highly associated with increase side effects, adverse drug reactions and bacterial resistances
  • Psychological impacts: Misuse of medication could potentially cause the patient to rely on an unnecessary drug (Addiction and dependence)

How to avoid misuse of drugs

  • Take medicines only when needed
  • Talk to your Pharmacist/Doctor about your medicine
  • Do not pass down medicines from one family or friend to another.
  • Complete your dosage regimen
  • Receive medical advice only from healthcare professionals
  • Avoid self medications

In addition, drug misuses can be minimized by educating yourself, your family, and friends. Safeguard the prescription drugs as they are brought home. Safely store your medicines to avoid accidental exposure.


Abubakar Mukhtar BPharm. MSc. (In view)


Further reading:

http://www.ulifeline.org/articles/390-the-dangers-of-misused-prescription-drugs

https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/what-scope-prescription-drug-misuse

https://www.pharmacologyeducation.org/clinical-pharmacology/drug-misuse

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Ecopharmacovigilance

Introduction

Thanks to the evolution of medicine and the advancement in pharmacotherapy, a lot of diseases has become a history, while those still lingering around, their severity and situated risk have been greatly reduced, but as the saying goes; “Every rose has a thorn,” so do the Pharmaceutical drugs. A drug is a blessing to humanity, although not entirely but to a large degree, in reducing the pain and burden of various disease conditions. Along with their beneficial effects, they often express adverse reactions, sooner or later. One of such undesirable effect is how they affect our environment.

Ecopharmacovigilance is a term that is derived from Ecology and Pharmacovigilance which is a science and activities related to the detection, assessment, understanding, and prevention of adverse effects or other problems related to the existence of pharmaceuticals (Drugs) in the environment. Ecopharmacovigilance concerns with adverse drug-related events within the ecosystem with all environmental impacts on humans and other organisms.

Ecopharmacovigilance Objectives:

To ensure that significant pharmaceuticals-related environmental issues are correctly detected and efficiently treated.

Monitoring the adverse effects of pharmaceutical medications on humans through non-therapeutic environmental exposure.

Sources of contamination of the environment by drugs

  • Patient excretion of the drug or its metabolites via the sewage system.
  •  Direct release from wastewater system from manufacturing units.
  • Hospital or self-disposal of unused, unwanted, expired drugs via trash or flushing.

Some important examples of drugs causing harmful effects on the environment are:

  • Vultures’ death after consuming carcass of animals treated with Diclofenac sodium.
  •  Ethinyl estradiol adversely affecting fish through its “feminization” of males.
  • Progesterone producing sterility in frogs.
  • Ivermectin adversely affecting the growth of dung beetle.
  • Fluoxetin causing behavioural changes in shrimps and bacterial resistance.

Corrective Measures.

Some corrective measures can be put in place to reduce the number of drugs entering the environment. They include reducing the amount of pharmaceutical waste generated, increasing the efficiency of sewage treatment plants, green pharmacy practices, and developing better drug disposal programs. Various attempts have been made by regulatory authorities to reduce the environmental impact of pharmaceuticals, including the Environmental Risk Assessment (ERA) of drugs. Monitoring the adverse effects of the drug is not only good for medical practice but also essential for the protection of our environment.

Abubakar Mukhtar BPharm. MSc. (In view)


Further Readings:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912800

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691479/

https://www.pubfacts.com/search/Ecopharmacovigilance

https://www.sciencedirect.com/science/article/abs/pii/S0045653501001448

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The pharmacovigilance processes

The basic component of Pharmacovigilance processes is summarized below.

Data generation;

Data generation is the first stage in pharmacovigilance in which data is sourced from spontaneous reporting or mandatory reporting

1-Spontaneous reporting.

 The most common form of adverse drug reaction reporting. Healthcare professionals identify and report any suspected adverse drug reaction to their national pharmacovigilance centers or the manufacturers.

2-Mandatory reporting.

Manufacturers are required to submit reports they received from healthcare providers and from the surveys (Post-marketing surveillance) they made to the national authority in the form of a PSUR (Periodic Safety Update Report) which is a regulatory document prepared by the Marketing Authorisation Holder & submitted to the national regulatory agency (FDA in the USA) (NAFDAC in Nigeria).

Worldwide post-authorisation safety experience includes information gathered on all ADRs collected irrespective of the reporting country and includes scientific evaluation of the risk-benefit balance.

Case Evaluation And Reporting.

Product manufacturers are required to evaluate each case for seriousness, expectedness, and causality. Manufacturers can also contact the patient or other healthcare professionals to get additional information. After analyzing available information, manufacturers may determine if the case is urgently reportable to the regulatory authorities. Manufacturers are also required to maintain information on all reports of adverse events irrespective of their seriousness, expectedness, or causality.

Aggregate data analysis.

Various types of a report may indicate some level of association between the suspected medicinal product and the event occurred. However, confirming a causal relationship between adverse the drug and adverse event requires careful analysis of all the collected data to properly ascertain the causal relationship. Uppsala Monitoring Center UMC (The World Health Organization center for pharmacovigilance and drug monitoring) is responsible for receiving the worldwide report and maintain the record of the received cases in their database (Vigibase).

Safety data dissemination

UMCcenter maintains the publications of new potential safety signals identified. The information may contain warning letters to various nationals regulatory agencies about the safety of the particular drug. National regulatory centers are required also to disseminate such information to health care professionals about the safety issues and take actions such as drug withdrawal and license cancellation when necessary.

References:

https://www.who-umc.org/global-pharmacovigilance/pharmacovigilance-communications/

https://www.who.int/medicines/areas/quality_safety/safety_efficacy/pharmvigi/en

http://www.pharmawisdom.com/Basic-steps-in-Phamacovigilance-Case-Processing.htm


A. Mukhtar BPharm, MSc. (In view).

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Role of pharmacovigilance in the fight against drug abuse.

Drug abuse and illicit trafficking are no doubt one of the major public health-related issues that are constantly present in our society. According to the research drug use is directly or indirectly responsible for 11.8 million deaths each year. With so many forms of drug abuse and substances of abuse, this article focus on prescription drug abuse and addictions and the role of pharmacovigilance in curtailing the problem.

Over the years, prescription drug abuse has become an accelerating problem, partly due to their increasing availability, and partly associated with prescription patterns and decrease patient compliance, with most commonly abuse drugs involving opioid painkillers, sedatives hypnotics, stimulants, and antianxiety medications. 

Many people start taking these drugs to manage a specific medical condition, but due to the nature of those medications of causing drug dependence and addiction, over time, increased doses are needed to achieve the same level of relief and decrease in disease progressions.

Pharmacovigilance as sciences of drug monitoring and detection of adverse drug reactions play a vital role in preventing the harm associated with the use of the prescription drug of abuse through providing timely information about the safety of the healthcare products to the patients, healthcare professional, and the general public. It is noted that prescription drugs of abuse are potentially associated with drastic adverse drug reactions as a result of lack of compliance with the prescription orders, such effects can be minimized if adequate reporting and monitoring are in place.

However, it is not gainsaying that poor regulation of drugs supply chain, unethical practices by some professionals, lack of patient compliance, and increase open drug markets due to lack of implementation of government policies are the chief culprits and the co-contributing factors to drug abusetherefore all hand must be on deck to be able to reduce the menace of drug abuse and illicit trafficking, through proper implementation of drug regulatory policies on the safe use of medications and increase public awareness on the danger of drug abuse to the general populations.

Abubakar Mukhtar B. Pharm, MSc. (in view)

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Fight against drug abuse..

𝑨𝒔 π’Šπ’π’•π’†π’“π’π’‚π’•π’Šπ’π’π’‚π’ π’…π’‚π’š 𝒐𝒇 π’‚π’ˆπ’‚π’Šπ’π’”π’• π’…π’“π’–π’ˆ 𝒂𝒃𝒖𝒔𝒆 𝒂𝒏𝒅 π’Šπ’π’π’Šπ’„π’Šπ’• 𝒖𝒔𝒆 π’•π’“π’‚π’‡π’‡π’Šπ’„π’Œπ’Šπ’π’ˆ (26𝑻𝑯 𝑱𝒖𝒏𝒆, 2020) is fast approaching, it’s time to rethink, re-strategize and come together to find an effective way to put an end to this menace, especially in this unprecedented times.

Have you got an article on drug abuse, misuse, and ways to eradicate them? If yes, please contact Vigivital on Facebook or via email at @info.vigivital@gmail.com for a chance of your article to be published on www.vigivital.com

Pharmacist: A Primary Healthcare Provider.

(World Pharmacist Day 25th September 2020)

Primary healthcare can be described as a patient’s first contact point in the health care system. As such, pharmacists are an important part of primary health care because they are the most easily accessible in the community. the position of the pharmacist extends beyond the traditional product-oriented role of the dispensing, distribution of medicines and health supplies. Today’s pharmacist plays a more patient-oriented, administrative and public health role.

Aside from dispensing of medicines, pharmacists have proved to be an accessible resource for health and drug information. The centralized placement in the community and the clinical expertise of the pharmacist are invaluable. There are many public health functions that can benefit from the unique knowledge of pharmacists, including pharmacotherapy, access to care and prevention services, they further include;

  • Providing pharmaceutical care based on sound therapeutic principles and evidence-based data in collaboration with patients, prescribers, and other members of an inter-professional health care team.
  • Manage and use the resources of the health care system in collaboration with prescribers and other health care providers.
  • Promote health improvement, wellness and disease prevention in cooperation with patients, communities, at-risk populations and other members of the inter-professional health care team.
  • Manage complex drug therapy and make recommendations for initiation, modification and termination of therapy.
  • Manage and control drug accessibility to different categories of patient, in addition to the prevention of irrational and illegal drug use.  
  • Counsel and educate patient on health and nutrition.
  • Screen and refer patients to specialists and other health care providers
  • Provide education to enable patients make decisions about their health.
  • Pharmacists are increasingly integrated into these primary care teams, family practice settings, out-patient clinics and in community-based locations.

It is envisaged, through transdisciplinary approaches, that the contribution of the pharmacist to the public health workforce, health education, disease prevention and health promotion, public health advocacy and the quality of health will contribute to the achievement of optimal public health outcomes.


Abubakar Mukhtar BPharm. MSc

Reference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755826/

https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/07/13/05/the-role-of-the-pharmacist-in-public-health

World Hepatitis Day 2020

World Hepatitis Day is commemorated on 28th July Every year to raise awareness of viral hepatitis, a liver inflammatory disease that causes a series of health problems, including liver cancer.Β  This year’s theme is “Hepatitis-free future.” It is therefore, more essential to know the nature, prevention and treatment of these viral diseases.Β 

Viral hepatitis remains a big public health challenge, not only in Nigeria but worldwide. Although half of the world ‘s population has been exposed to various types of hepatotropic viruses, the disease distribution often varies according to the geographical location.  

According to the World Health Organisation (WHO) β€œ325 million people worldwide live with viral hepatitis B and C in which a total of 9 million people die each year from infection with the hepatitis B virus’. Hepatitis is an infection of the liver which can frequently lead to a variety of health complications and death.

Cause of Hepatitis

  • Hepatitis A and E are mainly caused by the intake of contaminated food and water.
  • Hepatitis B, C and D usually occur after contact with infected blood and body fluids.

Sign and Symptoms

Symptoms of acute viral hepatitis include flu-like symptoms, fever, fatigue, dark urine, vomiting, and jaundice (yellow discolouration of the skin and eyes). However, infection with these viruses (hepatitis) may occur with minimal symptoms or may even go unnoticed.

Screening and early detection

As a sign and symptom of hepatitis often become undetected especially in the early stages, Screening and early detection will be a key to the successful elimination of these viruses before irreversible damage to the liver occurs. Without finding out about undiagnosed patients in the silent phase and linking them to care, millions will continue to suffer and lives will continue to be lost.

Some precaution to take against Hepatitis

  • Avoid needles sharing or any other personal items like razors, and toothbrushes
  • Avoiding unprotected sex
  • Getting tested regularly for the virus.
  • Avoid eating contaminated food and drinks
  • Avoid roadside food vending, especially fruit juices, milkshakes.
  • Washing hands properly before and after preparing and eatingΒ food
  • Barber shops,Β Beauty salon – sharing of razor blades, metal scraper used to remove blackheads and whiteheads from facial skin can act as a source of infection if not disposable or if not properly sterilized.

In conclusion, educating the people is the step forward to find the millions who are suffering and to ensure that they receive adequate treatment and care. Only then we canΒ significantly reduce the number of patients who will suffer from these diseases and eradicate the risk of the virus in due time and fulfill the vision of “Hepatitis-free future.”


Abubakar Mukhtar BPharm, MSc. (In view)

Disclaimer: Personal view, not for medical consumption.

Pharmacovigilance and its significance in healthcare.

Pharmacovigilance (PV), also known as drug safety, is the pharmacological science that is related to the detection, collections, assessment, monitoring, and prevention of adverse drug effects with pharmaceutical products or any drug-related problem. The word “pharmacovigilance” is derived from two Greek words; Pharmakon (for drug) and Vigilare (to keep watch). As such, pharmacovigilance heavily focuses on the detection of adverse drug reactions associated with the use of medicinal products, Adverse drug reactions ADRs, which is defined as any response to a drug which is noxious and unintended, including lack of efficacy.


Why there is a need for Pharmacovigilance?

Pharmacovigilance is all about the safer and more effective use of medicines for everyone, young and old. Therefore, before the drug is being approved for marketing authorization, clinical trials are employed as a gold standard method in evaluating the safety of the drug, efficacy of the drug on a particular disease, monitor and identify side effects associated with the drug. Due to the nature of clinical trials, it is impossible to determine the complete safety profile of the product in pre-marketing studies as still some of the adverse reactions may remain undetected during studies due to varying reasons, some of which are;

  • Clinical trials are often carried out on a limited number of subjects (Patients) usually Less than 10,000 compared to the end number of potential users of the medications.
  • Limited periods of the trials allow only the detection of short terms ADRs and left long term manifested ADRs to be undetected.
  • Vulnerable people (pregnant women and childbearing age individuals) are also excluded even though they may be potential users of the medicine.
  • People of extreme ages (children and old aged) are often excluded during clinical trials unless the drug is to be used for such populations.
  • People with multiple diseases (comorbidity) are also excluded.
  • In clinical trials, only a single medication is given at a time compared to the multiple drugs a patient might take at the hospitals’ settings.
  • Clinical trials are done in a controlled environment with constant monitoring compare to when the drug is released to the market, in which various factors including the environmental factors that could affect the drug.

Aims of Pharmacovigilance:

The objective of pharmacovigilance is the reduction of the frequency and the severity of adverse effects of drugs while maintaining or, better, improving their efficacy. The aims include but not limited to;

  • Ensure the rational and safe use of medical drugs
  • Encourage their safe, rational, more effective, and cost-effective use.
  • Educating and informing patients.
  • Assessment and communication of risks and benefits of the drug.
  • Β Promote understanding, education and clinical training in Pharmacovigilance and its effective communication to the public.
  • Improve patient and public healthcare and safety concerning the use of medicines.
  • Contribute to regulatory assessment of benefit, harm, effectiveness, and risk of medicines.


Abubakar Mukhtar BPharm, MSc. (In view)

Theme for the 2020 International day for drug abuse…

The theme for the 2020 International day Against drug abuse and illicit trafficking according to the UN is β€œBetter Knowledge for better care” which emphasizes the need to improve the understanding of the world drug problem and how in turn, better knowledge will foster greater international cooperation for countering its impact on health, governance and security.

United Nations