Pharmacoepidemiology:

More Presentations from Dr.Naina Mohamed Pakkir Maideen

©  Pharmacoepidemiology is the study of effects of drugs in large numbers of people.

©  The word Pharmacoepidemiology is derived from greek words Pharmakon (Drug), Epi (upon), Demos (People) and Logos (Study).

©  Epidemiologic study designs include:

Ø Case reports

Ø Case series

Ø Analyses of secular trends

Ø Case-control study

Ø Cohort study

Ø Randomized clinical trials

©  Pharmacoepidemiologic studies are conducted for:

Ø Regulatory reasons

Ø Marketing reasons

Ø Legal reasons

Ø Clinical reasons

©  Pharmacoepidemiologic studies are used by:

Ø Government agencies & Health care plans

Ø Pharmaceutical industries

Ø Practitioners

Ø Academicians

Ø Attorneys

Ø Consumers and Patients

©  Pharmacists are considered drug experts and naturally they play an important role in Pharmacoepidemiology.

©  Pharmacists and other health care practitioners may serve on Pharmacy Therapeutic Committee, Patient Safety Committees or other groups deciding health care plans.

FDA's warning against “Feng Shi Ling”:

More Presentations from Dr.Naina Mohamed Pakkir Maideen

§  On 20^th Nov 2014, the Food and Drug Administration (FDA) is advising consumers not to purchase or use “Feng Shi Ling”.

§  “Feng Shi Ling” is promoted and sold as an herbal medication for arthritic pain associated with rheumatoid arthritis and osteoporosis.

§  FDA laboratory analysis found that “Feng Shi Ling” contains the undeclared NSAIDs (Diclofenac and Indomethacin).

§  Due to the presence of NSAIDs, “Feng Shi Ling” may increase the risk of …

·      Myocardial infarction

·      Stroke

·      Gastro Intestinal Hemorrhage

·      Gastro Intestinal perforation

·      Bronchoconstriction

·      Rhinosinusitis

·      Acute urticaria

·      Angioedema (skin, lips, and mouth)

·      Allergic reactions (Urticaria, Angioedema or Anaphylaxis)

·      Bleeding

·      Early closure of Ductus arteriosus

·      Renal ischemia (In patients with CHF, CKD, etc)

·      Edema and Hypertensive complications

§  These hidden drug ingredients may interact with other medications such as …

·      Warfarin, Apixaban, Rivaroxaban, Enoxaparin, Dalteparin, Aredeparin, Tinazaparin, Ibritumomab, Tositumomab, Cabozantinib, Ponatinib, Regoratinib, Prasugrel, Anisindione, Fondaparinux or Desirudin

·      Leflunomide, Teriflunomide or Lomitapide

·      Adefovir, Cidofovir, Tenofovir, Tacrolimus, Sirolimus, Sodium Biphosphate or IV Immunoglobulins

·      ACE inhibitors

·      Corticosteroids or SSRIs

§   Consumers should stop using this product immediately and throw it away.

§  Consumers should consult a health care professional as soon as possible if they have experienced any negative side effects, such as unusually dark stools or urine, stomach pain, increased bruising, and other signs of bleeding.

Health benefits of smoking cessation:

More Presentations from Dr.Naina Mohamed Pakkir Maideen

Ø The smokers who quit smoking before the age of 40 live about 10 years longer, on average.

Ø The health of smokers will improve in following ways, when they quit smoking…

·      Better sex

·      Improved fertility

·      Younger looking skin

·      Whiter teeth

·      Better breathing

·      Longer life

·      Less stress

·      Improved smell and taste

·      More energy

·      Healthier loved ones

Ø Stop Smoking and Stay Healthy

Smoking cessation:

More Presentations from Dr.Naina Mohamed Pakkir Maideen

 

©  Many smokers understood the ill effects of smoking and tried to quit smoking, but failed due to addiction.

©  The Public Health Service (PHS) and the Agency for Healthcare Research and Quality (AHRQ) guidelines for treating tobacco use and dependence, recommends…

·      Brief clinical interventions

·      Pharmacotherapy

©  The PHS guidelines emphasize on use of the 5 A's in clinical settings:

·      Ask about tobacco use

·      Advise to quit

·      Assess willingness to make a quit attempt

·      Assist in quit attempt

·      Arrange for follow-up

©  Nicotine dependence may be treated by the following…

·      Nicotine replacement Therapy (NRT)

o  Over-the-counter (e.g., Nicotine patch, gum, lozenge)

o  Prescription (e.g., Nicotine inhaler, nasal spray)

·      Non-nicotine Prescription medications

o  Bupropion SR (Zyban^®)

o  Varenicline tartrate (Chantix^®)

©  TIPS to quit smoking…

·      Hide the matches, lighters, and ashtrays.

·      Designate the home a non-smoking area.

·      Ask people not to smoke around you.

·      Drink fewer caffeinated beverages which may stimulate the urge to smoke.

·      Avoid alcohol which may also increase the urge to smoke.

·      Change the habits connected with smoking.

·      Keep mints or gum (preferably sugarless) on hand to suppress urge to smoke.

·      Stay active to keep the mind off smoking and help relieve tension.

·      Take a walk, exercise, read a book, brush your teeth, take a shower, take a deep breath or try a new a hobby.

·      Make a list of reasons why you want to quit.

·      Carry this with you at all times. When you have an urge for a cigarette, read your list and it will help strengthen your resolve.

·      Look for support from others. Join a support group or smoking cessation program.

·      Do not go places where many people are smoking such as bars or clubs, and smoking sections of restaurants.

·      Find someone who can support you, for example a family member, friend or doctor.

Smoking and young generation:

More Presentations from Dr.Naina Mohamed Pakkir Maideen

 

§  Many kids start using tobacco by age 11and many are addicted by age 14.

§  Teens are often influenced by TV, movies, the Internet, advertising, and their own friends.

§  Smoking parents should quit first to influence their children.

§  Parents should talk to their kids about the ill effects of smoking.

§  CDC recommends the parents to offer their smoking kids with 5 Ds to get through the tough times:

o  Delay: The craving will go away with time.

o  Deep breath: Take a few calming deep breaths.

o  Drink water: It will help flush out the chemicals.

o  Do something else: Find a new, healthy habit.

o  Discuss: Talk about your thoughts and feelings.

§  Let’s make the next generation tobacco-free!

Smoking and pregnancy:

More Presentations from Dr.Naina Mohamed Pakkir Maideen

 

ª  The hazardous chemicals found in tobacco smoke can mix with mothers’ bloodstream and passed to babies to cause many complications.

ª  Smoking during pregnancy may cause many health problems in babies include:

Ø Low birth weight

Ø Premature birth (being born too early)

Ø Still birth

Ø Respiratory complications

Ø Congenital heart defects

Ø CNS effects

Ø Fetal death

Ø Infant death

ª  Smoking during pregnancy may cause many health problems in mothers as well, include:

Ø Placental Abruption (Early seperation of Placenta )

Ø Placenta previa (Placenta covers the cervix)

Ø Premature rupture of membranes (PROM) (Early breaking of water)

Ø Ectopic pregnancy (Pregnancy occurs outside the womb)

ª  Nicotine and carbon monoxide found in tobacco smoke reduce the oxygen supply to the babies leading to Low birth weight, premature delivery and Stillbirth.

ª  The risk of Asthma or SIDS is increased in babies of smoking mothers due to delayed lungs development.

ª  Smoking during Pregnancy can increase the risk of Right ventricular outflow tract obstructions & atrial septal defects in babies.

ª  The risk of Learning disorders, behavioral problems & relatively low IQs is elevated in babies born to smoking mothers.

ª  The mother and baby would be in danger due to placental abruption caused by Smoking during Pregnancy.

ª  The risk of Bleeding, C – section, Placenta accreta, Hysterectomy, etc. is enhanced by Placenta previa caused by Smoking during Pregnancy.

ª  Premature rupture of membranes (PROM) can occur due to Smoking during Pregnancy and it increases the risk of infections.

ª  Smoking during pregnancy increases the risk of Ectopic Pregnancy leading to Hypovolemic shock.

ª  If the mother is regularly exposed to secondhand smoke, the risk of lung cancer, heart disease, emphysema, allergies, asthma, and other health problems is increased in the mother and the growing baby.