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Pharmacoepidemiology, Volume 3, Issue 4 (December 2024) – 3 articles

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14 pages, 1142 KiB  
Review
Maternal Medication Use in Pregnancy: A Narrative Review on Assessing and Communicating the “Risk” of Birth Defects to the Patient
by Sura Alwan and Kimberly S. Grant
Pharmacoepidemiology 2024, 3(4), 336-349; https://doi.org/10.3390/pharma3040023 - 5 Oct 2024
Viewed by 490
Abstract
The state of knowledge regarding the teratogenic effects of maternal use of medications during pregnancy is constantly evolving and is often uncertain. Timely access to high-quality information may reduce prolonged harmful exposures, decrease the number of preventable birth defects, empower patients with accurate [...] Read more.
The state of knowledge regarding the teratogenic effects of maternal use of medications during pregnancy is constantly evolving and is often uncertain. Timely access to high-quality information may reduce prolonged harmful exposures, decrease the number of preventable birth defects, empower patients with accurate information about the risks of exposure, and prevent unnecessary patient anxiety and pregnancy termination. In this narrative review, we describe the process by which the teratogenic risk of medications is assessed by experts in medicine, genetics, and epidemiology and how identifiable risks can be effectively communicated to patients. Risk assessment of birth defects in human pregnancy involves collecting and synthesizing available data through a proper and rule-driven evaluation of scientific literature. Expert consensus is a practical approach to determine whether a given exposure produces damage after careful consideration of gestational timing, dose and route of the exposure, maternal and fetal genetic susceptibility, as well as evidence for biological plausibility. The provision of teratogen risk counseling through appropriate interpretation of information and effective knowledge translation to the patient is critical for the prevention of birth defects and maximizing healthy pregnancies. Full article
(This article belongs to the Special Issue Pharmacoepidemiology and Drug Safety in Pregnancy and Breastfeeding)
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22 pages, 283 KiB  
Article
Storage, Disposal, and Misuse of Unused and Expired Pharmaceuticals in Households amongst Staff Working at Dakshinapaya Ministry Complex, Labuduwa, Galle Region: A Qualitative Phenomenological Study
by Pramila G. Chandrasena, Sampath Gunawardena and Shanika V. Karunanayaka
Pharmacoepidemiology 2024, 3(4), 314-335; https://doi.org/10.3390/pharma3040022 - 5 Oct 2024
Viewed by 405
Abstract
(1) Background: Although Sri Lanka is a developing country and boasts of having a well-established healthcare system along with good healthcare indices, we are still lagging in certain aspects of healthcare. One such aspect is the deficiencies in guidelines and practices related to [...] Read more.
(1) Background: Although Sri Lanka is a developing country and boasts of having a well-established healthcare system along with good healthcare indices, we are still lagging in certain aspects of healthcare. One such aspect is the deficiencies in guidelines and practices related to the handling of pharmaceutical waste. (2) Methods: This was a qualitative study performed using in-depth interviews with the help of a semi-structured questionnaire conducted among staff who are working at a ministry complex in Galle, Sri Lanka. Data analysis was performed using thematic analysis, (3) Results: There were 40 participants which included 29 (72.5%) females. Three main themes were identified, namely, (I) current knowledge, (II) perceptions, and (III) practices towards storage, disposal, and misuse of pharmaceutical waste. The death of the patient, forgetting, relieving symptoms, and adverse effects were some reasons for the accumulation of unused pharmaceuticals at home. Most of the participants did not believe that the reuse of unused medications can cause various health hazards. Moreover, all participants practiced unsafe methods such as flushing down toilets, pouring into a sink, burning, etc. (4) Conclusions: The incorrect practices and poor knowledge in the handling of pharmaceutical waste and less concern for the environment highlight the need for awareness programs to the general public and establishing proper medication waste management such drug take-back systems. Full article
7 pages, 911 KiB  
Case Report
Off-Label Use of Dalbavancin in Enterococcus spp. Abscess and Streptococcus pneumoniae Bacteremia Secondary to Septic Arthritis: A Retrospective Case Report
by Miriam Banoub Morkos, Giovani Leon, Mai-Chi Hong, Joshua Allan Garcia, Martin J. Breen, Bhanu Sud and Lee Nguyen
Pharmacoepidemiology 2024, 3(4), 307-313; https://doi.org/10.3390/pharma3040021 - 29 Sep 2024
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Abstract
Dalbavancin, a semi-synthetic lipoglycopeptide with an extended half-life that allows for weekly dosing, is currently approved for the treatment of bacterial skin and soft tissue infections caused by susceptible gram-positive organisms. This case report discusses the successful treatment of septic arthritis with dalbavancin [...] Read more.
Dalbavancin, a semi-synthetic lipoglycopeptide with an extended half-life that allows for weekly dosing, is currently approved for the treatment of bacterial skin and soft tissue infections caused by susceptible gram-positive organisms. This case report discusses the successful treatment of septic arthritis with dalbavancin in a 38-year-old obese male. Septic arthritis, commonly caused by Staphylococcus aureus and Streptococcus species, was diagnosed in this patient following a mechanical fall that led to worsening shoulder pain. Given the patient’s morbid obesity and concerns about antibiotic penetration, dalbavancin 1500 mg IV biweekly was chosen for its extended half-life and ease of administration. This case underscores dalbavancin’s efficacy in managing septic arthritis in obese patients, offering a convenient alternative to traditional therapies that require a peripherally inserted central catheter (PICC line), frequent dosing, therapeutic monitoring, and prolonged hospital stays. Despite its higher cost, dalbavancin’s advantages include reduced need for PICC lines, additional staff and resources to monitor therapeutic drug levels, and fewer complications, which can offset some expenses. To our knowledge, this is the first documented case investigating the use of dalbavancin for enterococcal septic arthritis with a biweekly dosing regimen. Full article
(This article belongs to the Special Issue Anti-Infectives: Pharmacoepidemiology and Clinical Pharmacology)
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