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The Use And Misuse Of Nonsteroidal Anti-inflammatory Drugs (nsaids)
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Health-system pharmacists have responsibilities for ensuring a safe and effective medication-use system, including legal and organizational responsibilities for medication distribution and control across the continuum of practice settings within health care organizations. With this combination of knowledge and organizational responsibilities, pharmacists are prepared to serve in leadership and service roles in substance abuse prevention and education and assist in a variety of patient care, employee health, and community activities.
A study carried out among 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia showed that NSAIDs were prescribed for almost all arthritic patients either in regular or pro re nata basis irrespective of the rheumatological diagnosis. In that survey, rheumatoid arthritis patients receiving NSAIDs outnumbered other rheumatic disorders compared to the study conducted by Wynne and Long where NSAIDs were mostly prescribed for osteoarthritis followed by rheumatoid arthritis and other disorders(Wyne and Long, 2006). The difference obtained appeared to be attributed to the number of Rheumatoid arthritis patients most commonly seen at the rheumatology clinic, whereas more of Osteoarthritis patients were treated by orthopedic surgeons.
The choice of NSAIDs prescribed is individualized and varies in different practices.Drug availability, cost, familiarity and tolerability are among many factors which play an important role in the treatment strategy for rheumatic diseases. In this study most of the older NSAIDs (indomethacin, diclofenac sodium, ibuprofen, naproxen, meloxicam) and newer COX-2 inhibitors (celecoxib, etoricoxib) were readily available. The duration of NSAIDs usage and the quantity needed to be taken varied from patient to patient (Sulaiman et al, 2012).
1.2 STATEMENT OF THE PROBLEM
The use of NSAIDs accounts for an estimated 76 000 hospitalizations and 7600 deaths in the United States ( Fries, 1992) and 3897 hospitalizations and 365 deaths in Canada (IMSC, 1997) every year. These hospitalizations and deaths are majorly due to ulcer and gastrointestinal bleeding related to NSAID use. Irrational prescribing has further complicated the adverse effects from the use of NSAIDs.
Asides gastrointestinal toxicity, renal failure has been recently known to be a risk if the patient is also concomitantly taking an ACE inhibitor and a diuretic - the so-called “triple whammy†effect. Liver problems are also possible with the long term use of NSAIDs (Awodele et al, 2015).
1.4 JUSTIFICATION OF THE STUDY
Self-medication is widespread all over the world and occurs in both urban (Pandy et al, 2013) and rural population(Bello and Bello, 2013). Pharmacies and patient medicine stores are visible in both urban and rural settlements in the study area suggest access of people to various types of drugs. These medications may be acquired with or without recommendation from qualified medical practitioners. The potential of NSAIDs to cause significant unwanted effects for users especially when taken in high doses and for prolonged duration, necessitates this study. The new trend in pharmacy practice entails appropriate guide in medication use (Isetts and McGann, 2012)
1.5 STUDY OBJECTIVES
The general objective of this study was To evaluate rationale use of NSAID in Ilorin metropolis
The specific objectives of this study include to:
1. Assess the level of prevalence and pattern of misuse of NSAIDS among the residents of Ilorin
2. Describe the Prescribing pattern of NSAIDs among prescribers in the University of Ilorin Teaching Hospital.
3. Assess the Dispensing pattern of NSAIDs among the Community Pharmacists in Ilorin metropolis
4. Determine factors that influence misuse of NSAIDs among the residents.
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ABSRACT - [ Total Page(s): 1 ]ABSTRACT COMING SOON ... Continue reading---
CHAPTER TWO - [ Total Page(s): 3 ]EXCLUSION CRITERIAAll pharmacists not practicing as community pharmacistsAll patent medicine vendors and outlets2.4 SAMPLE SIZE DETERMINATIONa. Retrospective review of prescriptions: All prescriptions from November 2013 and April 2014 were obtained from the Outpatient Pharmacy Department prescription bank. The prescriptions containing NSAIDs were separated from those without NSAIDs.b. Ilorin metropolis is made up of three local government areas: Ilorin West, Ilori ... Continue reading---
CHAPTER THREE - [ Total Page(s): 8 ]CHAPTER THREE RESULTS3.1 RESULTS OF ANALYSIS OF PRESCRIPTIONS/TREATMENT SHEETSOut of 1497 prescription sheets 1297 prescriptions contained NSAIDs with total of 1392 NSAIDs. The prescribing rate was hence found to be 86.6%. 7.3% of prescriptions contained more than one NSAIDs. ... Continue reading---
CHAPTER FOUR - [ Total Page(s): 2 ]CHAPTER FOURDISCUSSIONStudy of the Prescribing pattern of Nonsteroidal Antiinflammatory Drugs indicated more number of females assess health care for pain and related conditions than their male counterpart (Table 3.1), although there is widespread assumption that women will consult more readily for all symptoms or conditions and that men will be more reluctant or will delay consulting may result in health care providers assuming that women have a lower level of symptom severity before deciding ... Continue reading---
CHAPTER FIVE - [ Total Page(s): 1 ]CHAPTER FIVE CONCLUSIONThe prescribing rate of NSAIDs was high. The prevalence of NSAIDs misuse by residents was high Ibuprofen was the most highly misused among the residents. Dispensing pattern of NSAIDs by Pharmacists appeared to agree with the choice of medication use among residents. Educational status, occupation, prior knowledge of medication use and dispensing pattern of Pharmacists are factors that can influence public choice of NSAIDs use. ... Continue reading---
REFRENCES - [ Total Page(s): 5 ]Slater DM, Zervou S, Thornton S. (2002). Prostaglandins and prostanoid receptors in human pregnancy and parturition. J. Soc. Gynecol. Investig. 9:118-124.Soleymani F, Ahmadizar A and Abdollahi MA(2013). Survey on the factors influencing the pattern of medicine's use: Concerns on irrational use of drugs. J Res Pharm Pract. 2(2), 59–63.Solomon SD, McMurray JJ, Pfeffer MA, Wittes J, Fowler R, Finn P, Anderson WF, Zauber A, Hawk E, Bertagnolli M (2005). Cardiovascular risk associated with c ... Continue reading---
