Medication: Difference between revisions

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==Compliance with taking medications==
==Compliance with taking medications==
Many people have difficulty with taking all the medications that they have been prescribed.<ref name="pmid8492406">{{cite journal |author=Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G |title=The rational clinical examination. Is this patient taking the treatment as prescribed? |journal=JAMA |volume=269 |issue=21 |pages=2779–81 |year=1993 |pmid=8492406 |doi=}}</ref> Among patients who have to take numerous drugs for their health (polypharmacy), not taking all of their medications may lead to poorer health outcomes.<ref name="pmid16790458">{{cite journal |author=Simpson SH, Eurich DT, Majumdar SR, ''et al'' |title=A meta-analysis of the association between adherence to drug therapy and mortality |journal=BMJ |volume=333 |issue=7557 |pages=15 |year=2006 |pmid=16790458 |doi=10.1136/bmj.38875.675486.55}}</ref> Improving compliance may improve health.<ref name="pmid16916809">{{cite journal |author=Wu JY, Leung WY, Chang S, ''et al'' |title=Effectiveness of telephone counselling by a pharmacist in reducing mortality in patients receiving polypharmacy: randomised controlled trial |journal=BMJ |volume=333 |issue=7567 |pages=522 |year=2006 |pmid=16916809 |doi=10.1136/bmj.38905.447118.2F}}</ref>
Many people have difficulty with taking all the medications that they have been prescribed.<ref name="pmid8492406">{{cite journal |author=Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G |title=The rational clinical examination. Is this patient taking the treatment as prescribed? |journal=JAMA |volume=269 |issue=21 |pages=2779–81 |year=1993 |pmid=8492406 |doi=}}</ref> Among patients who have to take numerous drugs for their health (polypharmacy), not taking all of their medications may lead to poorer health outcomes.<ref name="pmid16790458">{{cite journal |author=Simpson SH, Eurich DT, Majumdar SR, ''et al'' |title=A meta-analysis of the association between adherence to drug therapy and mortality |journal=BMJ |volume=333 |issue=7557 |pages=15 |year=2006 |pmid=16790458 |doi=10.1136/bmj.38875.675486.55}}</ref> Improving compliance may improve health.<ref name="pmid16916809">{{cite journal |author=Wu JY, Leung WY, Chang S, ''et al'' |title=Effectiveness of telephone counselling by a pharmacist in reducing mortality in patients receiving polypharmacy: randomised controlled trial |journal=BMJ |volume=333 |issue=7567 |pages=522 |year=2006 |pmid=16916809 |doi=10.1136/bmj.38905.447118.2F}}</ref>
23% of patients report skipping doses or cutting pills in half to make their supply last longer according to one survey.<ref> USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: the public on prescription drugs and pharmaceutical companies - kaiser family foundation. Retrieved March 10, 2008, from http://www.kff.org/kaiserpolls/pomr030408pkg.cfm.</ref> This is more common among low-income patients.


==Polypharmacy==
==Polypharmacy==

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A medication is a licensed drug taken to cure or reduce symptoms of an illness or medical condition. Medications are typically produced by pharmaceutical companies and are often patented to protect their exclusive rights to produce them, but they can also be derived from naturally occurring substance in plants called herbal medicine. Those that are not patented (or with expired patents) are called generic drugs since they can be produced by other companies without restrictions or licenses from the patent holder.

Classification

Medication can be usually classified in various ways, e.g. by its chemical properties, mode of administration, or biological system affected. An elaborate and widely used classification system is the Anatomical Therapeutic Chemical Classification System.

Regulation

Medications are generally divided into groups by the United States and similar laws.

Over-the-counter drug

Over-the-counter drug (OTC) medications, which are available in pharmacies and supermarkets without special restrictions

Behind the counter

Behind the counter (BTC) are dispensed by a pharmacist without needing a doctor's prescription,

Prescribed drugs

Prescription only medicines (POM), which must be prescribed by a physician, physician assistant, nurse practitioner, or dentist. These medications are approved by national entities such as the Food and Drug Administration in the United States or by international entities such as the European Medicines Agency (EMEA) of the European Union.

Proscribed drugs

The International Narcotics Control Board of the United Nations imposes a world law of prohibition or censorship of certain medications. They publish a lengthy list of chemicals and plants whose trade and consumption (where applicable) is forbidden. Most OTC medication is generally considered to be safe enough that most persons will not hurt themselves accidentally by taking it as instructed. Many countries, such as the UK have a third category of pharmacy medicines which can only be sold in registered pharmacies, by or under the supervision of a pharmacist. However, the precise distinction between OTC and prescription depends on the legal jurisdiction.

Medication information for consumers

Medication guides, or labels are given by the pharmacist with every prescription. It generally includes description, clinical pharmacology (pharmacokinetics, pharmacodynamics), clinical trials, indications and usage, contraindications, warnings, precautions, adverse reactions, dosage and administration, overdosage, how supplied, storage, revision date and manufacturer and distributor.

United States Food and Drug Administration approved labels

European Union

Compliance with taking medications

Many people have difficulty with taking all the medications that they have been prescribed.[1] Among patients who have to take numerous drugs for their health (polypharmacy), not taking all of their medications may lead to poorer health outcomes.[2] Improving compliance may improve health.[3]

23% of patients report skipping doses or cutting pills in half to make their supply last longer according to one survey.[4] This is more common among low-income patients.

Polypharmacy

For more information, see: Polypharmacy.

Drug toxicity

For more information, see: Drug toxicity.

Unfortunately, drugs may also cause drug toxicity (also called adverse drug reaction or adverse drug event).

Types of medication

For the gastrointestinal tract or digestive system

For the cardiovascular system

For the central nervous system

See also: Psychoactive drug

hypnotic, anaesthetics, antipsychotic, antidepressant (including tricyclic antidepressants, monoamine oxidase inhibitor, lithium salt, selective serotonin reuptake inhibitor), anti-emetic, anticonvulsant and antiepileptic, anxiolytic, barbiturate, movement disorder drug, stimulant (including amphetamines), benzodiazepine, cyclopyrrolone, dopamine antagonist, antihistamine, cholinergic, anticholinergic, emetic, cannabinoids, 5-HT antagonist

For pain & consciousness (analgesic drugs)

Further information: Analgesic

The main classes of painkillers are NSAIDs, opioids and various orphans such as paracetamol, tricyclic antidepressants and anticonvulsants.

For musculo-skeletal disorders

NSAIDs (including COX-2 selective inhibitors), muscle relaxant, neuromuscular drug
anticholinesterase

For the eye

For the ear, nose and oropharynx

sympathomimetic, antihistamine, anticholinergic, NSAIDs, steroid, antiseptic, local anesthetic, antifungal, cerumenolytic

For the respiratory system

bronchodilator, NSAIDs, anti-allergic, antitussive, mucolytic, decongestant
corticosteroid, beta-receptor antagonist, anticholinergic, steroid

For endocrine problems

androgen, antiandrogen, gonadotropin, corticosteroid, growth hormone, insulin, antidiabetic (sulfonylurea, biguanide/metformin, thiazolidinedione, insulin), thyroid hormones, antithyroid drugs, calcitonin, diphosponate, vasopressin analogues

For the reproductive system or urinary system

antifungal, alkalising agent, quinolones, antibiotic, cholinergic, anticholinergic, anticholinesterase, antispasmodic, 5-alpha reductase inhibitor, selective alpha-1 blocker, sildenafil

For contraception

contraceptive, oral contraceptives, spermicide, depot contraceptives

For obstetrics and gynaecology

NSAIDs, anticholinergic, haemostatic drug, antifibrinolytic, Hormone Replacement Therapy, bone regulator, beta-receptor agonist, follicle stimulating hormone, luteinising hormone, LHRH
gamolenic acid, gonadotropin release inhibitor, progestogen, dopamine agonist, oestrogen, prostaglandin, gonadorelin, clomiphene, tamoxifen, Diethylstilbestrol

For the skin

emollient, anti-pruritic, antifungal, disinfectant, scabicide, pediculicide, tar products, vitamin A derivatives, vitamin D analogue, keratolytic, abrasive, systemic antibiotic, topical antibiotic, hormones, desloughing agent, exudate absorbent, fibrinolytic, proteolytic, sunscreen, antiperspirant, corticosteroid

For infections and infestations

antibiotic, antifungal, antileprotic, antituberculous drug, antimalarial, anthelmintic, amoebicide, antiviral, antiprotozoal, antiserum

For immunology

vaccine, immunoglobulin, immunosuppressant, interferon, monoclonal antibody

For allergic disorders

anti-allergic, antihistamine, NSAIDs

For nutrition

tonic, iron preparation, electrolyte, parenteral nutritional supplement, vitamins, anti-obesity drug, anabolic drug, haematopoietic drug, food product drug

For neoplastic disorders

cytotoxic drug, sex hormones, aromatase inhibitor, somatostatin inhibitor, recombinant interleukins, G-CSF, erythropoietin

For diagnostics

contrast media

For euthanasia

A euthanaticum is used for euthanasia and physician-assisted suicide, see also barbiturates.

Other/related topics

Polypharmacy: suggests that multiple use of prescribed and non-prescribed medications, (use of 5 or more), can have adverse effects on the recipient.

Zoopharmacognosy: Animal usage of drugs and non-foods.

See also

External links

  1. Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G (1993). "The rational clinical examination. Is this patient taking the treatment as prescribed?". JAMA 269 (21): 2779–81. PMID 8492406[e]
  2. Simpson SH, Eurich DT, Majumdar SR, et al (2006). "A meta-analysis of the association between adherence to drug therapy and mortality". BMJ 333 (7557): 15. DOI:10.1136/bmj.38875.675486.55. PMID 16790458. Research Blogging.
  3. Wu JY, Leung WY, Chang S, et al (2006). "Effectiveness of telephone counselling by a pharmacist in reducing mortality in patients receiving polypharmacy: randomised controlled trial". BMJ 333 (7567): 522. DOI:10.1136/bmj.38905.447118.2F. PMID 16916809. Research Blogging.
  4. USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: the public on prescription drugs and pharmaceutical companies - kaiser family foundation. Retrieved March 10, 2008, from http://www.kff.org/kaiserpolls/pomr030408pkg.cfm.