Все это происходит на фоне экономической ситуации, когда правительства стемятся урезать затраты на медицинскую помощь, взваливая тем самым на плечи потребителей все более тяжкое бремя расходов на лекарства


Избегая ненужного использования лекарств



жүктеу/скачать 5.36 Mb.
бет62/92
Дата28.06.2016
өлшемі5.36 Mb.
#163312
1   ...   58   59   60   61   62   63   64   65   ...   92

Избегая ненужного использования лекарств


В целом, необходимо акцентировать важность осторожного обращения с лекарствами во время беременности. Согласно Британскому национальному фармакологическому справочнику,

«Ни одно лекарство не является стопроцентно безопасным на ранней стадии беременности... При беременности лекарства должны назначаться только тогда, когда считается, что ожидаемая польза для матери превышает риск для плода, а во время первого триместра по возможности следует избегать всех лекарств.» [97]



К сожалению, потребление лекарств при беременности часто бывает ненужно и тревожно высоким, что подвергает плод риску врожденных пороков или проблем развития.

Рекомендации к действию


  1. Органам здравоохранения следует подготовить для женщин информацию о лекарствах, типично используемых при беременности, и о немедикаментозных мерах для решения обычных проблем со здоровьем, происходящих во время беременности.

  2. Для лиц, назначающих и отпускающих медикаменты, следует подготовить аналогичную информацию, а также материалы для вывешивания на видном месте, в которых напоминалось бы о необходимости быть осторожными при беременности.

  3. Следует внедрить в международном масштабе единые категории для маркировки лекарств, которые бы ясно указывали на их относительный риск при беременности.

  4. Следует создать ясный, понятный и повсеместно узнаваемый графический символ, который показывал бы, что конкретный продукт не должен использоваться при беременности; этим символом следует маркировать все лекарства, отпускаемые по рецепту и без него, безопасность которых при беременности не была подтверждена.



Источники


  1. Anon., "Acne, Accutane, abortions and life-threatening birth defects", Health Letter, 12 May 1988.

  2. Lynch, C.M., Sinnott, J.V., et al, "Use of antibiotics during pregnancy", American Family Physician, Vol 43, No 4, Apr 1991, pp1365-8.

  3. Niebyl, J.R., "Drugs and related areas in pregnancy", Zent.bl. Gynakol., Vol 113, 1991, pp375-88.

  4. Laurence, D.R. and Bennett, P.N., Clinical Pharmacology, London, Churchill Livingstone, (6th edn), 1987, p85.

  5. AMA, Drug Evaluations, Philadelphia, W.B. Saunders Co., (6th edn) 1986, pp41-50.

  6. Martínez-Frías, M.L. and Salvador, J., "Megadose vitamin A and teratogenicity", Lancet, No 8579, 30 Jan 1988, p236.

  7. Gilman, A.G., Rail, T.W., Nies, A.S., and Taylor, P., Goodman and Gilman's The Pharmacological Basis of Therapeutics, New York, Pergamon Press, (8th edn) 1990, p13.

  8. Collaborative Group on Drug Use in Pregnancy, "Medication during pregnancy: an intercontinental cooperative study", International Journal of Gynecology and Obstetrics, Vol 39, 1992, pp185-96.

  9. Rubin, P.С. (ed.), Prescribing in Pregnancy, London, British Medical Journal, 1987, p1.

  10. Whittle, M.J. and Hanretty, K.P., "Identifying abnormalities", in: Rubin, op cit, pp8-18.

  11. de Jong-van den Berg, L.T.W., van den Berg, P.В., et al, "Investigating drug use in pregnancy: methodological problems and perspectives", Pharmaceutisch Weekblad Scientific Edition, Vol 13, No 1, 1991, pp32-8.

  12. Fugh-Berman, A., "On the FDA's recommendations for the use of isotretinoin", The Drug Monitor (Philippines), Vol V, No 10, Oct 1990, pp127-8.

  13. Collier, J., The Health Conspiracy, London, Century Hutchinson, 1989, p15.

  14. Mitchell, A.A., "Oral retinoids: what should the prescriber know about their teratogenic hazards among women of child-bearing potential?", Drug Safety, Vol 7, No 2, 1992, pp79-85.

  15. Ledward, R.S., "Antimicrobial drugs in pregnancy", in: Hawkins, D.F. (ed.), Drugs and Pregnancy, London, Churchill Livingstone, (2nd edn) 1987, pp148-65.

  16. Camera, G. and Pregliasco, P., "Ear malformation in baby born to mother using tretinoin cream", Lancet, Vol 339, 14 Mar 1992, p687.

  17. AMA, op cit, p42.

  18. Parish, P., Medicines: a guide for everybody, London, Penguin (6th edn, revised), 1989, ррЗЗ-4.

  19. Henry, J. (ed.), The British Medical Association Guide to Medicines & Drugs, London, Dorling Kindersley, (2nd edn) 1991, p20.

  20. Parish, op cit, p34.

  21. Lewis, P.J. and Hurden, E.L., "Breast feeding and drug treatment", in; Hawkins, D.F. (ed.), Drugs and Pregnancy, London, Churchill Livingstone, (2nd edn) 1987, pp304-32.

  22. BMA and the Royal Pharmaceutical Society of Great Britain, British National Formulary, BMA and the Pharmaceutical Press, No 23, Mar 1992, pp517-21.

  23. Food and Drug Administration, "Sandoz Pharmaceuticals Corp.; Bromocriptine Mesylate (Parlodel) for the Prevention of Psyhological Lactation; Opportunity for a Hearing on a Proposal to withdraw approval of the indication", Federal Register, 23 Aug 1994, vol 59, No 162, pp43347-52.

  24. Anonymous, "Parlodel indication whitdrawn in US", Scrip, No 1952, 26 Aug 1994, p18.

  25. Food and Drug Administration, "Sandoz Pharmaceuticals Corp.; Bromocriptine Mesylate (Parlodel); Withdrawal of approval of the indication for the Prevention of Psyhological Lactation", Federal Register, 17 Jan 1995, vol 60, No 10, pp3404-5.

  26. Sandoz Pakistan, "Breast disorders and the breast drug" PLO_BBD 02/0794.

  27. Tulloch, J., personalcommunication, 19 Dec 1994; WHO/UNICEF, Breasfeeding counselling: a training course. Participant's Manual, Geneva, WHO, 1993.

  28. Khanna, J., van Look, P.F.A., and Griffin, P.D. (eds), Reproductive Health: a Key to a Brighter Future, Geneva, WHO, 1992, p104.

  29. Jacobson, J.L., "Improving women's reproductive health", chapter 6 in: Brown, L.R., Brough, H., et al, State of The World 1992, London, Earthscan, 1992, pp83-99.

  30. Adashi, E.Y., Rock J.A., Sapp, K.C. et al, "Gestational outcome of clomiphene-related conceptions", Fertility and Sterility Vol 31, 1979, pp620-626, cited in: Jong-v.d. Berg, L.T.W., Cornel, M.C., van den Berg, P.B., et al "Ovulation-inducing drugs: a drug utilization and risk study in the Dutch population", International Journal of Risk and Safety in Medicine, Vol 3, 1992, p107.

  31. Henry, J. (ed.), The British Medical Association Guide to Medicines & Drugs, London, Dorling Kindersley, (2nd edn) 1991, p160.

  32. Phillips, et al, op cit, p429.

  33. Gilman, A.G., Rail, T.W., Nies, A.S., and Taylor, P., op cit, p1397.

  34. Jong-v.d. Berg et al, 1992, op cit, p100.

  35. Rowland, Rl, Living Laboratories: Women and reproductive technology, London, Lime Tree/Octopus, 1992, pp50-1.

  36. Howden, C.W., "Treatment of common minor ailments" in: Rubin, op cit, pp 19-25.

  37. Werler, M.M., Mitchell, A.A. and Shapiro, S., "The relation of aspirin use during the first trimester of pregnancy to congenital cardiac defects", New England Journal of Medicine, Vol 321, No 24, 14 Dec 1989, pp1639-42.

  38. Australian Drug Evaluation Committee, Medicines in Pregnancy, Canberra, Australian Government Publishing Service, 1989, p6.

  39. Howden, op cit, pp19-25.

  40. See for example: Elder, M.G., de Swiet, M., et al, "Low-dose aspirin in pregnancy", Lancet, No 8582, 20 Feb 1988, p410;
    Schiff, E., Peleg, E., et al, "The use of aspirin to prevent pregnancy-induced hypertension and lower the ratio of thromboxane A2 to Prostacyclin in relatively high-risk pregnancies", New England Journal of Medicine, Vol 321, No 6, 10 Aug 1989, pp351-6;
    Cunningham, F.G. and Gant, N.F., "Prevention of preeclampsia - a reality?", New England Journal of Medicine, Vol 321, No 9, 31 Aug 1989, рр606-7;
    Werler, et al, op cit, pp1639-42;
    Uzan, S., Beaufils, M., et al, "Prevention of fetal growth retardation with low-dose aspirin: findings of the EPREDA trial", Lancet, Vol 337, 15 Jun 1991, pp1427-31;
    Anon., "Aspirin beneficial in pregnancy", Scrip, No 1637, 26 Jul 1991, p27.

  41. Anon., "US FDA tightens aspirin warning", Scrip, No 1530, 11 July 1990, p22.

  42. Uzan, et al, op cit, pp1427-31.

  43. BMA and the Royal Pharmaceutical Society of Great Britain, op cit, p176.

  44. Hawkins, op cit, p79.

  45. Anon., "Drug use in pregnancy", The Prescriber, No l, Jan 1992, p7.

  46. Moise, K.J., Huhta J.C., et al, "Indomethacin in the treatment of premature labor", New England Journal of Medicine, Vol 319, No 6, 11 Aug 1988, pp327-31.

  47. Lewis, J.H., "Drug hepatotoxicity in pregnancy", European Journal of Gastroenterology and Hepatology, Vol 3, No 12, 1991, pp883-91.

  48. Ledward, op cit, pp148-65.

  49. Lynch, et al, op cit, pp1365-8.

  50. Ledward, op cit, p155.

  51. Lynch, et al, op cit, pp1365-8.

  52. Rubin, op cit, p38.

  53. Ledward, op cit, pp148-65.

  54. Collignon, P., Heihir, J. and Mitchell, D., "Successful treatment of falciparum malaria in pregnancy with mefloquine", Lancet, No 8644, 29 Apr 1989, p967.

  55. Anon., The Prescriber, op cit, p8.

  56. Hawkins, op cit, pp100-1 and 105.

  57. Chetley, A., Peddling Placebos: an analysis of cough and cold remedies, Amsterdam, HAI, 1989.

  58. MIMS Africa, Vol 31, No 4, July 1991, p111;
    MIMS Caribbean, Vol 21, No 1, Jan 1991, p62.

  59. Loudon, J.B., "Psychotropic drugs", in: Rubin, op cit, pp49-57.

  60. Palmer, P.G., "Sedatives and anticonvulsants in pregnancy", in: Hawkins, op cit, pp128-147.

  61. Niebyl, op cit, pp375-88.

  62. Palmer, op cit, pp128-147.

  63. Anon., The Prescriber, op cit, p10.

  64. AMA, op cit, p90.

  65. Palmer, op cit, pp128-147.

  66. Sidhu, R.K., "Corticosteroids in pregnancy" in: Hawkins, op cit, pp166-79.

  67. Anon., "Asthma, progesterone, and pregnancy", Lancet, Vol 335, 27 Jan 1990, p204.

  68. Jones, K.L., Lacro, R.V., et al, "Pattern of malformations in the children of women treated with carbamazepine during pregnancy", New England Journal of Medicine, Vol 320, No 25, 22 June 1989, pp1661-6.

  69. Brodie, M.J., "Management of epilepsy during pregnancy and lactation", Lancet, Vol 336, 18 Aug 1990, pp426-7.

  70. Anon., "Teratogenesis with carbamazepine", Lancet, Vol 337, 1 Jun 1991, pp1316-17.

  71. Piacquadio, К., Hollingsworth, D.R. and Murphy, H., "Effects of in-utero exposure to oral hypoglycaemic drugs", Lancet, Vol 338, 5 Oct 1991, pp866-9.

  72. Hawkins, op cit, pp 100-1 and 105.

  73. Phillips, A., Rakusen,J. (eds) and the Boston Women's Health Collective, The New Our Bodies, Ourselves (2nd UK edition), London, Penguin Books, 1989, p347.

  74. Howden, op cit, pp19-25.

  75. Jackson, D.M. and Soothill, R., Is the Medicine Making You ill?, North Ryde, Australia, Angus & Robertson, 1989, p100.

  76. Howden, op cit, pp19-25.

  77. BMA and the Royal Pharmaceutical Society of Great Britain, op cit, p162.

  78. Hawkins, op cit, p105.

  79. Anon., "PDA tightens warning on ACE-inhibitors", Scrip, No 1702,20 Mar 1992, p20.

  80. Weber, J.C.P., "Limitations of a voluntary reporting system", in: Hawkins, op cit, pp37-47.

  81. Henry, op cit, p409.

  82. Phillips, and Rakusen, op cit, p347.

  83. Hawkins, op cit, p67.

  84. AMA, op cit, pp843-4.

  85. Hawkins, op cit, pp64-6.

  86. Anon., "Preventing iron-deficiency anaemia", Lancet, No 8673, 18 Nov 1989, p1231.

  87. Ramalingaswami, V., "Challenges and opportunities - one vitamin, two minerals", World Health Forum, Vol 13, No 2/3, 1992, pp222-31.

  88. Larroque, В., Kaminski, M., et al, "Folate status during pregnancy: relationship with alcohol consumption, other maternal risk factors and pregnancy outcome", European Journal of Obstetrics and Gynecology and Reproductive Biology, Vol 43, 1991, pp19-27.

  89. Hobbms.J.C., "Diagnosis and management of neural-tube defects today", New England Journal of Medicine, Vol 324, No 10, 7 Mar 1991, pp690-l.

  90. Anon., "UK folic acid supplementation", Lancet, Vol 341, 2 Jan 1993, p46.

  91. Gilman, et al, op cit, p1290.

  92. AMA, op cit, p701.

  93. WHO, Drugs in Pregnancy and Delivery, Copenhagen, Dec 1984, p53.

  94. Cody, P., "A history of the DES action movement", in: Mintzes, B. (ed.), DES: A Drug with Consequences for Current Health Policy, Utrecht, DES Action The Netherlands, 1990, pp10-12.

  95. Gilman, et al, op cit, p1401.

  96. AMA, op cit, p727.

  97. BMA and the Royal Pharmaceutical Society of Great Britain, op cit, p499.


ЭНДРЮ ЧЕТЛИ. ПРОБЛЕМНЫЕ ЛЕКАРСТВА

ЭНДРЮ ЧЕТЛИ. ПРОБЛЕМНЫЕ ЛЕКАРСТВА




Содержание :: ANTIBIOTIC.ru



Главы: 

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27



жүктеу/скачать 5.36 Mb.

Достарыңызбен бөлісу:
1   ...   58   59   60   61   62   63   64   65   ...   92



©dereksiz.org 2024
әкімшілігінің қараңыз
    Басты бет