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The Use And Misuse Of Nonsteroidal Anti-inflammatory Drugs (nsaids)
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Although side effects of NSAIDs are the major reasons for their cautionary measure in their use() but only about 23% of the respondents were aware of the existence of any side effects from the NSAIDs use while slightly above 10% were indifferent. Two hundred and sixteen (34.3%) residents used NSAIDs more frequently(Table 3.4). This translates to prevalence of misuse among the residence. Low awareness of side effects of these drugs could account for such high level. Majority of the respondents (61.2%) claimed to have relief when self medicated with NSAIDs though pain could be relieved without taking any medication(Bekerom et al ,2012 ).
Out of 115 respondents who claimed that experienced side effects from NSAIDs use, single and multiple side effects were identified ranging from skin rash to Dizziness (Figure 3.1). The most frequently encountered was stomach pain confirming the ability of the NSAIDs to irritate gastrointestinal tract with the least commonly encountered side effects being vomiting.
Results of survey conducted on Pharmacists in Ilorin indicated that there were more male pharmacists than female practicing in Community Pharmacy and were within the age group of 40-50 years which is within the productive age group. Almost half of them had previous experience in either Hospital or Industrial Pharmacy which indicated their wider scope of experience. Less than two-third of them had post Barchelor of Pharmacy with clinical affiliation related training and this may limit their ability to provide optimal patient oriented services. Majority of the pharmacists provide adequate number of hours in their premises. This is consistent with a study obtained in Warri where pharmacists were present in most hours of the day (Adje and Oli, 2013).
More than 75% of the Pharmacies were within a distance of 5 kilometer from an existing Health Facility which effectively utilized could promote healthcare system integration which make pharmacy part of the patient pathway by formalizing patient referrals to nominated pharmacies for follow-up, assisting with registration with a chosen pharmacy for advice about new medicines, and offering community-based monitoring and management(Anscombe, 2012). Obviously, there was no professional collaboration between the Pharmacies and the Health care facilities as there was minimal prescriptions refilling with over 60% of the receive less than 20 prescriptions per week.
Pharmacists’ Perceived level of NSAID prescribing and misuse by the public were viewed to be high with ibuprofen, diclofenac and piroxicam leading the most misused NSAID while celecoxib, ketoprofen and naproxen were found to be the least misused. The perception of the pharmacists was consistent with the study of Hackethal, 2015 where ibuprofen was found to be the most commonly abused NSAIDs. It could also be noted that the least misused NSAIDs are the more expensive ones which possibly cost may be a factor in their being prescribed more frequently or being abused by potential users.
There was significant association between gender and educational status of the residents. Significant number of female respondents had tertiary level of education, p=0.006(CI; 0.244 to 0.787) indicating higher level of male respondents than their female counterpart.
There was also a significant association between the level of awareness of side effects of NSAIDs and educational status of the residents as more residents with higher level of education were aware of side effects of NSAIDs, p=0.016. Male gender were also appeared to show higher level of awareness of NSAIDs side effects than their female counterpart, p=0.035. A similar study carried out in Malaysia on patient’s knowledge and perception towards the use of Non-steroidal Antiinflammatory drugs indicated a higher level of awareness of NSAD’s side effects, 54.2% (Sulaiman et al, 2012) compare to value obtained in this study, 22.9%. . Male acquired better level of education than their female counterpart which could probably be responsible for significant difference in the awareness of side effects associated with the use of NSAIDs (Table 3.8).
Perceived level of improvement was found to be related to the frequency of use of NSAIDs by the residents as the respondents claimed to achieve cure of the pain ailment with increased use of NSAIDs, p=0.003(Table 3.10) although this has also been known to be associated with increase level of NSAID toxicity(Ong et al, 2007). It is also worth noting that statistically significant difference exists between male and female respondents in their frequency of misuse of NSAIDs as more number of male respondents frequently misuse NSAIDs than their female counterpart (Table 3.11). Occupational distribution of the residents was also found to influence frequency of self medication with NSAIDs among the residents( Table 3.12).
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ABSRACT - [ Total Page(s): 1 ]ABSTRACT COMING SOON ... Continue reading---
CHAPTER ONE - [ Total Page(s): 16 ]TNF, originally termed "cachectin" because of its ability to produce a wasting syndrome, is composed of two closely related proteins: mature TNF (TNF-a) and lymphotoxin (TNF-b), both of which are recognized by the same cell-surface receptors. There are two types of TNF receptors, a 75-kd type 1 receptor and a 55-kd type 2 receptor. IL-1 and TNF produce many of the same proinflammatory responses. A naturally occurring IL-1 receptor antagonist (IL-1ra), competes with IL-1 for receptor binding, blo ... 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 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---
