http://hdl.handle.net/10147/244211 Thu, 20 Jun 2013 07:42:11 GMT 2013-06-20T07:42:11Z http://hdl.handle.net/10147/274572 Title: Annual Report 2011 Authors: The Drug Treatment Centre Board (DTCB) Sat, 01 Jan 2011 00:00:00 GMT http://hdl.handle.net/10147/274572 2011-01-01T00:00:00Z http://hdl.handle.net/10147/248719 Title: Drug use prevention: an overview of research Authors: Morgan, Mark Description: This is the first Report to be published by the National Advisory Committee on Drugs which was established in 2000. The role of the Committee is to advise the Government in relation to the prevalence, prevention, treatment and consequences of problem drug use and I am delighted that the Committee's first Report looks at the important area of prevention and the effectiveness of various programmes and initiatives that have been undertaken. We are all too aware of the havoc that drug misuse continues to wreak on the lives of individuals, families and communities. As the Report points out there is no single drug problem - instead there are a variety of different problems each of which requires a somewhat different approach. The Report also found that problem drug use is particularly likely where other factors involving social and educational disadvantage and deprivation are involved. The new National Drugs Strategy 2001 - 2008, which was launched by the Government in May 2001, is built around the four pillars of supply reduction, prevention, treatment and research. A number of the 100 actions in the Strategy relate to the area of prevention and this Report is, therefore, both timely and thought-provoking as we start to implement these actions. Mon, 01 Jan 2001 00:00:00 GMT http://hdl.handle.net/10147/248719 2001-01-01T00:00:00Z http://hdl.handle.net/10147/244356 Title: Reports of side effects associated with the use of drugs 1987-1988 Authors: National Drugs Advisory Board (NDAB) Description: During 1987 the National Drugs Advisory Board received 1,288 reports concerning patients who experienced adverse reactions associated with the use of medicines. From these reports 2,251 side effects were recorded. Thirty-five percent of the reports were forwarded by general pract1t1oners, 21% by pharmacists (about half of those were received from pharmacists conducting special surveys, one in the Drug Information Centre. St. James's Hospital. and the other from a special research project.) Hospital Consultants were the source of 15% of the reports while the Board's intensive monitoring scheme provided 16% Pharmaceutical Companies' reports accounted for 10%. One percent of the reports came from dentists. Deaths Associated with Drugs Twenty-one deaths were recorded as associated with ingestion of medicines. In s1x of these cases the medications were not regarded as implicated aetiologically while two resulted from overdosage (one of Paracetamol). In five other cases, drugs ingestion could possibly have contributed to death primarily due to major pathology. Of the eight remaining deaths two occurred with NSAID, one after a mass1ve gastrointestinal haemorrhage and one following severe diarrhoea with consequent electrolyte imbalance - both patients were over 75 years of age. One occurred with induction of anaesthesia, one followed the unexpected development of malignant neuroleptic syndrome, one followed complete heart block consequent to the use of an antiarrhythmic, one was consequent on renal failure produced in a patient on captopril with thrombosis of a single renal artery. An interaction between warfarin and miconazole led to a prolonged prothrombin time and extensive cerebellar haemorrhage in a patient. Another interaction between a phenothiazine and a tricyclic antidepressant led to epileptiform seizures and death. Fourteen interactions were reported during 1987. In 5 the effect was additive pharmacodynamic reaction, 2 with CNS depression, 1 with hypokalaemia, 1 negative inotropism, and 1 an anticoagulant effect. Additive toxicity was noted in 6 cases, gastrointestinal damage in 1, CNS confusion in 1 and tyramine reactions in 4. Pharmacokinetic interactions were responsible in 3 cases, 2 a displacement from protein binding and 1 from inhibition of hepatic microsomal enzymes. Fri, 01 Jan 1988 00:00:00 GMT http://hdl.handle.net/10147/244356 1988-01-01T00:00:00Z http://hdl.handle.net/10147/244354 Title: Reports of side effects associated with the use of drugs 1985 Authors: National Drugs Advisory Board (NDAB) Description: Halothane In the ten year period of 1970 to 1980 the Board received 9 reports of hepatitis (2 fatal) associated with the repeated use of halothane. This mirrors experience in other countries. Although the mechanism of action is not as yet generally accepted, the role of allergenicity is considered highly significant. It is recommended that where ever possible administration of halothane should not be repeated at less than 3 monthly Intervals. A second potential source of risk from halothane lies in its cardiodepressant action, a tendency to bradycardia, and to arrhythmias which may lead to particular problems when the anaesthetic is administered to patients maintained on beta-adrenoceptor blockade. It Is essential that anaesthetists be aware of medications used on patients coming under their cam so that appropriate precaution can be taken. 2. Carbamazepine This drug Is being used more frequently in the management not only of epilepsy but for other conditions. It is useful therefore to review the types of side effects for which clinicians need to be on the alert. The most Important of these concern the central nervous system with incoordination, drowsiness and ataxia, hypersensitivity reactions affecting skin, liver, blood and lung particularly, and those apparently directly related to plasma levels of carbamazepine such as the syndrome of inappropriate secretion of antidiuretic hormone. 3. Glutethimide This drug was withdrawn from the market in 1983. As has been reported in other countries its use has been associated with cases of dependence. 4. Phenothiazineu The Neuroleptic Malignant Syndrome characterised by hyperthermia, semi coma to coma, muscular rigidity and autonomic disorders is generally recognised as being most frequently associated with the high potency anti psychotic drugs such as chlorpromazine, flupenthixol and trifluoperazine. It is less commonly known that a similar adverse effect can develop with prolonged antihistamine therapy especially with the phenothiazines, but also with some of the other antihistamines. Recovery is delayed with those drugs having a long half life or presented as a dep6t preparation. The reaction can be particularly severe in the young. 5. Benzodiazepines It is again noteworthy that central nervous system irritability manifested as confusion, bizzare behaviour, nightmares, hallucinations, aggression, and occasionally withdrawal syndrome, etc. occurs In some individuals in association with drugs of this group particularly those with a short half-life, when used over prolonged periods, in association with other centrally active drugs, or in the elderly. It is important tl1at use of benzodiazepines should be limited to short periods of 4 to 6 weeks or less, whether the drug is intended for Insomnia or anxiety, kept to as low a dose as possible if given concomitantly with other central nervous system drugs, and used at minimal levels for the elderly. 6. Midazolam This short acting benzodiazepine has been available for about 18 months as a parenterally administered anaesthetic for short duration minor procedures. Particular care is required in its rate of administration and in the selection of patients for its use since It has a significant propensity for cardiorespiratory functional depression Tue, 01 Jan 1985 00:00:00 GMT http://hdl.handle.net/10147/244354 1985-01-01T00:00:00Z