The Experts below are selected from a list of 132 Experts worldwide ranked by ideXlab platform
Randall G Bond - One of the best experts on this subject based on the ideXlab platform.
-
severe injury or death in young children from Therapeutic Errors a summary of 238 cases from the american association of poison control centers
Clinical Toxicology, 2009Co-Authors: Leah S Tzimenatos, Randall G BondAbstract:Introduction. Medication-related Errors pose a risk to children, but accurate data regarding Errors with clinically significant outcomes are not available. We attempt to describe Errors, identify patterns of Error, and find targets for prevention using a large series of pediatric Therapeutic Errors with severe outcomes. Methods. A national, retrospective poison center chart review study including all cases of severe injury or death from Therapeutic Error involving children less than 6 years which were reported to the American Association of Poison Control Centers from 2000–2004 was performed. Results. Among 272 cases identified, 238 were included in analysis and 34 were excluded; 162 cases occurred in the home and 70 in health care facilities. Significant Errors disproportionately affected children less than 1 year (107/238 cases, 45%). The majority of Errors were due to excessive dosing (171/238, 72%). Common mechanisms of Error were identified: 10-fold Errors, confusion about formulation or units of mea...
Christina M. Yadao - One of the best experts on this subject based on the ideXlab platform.
-
Characterization of Methylphenidate Exposures Reported to a Regional Poison Control Center
Archives of pediatrics & adolescent medicine, 2000Co-Authors: Suzanne R. White, Christina M. YadaoAbstract:Objective To investigate the frequency, risk population, symptoms, reason, and outcome surrounding human methylphenidate exposures reported to a regional poison control center. Design Retrospective case series. Setting/Patients All human methylphenidate exposures reported to a regional poison control center during a 2-year period were included. Main Outcome Measures Data collected included age, dose, reason for exposure, symptoms (type and severity), treatment, and outcome. Age data for all other exposures reported during the same time period were also compiled. Results The study included 289 patients. Overall, 31% developed symptoms, most commonly tachycardia, agitation, and lethargy. No patient developed severe symptoms, although a less favorable outcome was seen with intentional vs unintentional exposures. When compared with the age data for all other exposures reported during the same time period, a trimodal vs bimodal pattern was seen, with the novel peak occurring in 6- to 9-year-old children. Within this age group, Therapeutic Error was the most common reason for exposure. Conclusions Methylphenidate exposure was associated with symptom development in 31% of cases. An unusually high incidence of Therapeutic Error was noted surrounding its use, most commonly in the 6- to 11-year-old age group, defining a unique population at risk for toxic exposure. This initial data may allow targeted poisoning prevention efforts for this age group.
A Pompilio - One of the best experts on this subject based on the ideXlab platform.
-
3PC-029 Paediatric drug resistant epilepsy: nitrazepam 1 mg/mL solutions to avoid clinical Therapeutic Error
Section 3: Production and Compounding, 2020Co-Authors: M A Berardi, G B Ortenzi, V Moretti, E Adresciani, Amf Garzone, S Cappanera, C Polidori, A PompilioAbstract:Background and importance The management of paediatric patient with drug resistant epilepsy (EDR) is complicated and often requires therapy and dose adjustments. The clinical pharmacist and child neuropsychiatry unit cooperate to prevent clinical Therapeutic Errors, common in the prescription of drugs with reduced and personalised dosages. Nitrazepam (NTR) in children is recommended in epileptic spasms, in Dravet, West and Lennox–Gastaut syndromes. There is a probable risk of administration Error due to the low prescribed dosage (125 µg/kg)1 and crushing of commercial tablets. Aim and objectives To make a liquid formulation with a standard concentration, easily adaptable to paediatric needs as weight changes, that is palatability, suitable and simple to use during hospitalisation and at home. Material and methods Multiphase study: • Phase I: data collection. Retrospective study examined the medical records of children born 2008–2019 with a certain diagnosis of EDR: patient number, sex, age, epilepsy classification according to the International League Against Epilepsy criteria,2 antiepileptic therapy and dose of drug were collected. • Phase II: subject study of nitrazepam, its dosage and the galenic compounding formulation it was possible to use. • Phase III: chemical–physical–microbiological stability analysis of nitrazepam 1 mg/mL. Samples were stored for 30 days at 2–8°C and/or ambient at 25°C. Chemical–physical stability was measured by quantitative determination of the molecular ions of nitrazepam C282.1/C236, using high pressure liquid chromatography (HPLC), equipped with a UV detector, interfaced with a triple quadrupole mass detector (mass spectrometer, MS/MS), column Luna C1850 mm, standard nitrazepam D5 100 µg/mL.3 Microbiological stability was assessed according to the Italian Ufficial Farmacopea (FUI).4 Results A total of 101 children with EDR (54 males, 47 females) were studied, aged mainly 3–4 years (20%) and 9–10 years (33%). Classifications: focal onset in 34.86%, focal to bilateral tonic–clonic in 17.10%, generalised onset in 47.36% and unclassified in 0.65%. Thirty-one drugs are prescribed, the most used were: levetiracetam (27%), clobazam (25%), topiramate (21%) and NTR (12%). Required dosages of NTR difficult to administer: 0.625 mg, 0.83 mg, 1.25 mg, 1.66 mg and 2.5 mg. Three liquid galenic formulations were set up (NTR from Mogadon 5 mg tablets): NTR 1 mg/mL simple syrup methylcellulose 1%, NTR 1 mg/mL suspension tragacanth gum and NTR 1 mg/mL Syrspend SFAlkaDry.5 HPLC MS/MS analysis confirmed uniform and steady dosage, and 30 day stability for NTR 1 mg/mL suspension and NTR 1 mg/mL Syrspend SFAlkaDry. Conclusion and relevance Good clinical practice and collaboration between departments allowed better management of epileptic seizures in children affected by severe EDR. Reproducible and safe therapy means improving patient‘s life and Therapeutic compliance. References and/or acknowledgements 1. British National Formulary for Children 2014 2. https://www.ilae.org/files/ilaeGuideline 3. https://www.sigmaaldrich.com 4. Farmacopea Ufficiale Italiana XII ed. 5. https://fagron.com/en/product/syrspendr-sf-alka-dry No conflict of interest.
-
3pc 029 paediatric drug resistant epilepsy nitrazepam 1 mg ml solutions to avoid clinical Therapeutic Error
European Journal of Hospital Pharmacy-Science and Practice, 2020Co-Authors: M A Berardi, G B Ortenzi, V Moretti, E Adresciani, Amf Garzone, S Cappanera, C Polidori, A PompilioAbstract:Background and importance The management of paediatric patient with drug resistant epilepsy (EDR) is complicated and often requires therapy and dose adjustments. The clinical pharmacist and child neuropsychiatry unit cooperate to prevent clinical Therapeutic Errors, common in the prescription of drugs with reduced and personalised dosages. Nitrazepam (NTR) in children is recommended in epileptic spasms, in Dravet, West and Lennox–Gastaut syndromes. There is a probable risk of administration Error due to the low prescribed dosage (125 µg/kg)1 and crushing of commercial tablets. Aim and objectives To make a liquid formulation with a standard concentration, easily adaptable to paediatric needs as weight changes, that is palatability, suitable and simple to use during hospitalisation and at home. Material and methods Multiphase study: • Phase I: data collection. Retrospective study examined the medical records of children born 2008–2019 with a certain diagnosis of EDR: patient number, sex, age, epilepsy classification according to the International League Against Epilepsy criteria,2 antiepileptic therapy and dose of drug were collected. • Phase II: subject study of nitrazepam, its dosage and the galenic compounding formulation it was possible to use. • Phase III: chemical–physical–microbiological stability analysis of nitrazepam 1 mg/mL. Samples were stored for 30 days at 2–8°C and/or ambient at 25°C. Chemical–physical stability was measured by quantitative determination of the molecular ions of nitrazepam C282.1/C236, using high pressure liquid chromatography (HPLC), equipped with a UV detector, interfaced with a triple quadrupole mass detector (mass spectrometer, MS/MS), column Luna C1850 mm, standard nitrazepam D5 100 µg/mL.3 Microbiological stability was assessed according to the Italian Ufficial Farmacopea (FUI).4 Results A total of 101 children with EDR (54 males, 47 females) were studied, aged mainly 3–4 years (20%) and 9–10 years (33%). Classifications: focal onset in 34.86%, focal to bilateral tonic–clonic in 17.10%, generalised onset in 47.36% and unclassified in 0.65%. Thirty-one drugs are prescribed, the most used were: levetiracetam (27%), clobazam (25%), topiramate (21%) and NTR (12%). Required dosages of NTR difficult to administer: 0.625 mg, 0.83 mg, 1.25 mg, 1.66 mg and 2.5 mg. Three liquid galenic formulations were set up (NTR from Mogadon 5 mg tablets): NTR 1 mg/mL simple syrup methylcellulose 1%, NTR 1 mg/mL suspension tragacanth gum and NTR 1 mg/mL Syrspend SFAlkaDry.5 HPLC MS/MS analysis confirmed uniform and steady dosage, and 30 day stability for NTR 1 mg/mL suspension and NTR 1 mg/mL Syrspend SFAlkaDry. Conclusion and relevance Good clinical practice and collaboration between departments allowed better management of epileptic seizures in children affected by severe EDR. Reproducible and safe therapy means improving patient‘s life and Therapeutic compliance. References and/or acknowledgements 1. British National Formulary for Children 2014 2. https://www.ilae.org/files/ilaeGuideline 3. https://www.sigmaaldrich.com 4. Farmacopea Ufficiale Italiana XII ed. 5. https://fagron.com/en/product/syrspendr-sf-alka-dry No conflict of interest.
Huang Gui-qiu - One of the best experts on this subject based on the ideXlab platform.
-
Misdiagnosis of 592 cases of nasopharyngeal carcinoma
Journal of Modern Oncology, 2004Co-Authors: Huang Gui-qiuAbstract:Objective To explore the cause and its countermeasures of misdiagnosis and Therapeutic Error of nasopharyngeal carcinoma(NPC) cases in Zhongshan city. Methods The clinical data of 592 misdiagnosis cases of nasopharyngeal cacinoma was analyzed retrospectively.Results The total misdiagnosis rate and the average period were 79.16%(592/777), and 7.23±8.45(x2±S)months respectively, and there was no tendency of increasing or descending for the misdiagnosis rate and the average period through 1993～2002.The misdiagnosis period was longer at countryside clinic than at the hospital in town and city,which were 21.67±16.58months,5.80±6.56 months and 5.27±5.35 months respectively .And the misdiagnosis period in E N T department is shorter than that in non E N T department, which were 5.96±7.71 months and 7.74±9.53 months respectively.Most people (36.15% of them)first come to the doctor for the symptom of cervical mass. Conclusion The inpatient's misdiagnosis rate of NPC is high in Zhongshan city ,being short of the knowledge of NPC by patients and non ENT doctor, hidden carcinoma are the main causes .In order to minimize the possibility of misdiagnosis and diminish the average period of misdiagnosis ,patients and doctors should improve their knowledge of NPC,and the ENT doctors should improve their skill of biopsies.
Leah S Tzimenatos - One of the best experts on this subject based on the ideXlab platform.
-
severe injury or death in young children from Therapeutic Errors a summary of 238 cases from the american association of poison control centers
Clinical Toxicology, 2009Co-Authors: Leah S Tzimenatos, Randall G BondAbstract:Introduction. Medication-related Errors pose a risk to children, but accurate data regarding Errors with clinically significant outcomes are not available. We attempt to describe Errors, identify patterns of Error, and find targets for prevention using a large series of pediatric Therapeutic Errors with severe outcomes. Methods. A national, retrospective poison center chart review study including all cases of severe injury or death from Therapeutic Error involving children less than 6 years which were reported to the American Association of Poison Control Centers from 2000–2004 was performed. Results. Among 272 cases identified, 238 were included in analysis and 34 were excluded; 162 cases occurred in the home and 70 in health care facilities. Significant Errors disproportionately affected children less than 1 year (107/238 cases, 45%). The majority of Errors were due to excessive dosing (171/238, 72%). Common mechanisms of Error were identified: 10-fold Errors, confusion about formulation or units of mea...
