1.The effect of nifedipine used as tocolytic agent on postpartum blood loss among Filipino pregnant patients in a tertiary hospital: A prospective cohort study.
Ma. Sheryll R. DE JESUS ; Carolyn R. ZALAMEDA-CASTRO
Acta Medica Philippina 2018;52(1):32-39
OBJECTIVE: To determine the risk of postpartum hemorrhage among patients who were treated with nifedipine for tocolysis of preterm labor.
METHODS: A prospective cohort study was conducted with 66 pregnant women admitted for preterm labor. One group of women was given nifedipine to give time for the administration of corticosteroids for fetal lung maturity and/or control of preterm labor and another group was not given nifedipine as they were admitted in advanced stage of labor (ie, more than or equal to 4 cm cervical dilatation). Independent/paired sample t-test, Mann-Whitney U/Wilcoxon signed rank test, and Fisher's exact test were used to determine the difference of mean, median, and frequency between and within groups, respectively. STATA 12.0 was used for data analysis.
RESULTS: There was more blood loss during delivery, which was statistically significant, among those who received nifedipine compared to those who have not taken the medicine (350 mL versus 250 mL, p = 0.021). Furthermore, the decreases in hemoglobin and hematocrit were also lower among those who did not receive nifedipine compared to those who received nifedipine for tocolysis (8.5 mg/dL versus 16.0 mg/dL, p = 0.014 and 0.03 versus 0.05, p = 0.010), again, statistically significant.
CONCLUSION: Nifedipine used as tocolytic appear to increase blood loss during delivery, which was statistically significant. Greater amount of blood loss may be anticipated among those with nifedipine intake thus helping the obstetrician in preparing for active management of postpartum hemorrhage and preventing maternal morbidity and mortality.
Human ; Female ; Adult (a Person 19-44 Years Of Age) ; Nifedipine ; Obstetric Labor, Premature ; Postpartum Hemorrhage ; Tocolytic Agents ; Nifedipine-adverse Effects
3.Evaluation of anticholinergic burden in elderly outpatients and the risk factors.
Xikui LU ; Hangxing HUANG ; Yamin HUANG ; Lu ZHANG ; Xiangping WU ; Zhenting WANG ; Jian XIAO
Journal of Central South University(Medical Sciences) 2023;48(1):114-122
OBJECTIVES:
The use of anticholinergic drugs in the elderly may lead to negative events such as falls, delirium, urinary retention and cognitive decline, and the higher the number of anticholinergic drugs use, the more such negative events occur. This study aims to analyze the risk factors associated with the prescription of total anticholinergic drugs in elderly outpatients and evaluate the rationality of anticholinergic drugs, and to provide a reference for reducing the adverse effects of anticholinergic drugs.
METHODS:
A list of drugs with anticholinergic activity based on the Beers criteria was established. The basic information (such as age and gender), clinical diagnosis, and medications of elderly outpatient were extracted from hospital electronic medical records, and the Anticholinergic Cognitive Burden (ACB) Scale was used to calculate the anticholinergic burden for each patient. Logistic regression analysis was used to identify the potential risk factors for the occurrence of problems such as multiple medication and insomnia.
RESULTS:
A total of 1 840 prescriptions for elderly patients were reviewed. Of these patients, ACB score was more than or equal to 1 in 648 (35.22%) patients. Number of prescription medication (95% CI: 1.221 to 1.336) and insomnia (95% CI: 3.538 to 6.089) were independent factors affecting ACB scores (both P<0.01). Medications for patients of ACB scores were most commonly treated with the central nervous system drugs (such as alprazolam and eszopiclone) and for the cardiovascular system drugs (such as metoprolol and nifedipine).
CONCLUSIONS
There is a high rate of ACB drugs use in geriatric patients, and the clinical focus should be on multiple medication prescriptions, especially on the central nervous system drugs (such as alprazolam and eszopiclone) and cardiovascular system drugs (such as metoprolol and nifedipine). The prescription review should be emphasized to reduce adverse reactions to anticholinergic drugs in elderly patients.
Humans
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Aged
;
Cholinergic Antagonists/adverse effects*
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Outpatients
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Metoprolol
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Alprazolam
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Eszopiclone
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Nifedipine
;
Sleep Initiation and Maintenance Disorders
;
Risk Factors
4.Analysis of risk indicator for nifedipine-induced gingival hyperplasia.
Xiao LI ; Qing-Xian LUAN ; Peng LI
Chinese Journal of Stomatology 2007;42(11):677-680
OBJECTIVETo investigate the prevalence and risk indicator of nifedipine-induced gingival overgrowth in a community population in Beijing.
METHODSA cross-sectional survey was conducted in 616 community subjects with hypertension or coronary vascular disease in Beijing, China. Among them 205 individuals took nifedipine for at least half year and 411 individuals who had never received calcium channel blocker (CCB) were recruited as controls. Smoking, oral hygienic habit, systemic health, pharmacological and demographic data for each subject were recorded by questionnaire. Sulcus bleeding index (SBI) was assessed in 12 anterior teeth per subject. Turesky modified Quigley-Hein plaque index (PI) and gingival overgrowth index in anterior teeth were scored on photograph. 38.6% was defined as threshold to identify individual with significant gingival overgrowth.
RESULTS7.3% of the subjects taking nifedipine were found to have significant gingival overgrowth in this population. The prevalence of gingival overgrowth in nifedipine group was statistically higher than that in the control group. By logistic regression analysis, SBI was found to be the only risk indicator (odds ratio = 5.92, P = 0.001).
CONCLUSIONSThe presence of gingival inflammation was an important cofactor for the occurrence of gingival overgrowth.
Adult ; Aged ; Aged, 80 and over ; Calcium Channel Blockers ; adverse effects ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Gingival Overgrowth ; chemically induced ; epidemiology ; Humans ; Logistic Models ; Male ; Middle Aged ; Nifedipine ; adverse effects ; Prevalence ; Risk Factors
5.A Case of Severe Coronary Spasm Associated with 5-Fluorouracil Chemotherapy.
Sang Min KIM ; Cheol Hoon KWAK ; Bora LEE ; Seong Beom KIM ; Jung Ju SIR ; Wook Hyun CHO ; Suk Koo CHOI
The Korean Journal of Internal Medicine 2012;27(3):342-345
Cardiotoxicity associated with 5-fluorouracil (FU) is an uncommon, but potentially lethal, condition. The case of an 83-year-old man with colon cancer who developed chest pain during 5-FU infusion is presented. The electrocardiogram (ECG) showed pronounced ST elevation in the lateral leads, and the chest pain was resolved after infusion of nitroglycerin. A coronary angiogram (CAG) revealed that the patient had significant atherosclerosis in the proximal left circumflex artery. Coronary artery spasm with fixed stenosis was considered, and a drug-eluting stent was implanted. After 8 hours, the patient complained of recurring chest pain, paralleled by ST elevation on the ECG. The chest pain subsided after administration of intravenous nitroglycerin followed by sublingual nifedipine. Repeated CAG showed patency of the previous stent. This case supports the vasospastic hypothesis of 5-FU cardiac toxicity, indicating that a calcium channel blocker may be effective in the prevention or treatment of 5-FU cardiotoxicity.
Aged, 80 and over
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Angina Pectoris/chemically induced
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Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse effects
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Calcium Channel Blockers/administration & dosage
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Colonic Neoplasms/*drug therapy
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Coronary Angiography
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Coronary Vasospasm/*chemically induced/diagnosis/therapy
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Drug-Eluting Stents
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Electrocardiography
;
Fluorouracil/administration & dosage/*adverse effects
;
Humans
;
Leucovorin/administration & dosage/adverse effects
;
Male
;
Nifedipine/administration & dosage
;
Nitroglycerin/administration & dosage
;
Organoplatinum Compounds/administration & dosage/adverse effects
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Percutaneous Coronary Intervention/instrumentation
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Recurrence
;
Severity of Illness Index
;
Treatment Outcome
;
Vasodilator Agents/administration & dosage