Pharmacy最新文献

{"title":"Development of Chronic Kidney Disease Screening Integrative Care Model Led by Community Pharmacists.","authors":"Piangkwan Srimongkhol, Sirirat Anutrakulchai, Amponpun Theeranut, Nonglak Methakanjanasak, Sunee Lertsinudom","doi":"10.3390/pharmacy13010027","DOIUrl":"10.3390/pharmacy13010027","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of chronic kidney disease (CKD) is rising, increasing demand for renal replacement therapy (RRT). Community pharmacies, as accessible healthcare hubs, can play a pivotal role in CKD prevention. This study aimed to develop care models for community pharmacies to optimize medication use, encourage behavior modification, and promote self-management among at-risk individuals.</p><p><strong>Methods: </strong>Conducted between June 2017 and July 2018, this study utilized an action research approach. Microalbuminuria was assessed using urine dipsticks, and pharmacists applied behavioral change and self-management support (SMS) strategies to slow CKD progression. Participants were categorized by albuminuria levels and enrolled in pharmacist-led care programs, with follow-up assessments at weeks 0 and 12.</p><p><strong>Results: </strong>Of 521 participants screened, 57% tested positive for albuminuria. For these individuals, serum creatinine testing and referrals to primary care were initiated. Self-management behavior assessment (S1) scores significantly improved (<i>p</i> = 0.024). Key factors associated with urine albumin levels included age < 60 years (OR = 0.44), diabetes (OR = 3.69), hypertension (OR = 2.01), BMI < 27.5 kg/m² (OR = 0.42), eGFR ≥ 60 mL/min/1.73 m² (OR = 3.34), lower systolic (OR = 0.55) and diastolic blood pressure (OR = 0.34), and fasting plasma glucose < 126 mg/dL (OR = 0.29).</p><p><strong>Conclusions: </strong>Community pharmacist-led albuminuria screening effectively supports CKD prevention and enhances self-awareness within communities.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of Challenges and Opportunities for Good Pharmacy Practices in Bangladesh: A Qualitative Study.","authors":"Nantu Chakma, Sunjida Binta Ali, Md Saimul Islam, Tanisha Momtaz, Noshin Farzana, Raian Amzad, Sharful Islam Khan, Md Iftakhar Hassan Khan, Abul Kalam Azad, Zaheer-Ud-Din Babar, Aliya Naheed","doi":"10.3390/pharmacy13010026","DOIUrl":"10.3390/pharmacy13010026","url":null,"abstract":"<p><strong>Background: </strong>In 2015, the Directorate General of Drug Administration (DGDA) of Bangladesh accredited model pharmacies (MPs) to enhance the quality of pharmacy services across the country. We examined the challenges and opportunities for pharmacists in MPs, and also explored the perspectives of the pharmacy stakeholders for improving good pharmacy practices (GPPs) in Bangladesh.</p><p><strong>Methods: </strong>In-depth interviews (IDIs) were conducted with graduate pharmacists (Grade A) and diploma pharmacists (Grade B) recruited from a few selected MPs that were included in a previous study. Key informant interviews (KIIs) were conducted with the government and non-government stakeholders who were involved in pharmacy regulations and practices. Trained qualitative researchers conducted IDIs and KIIs using interview topic guides under relevant themes developed by the study investigators.</p><p><strong>Results: </strong>Between February and March 2021, nine Grade A and six Grade B pharmacists and nine government and non-government stakeholders were interviewed. The key challenges, as well as demotivational factors, for Grade A pharmacists were reported to be multiple responsibilities, inadequate salary, poor social status, an unfavorable working environment, long working hours, a lack of recognition, and low respect for their profession. However, Grade B pharmacists expressed job satisfaction, primarily due to working opportunities in reputable pharmacies and learning opportunities. The stakeholders reported a high operation cost of the MPs, a shortage of trained pharmacists, poor salary structures, and a lack of public awareness about the critical roles of the pharmacists in healthcare to be challenges of retaining Grade A pharmacists at the MPs. Addressing the challenges of the pharmacists and revising compensation packages along with strengthening monitoring systems would be important for improving GPPs at the MPs.</p><p><strong>Conclusions: </strong>This study has demonstrated that specifying the roles of the pharmacists, offering competitive packages, conducive working hours, and professional recognition would be imperative for the retention of trained pharmacists at MPs. Implementing regulatory standards and monitoring performance would enhance good pharmacy practices in Bangladesh.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resentful, Resigned and Respectful: Opioid Analgesics, Pain and Control, a Qualitative Study.","authors":"Richard Cooper, Catriona Matheson, Emily Pagan, Helen Radford","doi":"10.3390/pharmacy13010025","DOIUrl":"10.3390/pharmacy13010025","url":null,"abstract":"<p><p>Opioid analgesic prescribing has increased significantly with associated concerns about dependence and overdose. This study aimed to explore non-cancer patients' experiences and views of taking opioid analgesics to manage their pain. Twenty-two patients were purposively sampled from English GP practices and participated in semi-structured telephone interviews. Braun and Clarke's thematic analysis was used to generate emerging latent and semantic themes. Patients resented taking opioid analgesics due to tolerance and addiction fears but were resigned to experiencing chronic pain. Control emerged in relation to patients' acceptance of doctors' control over treatment decisions but also patients' attempted self-control over medicine adherence. This involved negatively perceived attempts to control pain but also prevent tolerance and addiction. Non-pharmacological treatments were viewed negatively by patients and addiction awareness arose from various sources. Patients were respectful of doctors but expressed negativity about the lack of addiction warnings, medication reviews and appointments. Family and friends were infrequently mentioned, as was reference to shared decision-making, suggesting patients navigate control over opioids and pain in relatively isolated ways. Patients reported generally negative experiences of opioid use for pain, which provides key insights for health professionals to enhance understanding and the management of such patients.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"University Pharmacy Clinic: Preventing Errors and Enhancing Lives Through Expert Medication Management.","authors":"Alesha Smith, Dhanya Hariharan Nair, Emma R Smith, Tara F Wheeler, Lauren E Smith, Bruce R Russell, Carlo A Marra","doi":"10.3390/pharmacy13010024","DOIUrl":"10.3390/pharmacy13010024","url":null,"abstract":"<p><p>The University of Otago School of Pharmacy Clinic serves as a model for innovative medication management, tackling critical medication-related problems (MRPs) to enhance patient outcomes and advance pharmacy education. This study evaluated the clinic's impact, examining 456 patient consultations over four years, with a focus on MRPs such as dosing errors, non-adherence, and inadequate monitoring. Using the DOCUMENT classification system, pharmacists identified 754 MRPs and issued 836 recommendations, primarily related to medication adjustments and monitoring. Patients reported significant improvements in health-related quality of life, as measured by the SF12V2 survey, with notable gains in mental and physical health metrics. This outcome highlights the clinic's dual role in optimising patient care and providing pharmacy students with experiential learning opportunities. By integrating hands-on training within a supervised clinical environment, the clinic addresses workforce shortages and reinforces the value of pharmacist-led interventions. The findings advocate for university-based clinics as pivotal hubs for resolving MRPs through interprofessional collaboration, targeted interventions, and innovative technologies such as telepharmacy. The study underscores the need for expanded roles for clinical pharmacists in healthcare policy and practice, showcasing their potential to prevent medication errors, enhance lives, and reshape the future of pharmacy education and patient care.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Physicochemical Stability Study of Pembrolizumab Vial Leftovers: Let Us Stop Pouring Good Money Down the Drain.","authors":"Alexandra Porlier, Pierre-Yves Gagnon, Valérie Chénard, Marc Veillette, Nicolas Bertrand, Caroline Duchaine, Chantale Simard, Benoît Drolet","doi":"10.3390/pharmacy13010022","DOIUrl":"10.3390/pharmacy13010022","url":null,"abstract":"<p><strong>Background: </strong>Pembrolizumab is a monoclonal antibody (mAb) approved for treating Non-Small Cell Lung Cancer (NSCLC), melanoma and lymphomas. Commercialized in single-size (100 mg/4 mL) vials, the pembrolizumab solution contains no preservative. As such, the manufacturer recommends using pembrolizumab vials only once, and thus, to rapidly dispose of any unused portion. Thus, appreciable amounts of this costly product are wasted.</p><p><strong>Objective: </strong>To evaluate the physical, chemical and microbiological stability of pembrolizumab vial leftovers stored at room temperature or at 4 °C, 7 and 14 days after first vial puncturing.</p><p><strong>Methods: </strong>Following pH assessments, submicronic aggregation and turbidity of pembrolizumab were measured by dynamic light scattering (DLS) and spectrophotometry, respectively. In addition, SE-HPLC (size-exclusion high-performance liquid chromatography), IEX-HPLC (ion exchange HPLC) and peptide mapping HPLC served to respectively evaluate aggregation and fragmentation, distribution of charge and primary structure of pembrolizumab. Incubation at 37 °C for 48 h of pembrolizumab vial leftovers on blood agar plates was used to determine their microbiological stability.</p><p><strong>Results: </strong>Physical, chemical and microbiological stability of pembrolizumab leftovers was demonstrated for at least two full weeks.</p><p><strong>Conclusions: </strong>These results argue forcefully in favor of allowing prolongation of pembrolizumab vial leftovers usage well beyond a single day.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting Amyloid Pathology in Early Alzheimer's: The Promise of Donanemab-Azbt.","authors":"Nadia Khartabil, Ayda Awaness","doi":"10.3390/pharmacy13010023","DOIUrl":"10.3390/pharmacy13010023","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this review is to examine the potential role of donanemab-azbt in the treatment and management of early-stage Alzheimer's disease (AD), with a focus on its efficacy, safety, and clinical relevance based on data from key clinical trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;A comprehensive literature search of PubMed was conducted using relevant keywords such as \"donanemab\", \"Alzheimer's disease\", \"Kisunla\", \"TRAILBLAZER clinical trials\", and \"amyloid-related imaging abnormalities (ARIA)\". Additional data were extracted from clinical trial records (clinicaltrials.gov), conference abstracts, and product monographs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection and data extraction: &lt;/strong&gt;Only English-language studies conducted in human populations were included. Clinical trials and peer-reviewed studies detailing the efficacy, safety, and mechanistic insights of donanemab-azbt were prioritized.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data synthesis: &lt;/strong&gt;Key findings from the TRAILBLAZER series of clinical trials highlighted the potential of donanemab-azbt in slowing cognitive and functional decline in early-stage AD: (1) TRAILBLAZER-ALZ (Phase 2): This trial focused on participants with intermediate levels of tau protein. Results demonstrated a statistically significant slowing of cognitive and functional decline. (2) TRAILBLAZER-ALZ 2 (Phase 3): A large-scale, randomized, double-blind, placebo-controlled study confirmed the efficacy of donanemab-azbt in reducing amyloid plaque accumulation and cognitive decline. Key results included a 35% slowing of decline on the Integrated Alzheimer's Disease Rating Scale (iADRS) and a 36% slowing on the Clinical Dementia Rating-Sum of Boxes (CDR-SB). Additional secondary outcomes showed improvements in activities of daily living and reduced risk of disease progression. (3) TRAILBLAZER-ALZ 3: This ongoing trial is evaluating donanemab's potential in delaying or preventing Alois Alzheimer in cognitively normal individuals with amyloid plaques, broadening the scope of early intervention strategies. (4) TRAILBLAZER-ALZ 4: A head-to-head comparison with aducanumab revealed superior amyloid plaque clearance with donanemab. (5) TRAILBLAZER-ALZ 5: Currently recruiting, this trial aims to evaluate safety and efficacy across diverse populations with varying tau levels and comorbidities. (6) TRAILBLAZER-ALZ 6 (Phase 3b): This trial investigates modified dosing regimens to reduce ARIA while maintaining efficacy, particularly in populations with genetic risk factors like ApoE ε4 homozygotes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Relevance to patient care and clinical practice: &lt;/strong&gt;Donanemab-azbt represents a promising treatment option for patients with early-stage AD. It specifically targets and reduces amyloid beta plaques, a hallmark of the disease, potentially slowing progression and preserving cognitive function. However, its administration requires careful patient selection, including genetic testing for ApoE ε4 status, to mit","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention.","authors":"Kathryn King, Wladyslawa Czuber-Dochan, Trudie Chalder, Christine Norton","doi":"10.3390/pharmacy13010021","DOIUrl":"10.3390/pharmacy13010021","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is treated with medications to induce and maintain remission. However, many people with IBD do not take their prescribed treatment. Identifying factors associated with IBD medication adherence is crucial for supporting effective disease management and maintaining remission. Quantitative and qualitative studies researching IBD medication adherence between 2011 and 2023 were reviewed. In total, 36,589 participants were included in 79 studies. The associated non-adherence factors were contradictory across studies, with rates notably higher (72-79%) when measured via medication refill. Non-adherence was lower in high-quality studies using self-report measures (10.7-28.7%). The frequent modifiable non-adherence risks were a poor understanding of treatment or disease, medication accessibility and an individual's organisation and planning. Clinical variables relating to non-adherence were the treatment type, drug regime and disease activity. Depression, negative treatment beliefs/mood and anxiety increased the non-adherence likelihood. The non-modifiable factors of limited finance, younger age and female sex were also risks. Side effects were the main reason cited for IBD non-adherence in interviews. A large, contradictory set of literature exists regarding the factors underpinning IBD non-adherence, influenced by the adherence measures used. Simpler medication regimes and improved accessibility would help to improve adherence. IBD education could enhance patient knowledge and beliefs. Reminders and cues might minimise forgetting medication. Modifying risks through an adherence support intervention could improve outcomes.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Determinants of Health and Medication Adherence in Older Adults with Prevalent Chronic Conditions in the United States: An Analysis of the National Health and Nutrition Examination Survey (NHANES) 2009-2018.","authors":"Omolola A Adeoye-Olatunde, Tessa J Hastings, Michelle L Blakely, LaKeisha Boyd, Azeez B Aina, Fatimah Sherbeny","doi":"10.3390/pharmacy13010020","DOIUrl":"10.3390/pharmacy13010020","url":null,"abstract":"<p><strong>Background: </strong>The older adult population is rapidly expanding in the United States (US), with a high prevalence of high blood pressure, high cholesterol, and diabetes. Medication nonadherence is prevalent in this population, with less evidence on the influence of social determinants of health (SDoH). Thus, the objective of this study was to identify and prioritize SDoH associated with medication adherence among US older adults with these comorbidities.</p><p><strong>Method: </strong>Using the World Health Organization Commission on Social Determinants of Health and Pharmacy Quality Alliance Medication Access Conceptual Frameworks, publicly available National Health and Nutrition Examination Survey datasets (2009-2018) were cross-sectionally analyzed among respondents aged 65 and older who were diagnosed with study diseases. Data analyses included descriptive statistics, and logistic regression using an alpha level of 0.05.</p><p><strong>Result: </strong>Analyses included 5513 respondents' data. Bivariate analysis revealed significant differences in medication adherence based on several structural (e.g., ethnicity) and intermediary (e.g., disability status) determinants of health. Multivariable analysis revealed significant differences in medication adherence for alcohol consumption (<i>p</i> = 0.034) and usual healthcare place (<i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>The study findings underscore pertinent implications for public health and policy, with specific SDoH being the most likely to affect medication adherence in common chronic conditions among older adults in the US.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Evaluation and Utilization Analysis of Mental Health Prescription Digital Therapeutics Within the Current Regulatory Landscape.","authors":"Sherry Huinan Xia, Megha Mohan Narayanan, Venkatesh Swamy, Kari Franson","doi":"10.3390/pharmacy13010019","DOIUrl":"10.3390/pharmacy13010019","url":null,"abstract":"<p><p>Prescription digital therapeutics (PDTs) are emerging as a pivotal component of digital healthcare, providing software-based therapies for various diseases. This review aims to analyze the regulatory landscape in the U.S., safety, efficacy, and current challenges of PDTs, focusing on mental health conditions. Relevant articles were searched on PubMed, Google Scholar, ClinicalTrials.gov, and FDA Guidance Documents databases, supplemented by manual searches of reference lists from included studies. Inclusion criteria covered English-language studies on the development and application, therapeutic efficacy, and regulatory guidelines of PDTs in mental health. Data extraction and synthesis were conducted to summarize key findings and trends in the literature. FDA regulatory frameworks for PDTs are evolving through pathways of de novo and 510(k) applications, with patient-centric guidance. Clinical trials and real-world data support PDTs' safety and efficacy, while highlighting regulatory needs. Challenges include payer coverage, patient accessibility, and data privacy concerns. Mixed patient feedback reveals areas for improvement. Limited healthcare provider engagement and payer coverage contributed to financial challenges for PDT manufacturers. Future trends suggest that PDTs will expand beyond mental health. The evolving landscape underscores the need for continued research, regulatory refinement, and collaborative efforts across stakeholders to ensure the successful integration of PDTs into healthcare.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review.","authors":"Axel Maurice-Szamburski, Cyril Quemeneur, Romain Rozier, Philippe Cuvillon, Claude Ecoffey","doi":"10.3390/pharmacy13010018","DOIUrl":"10.3390/pharmacy13010018","url":null,"abstract":"<p><p>Intravenously administered nonsteroidal anti-inflammatory drugs (NSAIDs) constitute a crucial component of multimodal analgesia strategies in surgical settings. This narrative review aims to provide an up-to-date evaluation of the efficacy, safety, and clinical use of intravenous (IV) NSAIDs for perioperative pain management in adults and children. The NSAIDs and selective COX-2 inhibitors (coxibs) approved in Europe for the short-term symptomatic treatment of acute, moderate perioperative pain via IV infusion in adults and/or children have been influenced by US and global guidelines and practice: the drugs primarily reviewed here are ibuprofen, ketorolac, ketoprofen, naproxen, paracetamol, and acetylsalicylic acid. Furthermore, intravenous ibuprofen is authorized for the short-term symptomatic treatment of fever. In contrast to intravenous ketoprofen, intravenous ibuprofen is authorized for administration to children over 6 years of age or weighing more than 20 kg. Overall, IV ibuprofen had a more favorable profile with regard to peri- and postoperative opioid sparing and pain relief. Oral ibuprofen and IV ibuprofen have similar levels of efficacy, although IV ibuprofen has a shorter onset of action and is required in patients who are unable to take oral medications. The frequency of significant adverse events appears to be similar for ibuprofen and paracetamol. Systematic reviews and meta-analyses report that intravenous NSAIDs reduce postoperative opioid consumption by approximately 20-60%, improving pain management with fewer opioid-related side effects. In indications in infants, the choice of medication is limited, and the oral route is not always feasible; IV formulations of ibuprofen are preferred in this setting. Topics for further research should include head-to-head trials of IV NSAIDs.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}