Drugs online research references
stevenshof.nl
OBJECTIVE: To describe the patterns of use of bupropion in daily clinical practice and factors which determine successful smoking cessation. METHODS: Retrospective follow-up study in 36 pharmacies in the Netherlands. Patients who received at least one prescription for bupropion between January and April, 2000 were included. The pharmacists noted several characteristics relating to the patient, use of bupropion and co-medication. Patients were interviewed by telephone about their current and former smoking habits, the success of their smoking cessation and their experiences with bupropion. MAIN OUTCOME MEASURE: Abstinence rate and factors determining successful abstinence after six months. RESULTS: 322 patients with a least one prescription for bupropion were identified. In 93.5% of patients bupropion was prescribed by the general practitioner. Half of the patients were dispensed 30 or fewer tablets. Pharmacists interviewed 215 (66.8%) patients by telephone. Of these patients 58 (27.0%) still did not smoke six months after the prescription for bupropion. The number of tablets used, lack of co-morbidity, less than two previous attempts to stop smoking and private-insurance were associated with a higher rate of successful abstinence. CONCLUSION: Most patients do not use bupropion in accordance with the recommended period and did not receive the same degree of additional support provided in clinical trials. Nevertheless 27.0% of patients reported to have stopped smoking six months after the prescription for bupropion. This self-reported abstinence rate is only slightly lower than is reported in literature. This might be partly related to the fact that we did not validate smoking cessation by carbonmonoxide monitoring. Bupropion is not reimbursed in the Netherlands. It is difficult to assess whether patients' self-payment has led to the selection of motivated patients, or has been a barrier to finishing using bupropion.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14584227&dopt=Abstract
word match zyban online literature
dsru.org
BACKGROUND: Bupropion (Zyban) is the first new pharmacological treatment for smoking cessation to be introduced since nicotine replacement therapy. In smoking cessation trials, it has been associated with minimal side effects. A range of suspected adverse drug reactions (ADRs) were reported via the spontaneous reporting system following its use in smoking cessation. AIM: To examine the safety of bupropion used in general medical practice in England as a treatment for cessation of smoking. OBJECTIVES: To quantify the incidence of events that were reported for patients prescribed bupropion; and to identify any previously unrecognised ADRs. METHODS: A post-marketing observational cohort study was conducted using the methodology of prescription-event monitoring (PEM). Exposure data were derived from the first prescription dispensed for patients whose prescription details were processed by the Prescription Pricing Authority in August 2000. Outcome data were derived from 'green form' questionnaires (GFs) sent to general practitioners (GPs) at least 6 months following the first prescription issued. Incidence densities (IDs) were calculated for events reported per 1000 weeks of patient treatment and ID differences between time periods analysed. Events of interest were followed up by postal questionnaire sent to GPs. All-cause and condition-specific mortality up to 12 weeks after starting bupropion were compared through indirect standardisation between the PEM cohort and Cancer Prevention Study-II (USA) (CPS-II) data. RESULTS: GF response rate was 48.1%, with 11,735 GFs containing useful data - of these patients, 5695 (48.5%) were male (median age 47 years, range 16-88 years) and 6009 (51.2%) were female (median age 47 years, range 16-87 years). Age was recorded for 4092 (34.9%) of the cohort of 11,735 after follow-up. There were 566 events in 350 patients reported by GPs as ADRs to bupropion. GPs reported 10,200 reasons for stopping bupropion among 9056 patients. The highest ranked clinical events (by ID for weeks 1-6 of treatment) were; 'insomnia' ( n=308), 'nausea/vomiting' ( n=243) and 'dizziness' ( n=185). Bupropion was taken in the first trimester of 12 pregnancies and the outcome ascertained in eight cases - five live births (no congenital abnormalities reported), two therapeutic terminations and one intrauterine death (no further details). The standardised mortality ratio (SMR) for all-cause mortality up to 12 weeks after starting bupropion was 0.77 (95% CI: 0.42, 1.28). CONCLUSION: This study describes the safety profile of bupropion (Zyban) as used in the community; a small number of adverse events were reported that were not included on the SmPC. For many events, nicotine withdrawal was a confounding factor. SMR calculations did not provide evidence for a higher rate of mortality (either all-cause or condition-specific) in the PEM cohort relative to smokers from the CPS-II cohort in the USA. While reassuring, the SMR should be interpreted in context with results from other studies on bupropion when used for smoking cessation.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14615857&dopt=Abstract [PubMed - in process]
word match zyban online literature
saludalia.com
The association of bupropion and nicotine is a good choice in the treatment of smoking cessation. However, not all patients actually give up smoking. STUDY OBJECTIVES: This work was undertaken with the aim of finding out the functional or clinical variables that could be associated with the success of the cessation therapy. DESIGN: In one year, 88 patients who were treated with bupropion 300 mg/day and nicotine patches were followed-up, for 1 month and 3 months, respectively. They were all questioned about the number of cigarettes per day, the years they have been smoking, the number of quitting attempts, and concurrent pulmonary conditions were sought for. The Fagestrom Test, forced spirometry (FVC, FEV-1, FEF25-75), and exhaled carbon monoxide (by co-oxymetry) were also assessed. For the statistical analysis, a logistic regression model allowing to predict the response of new subjects to the treatment, with the lowest error possible, was applied. To choose the working model, the highest and lowest value of each variable were found, drawing the correlation matrix between dependent and independent variables, by means of the box-plot procedure. Then, the model's application conditions were analysed: linearity, homoscedasticity, independence of the applications, and normality of the distributions. To assess the discrimination of the model, a ROC curve was used. RESULTS: Showed that at the end of the follow-up year, 59.1% of the patients quitted smoking. The multivariate analysis with logistic regression showed that no previous history of chronic obstructive pulmonary disease (COPD), a FEF25-75 value and effectively quit after the first week of treatment were independent prognostic factors of treatment success. When the diagnosis precision of our model was analysed by means of the ROC curve, it showed a 78% value, with the 95% confidence interval ranging from 68.5% to 86.9%. At the optimal cut-off point of our model, sensitivity and specificity for quitting smoking were found to be 66.7% and 80%, respectively. CONCLUSIONS: We conclude that with a diagnosis precision of 78.8% patients with no history of COPD, who quitted at the first week of therapy with bupropion and with low FEF25-75, will remain non-smokers after one year follow-up. Contrarily, COPD patients who still smoke after one week of therapy, will not achieve quitting smoking.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14635510&dopt=Abstract
word match zyban online literature
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