Label Uses of Medication

Label Uses of Medication

“Off-label prescribing is defined as prescribing a medication for an indication not approved by the Food and Drug Administration (FDA)” (Mayhem, 2008). Off-labeling is most frequent with the special population of pediatrics. Off- label medications should be prescribed to children responsibly when there is sufficient evidence to support, when additional research is necessary, and when patients and their families are aware of possible side effects (Dresser and Frader, 2009).

Safer Strategies

Safer strategies that should be used each and every time a medication is prescribed to a pediatric is utilizing the weight of the child for dosage purposes along with the age of the child (Arcangelo and Peterson, 2013). Another strategy is reviewing the patient’s current medications to determine what other medications may interact with the new medication that is being prescribed.

Specific Medications

There are multiple medications that are used as off-label which consist of antibiotics, antidepressants, and respiratory medications. Antimicrobials such as amoxicillin, cephalexin, and zithromycin are most frequent off-label uses (Bazzano et al., 2009). Respiratory medications to assist with breathing such as albuterol and steroids used intranasally susch as flonase are frequently used off label (Bazzano et al., 2009). As practitioners it is important to make sure that when prescribing off label medications the patient and family are educated on the expected results as well as the side effects.

discussion no.2

Prescribing off-label drugs

Off- labeling consists of prescribing drugs for purposes other than what it is approved for by the FDA or a particular patient population (Mayhew, 2009). Off- label prescribed drugs in pediatrics should be used when practitioners have weighed the risks and benefits and establish patient safety as well as the beneficial results. The practitioner must be able to justify prescribing off- label medication and should review all risks and benefits with the caregiver or child (if age appropriate) when prescribing medication. Off- labeling consists of prescribing drugs for purposes other than what it is approved for by the FDA or a particular patient population (Mayhew, 2009). Providers must use their best knowledge and judgement to provide successful care to patients. Physicians are known to utilize off-label drugs in children for the majority of their office visits in the US (Bazzano, A.T., Mangione-Smith, R., Schonlau, M., Suttorp, M., Brook, R.H., 2009).

Safe strategies

Strategies and dose usage for safe medication delivery for children consists of knowing the patients type; for example an infant, pediatric or adolescent (Arcangelo, V.P. & Peterson, A.M., 2013). It is important to establish the recommended body weight dose per patient type since this is commonly the method used for pediatric dosing (Arcangelo, V.P. & Peterson, A.M., 2013). Therefore, utilizing off-label medication requires the prescriber to determine the dose based on patient age and weight.

Off-label drugs that require extra care

Off label medications that require extra care are respiratory medications, anti-infectives, central nervous system drugs and antihistamines (Bazzano, A.T., Mangione-Smith, R., Schonlau, M., Suttorp, M., Brook, R.H., 2009). Off label prescribing is not regulated by the FDA and can be utilized as the prescriber sees fit (Mayhew, 2009). However, it the responsibility of the prescriber to ensure the medication being prescribed is appropriate and used for the greater good of the patient. Education about drug purpose and adverse effects is also important to teach families. The goal is to ensure the welfare and safety of the child.

please write a comment on both discussion in different paragraph and make a question to the writer

Post 114

Ask a probing question, substantiated with additional background information, and evidence AND

Share an insight synthesizing the information to provide new perspectives.

Key Concepts of Reviewing a Qualitative Study

Focus on the nature of study category scheme and its description, logic, and completeness and also check for the overlapping categories.

The appropriateness of data analysis and organization method for research design.

The theme of the study appears to capture the meaning of the narratives.

The study is co-related with the method of analysis and it is suitable for the study.

The usage of metaphor in the study and it is offering an insightful view of the findings.

The report of the study gives a clear picture of the social and emotional picture of participants and analysis yield a meaningful and insightful picture of the phenomenon under study.

Analysis of Qualitative Data

1. Quasi-statistics-is a tabulation of the frequency with which certain themes or insights are supported by data.

Example: Flinkman M; Laine M; Leino-Kilpi H; Hasselhorn HM; Salanterä S, International Journal Of Nursing Studies, (2008 May); A qualitative survey to discover what proportion of nurses intends to leave the profession in Finland and the reasons behind their decisions.

2. Qualitative content analysis-it is the analysis of the content of narrative data to identify prominent themes and patterns among the themes. This method involves breaking down data into smaller units, coding and naming the units according to the content they represent, and grouping coded material based on shared concepts.

Example: Vaismoradi M; Turunen H; Bondas T, Nursing & Health Sciences (2013 Sep)An internationalized curriculum in nursing education was created in response to the rise of globalization and the need to provide nursing care to the people of diverse cultures.

3. Ethnographic analysis-this method analysis begins as the researchers enters the field and theycontinually search for the patterns in the behavior and expressions of study participants.

The Spradley’s method is one of the main Ethnographic analysis and according to him there are four levels of data analysis.

Domain analysis-identifying domains, or units of cultural knowledge.

Nomic analysis-selecting key domains and constructing taxonomies or systems of classification.

Componential analysis-comparing and contrasting terms in a domain.

Theme analysis- this means uncovering cultural themes.

Example: Broussard AB, (1995) Purpose of the research was to identify recurring themes in the lives of pregnant women with self-efficacy for childbirth, and to propose relationships between these recurring themes.

The Leininger’s Ethnonursing method is another import ethnographic method and it involves four phases.

Collecting and recording data

Categorizing descriptors

Searching for repetitive patterns

Abstacting major themes

Example: Ottenvall Hammar I; Dahlin-Ivanoff S; Wilhelmson K; Eklund K, BMC Geriatrics, (2014 Nov 28). Older persons’ right to exercise self-determination in daily life is supported by several laws. Research shows that older persons’ self-determination is not fully respected within healthcare.

4. Phenomenological analysis-this method there are several approaches to this method, however, the frequently used methods are Colaizzi, Giorgi, and Van Kaam and the main goal of these methods is to find common patterns of experiences shared by particular instances.

Example: Snelgrove, Sherrill Ray; Nurse Researcher, (2014). An interpretive phenomenological analysis of patients; experiences of chronic low back pain

5. Grounded theory analysis-this method uses the constant comparative method of data analysis, which involves identifying characteristics in one piece of data and comparing them with those of others to assess similarity and theory must fit the data and not be forced.

The Glaser and Strauss method is one of the main approach in Grounded theory and in this method there are two broad types of codes that are being used.

Substantive codes- in which the empirical substances of the topic is conceptualized.

Theoretical codes- in which the relationship among the substantive codes are conceptualized.

The Glaser and Strauss method, researchers are performing constant comparison, the researchers’ compares concepts from existing theory or research to determine which part have emergent fit with the theory method whose outcome is a full preconceived conceptual description.

Example: Nunney J; Raynor DK; Knapp P; Closs SJ, Drugs & Aging, (2011 May 1) Semi-sttructured interviews were conducted with 15 older people living independently and receiving primary healthcare from two health service agencies.

References:

Broussard AB; LOUISIANA STATE UNIVERSITY MEDICAL CTR. IN NEW ORLEANS, S. OF NURSING, 1995

Flinkman M; Laine M; Leino-Kilpi H; Hasselhorn HM; Salanterä S, International Journal Of Nursing Studies [Int J Nurs Stud], ISSN: 0020-7489, 2008 May; Vol. 45 (5), pp. 727-39; Publisher: Pergamon Press; PMID: 17280674, Database: MEDLINE with Full Text

Nunney J; Raynor DK; Knapp P; Closs SJ, Drugs & Aging [Drugs Aging], ISSN: 1179-1969, 2011 May 1;Vol. 28 (5), pp. 403-14; Publisher: Adis, Springer International; PMID: 21542662

Ottenvall Hammar I; Dahlin-Ivanoff S; Wilhelmson K; Eklund K, BMC Geriatrics [BMC Geriatr], ISSN: 1471-2318, 2014 Nov 28; Vol. 14, pp. 126; Publisher: BioMed Central; PMID: 25432268

Prorok JC; Horgan S; Seitz DP, CMAJ: Canadian Medical Association Journal = Journal De L’association Medicale Canadienne [CMAJ], ISSN: 1488-2329, 2013 Oct 1; Vol. 185 (14), pp. E669-80;Publisher: Canadian Medical Association; PMID: 24003093

Snelgrove, Sherrill Ray; Nurse Researcher, 2014 Sep; 22 (1): 20-5. (journal article -research, tables/charts) ISSN: 1351-5578 PMID: 25251816

Vaismoradi M; Turunen H; Bondas T, Nursing & Health Sciences [Nurs Health Sci], ISSN: 1442-2018, 2013 Sep; Vol. 15 (3), pp. 398-405; Publisher: Blackwell Science Asia; PMID: 23480423,