過剰投薬、過量投薬

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/10 04:31:49」(JST)

wiki en

Overmedication is an inappropriate medical treatment that occurs when a patient takes unnecessary or excessive medications. This may happen because the prescriber is unaware of other medications the patient is already taking, because of drug interactions with another chemical or target population, because of human error, because of undiagnosed medical conditions or because of conflicts of interest in the pharmaceutical industry, creating-over promotion (via advertising campaigns, sales to private practice Doctors, or biased or altered medical studies) causing widespread unnecessary use of a specific medicine, or unnecessary dosage of a medicine, due to excessive profit motives in the pharmaceutical industry. This is also sometimes described as the commercialization of medicine.

Overmedication can also occur when consumers take more medication than is prescribed or as labeled on over-the-counter products—either intentionally or unintentionally—or when consumers unknowingly take both prescription and nonprescription drug products containing the same active ingredients. For example, overmedication^{[dubious – discuss]} (in the form of acute overdose) can occur when a prescription drug like Vicodin, which contains both hydrocodone and acetaminophen, is taken along with the nonprescription product Tylenol, which contains acetaminophen as the active ingredient. In other words, overmedication can be caused by both prescribers and consumers or their caretakers.

Another important instance of overmedication occurs when consumers are either prescribed or take additional prescribed or OTC drugs which produce the same or similar therapeutic effects. For instance, if a patient is taking a prescription strength ibuprofen product and also uses a naprosyn product—whether prescription or OTC strength—this, too, can constitute overmedication, can be dangerous, and can be costly to the patient in overall health care costs.^{[medical citation needed]} Often consumers/patients overmedicate themselves by taking their medications at shorter intervals than prescribed or than container labels specify. As a result, medications may accumulate at higher levels, causing undesired side effects, sometimes serious, or even fatal. Such situations are often reversed through targeted Deprescribing by members of the medical team.

Persons who feel that they are overmedicated tend to not to follow their physician's instructions for taking their medication.^[1]

Overmedication of children

There are complaints that children are sometimes overmedicated in the course of addressing concerns with the child's behavior.^[2]^[3]^[4]

Sources

^ Fincke, Benjamin Graeme; Miller, Donald R.; Spiro, Avron (March 1998). "The interaction of patient perception of overmedication with drug compliance and side effects". Journal of General Internal Medicine 13 (3): 182–185. doi:10.1046/j.1525-1497.1998.00053.x.
^ Nakamura, Richard K. (26 September 2002). "NIMH · Attention Deficit/Hyperactivity Disorders: Are Children Being Overmedicated?". nimh.nih.gov. Retrieved 24 March 2014.
^ Drake, Daniele (16 December 2013). "I overmedicated my kid: No, it isn’t ADHD — Big Pharma’s attention obsession puts children at risk - Salon.com". salon.com. Retrieved 24 March 2014.
^ Park, Madison (24 May 2014). "Little people, lots of pills: Experts debate medicating kids". cnn.com. Retrieved 24 March 2014.

External links

Medicating Kids, a, April 2001 video and article series presented by PBS
Overmedication: Are Americans Taking Too Many Drugs?
Health Care in Crisis: Overmedicating America

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 慢性閉塞性肺疾患（COPD）治療におけるメチルキサンチンの役割 role of methylxanthines in the treatment of copd
2. 妊娠時のブプレノルフィン補充療法 buprenorphine substitution therapy in pregnancy
3. 知的障害（精神遅滞）をもつ成人のプライマリケア primary care of the adult with intellectual disability mental retardation
4. 小児における疼痛の評価およびマネージメント evaluation and management of pain in children
5. 高齢者における喘息の診断およびマネージメント diagnosis and management of asthma in older adults

English Journal

School-Based Health Centers to Advance Health Equity: A Community Guide Systematic Review.

Knopf JA1, Finnie RK1, Peng Y1, Hahn RA2, Truman BI3, Vernon-Smiley M4, Johnson VC5, Johnson RL6, Fielding JE7, Muntaner C8, Hunt PC4, Phyllis Jones C9, Fullilove MT10; Community Preventive Services Task Force.
American journal of preventive medicine.Am J Prev Med.2016 Jul;51(1):114-26. doi: 10.1016/j.amepre.2016.01.009.
CONTEXT: Children from low-income and racial or ethnic minority populations in the U.S. are less likely to have a conventional source of medical care and more likely to develop chronic health problems than are more-affluent and non-Hispanic white children. They are more often chronically stressed, t
PMID 27320215

Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis.

Lacson R1, O'Connor SD1, Sahni VA1, Roy C2, Dalal A2, Desai S3, Khorasani R1.
BMJ quality & safety.BMJ Qual Saf.2016 Jul;25(7):518-24. doi: 10.1136/bmjqs-2015-004276. Epub 2015 Sep 15.
INTRODUCTION: Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation of closed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alert
PMID 26374896

Benzodiazepine Use, Misuse, and Harm at the Population Level in Canada: A Comprehensive Narrative Review of Data and Developments Since 1995.

Murphy Y1, Wilson E2, Goldner EM2, Fischer B3,4,5.
Clinical drug investigation.Clin Drug Investig.2016 Jul;36(7):519-30. doi: 10.1007/s40261-016-0397-8.
Benzodiazepines are commonly prescribed psycho-pharmaceuticals (e.g., for anxiety, tension, and insomnia); they are generally considered safe but have potential adverse effects. Benzodiazepine use in Canada versus internationally is comparably high, yet no recent comprehensive review of use, misuse,
PMID 27056579

Japanese Journal

甲状腺全摘出後カルシウム補充療法中の腎機能障害についての検討:～特に血清カルシウム値正常例について～

村上大造,湯本英二
頭頸部外科 22(1), 93-98, 2012
甲状腺全摘出後には副甲状腺機能低下をきたし，カルシウム補充療法が必要となることが多い。過剰投与となった場合，高カルシウム血症により腎機能障害をきたす可能性があることは周知の事実である。しかしながら，今回われわれは血清カルシウムが正常範囲でありながら，カルシウム過剰投与による腎機能障害が疑われた症例を経験した。また，甲状腺全摘出を施行され，カルシウム補充療法を必要とした症例の血清カルシウムとクレアチ …
NAID 130002137098

Delirium in Elderly Patients Admitted to a Psychiatric Hospiral: Causative Factors and Treatment

Suzuki Hiroshi,Kuroda Shigetoshi,Ishizu Hideki,Yamamoto Tomoyuki,Kawada Ryusuke
Acta Medica Okayama 53(2), 1999-04-00
… Twenty-one patients exhibited precipitating factors, the most common of which were overmedication and poisoning. …
NAID 120002313259