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Journal of General Internal Medicine Apr 2003Little is known about how the public uses formerly prescription medications that are available over-the-counter (OTC). This study examines whether consumers...
OBJECTIVES
Little is known about how the public uses formerly prescription medications that are available over-the-counter (OTC). This study examines whether consumers inappropriately use and substitute a recently widely distributed OTC urinary analgesic, phenazopyridine, for provider care.
DESIGN/SETTING
We conducted a cross-sectional survey of a stratified cluster random sample of OTC phenazopyridine purchasers (N = 434) in 31 Los Angeles retail pharmacies over 5 months. Recruited by shelf advertisements, participants were 18 years or older who purchased a phenazopyridine product. Each completed a 25-item self-administered anonymous questionnaire. Inappropriate use was defined as 1) having medical contraindications to phenazopyridine, or 2) not having concurrent antibiotic and/or provider evaluation for the urinary symptoms.
RESULTS
The survey response rate was 58%. Fifty-one percent of the respondents used OTC phenazopyridine inappropriately, and 38% substituted it for medical care. Multiple logistic regression analyses revealed that inappropriate use was correlated with having little time to see a provider (odds ratio [OR], 1.57; 95% confidence interval [95% CI], 1.26 to 1.96), receiving friend's or family's advice (OR, 1.25; 95% CI, 1.05 to 1.47), having prior urinary tract infections (OR, 0.49; 95% CI, 0.30 to 0.80), having used prescription phenazopyridine, (OR, 0.40; 95% CI, 0.25 to 0.63), and having back pain (OR, 0.34; 95% CI, 0.16 to 0.74). Similar correlates were found in those who substituted OTC phenazopyridine for provider care. Respondents with incorrect knowledge about phenazopyridine's mode of action had 1.9 times greater odds of inappropriate use and 2.2 times greater odds of substitution than those who had correct knowledge about this drug.
CONCLUSION
Inappropriate use of OTC phenazopyridine appears common. Increasing the public's knowledge about reclassified drugs may help to mitigate this problem.
Topics: Adult; Anesthetics, Local; Attitude to Health; Confidence Intervals; Cross-Sectional Studies; Female; Humans; Logistic Models; Los Angeles; Male; Nonprescription Drugs; Odds Ratio; Phenazopyridine; Self Medication; Socioeconomic Factors; Surveys and Questionnaires
PubMed: 12709095
DOI: 10.1046/j.1525-1497.2003.20709.x -
Primary Care Sep 2013Clinical presentation helps differentiate between upper and lower urinary tract infections (UTIs). UTIs are classified as either complicated or uncomplicated. A... (Review)
Review
Clinical presentation helps differentiate between upper and lower urinary tract infections (UTIs). UTIs are classified as either complicated or uncomplicated. A complicated UTI is associated with an underlying condition that increases the risk of failing therapy. Primary laboratory tests for UTIs consist of urinalysis and urine culture. The most common pathogen for uncomplicated cystitis and pyelonephritis is Escherichia coli. Nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole are first-line therapies for acute uncomplicated cystitis. Decisions regarding antibiotic agents should be individualized based on patients' allergies, tolerability, community resistance rates, cost, and availability.
Topics: Age Factors; Anesthetics, Local; Anti-Infective Agents, Urinary; Drug Resistance, Microbial; Humans; Phenazopyridine; Primary Health Care; Pyelonephritis; Risk Factors; Sex Factors; Sexual Behavior; United States; Urinalysis; Urinary Tract Infections
PubMed: 23958364
DOI: 10.1016/j.pop.2013.06.005 -
Journal of Environmental Management Jan 2020In the present study, the potential of Azolla filiculoides (A. filiculoides) was first investigated for degradation of Phenazopyridine (PhP), an analgesic drug. The...
In the present study, the potential of Azolla filiculoides (A. filiculoides) was first investigated for degradation of Phenazopyridine (PhP), an analgesic drug. The effects of main variables such as initial pharmaceutical concentration, amount of plant, and pH were studied on the efficiency of the biological process. It was observed that A. filiculoides was able to remove pharmaceuticals from contaminated water up to 85.90% during 48 h. Then, the electro-Fenton (EF) method was applied for further removal of PhP yielding a removal rate of about 98.72% under optimum conditions during 2 h. The effects of variables including the current, amount of catalyst, and pH were also studied in this phase. Also, the probability of adsorption was investigated during this step. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis were performed for the used magnetite nanoparticles, total organic carbon (TOC) were performed to investigate PhP removal efficiency during the reaction time and Gas chromatography-mass spectrometry (GC-MS) were performed to analyze degradation byproducts of PhP. Based on the results, it was found that a combination of these bioremediation and electrochemical removal steps were capable of PhP removal from contaminated water. Therefore, this approach may be effective for phytoremediation of pharmaceutical-contaminated aquatic ecosystems.
Topics: Ecosystem; Hydrogen Peroxide; Iron; Oxidation-Reduction; Phenazopyridine; Wastewater; Water Pollutants, Chemical
PubMed: 31731027
DOI: 10.1016/j.jenvman.2019.109802 -
The Journal of Urology Feb 2017There is currently a national shortage of indigo carmine. In efforts to identify the most efficient aid for visualizing ureteral efflux intraoperatively we investigated... (Comparative Study)
Comparative Study
PURPOSE
There is currently a national shortage of indigo carmine. In efforts to identify the most efficient aid for visualizing ureteral efflux intraoperatively we investigated the time to excretion of phenazopyridine vs a newly identified alternative, sodium fluorescein.
MATERIALS AND METHODS
We analyzed prospectively collected data on a cohort of women who underwent pelvic reconstructive surgery in 2015. Per provider preference patterns a number of patients were administered 200 mg phenazopyridine orally with a sip of water 1 hour prior to the start of operative time. Other patients were given 0.5 ml 10% sodium fluorescein intravenously in the operating room. In all cases time was measured between the administration of the agent and the visualization of color changes consistent with agent efflux in an indwelling catheter, which was placed at the start of the operation. Differences in excretion times between the groups were compared with the Wilcoxon rank sum test.
RESULTS
Seven women received phenazopyridine and 5 received sodium fluorescein. Mean excretion time was significantly longer in the phenazopyridine group compared to the sodium fluorescein group (81.9 vs 5.1 minutes, p = 0.0057). Median excretion time for phenazopyridine was 70 minutes (range 59 to 127) and for sodium fluorescein it was 5 minutes (range 3 to 9).
CONCLUSIONS
Sodium fluorescein is excreted significantly faster in the operating room compared to phenazopyridine. Depending on the cost of these agents at an institution, in addition to the desire to decrease operative time, this may impact practice patterns and agent selection.
Topics: Adult; Aged; Aged, 80 and over; Cystoscopy; Female; Fluorescein; Fluorescent Dyes; Humans; Iatrogenic Disease; Intraoperative Complications; Middle Aged; Pelvic Floor; Phenazopyridine; Plastic Surgery Procedures; Ureter; Urinary Catheters
PubMed: 27664579
DOI: 10.1016/j.juro.2016.07.099 -
Analytical and Bioanalytical Chemistry May 2005This paper describes a new LC-MS method for the determination of phenazopyridine and the subsequent development of a pharmacokinetic model for phenazopyridine in vivo....
This paper describes a new LC-MS method for the determination of phenazopyridine and the subsequent development of a pharmacokinetic model for phenazopyridine in vivo. Phenazopyridine hydrochloride is a strong analgesic used in the treatment of urinary tract infections. Although it has been used as a clinical treatment for a very long time, pharmacokinetic data and suitable methods for its determination in plasma are currently lacking. The study described in this paper used high performance liquid chromatography-mass spectrometry, HPLC-MS, to determine the plasma concentrations of phenazopyridine in human subjects after oral administration. After liquid-liquid extraction, the phenazopyridine in the plasma was analyzed on a C18 column under SIM mode. A double-peak phenomenon was observed in most of the concentration-time profiles of the subjects. Although some drugs are known to cause this phenomenon, phenazopyridine has not been reported to do so. Several possible causes were analyzed in order to obtain an explanation. We proposed a two-site absorption compartment model to fit the concentration data in vivo, which has one more absorption site than the classical one-compartment model. The model describes the concentration profiles in different dose groups well and could provide an explanation for the double-peak phenomenon. The three dose groups exhibited similar model parameters and a linear pharmacokinetic process over the dose range used.
Topics: Area Under Curve; Chromatography, High Pressure Liquid; Half-Life; Humans; Mass Spectrometry; Phenazopyridine; Sensitivity and Specificity
PubMed: 15900475
DOI: 10.1007/s00216-005-3197-1 -
Drug Intelligence & Clinical Pharmacy Nov 1987
Topics: Adult; Aminopyridines; Anemia, Hemolytic; Female; Glomerulonephritis, IGA; Glucosephosphate Dehydrogenase Deficiency; Humans; Phenazopyridine
PubMed: 3678069
DOI: 10.1177/106002808702101116 -
Fertility and Sterility May 2007The embryo transfer is a critical part of in vitro fertilization. When performed under abdominal ultrasound guidance, the embryo transfer procedure requires a full... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
The embryo transfer is a critical part of in vitro fertilization. When performed under abdominal ultrasound guidance, the embryo transfer procedure requires a full bladder. Patients often state that the discomfort of the distended bladder causes more pain than the actual transfer procedure. Phenazopyridine HCl is a bladder analgesic. The objective of this study was to determine if a single dose of phenazopyridine prior to embryo transfer reduces patient discomfort during that procedure.
DESIGN
Prospective randomized double-blinded clinical trial.
SETTING
University-based Reproductive Medicine practice.
PATIENT(S)
Eighty-five reproductive age infertile women undergoing in vitro fertilization.
INTERVENTION(S)
Phenazopyridine (200 mg) or placebo taken 1 hour prior to embryo transfer utilizing transabdominal sonography.
MAIN OUTCOME MEASURE(S)
Pain as assessed by visual analogue pain scale and physician and nurse assessment of patient discomfort.
RESULT(S)
Study groups were similar in their demographic background. Mean pain score as assessed by a visual analogue pain scale during the procedure was 2.95 +/- 2.4 in the placebo group, and 3.03 +/- 2.6 in the active medication group (NS). There were also no significant differences in the observations of pain assessments.
CONCLUSION(S)
Phenazopyridine used in a single dose prior to embryo transfer does not alleviate patient discomfort.
Topics: Adult; Double-Blind Method; Embryo Transfer; Female; Humans; Pain; Pain Measurement; Phenazopyridine; Prospective Studies
PubMed: 17239870
DOI: 10.1016/j.fertnstert.2006.08.097 -
Journal of Separation Science Jul 2020Magnetic dispersive solid-phase extraction followed by dispersive liquid-liquid microextraction coupled with gas chromatography/mass spectrometry was applied for the...
Quantitative determination of trace phenazopyridine in human urine samples by hyphenation of dispersive solid-phase extraction and liquid-phase microextraction followed by gas chromatography/mass spectrometry analysis.
Magnetic dispersive solid-phase extraction followed by dispersive liquid-liquid microextraction coupled with gas chromatography/mass spectrometry was applied for the quantitative analysis of phenazopyridine in urinary samples. Magnetic dispersive solid-phase extraction was carried out using magnetic graphene oxide nanoparticles modified by poly(thiophene-pyrrole) copolymer. The eluting solvent of this step was used as the disperser solvent for the dispersive liquid-liquid microextraction procedure. To reach the maximum efficiency of the method, effective parameters including sorbent amount, adsorption time, type and volume of disperser and extraction solvents, pH of the sample solution, and ionic strength as well as desorption time, and approach were optimized, separately. Characterization of the synthesized sorbent was studied by utilizing infrared spectroscopy, scanning electron microscopy, and energy-dispersive X-ray analysis. Calibration curve was linear in the range of 0.5-250 ng/mL (R = 0.9988) with limits of detection and quantification of 0.1 and 0.5 ng/mL, respectively. Intra- and interday precisions (RSD%, n = 3) of the method were in the range of 4.6-5.4% and 4.0-5.5%, respectively, at three different concentration levels. Under the optimal condition, this method was successfully applied for the determination of phenazopyridine in human urine samples. The relative recoveries were obtained in the range of 85.0-89.0%.
Topics: Gas Chromatography-Mass Spectrometry; Humans; Liquid Phase Microextraction; Magnetic Phenomena; Phenazopyridine; Solid Phase Extraction
PubMed: 32396240
DOI: 10.1002/jssc.202000055 -
Urology Practice Jun 2024Office administration of intradetrusor onabotulinumtoxinA is commonly used to treat overactive bladder. For preprocedure analgesia, either 50 mL 2% intravesical...
INTRODUCTION
Office administration of intradetrusor onabotulinumtoxinA is commonly used to treat overactive bladder. For preprocedure analgesia, either 50 mL 2% intravesical lidocaine instillation for 20 to 30 minutes or 200 mg oral phenazopyridine can be used. Phenazopyridine is associated with shorter appointment times and is noninferior to lidocaine for pain control in this setting. We performed a cost analysis of phenazopyridine vs lidocaine for analgesia before office intradetrusor onabotulinumtoxinA injection for the treatment of idiopathic overactive bladder.
METHODS
A health care sector-perspective cost analysis was performed. The following assumptions were made: (1) similar efficacy of each medication in providing adequate analgesia, (2) similar physician ease of performing the procedure with either analgesic, and (3) similar patient satisfaction with either analgesic. Average cost of medications, adverse reactions, nursing tasks, and office visit time were found in publicly available data. Sensitivity analyses were performed using TreeAge Pro 2021, R1 software.
RESULTS
Phenazopyridine is less costly compared to lidocaine per visit for office intradetrusor onabotulinumtoxinA injection ($827 vs $925). A difference of $98 per procedure provides a total annual cost savings of over $24 million if all procedures are performed with phenazopyridine instead of lidocaine. Sensitivity analysis showed that phenazopyridine remained less costly under most circumstances, and threshold analysis provided exact circumstances under which phenazopyridine is no longer cost saving.
CONCLUSIONS
Phenazopyridine provides cost savings compared to lidocaine for analgesia before office intradetrusor onabotulinumtoxinA injection for the treatment of idiopathic overactive bladder. If adopted by providers nationwide, phenazopyridine may reduce health care spending and minimize office visit time while maintaining patient pain control and satisfaction.
PubMed: 38913587
DOI: 10.1097/UPJ.0000000000000628 -
JAMA Sep 1972
Topics: Anesthetics, Local; Azo Compounds; Humans; Male; Phenazopyridine; Prostatic Diseases; Pyridines; Urinary Bladder Calculi
PubMed: 5068650
DOI: No ID Found