Psychotropic drugs in Bulgaria-frequency and risk of adverse drug reactions

The aim of the study is to determine the frequency and risk of appearance of adverse drug reactions/ADRs/during the treatment with psychotropic drugs. The first part of the study is an analysis of the use of the psychotropic drugs for one-year period of time in our country, performed by DDD methodology. An attempt is made to equalize the Bulgarian list of the psychotropic drugs with the ATC classification and to estimate the DDD/1000/day. The data for Bulgaria is compared with that of the other countries. The collected data for the psychotropic drug use is divided into 2 groups: Psycholeptics and Psychoanaleptics. It is made an attempt to explain the main differences between them. The number of the standard therapeutic courses/NT/is used for assessment of the frequency and risk of ADRs. The results from the study show that the determined frequency of appearance of ADR for the different drugs is within "rare" and "very rare' for 100,000 inhabitants, according to the WHO terminology. Only for the drug Tardyl (EGIS Pharmaceuticals, Hungary) with INN Aminobarbitalum + Glutethimidum + Promethazini hydrochloridum the frequency is above 1%. That fact makes us to recommend a limitation of the prescription and usage of this drug to the Bulgarian Ministry of Health and to the National Drug Agency.

Previously treated, locally recurrent breast cancer: treatment with superselective intraarterial chemotherapy

PURPOSE

To evaluate the effectiveness of intraarterial infusion chemotherapy (IAC) with mitoxantrone hydrochloride in patients with previously treated, locally recurrent breast cancer.

MATERIALS AND METHODS

Thirty-nine women (aged 31-82 years) with recurrent breast cancer underwent superselective IAC (25 mg/m2 mitoxantrone hydrochloride every 24 hours) through the subclavian artery branches after heparin administration. The extent of tumor perfusion was monitored with computed tomography during the intraarterial administration of contrast medium. IAC was repeated one to nine times. Patients had previously undergone radiation therapy (n = 39), surgery (n = 20), or systemic chemotherapy (n = 23).

RESULTS

The overall response rate was 77% (n = 30). Eight patients had complete remission. Progression occurred in three patients. Remission was observed in cases of lymph node involvement (n = 9). Seven patients are still undergoing treatment. Side effects were usually moderate. Nine patients died of systemic tumor spread. In 14 patients, distant metastases developed during the first 18 months of treatment.

CONCLUSION

IAC is an effective, well-tolerated therapy in patients with locally recurrent breast cancer.