Off label and unlicensed drug use in neonatal wards (excluding neonatal ICU) at Tygerberg children's hospital (TBH)

dc.contributor.advisorKruger, Marianaen_ZA
dc.contributor.authorMyeko, Zodidien_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Science. Dept. of Paediatrics and Child Health.en_ZA
dc.date.accessioned2019-11-26T09:09:11Z
dc.date.accessioned2019-12-11T06:41:51Z
dc.date.available2021-02-01T03:00:11Z
dc.date.issued2019-12
dc.descriptionThesis (MMed)--Stellenbosch University, 2019.en_ZA
dc.description.abstractENGLISH ABSTRACT: Off label use of medicines is defined as the use of an authorised medicine for a purpose or in a manner other than that stipulated in the summary of product characteristics (SmPC) (1), or as approved by the medicine control council or authirity of a country (1).The off label use can be for an unapproved indication, for dose, for administering route or, for use in an age group or population not registered during the approval process (2). Unregisterd medicines are medications that have not been approved for medicinal use in a particular country.(1) The majority of medication prescribed to neonates and young infants have not been tested in them and in the European Union 45% to 60% of medicine are given to children off label (3 ). In the period before 1995 and 2005, only one third of registered medication in Europe were approved for use in children (4), while 54% are approved in the United States of America (4). An Estonian study demonstrated that 80-98% of drugs used in neonates were used off label (5). The regulation of modern medicine started only after breakthrough progress in the fields of chemistry, physiology and pharmacology (6). This laid a firm basis for medicine testing and research. Certain events such as the diethylene glycol poisoning and thalidomide induced congenital abnormalities in history, also led to establishment of medicine regulatory bodies. In 1937 people in the USA died from diethylene glycol poisoning, which was used as a solvent with no prior safety testing and this led to the establishment of The Federal Food, Drug and Cosmetics act (6). The second important event occurred between 1956 and 1960 and involved the world wide use of Thalidomide (6). Thalidomide was developed in Germany in 1956 and was used as a hypnotic and sedative. Thalidomide’s widespread use in more than 46 countries, led to the birth of many babies with phocomelia (6). In 1956, an association was made between Sulfonamide antibiotics use, kernicterus and high rates of mortality in the premature neonate, this was higher than in infants receiving a tetracycline (7). In 1959, a syndrome of sudden cardiovascular collapse was described by Sutherland in three neonates who had received high dose chlorompenicol (8).en_ZA
dc.description.versionMastersen_ZA
dc.embargo.terms2020-12-31
dc.format.extent31 pagesen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/106987
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectOff-label drug useen_ZA
dc.subjectUnlicenseden_ZA
dc.subjectDrug useen_ZA
dc.subjectNeonatalen_ZA
dc.subjectTygerberg Children’s Hospitalen_ZA
dc.subjectHyperbilirubinemia, Neonatalen_ZA
dc.titleOff label and unlicensed drug use in neonatal wards (excluding neonatal ICU) at Tygerberg children's hospital (TBH)en_ZA
dc.typeThesisen_ZA
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