How can we prevent the need to mix medicines?
Staggering the administration times of medicines or determining if one medicine can be temporarily stopped, without compromising patient care, while another is given, can also prevent the need to mix medicines. . Monitor for reactions caused by drug incompatibilities, even when mixing apparently compatible medicines.
What is a mixing of effects in psychology?
Confounding is often referred to as a “mixing of effects” , wherein the effects of the exposure under study on a given outcome are mixed in with the effects of an additional factor (or set of factors) resulting in a distortion of the true relationship.
How can I minimize the risk of drug interactions?
Minimizing the risk of interactions 1. Know why you are taking each medication 2. Know how to take the drug 3. Fill all your prescriptions at the same pharmacy 4. Be suspicious of supplements 5. Go easy on grapefruit juice 6. Limit alcohol 7. Talk to your pharmacist
What are the risks of mixing drugs?
Since chemical reactions between the mixed drugs can result in a reduction in the amount of active drug, patients should also be monitored for treatment failure. Seek advice about the compatibilities of the drug that is to be mixed.
How do you ensure reliability and validity in mixed methods research?
The main instruments used in the mixed method researches consist of closed-ended, open-ended questionnaires, interviews and classroom observations. These different ways of gathering information can supplement each other and hence boost the validity and dependability of the data.
What are vital aspects for ensuring quality of mixed method research?
Researchers should do the following:Collect both quantitative and qualitative data.Employ rigorous data collection and analysis procedures.Integrate different sources of data to better understand the research problem.Use a mixed methods research design and integration strategies consistent with the design.More items...•
How can mixed methods be used in research?
Mixed methods research combines elements of quantitative research and qualitative research in order to answer your research question. Mixed methods can help you gain a more complete picture than a standalone quantitative or qualitative study, as it integrates benefits of both methods.
Which research design is best for mixed methods?
The most common and well-known approach to mixing methods is the Triangulation Design (Figure 4.1a) (Creswell, Plano Clark, et al., 2003). The pur- pose of this design is “to obtain different but complementary data on the same topic” (Morse, 1991, p. 122) to best understand the research problem.
What are the challenges of mixed methods research?
One of the key challenges within mixed methods research is the successful integration of quantitative and qualitative data during analysis and interpretation.
How do you critique a mixed methods research article?
2:398:45Mixed Method Research Paper Critique - YouTubeYouTubeStart of suggested clipEnd of suggested clipThe use of explanatory sequential mixed method design is the most appropriate to explore the nursesMoreThe use of explanatory sequential mixed method design is the most appropriate to explore the nurses perspectives as well as their experiences.
What does it mean when one says they used mixed methods for their research study?
The major characteristic of mixed-methods research is that it combines quantitative and qualitative approaches by including both quantitative and qualitative data in a single research study (Gay, Mills, & Airasian, 2009).
Why is mixed methods research important?
Mixed methods enables investigators conceptually and analytically to integrate qualitative research and qualitative data (e.g., semi-structured interviews, observations, focus groups) with traditional epidemiological and quantitative methods of research to facilitate translation.
What is the importance of understanding the mixed method research design?
The overall goal of mixed methods research, of combining qualitative and quantitative research components, is to expand and strengthen a study's conclusions and, therefore, contribute to the published literature. In all studies, the use of mixed methods should contribute to answering one's research questions.
What are the three types of mixed methods research?
Based on a review of the literature (see Creswell et al., 2003), there are three general approaches to mixed methods—sequential, concurrent, or data transformation—that are most applicable to BER studies.
What is mixed sampling method?
Where a sample plan envisages the use of two or more basic methods of sampling it is termed mixed sampling. For example, in a multistage sample, if the sampling units at one stage are drawn at random and those at another by a systematic method, the whole process is “mixed”.
What are the three types of mixed method research and its uses?
Quantitative research deals with numbers and statistics, while qualitative research deals with words and meanings. Quantitative methods allow you to systematically measure variables and test hypotheses. Qualitative methods allow you to explore concepts and experiences in more detail.
How to compare the effectiveness of two treatments?
To compare the effectiveness of two treatments, the only way to deal with this is to ensure that the study design requires patients with the same range of condition severity are included in both treatment groups and that choice of treatment is not based on condition severity. Dealing with confounding.
How to adjust for confounding?
There are a number of ways of assessing and adjusting for confounding, however a detailed discussion of this is beyond the scope of this article. Briefly, a few examples of how this could be accomplished include: 1 During study planning, inclusion could be restricted by specific confounding variables, such as age. 2 Several methods of “adjusting” the effect estimate as part of the analysis can be used. Stratification (as shown above) is one that can be relatively straightforward and involves looking at the association between the exposure and outcome for each factor category (or stratum) by calculating a stratum-specific estimate. 3 Multivariate analysis, a set of statistical methods which allows for adjustment of multiple variables simultaneously via mathematical modeling, can also be used to “control” for confounding.
What is confounding in science?
What is confounding? Confounding is often referred to as a “mixing of effects”1,2wherein the effects of the exposure under study on a given outcome are mixed in with the effects of an additional factor (or set of factors) resulting in a distortion of the true relationship.
Can the severity of a condition be separated from the severity?
Given that the severity of the condition is likely associated with the outcome and that the severity is also associated with the treatment choice, the effects of the treatment cannot be separated from those of the severity. To compare the effectiveness of two treatments, the only way to deal with this is to ensure that the study design requires ...
What is the guidance for mixing medicine?
This guidance explains which healthcare professionals can prescribe and administer medicines that are intended to be mixed. It also stipulates that the mixing of medicines should: only be undertaken in the best interests of the patient; be avoided where possible; only be done by a person who is competent and willing to do so;
How to avoid mixing drugs?
Avoid mixing by using an alternative route of drug administration (e.g. rectal or sublingual), or prescribing a suitable alternative drug. Multi-lumen tube sets can also be used to allow a number of different intravenous drugs to be administered separately at the same time.
What happens when you mix two or more diluents?
When two or more medicines and their diluents are mixed together in the same syringe or infusion bag, or when two or more infusion lines meet at a Y-site junction, there is a risk that they may be incompatible with one another.
Why is pH important for drug administration?
Formulation in this manner, at a pH where the drug is predominantly in its ionised form, increases the solubility of the drug when added to an aqueous solution for administration. The pH of the administration fluid is important because it determines whether the drug will be in an ionised or unionised form when it is diluted [4]#N#.
What drugs are incompatible with high pH solutions?
Incompatible with high pH solutions, must be administered separately to drugs with high pH such as thiopental to prevent precipitation. Lidocaine and propofol. Layering and coalescence of propofol vehicle, caused by lidocaine disrupting the surfactant properties of the vehicle.
Why should patients be monitored for treatment failure?
Since chemical reactions between the mixed drugs can result in a reduction in the amount of active drug, patients should also be monitored for treatment failure. Seek advice about the compatibilities of the drug that is to be mixed. Information provided by the manufacturer should always be consulted first.
What happens when a mixture is physicochemically reacted?
Physicochemical reactions within the mixture can cause precipitation, separation, gas formation and changes in colour or turbidity. This can, theoretically, result in catheter occlusion or emboli formation, causing organ failure and death. Typically, these reactions are detectable through a visual check.
How do drug interactions happen?
Drugs don't combine in the body to produce chemical reactions. Instead, a drug, supplement, or food may affect how long a medication stays in the body, often by stimulating or inhibiting the production of specific enzymes in the liver or intestine.
What are some serious drug interactions?
Some of the most serious drug interactions involve prescription medications and supplements. Not only are supplements less likely than FDA-approved medications to be listed in the databases of drug interactions, but health care providers also may not know what supplements people are taking.
Can you take bisphosphonate with food?
On the other hand, some drugs are better taken with food, either to aid their absorption or to prevent them from irritating the stomach lining. And some drugs are not to be taken with specific foods. For example, the antibiotic tetracycline shouldn't be taken with dairy products because calcium interferes with the drug's absorption.
Is the health care system fragmented?
The health care system is still fragmented. Your primary care team is likely to have a record of the prescriptions you've gotten from that office, as are the specialists you have seen. However, each isn't likely to know what the others have prescribed.
Can a drug interact with food?
If so, you may be at increased risk for drug interactions, which occur when a drug, a supplement, or even a food affects the way your body processes a medication. Such interactions can make a drug more powerful—so that a standard dose becomes an overdose—or can render it less potent or altogether ineffective.
Is it realistic to expect us to memorize every interaction for every medication we take?
Dr. Phansalkar acknowledges that it isn't realistic to expect us to memorize every possible interaction for every medication we take. But the following can go a long way in reducing problems:
What is perfect mixing?
Perfect mixing for reactions is defined as the instant reduction to a homogeneous concentration field. This also corresponds to the perfectly micro-mixed mixing condition (Levenspiel [ 10 ]). Good mixing rapidly approaches this perfectly homogeneous condition and hence approaches the maximum yield of desired product.
How are mixing and apparent reaction rates related?
Mixing and apparent reaction rate are intrinsically related: reactions involving multiple reactants cannot occur without the reactants being contacted intimately at a molecular level. In a reactor, reactants are added at the macro- or meso-scale. For the reaction to occur, the pure reactants need to be homogenized at the molecular scale so that molecules can collide. If the mixing is fast enough, the intrinsic chemical kinetics governs the rate of production of new species. This requires a reduction of scale and of differences in concentration, which is the very definition of mixing as it pertains to chemical reactions.
What is the relationship between mixing and turbulence?
In the fine chemicals industry, reactions are frequently carried out in semi-batch stirred tanks. Mixing and turbulence are very closely related and the rate of mixing is greatly influenced by the turbulence intensity within the tank, which can vary by orders of magnitude in different regions of the tank.
What are the two classes of mixing sensitive reactions?
There are two classes of mixing sensitive reactions: competitive-consecutive and competitive-parallel. The yield of desired product from these coupled reactions depends on how fast the reactants are brought together. Recent experimental results have suggested that the mixing effect may depend strongly on the stoichiometry of the reactions.
What happens if your control group differs from the treatment group?
If your control group differs from the treatment group in ways that you haven’t accounted for, your results may reflect the interference of confounding variables instead of your independent variable.
What is treatment in research?
The treatment is any independent variable manipulated by the experimenters, and its exact form depends on the type of research being performed. In a medical trial, it might be a new drug or therapy. In public policy studies, it could be a new social policy that some receive and not others.
How to reduce confounding variables?
There are several methods you can use to decrease the impact of confounding variables on your research: restriction, matching, statistical control and randomization. In restriction, you restrict your sample by only including certain subjects that have the same values of potential confounding variables.
What is quasi-experimental design?
While true experiments rely on random assignment to the treatment or control groups, quasi-experimental design uses some criterion other than randomization to assign people. Often, these assignments are not controlled by researchers, but are pre-existing groups that have received different treatments.
How to test the effectiveness of a pill?
To test its effectiveness, you run an experiment with a treatment and two control groups. The treatment group gets the new pill. Control group 1 gets an identical-looking sugar pill (a placebo) Control group 2 gets a pill already approved to treat high blood pressure. Since the only variable that differs between the three groups is the type ...
What does it mean to use a control group?
Then they compare the results of these groups. Using a control group means that any change in the dependent variable can be attributed to the independent variable.
What is the treatment group?
The treatment group (also called the experimental group) receives the treatment whose effect the researcher is interested in. The control group receives either no treatment, a standard treatment whose effect is already known, or a placebo (a fake treatment). The treatment is any independent variable manipulated by the experimenters, ...
Risks of Mixing
Physicochemical Reactions
- Changes in pH can cause drugs to precipitate out of solution. Most medicines are small chemical organic molecules that are often formulated as weak acid or weak base salts. Formulation in this manner, at a pH where the drug is predominantly in its ionised form, increases the solubility of the drug when added to an aqueous solution for administration. The pH of the administration fluid i…
Chemical Instability
- Oxidation, reduction and hydrolysiscan cause the chemical degradation of a drug, resulting in a loss of potency or the formation of toxic by-products. These processes can be accelerated by: the addition of an aqueous solution when reconstituting dry powders; ultraviolet light; exposure to oxygen; and changes in temperature or pH. When erythromycin is reconstituted, it is degraded b…
Reducing Risk
- A number of factors should be considered before mixing medicines to reduce the risk of inappropriate mixing. Avoid mixingby using an alternative route of drug administration (e.g. rectal or sublingual), or prescribing a suitable alternative drug. Multi-lumen tube sets can also be used to allow a number of different intravenous drugs to be administe...