Our response to COVID-19 as endocrinologists and diabetologists. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Angiotensin-converting enzyme 2 (ACE2) is the cell surface receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are several different ways to summarize concomitant medication data: Preferred term, ATC Text, Indication by Preferred term, and various other combinations.

Almost every reported concomitant medication has a reason – and many, if not all of these reasons should be reported as adverse events. update, PA will be required in situations where members fill opioid and benzodiazepine medications for at least 60 days within a 90-day period. Below is a list of common medications used to treat or reduce the symptoms of concomitant hypertension and osteoarthritis. Concomitant Medication Dose Form (CMDOSFRM) text Extensible: Yes: C78418: Concomitant Medication Dose Form: A terminology subset of the CDISC SDTM Pharmaceutical Dosage Form codelist created for CDASH Concomitant Medication Dose Form codelist. We have a small list of ATC codes with multiples Stockman LJ, Bellamy R, Garner P. SARS: systematic review of treatment effects. Has the patient taken any concomitant medications since last medication assessment? radio: ny: CMSPID: CM Number: What is the medication /treatment identifier? HFSA/ACC/AHA statement addresses concerns re: using RAAS antagonists in COVID-19. Horby P, Lim WS, Emberson J, et al. It has been hypothesized1 that the modulation of ACE2 associated with ACE inhibitors or ARBs could suppress or enhance SARS-CoV-2 replication.2 Investigations of the role of ARBs and recombinant human ACE2 in the treatment and prevention of SARS-CoV-2 infection are underway.3, Whether these medications are helpful, harmful, or neutral in the pathogenesis of SARS-CoV-2 infection is unclear. See Corticosteroids for a detailed discussion of these recommendations. Corticosteroids as adjunctive therapy in the treatment of influenza. The Concomitant Medications module was one of the group of variables included in the third round of the CRF Harmonization and Standardization Initiative. It has been proposed that these agents have a potential role in managing patients with severe COVID-19.12 Observational studies have reported that statin therapy may reduce cardiovascular morbidity in patients admitted with other respiratory infections, such as influenza and bacterial pneumonia. Hiding in plain sight: an approach to treating patients with severe COVID-19 infection. 2020. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? In outbreaks of other novel coronavirus infections5,6 (i.e., Middle East respiratory syndrome [MERS] and SARS), corticosteroid therapy was associated with delayed virus clearance. Some drugs may interact with the study intervention and must not be taken during the study. Conclusion: Each investigational drug and new drug class in oncology has a unique DDI profile. In mid-March 2020, news agencies promoted reports that anti-inflammatory drugs may worsen COVID-19. Corticosteroid therapy for critically ill patients with Middle East respiratory syndrome. Select the iCRF from the drop-down list to display this report. Con-meds may be used by study subjects … This designation is used when medicinal drugs are given either at the same time or almost at the same time. The Concomitant Medications Report details the information captured on a particular Concomitant Medication iCRF. Make a new entry when a dosage and/or frequency change occurs. support current North American guidelines, which suggest use of proton pump inhibitors or misoprostol for traditional NSAID users taking concomitant medications such as antithrombotics, corticosteroids, or SSRIs, and use of PPIs for low-dose-aspirin users taking antithrombotics or taking corticosteroids if these patients are 60 years old. Collecting concomitant medications taken during a study is also important for safety reasons. Concomitant medications were always important for the inclusion and exclusion criteria used to allow patients to take part in trials. The link to Table 69 above can be used for more information on PA requirements and evaluation criteria. Concomitant drugs refer to two or more drugs or medications taken at the same time. Almost every reported concomitant medication has a reason – and many, if not all of these reasons should be reported as adverse events. Bancos S, Bernard MP, Topham DJ, Phipps RP. HMG-CoA reductase inhibitors, or statins, affect ACE2 as part of their function in reducing endothelial dysfunction. v Note: Forms with a No Data status are not included in the report. If a patient is taking a medication PRN, do not use a separate line for each time the medication is taken, instead report the first and last dates taken. DOSE/UNIT/ FREQ; Start Date; End Date or CONT. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. A short course of betamethasone and dexamethasone, which are corticosteroids known to cross the placenta, is routinely used to hasten fetal lung maturity and decrease the risk of neonatal respiratory distress syndrome in the premature infant with threatened delivery.10,11. Route; Indication; Related AE, if any; Author: Sector Pharma Created Date: 02/26/2019 10:21:00 Title: CON MEDS LAF 2203 Procarbazine ( Matulane ): Used in addition to other medications to treat Hodgkin’s disease. Available at: Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal. This was essential to avoid adverse reactions between two drugs that were known to exist. Purpose. Record all concomitant medications from baseline as specified in the protocol. Collecting concomitant medications taken during a study is also important for safety reasons. Importing Instruments. Serotonergic Drugs: Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. Angiotensin II Antagonists, Aldosterone Blockers, Heparin, Low Molecular Weight Heparin, And Other Drugs Known To Cause Hyperkalemia … https://www.covid19treatmentguidelines.nih.gov/concomitant-medications Analysis of Concomitant Medication Data (continued) improvements required. If a patient receives treatment or therapy for an adverse event, also record the specific medications or therapies prescribed to treat adverse events on this CRF. Currently, there is a lack of sufficient clinical evidence demonstrating that ACE inhibitors or ARBs have any impact on the susceptibility of individuals to SARS-CoV-2 or on the severity or outcomes of infection. In each study, the randomized patient population was divided into 3 subgroups based on the use of concomitant medications at study entry: a dopaminergic agonist group, a MAO-B inhibitor group (rasagiline and selegiline), and an amantadine group. Rodrigo C, Leonardi-Bee J, Nguyen-Van-Tam J, Lim WS. FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19. Additionally, there may be some drugs that are not known to interact with the study intervention and may be identified through an adverse event. Ibuprofen and other widely used non-steroidal anti-inflammatory drugs inhibit antibody production in human cells. J17�]���5I�XvY7V^!-R��:�ť�r�irٓf:�j`|�CU�n�����D� �o��.����˹���g� ��,��f�R�KH�vnM�T��nͿ�C�z�l ��>��{�4��D���p�.��N ���H�B$\H�'�u���� X)�"���3�O� ���. How to use concomitant in a sentence. Concomitant Opioid Benzodiazepine Initiative See Table 69 Please see the links below for a description of the Concomitant Opioid Benzodiazepine Initiative (COBI), including a medication list and frequently asked questions. Medication List; Q & A; About Ischemic Stroke. Effect of dexamethasone in hospitalized patients with COVID-19: preliminary report. Record all concomitant medications, including therapies given to treat adverse events. The reference table on the next page lists the opioid and benzodiazepine medications included in the Concomitant Opioid and Benzodiazepine Initiative. Did You Know? In severe pneumonia caused by influenza, corticosteroid therapy may lead to worse clinical outcomes, including secondary bacterial infection and mortality.7. American College of Cardiology. Liggins GC, Howie RN. Concomitant medications (a.k.a., con-meds) are other prescription medications, over-the-counter (OTC) drugs or dietary supplements that a study participant takes in addition to the drug under investigation. The Panel's recommendation against the use of these medications for the treatment of COVID-19 is in accord with a joint statement of the American Heart Association, the Heart Failure Society of America, and the American College of Cardiology.3, It has been proposed that the anti-inflammatory effects of corticosteroids have a potential therapeutic role in suppressing cytokine-related lung injury in patients with COVID-19.4 Data reported for other respiratory infections have shown that systemic corticosteroids can affect the pathogenesis of these infections in various ways. Rasagiline ( Azilect ): Used to treat symptoms of Parkinson’s disease. B. PK ! A GENERIC NAME OF MEDICATION B If medication When tabulating concomitant medications it is often necessary to categorize data by preferred term. Concomitant Medications NCI CRF Standards: Round 3. Patients with COVID-19 may also be receiving systemic corticosteroid therapy for a variety of underlying conditions. Food and Drug Administration. Before initiating dexamethasone, clinicians should review the patient’s medical history and assess the potential risks and benefits of administering corticosteroids to the patient. Concomitant medication is combining two or more treatment regimes when treating diseases. Concomitant administration of ACE inhibitors with potassium -sparing diuretics has been associated with severe hyperkalemia. Some drugs may interact with the study intervention and must not be taken during the study. This is often the case in medicine. Drugs that may decrease insulin requirements include alcohol, anabolic steroids, aspirin, fenfluramine and monoamine oxidase inhibitors; there have been isolated reports of decreased insulin requirements with captopril, clofibrate, cyclophosphamide, guanethidine, mebendazole, methandienone and oxytetracycline. Concomitant drug therapy may alter insulin requirements. To import this instrument please follow the instructions here. Pharmacists can create a personalized "concomitant-medication review guide" listing key medication-use information in table format to assist other clinicians in preventing and assessing DDIs during a patient's clinical trial participation. Examples of concomitant in a sentence, how to use it. 100 examples: Disorganized attachment in early childhood : meta-analysis of precursors… 0___ No 1___ Yes If YES, enter all prescription and over-the-counter drugs taken therapeutically during the study including herbal preparations. It has been proposed that NSAIDs such as ibuprofen can increase the expression of ACE21 and inhibit antibody production.13 Shortly after these reports, the Food and Drug Administration stated that there is no evidence linking the use of NSAIDs with worsening of COVID-19 and advised patients to use NSAIDs as directed.14, Statement on Casirivimab Plus Imdevimab EUA, Chloroquine or Hydroxychloroquine With or Without Azithromycin, Clinical Data: Chloroquine or Hydroxychloroquine, Lopinavir/Ritonavir and Other HIV Protease Inhibitors, Table 2 Characteristics of Antiviral Agents, Table 3a Immune-Based Therapy Clinical Data, Table 3b Characteristics of Immune-Based Therapy, https://www.ncbi.nlm.nih.gov/pubmed/32171062, https://www.ncbi.nlm.nih.gov/pubmed/32208485, https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19, https://www.ncbi.nlm.nih.gov/pubmed/32362390, https://www.ncbi.nlm.nih.gov/pubmed/29161116, https://www.ncbi.nlm.nih.gov/pubmed/16968120, https://www.ncbi.nlm.nih.gov/pubmed/26950335, https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1, https://www.ncbi.nlm.nih.gov/pubmed/32232480, https://www.ncbi.nlm.nih.gov/pubmed/4561295, https://www.ncbi.nlm.nih.gov/pubmed/26842679, https://www.ncbi.nlm.nih.gov/pubmed/32198163, https://www.ncbi.nlm.nih.gov/pubmed/19345936, https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19, Persons with COVID-19 who are prescribed ACE inhibitors or ARBs for cardiovascular disease (or other indications) should continue these medications, The COVID-19 Treatment Guidelines Panel (the Panel), On the basis of the preliminary report from the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial, the Panel recommends using, If dexamethasone is not available, the Panel recommends using alternative glucocorticoids such as, Oral corticosteroid therapy that was used prior to COVID-19 diagnosis for another underlying condition (e.g., primary or secondary adrenal insufficiency, rheumatological diseases) should not be discontinued, Inhaled corticosteroids that are used daily for patients with asthma and chronic obstructive pulmonary disease for control of airway inflammation should not be discontinued in patients with COVID-19, Given the potential benefit of decrease in maternal mortality and the low risk of fetal adverse effects for this short course of therapy, the Panel recommends using, Persons with COVID-19 who are prescribed statin therapy for the treatment or prevention of cardiovascular disease should continue these medications, Persons with COVID-19 who are taking NSAIDs for a comorbid condition should continue therapy as previously directed by their physician, The Panel recommends that there be no difference in the use of antipyretic strategies (e.g., with acetaminophen or NSAIDs) between patients with or without COVID-19, Persons with COVID-19 who are prescribed angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for cardiovascular disease (or other indications) should continue these medications, Persons with COVID-19 who are taking nonsteroidal anti-inflammatory drugs (NSAIDs) for a comorbid condition should continue therapy as previously directed by their physician, The Panel recommends that there be no difference in the use of antipyretic strategirs (e.g., with acetaminophen or NSAIDs) between patients with or without COVID-19. This information may be collected as a history item as well as during the study. Patel AB, Verma A. COVID-19 and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: what is the evidence? [Content_Types].xml �(� ĖMO�@��&��f��.p0�P5��Na�~ewP��N)4F���x! For instance, chemotherapy is often cited as a prime example of therapeutic concomitant drugs wher… Kaiser UB, Mirmira RG, Stewart PM. How this categorization occurs is a commonly misunderstood process. Intervention: If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Arabi YM, Mandourah Y, Al-Hameed F, et al. When a subject takes aspirin to relieve a toothache, it still inhibits platelet action. Antenatal betamethasone for women at risk for late preterm delivery. Concomitant medications (a.k.a., con-meds) are other prescription medications, over-the-counter (OTC) drugs or dietary supplements that a study participant takes in addition to the drug under investigation. COVID-19 is an emerging, rapidly evolving situation. First, medications with multiple codes are re-listed with all of their codes. The treatment of these other diseases has an effect on blood sugar levels, so the patient's usual diabetes treatment may have to be changed. (NCI) CDISC CDASH Concomitant Medication Dose Form Terminology: AEROSOL: C42887: aer An Ischemic stroke occurs when a blood … Concomitant Medication. 2020. Concomitant illnesses may make it more difficult for the treating physician to determine the diagnosis or treatment of the primary illness. Purpose. Fedson DS, Opal SM, Rordam OM. Were any medications taken? Concomitant : Medications / Therapies: List all Medications administered: during the treatment & follow-up periods: Medication / Non-Drug Therapy. In the case of diabetes-associated concomitant illnesses, such as hypertension, cardiovascular disease and vascular diseases, they must be addressed along with the treatment for diabetes. Selegiline ( Eldepryl, Zelapar ): May be used for the treatment of Parkinson’s disease in addition to other medications. Additionally, there may be some drugs that are not known to interact with the study intervention and may be identified through an adverse event. Variable Variable Name Question Field Type (Validation Type) Code List; CMYN: Any meds? MassHealth Drug List. Preliminary clinical trial data from a large, randomized, open-label trial suggest that dexamethasone reduces mortality in hospitalized patients with COVID-19 who require mechanical ventilation or supplemental oxygen.8 The recommendations for using corticosteroids in patients with COVID-19 depend on the severity of illness. https://treatmentwithcbd.com/15-medications-cbd-drug-interactions Concomitant definition is - accompanying especially in a subordinate or incidental way. )3��Φy;�x�&{���w�}���^i7-���M�e �S�x[@b����"@�hڥ���9�I����� �*��V =�)B��)�a�ʥw{Xi��� �Hۼ� . Concomitant Medication – Prescription and over-the-counter drugs and supplements a study participant has taken along with the study intervention. The time frame that constitutes the same time varies according to desired effect of the drug, the half-life of each drug administered, the metabolism of each drug, the excretion of each drug and the side effects of each drug individually and collectively. 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