ABSTRACT
Background: In 2013 the Chilean regulatory sanitary agency issued a warning concerning dose adjustment and use restriction to avoid severe adverse effects of metoclopramide such tardive dyskinesia. Aim: To study dyskinesia type adverse effects in a population using metoclopramide. Material and Methods: A cross sectional observational study was conducted among patients pertaining to palliative care and diabetes mellitus programs and consuming 10 mg/day or more of metoclopramide. Patients were interrogated looking for extrapiramidal signs and symptoms using a questionnaire validated by two neurologists. Results: In 40% of diabetic patients with gastroparesia and 35% of palliative care patients, extrapyramidal adverse reactions to metoclopramide were suspected. Palliative Care patients suffered the largest number of adverse events. The period of use and individual doses of the drug were largely above Chilean regulatory agency recommendations in all cases. Conclusions: A significant number of patients using metoclopramide could experience extrapyramidal adverse reactions.
Subject(s)
Humans , Male , Female , Pain/drug therapy , Diabetes Mellitus, Type 2/drug therapy , Dopamine D2 Receptor Antagonists/adverse effects , Metoclopramide/adverse effects , Palliative Care , Chile , Cross-Sectional Studies , Surveys and Questionnaires , Pharmacovigilance , Dopamine D2 Receptor Antagonists/administration & dosage , Metoclopramide/administration & dosageABSTRACT
Qualquer psicodiagnóstico pode ser considerado um diálogo contínuo e um acontecimento com efeito orientador. Da interação entre o psicólogo e o paciente surge uma relação especial e única com efeitos específicos caso o profissional não atue apenas como um coletor de dados senão como o outro ator no processo. Esta dualidade interativa não deve ser reduzida a uma exibição do passado ou a uma projeção recíproca. Em vez disso, ela deveria gerar uma co-produção da subjetividade que permita algo novo acontecer. Esses acontecimentos produzem efeitos internos que podem dar um novo significado à vida da pessoa, oferecendo uma nova orientação para seu presente e sua situação futura.
Todo proceso psicodiagnóstico, entendido como quehacer dialógico y acontecimiento, conlleva un efecto orientador. La inter-versión que se produce entre psicólogo y consultante es un hecho singular que puede inscribirse como novedad produciendo efectos, no sólo resultados, si el profesional lejos de ser mero recolector de datos se constituye en el otro actor del proceso. Ese entre-dos, no se reduce al despliegue del pasado o a la proyección de uno sobre otro, sino que genera una suerte de co-producción de subjetividad favorecedora de acontecimientos con efectos subjetivantes que resignificarán la vida de las personas, orientándolas en sus circunstancias presentes y futuras.
Any assessment process can be seen as an ongoing dialog and an event that has guiding effects. The interaction between psychologist and client results in a unique relationship that has specific effects, if the professional acts not only as a data collector, but also as the other actor in the process. This dyadic interaction should not be reduced to a display of the past nor a mutual projection. Instead, it should generate a co-production of subjectivity that should allow for something new to happen. These events can produce inner effects that can re-signify the persons life, thus providing a new guidance for his or her present and future circumstances.