Frequency of Self-Medication and Knowledge about Out-of-Counter Drugs during the COVID-19 Pandemic in a Group of Iranian Dental Students

Abstract Objective: To study the frequency of self-medication and knowledge about out-of-counter drugs during the COVID-19 pandemic in a group of Iranian dental students. Material and Methods: A descriptive cross-sectional study was conducted among dental undergraduates from September 2021 to November 2021 after receiving ethical clearance from the Kerman Medical University Ethical Committee. A valid and reliable questionnaire, consisting of demographic data and questions about self-medication and knowledge about out-of-counter drugs, was sent to participants via E-mail. Data was analyzed by SPSS 26 software by using a t-test. The P-value was considered at a 0.05% significant level. Results: A total of 88 students participated in the study with a mean age of 21.39±3.71 years. Prevalence of self-medication was found in 53.4%. The most common cause for self-medication was headache. Acetaminophen was the most commonly used medicine for self-medication. Females had more self-medication than males, but there was no significant differences. There was no significant differences between entering year to university and self-medication. Younger students had significantly more self-medication (p=0.007). Knowledge about out-of-counter drugs was moderate. Conclusion: Moderate self-medication as noticed. The out-of-counter drugs were the most used. Although out-of-counter drugs seem relatively safe, their improper use can cause serious side effects. Dental students need to be educated regarding appropriate safe medication and out-of-counter drugs.

Cumplimiento de la normatividad en la publicidad televisiva de medicamentos de venta libre en Colombia. Estudio descriptivo retrospectivo 2018 / Compliance with regulations in the television advertising of over-the-counter drugs in Colombia. Retrospective descriptive study 2018

Resumen Introducción: la publicidad televisiva es una estrategia utilizada por la industria farmacéutica para ofrecer sus productos. En el caso de los medicamentos de venta libre, se tiene la responsabilidad de ajustarse a la normativa relacionada con estos productos, con el propósito de proteger al televidente de influencias negativas por posible publicidad imprecisa o engañosa. Objetivo: evaluar el cumplimiento normativo de la publicidad televisiva de medicamentos de venta libre en Colombia de agosto de 2018 en los canales nacionales Caracol y RCN. Metodología: se revisaron las grabaciones de anuncios publicitarios de medicamentos en los canales Caracol y RCN. Aleatoriamente, se seleccionaron los días 2, 4, 22 y 26 de agosto de 2018. La revisión de las grabaciones se realizó por dos evaluadores independientes. Los datos de los anuncios publicitarios se analizaron con estadística descriptiva. Resultados: se identificaron 624 anuncios publicitarios relacionados con medicamentos de venta libre: 601 pautas (96,3 %) y 23 comerciales (3,7 %). Entre los 624 anuncios emitidos, 226 (36,2 %) de 18 medicamentos no cumplieron con algunas condiciones establecidas en la normatividad. Discusión: este estudio, comparado con la publicación del 2014, mostró un incremento en la cantidad de anuncios que no cumplen con la norma, pasando de 8 % a 36,2 %. La principal situación de incumplimiento se debe al tamaño de la fuente, que puede limitar la lectura en poblaciones especiales. Conclusiones: los anuncios televisivos emitidos en los canales nacionales Caracol y RCN, en un 36,2 %, no cumplen con los requisitos definidos por la normatividad vigente.

Abstract Introduction: Advertising broadcast by mass media is a strategy used by the pharmaceutical sectors to offer their products. For of over-the-counter drugs, this sector is responsible for complying with the regulations related to these products, in order to protect the viewers from negative influences, for possible inaccurate or misleading advertising. Objective: To evaluate regulatory compliance in television advertising of over-the-counter drugs in Colombia in August 2018 on Caracol and RCN national channels. Methods: The recordings of the drug advertisements of two national television channels Caracol and RCN were reviewed. The days 2, 4, 22, 26 of august 2018 were randomly selected. Two independent evaluators reviewed the recordings. The data from the advertisements was analyzed with descriptive statistics. Results: A total of 624 commercials related to over-the-counter drugs were identified: 601 guidelines (96.3%) and 23 commercials (3.7%). Among the 624 advertisements broadcast by both national channels, 226 (36.2%) of 18 drugs did not meet some of the conditions established in the regulations. Discussion: Compared to the work done in 2014, shows that there was an increase in the number of advertisements that do not comply with the norm (from 8% to 36.2%). The main non-compliance situation presented by advertisements is related to the source size since small letters can limit the reading of special populations. Conclusion: 36.2% of the television advertisements broadcast on the national television channels Caracol and RCN do not meet the requirements defined by current regulations.

Effect of whitening mouth rinses on the chemical and physical properties of a nanofilled composite

Aim: This study analyzed the effect of whitening mouth rinses on water sorption (WS), solubility (SL), color change, and surface roughness of a nanofilled composite. Whitening perceptibility and acceptability (WID) were also studied. Methods: Forty specimens of Filtek Z350XT, shade EA2 were produced and randomly distributed (n=8) to AS ­ artificial saliva (control); LWE ­ Listerine Whitening Extreme; CLW ­ Colgate Luminous White; LCM ­ Listerine Cool Mint; and CP ­ Colgate Plax. They were immersed in the mouth rinses 2x/day, for one minute, during 28 days. The color was assessed using an Easyshade spectrophotometer (CIE-L*a*b* system). Surface roughness (Ra-µm) was measured with three parallel measures, using an RP-200 roughness meter. The WS and SL (µg/mm-3) were analyzed based on the ISO 4049 recommendations. The data were analyzed using one- and two-way ANOVA/Tukey tests (α=0.05). Results: Surface roughness significantly increased after immersion in AS and LCM, with no significant differences between the groups either before or after immersion. The ΔE* was not significantly different between the groups. All substances produced a ΔWID higher than the 50%:50% perceptibility and acceptability thresholds. The WS and SL were not significantly affected by the mouth rinses. Conclusion: Whitening mouth rinses did not affect WS, SL, surface roughness, and color stability of a nanofilled composite, regardless of the presence of ethanol in the composition

Automedicação e Saúde Pública: dimensionamento dos fatores de risco e comportamentos de saúde / Self-medication and Public Health: a study of risk factors and health-related behavior

O objetivo deste estudo foi caracterizar a prática da automedicação na população adulta, bem como, investigar os fatores de risco e os comportamentos individuais de saúde.Trata-se de um estudo epidemiológico,transversal, realizado na atenção primária em saúde no Brasil. Como instrumento da coleta foi utilizado um inquérito semiestruturado e dimensionado em blocos temáticos. Para estatística foram empregadas a análise bivariada e regressão logística binomial. Dos 537 entrevistados, 42,83% relataram ter feito uso de medicamentos sem prescrição no período de 15 dias. Verificaram-se associações entre a variável dependente e enxaqueca (OR=3,347); presença de dor atualmente (OR=2,189); uso do medicamento sob influência de familiares (OR=2,431); falta de leitura da bula (OR=1,682) e ausência de atividades de lazer (OR=4,335). Conclui-se que mais da metade dos usuários da atenção primária à saúde no Brasil, fez uso de medicamentos sem a prescrição.

This study characterized and measured self-medication in adult population, as well as identified possible associations between lifestyle and risk factors for the use of over-the-counter medications. This is an epidemiological, cross-sectional study, carried out in the primary health care of a city in Brazil. The data collection instrument was a semi-structured survey grouped into thematic blocks. The statistical analysis included a bivariate analysis and a binomial logistic regression provided the statistics. Of the 537 participants, 42.83% reported having used medication without a prescription in the last 15 days. There were associations between the dependent variable and migraine (OR = 3.347); current pain (OR = 2.189); use of medications under the influence of family members (OR = 2.431); not reading drugs' leaflet (OR = 1.682); and lack of leisure activities (OR = 4.335). A significant part of users of primary health care self-medicated.

Automedicação em pacientes renais crônicos hemodialíticos / Self-medication in chronic kidney disease patients on hemodialysis / Automedicación de pacientes renales crónicos en hemodiálisis

Objetivo: Analisar o uso de medicamentos por automedicação em pacientes renais crônicos hemodialíticos. Métodos: Estudo quantitativo, descritivo e transversal, realizado em um centro de tratamento hemodialítico, na região Sudoeste da Bahia, em março de 2015, por meio da aplicação de formulário contendo variáveis sociodemográficas, clínicas e farmacoterapêuticas de 170 pacientes. A amostra compôs-se de pacientes em tratamento hemodialítico crônico há mais de um ano, com idade maior ou igual a 18 anos. Utilizou-se o Epidata 3.1 como banco de dados. Realizou-se análise descritiva e empregou-se o método de regressão logística binária, usado para avaliar a associação entre automedicação e variáveis independentes, utilizando o programa SPSS, versão 21.0. Resultados: Dos participantes, 64,1% (109) eram homens, com idade média de 50,5 anos (± 14,9); 57% (98) possuíam renda menor que um salário mínimo; 20% (34) nunca estudaram; 48,2% (82) estavam dialisando em período de um a cinco anos e 92,9% (158) não possuíam plano de saúde. Contabilizaram-se 104 medicamentos utilizados por automedicação, com destaque para o calcitriol (9,6%) e a clonidina (6,7%). Verificou-se que pacientes com maior escolaridade (OR=1,32; IC95%=1,32-28,72) e que usam sobra de medicamentos em casa (OR=22,48; IC95%=6,53-77,38) têm mais chances de se automedicar. Conclusão: Há baixa frequência de automedicação na população de renais crônicos investigada, sendo associada ao uso de medicamentos guardados em casa e à baixa escolaridade.

Objective: To analyze self-medication in chronic kidney disease patients on hemodialysis. Methods: A quantitative descriptive cross-sectional study was conducted at a hemodialysis center in Southwestern Bahia in March 2015 using a form to collect sociodemographic, clinical and drug therapy data from 170 patients in March 2015. The sample comprised patients undergoing chronic hemodialysis treatment for over one year aged 18 years or older. Epidata 3.1 was used as a database. Descriptive analysis was performed and binary logistic regression was used to check for associations between self-medication and independent variables using the SPSS software version 21.0. Results: In all, 64.1% (109) of the participants were men and the mean age was 50.5 years (±14.9). 57% (98) of the participants earned less than one minimum wage, 20% (34) had never studied, 48.2% (82) had been on dialysis for one to five years, and 92.9% (158) had no health insurance. We confirmed self-medication of 104 drugs, particularly calcitriol (9.6%) and clonidine (6.7%). Patients with higher levels of education (OR=1.32; 95%CI=1.32-28.72) and those who use leftover drugs at home (OR=22.48; 95%CI=6.53-77.38) were more likely to self-medicate. Conclusion: The rate of self-medication in chronic kidney disease patients is low and it is associated with the use of drugs stored at home and low levels of education.

Objetivo: Analizar el uso de medicamentos por automedicación de pacientes renales crónicos en hemodiálisis. Métodos: Estudio cuantitativo, descriptivo y transversal realizado en un centro de tratamiento de hemodiálisis de la región Sudoeste de Bahía en marzo de 2015 a través de la aplicación de un formulario con variables sociodemográficas, clínicas y de tratamiento farmacológico de 170 pacientes. La muestra ha sido de pacientes en tratamiento de hemodiálisis desde hace más de un año con edad mayor o igual a 18 años. Se utilizó el Epidata 3.1 para el banco de datos. Se realizó un análisis descriptivo y se utilizó el método de regresión logística binaria para evaluar la asociación entre la automedicación y las variables independientes con el programa SPSS, versión 21.0. Resultados: Entre los participantes, el 64,1% (109) era hombres con edad media de 50,5 años (± 14,9); el 57% (98) tenía renta de menos de un sueldo mínimo; el 20% (34) nunca ha estudiado; el 48,2% (82) realizaba la hemodiálisis desde el periodo entre uno y cinco años y el 92,9% (158) no tenía seguro de salud. Se ha contabilizado 104 medicamentos utilizados por la automedicación con énfasis para el calcitriol (9,6%) y la clonidina (6,7%). Se verificó que los pacientes con mayor escolaridad (OR=1,32; IC95%=1,32-28,72) y los que usan lo que queda de los medicamentos que tienen en casa (OR=22,48; IC95%=6,53-77,38) tienen más oportunidades para la automedicación. Conclusión: Hay baja frecuencia de automedicación en la población de renales crónicos investigados y la misma se asoció con el uso de medicamentos almacenados en casa y las personas de baja escolaridad.

In vitro tooth whitening effectiveness of whitening mouth rinses

Regardless of the extensive availability of mouth rinses that claim to whiten teeth, evidence of achievement of such effect is still missing. Aim: Therefore, this study assessed in vitro the whitening effectiveness of whitening mouth rinses. Methods: Sixty intact bovine incisors were embedded in acrylic resin and had their buccal surface flattened and polished. Then, the specimens were randomly allocated to three conventional (Colgate Plax, Cepacol and Listerine Cool Mint) and three whitening mouth rinse groups (Colgate Luminous White, Cepacol Whitening and Listerine Whitening Extreme) (n=10). Following, the specimens were immersed twice a day in the mouth rinses for one minute for 28 days. In between each immersion period, the specimens remained in artificial saliva at 37oC. Color was measured at baseline, 7, 14, 21, and 28 days using a portable spectrophotometer (Easyshade, Vita Zahnfabrik, Germany) with a 6 mm of diameter probe. Color change was analyzed considering the parameters of ∆L*, ∆a*, ∆b* and, ultimately, ∆E*. The whitening efficacy of the mouth rinses was analyzed using the Whiteness Index for Dentistry (WID). Data of ∆s was analyzed using two-way ANOVA and Tukey's test (α=0.05). Results: The type of mouth rinse affected significantly all the ∆ parameters (p<0.05). A non-whitening (conventional) mouth rinse produced the highest ΔE*, followed by the three whitening mouth rinses. The application time also affected ΔE* (p<0.05), with emphasis on the third week of treatment. Only the hydrogen peroxide-containing mouth rinse (Listerine Whitening Extreme) presented a whitening effect, with an increasing trend over time. Conclusion: Although the overall color change was not different when comparing conventional and whitening mouth rinses, the hydrogen peroxide-containing whitening mouth rinse produces an increasing whitening trend over time. Not every mouth rinse that claims to whiten teeth produces the desired effect

Presença de lactose em medicamentos isentos de prescrição / Presence of lactose in nonprescription drugs

Introdução: a polifarmácia e a automedicação estão presentes na população brasileira, sendo frequente sua ocorrência com medicamentos isentos de prescrição. Ademais, a lactose é utilizada como excipiente em formas farmacêuticas sólidas. Objetivo: o presente estudo constitui uma pesquisa sobre lactose, na condição de excipiente, em medicamentos isentos de prescrição (MIPs). Metodologia: em 391 MIPs presentes em cinco formas farmacêuticas sólidas e analisadas por classes, categorias e marcas, foram coletadas, nos meses de abril e maio de 2018, informações quanto à presença de lactose em bulas disponíveis nos sites da Agência Nacional de Vigilância Sanitária e da indústria farmacêutica no Brasil. Resultados: constatou-se que a lactose está presente em 43,48% dos MIPs, sendo mais frequente nos comprimidos e comprimidos revestidos, nas proporções de 42,94% e 36,47%, respectivamente. Ela foi encontrada, predominantemente, em medicamentos similares, principalmente antialérgicos, analgésicos não opioides e anti-inflamatórios não esteroides, bem como na totalidade dos antidiarreicos e laxantes. Das 88 marcas analisadas, 30 apresentaram mais de 50% dos produtos com lactose. Identificou-se um percentual expressivo de medicamentos utilizados no controle dos sintomas de intolerância à lactose que continham esse carboidrato como excipiente. Conclusão: nas formas farmacêuticas analisadas, a presença de lactose nos MIPs é superior a 40%. A lactose presente pode ser agravante de sintomas gastrintestinais. Portanto, é essencial incluir, na embalagem dos medicamentos, a frase de alerta sobre a presença desse açúcar, visando à sua ampla divulgação, particularmente dirigida aos indivíduos com restrição de uso dessa substância.

Introduction: polypharmacy and self-medication are present in Brazilian population, frequently occurring for prescription-free medicines. In addition, lactose is used as an excipient in solid dosage forms of prescription-free medicines. Objective: the present study constitutes a research on lactose, as an excipient, in prescription-free medicines (MIPs). Methodology: in 391 MIPs present in five solid dosage pharmaceutical forms and analyzed by classes, categories and brands, in April and May 2018, information was collected on the presence of lactose in the package inserts available on the websites of the National Sanitary Surveillance Agency and on the pharmaceutical industry websites in Brazil. Results: it was found that lactose is present in 43.48% of the MIPs, being more frequent in tablets and coated tablets, in the proportions of 42.94% and 36.47%, respectively. It has been found predominantly in similar drugs, mainly antiallergics, non-opioid analgesics and non-steroidal anti-inflammatory drugs, as well as in all antidiarrheals and laxatives. Of the 88 brands analyzed, 30 presented over 50% of lactose products. An expressive percentage of drugs used to control the symptoms of lactose intolerance that contained this carbohydrate as an excipient were identified. Conclusion: in the pharmaceutical forms analyzed, the presence of lactose in the MIPs is higher than 40%. The lactose present may be aggravating gastrointestinal symptoms. It is therefore essential to include a warning on the presence of this sugar on the packaging of medicinal products, with a view to their wide dissemination, particularly for those who have a restricted use of that substance.

Comparison of Approval Process for Nonprescription Drugs in Different Countries

Nonprescription drugs have become increasingly important in Korean healthcare. By leveraging lower-cost drugs and reducing expenditure associated with fewer physician visits, the nonprescription segment can deliver tremendous value to individual consumers and the Korean healthcare system. Many countries have provided simpler and more rapid routes to market entry for qualifying nonprescription drug products, using the established data on drug safety and efficacy, as well as public and professional opinion. In US, the FDA waived the pre-approval process for over-the-counter (OTC) drugs marketed through the OTC Monograph Process. In Australia and Canada, different OTC product application levels are defined, with a reduced level of assessment required when the risks to consumers are considered low. Japan established a new OTC evaluation system in 2014 to facilitate the Rx-to-OTC switch process. The legislative framework for medicinal products in the European Union allows for drugs to be approved with reference to appropriate bibliographic data for old active substances with well-established uses. Through a comparison of the regulatory framework and the requirements for nonprescription approval process in different countries, several ways to improve regulatory practice for the evaluation of nonprescription drugs in Korea have been suggested.

Changes in Toxicological Characteristics after Sales of Nonprescription Drugs in Convenience Stores

PURPOSE: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. METHODS: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). RESULTS: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. CONCLUSION: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

Comparative Analysis of Ethical-the-counter Drugs and Over-the-counter Drugs for the Adverse Events from the Community Pharmacy

OBJECTIVE: To compare adverse event reporting patterns between ethical-the-counter and over-the-counter drugs from community pharmacies and outpatient settings. METHODS: We conducted a descriptive study using the adverse event reporting database, wherein data were collected from the regional pharmacovigilance centers of the Korean Pharmaceutical Association between January 1, 2016 and December 31, 2016. The reported drugs were classified into either ethical-the-counter or over-thecounter drugs, and we compared the distribution of patient age and gender, frequent adverse events and medications, serious adverse events, and causality assessment results, where causality assessments were performed according to the World Health Organization-The Uppsala Monitoring Centre's system. RESULTS: We included 17,570 reports (75,451 drug-adverse event pairs). Ethical-the-counter and over-the-counter drugs accounted for 81.4% and 18.6% of the total adverse event reports, respectively. The use of over-the-counter drugs was higher in females and patients aged 65 years. Alimentary tract and metabolism drugs, and respiratory system drugs were the most frequent ethical-the-counter and over-the-counter drugs, respectively. From causality assessment results, “possible” (75.4%) was the most commonly assigned category for ethical-the-counter drugs, while “possible” (44.0%) and “unlikely” (47.7%) were the most common categories for over-the-counter drugs. The distribution of serious adverse events were similar for both ethical-thecounter and over-the-counter drugs. CONCLUSION: Differences were observed in age, gender, reported medications, and symptoms for both ethical-the-counter and over-the-counter drugs. Further pharmacovigilance activities considering the adverse event characteristics of over-the-counter drugs, which are comparable to ethical-the-counter drugs, should be performed.

Estudio Transversal: Prescripción, Consumo y Automedicación de Inhibidores de Bomba de Protones en Pacientes de Atención Primaria del Azuay, 2016 / Cross-Sectional Research: Prescription, Consumption and Self-Medication of Proton Pump Inhibitors in Primary Care Patients from Azuay, 2016

OBJETIVO: El objetivo del presente estudio fue determinar la frecuencia de prescripción, consumo y prevalencia de automedicación de los inhibidores de la bomba de protones en pacientes atendidos en los Centros de Salud de Ludo y Cuchil, pertenecientes al cantón Sigsig ­ Azuay ­ Ecuador, durante el año 2016. MÉTODO: Estudio descriptivo transversal realizado con todos los pacientes quienes a la fecha de la consulta médica se encontraban consumiendo o tuvieron prescripción de inhibidores de la bomba de protones (IBPs). Se estudiaron las características socio-demográficas de la población, fármaco utilizado, indicaciones para su prescripción, prevalencia de automedicación y su relación con el género, edad, escolaridad y auto identificación étnica. RESULTADOS: Se revisaron 4758 pacientes, 228 pacientes ingresaron al estudio (4.79 %). La edad media fue de 48 ±20 años, las mujeres representaron el 73.25 %. El Omeprazol fue utilizado en el 96 % de los casos. La prevención de lesiones por AINES fue la principal indicación para el uso del medicamento. La prevalencia de automedicación fue de 31.58 %, existiendo relación con la edad mayor a 60 años (RP: 4.13; IC-95 %: 2.68-6.38) y la escolaridad primaria o inferior (RP: 4.87; IC-95 %: 2.22-10.68). CONCLUSIÓN: La frecuencia de prescripción y consumo de inhibidores de la bomba de protones fue de alrededor del 5 % de los pacientes estudiados. El Omeprazol fue el IPB de uso más frecuente. Existe una relación de riesgo y asociación entre la edad superior a 60 años y el nivel de escolaridad (primario o inferior) con la frecuencia de automedicación.(au)

OBJECTIVE: To determine the frequency of prescription, consumption and prevalence of self-medication of proton pump inhibitors in patients who attended to Ludo and Cuchil Health Centers during 2016. METHOD: A cross-sectional descriptive study performed with all the patients who were consuming or had a proton pump inhibitors (PPIs) prescription at the time of the medical attention. Socio-demographic characteristics of the population, used drug, prescription indications, self-medication prevalence and its relation with gender, age, schooling and ethnic self-identification were studied. RESULTS: Were reviewed 4758 patients, and 228 patients entered in this study (4.79 %). Average age was 48 ±20 years, 73.25 % of patients were female. Omeprazole was used in 96 % of the cases. Prevention of NSAID lesions was the main indication to use the drug. Self-medication prevalence reached 31.58 % and had a relation with age over 60 years (PR: 4.13; 95 %-CI: 2.68-6.38) and primary or lower scholarship (RP: 4.87; 95 %-CI: 2.22-10.68). CONCLUSION: Frequency of prescription and consumption of PPIs was around 5 % of students patients. Omeprazole was the most used PPI. There is an association and a risk relation between self-medication frequency and age over 60 years and lower scholarship level.(au)

Automedicación y creencias en torno a su práctica en cartagena, colombia / Automedicação e crenças em torno a sua prática em cartagena, colômbia / Self-medication and beliefs around its practice in cartagena, colombia

INTRODUCCIÓN: El uso racional de los medicamentos tiene implicaciones sanitarias de gran importancia, una vez que si se practica la automedicación se generan importantes efectos negativos sobre la salud. Objetivo: Describir las creencias en torno a la práctica de la automedicación entre los habitantes con edades de 20 a 59 años de la localidad 2 de la ciudad de Cartagena, Colombia. MATERIALES Y MÉTODOS: Estudio descriptivo de corte trasversal. La población de estudio fue de 428 personas, a quienes se les aplicó un instrumento, cuya información se analizó mediante estadística descriptiva. RESULTADOS Y DISCUSIÓN: Los encuestados fueron de sexo femenino (58,6%), de 20-29 años de edad (35%), con formación secundaria completa (29,7%), de procedencia urbana (78%), jefes de hogar (50,2%), en unión libre (44,2%). La prevalencia de la automedicación estuvo en 89,7%. La falta de tiempo (28,3%) y la demora en la atención médica (22,7%) fueron las principales razones para hacerlo. La principal influencia proviene de la familia (49,3%). Los encuestados creen que algunos medicamentos son milagrosos y de efecto rápido; es común el uso de hierbas y plantas medicinales. Los medicamentos de mayor consumo fueron los destinados al tratamiento del dolor (95,1%), junto con los antipiréticos (72,4%) y las vitaminas/minerales (53,7%). CONCLUSIONES: La automedicación fue una práctica muy usada y difundida en la población estudiada

INTRODUÇÃO: O uso racional de medicamentos tem implicações sanitárias de grande importância, uma vez que a prática de automedicação gera importantes efeitos negativos sobre a saúde. Objetivo: Descrever as crenças em torno à prática da automedicação entre os habitantes com idades de 20 a 59 anos, da localidade 2, da cidade de Cartagena, Colômbia. MATERIAIS E MÉTODOS: Estudo descritivo de coorte transversal. A população foi de 428 pessoas, foi aplicado um instrumento, cuja informação foi analisada mediante estatística descritiva. RESULTADOS E DISCUSSÃO: Os entrevistados eram do sexo feminino (58.6%), entre 20 e 29 anos de idade (35%), com ensino médio completo (29.7%), proveniente de zona urbana (78%), chefes de família (50.2%), união de facto (44,2%). A prevalência da automedicação foi de 89.7%. A falta de tempo (28.3%) e a demora no atendimento médico (22.7%) foram os principais motivos para o fazerem. A principal influência veio da família (49.3%). Entrevistados acreditam que alguns medicamentos são milagrosos e de efeito rápido; é comum o uso de ervas e plantas medicinais. Os medicamentos de maior consumo foram destinados para o tratamento da dor (95.1%), junto como os antitérmicos (72.4%) e as vitaminas/minerais (53.7%). CONCLUSÕES: A automedicação foi uma prática muito usada e divulgada na população estudada

INTRODUCTION: Rational use of medications has important health implications, thereby, whenever self-medication is practiced, substantially negative health effects are generated. Objective: Herein, we sought to describe beliefs around the self-medication practice among inhabitants from 20 to 59 years of age in locality 2 of the city of Cartagena, Colombia. MATERIALS AND METHODS: This was a descriptive cross-sectional study. The study population involved 428 individuals, who were applied an instrument and whose information was analyzed through descriptive statistics. RESULTS AND DISCUSSION: Of the participants surveyed, 58.6% were females, from 20 to 29 years of age (35%), with complete secondary education (29.7%), from urban background (78%), heads of household (50.2%), in common-law relationship (44.2%). Self-medication prevalence was at 89.7%. Lack of time (28.3%) and delays in medical care (22.7%) were the principal reasons for practicing it. The main influence comes from the family (49.3%). Those surveyed believe that some medications are miraculous and fast acting; the use of herbs and medicinal plants is quite common. The medications of highest consumption were those destined to pain treatment (95.1%), along with antipyretics (72.4%) and vitamins/minerals (53.7%). CONCLUSIONS: Self-medication was a practice widely used and disseminated within the population studied

Hábitos de automedicação de pacientes cirúrgicos: há motivo de preocupação? / Self-medication habits of surgical patients: there cause for concern?

Estudo quantitativo e transversal com objetivo de investigar hábitos de automedicação de pacientes cirúrgicos. A amostra consistiu de 59 pacientes, majoritariamente do sexo feminino, com idade entre 40 e 49 anos, nível de escolaridade e renda familiar baixo. Foi menciondo total de 122 tipos de medicamentos, adquiridos predominantemente por conta própria, para alívio de sintomas álgicos. Relataram desconhecer os efeitos colaterais dos medicamentos utilizados e não terem sido questionados quanto ao hábito de se automedicar. Estas características mostram a necessidade de se implementar estratégias, como a reconciliação medicamentosa, a fim de se promover a segurança do paciente cirúrgico...

A quantitative and cross-sectional study with the objective to investigate habits of self-medication of surgical patients. The sample consisted of 59 patients, mainly female, between the age of 40 and 49 years, with low educational levei and low family income. A total of 122 types of medicines purchased predominately on their own for the relief of pain symptoms were mentioned. These patients reported not knowing Estudo the si de effects of medications and had never been asked about the habit of self-medicating. These characteristics indicate the need to implement strategies, as the medication reconciliation in order to promote the safety of surgical patient...

Este estudio cuantitativo y transversal tuvo como objetivo investigar los hábitos de automedicación de los pacientes quirúrgicos. El estudio tuvo una muestra total de 59 pacientes, en su mayoría mujeres, con edades entre 40 a 49 anos, de nivel escolar y ingreso económico bajo. Fue mencionado un total de 122 medicamentos adquiridos principalmente por cuenta propia de estos, para aliviar los síntomas dei dolor. Manifestaron no conocer los efectos secundarios de los medicamentos utilizados y no les preguntaron sobre el hábito de la automedicación. Estas características demuestran la necesidad de implementar estrategias, como la reconciliación medicamentosa a fin de promover la seguridad de los pacientes quirúrgicos...

Drug therapy for the common cold

The common cold is an acute, self-limiting viral infection of the upper respiratory tract involving the nose, sinuses, pharynx and larynx. Drug therapies for the common cold are normally aimed at relieving the symptoms of the illness. Over-the-counter cough and cold medications should not be used in children younger than four years old because of potential harms and lack of benefit. Antibiotics, antitussives, anti-histamines, and inhaled corticosteroids are not effective in children. Products that may improve symptoms in children include expectorants, mucolytics, honey, vitamin C, zinc lozenges, geranium extract, and nasal saline irrigation. In adults, antihistamines, intranasal corticosteroids, codeine, intranasal ipratopium, and antibiotics are not effective. Decongestants, antihistamine/decongestant combi-nations, expectorants, and mucolytics may improve cold symptoms in adults. Nonsteroidal anti-inflammatory drugs and acetaminophen reduce pain secondary to upper respiratory tract infection in adults. Among complementary and alternative medicinetherapeutics, products containing vitamin C, zinc, or garlic may improve cold symptoms in adults. Prophylactic use of probiotics may decrease the frequency of colds in adults and children.

Condición de venta de analgésicos antiinflamatorios no esteroides, legalmente autorizados para su comercialización en Colombia. Estrategias de uso racional / Condition of sale of non-steroidal anti-inflammatory drugs authorized for marketing in Colombia. Strategy of rational use

La condición de comercialización (venta libre, con fórmula médica, bajo control especial o para uso hospitalario exclusivamente) determina las circunstancias en las cuales puede ser publicitado y comercializado un medicamento. La venta libre no involucra una consulta al equipo de salud, quienes no participan de la selección del medicamento, su dispensación ni seguimiento fármaco-terapéutico. El presente trabajo, mediante un estudio observacional descriptivo de corte transversal desarrollado partiendo del universo de registros sanitarios de medicamentos en Colombia, identifica y describe las variaciones en la condición de venta de analgésicos antiinflamatorios no esteroides. Para este grupo farmacológico, de gran consumo en el país, predominan la modalidad de registro "fabricar y vender", las formas farmacéuticas sólidas no estériles, la condición de venta con fórmula médica y la vía de administración enteral; asimismo, predomina como principio activo el diclofenaco, seguido de ibuprofeno y piroxicam. Ocho de los principios activos de este grupo farmacológico poseen doble condición de venta (venta sin prescripción facultativa o libre y venta con fórmula médica) y alcanzan el 70% de las autorizaciones de comercialización de aines en Colombia. Se evidencia una relación entre la cantidad principio activo por unidad posológica y la condición de venta autorizada, relación que no es evidente con respecto a la indicación.

The commercialization status (otc, under medical prescription, under special monitoring or for hospital use only) sets out the circumstances under which it may be publicized and marketed a drug. The otc does not involve consulting the health team, who do not participate in the selection of the drug, its dispensing or therapeutic monitoring. Present work through an observational, descriptive, cross-sectional study from the universe of Colombian drug approvals, identify and describe the variations in the condition of sale of non-steroidal anti-inflammatory drugs. For this pharmacological group, widely consumed in the country, dominated the modality "make and sell", the non-sterile solid dosage forms, the condition of sale under prescription and the enteric route of administration, likewise predominate as active substance diclofenac, followed by ibuprofen and piroxicam. Eight of the active ingredients of this pharmacological group have double condition of sale (otc and under medical prescription) achieving 70% of marketing authorization for nsaids in Colombia. It is evidenced a relationship between the amount of active substance per dosage unit and the commercialization status, a relationship that is not evident with respect to the indication.

An Opinion Survey on Purchasing Nonprescription Drugs over the Internet in Remote Islands / 医薬品情報学

<b>Objective: </b>The revised Pharmaceutical Affairs Act that came into force in June 2009 prohibits the sale of nonprescription drugs via mail.  However, as a provisional measure, regular users and inhabitants of remote islands who do not have access to pharmacies or drug stores are allowed to purchase nonprescription drugs via mail until the end of May 2013.  This study involves a survey on the purchasing of nonprescription drugs by Internet-illiterate inhabitants of the remote Goto Islands, Nagasaki Prefecture, Japan.<br><b>Methods: </b>Our process began with the distribution of questionnaires via mail to inhabitants of the remote Goto Islands, of whom 3,819 were randomly selected.  The responses were sent between January 22 and February 26, 2011.  We analyzed problems presented by 522 inhabitants who were Internet-illiterate.<br><b>Results: </b>The results revealed that 57.3% of the respondents living on large islands—with pharmacies, drug stores, and pharmacists— (e.g., Fukueshima) and 85.3% of respondents living on small islands scattered around large islands—with none of the abovementioned amenities— (e.g., Maeshima) were Internet-illiterate.  Additionally, a majority of the respondents (more than 80%) felt no need to purchase nonprescription drugs over the Internet.  However, considering that a handful of these inhabitants do, or will at some time need to purchase nonprescription drugs over the Internet, we strive to establish an optimal system for supplying medications to these Internet-illiterate inhabitants.<br><b>Conclusion: </b>Community pharmacists need to establish close relationships with the Internet illiterate (particularly those living on small islands) and promote the overall appropriate use of medicinal products.

Self-medication in health students from two Brazilian universities

Introduction: Self medication is a component of self care and it is considered as primary public health resource in health care system. It can be defined as use of non-prescription medicines by people on their own initiative. Dentists, together with doctors and veterinarians, comprise the professional classes that may and must prescribe medications for their patients. On the other hand, the nursing professionals are the ones who more administer drugs to patients in the ambulatory and hospital. Objective: This study was aimed to find out the frequency of self medication in selected university students, to find out the difference in the proportions of self medication between dentistry and nursing students, as well to evaluate the students' knowledge of harmful effects of self medication and common problems of students that use the self medication. Material and methods: We were applied 209 questionnaires among dentistry students from the 3rd to 8th semesters at the Paulista University/Goiânia and 542 among nursing students from the 3rd to 8th semesters at the Estacio de Sa University of Goiás. Results and conclusion: In the present study was observed a high rate of self-medication among undergraduate students in the health area, particularly among the dentistry and nurse students. The result was alarming because the professional him/herself who should educate patients and dissuade them from this practice is a habitual user; it makes it more difficult to aspire to the future inhibition and reduction of this practice that is so harmful to health.

Use of prescribed and non-prescribed medications among children living in poor areas in the city of Salvador, Bahia State, Brazil / Consumo de medicamentos prescritos e não prescritos entre crianças residentes em áreas pobres de Salvador, Bahia, Brasil

A cross-sectional study of children living in poor areas in the city of Salvador, Bahia State, Brazil, was carried out in 2006 to investigate the prevalence of use of prescribed and non-prescribed medication. This population-based study included 1,382 children aged 4-11 years. The use prescribed and non-prescribed medication during the 15 day period preceding the interview was adopted as the dependent variable. Of the 1,382 children, 663 (48 percent) had used at least one type of medication in the 15 days prior to the interview: in 267 cases (40.3 percent), mothers reported that the child had taken prescribed medication, while in 396 cases (59.7 percent), the child had taken medication that had not been prescribed by a physician. The most commonly prescribed drugs were analgesics (42.3 percent), systemic antibiotics (21.3 percent) and antiasthmatic (16.5 percent). With respect to non-prescribed drugs, the most common were analgesics (65.2 percent), antitussives (15.7 percent) and vitamins (9.3 percent). The results show a high prevalence of the use of non-prescription drugs among poor children, and large drug purchases of drugs by the head of household, highlighting deficiencies in coverage of the health system.

A prevalência de uso de medicamentos prescritos e não prescritos foi investigada por intermédio dum estudo transversal, em crianças que vivem em áreas pobres da cidade de Salvador, Bahia, Brasil, em 2006. Estudo de base populacional que incluiu 1.382 crianças entre 4 e 11 anos de idade. O consumo de medicamentos prescritos e não prescritos nos 15 dias anteriores à entrevista foi considerado a variável dependente. Das 1.382 crianças, 663 (48 por cento) haviam consumido ao menos um medicamento nos últimos 15 dias: 267 (40,3 por cento) referidas pela mãe haviam consumido medicamentos prescritos e 396 (59,7 por cento) consumiram medicamentos não prescritos. Os grupos farmacológicos prescritos mais consumidos foram analgésicos (42,3 por cento), antibacterianos sistêmicos (21,3 por cento) e antiasmáticos (16,5 por cento). Os grupos farmacológicos não prescritos mais consumidos foram analgésicos (65,2 por cento), antitussígenos (15,7 por cento) e vitaminas (9,3 por cento). Os resultados mostram uma alta prevalência do uso de medicamentos sem prescrição em crianças pobres, bem como elevada compra de medicamentos pelas famílias, evidenciando deficiências de cobertura do sistema de saúde.

Uso de medicamentos sem prescrição médica em Teresina, PI / Drugs use without medical prescription in Teresina, PI

Objetivo: Investigar a prevalência de uso de medicamentos sem prescrição na população de Teresina-PI, as motivações de uso e as classes de medicamentos mais utilizadas. Métodos: Estudo transversal com amostra probabilística constituída por 464 adultos, residentes na zona urbana de Teresina-PI. Foram observadas as variáveis sociodemográficas e prática da automedicação. Resultados: A prevalência de automedicação alcançou 92,7%. Os analgésicos foram os medicamentos mais consumidos (63,4%). A principal justificativa para a automedicação foi a experiência anterior com o medicamento. As cólicas abdominais (85,3%), diarreia (76,5%) e cólicas menstruais (74,0%) foram os principais motivos apontados para a prática de automedicação. Conclusão: Foi evidenciada elevada prevalência de automedicação entre os teresinenses. Em concordância ao encontrado em outros estudos populacionais, os analgésicos representam a classe de medicamentos mais utilizada, sendo a dor o principal motivo da automedicação, e a experiência anterior com o medicamento a principal justificativa para a automedicação.

Objective: To investigate the prevalence of drugs use without medical prescription in Teresina, PI, the motivations of use and drugs groups most used. Methods: Cross sectional random sample consisted of 464 adults living in the urban area of Teresina-PI. Sociodemographic variables and self-medication were investigated. Results: The prevalence of self-medication has reached 92.7%. Painkillers were the most frequently consumed drugs (63.4%). The main justification for self-medication was previous experience with the product. Abdominal cramps (85.3%), diarrhea (76.5%) and menstrual cramps (74.0%) were the main reasons cited for the practice of self medication. Conclusion: It was demonstrated of self-medication among Teresina people. In agreement to that found in other studies, analgesics represent a class of drugs most used, with pain being the main motive of self-medication, and previous experience with the drug was the main justification for self-medication.

Publicidad y promoción de medicamentos: regulaciones y grado de acatamiento en cinco países de América Latina / Drug advertising and promotion: regulations and extent of compliance in five Latin American countries

OBJETIVO: Analizar las distintas regulaciones sobre promoción de fármacos y su grado de acatamiento reflejado en piezas publicitarias expuestas al público en Argentina, Colombia, Ecuador, Nicaragua y Perú. MÉTODOS: Se recogieron 683 piezas promocionales expuestas en establecimientos de salud, farmacias y en la vía pública, de las cuales 132 piezas seleccionadas al azar fueron objeto de análisis. Se examinaron las regulaciones sobre publicidad farmacéutica -incluidas sus coincidencias con los criterios éticos de la Organización Mundial de la Salud (OMS)- tomadas de los sitios web oficiales y mediante entrevistas con los responsables de los organismos regulatorios y ministerios de salud de los cinco países del estudio. Se evaluaron los contenidos de los materiales de la muestra para determinar su grado de acatamiento respecto a las regulaciones nacionales y las recomendaciones sobre promoción de medicamentos de la OMS. RESULTADOS: Los países cuentan con regulaciones que incorporan los criterios éticos de la OMS. Más de 80 por ciento de las piezas analizadas incluían las indicaciones del fármaco y más de 70 por ciento omitían información sobre efectos adversos. Cincuenta por ciento de los anuncios de medicamentos de venta libre (MVL) expuestos en farmacias incluían indicaciones no aprobadas por la autoridad sanitaria correspondiente. En los anuncios expuestos en farmacias, no se hallaron diferencias significativas entre los riesgos de la información inadecuada con relación a su condición de venta (MVL o medicamentos de venta con prescripción médica). El riesgo relativo de ausencia de información sobre posología fue de 2,08 (intervalo de confianza de 95 por ciento 1,32-3,39) en las piezas distribuidas en farmacias, comparadas con las expuestas en establecimientos de salud. CONCLUSIONES: Si bien en general los cinco países del estudio incorporan en sus regulaciones sobre promoción y publicidad de medicamentos las recomendaciones de la OMS, con frecuencia dichas ordenanzas no se reflejan en los contenidos de las piezas promocionales.

OBJECTIVE: To analyze differing regulations regarding drug promotion, and the extent of compliance as seen in samples of advertising directed to the public in Argentina, Colombia, Ecuador, Nicaragua, and Peru. METHODS: A total of 683 pieces of promotional material on display in health facilities, pharmacies, and on the street were collected, 132 of which were randomly selected for analysis. The regulations governing pharmaceutical advertising, taken from official websites and interviews with regulatory officials and Ministry of Health staff in the five countries covered, were reviewed, along with their adherence to the ethical criteria of the World Health Organization (WHO). The contents of the materials in the sample were evaluated to determine their degree of compliance with national regulations and WHO recommendations on drug promotion. RESULTS: The countries have regulations incorporating WHO ethical criteria. Over 80 percent of the material analyzed included the indications for the drug, while over 70 percent omitted information on adverse effects. Fifty percent of the advertisements for overthe-counter (OTC) drugs on display in pharmacies listed indications not approved by the relevant health authority. In advertising in pharmacies, the risks from inadequate information were not found to differ significantly for OTC or prescription medications. Compared with materials provided in health facilities, the relative risk of the absence of information on dosage in the material distributed in pharmacies was 2.08 (confidence interval 95 percent 1.32-3.39). CONCLUSIONS: Although regulations on drug promotion and advertising in the five countries studied generally incorporate the WHO recommendations, promotional materials often fail to reflect the fact.