ABSTRACT
Introdução: Medicamento manipulado é a preparação farmacêutica obtido por procedimento farmacotécnico a partir de uma prescrição de profissional habilitado destinada a um paciente individualizado ou cuja fórmula esteja inscrita no Formulário Nacional ou Internacional. Objetivo: Descrever o perfil das notificações relacionadas aos medicamentos manipulados, reportadas ao Sistema Nacional de Notificação em Vigilância Sanitária (Notivisa). Método: Estudo exploratório descritivo, retrospectivo ao período de 2006-2016 das notificações de medicamentos manipulados reportadas ao Notivisa. Os dados foram registrados e analisados no programa Excel versão para Windows 3.5.4. Resultados: De um total de 108.400 notificações referentes a medicamentos no período estudado, 335 (0,32%) foram relacionadas a notificações de medicamentos manipulados. As queixas técnicas (QT) obtiveram 90,40% das notificações, enquanto os eventos adversos (EA) obtiveram 9,60%. A Região Sudeste foi a principal notificadora (66,00%) e o estado de São Paulo, responsável por 54,00% do total das notificações. Os hospitais foram as instituições com maior frequência de notificação (81,00%). Foi possível avaliar os motivos que geraram as notificações, das quais as alterações relacionadas ao aspecto da preparação farmacêutica foram as predominantes dentre as QT, enquanto para os EA destacaram-se as reações adversas a medicamentos. Conclusões: As ocorrências observadas na farmacovigilância de medicamentos manipulados são próprias de cada produto com suas particularidades, embora o que se busque seja um padrão. Desta forma, tal observação poderá prevenir a ocorrência de danos à população exposta a situações semelhantes, se for devidamente notificada e amplamente divulgada.
Introduction: Compounded drug is a pharmaceutical preparation obtained by a pharmacotechnical procedure from a prescription of a qualified professional intended for an individualized patient, or whose formula is registered in the National or International Form. Objective: To describe the profile of notifications related to compounded drugs, reported to the National Health Surveillance Notification System (Notivisa). Method: Descriptive exploratory study, retrospective to the period 2006-2016, of the notifications of compounded drugs reported to Notivisa. Data were recorded and analyzed using the Excel program, version for Windows 3.5.4. Results: Of a total of 108,400 notifications referring to medicines in the studied period, 335 (0.32%) were related to reports of compounded drugs. Technical complaints (QT) obtained 90.40% of the notifications, while adverse events (AE) obtained 9.60%. The Southeast region was the main notifier (66.00%), and the state of São Paulo was responsible for 54.00% of the total notifications. Hospitals were the institutions with the highest frequency of notification (81.00%). It was possible to evaluate the reasons that generated the notifications, of which the changes related to the aspect of the pharmaceutical preparation were the predominant among the QT, while for the AEs, the adverse drug reactions stood out. Conclusions: The occurrences observed in the pharmacovigilance of compounded drugs are specific to each product with its particularities, although, what is sought is a pattern. In this way, such observation can prevent the occurrence of damages to the population exposed to similar situations, if it is duly notified and widely disseminated.
ABSTRACT
A lock solution composed of gentamicin sulfate (5 mg/mL) and ethylenediaminetetraacetic acid disodium salt (EDTA-Na2, 30 mg/mL) could fully eradicate in vivo bacterial biofilms in totally implantable venous access ports (TIVAP). In this study, fabrication, conditioning and sterilization processes of antimicrobial lock solution (ALS) were detailed and completed by a stability study. Stability of ALS was conducted for 12 months in vial (25 °C ± 2 °C, 60％ ± 5％ relative humidity (RH), and at 40 °C ± 2 °C, RH 75％ ± 5％) and for 24 h and 72 h in TIVAP (40 °C ± 2 °C, RH 75％ ± 5％). A stability indicating HPLC assay with UV detection for simultaneous quantification of gentamicin sulfate and EDTA-Na2 was developed. ALS was assayed by ion-pairing high performance liquid chromatography (HPLC) needing gentamicin derivatization, EDTA-Na2 metallocomplexation of samples and gradient mobile phase. HPLC methods to separate four gentamicin components and EDTA-Na2 were validated. Efficiency of sterility procedure and conditioning of ALS was confirmed by bacterial endotoxins and sterility tests. Physicochemical stability of ALS was determined by visual inspection, osmolality, pH, and sub-visible particle counting. Results confirmed that the stability of ALS in vials was maintained for 12 months and 24 h and 72 h in TIVAP.