Automedicación y autoprescripción / Self-medication and self-prescription

Resumen La automedicación y la autoprescripción son acciones de los pacientes; la primera como elemento del autocuidado que involucra medicamentos de venta libre y la segunda como una violación a la ley de salud, pues comprende medicamentos que solo pueden expenderse con receta. Todos los inconvenientes que se han atribuido a la automedicación en realidad lo son de la autoprescripción.

Abstract Self-medication and self-prescription are actions undertaken by patients; the former, as an element of self-care that involves over-the-counter drugs, and the latter, as a violation of the Statute of Health, since it includes drugs that can only be dispensed with a medical prescription. All the drawbacks that have been attributed to self-medication are actually associated with self-prescription.

Automedicación en estudiantes de la Sede Neiva de la Universidad Cooperativa de Colombia / Self-medication in the students from Neiva Campus of the Universidad Cooperativa de Colombia

RESUMEN La automedicación es una práctica riesgosa cuyas consecuencias incluyen enmascaramiento de una enfermedad, aparición de reacciones adversas, interacciones medicamentosas, aumento de la resistencia a ciertos tipos de fármacos y fármaco dependencia. La Organización Mundial de la Salud contempla la posibilidad de educar a la población en prácticas de automedicación responsable, señalando al profesional farmacéutico como figura clave de este proceso educativo. El presente trabajo analiza las conductas de automedicación en una población encuestada de 600 estudiantes de la Universidad Cooperativa de Colombia Campus Neiva. Los resultados de la encuesta han sido analizados en forma global y diferenciando a los encuestados en subgrupos de: a) programa académico y b) variables sociodemográficas. Los resultados indican que la automedicación es una práctica común en estudiantes de la Universidad Cooperativa de Colombia Campus Neiva que no siempre se lleva a cabo de acuerdo con las recomendaciones de la OMS para poder considerarse una práctica responsable y segura.

SUMMARY Self-medication is a dangerous practice with consequences including masking of disease, adverse reactions to medications, drug interaction, resistance to certain types of therapeutic agents and drug dependence. The World Health Organization has considered the possibility of educating population in practices of responsible self-medication, pointing at the pharmacist as a key figure in this educational process. In the present work we have analyzed the self-medication conducts of 600 surveyed college students of the Universidad Cooperativa de Colombia Sede Neiva (UCC). The overall results of the survey have been analyzed; we have also divided the surveyed population in subgroups of: a) Academic program and b) Sociodemographic variables. Results indicate that self-medication is a common practice among college students of UCC, and that it is not always practiced according to WHO recommendations for responsible, safe self-medication.

El proceso de enfermar de los médicos y sus consecuencias en el profesionalismo / The process of physicians falling ill and consequences for their professionalism / O processo de adoecimento dos médicos e as suas consequências acerca do profissionalismo

Resumen: La idiosincrasia de la profesión médica, los rasgos de personalidad característicos del médico y la falta de formación específica para reconocer y tratar adecuadamente la propia vulnerabilidad, predisponen a este colectivo a padecer más patología mental y, probablemente, un deficiente tratamiento de otras enfermedades. La mayoría de los estudios realizados hasta el momento se centran en la patología mental y adictiva del médico, desde el punto de vista del riesgo para la mala praxis y la seguridad de sus pacientes. La revisión narrativa de la literatura científica realizada (MEDLINE, EMBASE e IME 1985-2016) ha mostrado que, en el entorno hispanoparlante, apenas disponemos de información actualizada sobre el médico como paciente, a pesar de ser un tema de indudable relevancia desde el punto de vista de la seguridad asistencial, del profesionalismo y del propio bienestar de los profesionales. La situación del médico que enferma es compleja y poco conocida, con conflicto de roles y con repercusiones en la ética profesional y la calidad asistencial.

Abstract: The idiosyncrasy of the medical profession, the characteristic personality traits of the physician and the lack of specific training to properly recognize and treat one's own vulnerability dispose this group to suffer more mental pathology and probably worse control of other medical diseases. Most of the studies promoted so far focus on the psychiatric and addictive concerns of the physician, from the point of view of the sick doctor as being at risk for malpractice and to guarantee the safety of their patients. The narrative review of scientific literature (MEDLINE, EMBASE and IME 1985-2016) has shown that we do not have in the Spanish-speaking environment updated information about the doctor as a patient, despite being a topic of incipient media repercussion and undoubtedly relevant from the point of view of patient safety, professionalism and medical ethics and as well as the welfare of professionals. The characteristic of a sick doctor are more complex than the rest of patients with a conflict of roles and repercussions on professional ethics and the quality of care.

Resumo: A idiossincrasia da profissão médica, as características de personalidade característica do médico e a falta de formação específica para reconhecer e, corretamente, tratar a própria vulnerabilidade, predispõem esse grupo a sofrer mais patologias mentais, e provavelmente tratamento deficiente de outras doenças. A maioria dos estudos realizados até agora tem como foco a patologia mental e o comportamento aditivo do médico, do ponto de vista do risco por negligência e segurança de seus pacientes. A revisão narrativa da literatura científica realizada (MEDLINE, EMBASE e IME 1985-2016) tem mostrado que no ambiente de idioma hispânico temos apenas informações atualizadas sobre o médico como paciente, apesar de ser uma questão de relevância inquestionável do ponto de vista da segurança assistencial, do profissionalismo e do próprio bem-estar dos profissionais. A situação do médico enfermo é complexa e pouco conhecida, com conflito de papéis e impacto sobre a ética profissional e a qualidade dos cuidados médicos. São necessários mais estudos, tanto quantitativos como qualitativos, que permitam compreender o processo do adoecimento dos médicos em cada um dos seus estágios profissionais (desde a graduação até a aposentadoria) para ser capaz de considerar estratégias para a melhoria na atenção da saúde desses profissionais.

The clinical effect and the preventive analysis of complications on the application of self- prescription soup for eliminating haemorrhoids after patients with moderate or severe hemorrhoids received surgery / 中国医学装备

Objective:To analyze the clinical effect and the preventive analysis of complications on the application of self-prescription soup for eliminating haemorrhoids after patients with moderate or severe hemorrhoids accepted surgery.Methods: 44 patients with moderate and severe hemorrhoids who once accepted operative treatment were divided into observation group and control group as random number table. The patients of control group received the treatment of hip bath by using potassium permanganate tablets, while the patients of observation group received the treatment of hip bath with fuming and washing by using self-prescription soup for eliminating haemorrhoids. The clinically curative effect, postoperative complication, pain, bleeding, edema, disappearance time of anal pendant expansion and healing time of wound between the two groups were compared and analyzed.Results: The total effective rate (100%) of the observation group was significantly better than that (77.27%)of the control group (x2=5.641,P<0.05). The cases of complication including pain, bleeding, constipation, infection, urinary retention and anal stenosis of observation group were significantly less than that of control group (t=7.333,t=15.655,t=5.500, t=4.247,t=8.193,t=5.500,P<0.05). Besides, the times of pain, bleeding, edema, disappearance of anal pendant expansion and wound healing of observation group were significantly, respectively, less than that of control group (t=3.171, t=5.864,t=4.263,t=6.219, t=10.803,P<0.05).Conclusion: The curative effect of self-prescription soup for eliminating haemorrhoids after patient with moderate or severe hemorrhoids accept surgery is significant, and it can effectively prevent and treat various complication.

Clinical Observation of Self-prescribed Zuoyu No. 2 in the Treatment of Anal Eczema after Complex Anal Fistula Operation / 中国药师

Objective:To observe the clinical effect of self-prescribed Zuoyu No. 2 (ZY2) in the treatment of anal eczema after complex anal fistula operation. Methods: Totally 100 patients were randomly divided into two groups, the patients in the treatment group were given ZY2 combined with the conventional wound dressing treatment after defecation everyday, while the patients in the con-trol group were treated with washing infection area with warm water followed by applying triamcinolone acetonide and econazole creams on the lesion or itching skin combined with the conventional wound dressing after defecation everyday. Results:The efficiency rate in the treatment group was higher than that in the control group (82. 0% vs 60. 0%, P<0. 05), the total effective rate in the treatment group was also significantly higher than that in the control group (100% vs 90. 0%, P<0. 05). The anal pruritus disappearance time and the skin lesion recovery time in the treatment group were better than those in the control group(P<0. 05). Conclusion:ZY2 has a good clinical curative efficacy in the treatment of anal eczema after complex anal fistula operation with improvement of clinical symp-toms, which is worthy of promoted application.

La automedicación de antibióticos: un problema de salud pública / Automédication with antibiotics: public health problem

Objetivo: Indagar sobre el consumo de antibióticos sin prescripción médica en la población adulta bogotana. Materiales y métodos: Se realizó un estudio observacional descriptivo transversal en las 20 localidades de Bogotá. La información se obtuvo de 597 personas mayores de 20 años, encuestadas mediante un instrumento previamente ajustado en una prueba piloto. Resultados: El 56,1 % de los encuestados manifestó que se automedicaba; las mujeres (60 %) son las que más recurren a esta práctica. El antibiótico más utilizado es la amoxicilina (50,9 %), seguido por la ampicilina (18,6 %). Los motivos más comunes de automedicación son: infecciones de la garganta (31,7 %), gripa (22,2 %), fiebre y malestar general (10,8 %). El tratamiento es realizado entre uno y dos días. Conclusiones: En la población muestreada se pudo observar que los antibióticos están siendo usados de forma indiscriminada e indebida por parte de algunos sectores de la población bogotana, sin medir los riesgos potenciales de esta práctica.

Objective: To explore the consumption of antibiotics without medical prescription in Bogota's adult population. Material and methods: Descriptive exploratory cross-sectional study carried out in 20 locations of Bogotá, where 597 people older than 20 years were surveyed. Results: We found that 56.10% of respondents self-medicated, being women (60%), those who come to this practice. The antibiotic most used was the amoxicillin (50.9%), followed by the ampicillin (18.6%). The most commonly described pathologies were throat infections (31.70%), flu (22.20%), fever and malaise (10.80%), and urinary tract infections (7.50%). Most people take antibiotics (50.0%) for one and two days. 82.60% consumed more than the indicated dosage of antibiotic. Only 13.20% of those surveyed said they demanded was made to sell the drug. Conclusions: Self-prescription of antibiotics is a common practice for various pathological processes or symptoms, and often people resort to informal channels to obtain information about them and drugstores where they are sold without requesting a formal medical prescription.

Polifarmacia en los adultos mayores / Polypharmacy in the older adults

Se realizó un estudio descriptivo de corte transversal con 118 senescentes de la población de adultos mayores del consultorio del Médico de la Familia 80.1 del Policlínico "Ana Betancourt", en el municipio Playa. A todos se les llenó una encuesta formulario que contemplaba sus datos generales, así como las enfermedades crónicas y los trastornos de los órganos de los sentidos que padecía. Se enumeraron los medicamentos que ingieren, con la dosis y periodicidad, tanto los prescritos como los autoprescritos, y se consignaron las reacciones adversas atribuidas a los fármacos consumidos. Se revisaron los controles de dispensarización y sus historias clínicas individuales.La prevalencia de polifarmacia detectada fue de 46 casos (39 %). El total de preparados prescritos fue de 303, con un promedio de 3,1 por paciente, la cifra de autoprescripciones fue 49 casos (41 %) con 113 fármacos, y un promedio de preparados autorrecetados por anciano de 2,3, siendo los fármacos más indicados por los facultativos los hipotensores, los diuréticos, los psicofármacos, los analgésicos y los antidiabéticos; y entre los autorrecetados se encontraban las vitaminas, los analgésicos, los laxantes, los antihistamínicos y los psicofármacos. Las reacciones adversas se presentaron en 36 casos (37,2 %), señalándose que todas fueron ligeras y atribuidas a fármacos prescritos por los facultativos.

A descriptive cross-sectional study was conducted among 118 senescents from the population of older adults of the family physician office 80.1 of "Ana Betancourt" Polyclinic, in Playa municipality. All of them answered a questionnaire to collect their general data, as well as information about the chronic diseases and disorders of the sense organs they suffered from. The drugs they were taking, both prescribed and self-prescribed, with their doses and periodicity were related, and the adverse reactions attributed to the drugs consumed were also exposed. The classification registries and the individual medical histories were reviewed. The prevelance of polypharmacy detected was of 46 cases (39 %), The total of preparations prescribed was of 303 for an average of 3.1 per patient. The figure of self-prescriptions was of 49 cases (41 %) with 113 drugs and an average of self-prescribed preparations by aged person of 2.3. The drugs prescribed the most by the physicians were the lowering pressure drugs, diuretics, psychotropic drugs, analgesics and antidiabetes drugs. The most self-prescribed drugs were vitamins, analgesics, antihistamines and psychotropic drugs. The adverse reactions were observed in 36 cases (37.2 %). They were mild and attributed to drugs prescribed by the physicians.