Transtorno do espectro do autismo e o uso materno e paterno de medicamentos, tabaco, álcool e drogas ilícitas / Maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder

Resumo O presente estudo objetivou investigar a associação entre o TEA e o uso materno e paterno de medicamentos, tabaco, álcool e drogas ilícitas. Trata-se de um estudo caso-controle realizado com crianças e adolescentes diagnosticados com TEA e indivíduos neurotípicos. Os dados foram colhidos por meio de entrevista com as mães ou responsáveis. Foram analisadas as variáveis sexo e idade das crianças/adolescentes; idade dos pais; uso de medicamentos antes e durante a gestação; classes de medicamentos usados na gestação; tabagismo materno e paterno; etilismo materno e paterno; uso de drogas ilícitas pelos pais. Para a análise das informações, utilizou-se o modelo de regressão logística, além da razão de chances (OR) bruta e ajustada. Os resultados mostraram que, após os ajustes, foi encontrada associação entre o uso materno na gestação de antitérmicos/analgésicos (OR = 2,26; IC95% 1,29-3,95; p < 0,040) com o TEA. Já o uso de tabaco, álcool e drogas ilícitas materno e paterno, antes e durante a gestação, não apontou relação com o TEA. Os dados encontrados sugerem que existe influência de fatores ambientais no desenvolvimento do TEA.

Abstract The aim of this study was to investigate the association between maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder (ASD). We conducted a case-control study with children and adolescents diagnosed with ASD and neurotypical individuals. The data were collected using a semi-structured questionnaire administered during interviews with the children's mothers or guardians. The following variables were analyzed: child sex and age; maternal and parental age; use of medicines before and during pregnancy; classes of medicines used during pregnancy; maternal and paternal smoking; maternal and paternal drinking; maternal and paternal illicit drug use. The data were analyzed using logistic regression and crude and adjusted odds ratios (OR). After adjustment, the results showed an association between maternal use of antipyretics/pain killers during pregnancy (OR = 2.26; 95%CI 1.29-3.95; p < 0.040) and ASD. No association was found between maternal and paternal smoking, drinking and illicit drug use before and during pregnancy and ASD. The findings suggest that the development of ASD is influenced by environmental factors.

Comparison and enlightenment of anti-infective medicines between WHO model list of essential medicines for children，essential medicine list of WHO and national essential medicine list / 中国药房

OBJECTIVE To provide suggestions and reference for enriching the selection of anti-infective medicines for children in China and promoting the establishment of the Essential Medicine List for Children in China. METHODS Descriptive analysis method was used to statistically compare the differences and similarities of anti-infective medicines included in the World Health Organization Model List of Essential Medicines for Children （EMLc）， World Health Organization Model List of Essential Medicines （EML） and National Essential Medicine List （NEML） in terms of drug category， variety， dosage form， specification， symbol mark， etc. RESULTS All anti-infective medicines of EMLc were covered by EML （85.3%）. NEML lacked the information of anti-infective medicines relatively， and contained few new categories； for example， the third-generation and above cephalosporins in EMLc were not included， and the drug dosage forms were also relatively limited （mainly tablets， capsules and injections）， but the specifications were relatively rich. CONCLUSIONS With reference to EMLc， the guidance on the use of essential medicines for children in China should be added from the aspects of age， body weight， combined medication， etc.， and the dosage forms suitable for children such as oral liquid preparations and scored tablets should be added to NEML； when updating the NEML the newer drugs suitable for children such as cefixime and dacatavir should be included. Finally， with reference to the continuity of EML and EMLc， the Essential Medicine List for Children in China should be established based on NEML to meet the drug needs of children and promote the safe use of drugs in children.

Effects and implications of the COVID-19 pandemic on medicine use by employees of a Brazilian public university: a cross-sectional study

Abstract BACKGROUND: During the COVID-19 pandemic, universities have had to adopt remote education, a strategy that caused sudden changes of routine for everyone involved in academia. OBJECTIVE: To assess the profile of medicine use by the employees of a Brazilian public university during the COVID-19 pandemic. DESIGN AND SETTING: Cross-sectional study at a Brazilian public university. METHODS: Employees were invited to answer an online self-administered questionnaire, containing questions on sociodemographic features, medicine use, mental health and lifestyle habits during the COVID-19 pandemic. The outcome variable was the use of medicines stratified according to occupation. Descriptive, bivariate and multivariate (Poisson regression) statistical analyses were performed. RESULTS: A total of 372 employees participated in the study and use of medicine was reported by 53.2%. Among professors, suicide attempts (prevalence ratio [PR], 1.81; 95% confidence interval [CI], 1.20-2.74), physical activity (PR, 1.53; 95% CI, 1.11-2.11) and poor self-rated health (PR, 1.29; 95% CI, 1.01-1.66); and among technicians, decreased workload during the COVID-19 pandemic (PR, 1.41; 95% CI, 1.00-1.99), excess body weight (PR, 1.39; 95% CI, 1.02-1.88) and poor self-rated health (PR, 1.48; 95% CI, 1.14-1.92) were positively associated with use of medicines. In addition, among technicians, engaging in physical activity (PR, 0.60; 95% CI, 0.46-0.78) was a protective factor against medicine use. CONCLUSION: The profile of medicine use among these employees was similar to that of the Brazilian population. However, some associated factors may have been influenced by the COVID-19 pandemic, thus highlighting the need to examine this topic in a longitudinal study.

Avaliação da prescrição e perfil de utilização de medicamentos antimicrobianos pela rede pública municipal de saúde de Encanto-RN / Evaluation of the prescription and utilization profile of antimicrobial medicines by the municipal public health network of Encanto/RN

Os antimicrobianos são uma classe de medicamentos capaz de inibir ou matar bactérias, fungos e protozoários mediante interações com estruturas dos micro-organismos. A crescente resistência microbiana a esses medicamentos decorrente de seu uso indiscriminado se constitui como um dos problemas de saúde pública mais relevantes da atualidade. Diante disso, o objetivo desta pesquisa foi avaliar a prescrição e o perfil de utilização de antimicrobianos na Farmácia Básica de Encanto/RN. Trata-se de um estudo transversal, quantitativo do tipo descritivo. A coleta de dados foi realizada por meio de questionário aplicado no período de julho de 2018 a janeiro de 2019. Foram entrevistados 100 usuários selecionados com base nos critérios de inclusão e exclusão. Os resultados apontaram a prevalência de pessoas do sexo feminino (70%), casadas ou em união estável (66%), com faixa etária entre 31 e 60 anos (60%). A maioria dos entrevistados tinham baixa escolaridade (45%) e renda familiar de um salário mínimo (41%). Os antimicrobianos dispensados com maior frequência foram amoxicilina (34,6%), ciprofloxacino (25,0%) e azitromicina (22,1%). Com relação às inconformidades das prescrições, 38% apresentaram falta de dados, sendo a mais recorrente a ausência da duração do tratamento. Foram identificadas possíveis interações medicamentosas em 9% das prescrições. Os resultados apresentados evidenciam a importância da atuação do farmacêutico na farmácia comunitária, tanto na sensibilização dos prescritores com relação à escolha e prescrição adequada destes medicamentos quanto na orientação dos pacientes com vistas à promoção do uso racional de antimicrobianos.

Antimicrobials are a class of medications able to inhibit or kill bacterium, fungi, and protozoa through the interactions with the structures of the microorganisms. The growing microbial resistance on these medicines resulting from their indiscriminate use constitutes one of the more relevant public health problems nowadays. In addition, the main point of this research was to evaluate the prescriptions and utilization profile of antimicrobials in the basic pharmacy of Encanto/RN. It is a cross-sectional study, quantitative of the descriptive type. The data collection was realized through a questionnaire applied in July 2018 and January 2019. We interviewed 100 selected people based on inclusion and exclusion. The results show the prevalence of females (70%), married or in a stable union (66%), with an age group between 31 and 60 years old (60%). Most interviewed people had a low education level (45%) and family income (41%). The antimicrobials dispensed most often were amoxicillin (25.0%), ciprofloxacin (25.0%), and azithromycin (22.1%). Regarding the nonconformities of the prescriptions, 38% presents a lack of data, with the absence of the treatment duration being the most recurrent. Possible drug interactions were identified in 9% of the prescriptions. The results presented evidence of the importance of the pharmacist work on the community pharmacy, both in the sensitization of the prescribers concerning the appropriate choice and the prescription of these medicines with the orientation of patients to promote the rational use of antimicrobials.

The impacts of the health policy reform under the national health insurance on medicine use and treatment cost: A study on type-2 diabetic mellitus patients in Jakarta, Indonesia

This study was aimed to assess the impacts of policy reform under the Indonesian National Health Insurance (NHI) program called Jaminan Kesehatan Nasional on medicine use and treatment costs in type 2 diabetes mellitus (T2DM) outpatients. A longitudinal time-series design was conducted retrospectively to observe patient’s treatment and cost data to T2DM outpatients in five hospitals in Jakarta Province. The medicine use and treatment costs were compared before and after the NHI by Wilcoxon test. The 466 patients were included in the analysis. The implementation of the NHI had several impacts on decreasing medicine use indicators such as the average number of medicine prescribed, non-diabetes mellitus (DM) medicines the originator brand and generic products (p < 0.05). The cost of treatment, medicines and DM medicines also decreased (p < 0.05). However the cost of non-DM medicines did not change after the NHI implementation. The proportion of the cost of medicines to the cost of treatment was high; 70% of the cost of treatment was for medicines. In conclusion this study highlights the implementation of NHI had positive impacts on reducing medication usage and treatment costs. The high cost of medicines requires attention to prevent inefficiency in treatment.

Meta-analysis of Therapeutic Efficacy of TCM External Treatment for Alopecia Areata and Investigation on the Regularity of Prescription Selection and Medicine Use / 中国药房

OBJECTIVE:To systematically evaluate the therapeutic efficacy and safety of TCM external treatment for alopecia areata,and to investigate the regularity of prescription selection and medicine use. METHODS:Retrieved from PubMed,EMBase, Cochrane Library,CBM and CNKI,RCTs about TCM external treatment(trial group)vs. routine regimen(control group)in the treatment of alopecia areata were included. The qualities of included studies were evaluated with modified Jadad scale after literature screening and data extraction. Meta-analysis was conducted by using Rev Man 5.3 statistical software. Frequency statistics and ingredient analysis were conduced among included prescriptions. RESULTS:A total of 21 RCTs were included,involving 2 510 patients. Meta-analysis showed that total response rate of trial group was significantly higher than that of control group,with statistical significance [OR=4.14,95%CI(3.04,5.65),P<0.001]. There was no statistical difference in the incidence of ADR between 2 groups [OR=1.66,95%CI(3.04,5.65),P=0.48]. A total of 20 prescriptions among included 21 RCTs were included after the repeated prescriptions were deleted. Above prescriptions were analyzed statistically;there were 53 ingredients in 20 prescriptions,and the sum of use frequency for those ingredients was 138.The ingredients with high use frequency were Carthamus tinctorius,Platycladus orientalis,Salvia miltiorrhiza;main types of medicines were restoring vital energy,relieving exterior disorder,invigorating blood circulation and eliminating stasis,etc. CONCLUSIONS:TCM external treatment shows good therapeutic efficacy and safety. Medicines are mainly used for restoring vital energy,invigorating blood circulation and eliminating stasis.

Research of Transparency Measurement Scale on Medicine Use Information in Primary Health Care Facilities / 医药导报

Objective To develop transparency measurement scale on medicine use information in primary health care facilities. Methods The dimensions and items of scale were determined through literature review and expert consultation. The scale was used to investigate 100 primary health care facilities in eastern, central and western regions. Correlation coefficient analysis, Cronbach's coefficient, and exploratory factor analysis were used to select items. Five dimensions and 20 items were selected for the final scale. Cronbach's coefficient was used to evaluate the reliability of the formal scale. Factor analysis was used for construct validity evaluation. Results Dimensions were measured, including service processes, organization and regulation for pharmacy administration, patients informing and education, medicine catalogue, and the economic burden of patients. The scale had good reliability since overall Cronbach coefficient was 0. 844. Factor analysis extracted five common factors, total explaining 89. 69% of the cumulative variance, and the item distribution in five common factors was completely consistent with formal scale, indicating good construct validity. Conclusion This scale had good reliability and validity as a measurement tool to evaluate the transparency level of primary health care facilities in China.

Crítica al programa de estudio del curso de Promoción de uso racional de medicamentos de la maestría de farmacoepidemiología / Critic to the syllabus of the course Promotion of medicine rational use of the Master’s course in Pharmacoepidemiology

Introducción: la Educación Médica cubana ante la demanda de formar los recursos humanos que la sociedad necesita, precisa de contar con un currículo creativo y flexible. Objetivo: analizar el programa del curso Promoción de uso racional de medicamentos contenido en el programa de la Maestría de Farmacoepidemiología de la Escuela Nacional de Salud Pública. Métodos: se realizó un trabajo en el campo de la educación médica específicamente el diseño curricular, se tomó como unidad de análisis el curso: Promoción de uso racional de medicamentos de la Maestría de Farmacoepidemiología. Se estudió la pertinencia y nexo con el currículo, la ubicación del curso, el proceso enseñanza aprendizaje y la bibliografía. Resultados: el programa analizado tributa al perfil del egresado declarado en la maestría, que está dirigido a formar y brindar los conocimientos, hábitos y habilidades necesarios para dar solución a los principales problemas con los que se enfrenta la atención primaria de salud. Se identificaron áreas de mejora en el diseño de los objetivos y se hicieron propuestas, así como la necesidad de actualización de la bibliografía declarada. Conclusiones: se determinaron los principales problemas en su diseño y se proponen modificaciones del programa con vista a su perfeccionamiento(AU)

Introduction: Cuban medical education facing the demand for training human resources required by the society, need to have a creative and flexible syllabus. Objective: To analyze the syllabus of the course Promotion of medicine rational use of the Master's course in Pharmacoepidemiology of the National School of Public Health. Methods: A work in the field of medical education was carried out specifically regarding syllabus design. The course Promotion of medicine rational use of the Master's course in Pharmacoepidemiology was taken as unit of analysis. Pertinence and link to the syllabus was studies, together with the teaching-learning process and the bibliography. Results: The syllabus analyzed contributes with the graduate's working profile as declared in the master's degree course, directed to training and providing knowledge, habits and skills necessary for giving solution to the main problems faced by primary health care. Improvement areas were indentifies regarding the design of the objectives and proposals were made, together with the update necessity concerning the bibliography declared. Conclusions: The main problems in its design were determined and modifications were proposed to the program for its improvement(AU)

Analysis of the Utilization of TCM Decoction Pieces for Clearing Damp and Promoting Diuresis in Affiliated Hospital of Nanjing University of TCM During 2009-2013 / 中国中医药信息杂志

Objective To know the utilization and development trend of TCM decoction pieces for clearing damp and promoting diuresis in our hospital;To provide references for rational medicine use and purchase in clinic. Methods Excel software was used to analyze the utilization of TCM decoction pieces for clearing damp and promoting diuresis in our hospital during 2009-2013 from the aspects of consumption quantity, consumption sum, and annual average growth. Results The consumption quantity of TCM decoction pieces for clearing damp and promoting diuresis in our hospital increased year by year with average growth rate of 10.58%;the consumption sum increased year by year with average growth rate of 20.21%. The consumption quantity of TCM decoction pieces for inducing diuresis to alleviate edema took the lead among all kinds of medicine, followed by medicine for inducing dampness for treating jaundice, and medicine for inducing diuresis for treating stranguria. Conclusion Both the consumption quantity and the consumption sum of TCM decoction pieces for clearing damp and promoting diuresis in our hospital have been increasing year by year. The proportion of which in total quantity and the consumption sum of TCM decoction pieces and the medicine utilization structure have kept stable, and its usages is rational on the whole.

Introduction of Foreign System of Expired Medicine Recycling and Its Enlightenment for China / 中国药房

OBJECTIVE:To provide reference for the establishment of a system of expired medicine recycling in China. METHODS:The experience of developed countries with respect to the system of expired medicine recycling was summed up,and the existing problems about the recycling of expired medicines in China were considered to make suggestions to the establishment of a system of medicine recycling in China. RESULTS & CONCLUSIONS:Generally,the developed countries such as Britain, France,Germany and America treat expired medicines as hazardous wastes in the Environmental Protection Law,Waste Disposal Law and other laws,and have basically standardized the recycling of expired medicines. The projects of recycling expired medi-cines in those countries are usually funded by their governments or enterprises of manufacturing or selling medicines,where the medicines were recycled at designated places or on a regular basis or by post,executed by pharmacists and pharmacies,and then disposed on the basis of classification or burned and buried at dumps. However,currently there are no laws and regulations and spe-cial funds for medicine recycling in China,leading to people’s lacking of enthusiasm to recycle the expired medicines. It is suggest-ed that China should take such measures as soon as possible,including establishing and improving the laws and regulations of ex-pired medicine recycling,distinguishing the reasonably determination and disposition of different types of expired medicines,accel-erating the reform of the medical insurance payment system,giving full play to the pharmacist’s role of medication guidance,and fully increasing information transparency.

Analysis on Usage Situation of Traditional Chinese Medicine Injections in Our Hospital / 中国中医药信息杂志

Objective To know the usage situation of traditional Chinese medicine (TCM) injections;To improve the level of rational administration of TCM injections.Methods Totally 2686 medical records of inpatients from Aug. 2012 were randomly selected. Patient genders, ages, medication types, dosage and solvent, etc. were analyzed respectively.Results There are 38 varieties of traditional Chinese medicine injections in this survey. There are 22 varieties of traditional Chinese medicine injections involving the unreasonable usage in solvent, a total of 453 times. The total qualified rate was 80.59%. There are 9 varieties of traditional Chinese medicine injections involving the unreasonable dosage. The total qualified rate was 88.77%.Conclusion In order to guarantee the medication safety, the reasonable usage of TCM injections should be strengthened in the clinic, which can be realized by reading package inserts carefully, prescribing through syndrome differentiation.

Investigation Analysis of Pregnancy Contraindication in Specifications of Chinese Patent Medicine in Shunyi Hospital of Beijing Chinese Medicine Hospital / 中国中医药信息杂志

Objective To provide references for clinical rational use of Chinese patent medicine. Methods Totally 387 specifications of Chinese patent medicine in our hospital were analyzed, and were judged by pregnancy contraindication according to China Pharmacopeia (2010 edition). Results The 387 Chinese patent medicines involved 32 prohibited pregnancy ingredients, 1 taboo ingredient. In 89 Chinese patent medicines contraind prohibited ingredients, 33 marked prohibited ingredients, 18 marked contraindicated ingredients, 14 marked cautious ingredients, and 24 marked without-contraindication ingredients. 68 Chinese patent medicines contained pregnancy contraindication labels but without prohibited ingredients. Conclusion A unified standard of pregnancy contraindication should be established;researches on pregnancy contraindication should be strengthened;medicine specifications should be standardized and perfected.

Diagnóstico de los principales antibióticos recomendados para pollo de engorde (broiler) por los centros agropecuarios del municipio de Pasto, Nariño, Colombia / Diagnosis of the Main Antibiotics for Broiler Chicken Recommended by Farming Centers from the Municipality of Pasto, Nariño, Colombia / Diagnóstico dos principais antibióticos recomendados para frango de engorde (broiler) pelos centros agropecuários do município de Pasto, no Departamento de Nariño, na Colômbia

Objetivo: determinar los principales antibióticos recomendados para pollo de engorde (broiler), por los centros agropecuarios del municipio de Pasto, departamento de Nariño, Colombia. Materiales y métodos: la recolección de la información se realizó mediante encuestas dirigidas a las personas encargadas de prescribir medicamentos en los centros agropecuarios. Los datos se analizaron con la ayuda del paquete estadístico Statgraphics plus 5.0. Resultados: solo el 37,65% de los almacenes agropecuarios cuenta con personal capacitado para desempeñar la labor de prescribir medicamentos veterinarios. Los antibióticos son los medicamentos más recomendados en los almacenes agropecuarios (52,94%), entre los cuales se destacan las quinolonas (39,98%), seguidas del grupo inmunológico o vacunas (18,82%), principalmente la vacuna de Newcastle cepa B1 Hitchner (8,24%), el grupo de vitaminas (14,11%), los antiparasitarios (12,94%) y el grupo de los mucorreguladores (1,17%). Conclusiones: la mayoría de los almacenes agropecuarios no cuenta con personal capacitado para la formulación o prescripción de medicamentos. El 51% de estos medicamentos se maneja fuera del rango terapéutico (sobredosis o subdosis). El uso terapéutico más recomendado es para el tratamiento de enfermedades respiratorias y digestivas, y la vía de administración oral es la más común sin realizar ningún tipo de advertencia ni precaución.

Objective: To determine the main antibiotics for broiler chicken, recommended by farming centers from the Municipality of Pasto, Department of Nariño, Colombia. Methods and Materials: The information was gathered through surveys with the people in charge of prescribing medicines in the farming centers. The data was analyzed with the help of the statistical platform Statgraphics Plus 5.0. Results: Only 37.65% of the farming stores have the qualified staff to perform the duty of prescribing veterinary medicine. Antibiotics are the most recommended medicine in farming stores (52.94%), particularly quinolones (39.98%), followed by the immune group or vaccines (18.82%), mainly the Newcastle vaccine strain Hitchner B1 (8.24%), the group of vitamins (14.11%), anti-parasitic (12.94%) and the group of mucus regulators (1.17%). Conclusions: Most of the farming stores do not have the qualified staff for the formulation or prescription of medicine. 51% of these medicines are handled outside the therapeutic range (overdose or underdose). The most recommended therapeutic use is for the treatment of digestive and respiratory diseases, and oral administration of medicine is the most commonly suggested without any kind of warnings or cautions.

Objetivo: determinar os principais antibióticos recomendados para frango de engorde (broiler), pelos centros agropecuários do município de Pasto, departamento de Nariño, na Colômbia. Materiais e métodos: A recolecção da informação se realizou mediante enquetes dirigidas às pessoas encarregadas de prescrever medicamentos nos centros agropecuários. Os dados se analisaram com a ajuda do pacote estatístico Statgraphics plus 5.0. Resultados: só o 37,65% das lojas agropecuárias ou agrícolas conta com pessoal capacitado para desempenhar o trabalho de prescrever medicamentos veterinários. Os antibióticos são os medicamentos mais recomendados nas lojas agropecuárias (52,94%), entre os quais se destacam as quinolonas (39,98%), seguidas do grupo imunológico ou vacunas (18,82%), principalmente a vacina de Newcastle cepa B1 Hitchner (8,24%), o grupo de vitaminas (14,11%), os antiparasitários (12,94%) e o grupo dos muco-reguladores (1,17%). Conclusões: a maioria das lojas agropecuárias não conta com pessoal capacitado para a formulação ou prescrição de medicamentos. O 51% destes medicamentos se maneja fora do rango terapêutico (overdose ou escassez de dose). O uso terapêutico mais recomendado é para o tratamento de doenças respiratórias e digestivas, e a via de administração oral é a mais comum sem realizar nenhum tipo de advertência nem precaução.

Use of Antimicrobial Medicines among University Students in Sierra Leone.

Aims: Misuse of antimicrobial medicines is a major contributory factor to development of resistant strains of micro-organisms, therapeutic failure and increased healthcare costs in many countries. To identify pattern of antimicrobial use among undergraduate students of the University of Sierra Leone and to determine possible gaps in their understanding of appropriate use of these therapeutic agents. Study Design: A cross-sectional survey of the students using a structured questionnaire and a stratified random sampling method to obtain the respective number of students from each college. Place and Duration of Study: Registered undergraduates in the three Colleges of the University of Sierra Leone, between March and June 2012. Methodology: A 25-item structured questionnaire was administered on a random sample of four hundred and eighteen (418) undergraduates of the University. The instrument explored respondents’ pattern of self-medication with antimicrobials, knowledge of the indications for use and sources of supply. Results: Most students reported having self-medicated with antimicrobials at various times and there were gaps in their understanding of the medicines; with about 67% having some knowledge of correct indications for use. Majority of them (70%) obtained the medicines on demand from open drug markets without prescriptions and the medicines were used for such ailments as common colds and diarrhea. Previous experiences of treating similar symptoms ranked highest as the factor affecting demand and penicillins topped the list of commonly used antimicrobials. Most of the students did not complete full regimen of the medication for reasons of cost, long duration of treatment and side effects. Conclusion: There were knowledge gaps in the proper use of antimicrobial medicines and unrestricted access to prescription drugs was a major factor of misuse. The existing drug laws in the country should be strengthened to control indiscriminate sale and distribution. Basic courses on rational medicine use may need to be incorporated in the general studies programme of the University; with emphasis on the consequences of indiscriminate use of antimicrobial medicines.

Evaluation and Analysis of Unreasonable Medicine Use：132 Inpatient Prescriptions of Traditional Chinese Medicine Injections / 中国中医药信息杂志

Objective To review and analyze unreasonable medicine use of TCM injections in inpatient prescriptions in our hospital; To provide reference for reasonable clinical medicine use. Methods According to instructions and requirements in “basic principles for TCM injections in clinical use”, 132 cases (01. 2013-05. 2013) of TCM injections following the doctors’ advice in the hospital were reviewed and analyzed. Results Problems in unreasonable medicine use of TCM injections mainly concentrated in incompatibility, unsuitable solvent, and unsuitable indications, etc. Conclusion TCM injections in clinical use in the hospital showed some cases containing unreasonable medicine use. Therefore, effective intervention should be taken to regulate medicine use and promote TCM injections in clinical application, in order to make it safer, more reasonable, and more effective and reduce the occurrence of adverse reactions.

Challenges faced by visually disabled people in use of medicines, self-adopted coping strategies and medicine-related mishaps.

Background: Difficulties faced by visually disabled people when using medicines, self-adopted coping strategies, and medicine-related mishaps have been under-explored locally and internationally. The objective of this study was to gain insight regarding this long-neglected issue. Methods: A descriptive cross-sectional study, using an interviewer administered questionnaire on 63 visually disabled adults was carried out at a vocational training centre and a school for visually disabled students in Sri Lanka. Results: Among 63 participants, 71% wanted to be independent in medicine use and 79% in spite of difficulties had self-administered medicines. They had difficulty in locating medicines (25.39%), identifying medicines and medicine containers (17.46%), and administering liquid medications (25.39%). These difficulties led to inaccurate dosing (14.28%), missed doses (39.68%), and discontinuation of treatment prematurely (28.57%). Self-adopted coping strategies to overcome these difficulties included using different sized and shaped containers, tying medicines to the attire, and dipping their finger into a measuring cup while measuring liquid medicines. Mishaps related to medicines such as taking vinegar instead of gripe mixture and, putting ear drops into eyes were disclosed. Conclusions: There were many challenges for visually disabled people in taking medicines and some self-adopted coping strategies were inadequate to overcome these.

Prescription Audit and the Compliance of Medicines Prescribed in Pregnant Women.

Proper use of medicines can be ensured in the society through various ways. Scientific and rational prescription is one of them, but at the same time judicious use of medicines by the patients is also equally important. Compliance of therapy can determine fate of any medicine. This study was planned to explore some important aspects of use of medicines in pregnant women in remote villages of India. This was an observational, cross sectional study using face to face interview of the pregnant ladies and also auditing the prescriptions available from them. Present study revealed that the average age of the study population was 23.6 years and primi-gravida (51.4%) constituted slight majority over multi-gravida. Most commonly prescribed medicine during pregnancy was iron, folic acid (79%) and injection tetanus toxoid (91%). A large number of pregnant women (37.5%) were non compliant with the medicine prescribed for them. In modern therapeutics, drugs or medicines play an important role in the health of any individual. But at the same time its proper use should be ensured. This study showed the importance of use of medicines by the patient. Judicious use of scarce resources on medicines not only improves the quality of therapy but also the quality of life.

Prescrição médica: orientações adequadas para o uso de medicamentos? / Medical prescriptions: adequate orientation to medicine use?

O conhecimento insuficiente de informação dada ao paciente durante a consulta médica resulta em grandes dificuldades para a condução correta da terapêutica medicamentosa. Baseados nesse contexto, o estudo teve como objetivo avaliar o grau de conhecimento dos pacientes sobre os medicamentos prescritos na Atenção Básica no município de Esperança (PB). Para tal, foram entrevistadas 199 pessoas que, após consulta médica, receberam prescrição, tendo sido avaliado o nível de conhecimento desses pacientes em relação ao nome do medicamento, a dose, o horário, a finalidade, o tempo de uso e reações desagradáveis. Entre os entrevistados, 53,8 por cento evidenciaram desconhecer o nome do medicamento, 20,3 por cento a dosagem e 25,4 por cento o horário de utilização. O item em que se observou maior frequência de acerto foi finalidade do medicamento, tendo 75,1 por cento dos pacientes apresentado bom conhecimento. No que se refere ao tempo de uso e às reações desagradáveis, 57,4 por cento e 94,4 por cento dos pacientes, respectivamente, não possuíam nenhuma informação correta. Os resultados sugerem que a maioria dos pacientes não apresenta o conhecimento adequado e seguro para a utilização dos medicamentos prescritos.

During physician's consultation, the lack of adequate information on medication to the patient is a major problem to reach the correct pharmacotherapy. This study aims at assessing the patient knowledge about prescribed drugs. In order to proceed the investigation, interviews were performed about type of medication, dosage, administration schedule, purpose, duration of treatment and side effects. From 199 patients interviewed after they had received a prescription, 53.8 percent didn't have any information about the medicine, 20.3 percent didn't know the dosage and 25.4 percent didn't know the medication schedule. The purpose of the medication was the information with the highest percentage of correct answers, with 75.1 percent of the patients showing good level of knowledge. Regarding to the duration of the treatment and side effects, 57.4 percent and 94.4 percent of the patients, respectively, didn't present any correct information. Results suggest that the majority of the patients didn't have sufficient and safe knowledge to the use of prescribed medication.

Uso racional de medicamentos: la automedicación como consecuencia de la publicidad / Rational drug use: self-medication as a result of advertising

El gasto en productos farmacéuticos viene creciendo de forma notable en todo el mundo y se estima que es una tendencia que va en aumento. La publicidad se dirige, cada vez más, a la incitación del consumo de drogas de venta libre; generando expectativas poco realistas sobre los beneficios de la medicación y una demanda inapropiada de ésta. Un problema difícil de abordar y solucionar. Pacientes, profesionales de la salud y obras sociales debemos trabajar en conjunto para implementar medidas con el fin de maximizar un aspecto positivo de la publicidad, aumentar el uso de los medicamentos de los que más se beneficiarían probablemente, y a la vez minimizar las preocupaciones sobre la seguridad y los gastos innecesarios en usos inapropiados

The cost in pharmaceutical products comes anywhere in the world growing from remarkable form and esteem that is a tendency that increases. The publicity goes, more and more, to the incitación of the drug consumption of free sale; generating realistic expectations little on the benefits of the medication and one it demands unsuitable of this one. A problem difficult to approach and to solve. Patients, social professionals of the health and works we must work altogether to implement measures with the purpose of maximizing a positive aspect of the Publicity, increasing the use of the medicines from which they would benefit more probably, and simultaneously to diminish risks

Disponibilidad y uso de medicamentos antimaláricos en Bolivia / Availability and use of drugs im Bolivia antimaláricos

Pregunta de investigación ¿Como es la disponibilidad y el uso de los antimaláricos en Bolivia? Objetivos. Evaluar la disponibilidad y uso de los medicamentos antimaláricos en zonas endémicas de malaria de acuerdo a las normas nacionales. Métodos. Siguiendo los indicadores pre diseñados del manual de gestión farmaceutica de la malaria del management for Sciencies health (MSH). fue evaluada la disponibilidad de los antimaláricos revisando registros 2004-2005 de 21 establecimientos de salud de nivel I y II además de 4 almacenes regionales de los departamentos de Beni, Pando y Tarija y uno del nivel central (La Paz). Para evaluar el uso de los antimaláricos se utilizó la misma herramienta revisando 780 casos de malaria de los registros de tratamiento de pacientes con malaria no complicada atendidos durante el mismo periodo, tambien se observaron 156 atenciones a pacientes con malaria no complicada, habiendose entrevistado a 146 de ellos (93 por ciento) inmediatamente despues de recibir el tratamiento, asi como tambien se realizaron compras de antimaláricos en 28 farmacias privadas de los mismos departamentos. Resultados. El 76 por ciento (5/21) de los establecimientos evaluados no tienen registro de entrada y salida de medicamentos, la disponibilidad de medicamentos antimaláricos para malaria por P. vivax es del 100 por ciento, malaria no complicada por P.falciparum 53 por ciento, malaria y embarazo por P. falciparum 3 por ciento y malaria grave por P. falciparum 0 por ciento en los establecimientos de salud mientras que en los almacenes evaluados es el 90 por ciento, 25 por ciento, 25 por ciento y 38 por ciento respectivamente. los almacenes con mayor tiempo de desabastecimiento (365 días) fueron el de Riberalta y Guayaramerin para el artesunato,clindamicina y biclorhidrato ...

Research question How is it the availability and the use of antimalarial drugs in Bolivia?Objective Evaluate the availability and the use of antimalarial drugs in endemic areas of malaria according to the national norms.METHODS Following the indicator pre-designed in the manual of pharmaceutical management of the malaria of the Management for Sciences Health, the availability of the antimalarial drugs was evaluated revising the registers 2004-2005 of 21 health’s establishments level I and II and 4 regional depots of the Departments of Beni, Pando y Tarija. To...