Construção e validação de ferramenta preventiva sobre incompatibilidade medicamentosa em via Y / Construction and validation of a preventive tool on drug incompatibility in the Y-route / Construcción y validación de una herramienta preventiva de incompatibilidad de medicamentos en la ruta Y

Introdução: A terapia com medicamentos endovenosos é muito utilizada nas unidades hospitalares, porém, possui uma elevada chance de incidentes, principalmente quando os medicamentos são administrados simultaneamente em via Y. Essa prática pode resultar em incompatibilidades medicamentosas classificadas em reações físicas e químicas. Objetivo: Construir e validar uma ferramenta preventiva de incompatibilidade medicamentosa em via Y. Método: Estudo metodológico com abordagem quantitativa. Foi desenvolvido em três etapas: Levantamento bibliográfico, construção e diagramação do material e por fim, a validação da ferramenta preventiva. Para validação, a ferramenta preventiva foi submetida ao processo de validação de face e conteúdo por juízes com expertise na temática. Resultados: Construiu-se e validou-se uma ferramenta preventiva através da busca de dados na literatura com a participação de sete juízes especialistas na temática. Os itens avaliativos referentes a tabela de incompatibilidade medicamentosa quanto aos objetivos, estrutura, apresentação e relevância da ferramenta preventiva foi considerada válida, pois foram julgados como adequado pelos especialistas. Conclusão: A validação de conteúdo, foi considerada válida pelos juízes, portanto, espera-se que o material alcance o seu objetivo ao ser aplicado durante a prática clínica. Dessa forma, será disponibilizado à instituição para que seja utilizado, favorecendo a prevenção de danos e contribuindo para a segurança dos pacientes, bem como melhorando a qualidade da assistência e educação em saúde.

Introduction: Intravenous drug therapy is widely used in hospital units, however, it has a high chance of incidents, especially when drugs are administered simultaneously in a Y route. This practice can result in drug incompatibilities classified into physical and chemical reactions. Objective: To build and validate a preventive tool for drug incompatibility in the Y pathway. Method: Methodological study with a quantitative approach. It was developed in three stages: bibliographic survey, construction and layout of the material and finally, the validation of the preventive tool. For validation, the preventive tool was submitted to the face and content validation process by judges with expertise in the subject. Results: A preventive tool was built and validated through the search for data in the literature with the participation of seven expert judges on the subject. The evaluative items referring to the medication incompatibility table regarding the objectives, structure, presentation and relevance of the preventive tool were considered valid, as they were judged as adequate by the specialists. Conclusion: The content validation was considered valid by the judges, therefore, it is expected that the material reaches its objective when applied during clinical practice. In this way, it will be made available to the institution for use, favoring the prevention of damage and contributing to patient safety, as well as improving the quality of health care and education.

Introducción: La farmacoterapia intravenosa es ampliamente utilizada en las unidades hospitalarias, sin embargo, tiene una alta probabilidad de incidencias, especialmente cuando los fármacos se administran simultáneamente en una vía Y. Esta práctica puede dar lugar a incompatibilidades medicamentosas clasificadas en reacciones físicas y químicas. Objetivo: Construir y validar una herramienta preventiva de incompatibilidad de medicamentos en la vía Y. Método: Estudio metodológico con enfoque cuantitativo. Se desarrolló en tres etapas: relevamiento bibliográfico, construcción y diagramación del material y finalmente, la validación de la herramienta preventiva. Para la validación, la herramienta preventiva fue sometida al proceso de validación facial y de contenido por jueces expertos en el tema. Resultados: Se construyó y validó una herramienta preventiva a través de la búsqueda de datos en la literatura con la participación de siete jueces expertos en el tema. Los ítems evaluativos referentes a la tabla de incompatibilidad de medicamentos en relación a los objetivos, estructura, presentación y relevancia de la herramienta preventiva fueron considerados válidos, pues fueron juzgados como adecuados por los especialistas. Conclusiones: La validación del contenido fue considerada válida por los jueces, por lo tanto, se espera que el material alcance su objetivo al ser aplicado durante la práctica clínica. De esta forma, se pondrá a disposición de la institución para su uso, favoreciendo la prevención de daños y contribuyendo a la seguridad del paciente, además de mejorar la calidad de la atención y educación en salud.

Anti-Snake Venom Properties of Medicinal Plants: A Comprehensive Systematic Review of Literature

Abstract Snakebite is one of the major health issues posing considerable morbidity and mortality. According to an estimate of World Health Organization (WHO) (World health organization, 2021) approximately 5 million people are bitten by several species of snakes resulting in up to 2.5 million envenomation cases annually. The mainstay of treatment for envenomation is intravenous administration of anti-snake venom. Although antivenom neutralizes the systemic effects but it does not relieve the symptoms such as venom-induced hemorrhage, necrosis and nephrotoxicity. Moreover, the use of antivenoms is associated with hypersensitivity reactions including urticaria, anaphylaxis, or serum sickness due to their heterologous property. Furthermore, stringent storage conditions and narrow specificity of antivenoms limit their use in both developed as well as developing countries. In this context, researchers have been searching for natural products and plant extracts to explore their antivenom activity along with anti-myotoxic, anti-hemorrhagic and anti-inflammatory properties. Plant remedies may prove to be an effective alternate for antivenom sera with less adverse events and better tolerability. To the best of our knowledge, this is the first comprehensive review of medicinal plants possessing anti-snake venom activities against certain species of snakes. The current review highlights the investigated plants with their phytochemical analysis to integrate the available information for future research and development of antivenom sera.

An attempt to enhance solubility of metoclopramide base by Solid dispersion strategy and its application on development of Transdermal device

Chemotherapy induced nausea and vomiting (CINV) is an issue, which usually occurs in cancer patient. Despite high bioavailability of oral and intravenous administration, these have some drawbacks. The oral route causes hepatic first pass metabolism and intravenous route is invasive in nature. Hence, antiemetic drug by means of transdermal route is necessary to administer in such cases. The aim of the present investigation is to develop suitable Transdermal Therapeutic System (TTS) with an objective to enhance solubility and skin permeability properties of metoclopramide base. Preformulation study begins with an approach to enhance solubility of 40 metoclopramide base by solid dispersion technique. transdermal films were prepared with 41 the solid dispersion as well as with pure drug. Phase solubility study at various temperatures reveals binding constants (Ka, 95-350 M-1 for PVP K30; 56-81 M-1 for HPßCD). Spontaneity of solubilization was justified by AL type linear profiles. The films showed satisfactory diffusion (%), permeation rate and flux after 8 h study. The transdermal patches as prepared were analyzed under FTIR, DSC and SEM. Both solubility and permeability rate in this investigation have been enhanced. So, it can be affirmed that this route would effectively enhance bioavailability

Acute hypotensive and diuretic activities of Berberis vulgaris root bark aqueous extract in normal rats

The aim of this study is to investigate the effectiveness of intravenous administration of Berberis vulgaris root bark aqueous extract (BRBD) on the cardiovascular and renal functions of healthy normotensive rats. The different doses of BRBD 1, 10 and 20 mg/kg were administered intravenously (i.v) in normal rats. Blood pressure, diuretic activity and serum renal profile were analyzed. Intravenous injection of BRBD at the different doses of 1, 10 and 20 mg/kg showed a dose-dependent reduction in mean arterial blood pressure (P<0.001). At different doses of 1, 10 and 20 mg/kg, the hypotensive effect remained for more than one hour. Single dose administration of BRBD at doses of 10 and 20 mg/kg caused a significant increase in urine output (P<0.001) as compared to the control rats. Serum renal profile test (albumin, Urea, Uric Acid, creatinine and BUN) did not show any significant alteration. The authors conclude that the BRBD is a potent hypotensive and possesses diuretic potential

Effect of intraoperative intravenous lidocaine on pain and plasma interleukin-6 in patients undergoing hysterectomy / Efeito da lidocaína venosa intraoperatória sobre dor e interleucina-6 plasmática em pacientes submetidas a histerectomia / Efecto de la lidocaína venosa intraoperatoria sobre el dolor e interleucina-6 plasmática en pacientes sometidas a histerectomía

BACKGROUND AND OBJECTIVES: Interleukin-6 is a predictor of trauma severity. The purpose of this study was to evaluate the effect of intravenous lidocaine on pain severity and plasma interleukin-6 after hysterectomy. METHOD: A prospective, randomized, comparative, double-blind study with 40 patients, aged 18-60 years. G1 received lidocaine (2 mg kg-1 h-1) or G2 received 0.9% saline solution during the operation. Anesthesia was induced with O2/isoflurane. Pain severity (T0: awake and 6, 12, 18 and 24 h), first analgesic request, and dose of morphine in 24 h were evaluated. Interleukin-6 was measured before starting surgery (T0), 5 h after the start (T5), and 24 h after the end of surgery (T24). RESULTS: There was no difference in pain severity between groups. There was a decrease in pain severity between T0 and other measurement times in G1. Time to first supplementation was greater in G2 (76.0 ± 104.4 min) than in G1 (26.7 ± 23.3 min). There was no difference in supplemental dose of morphine between G1 (23.5 ± 12.6 mg) and G2 (18.7 ± 11.3 mg). There were increased concentrations of IL-6 in both groups from T0 to T5 and T24. There was no difference in IL-6 dosage between groups. Lidocaine concentration was 856.5 ± 364.1 ng mL-1 in T5 and 30.1 ± 14.2 ng mL-1 in T24. CONCLUSION: Intravenous lidocaine (2 mg kg-1 h-1) did not reduce pain severity and plasma levels of IL-6 in patients undergoing abdominal hysterectomy. .

JUSTIFICATIVA E OBJETIVOS: A interleucina-6 (IL-6) é preditora de intensidade no trauma. O objetivo deste estudo foi avaliar o efeito da lidocaína por via venosa sobre a intensidade da dor e IL-6 após histerectomia. MÉTODO: O estudo foi prospectivo, randomizado, comparativo e duplo-encoberto em 40 pacientes, entre 18 e 60 anos. Foi administrada lidocaína (2 mg.kg-1.h-1) no G1 ou solução salina a 0,9% no G2 durante a operação. A anestesia foi com O2/isoflurano. Foi avaliada a intensidade da dor (T0: despertar e seis, 12, 18 e 24 horas), a primeira solicitação de analgésico, a dose de morfina nas 24 horas. A IL-6 foi medida antes do início da operação (T0), após cinco horas do início (T5) e 24 horas após o término (T24). RESULTADOS: Não houve diferença na intensidade da dor entre os grupos. Ocorreu diminuição da intensidade da dor entre T0 e os outros momentos avaliados no G1. O tempo para primeira complementação foi maior no G2 (76,0 ± 104,4 min) do que no G1 (26,7 ± 23,3 min). Não houve diferença na dose de morfina complementar entre G1 (23,5 ± 12,6 mg) e G2 (18,7 ± 11,3 mg). Houve aumento das concentrações de IL-6 em ambos os grupos de T0 para T5 e T24. Não houve diferença na dosagem de IL-6 entre os grupos. A concentração de lidocaína foi 856,5 ± 364,1 ng.mL-1 em T5 e 30,1 ± 14,2 ng.mL-1 em T24. CONCLUSÃO: A lidocaína (2 mg.kg-1.h-1) por via venosa não promoveu redução da intensidade da dor e dos níveis plasmáticos de IL-6 em pacientes submetidas a histerectomia abdominal. .

JUSTIFICACIÓN Y OBJETIVOS: La interleucina-6 (IL-6) es predictora de intensidad en el trauma. El objetivo de este estudio fue evaluar el efecto de la lidocaína por vía venosa sobre la intensidad del dolor e IL-6 después de la histerectomía. MÉTODO: El estudio fue prospectivo, aleatorizado, comparativo y doble ciego en 40 pacientes, entre 18 y 60 años. Fue administrada lidocaína (2 mg/kg-1.h-1) en el G1 o solución salina al 0,9% en el G2 durante la operación. La anestesia fue con O2/isoflurano. Se calculó la intensidad del dolor (T0: despertar y 6, 12, 18 y 24 h), la primera solicitud de analgésico, y la dosis de morfina en las primeras 24 h. La IL-6 se midió antes del inicio de la operación (T0), después de 5 h del inicio (T5) y 24 h después de finalizada (T24). RESULTADOS: No hubo diferencia en la intensidad del dolor entre los grupos. Hubo disminución de la intensidad del dolor entre T0 y los otros momentos evaluados en el G1. El tiempo para la primera complementación fue mayor en el G2 (76 ± 104,4 min) que en el G1 (26,7 ± 23,3 min). No hubo diferencia en las dosis de morfina complementaria entre G1 (23,5 ± 12,6 mg) y G2 (18,7 ± 11,3 mg). Hubo aumento en las concentraciones de IL-6 en los 2 grupos de T0 para T5 y T24. No hubo diferencia en la dosificación de IL-6 entre los grupos. La concentración de lidocaína fue 856,5 ± 364,1 ng/ml-1 en T5 y 30,1 ± 14,2 ng/ml-1 en T24. CONCLUSIÓN: La lidocaína (2 mg/kg-1 /h-1) por vía venosa no generó reducción de la intensidad del dolor y de los niveles plasmáticos de IL-6 en pacientes sometidas a histerectomía abdominal. .