Collective exposure to lead from an approved natural product-derived drug in Korea

BACKGROUND: In Asian countries, including Korea, lead poisoning caused by traditional herbal medicines is often observed in the clinic. However, there have been no reports thus far of lead poisoning caused by drugs that were approved by the Korea Food and Drug Administration (KFDA). Here, we describe seven patients who ingested a problematic natural product-derived drug (NPD). CASE PRESENTATION: In July 2018, seven patients visited a university hospital after ingesting an NPD, S. capsules. These patients complained of various symptoms, and their blood lead levels (BLLs) were elevated relative to those of the general population (arithmetic mean: 19.5 ± 11.6 µg/dL, range: 6.28–35.25 µg/dL). The total doses and BLLs were directly proportional to each other among the patients (r = 0.943, p = 0.001). After the patients discontinued drug intake, their BLLs decreased gradually. The capsule was confirmed to contain lead above the standard value (arithmetic mean: 2,547 ± 1,821.9 ppm). CONCLUSION: This incident highlights the need to strengthen standards for the management of NPD ingredients in Korea. NPDs are more likely to be contaminated than other drugs. Thorough management by the KFDA is essential to prevent a recurrence. Moreover, systematic health care is needed for many patients who have taken problematic NPDs.

La contaminación de medicamentos por el equipo de enfermería / Medicine Contamination by the Nursing Team

RESUMEN Introducción: Dentro de la unidad de salud las principales adversidades relacionadas a la contaminación se direccionan al paciente, existiendo fallas de las técnicas que pueden poner en riesgo la vida de las personas. Objetivo: identificar los principales problemas relacionados a la contaminación de medicamentos por el equipo de enfermería en el ambiente hospitalario. Métodos: Revisión integradora como forma de inclusión de los estudios relevantes sobre el tema en estudio. Las bases de datos seleccionadas fueron SCOPUS, PubMed Central: PMC, Web of Science/ Colección Principal, Scielo, Lilacs y CINAHL (EBSCO). Después de aplicar los criterios propuestos en el estudio, fueron identificados 123 artículos. De estos, solo siete cumplieron los criterios de inclusión y exclusión para el análisis: siendo dos trabajos de SciELO, dos de PubMed, un trabajo de Web of Science, uno de Lilacs y un trabajo de CINAHL. Conclusiones: Los resultados mostraron que la contaminación de medicamentos está relacionada con el equipo de enfermería y el local para la preparación del medicamento. Dentro de los errores encontrados se destacan: la manipulación y la falta de cuidados de asepsia. Estos factores aumentan los riesgos de contaminación y colocan en peligro la seguridad del paciente, lo que hace evidente la necesidad de adoptar las medidas efectivas y continuadas de educación farmacológica para el equipo de enfermería(AU)

ABSTRACT Introduction: Within the health unit, the main adversities associated with contamination affect the patient, and there are flaws in the techniques that can put people's lives at risk. Objective: To identify the main problems associated with the contamination of medicines by the nursing team in the hospital environment. Methods: Integrative review as a way to include relevant studies on the subject under analysis. The selected databases were SCOPUS, PubMed Central: PMC, Web of Science/Main Collection, Scielo, Lilacs, and CINAHL (EBSCO). After applying the criteria proposed in the study, 123 articles were identified, out of which number only seven met the inclusion and exclusion criteria for the analysis: two SciELO papers, two from PubMed, one from Web of Science, one from Lilacs, and one from CINAHL. Conclusions: The results showed that contamination of medications is associated with the nursing team and the local area for the medication preparation. The most representative errors include: manipulation and lack of aseptic care. These factors increase the risk for contamination and put patient safety at risk, which makes evident the need to adopt effective and continuous pharmacological education measures among the nursing team(AU)