Hábitos de prescripción y conocimientos sobre analgésicos opioides en profesionales de la Pediatría / Prescription habits and knowledge of opioid analgesics in Pediatric Health Professionals

Introducción: El dolor es uno de los síntomas que más sufrimiento produce en cualquier enfermedad y constituye un problema básico de salud en todo el mundo, con frecuencia infra tratado, sobre todo en el área de la Pediatría, con especial déficit en la prescripción de analgésicos opioides. Objetivo: Caracterizar los conocimientos sobre analgésicos opioides y su prescripción por profesionales de la Pediatría. Material y Métodos: Se aplicó un cuestionario construido ad hoc y validado por el método Delphi, a 43 profesionales de la pediatría de tres Hospitales de la provincia La Habana durante el periodo comprendido entre marzo 2017 a marzo 2018. Resultados: Los conocimientos sobre Farmacología de los analgésicos opioides fueron insuficientes en un 81,3 por ciento, regular en un 13 por ciento y buenos en el 5,7 por ciento. Las barreras en la prescripción de opioides más frecuentes fueron el temor a la depresión respiratoria (71,9 por ciento), la escasez de opioides en el Cuadro Básico de Medicamentos (56,3 por ciento) y el temor a la dependencia (36,3 por ciento). Se prescriben opioides sólo en el 39,5 por ciento de los casos, la codeína y el tramadol son los más frecuentemente prescritos. En el 55,8 por ciento de los participantes la formación y superación en analgesia fue insuficiente, en el 28 por ciento regular y solo en el 16,2 por ciento se consideró buena. Conclusiones: Los conocimientos farmacológicos deficientes relativos a los opioides y la baja disponibilidad de estos fármacos son los factores que más influyen en el manejo deficiente del dolor en Pediatría(AU)

Introduction: Pain is one of the symptoms that causes more suffering in any disease. It also constitutes a basic health problem all over the world, which is frequently under-diagnosed mostly in the area of Pediatrics with a special deficit in the prescription of opioid analgesics. Objective: To characterize the knowledge of opioid analgesics and their prescription made by pediatric health professionals. Material and Method: An ad hoc questionnaire, which was validated by the Delphi Method, was applied to 43 pediatricians of three Hospitals in Havana province from March 2017 to March 2018. Results: The knowledge of the pharmacology of opioid analgesics was insufficient in 81.3 percent, regular in 13 percent, and good in 5,7 percent. The most frequent barriers in the prescription of opioids were the fear to respiratory depression (71,9 percent), scarcity of opioids in the Basic Drugs Chart (56,3 percent), and the fear to addiction (36,3 percent). Opioids are prescribed only in 39,5 percent of the cases, being codeine and tramadol the ones that are more frequently prescribed. In 55.8 percent of the inquired cases, the formation and updating in analgesia was insufficient, in 28 percent it was fairly good, and only in 16.2 percent it was considered good. Conclusions: The insufficient pharmacologic knowledge of opioids and the poor availability of these drugs are the factors that most influence on the inadequate management of pain in Pediatrics in our study(AU)

Conhecimento da equipe de enfermagem acerca de eventos adversos do tratamento quimioterápico / Knowledge of a nursing team about chemotherapy adverse effects

Este estudo teve como objetivo identificar o conhecimento dos profissionais da equipe de enfermagem acerca dos eventos adversos decorrentes do tratamento quimioterápico. Estudo descritivo e transversal realizado entre março e maio de 2013 com 28 profissionais da equipe de enfermagem que trabalham no Ambulatório, na Unidade de Internação e na Central de Quimioterapia de um hospital universitário. Para a coleta dos dados foi utilizado um instrumento elaborado pelas autoras e validado por enfermeiras especialistas na área. Entre os participantes, 82,1% não possuem nenhum tipo de especialização na área de oncologia. As profissionais apresentaram dificuldades em classificar os eventos adversos em relação ao tempo de aparecimento, bem como ao manejo dos mesmos. Os eventos adversos relatados coincidem com os mais evidenciados na prática clínica. Diante da complexidade do tratamento quimioterápico, torna-se indiscutível a necessidade de capacitação dos profissionais de saúde que atuam na área quando consideramos uma prática assistencial em oncologia de qualidade.

This study aimed to identify the knowledge of the professional nursing team about the adverse events resulting from chemotherapy treatment. Descriptive cross-sectional study conducted between March and May 2013 with 28 professional nursing team working at the outpatient clinic, the inpatient unit and Chemotherapy Center of a university hospital. To collected data were used an instrument developed by the authors and validated by expertise nurses in this area. Among the participants, 82,1 % did not have any expertise in the area ofoncology. The professionals had difficulties in classifying adverse events in relation to time of onset, and their management. Reported adverse events coincide with the most evident in clinical practice. Given the complexity of chemotherapy becomes the indisputable need for training of health professionals working in the area when considering a care in oncology quality.

Aspectos a tener en cuenta en la atención integral de enfermería durante la quimioterapia en pediatría: issues to consider in nursing comprehensive care / Chemotherapy in children: issues to consider in nursing comprehensive care

La manipulación de fármacos citostáticos constituye una de las actividades más frecuentes de los profesionales de enfermería por la amplia administración de estos medicamentos en nuestros días. En la actualidad, en el mundo se han ido desarrollando estrategias para el manejo seguro de estos fármacos. El perfeccionamiento de la enfermería en Cuba ha permitido un gran avance en la especialidad y un real aporte al diagnóstico, tratamiento y monitoreo de las enfermedades hematológicas, por el elevado nivel profesional alcanzado por el personal de enfermería dentro de la especialidad. Se exponen las recomendaciones generales para la atención integral de enfermería que todo niño con leucemia debe recibir, esté hospitalizado o reciba atención ambulatoria. Se abordan los elementos fundamentales del manejo de los citostáticos y los elementos para garantizar la bioseguridad en el trabajo con estos medicamentos

The handling ofcytostatic drugsis one ofthe most frequent activitiesofnursesfor the extensiveadministration of these drugs nowadays.Today,strategies have been developed throughout the world forsafe handling ofantineoplasic agents. The developmentof nursing inCubahas alloweda breakthroughin the art anda real contributionto the diagnosis, treatment and monitoringofhematologicaldiseases, due to the highprofessional levelreachedby nurseswithin the specialty. General recommendations forcomprehensivenursing care every child withleukemiashould receive are described, whether hospitalizedor in outpatient care. Basic handling of cytostaticsand elementsto guarantee biosecurity when working withthese medications are included

An Overview of Pharmacotherapy-Induced Ototoxicity

This article provides an overview of ototoxic medication; as well as different pharmacological and audiological monitoring strategies. Although ototoxic medications play an important role in modern medicine; they also have the capacity to do great harm and lead to significant morbidity. Physicians have to be aware of the potential effects of medication in order to identify patients who are at increased risk of developing ototoxicity. Precaution should be taken to prevent any auditory impairment that might occur through appropriate administration and monitoring. Although some otoprotective substances have been used successfully in certain studies; further trials must be performed to assess their clinical utility. The clinical pharmacist and audiologist form an important part of the ototoxicity management healthcare team