Análise da automedicação pediátrica em pacientes atendidos em hospital de alta complexidade / Analysis of pediatric self-medication in patients treated at a highcomplexity hospital

A automedicação pediátrica ocorre quando pais ou responsáveis usam medicamentos sem prescrição para tratar doenças ou sintomas reconhecidos nas crianças. Analisar o perfil da automedicação pediátrica em um hospital de alta complexidade no interior do Ceará. Trata-se de um estudo transversal baseado na técnica de entrevista, realizado com 135 pais/responsáveis de crianças com idade entre 0 a 12 anos que procuraram atendimento hospitalar entre novembro de 2020 e março de 2021. Observou-se uma prevalência de automedicação de 60%. Quanto à frequência, 43,2% dos entrevistados relataram realizar às vezes. Destes, a maioria era: mãe (94,3%; p<0,0001), com 17 a 27 anos (48,6%; p<0,0001) e renda familiar de menos de 1 salário mínimo (57,1%; p=0,020); 59,3% apontaram como motivo considerar o problema de saúde simples. A principal causa da automedicação foi a febre e os medicamentos mais utilizados foram analgésicos e antipiréticos. A predominância da automedicação pediátrica pelas mães deve-se à experiência com seus outros filhos. Além disso, as condições socioeconômicas influenciaram as práticas errôneas da automedicação, pois as famílias que não possuem recursos para a consulta e compra dos fármacos acabam optando pela autoadministração. O uso indiscriminado de medicações deve ser reprimido, pois, a depender da dose, consequências graves podem ocorrer às crianças. Destaca-se a importância da equipe multiprofissional de saúde durante uma consulta pediátrica, com médicos, enfermeiros e farmacêuticos repassando aos pais informações a respeito dos medicamentos, seus benefícios e riscos, desestimulando a prática nesta faixa populacional e reduzindo os erros de medicação.

Pediatric self-medication occurs when parents or guardians use over-the-counter medications to treat recognized illnesses or symptoms in children. To analyze the profile of pediatric self-medication in a high-complexity hospital in the interior of Ceará. This is a cross-sectional study based on the interview technique, carried out with 135 parents/guardians of children aged 0 to 12 years old who sought hospital care between November 2020 and March 2021. There was a prevalence of self-medication of 60%. As for frequency, 43.2% of respondents reported doing it sometimes. Of these, the majority were: mothers (94.3%; p<0.0001); aged 17 to 27 years old (48.6%; p<0.0001); family income of less than 1 minimum wage (57.1 %; p=0.020); and 59.3% indicated that their reason for medicating was that they considered the health problem as simple. The main cause of self-medication was fever, and the most used drugs were analgesics and antipyretics. The predominance of pediatric self-medication by mothers is due to their experience with their other children. In addition, socioeconomic conditions influenced the erroneous practices of self-medication, as families that do not have the resources to consult and purchase drugs end up opting for self-administration. The indiscriminate use of medications must be repressed, because, depending on the dose, serious consequences can occur to children. The importance of a multidisciplinary health team during a pediatric consultation is highlighted, with doctors, nurses, and pharmacists providing parents with information about medication, their benefits and risks, discouraging the practice in this population group and reducing medication errors.

Prevalence of the Consumption of Tranquilizers without a Medical Prescription and Associated Factors in School-Based Adolescents in Colombia / Prevalencia del consumo de tranquilizantes sin prescripción médica y factores asociados en adolescentes escolarizados de Colombia / Prevalência do uso de tranquilizantes sem prescrição médica e fatores associados em adolescentes em idade escolar na Colômbia

Introduction: Non-prescription tranquilizers are a specific group of benzodiazepines, used as drugs that act on the central nervous system and have an extensive effect in patients with anxiety disorders and problems in sleep stages. Objective: To determine the prevalence of the year and month of consumption of tranquilizers without a medical prescription and the associated factors, in adolescents in school in Colombia. Methods: It is a cross-sec-tional study with an analytical scope. The universe of the study consisted of 3,243,377 students, from grades 7 to 11 (aged between 12 and 18 years), the valid surveys were 80,018. The adolescent who declared having used tranquilizers during the last 30 days and the last 12 months was considered a consumer. All variables were self-re-ported by adolescents. Results: The prevalence of tranquilizer use without medical prescription was 1.02% and 1.97% (month and year, respectively). Adolescents who presented disciplinary problems are the most predisposed to use during the last month with an OR 2.79 (95% CI: 2.20­3.53) and last year an OR of 2.77 (95 % CI: 2.34­3.27). Conclusions: There is a higher prevalence of the consumption of tranquilizers without medical prescription in women between 14 and 17 years of age, from mixed schools and it is associated with academic and disciplinary performance problems, in the last year. In addition, as age increases, the consumption of substances without a medical prescription increases

Introducción: Los tranquilizantes sin prescripción médica son un grupo específico de benzodiacepinas, usados como medicamentos que actúan sobre el sistema nervioso central y cuentan con un extenso efecto en pacientes con trastornos de ansiedad y problemas en las etapas del sueño. Objetivo: Determinar la prevalencia de año y mes de consumo de tranquilizantes sin prescripción médica y los factores asociados en adolescentes escolarizados de Colombia. Métodos: Estudio transversal con alcance analítico. El universo del estudio estuvo constituido por 3 243 377 estudiantes de los gados 7.º a 11.º (con edades entre 12 y 18 años). Las encuestas válidas fueron 80 018. Se consideró consumidor al adolescente que declaró haber consumido tranquilizantes durante los últimos 30 días y los últimos 12 meses. Todas las variables fueron autorreportadas por los adolescentes. Resultados: La prevalencia de consumo de tranquilizantes sin prescripción médica fue del 1,02 % y del 1,97 % (mes y año, respectivamente). Los adolescentes que presentaron problemas disciplinarios son los más predispuestos al consumo durante el último mes con un OR de 2,79 (IC95 %: 2,20-3,53) y último año un OR de 2,77 (IC95 %: 2,34-3,27). Conclusiones: Existe mayor prevalencia de consumo de tranquilizantes sin prescripción médica en mujeres entre los 14 y los 17 años, de colegios mixtos, y se encuentra asociada con problemas de rendimiento académico y disciplinarios, en el último año. Además, a medida que aumenta la edad, se incrementa el consumo de sustancias sin prescripción médica

Introdução: Os tranquilizantes isentos de prescrição são um grupo específico de benzodiazepínicos, usados como medicamentos que atuam no sistema nervoso central e têm um efeito extenso em pa-cientes com transtornos de ansiedade e problemas no estágio do sono. Objetivo: Determinar a prevalência anual e mensal do uso de tranquilizantes sem prescrição médica e os fatores associados em adolescentes em idade escolar na Colômbia. Métodos: Estudo transversal com escopo analítico. O universo do estudo consistiu em 3243377 alunos da 7ª à 11ª série (com idades entre 12 e 18 anos). Foram realizadas 80018 pesquisas válidas. Um adolescente foi considerado usuário, o qual relatou ter usado tranquilizantes nos últimos 30 dias e nos últimos 12 meses. Todas as variáveis foram autorrelatadas pelos adolescentes. Resultados: A prevalência do uso de tranquilizantes sem prescrição médica foi de 1,02% e 1,97% (mês e ano, respectivamente). Os adolescentes com problemas disciplinares apresentaram maior pro-babilidade de uso no último mês, com um OR de 2,79 (IC95%: 2,20-3,53) e no último ano, com um OR de 2,77 (IC95%: 2,34-3,27). Conclusões: Há uma maior prevalência de uso de tranquilizantes sem prescrição médica em mulheres de 14 a 17 anos, de escolas mistas, e isso está associado a problemas de desempenho acadêmico e disciplinar no último ano. Além disso, com o aumento da idade, aumenta o uso de substâncias sem prescrição médica.

A self-medicating scale and questionnaire based drug use survey and the effect of educational intervention among healthcare professional students

Background: Due to an array of reasons like easy accessibility and awareness about the available drugs, self-medication has steeply increased the already existent drug misuse. As the health professional students are exposed to all the information of drugs, it would be worthwhile to survey if this knowledge is misused to self-medicate. The present study was aimed at determining the impact of educational intervention on the prevalent attitudes and pattern of self-medication among medical, dental and nursing students as they constitute a vulnerable group for such practices.Methods: A total of 360 health professional students participated in the study. A validated questionnaire and self-medication scale (SMS) were used for the survey, before and after the educational workshop.Results: Of the 360 students 70% were females. 93.89% reported practicing self-medication, which reduced to 78.63% after the educational workshops. Average number of self-medication encounters before the workshop was 4.03±0.30. Analgesics were most commonly used. The modified SMS scores were significantly reduced (p<0.0001) after interventional workshops indicating that the enhanced knowledge, increased the reluctance to self-medicate and make students think twice before self-medicating so as to reduce such harmful, casual drug use habits. Educational workshops statistically (p<0.0001) enhanced the participants knowledge of ADRs, OTC drugs, expiry date, package inserts etc. 77.78% nursing students were habituated to at least one drug which was significantly higher (?2=20.45, p<0.0001) than that of medical and dental students taken together.Conclusions: Educational intervention reduces the evil of self-medication and enhances safe drug use habits among healthcare professional students.

Misuse of pharmaceuticals by regular psychostimulant users is linked to mental health problems / El uso indebido de psicofármacos entre los usuarios regulares de psicoestimulantes está relacionado con problemas de salud mental

Abstract: Introduction: Misuse of pharmaceutical drugs, particularly by young people, is an issue of rising concern. Poly-substance use is common among regular psychostimulant users (RPU), and mental health problems are associated with pharmaceutical misuse, but RPU do not generally acknowledge their use as problematic. Objective: To examine links between mental health and misuse of non-prescription pharmaceuticals in a group of regular users of illicit psychostimulants. Method: Face to face structured interviews were conducted in April 2015 with 763 regular users of illicit psychostimulants as part of the Annual Ecstasy and Related Drugs Reporting System study in Australia. Results: At least half of the RPU in this study reported extra-medical or misuse of pharmaceuticals in the last six months in addition to regular use of illicit psychostimulants. Higher levels of psychological distress were recorded for RPU who also reported recent illicit use of opioids, antidepressants, benzodiazepines, or over-the-counter (OTC) codeine. Recent misuse of benzodiazepines or OTC codeine was associated with self-reported mental health problems and having attended a mental health professional. Those reporting recent misuse of opioids were at increased risk of mental health problems and more likely to record high levels of psychological distress, but less likely to have received prescription medications for their mental health problem. Discussion and conclusion: Regular users of illicit psychostimulants who also misuse pharmaceuticals are at increased risk of mental health problems, even after accounting for their use of illicit psychostimulants. Screening of this group for mental health problems is recommended.

Resumen: Introducción: El uso indebido de psicofármacos, particularmente entre los jóvenes, es un tema de creciente preocupación. El policonsumo de sustancias es común entre los usuarios regulares de psicoestimulantes (URP), y, pese a que hay problemas de salud mental asociados con el uso indebido de medicamentos, los URP generalmente no reconocen su consumo como problemático. Objetivo: Examinar las relaciones entre la salud mental y el uso indebido de psicofármacos no prescritos en un grupo de URP. Método: Se realizaron entrevistas cara a cara con 763 URP como parte del Estudio Anual del Sistema de Reporte de Éxtasis y Drogas Relacionadas en Australia. Resultados: Al menos la mitad de los URP en este estudio informaron el uso extramédico o indebido de psicofármacos en los últimos seis meses, además del uso regular de psicoestimulantes ilícitos. Se hallaron niveles más altos de distrés psicológico para los URP, quienes también informaron de un uso ilícito reciente de codeína, opiáceos, antidepresivos o benzodiazepinas sin prescripción médica. El uso indebido reciente de codeína o benzodiazepinas sin prescripción se asoció a problemas autorreportados de salud mental y a asistencia a consulta con un profesional de salud mental. Aquellos que informaron el uso indebido reciente de opioides mostraron mayor riesgo de problemas de salud mental y mayor probabilidad de registrar altos niveles de distrés psicológico, pero menor probabilidad de haber recibido psicofármacos prescritos para su problema de salud mental. Discusión y conclusión: Los URP que también consumen indebidamente psicofármacos están en mayor riesgo de presentar problemas de salud mental, incluso después de considerar su consumo de psicoestimulantes ilícitos. Se recomienda una evaluación por tamizaje para problemas de salud mental en este grupo.

Automedicación en estudiantes de medicina de la Universidad del Rosario en Bogotá D. C., Colombia / Self-medication in medical students at the Universidad del Rosario in Bogota D. C., Colombia

Introducción. La automedicación es un problema de salud pública frecuente en población estudiantil, el cual se da sobre todo en estudiantes de medicina, dado su mayor conocimiento en farmacología. Por tratarse de los futuros prescriptores, es importante establecer la magnitud del problema en esta población. Materiales y métodos. Se realizó un estudio de corte transversal mediante una encuesta aplicada a 276 estudiantes de medicina, en el que se indagaron datos demográficos, antecedentes patológicos, hábitos, frecuencia de automedicación, medicamentos automedicados, porcentaje de automedicación responsable, razones para automedicarse y conocimiento sobre esta conducta. Resultados. De las 276 encuestas realizadas, se analizaron 270. La prevalencia de automedicación fue del 79,3%. El único factor con asociación estadística fue pertenecer a un semestre clínico (p = 0,020). Los medicamentos automedicados con mayor frecuencia son acetaminofén (10,8%), e ibuprofeno (3,9%). Entre los medicamentos automedicados, el 70,6% requiere prescripción médica. Las indicaciones más frecuentes fueron cefalea (10,6%), resfriado común (4,2%) y dismenorrea (3,4%). El 39,1% de los encuestados cumplen los criterios de automedicación responsable. Conclusión. La prevalencia de automedicación en la población evaluada es alta, y la mayoría de los medicamentos utilizados requieren fórmula médica. Los factores influyentes se relacionan con la edad y el semestre que cursan. La mayoría de estudiantes se automedica de manera inadecuada.

Introduction. Self-medication is a common public health problem among students, mainly among medical students who have greater knowledge in pharmacology. We consider that it is important to establish the magnitude of the problem in future prescribers. Materials and methods. We performed a cross-sectional study through a survey of 276 medical students. We analyzed demographic data, medical history, habits, frequency of this behavior, drugs used as self-treatment, percentage of self-medication, reasons for self-medication and knowledge about this behavior. Results. Of the 276 surveys 270 were analyzed. We found a prevalence of 79.3% self-medication. The only associated factor with higher statistical significance was students who were in clinical practice (p = 0.020). Drugs that were mostly used were: acetaminophen (10.8%) and ibuprofen (3.9%). 70.6% of the mentioned drugs require a medical prescription. Most frequent reasons were: headache (10.64%), common cold (4.20%) and dysmenorrhea (3.37%). Only 39.1% of respondents met criteria for responsible self-medication. Conclusion. Prevalence of self-medication among medical students is high. Most of used drugs need a medical prescription. The factor influencing this behavior is the year of medical school to which they belong. Self-medication is mostly found when students are in clinical practice. Most students do not self-medicate responsibly.

Acute liver failure and self-medication / Falência hepática aguda e automedicação

INTRODUCTION: Not responsible self-medication refers to drug use in high doses without rational indication and often associated with alcohol abuse. It can lead to liver damage and drug interactions, and may cause liver failure. AIM: To warn about how the practice of self-medication can be responsible for acute liver failure. METHOD: Were used the Medline via PubMed, Cochrane Library, SciELO and Lilacs, and additional information on institutional sites of interest crossing the headings acute liver failure [tiab] AND acetaminophen [tiab]; self-medication [tiab] AND acetaminophen [tiab]; acute liver failure [tiab] AND dietary supplements [tiab]; self-medication [tiab] AND liver failure [tiab] and self-medication [tiab] AND green tea [tiab]. In Lilacs and SciELO used the descriptor self medication in Portuguese and Spanish. From total surveyed were selected 27 articles and five sites specifically related to the purpose of this review. CONCLUSIONS: Legislation and supervision disabled and information inaccessible to people, favors the emergence of cases of liver failure drug in many countries. In the list of released drugs that deserve more attention and care, are some herbal medicines used for the purpose of weight loss, and acetaminophen. It is recommended that institutes of health intensify supervision and better orient their populations on drug seemingly harmless, limiting the sale of products or requiring a prescription for release them. .

INTRODUÇÃO: Automedicação não responsável refere-se ao uso de medicamentos em altas doses, sem parâmetros racionais e associada frequentemente ao álcool. Ela pode levar à interações medicamentosas danosas ao fígado, podendo causar falência hepática. OBJETIVO: Alertar sobre o quanto a prática da automedicação não responsável pode levar falência hepática aguda. MÉTODO: Foram utilizadas as bases Medline via PubMed, Cochrane Library, SciELO e Lilacs, e informações adicionais em sites institucionais de interesse cruzando os descritores acute liver failure[tiab] AND acetaminophen[tiab]; self-medication[tiab] AND acetaminophen[tiab]; acute liver failure[tiab] AND dietary supplements[tiab]; self-medication[tiab] AND liver failure[tiab]; e self-medication[tiab] AND green tea[tiab]. Na Lilacs e SciELO utilizou-se o descritor automedicação em português e espanhol. Do total pesquisado selecionou-se 27 artigos e cinco sites relacionados especificamente ao objetivo desta revisão. CONCLUSÕES: Legislação e fiscalização deficientes e informações pouco acessíveis à população favorecem ao aparecimento de casos de falência hepática medicamentosa em diversos países. Na lista de medicamentos liberados que merecem maior atenção e cuidado, encontraram-se alguns fitoterápicos utilizados com o objetivo de emagrecer, e o analgésico paracetamol. Recomenda-se que organismos nacionais de farmacovigilância intensifiquem a fiscalização e melhor orientem suas populações no consumo de medicamentos aparentemente inofensivos, limitando a sua venda produtos ou exigindo receita médica para liberação. .

Automedicación en estudiantes de la carrera de medicina, Facultad de Ciencias Médicas, UNAH / Self-medication among second to seventh year students of the Faculty of Medical Sciences, UNAH

El uso inadecuado de medicamentos sin prescripción médica o sobrantes de tratamientos anteriores impulsa el análisis sobre sus beneficios, consecuencias y la toma de decisiones al respecto. Objetivo: determinar la práctica y el conocimiento de automedicación de los estudiantes de la Carrera de Medicina de la Facultad de Ciencias Médicas (FCM), Universidad Nacional Autónoma de Honduras (UNAH). Metodos: Estudio descriptivo de corte transversal. La población fue de 3,447 estudiantes de la Carrera de Medicina de segundo a séptimo año y la muestra fue de 300 estudiantes. Se eligieron 50 estudiantes por cada año, en forma aleatoria. Se diseñó y facilitó un cuestionario que contempló cuatro aspectos: datos culturales, sociales, económicos y patológicos. Resultados: La prevalencia de automedicación fue de 70% (209) estudiantes, de estos, 34% (72) lo hacen una vez al mes, 33% (62) una vez al año, seguido por 29% (61) que lo practican cuando se enferman y 4% (8) una vez a la semana; 58% (121) eran mujeres y 42% (81) hombres. 39% (117) opinaron que es una práctica riesgosa que no se debe utilizar, 49% (151) afirmó tener amigos que se automedican, 48% (145) refirió tener familiares que lo realizan, 78% (164)lo hacen por tener síntomas leves, 24% (51) practican el hábito de fumar, 44% (92) ingieren bebidas alcohólicas.De los 209 estudiantes que se automedican 10% (20) han observado efectos secundarios, 82% (171) lo hacen con AINEs, 49% (102) se automedican cuando presentan resfriado común, 29% (61) por cefalea, 7%(14) por faringoamigdalitis y 8% (17) indicaron utilizar varios medicamentos. Conclusiones: La práctica de la automedicación es realizada en un 70% por estudiantes de la Carrera de Medicina en mejorar la sintomatología de procesos infecciosos y cefalea...

Survey of Consumer Views on Non-prescription Drugs and Self-Medication after the Revised Pharmaceutical Affairs Act in 2009 / 医薬品情報学

<b>Objective: </b>To clarify consumer views on the new sale system of non-prescription drugs, self-medication, and purchases in drugstores after the revised Pharmaceutical Affairs Act in 2009.<br><b>Methods: </b>The questionnaire was performed for 1,084 consumers on an enlightenment event of the proper use of non-prescription drugs and promotion of adequate self-medication held at Shinjuku Station that was a main terminal station.<br><b>Results: </b>Among the respondents, the degree of recognition of the new sale system for non-prescription drugs was 67.7%.  There was approximately threefold increase from the previous survey in 2008.  The most common positive reason was, “The safety of non-prescription drugs was clarified by classification according to three risk levels.”  On the other hand, the most common negative reason was, “I was unable to reach the medicine I wanted without having to listen to the pharmacist’s explanation.”  When consumers want to purchase non-prescription drugs, 77.1 and 44.5% of the respondents nominated “pharmacy and/or drugstore” and “a convenience store,” respectively.  The practice of self-medication positively correlated with the words “the self-medication.”  In this study, a surge in consumer interest for self-medication and non-prescription drugs was felt.  However, while consumers were interested in the safety of non-prescription drugs, they also demanded convenience.<br><b>Conclusions: </b>We thought that the role of experts such as pharmacists and registered salesclerks was to ensure safety, convenience, and understandability of consumers for non-prescription drugs.  In addition, to promote adequate self-medication, it was suggested that recognition of the words “self-medication” will be helped through events, the Internet, and the mass media.  It needs to be further explored.

Reform of OTC distribution in Korea

In the US, over-the-counter (OTC) drugs have long been available in non-pharmacy outlets, and in the UK, general sale list medicines can be supplied without the need for the supervision of a pharmacist. Recently, the Japanese government allowed medications for colds or fever and painkillers, which account for 95% of general pharmaceuticals, to be sold at retail stores through the amendment to the Pharmaceutical Affairs Act. Among the key trends of the global OTC market are major changes in product distribution. However, in Korea, the independent pharmacy model traditionally has been the method of OTC distribution for many years. 19 years have passed since the first civil petition for non-pharmacy distribution of selected OTC drugs. At last in 2012, Korea revised the Pharmaceutical Affairs Act, allowing selected non-prescription drugs to be distributed by non-pharmacy outlets. The revised Pharmaceutical Affairs Act restricted the number of selected OTC drugs to under 20. The new Act included the registrations of nonpharmacy outlets and the mandatory education of the sellers. We must discuss the criteria for placement of medicines on the GSL, the reclassification system based on the safety profile of the medicines, and the expansion of non-pharmacy outlets. In preparation for the aged society, we should implement health policies to lower the price of pharmaceuticals by adopting the market principle thus giving consumers a broader choice.