Long-Term Care medicines formularies: any reasons for pharmacists' concern?

Abstract This study aimed to characterize and compare medicines formularies (MFs) used in Long-Term Care (LTC) facilities in Portugal, and to identify the prevalence of Potentially Inappropriate Medicines (PIMs). A systematic contact with LTC facilities was undertaken in December 2021. MFs were systematized according to the Anatomical Therapeutical Chemical classification system (ATC), followed by descriptive content analysis. A structured comparison between MFs developed by public organizations and private LTC facilities was performed. After duplicate removal and exclusion of medicines not for systemic use, two explicit criteria - the Algorithm of medication review in frail older people and the EU(7)-PIM list - were employed for PIMs identification. Five MFs were obtained and assessed. The three MFs developed by private institutions covered 23% of the national LTC facilities and approximately 34% of the national total of beds. Heterogeneity was particularly high for the Alimentary tract and metabolism, Blood and blood-forming organs, Musculoskeletal system, and Respiratory system ATC groups. A PIM prevalence of 29,4% was identified. Medicines distribution between the MFs suggests the need to develop national guidelines towards harmonizing medicines usage in LTC. The prevalence of PIMs found highlights the importance of a particular optimized use of this health technology in aged sub-populations

Listado de procedimientos médicos y sanitarios / List of medical and sanitary procedures

El documento lista los procedimientos médicos y sanitarios contenidos en el plan esencial de aseguramiento en salud.PEAS vigente y su costo estándar.

Do Brazilian hospital pharmacists record, document, archive and disseminate their clinical practice?

An exploratory study was conducted to present the approach of Brazilian hospital pharmacists to registering, documenting, archiving and disseminating clinical practice. The data were collected using an electronic questionnaire (n=348). In fact, 97.41% of pharmacists record their clinical practice, out of which 64.01% (n=217) do in electronic form, mainly in private hospitals (p<0.000), in the central, southern and southeastern regions (p=0.040), and by professionals with 1-5 years of experience (p=0.001). The main software used is non-specific to clinical practice: an electronic spreadsheet (47.93%; n=104) and text editor (13.37%; n=29). The archiving of records is performed by 87.61% (n=297) of professionals, where 80.13% (n=238) do so in physical form; however, 77.31% (n=184) of these files are kept for less than the standard recommended time. Documentation in medical records is carried out by 55.17% (n=192) of pharmacists, increasing among those with 1-5 years of clinical practice (p=0.001), and dissemination is performed by 74.71% (n=260) of hospital pharmacists, with a lower frequency in public hospitals (p=0.012) and among professionals with fewer hours dedicated exclusively to clinical pharmacy (p=0.012). These results can undergird the revision of competency-based training programs of Brazilian clinical pharmacists to remain pharmacists as a valuable health team member

Formulario nacional de medicamentos esenciales / National form of essential medicines

El documento está elaborado por una Comisión de expertos, tomando como base al Petitorio Nacional Único de Medicamentos Esenciales, que incluye 428 principios activos en 662 presentaciones farmacéuticas que satisfacen las necesidades asistenciales prioritarias de la población, prestando especial atención a su importancia en la salud pública, a la evidencia sobre seguridad y eficacia, a los estudios de costo-efectividad o a estudios comparativos de costos, se precisan la forma farmacéutica, dosis, indicaciones, farmacocinética, contraindicaciones, precauciones, reacciones adversas, interacciones, tratamiento de sobredosis y de efectos adversos graves, almacenamiento y estabilidad, información básica para el paciente y otras especificaciones que garanticen la eficacia y seguridad para el uso de los medicamentos.

Combination of planning optimization formula with revision before manufacture process

The objectives of prospective process validation are to evaluate the key variables and their operational ranges and to predict the "worst cases" for each investigated variable. The targets of formulation design and optimization are to establish the quantitative relationships between input variables (ingredients/ processing conditions) and output variables (product properties). There are some intersectional ideas between validation and optimization as input-output relationships, quantifiable and predictable behaviours of input and output variables, constraints of independent and dependent variables, etc. The formulation design and optimization for paracetamol tablets, in combination with process prospective validation, using the optimization and what if prediction performed by INForm v3.0 as a frame work, was successfully done to (a) determine the critical variables as well as to estimate their optimized values, (b) to investigate the variable limits as well as to predict some worst cases

Clinical trial to compare the analgesic efficacy of selected Traditional Medicine Formulations (TMF-06,-24,-25) on experimentally induced pain in human subjects

Forty clinically healthy volunteers participated in the study aimed to evaluate the therapeutic efficacy of three Traditional Medicine Formulations (TMF-06, TMF-24 and TMF-25) on experimentally-induced cold compressor stimulation pain. The rationale underlying the study is that these formulations have beenproduced locally and used extensively as standard analgesics for pain relief at the Traditional Medicine Hospitals and dispensaries as well as through self-medication over-the-counter-durgs by the local community for many years but has yet received little investigative attention regarding efficacy and sefety. The study was a placebo controlled double-blind, complete cross-over single dose design using aspirin (acetyl salicylate) as positive standard and was evaluated on three basic pain response parameters namely, pain threshold, pain tolerance and pain sensitivity range. All three formulations showed a significant analgesic efficacy (p < 0.01) when compared to placebo (TMF-25 > TMF-24 > TMF-60). No, adverse effects were noted even when given at maximum recomended dose. It was concluded dose. It was concluded that the three TMFs can be used as an alternative to aspirin for the symptomatic relief of mild to moderate pain.

Investigation of antibacterial activity of three traditional medicine formulations

Three Traditional Medicine Formulations which are widely used by local people were investigated for antibacterial activity using 14 species of bacteria. The bacteria include one specie each of Escherichia coli, Klebsiella pneumoniae, Streptococcus pyogenes and Vibrio cholerae; two species each of Proteus, Salmonella and Staphylococcus and 4 species of Shigellae. The formulations were Ah-bein-nyin, Heleikdasonna and Nandwin-nganzay which contain herbs and chemicals and have been used as antipyretic or in the treatment of urinary disorders, gastrointestinal disorders and cardiovascular disorders. Fifty per cent alcoholic extract of these drugs were found to possess some antibacterial activity on certain bacteria. Moreover, extracts from 7 plants namely, Saxifraga ligulata (Wall) (Nat-hsay-gamone), Capparis sepiaria (Sugaut-net), Holoptelea integrifolia (Pyauk-seik), Zizyphus oenoplia (Baung-bet), Hygrophila spinosa (Su-padaung), Mitrahyna perviflora (Htain-they) and unidentified sp. (Thetyin-kadoe) were also tested on the above bacteria. It was observed that Saxifraga ligulata, Capparis sepiaria and Zizyphus oenoplia showed antibacterial activity on some bacteria.

Experimental screening for anti-peptic ulcer activity of some Myanmar traditional medicine formulations

Four Myanmar traditional medicine formulations (TMFs), namely TMF-02, TMF-03A, TMF-03B and TMF-08, locally claimed to be useful in treating dyspepsia, were screened for anti-peptic ulcer activity employing two experimental in vivo test models in rats. Only TMF-02, TMF-03B and TMF-08 markedly reduced ulcer severity to the ulcer indices of 17.4, 15.6 and 14.5 respectively. These effects were comparable to cimetidine (13.8), while that of the negative control was 35.Measuring gastric juice acidity in rats employing pyloric ligation confirmed that these three drugs did reduce gastric acidity, particularly diminishing the free acid one-third and shifting gastric pH from 6 to 7.

Clinical trial to determine the antidiarrhoeal potential of traditional medicine formulations TMFs-16, TMF-35a and TMF-43

Clinical trial to determine the therapeutic efficacy of three Traditional Medicine Formulations, claimed to have antidiarrhoeal action, were studied on 150 acute diarrhoeal patients admitted to the Infectious Diseases Hospital, Yangon. TMF-16 was found to possess a good antidiarrhoeal action with the antidiarrhoeal index (ADI) of 28.71 percent, which is approximately equal to that of the standard drug, loparamide which had the ADI of 27.94 percent. TMF-35a also possess a mild to moderate antidiarrhoeal action (ADI = 21.5 percent), but TMF-43 showed little or no antidiarrhoeal action (ADI = 9.64 percent). The cllinical significance of the study is that both TMF-16 and loparamide were found to reduce the stool output as well as the amount of fluid replacement required. TMF-16 is well tolerated, available locally and cheaply, and thus, may prove beneficial in the symptomatic relief of non-specific acute diarrhoea.

Clinical trial of antidiabetic traditional medicine formulation (TMF) No. 32

Clinical trial to determine the therapeutic efficacy of a traditional antidiabetic drug, TMF-32, was carried out on six Type II NIDDM patients who were admitted to the Traditional Medicine Hospital, Yangon. All patients, 3 males and 3 females, had a fasting blood glucose level of more than 150 mg percent (205.2 + 35.6) and a 2 hour post-prandial blood glucose level of more than 200 mg percent (323.0 + 62.09) and were clinically free from complications of diabetes. The study was a complete cross-over design, using tolbutamide as a control and was conducted under strict diabetic diet wupplying approximately 2500 kcals per day. Hypoglycaemic efficacy calculated from oral glucose tolerance test (OGTT) curves indicated that TMF-32, at doses of 2G and 3G, significantly reduces the blood glucose levels in these patients (p < 0.01 in both doses). The maximum hypoglycaemic effect was seen at approximately 2 hours after dosing and the duration of action lasted only up to 6 hours. Construction of log. dose-response curves showed TMF-32 of having a hypoglycaemic potency of 73 percent of tolbutamide but frequent side effects and cost of drug give rise to contradicting questions on whether it may be useful as a standard traditional antidiabetic drug.

Trinidad and Tobago Ministry of Health drug formulary: a guide to rational drug prescribing

A document listing drugs, which may be purchased by the Ministry of Health, and containing information on the indications, contraindications, side effects, dosage, and any other special information related to the drug.

Drug formulary: a guide to rational drug prescribing

A document listing drugs, which may be purchased by the Ministry of Health, and containing information on the indications, contraindications, side effects,dosage and any other special information related to the drug.

Bronchodilating activity of some traditional medicine formulations on the in vitro tracheal ring test model

The efficacy of seven reputed bronchodilating traditional medicine formulations were studied on the in vitro model of tracheal chain preparation using rabbit and guinea-pig. A new carbachol-induced model was introduced and comparison of its eficacy with normal preparation showed more promising results. Three formulations were found to produce significant relaxation as much as 127 12 Percent and 108 18 Percent in rabbit and guinea-pig models respectively.

Study of inhibitory effects of some traditional medicine formulations on adrenaline-induced hyperglycaemia in animal models

Traditional medicine formulations TMF-27, TMF-28 and TMF-32 have been used traditionally to treat diabetes in Myanmar. Blood Glucose levels of adrenaline-induced diabetic rabbits were determined after oral administration of maximum dose of the traditional medicine formulations TMF-27 TMF-28 and TMF-32 and their watey extracts respectively. From the data obtained, it was concluded that the oral administration of 1.6 g/kg TMFs did not produce inhibition of hypergly-caemic effect in rabbits. Only the water soluble extract of TMF-32 inhibited the hyperglycaemic blood glucose level on adrenaline-diabetic rabbits (p<0.05) ans rats (p<0.05).

Drug formulary: 1986

This formulary lists drugs which are used in Government health institutions of Trinidad and Tobago.

Barbados national drug formulary: a guide to rational prescribing

The BNDF is intended to be a pocket book for quick reference, of greatest value to young doctors, but also to every prescriber who needs to use a drug for the first time, to check general guidelines, major cautions and side effects or dose ranges; to identify an unfamiliar drug name or seek help with an unusual patient; in short to assist in rational prescribing. It is also an educational tool for pharmacists, nurses and other members of the health care team

Malawi national formulary: 1991

The Malawi National Formulary; a product of the Malawi Essential Drugs Programme; provides complete information on each item in the Malawi Standard Drug List 1991 which includes all the carefully selected drugs considered suitable and relevant for use in Malawi