ABSTRACT
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Subject(s)
Humans , Receptor, Angiotensin, Type 2/antagonists & inhibitors , Antidepressive Agents/therapeutic use , Drug Utilization Review , Evidence-Based Medicine , Health Knowledge, Attitudes, Practice , Retrospective StudiesABSTRACT
OBJECTIVE: To examine, through the analysis of the prescriptions billed during 2001, the brands of generic medicine prescribed by family doctors at 6 health centres in a primary care area. DESIGN: Descriptive study of medical prescription. SETTING. Primary care health area.Participants/context. 6 health centres: 3 urban and 3 metropolitan. METHOD: Pharmaceutical prescription was analysed through the billing procedures for medical prescriptions, with the help of the administrator for GAIA pharmaceutical provision. 50% of the total generics billed in 2001, involving 7 active principles, were studied. RESULTS: Statistically significant differences in the prescription at the 6 centres were only found in two (omeprazole and ranitidine) of the 7 active principles. There was wide variety in the prescription of the various brands for all active principles. By assessing the involvement of the pharmaceutical industry in health centres, it was found that the smallest and the most metropolitan centres had different patterns of brand prescription. CONCLUSIONS: Determined brands of generic drugs were prescribed more than others. Active information on brands of generic medicines, coming from professional purveyors of information for family doctors, influenced prescription more than passive information. Doctors' lack of information on a brand of generic medicine from a particular laboratory was no obstacle to their being represented just the same on pharmaceutical billing.
Subject(s)
Drug Prescriptions/statistics & numerical data , Drug Utilization/statistics & numerical data , Drugs, Generic , Drug Costs , Drug Prescriptions/economics , Drug Utilization/economics , Humans , Primary Health Care/economics , Primary Health Care/statistics & numerical data , SpainABSTRACT
Objetivo. Estudiar la marca prescrita de los medicamentos genéricos por los médicos de familia de 6 centros de salud de un área de atención primaria mediante el análisis de las recetas facturadas durante el año 2001.Diseño. Estudio descriptivo de la prescripción por receta médica. Emplazamiento. Área de salud de atención primaria. Participantes/contexto. Seis centros de salud, 3 de ubicación urbana y 3 de ubicación metropolitana. Método. Análisis de la prescripción farmacéutica a través del proceso de facturación de las recetas médicas con la ayuda del gestor para la prestación farmacéutica GAIA. El estudio se ha realizado con el 50 por ciento del total de los envases de medicamentos de alguna especialidad farmacéutica genérica (EFG) facturados durante el año 2001, correspondientes a 7 principios activos. Resultados. De los 7 principios activos, sólo en dos (omeprazol y ranitidina) se encontraron diferencias estadísticamente significativas en la prescripción en los 6 centros. Para todos los principios activos existe una gran variedad en la prescripción de las diferentes marcas. Evaluando la implicación de la industria farmacéutica en los centros, se observa que el centro más pequeño y metropolitano presenta características diferentes en cuanto a la prescripción por marcas. Conclusiones. Determinadas marcas de EFG se prescriben más que otras. La información activa sobre marcas de genéricos a través de profesionales de la información dirigida a médicos de familia ejerce una mayor influencia en su prescripción que la información pasiva. El hecho de carecer de este profesional de la información de una marca de genéricos para determinados laboratorios no es un obstáculo para estar representados equitativamente en la factura farmacéutica (AU)
Subject(s)
Child, Preschool , Child , Adolescent , Male , Female , Humans , Drugs, Generic , Disease Outbreaks , Risk Factors , Spain , Tumor Virus Infections , Logistic Models , Drug Costs , Odds Ratio , Warts , Disease Transmission, Infectious , Drug Prescriptions , Primary Health Care , Papillomavirus Infections , Cross-Sectional Studies , Drug Utilization , Hygiene , PapillomaviridaeABSTRACT
El objetivo del presente estudio ha sido analizar las tendencias y los cambios habidos en las autoagresiones medicamentosas en el área de un hospital urbano durante los últimos seis años. Se ha realizado un registro retrospectivo de todos los pacientes atendidos en el servicio de urgencias de un hospital general con ingestas intencionadas de fármacos. Un total de 1.000 pacientes (607 mujeres y 393 hombres) fueron atendidos durante el período estudiado. La edad media de los pacientes fue de treinta y cinco años. Los medicamentos mayoritariamente empleados fueron las benzodiazepinas (841 pacientes), seguidas por los antidepresivos tricíclicos (152 pacientes). Ciento cincuenta y cuatro pacientes asociaron alcohol a los medicamentos. últimamente se aprecia un descenso en el uso de antidepresivos tricíclicos en favor de los inhibidores selectivos de la recaptación de serotonina. Otros fármacos que aparecen con relativa frecuencia asociados a las autólisis medicamentosas son el paracetamol, los AINE y los antipsiróticos (AU)
Subject(s)
Adolescent , Adult , Aged , Female , Male , Middle Aged , Aged, 80 and over , Humans , Self Administration/adverse effects , Retrospective Studies , Age Distribution , Seasons , Benzodiazepines/adverse effects , Acetaminophen/adverse effects , Ethanol/adverse effects , Suicide, Attempted/statistics & numerical data , Spain/epidemiology , Antidepressive Agents/adverse effects , Antipsychotic Agents/adverse effectsABSTRACT
The influence of the natural bile acid surfactant sodium taurocholate (CAS 81-24-3) on colic and duodenal (i.e. the proximal third of the small intestine) absorption of cefadroxil (CAS 50370-12-2) was studied using the in situ rat gut technique, and compared with the effect of sodium lauryl sulfate (CAS 151-21-3), the most widely used synthetic anionic surfactant. Previously, the stability, compatibility, and micelle-solubilization characteristics of taurocholate were assessed in order to correct, when necessary, the absorption results. White the passive absorption rate constants (kf, h-1) determined in colon in the presence of increasing lauryl sulfate concentrations showed an asymptotic value about 7-fold higher than that of cefadroxil alone, only a 2-fold higher value was obtained in the presence of taurocholate at similar concentrations. Therefore the natural surfactant would increase the polarity of the colic absorbent membrane much less than lauryl sulfate does (about 3.5 times). The effects of taurocholate on the duodenal absorption of cefadroxil, which is the sum of a single passive process and a simultaneous carrier-mediated transport, can be summarized as follows: 1. When the working concentration of cefadroxil is far from carrier saturation (0.1 mg/ml) a slight but clear net decrease in the apparent kf value is observed in the presence of increasing concentrations of the natural surfactant (from 3.0 to 2.3 h-1) 2. When the concentration of the antibiotic in the working fluid is above carrier saturation (10 mg/ml) the picture is reversed, and a slight net increase in kf in the presence of increasing concentrations of taurocholate (from 0.8 to 1.2 h-1) is found. This means that the effect of taurocholate as a noncompetitive inhibitor of active cefadroxil transport is very much smaller than that observed with lauryl sulfate. Moreover, the increase in passive absorption relative to the synthetic surfactant is also much smaller. On the basis of allometric considerations it could be concluded that for practical purposes taurocholate does not act as a substantial absorption modifier for cefadroxil, at least in the small intestine, the main absorption site of the antibiotic. It can, however, not be considered an inert ingredient, and therefore oral administration of cefadroxil far from that of taurocholate-containing preparations, and even from lipid-rich meals should be strongly recommended.
