Emergency contraceptive pill safety profile. Comparison of the results of a follow-up study to those coming from spontaneous reporting.

BACKGROUND: The emergency contraceptive pill (ECP) containing levonorgestrel is dispensed without a prescription in Spain since 2009. An easy access could diminish unwanted pregnancies; however, there is a risk of misuse and, in any case, of developing some adverse events. The aim of the present study is to further learn the adverse effects of this ECP. METHODS: An ad hoc follow-up study was carried out in three community pharmacies in a city of Central Spain; the sample was composed of those women asking for the ECP; they were interviewed by telephone after at least a month since the last menses. We completed the safety profile obtained with that coming from spontaneous reporting in Spain. RESULTS: Out of 139 women surveyed, 113 developed any adverse event--two considered as severe; the most frequently reported events were menstrual disturbances, which accounted for 21% of all events. Through spontaneous reporting, 36 cases of whatever adverse events related to levonorgestrel as ECP were identified. Twenty-five cases were considered as severe. Both types of reaction and severity were significantly different in the follow-up study and in the spontaneous reporting. Some of the reactions identified, such as miscarriage, febrile neutropenia, and porphyria, are not included in the Summary of Product Characteristics. CONCLUSIONS: Levonorgestrel as an ECP is mostly safe. Attention should be paid to some severe events and particularly to those risk factors for them to appear. Combining spontaneous reporting with an ad hoc follow-up study, the whole safety profile of a given medication can be obtained.

Estudio de las reacciones adversas de los anticonceptivos hormonales desde la farmacia comunitaria / Study of the adverse reactions of hormonal contraceptives from the community pharmacy

Introducción: Los anticonceptivos hormonales (AH) son medicamentos muy efectivos y seguros; sin embargo, debido al elevado número de usuarias, se vigila constantemente su seguridad. Objetivos: Conocer las características de las usuarias de AH, de la prescripción y uso del AH; investigar la percepción de seguridad de la usuaria sobre el AH utilizado en la actualidad, determinar los factores de riesgo, enfermedades, medicación habitual e identificar Problemas Relacionados con los Medicamentos (PRM). Materiales y métodos: Se realizó un estudio transversal mediante un cuestionario no validado, administrado por el farmacéutico durante los meses de Febrero a Julio de 2013. Solamente participaron en el estudio las usuarias de AH que acudían a la farmacia demandando un AH. Resultados: Durante el periodo de estudio, 143 mujeres participaron en el mismo. Al 31,5% no le iba bien el tratamiento y el 30,8% experimentó al menos una reacción adversa (ganancia de peso, cefaleas, manchados irregulares, náuseas, etc.).El 52,5% de las usuarias presentaba factores de riesgo añadido para sufrir un evento cardiovascular. Durante el estudio se detectaron posibles PRM casi en el 20% de las usuarias. Conclusiones: Casi una de cada tres usuarias experimentó al menos una reacción adversa con el AH en uso. Las reacciones adversas que refirieron fueron leves y transitorias. Más de la mitad de las usuarias presentaba factores de riesgo añadido para sufrir un evento cardiovascular

Background: Hormonal contraceptives (HC) are very effective and safe. Nevertheless, their safety is constantly monitored due to the high number of users Aims: To find out the characteristics of HC’s users, the prescription and the HC use; to investigate the user’s perception of safety of the HC she currently uses; to determine the risk factors, diseases, and regular medication; to identify Problems Related to the Medicines (PRM). Methods: A cross-sectional study was conducted through a non-validated questionnaire, which was administered by the pharmacist from February to July, 2013. Only took part in the study the HC users who came to the pharmacy asking for a HC. Results: During the study period, 143 women took part on it. The treatment did not work for 31.5% of them and 30.8% experienced at least, an adverse reaction (weight gain, headaches, irregular spotting, nausea, etc.). 52.5% of the users presented risk f actors to suffering a cardiovascular event. During the study possible PRM were detected almost in 20% of the users. Conclusions: Nearly one in every three users experienced at least, an adverse reaction with the HC in use. The adverse reactions reported were mild and transient. More than half of the users presented added risk factors to suffer a cardiovascular event. The pharmacist has to take responsibility for the patient’s pharmacotherapy and follow the treatments in order to detect PRM and improve their quality of life

Avances en artritis reumatoide / Pharmacist’s update in rheumatoid arthritis

La artritis reumatoide (AR) es la forma más frecuente de poliartritis crónica. Afecta al 0,5% de la población española. En los últimos años se han producido importantes avances en la patogénesis de la AR, en el diagnóstico y en el tratamiento de la enfermedad. Un diagnóstico temprano es esencial con el fin de prevenir la erosión articular y de mejorar la prognosis y la calidad de vida de los pacientes con AR. En esta revisión se presentan los últimos hallazgos en la epidemiología, etiología, fisiopatología, clínica, diagnóstico y tratamiento de esta enfermedad severa pero tratable

Rheumatoid arthritis (RA) is the most frequent form of chronic polyarthritis. It affects 0.5% of the Spanish population. In recent years there have been significant advances in the pathogenesis of RA, in the diagnosis and treatment of the disease. An early diagnosis is essential in order to prevent the joint erosion and improve the prognosis and quality of life of patients with RA. In this review are presented the latest findings in the epidemiology, etiology, pathophysiology, clinical features, diagnosis and treatment of this severe but treatable disease

Dispensación de anticonceptivos hormonales en una farmacia comunitaria de Valladolid / Dispensation of hormonal contraceptive agents in a community pharmacy of Valladolid (Spain)

Objetivos: Conocer los factores de riesgo de las usuarias de anticonceptivos hormonales (AH), AH usado previamente, motivo del cambio de AH referido por la usuaria, AH dispensado, efectos adversos presentados con el ultimo AH utilizado y si olvido tomar/utilizar el AH de forma correcta. Material y metodos: Estudio observacional, descriptivo y transversal, mediante un cuestionario ad hoc administrado a las usuarias de AH que acudieron a una farmacia comunitaria de Valladolid. Resultados: 120 usuarias respondieron al cuestionario. El 43,3% tenía factores de riesgo añadido para sufrir un evento cardiovascular (hipercolesterolemia, tabaquismo, diabetes, etc.) y el 3,3%; al menos una contraindicación relativa para su uso. El AH usado previamente en más ocasiones fue getinilestradiol 35 ƒÊg + ciproterona 2 mg comprimidosh. Las usuarias cambiaron de AH principalmente por la presencia de efectos adversos. Los AH mas dispensados fueron aquellos que tenían drospirenona como progestageno. Los efectos adversos más frecuentes fueron cefaleas, ganancia de peso, manchados irregulares y cambios de humor. El 36,4 % de las pacientes reconocio haber olvidado tomar/utilizar el AH de forma correcta y el (29,7%) no sabía que tendría que hacer en caso de olvido. Conclusiones: Casi la mitad de las usuarias tenía factores de riesgo añadido para sufrir un evento cardiovascular. La usuaria refirió haber cambiado de AH principalmente por los efectos adversos. Los AH mas dispensados contenían drospirenona como progestageno. El 36,4% de las usuarias olvido tomar/utilizar el AH de forma correcta. Es necesario impulsar campanas educativas multidisciplinares para mejorar la utilización de estos medicamentos (AU)

Aims: To know the risk factors for users of hormonal contraceptives (HC), HC previously used, reason for the change of HC referred by the user, dispensing HC, adverse effects presented with the last used HC and if she forgot to take/use the HC correctly. Material and methods: Observational, descriptive, cross-sectional study by means of an administered questionnaire to users who attended a community pharmacy of Valladolid. Results: 120 users responded to the questionnaire. The 43.3 per cent had risk factors added to suffer a cardiovascular event (hypercholesterolemia, smoking, diabetes, etc.) and the 3.3 per cent had at least a relative contraindication for its use. The HC used previously in most occasions was gcyproterone 2 mg + ethinylestradiol 35 ƒÊg tabletsh. The users changed HC mainly by the presence of adverse effects. The most dispensing HC were those who had as progestin drospirenone. The most common side effects of the HC in use were headaches, weight gain, irregular spots and mood changes. The 36.4 per cent of the patients admitted to having forgotten to take/use the HC correctly and the (29.7 per cent) did not know what they would have to do in case of forgetfulness. Conclusions: Almost half of the users had risk factors added to suffer a cardiovascular event. The user said that she had changed from HC mainly by adverse effects. The most dispensing HC contained as progestin drospirenone. The 36.4 per cent of the users forgot to take/use the HC correctly. It is necessary to promote multidisciplinary educational campaigns to improve the use of these medications (AU)

Bicyclic anti-VZV nucleosides: thieno analogues bearing an alkylphenyl side chain have reduced antiviral activity.

Thieno analogues of the potent and selective furo-pyrimidine anti-VZV nucleoside family bearing a p-alkylphenyl side chain have been synthesised and tested for their antiviral activity against Varicella-Zoster virus (VZV). While the alkyl chain analogues were shown to retain full antiviral activity against VZV, these new analogues did not when compared to their furo parent nucleosides.