Storage of Medications: A Survey of Families in the Pediatric Emergency Department.

OBJECTIVES: To evaluate caregivers' practice of prescription medication storage, particularly of opioid medications, as well as to provide educational materials to families about the opioid crisis. METHODS: Caregivers of patients in a pediatric emergency department were asked to participate in a survey about medication storage practices and beliefs, focusing on opioid medications. Data were collected through a survey documenting demographic data along with knowledge and behaviors of medication storage. Brief education about the US opioid crisis and safe storage was provided. RESULTS: In total, 233 families participated; 3 families declined; 11.5% of caregivers reported storing prescribed medications in a locked or latched place, although most store them "out of reach." Most believed their child or children's friends could not easily access their medications (81.8%). Families who did not keep their medications in locked or latched places had never thought about it (39.7%). In total, 33% of respondents were unaware of the opioid crisis; 87.4% of caregivers said they would use a medication lock box if given one. CONCLUSIONS: Many caregivers are not aware of the opioid crisis and do not keep opioid medications locked up. Half of the caregivers surveyed stated they "never thought about" locking up medications. Most parents would use a lock box if given to them. This opens the door to further study, education, and interventions.

A pharmacy-based medication reconciliation and review program in hemodialysis patients: a prospective study

Background: Hemodialysis (HD) patients are on multiple medications, see many prescribers and have many hospitalizations which put them at risk for medication record discrepancies and medication related problems (MRP). Being able to effectively identify and reconcile these medication issues is crucial in reducing hospitalizations, morbidities, and mortalities. The care of the hemodialysis patients can be enhanced by incorporating a pharmacist into the interprofessional team. There is little data in the literature on medication record discrepancies and MRP’s in dialysis patients. Objective: The objectives of this research were to determine the types of medication discrepancies and MRPs in dialysis patients and if recommendations for changes based on these findings were accepted by providers. Methods: Patients were asked to bring medications to the dialysis unit for review. Discrepancy and MRP recommendations were communicated to the unit staff via written progress notes. A follow-up was performed an average of 33 days later to determine if the recommendations were accepted. Results: Overall, in 93 unique patients, 376 discrepancies (3.1 per patient) and 64 MRPs (0.5 per patient) were identified. The most common type of discrepancy and MRP was drug omission and indication without drug, respectively. Of the total 440 interventions, 77% were ultimately accepted. Discrepancies were more likely to be accepted as compared to MRPs (85% vs. 27%, respectively). Conclusion: Medication record discrepancies and MRPs are common in dialysis patients. Recommendations related to discrepancies were more likely to be accepted by the providers as compared to MRPs. Medication records became inaccurate within 12 months. A pharmacy-based medication reconciliation and review program may have an important impact on the care of hemodialysis patients (AU)

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Self-micro emulsifying drug delivery systems: a strategy to improve oral bioavailability / Sistema de administración de fármacos autoemulsionante: una estrategia para mejorar la biodisponibilidad oral

Aim: Oral route has always been the favorite route of drug administration in many diseases and till today it is the first way investigated in the development of new dosage forms. The major problem in oral drug formulations is low and erratic bioavailability, which mainly results from poor aqueous solubility, thereby pose problems in their formulation. For the therapeutic delivery of lipophilic active moieties (BCS class II drugs), lipid based formulations are inviting increasing attention. Methods: To that aim, from the web sites of PubMed, HCAplus, Thomson, and Registry were used as the main sources to perform the search for the most significant research articles published on the subject. The information was then carefully analyzed, highlighting the most important results in the formulation and development of self-micro emulsifying drug delivery systems as well as its therapeutic activity. Results: Self-emulsifying drug delivery system (SMEDDS) has gained more attention due to enhanced oral bio-availability enabling reduction in dose, more consistent temporal profiles of drug absorption, selective targeting of drug(s) toward specific absorption window in GIT, and protection of drug(s) from the unreceptive environment in gut. Conclusions: This article gives a complete overview of SMEDDS as a promising approach to effectively deal with the problem of poorly soluble molecules

Objetivo: La vía oral siempre ha sido la ruta preferida de administración de fármacos en muchas enfermedades y hasta hoy es la primera forma investigada en el desarrollo de nuevas formas de dosificación. El principal problema en las formulaciones de fármacos orales es la baja y errática biodisponibilidad, lo que resulta fundamentalmente por la escasa solubilidad en agua, con lo que plantean problemas en su formulación. Para la administración terapéutica de los grupos activos lipófilos (BCS clase II drogas), las formulaciones a base de lípidos están teniendo cada vez más atención. Métodos: Con ese objetivo, a partir de los sitios web de PubMed, HCAplus, Thomson, y sus registros se utilizaron como fuentes principales para llevar a cabo la búsqueda de los artículos de investigación más importantes publicados sobre el tema. A continuación, la información fue analizada cuidadosamente, poniendo de relieve los resultados más importantes en la formulación y desarrollo de sistemas de administración de fármacos auto-emulsionante micro, así como su actividad terapéutica. Resultados: El sistema de administración de fármacos autoemulsionante (SMEDDS) ha ganado más atención debido a la mejorada que permite la reducción de la biodisponibilidad oral en dosis, los perfiles temporales más consistentes de la absorción del fármaco, la orientación selectiva de fármaco (s) hacia la ventana de absorción específica en el tracto gastrointestinal, y la protección del fármaco (s) desde el entorno poco receptivo en el intestino. Conclusiones: Este artículo proporciona una visión completa de SMEDDS como un enfoque prometedor para abordar eficazmente el problema de moléculas poco solubles

A model for drug dispensing service based on the care process in the Brazilian health system

Access to medication emphasizes the availability of the product at the expense of providing a service. The goal of this paper is to propose a theoretical model for a drug dispensing service, beginning with a reflection on the current realities of the Unified Health System and drug dispensation in Brazil. A conceptual analytical research made by a methodological course called disciplined imagination was mainly the approach applied to develop the model. The drug dispensing service is part of the care process, which considers access as an attribute; reception, connection and accountability, management, and clinical pharmaceutical aspects as components; and the rational use of drugs as the purpose. The proposed model addresses access to the dispensing service and demands a reorientation of routines, instruments, and practices.

O acesso a medicamentos enfatiza a disponibilidade do produto em detrimento da provisão de um serviço. O objetivo deste trabalho é propor um modelo teórico para um serviço de dispensação de medicamentos, iniciando com uma reflexão sobre a realidade atual do Sistema Único de Saúde e a dispensação de medicamentos no Brasil. Uma pesquisa analítica conceitual realizada por meio de um percurso metodológico chamado de imaginação disciplinada constituiu a estratégia principal para o desenvolvimento do modelo. O serviço de dispensação é parte do processo de cuidado, o qual considera o acesso como um atributo; os aspectos acolhimento, vínculo e responsabilização, gestão e clínica farmacêutica como componentes e o uso racional de medicamentos como o propósito. O modelo proposto direciona o acesso para o serviço de dispensação e demanda a reorientação de rotinas, instrumentos e práticas.

Intervención grupal psicoeducativa en el trastorno bipolar / Group psychoeducation for patients with bipolar disorder

En el presente trabajo se realiza una revisión de lasintervenciones psicoeducativas en formato grupal descritaspara el trastorno bipolar, para luego exponer nuestroestudio. Un grupo de nueve pacientes completó unprograma de catorce sesiones y fueron reevaluados alcabo de un año de la finalización del grupo. Los resultadosson discutidos en base a las características de laintervención, los procesos que tuvieron lugar durante lamisma y el análisis de las diferencias existentes conotros programas, que son principalmente de naturalezacualitativa. En base a nuestra experiencia añadimosalgunas recomendaciones prácticas

After reviewing the state of the art regarding grouppsychoeducational interventions for bipolar disorder theauthors describe their own study. A sample of ninebipolar patients was treated along fourteen sessions andwas evaluated one year after finishing treatment. Theoutcome and the process of the intervention aredescribed and analysed. Although statistical results didnot differ from those reported in previous studies, somesignificant qualitative differences were found and discussed.Based on these findings some practical recommendationsare put forward