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Medicina UPB ; 41(1): 61-66, mar. 2022. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1362698


Los inhibidores de la bomba de protones (IBP) se encuentran entre los medicamentos más utilizados en el mundo por su bajo costo, extensa prescripción y efectividad. Sin embargo, su uso a largo plazo no es inocuo y aún hay vacíos en el conocimiento del empleo adecuado de estos medicamentos. Por lo tanto, en esta revisión se expone, además de sus propiedades generales, sus verdaderas indicaciones, el uso recomendado a largo plazo y las estrategias para lograr la deprescripción, con el fin de evitar el uso indiscriminado.

Proton pump inhibitors (PPIs) are among the most widely used drugs in the world, due to their low cost, extensive prescription and effectiveness. However, its long-term use is not safe and there are still certain gaps in the knowledge of the proper use of these drugs. Therefore, this review aims to expose their general properties as well as their true indications, the appropriate long-term use and strategies to achieve adequate deprescription of these drugs, seeking to avoid indiscriminate use.

Os inibidores da bomba de prótons (IBP) se encontram entre os medicamentos mais utilizados no mundo pelo seu baixo custo, extensa prescrição e efetividade. Embora, seu uso a longo prazo não é inócuo e ainda há vazios no conhecimento do uso adequado destes medicamentos. Por tanto, nesta revisão se expõe, além das suas propriedades gerais, suas verdadeiras indicações, o uso recomendado ao longo prazo e as estratégias para conseguir a deprescrição, com o fim de evitar o uso indiscriminado.

Humans , Proton Pump Inhibitors , Effectiveness , Prescriptions , Deprescriptions
Article in Chinese | WPRIM | ID: wpr-928153


An UPLC-Q-TOF-MS method was employed to characterize and classify the chemical components of the standard decoction of Yiguanjian, a classical famous recipe. Chromatographic separation was performed on an Acquity HSS T3(2.1 mm ×100 mm, 1.8 μm) column with a mobile phase of 0.1% formic acid water-0.1% formic acid acetonitrile using gradient elution. The flow rate was 0.4 mL·min~(-1) and the column temperature was 40 ℃. Mass spectrometry was performed on electrospray ionization source(ESI) with positive and negative ion scanning modes. The potential compounds were identified by comparing the reference compounds, analyzing the mass spectrometry data and matching the published articles on Masslynx 4.1 software and SciFinder database. Finally, a total of 113 compounds, including 11 amino acids, 19 terpenoids, 13 phthalides, 11 steroidal saponins, 10 coumarins, 9 alkaloids, 7 flavonoids, 8 phenylethanoid glycosides, 8 organic acids and 17 other categories were identified. The established method systematically and accurately characterized the chemical components in Yiguanjian, which could provide experimental evidences for the subsequent studies on the pharmacodynamical material basis and quality control of Yiguanjian.

Chromatography, High Pressure Liquid , Drugs, Chinese Herbal/chemistry , Flavonoids/analysis , Formates , Glycosides/analysis , Prescriptions
Article in Chinese | WPRIM | ID: wpr-928151


The chemical constituents of classical prescription Danggui Buxue Decoction were analyzed by reversed-phase(RP) chromatography and hydrophilic interaction chromatography(HILIC) coupled with quadrupole time-of-flight mass spectrometry. RP separation of Danggui Buxue Decoction was performed on ACQUITY UPLC HSS T3(2.1 mm×100 mm, 1.8 μm), while HILIC separation was on Waters BEH Amide(2.1 mm×100 mm, 1.7 μm). Mass spectrometry(MS) data were acquired in both negative and positive ion modes. Chemical constituents of Astragali Radix and Angelicae Sinensis Radix were searched from Reaxys and thus the in-house library was established. MS data were further analyzed by MassLynx 4.1 combined with in-house library, HMDB, Reaxys, and comparison with reference substances. In conclusion, a total of 154 compounds were identified and characterized: 16 saponins, 44 flavonoids, 10 phthalides, 7 phenylpropanoids, 15 bases and the corresponding nucleosides, 30 oligosaccharides, and 32 other compounds. Among them, 65 compounds were detected by HILIC-MS/MS. This study provides experimental evidences for the material basis research, quality control, and preparation development of Danggui Buxue Decoction and a reference method for comprehensive characterization of Chinese medicine decoctions typified by classical prescriptions.

Chromatography, High Pressure Liquid/methods , Drugs, Chinese Herbal/chemistry , Prescriptions , Tandem Mass Spectrometry
Article in Chinese | WPRIM | ID: wpr-928099


By the in-depth excavation of prescriptions containing herbal pair Acori Tatarinowii Rhizoma-Polygalae Radix in the Dictionary of Traditional Chinese Medicine Prescriptions, this study analyzed their formulation rules, so as to provide reference for their clinical application and new drug development. First, the prescriptions containing Acori Tatarinowii Rhizoma-Polygalae Radix were collected from the Dictionary of Traditional Chinese Medicine Prescriptions, and their indications, herbal compatibility, and dosage forms were analyzed statistically using the Traditional Chinese Medicine Inheritance Support System(TCMISS). Meanwhile, the formulation rules and common dosage forms for the top four indications(amnesia, palpitation, mania, and epilepsy) sorted by frequency were analyzed with Apriori algorithm. A total of 507 prescriptions containing Acori Tatarinowii Rhizoma-Polygalae Radix were screened out, involving 15 indications(frequency>10) like amnesia, palpitation, mania, and epilepsy. There were 30 commonly used Chinese herbs(frequency≥60), with the Qi-tonifying herbs(Ginseng Radix et Rhizoma and Glycyrrhizae Radix et Rhizome), mind-tranquilizing herbs(Poria and Poria cum Radix Pini), and Yin-nourishing herbs(Angelicae Sinensis Radix and Ophiopogonis Radix) being the core ones. The commonly used dosage forms were honey pill, paste pill, decoction, and powder. These have indicated that the herbal pair Acori Tatarinowii Rhizoma-Polygalae Radix is often combined with Qi-tonifying, Yin-nourishing, and mind-tranquilizing herbs for the treatment of "heart or brain diseases" caused by phlegm production due to spleen deficiency, Qi and blood deficiency, and phlegm-turbidity blocking orifice. In the treatment of amnesia, supplementing essence and replenishing marrow are considered on the basis of tonifying Qi, nourishing Yin, and tranquilizing mind. In the treatment of palpitation and mania, tranquilizing mind is emphasized. In the treatment of epilepsy, the emphasis is placed on resolving phlegm, extinguishing wind, and stopping convulsion.

Data Mining , Medicine, Chinese Traditional , Plant Roots , Prescriptions , Rhizome
Article in Chinese | WPRIM | ID: wpr-928056


This study aims to investigate the regulatory effect of Sishen Pills(SSP) and its split prescriptions Ershen Pills(EP) and Wuweizi Powder(WP) on T follicular helper(Tfh) cell subset in the dextran sodium sulfate(DSS)-induced colitis mice and the mechanism. A total of 60 male SPF BALB/c mice were used, 10 of which were randomly selected as the normal group. The rest 50 were induced with 3% DSS solution for colitis modeling. After modeling, they were randomized into 5 groups: model group, SSP group, EP group, WP group, and mesalazine group. Body mass, colon mass, colon mass index, colon length, and unit colon mass index in each group were observed. After hematoxylin-eosin(HE) staining, the pathological injury of colon tissue was scored. The expression levels of molecules related to the STAT/SOCS signaling pathway in colon tissues were analyzed by Western blot. Differentiation levels of Tfh cells such as CD4~+CXCR5~+IL-9~+(Tfh9), CD4~+CXCR5~+IL-17~+(Tfh17), and CD4~+CXCR5~+Foxp3~+(Tfr) in peripheral blood of mice were detected by flow cytometry. The results showed each treatment group demonstrated significant increase in body mass and colon length, decrease in colon mass, colon mass index, unit colon mass index, and histopathological score(P<0.05, P<0.01), reduction of the expression of p-STAT3, STAT3, p-STAT6, and STAT6(P<0.05, P<0.01), rise of the expression of SOCS1 and SOCS3(P<0.05, P<0.01), decrease of Tfh9 and Tfh17 cells, and increase of Tfr cells(P<0.05, P<0.01) compared with the model group. These results indicated that SSP and the split EP and WP may alleviate ulcerative colitis by inhibiting the activation of STAT/SOCS signaling pathway and regulating the balance of Tfr/Tfh9/Tfh17 cells.

Animals , Colitis/genetics , Colitis, Ulcerative/metabolism , Male , Mice , Mice, Inbred BALB C , Prescriptions , T-Lymphocytes, Regulatory
Article in Chinese | WPRIM | ID: wpr-928035


The discovery and identification of effective components are pivotal in the research on Chinese medicinal prescriptions. Given two basic conditions for effective components in Chinese medicinal prescriptions, i.e., active structure and a certain level of drug exposure in the body(including the intestine), a "six-step strategy" for the effective compounds in Chinese medicinal prescriptions based on in vitro-in vivo integration(SSS for short) has been proposed and established, as well as the key technologies. SSS contains qualitative and quantitative analyses of components in five steps, including those in Chinese medicinal extract, intestinal contents, portal vein blood, liver, and peripheral blood. The components(prototype components and metabolites) with a certain exposure level(including in the intestine) and those with large differences between in vitro content and in vivo exposure or in exposure among various parts in the body are selected as the minority prioritized candidates. The sixth step is to screen the pharmacological activity of candidate components specifically extracted from Chinese medicinal materials or artificially synthesized. SSS can significantly narrow the screening range, enhance the hit rate, and speed up the identification of effective components specifically targeting indications. Based on the effective components identified by the SSS, the "upstream" can be linked(mechanism research based on the effective components with clear structures) and the "downstream" can be combined(development of innovative component-based Chinese medicine with definite pharmacodynamic composition). In this study, the concept of component-based Chinese medicine and specific applications of SSS in the development of component-based Chinese medicine are also introduced.

China , Drugs, Chinese Herbal/pharmacology , Medicine, Chinese Traditional , Prescriptions
Article in Chinese | WPRIM | ID: wpr-928032


Since the implementation of drug registration in China, the classification of Chinese medicine has greatly met the needs of public health and effectively guided the transformation, inheritance, and innovation of research achievements on traditional Chinese medicine(TCM). In the past 30 years, the development of new Chinese medicine has followed the registration transformation model of " one prescription for single drug". This model refers to the R&D and registration system of modern drugs, and approximates to the " law-abiding" medication method in TCM clinic, while it rarely reflects the sequential therapy of syndrome differentiation and comprehensive treatment with multiple measures. In 2017, Opinions on Deepening the Reform of Review and Approval System and Encouraging the Innovation of Drugs and Medical Devices released by the General Office of the CPC Central Committee and the General Office of the State Council pointed out that it is necessary to " establish and improve the registration and technical evaluation system in line with the characteristics of Chinese medicine, and handle the relationship between the traditional advantages of Chinese medicine and the requirements of modern drug research". Therefore, based on the development law and characteristics of TCM, clinical thinking should be highlighted in the current technical requirements and registration system of research and development of Chinese medicine. Based on the current situation of registration supervision of Chinese medicine and the modern drug research in China, the present study analyzed limitations and deficiency of " one prescription for single drug" in the research and development of Chinese medicine. Additionally, a new type of " series prescriptions" was proposed, which was consistent with clinical thinking and clinical reality. This study is expected to contribute to the independent innovation and high-quality development of the TCM industry.

China , Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional , Prescriptions , Public Health
Article in Chinese | WPRIM | ID: wpr-927960


The core prescriptions and formulation characteristics in the treatment of edema by traditional Chinese medicine(TCM) masters were analyzed through data mining and their mechanisms were explored by network pharmacology. We collected journal reports on the treatment of edema by TCM masters in three sessions from China National Knowledge Infrastructure(CNKI) and constructed a database by Traditional Chinese Medicine Inheritance Support System 3.0. The prescriptions in the case studies were analyzed by association rules and k-means clustering. The chemical components and targets of Chinese medicines in core prescriptions were collected through TCMSP and TCMID. Edema-related targets were collected from DrugBank and GeneCards. The protein-protein interaction(PPI) network was constructed by STRING and the core targets were screened out. FunRich 3.1.3 was used to enrich the expression sites of core prescriptions. Metascape was used to perform Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analysis of intersection targets. Cytoscape 3.6.0 was used to visualize the "Chinese medicine-active ingredient-core target-pathway" network. The results showed that 315 pieces of medical records in the treatment of edema by TCM masters were obtained and five core prescriptions were analyzed by association rules and k-means clustering. Core prescription 1 contained Poria, Atractylodis Macrocephalae Rhizoma, Astragali Radix, Alismatis Rhizoma, Glycyrrhizae Radix et Rhizoma, and Codonopsis Radix, involving 166 chemical components and 1 125 targets. Core prescription 2 contained Astragali Radix, Salviae Miltiorrhizae Radix et Rhizoma, Poria, Chuanxiong Rhizoma, Paeoniae Radix Rubra, and Angelicae Sinensis Radix, involving 138 chemical components and 1 112 targets. Core prescription 3 contained Poria, Salviae Miltiorrhizae Radix et Rhizoma, Astragali Radix, Atractylodis Macrocephalae Rhizoma, Alismatis Rhizoma, and Coicis Semen, involving 126 chemical components and 1 121 targets. Core prescription 4 contained Poria, Forsythiae Fructus, Atractylodis Macrocephalae Rhizoma, Imperatae Rhizoma, Cicadae Periostracum, and Coicis Semen, involving 58 chemical components and 820 targets. Core prescription 5 contained Poria, Atractylodis Macrocephalae Rhizoma, Astragali Radix, Alismatis Rhizoma, Trionycis Carapax, and Dioscoreae Rhizoma, involving 68 chemical components and 919 targets. The core targets of core prescriptions included AKT1, ALB, CASP3, MAPK3, EGFR, SRC, MAPK1, and TNF. The potential targets of core prescriptions in the treatment were highly expressed in the stomach, bladder, lung, and kidney. KEGG pathways were enriched in inflammation and cell cycle pathways, especially the inflammation-relation pathways. The therapeutic effect of core prescriptions on edema is presumedly achieved by tonifying the spleen, draining water, activating blood, and benefiting Qi to resist inflammation and regulate the immune system. This study is expected to provide references for the summary of TCM masters' experience and new drug development.

Data Mining , Drugs, Chinese Herbal/pharmacology , Edema/drug therapy , Humans , Medicine, Chinese Traditional , Prescriptions , Rhizome
Article in Chinese | WPRIM | ID: wpr-927930


The present study explored the regularity of prescriptions for the treatment of intermediate and advanced lung cancer to provide references for clinical medication. CNKI, Wanfang, VIP, and CBM were searched for the research papers on the treatment of lung cancer by Chinese medicine published from database inception to May 31, 2021. The relevant information of qualified papers was extracted to establish a database. The Chinese medicines with frequency >3% underwent analysis of the latent structure and association rules by Lantern 5.0 and SPSS Molder 14.1, respectively, and the prescription regularity in the treatment of intermediate and advanced lung cancer was analyzed based on the frequency description. A total of 713 papers were included, involving 327 Chinese medicines with a cumulative frequency of 12 794 and 106 prescriptions with a cumulative frequency of 824. The commonly used Chinese medicines were dominated by deficiency-tonifying, heat-clearing, phlegm-resolving, and cough/dyspnea-relieving drugs, such as Astragali Radix, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Ophiopogonis Radix, Poria, and Hedyotis Diffusa, which are cold, warm, and plain in nature and sweet, bitter, and pungent in flavor, and mainly act on lung, spleen, and stomach meridians. Commonly used prescriptions included Shashen Maidong Decoction, Liujunzi Decoction, and Baihe Gujin Decoction. The latent structure analysis revealed 32 latent variables and 65 hidden classes. Six comprehensive clustering models and 11 core prescriptions were obtained by professional knowledge inference. The common syndromes of intermediate and advanced lung cancer were inferred to be Qi and Yin deficiency in the lung, Qi deficiency in the lung and spleen, Yin deficiency in the liver and kidney, combined phlegm and stasis, phlegm-heat obstructing lung, and Qi stagnation and blood stasis. Forty-four strong associations were screened out by association rules analysis, including four pairwise strong associations(Polygonati Odorati Rhizoma→Ophiopogonis Radix, Polygonati Odorati Rhizoma→Glehniae Radix, Amomi Fructus→Atractylodis Macrocephalae Rhizoma, and Polygonati Rhizoma→Astragali Radix) and 40 triplet strong associations(such as Trichosanthis Radix+Glehniae Radix→Ophiopogonis Radix, Polygonati Odorati Rhizoma+Glehniae Radix→Ophiopogonis Radix, Trichosanthis Radix+Ophiopogonis Radix→Glehniae Radix, and Scutellariae Barbatae Herba+Codonopsis Radix→Hedyotis Diffusa). In the treatment of intermediate and advanced lung cancer, Qi-replenishing and Yin-nourishing drugs are mainly employed, assisted with cancer-resisting, toxin-removing, spleen-invigorating, phlegm/stasis-resolving, and blood-activating drugs based on syndrome differentiation. The roots were treated following the principles of tonifying lungs and replenishing the spleen, and symptoms following the principles of removing the toxin, dispelling stasis, and resolving phlegm.

Drugs, Chinese Herbal/therapeutic use , Humans , Lung Neoplasms/drug therapy , Medicine, Chinese Traditional , Meridians , Prescriptions , Rhizome
Acta Paul. Enferm. (Online) ; 35: eAPE039009934, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1374025


Resumo Objetivo Avaliar a cobertura vacinal para influenza e os motivos para vacinação ou não em idosos, nas campanhas dos anos de 2019 e 2020. Métodos Estudo quantitativo e longitudinal, realizado em Três Lagoas (MS). Participaram idosos cadastrados em serviços de saúde ou de convivência. No primeiro trimestre de 2020, foram avaliados presencialmente 172 idosos, dos quais 86 foram reentrevistados entre agosto e outubro de 2020 por meio de contato telefônico. Na primeira entrevista, questionou-se sobre a vacinação contra a gripe em 2019 e os motivos para vacinação ou não. Na segunda, as questões foram sobre a vacinação em 2020 e os motivos. As coberturas vacinais de 2019 e 2020 foram comparadas pelo teste de McNemar. Resultados Houve predomínio de mulheres, com média de 69,1 anos de idade. A cobertura vacinal em 2019 foi de 90,7%. A maioria tomou a vacina por acreditar que era importante se vacinar. Como motivos para a não vacinação, destacaram-se as reações anteriores e o fato de não ficar gripado. Em 2020, a cobertura foi de 86,0%. A maioria dos idosos se vacinou pelo fato de a vacina estar disponível no Sistema Único de Saúde. Os motivos para não vacinação foram medo de sair de casa devido à pandemia e falta de orientação profissional. Não houve diferença significativa na cobertura vacinal em 2019 e 2020 (p=0,388). Conclusão A cobertura vacinal diminuiu no ano da pandemia, sem diferença significativa. Informações confiáveis de profissionais de saúde e da mídia são essenciais para a manutenção de altas coberturas vacinais.

Resumen Objetivo Evaluar la cobertura vacunal de la influenza y los motivos para la vacunación o no de adultos mayores en las campañas de los años de 2019 y de 2020. Métodos Estudio cuantitativo y longitudinal, realizado en Três Lagoas (Mato Grosso do Sul). Participaron adultos mayores registrados en servicios de salud o de convivencia. En el primer trimestre de 2020, 172 adultos mayores fueron evaluados presencialmente de los que 86 fueron entrevistados nuevamente entre agosto y octubre de 2020 por medio de contacto telefónico. En la primera entrevista, se preguntó sobre la vacunación contra la gripe en el 2019 y los motivos para vacunarse o no vacunarse. En la segunda, las preguntas fueron sobre la vacunación en el 2020 y los motivos. Las coberturas vacunales de 2019 y de 2020 fueron comparadas por la prueba de McNemar. Resultados Hubo un predominio de mujeres, con un promedio de 69,1 años de edad. La cobertura vacunal en el 2019 fue del 90,7 %. La mayoría tomó la vacuna por considerar que era importante vacunarse. Como motivos para la no vacunación, se destacaron las reacciones anteriores y el hecho de no quedarse engripado. En el 2020, la cobertura fue del 86,0 %. La mayoría de los adultos mayores se vacunó por el hecho de que la vacuna está disponible en el Sistema Único de Salud. Los motivos para la no vacunación fueron el miedo de salir de casa en función de la pandemia y la falta de orientación profesional. No hubo diferencia significante en la cobertura vacunal en el 2019 y el 2020 (p=0,388). Conclusión La cobertura vacunal disminuyó el año de la pandemia, sin significante diferencia. Informaciones confiables de profesionales de salud y de los medios son esenciales para el mantenimiento de altas coberturas vacunales.

Abstract Objective To assess influenza vaccination coverage and reasons for vaccination or not in older adults, in the campaigns of 2019 and 2020. Methods This is a quantitative and longitudinal study, carried out in Três Lagoas (MS). Older adults registered in health care or social services participated. In the first quarter of 2020, 172 older adults were assessed in person, of whom 86 were re-interviewed between August and October 2020 through telephone contact. In the first interview, questions were asked about the flu vaccination in 2019 and the reasons for vaccination or not. In the second, the questions were about vaccination in 2020 and why. Vaccination coverage for 2019 and 2020 was compared using the McNemar test. Results There was a predominance of women, with an average age of 69.1 years. Vaccination coverage in 2019 was 90.7%. Most of them took the vaccine because they believed it was important. As reasons for non-vaccination, the previous reactions and the fact that they did not have the flu were highlighted. In 2020, coverage was 86.0%. Most older adults were vaccinated because the vaccine was available in the Unified Health System (Sistema Único de Saúde). The reasons for non-vaccination were fear of leaving home due to the pandemic and lack of professional guidance. There was no significant difference in vaccination coverage in 2019 and 2020 (p=0.388). Conclusion Vaccination coverage decreased in the year of the pandemic, with no significant difference. Reliable information from healthcare professionals and the media is essential for maintaining high vaccination coverage.

Humans , Male , Female , Aged , Vaccination , Disease Prevention , Vaccination Coverage , Influenza, Human/prevention & control , Prescriptions , Interviews as Topic , Longitudinal Studies , Motivation
Afr. j. reprod. health ; 26(6): 1-9, 2022. tables
Article in English | AIM | ID: biblio-1390656


This study examined the management of North-East Moroccan physicians of menopause. The poll was carried out on a representative sample of physicians in the Nador region. The sample included gynecologists and general practitioner physicians in both public and private medical sectors. The survey contained focused and open-ended questions on the good knowledge or not of physicians about menopause, their patient population, their prescribing practices, their perceptions, and the different medical approaches to managing the symptoms of menopause. Among the general practitioners interviewed, only 16% of physicians are very knowledgeable about the management of menopause and only 3 physicians have followed continuous training. The others have mainly acquired their information from the internet, medical journals, and scientific magazines. Only one-third of physicians interviewed prescribe menopausal hormonal treatment in this region. The treatment is mainly prescribed to cope with hot flashes (97.1%) and menstrual cycle disruption (85.7%). Others are in favor of non-hormonal treatments and advise women to change their bad daily habits to relieve symptoms. In this region of Morocco, hormonal treatment for menopause is not very common and the majority of general practitioners are not familiar with menopause. (Afr J Reprod Health 2022; 26[6]:116-124).

Humans , Female , Menopause , Prescriptions , Therapeutics , Nonprescription Drugs , Hormonal Contraception
South African Family Practice ; 64(1): 1-6, 21 September 2022. Figures
Article in English | AIM | ID: biblio-1396908


Medical grade oxygen is classified as a drug and needs to be prescribed by a qualified healthcare professional. Oxygen therapy is prescribed to people who cannot maintain normal blood oxygen saturation while breathing atmospheric air. The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of the rational use of this scarce commodity. This study investigated oxygen therapy practices in adult ward patients. Methods: A cross-sectional study design with an analytical component was used in the adults' wards at a National District Hospital and the Pelonomi Academic Hospital in Bloemfontein. Data were collected from patient files, interviews and oxygen measurements of adult patients that received oxygen. Results: One hundred and fifteen patients were included in the study, of whom 47.0% received oxygen without an oxygen prescription. Around 62.3% of the patients with prescriptions did not receive oxygen as prescribed. The prescriptions and oxygen administration for COVID-19 patients were better than for non­COVID-19 patients. A quarter of the patients possibly received oxygen therapy unnecessarily. Conclusion: Poor oxygen therapy practices were identified, including prescription errors, oxygen administration errors and oxygen wastage. A protocol should be developed and implemented for the prescription and administration of oxygen therapy. Training should occur to prevent oxygen wastage. Contribution: This study highlighted poor oxygen practices and prescriptions, as well as oxygen wastage in the absence of local oxygen therapy guidelines.

Prescriptions , COVID-19 , Hyperbaric Oxygenation , Patients , Prescription Drug Misuse
Braz. J. Pharm. Sci. (Online) ; 58: e19832, 2022. tab, graf
Article in English | LILACS | ID: biblio-1394063


Abstract Medication reconciliation is a strategy to minimize medication errors at the transition points of care. This study aimed to demonstrate the effectiveness of medication reconciliation in identifying and resolving drug discrepancies in the admission of adult patients to a university hospital. The study was carried out in a 300-bed large general public hospital, in which a reconciled list was created between drugs prescribed at admission and those used at pre-admission, adapting prescriptions from the pharmacotherapeutic guidelines of the hospital studied and the patients' clinical conditions. One hundred seven patients were included, of which 67,3% were women, with a mean age of 56 years. Two hundred twenty-nine discrepancies were found in 92 patients; of these, 21.4% were unintentional in 31.8% of patients. The pharmacist performed 49 interventions, and 47 were accepted. Medication omission was the highest occurrence (63.2%), followed by a different dose (24.5%). Thirteen (26.5%) of the 49 unintentional discrepancies included high-alert medications according to ISMP Brazil classification. Medication reconciliation emerges as an important opportunity for the review of pharmacotherapy at transition points of care, based on the high number of unintentional discrepancies identified and resolved. During the drug reconciliation process, the interventions prevented the drugs from being misused or omitted during the patient's hospitalization and possibly after discharge.

Humans , Male , Female , Middle Aged , Patients/classification , Medication Reconciliation/methods , Hospitals, University/classification , Pharmacists/ethics , Pharmaceutical Preparations/administration & dosage , Drug Therapy/instrumentation , Prescriptions/standards , Patient Safety , Medication Errors/adverse effects
Article in English | WPRIM | ID: wpr-928924


OBJECTIVE@#To explore the prescription patterns of different dosage forms of Chinese herbal medicines (CHMs) for the treatment of rheumatoid arthritis (RA) and their effects on immune-inflammatory indices.@*METHODS@#Clinical data were collected from patients with RA in 4 hospitals (3 Class A comprehensive hospitals and 1 Class B comprehensive hospital) in Anhui Province, China, from August 2012 to June 2018 via the electronic medical record gathering system. Following extraction of prescription information, each prescribed herb was quantified and standardized according to the knowledge base to establish a database of RA treatment formulae. The medical records were divided into the granules group and decoction pieces group. Core herbs and their combination patterns were obtained from the two groups of cases using Liquorice software. Changes in immune-inflammatory and hepatic and renal function indices were compared between the two groups using SPSS 23.0 software. The Aprior module of SPSS Clementine 11.1 software was applied to analyse the correlation between CHMs and improvement in indices. Finally, the ORACLE 10 g tool was used to evaluate the random walk model of the immune-inflammatory indices between the two groups.@*RESULTS@#(1) We retrospectively analysed 35,898 prescriptions for 6,829 patients with RA who received CHM treatment. There were 3,816 patients in the granules group and 3,013 in the decoction pieces group. (2) The core herbs were Pi (Spleen)-strengthening and dampness-resolving drugs, blood-activating and stasis-resolving drugs, wind/dampness-dispelling drugs and heat-clearing and detoxifying drugs. (3) Both dosage forms could improve immune-inflammatory indices in RA patients, with similar efficacy and no influence on hepatic or renal function. (4) Herba Siegesbeckiae and Oldenlandia had a stronger association with immune-inflammatory indices in the two groups. (5) The immune-inflammatory indices showed obvious improvement after treatment with granules and decoction pieces of CHMs, and there were long range correlations between the comprehensive evaluation indices and interventions.@*CONCLUSIONS@#The principal CHM treatment methods for RA in four hospitals in Anhui Province are strengthening Pi and resolving dampness, activating blood and resolving stasis, dispelling wind/dampness and clearing heat. Granules and decoction pieces of CHMs have similar efficacy in improving immune-inflammatory indices in RA patients and could be used as treatment options for RA.

Arthritis, Rheumatoid/drug therapy , Data Mining , Drugs, Chinese Herbal/therapeutic use , Humans , Medicine, Chinese Traditional , Prescriptions , Retrospective Studies
Article in English | WPRIM | ID: wpr-928841


BACKGROUND@#Although the age-adjusted incidence and mortality of cancer and cardiovascular disease (CVD) have been decreasing steadily in Japan, both diseases remain major contributors to morbidity and mortality along with the aging society. Herein, we aim to provide a prescription of 10 health tips for long and healthy life named the "Lifelong Health Support 10 (LHS10)."@*METHOD@#The LHS10 was developed by the preventive medicine specialists at the National Cerebral and Cardiovascular Center in Suita, where it has been used for health guidance to prevent CVD, cancer, and cognitive decline in addition to their major risk factors such as hypertension, diabetes, and obesity. It consisted of the lifestyle modification recommendations of the 2014 Japanese Society of Hypertension guidelines and the 2017 Japan Atherosclerosis Society Guidelines for preventing atherosclerotic CVD. Further, it came in line with other international lifestyle modification guidelines. In this narrative review, we summarized the results of several Japanese epidemiological studies investigating the association between the LHS10 items and the risk of cancer, CVD, and other chronic diseases including dementia, diabetes, and chronic kidney disease.@*RESULTS@#The LHS10 included avoiding smoking and secondhand smoke exposure, engaging in physical activity, refraining from excessive alcohol drinking, reducing fried foods and sugary soft drinks, cutting salt in food, consuming more vegetables, fruits, fish, soy foods, and fibers, and maintaining proper body weight. All items of the LHS10 were shown to reduce the risk of cancer, CVD, and other chronic diseases.@*CONCLUSIONS@#The LHS10 can be a helpful tool for health guidance.

Cardiovascular Diseases/prevention & control , Humans , Hypertension/prevention & control , Japan/epidemiology , Life Style , Neoplasms , Prescriptions , Risk Factors
Rev. colomb. anestesiol ; 49(4): e200, Oct.-Dec. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1341236


Abstract Introduction Vasopressors are essential in the management of various types of shock. Objective To establish the trend of vasopressors use in the intensive care units (ICU) in a population of patients affiliated with the Colombian Health System, 2010-2017. Methods Observational trial using a population database of patients hospitalized in eleven ICUs in various cities in Colombia. The drugs dispensed to hospitalized patients over 18 years old, from January 2010 until December 2017 were considered. A review and analysis of the vasopressors dispensed per month was conducted, taking into account sociodemographic and pharmacological variables (vasopressor used and daily doses defined per 100/beds/day (DBD). Results 81,348 dispensations of vasopressors, equivalent to 26,414 treatments in 19,186 patients receiving care in 11 hospitals from 7 cities were reviewed. The mean age of patients was 66.3±18.1 years and 52.6 % were males. Of the total number of treatments recorded, 17,658 (66.8 %) were with just one vasopressor. Norepinephrine was the most frequently prescribed drug (75.9 % of the prescriptions dispensed; 60.5 DBD), followed by adrenaline (26.6 %; 41.6 DBD), dopamine (19.4%), dobutamine (16.0 %), vasopressin (8.5 %) and phenylephrine (0.9 %). The use of norepinephrine increased from 2010 to 2017 (+6.19 DBD), whilst the use of other drugs decreased, particularly the use of adrenaline (-60.6 DBD) and dopamine (-10.8 DBD). Conclusions Norepinephrine is the most widely used vasopressor showing a growing trend in terms of its use during the study period, which is supported by evidence in favor of its effectiveness and safety in patients with shock.

Resumen Introducción Los fármacos vasopresores son fundamentales en el manejo de los diferentes tipos de choque. Objetivo Determinar la tendencia de utilización de fármacos vasopresores en unidades de cuidados intensivos (UCI) en una población de pacientes afiliados al Sistema de Salud de Colombia, 2010-2017. Métodos Estudio observacional, a partir de una base de datos poblacional con pacientes hospitalizados en once UCI de diferentes ciudades de Colombia. Se obtuvieron las dispensaciones de pacientes mayores de 18 años hospitalizados desde enero de 2010 hasta diciembre de 2017. Se hizo revisión y análisis de la dispensación mensual de vasopresores. Se consideraron variables sociodemográficas y farmacológicas (medicamento vasopresor usado y dosis diarias definidas por 100 camas/día [DCD]). Resultados Se revisaron 81.348 dispensaciones de vasopresores, equivalentes a 26.414 terapias en 19.186 pacientes atendidos en 11 hospitales de 7 ciudades, cuya edad promedio fue 66,3±18,1 años y el 52,6 % eran hombres. Del total de terapias registradas, 17.658 (66,8 %) fueron con un solo vasopresor. La norepinefrina fue el más comúnmente prescrito (75,9 % de las dispensaciones; 60,5 DCD), seguido por adrenalina (26,6 %; 41,6 DCD), dopamina (19,4 %), dobutamina (16,0 %), vasopresina (8,5 %) y fenilefrina (0,9 %). El uso de norepinefrina se incrementó de 2010 a 2017 (+6,19 DCD), mientras que el de otros fármacos disminuyó, especialmente adrenalina (-60,6 DCD) y dopamina (-10,8 DCD). Conclusiones La norepinefrina es el fármaco vasopresor más utilizado y el que ha demostrado una tendencia de uso incremental durante el periodo de estudio, lo cual está respaldado por evidencia a favor de su efectividad y seguridad en pacientes con choque.

Humans , Male , Middle Aged , Aged , Shock , Vasoconstrictor Agents , Vasopressins , Intensive Care Units , Phenylephrine , Pharmaceutical Preparations , Dopamine , Epinephrine , Norepinephrine , Dobutamine , Drug Utilization , Dosage , Prescriptions
Rev. chil. infectol ; 38(6): 737-744, dic. 2021. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388314


INTRODUCCIÓN: El uso indebido de cefalosporinas puede provocar resistencia de las bacterias. OBJETIVO: Determinar el perfil de prescripción e indicación de cefalosporinas en un grupo de pacientes afiliados al Sistema de Salud de Colombia. MÉTODOS: Estudio transversal. A partir de una base de datos poblacional se obtuvo una muestra aleatoria de pacientes atendidos en consulta ambulatoria para identificar las indicaciones de cefalosporinas en registros clínicos. Se evaluaron variables farmacológicas relacionadas con formulación no indicada según guías de práctica clínica. RESULTADOS: En 381 pacientes, con edad media 41,2 ± 15,4 años, el 61,4% (n = 234) eran mujeres. Cefalexina fue la más utilizada (n=318; 83,5%), con duración media del tratamiento de 7,3 ± 3,2 días, seguida de cefradina (n = 43, 11,3%) y ceftriaxona (n = 20, 5,2%). Se prescribieron para infecciones de piel y tejidos blandos (n = 177; 46,4%, de las cuales 47,5% eran purulentas), del tracto urinario (n = 70; 18,4%), de vías respiratorias superiores (n = 57; 15,0%), e infecciones de transmisión sexual (n = 21; 5,5%). Estaban indicadas en 169 pacientes (44,4%), pero sólo 103 (60,9%) tenían prescripciones que cumplían las recomendaciones de dosificación. CONCLUSIONES: Más de la mitad de pacientes prescritos con cefalosporinas en un contexto ambulatorio tenían prescripciones consideradas no indicadas, en particular por su uso en infecciones de piel y tejidos blandos purulentas.

BACKGROUND: Misuse of cephalosporins can lead to bacterial resistance. Aim: To determine the prescription profile and indication of cephalosporins in the patients affiliated to the Colombian Health System. METHODS: Cross-sectional study. From a population database, a random sample of patients treated in an outpatient consultation was obtained, to identify the indications of the prescribed cephalosporins in their clinical record. Pharmacological variables, and those related to non-indicated formulations were evaluated according to the clinical practice guidelines. RESULTS: In 381 patients, the mean age was 41.2 ± 15.4 years, and 61.4% (n = 234) were women. Cefalexin was the most widely used (n=318; 83.5%), with a mean duration of treatment of 7.3 ± 3.2 days; followed by cefradine (n = 43; 11.3%), and ceftriaxone (n = 20; 5.2%). The most common uses were for skin and soft tissue infections (n = 177; 46.4% of which 47.5% were purulent), urinary tract infections (n = 70; 18.4%), upper respiratory airway infections (n = 57; 15.0%) and sexually transmitted diseases (n = 21; 5.5%). The use was considered indicated in 169 patients (44.4%), but only 103 (60.9%) had prescriptions that met the dosage recommendations from the clinical practice guidelines. CONCLUSIONS: More than half of the patients prescribed with cephalosporins in the outpatient setting had prescriptions considered not indicated, particularly for their use in purulent skin and soft tissue infections.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Respiratory Tract Infections , Soft Tissue Infections/drug therapy , Outpatients , Cephalosporins/therapeutic use , Cross-Sectional Studies , Colombia , Prescriptions , Anti-Bacterial Agents/therapeutic use
Rev. bras. ciênc. mov ; 28(4): 120-128, ago. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1342754


O treinamento de força (TF) demonstra importante impacto para melhora e/ou manutenção da aptidão física. Programas de TF tem como principal objetivo o aumento de força e da área de secção transversa. Essas adaptações crônicas do TF são induzidas por vias de sinalização para otimizar o aumento da área de secção transversa. Portanto, a interação entre as variáveis do TF torna possível uma prescrição adequada dos programas. Sendo algumas das variáveis do TF definidas pela seleção dos exercícios, volume, intensidade, intervalo entre séries, velocidade de execução (cadência), ordem dos exercícios, ação muscular, frequência semanal. O objetivo do presente estudo foi verificar quais variáveis do TF são manipuladas nas planilhas de treinamento, nas academias da região metropolitana de Campinas (RMC). O estudo contou com a participação de 114 academias da RMC do estado de São Paulo (SP). Foi verificada através de inspeção visual as variáveis do TF exercícios, volume, intensidade, intervalo entre séries, velocidade de execução, ordem dos exercícios, ação muscular e frequência semanal presente nas planilhas de treinamento, além da quantidade de funcionários envolvidos durante o processo de prescrição e monitoramento do TF. Os resultados do presente estudos demonstram que as variáveis exercício, volume, intensidade e ordem dos exercícios estão presente em 100% das planilhas de treinamento, enquanto que menos de 50% das planilhas de treinamento apresentam as variáveis intervalo entre séries, velocidade de execução e ação muscular. Os achados do presente estudo sugerem concluir que as principais variáveis do TF não são manipuladas nas planilhas de treinamento das academias da RMC.(AU)

Resistance training (RT) demonstrates important impact to improving and/or maintaining physical fitness. RT program has as main purpose the increase of strength and cross-sectional area. These chronic adaptations are induced by signaling pathways to optimize the increase of cross-sectional area. Therefore, the interaction between RT variables makes it possible a adequate prescription of program. Some of the RT variables are defined by exercises selection, volume, intensity, intervals between set, speed of execution, exercises order, muscle action, weekly frequency. The purpose of present study was verify which RT variables are manipulated in training worksheets, in fitness center of metropolitan region of Campinas (MRC). The study counted with the participation of 114 fitness center of MRC of São Paulo (SP) state. It was verified through visual inspection the RT variables exercises, volume, intensity, intervals between set, speed of execution, exercises order, muscle action, weekly frequency, besides the quantity of employed involved during prescription process and monitoring the RT. The results of the present study demonstrate that variables exercise, volume, intensity and exercise order are present in 100% of training worksheets, while less 50% of training worksheets exhibited the variables intervals between sets, speed of execution and muscle action. The findings of present study suggest conclude that the main RT variables are not manipulated in training of worksheets of fitness center of MRC.(AU)

Humans , Male , Female , Exercise , Fitness Centers , Resistance Training , Muscles , Physical Education and Training , Physical Fitness , Environmental Monitoring , Prescriptions
Ciênc. Saúde Colet. (Impr.) ; 26(5): 1781-1792, maio 2021. tab
Article in Portuguese | LILACS | ID: biblio-1249491


Resumo Os idosos são vulneráveis aos riscos do uso de medicamentos, principalmente daqueles considerados potencialmente inapropriados (MPI) em que os riscos superam os benefícios. O estudo buscou avaliar os MPI prescritos na Atenção Primária à Saúde (APS) e seus fatores associados. Realizou-se um estudo transversal, analítico, de março a dezembro de 2019, na APS em Campina Grande, Paraíba, através de entrevistas com 458 idosos. As variáveis independentes abrangeram características socioeconômicas, condição de saúde e utilização de medicamentos e o desfecho foi medicamento classificado como MPI pelo Consenso Brasileiro de Medicamentos Potencialmente Inapropriados. Verificou-se a prescrição de pelo menos um MPI para 44,8% dos idosos e a maioria de atuação no Sistema Nervoso Central (54,4%). No modelo ajustado, depressão (RP=2,01; IC95% 1,59-2,55), utilizar outros medicamentos além dos prescritos (RP=1,36; IC95% 1,08-1,72) e polifarmácia (RP=1,80; IC95% 1,40-2,33) permaneceram como fator associado e autorreferir ser portador de hipertensão arterial sistêmica tornou-se fator de proteção (RP=0,65; IC95% 0,49-0,87). Evidencia-se necessidade de ações que qualifiquem o uso de medicamentos por idosos, de modo a garantir acesso aliado à segurança.

Abstract The elderly population is vulnerable to the risks of the use of medications, especially those considered potentially inappropriate medications (PIMs), in which the risks outweigh the benefits. The study sought to evaluate the PIMs prescribed in Primary Health Care (PHC) and associated factors. A cross-sectional, analytical study was carried out from March to December 2019 in PHC in Campina Grande, Paraíba, through interviews with 458 elderly individuals. The independent variables included socioeconomic characteristics, health status and the use of medications, and the outcome was classified as PIM by the Brazilian Consensus on Potentially Inappropriate Medications. There was a prescription of at least one PIM for 44.8% of the elderly and the majority affecting the Central Nervous System (54.4%). In the adjusted model, depression (PR=2.01; 95%CI 1.59-2.55), using other medications in addition to those prescribed (PR=1.36; 95%CI 1.08-1.72) and polypharmacy (PR=1.80; 95%CI 1.40-2.33) remained an associated factor, and self-reporting systemic arterial hypertension became a protective factor (PR=0.65; 95%CI 0.49-0.87). This reveals the need for actions to monitor closely the use of PIMs by the elderly to ensure access in conjunction with safety.

Humans , Aged , Inappropriate Prescribing , Potentially Inappropriate Medication List , Primary Health Care , Brazil , Cross-Sectional Studies , Risk Factors , Polypharmacy , Prescriptions