Trazodone-induced delirium: case report / Delirio inducido por trazodona: reporte de caso

ABSTRACT Trazodone is used as an antidepressant in doses between 150 and 600 mg. At lower doses, it is commonly used to treat insomnia. There are few case reports about confusional symptoms as an undesirable side effect of this drug. We report a case of a patient who presented with delirium after prescription of trazodone 100 mg. She required hospitalisation but, shortly after discontinuation of trazodone, the symptoms disappeared without antipsychotic medication. Seven months after the episode, the patient remains asymptomatic.

RESUMEN La trazodona se usa como antidepresivo en dosis de 150-600 mg. En dosis más bajas, se usa comúnmente para tratar el insomnio. Hay pocos reportes de caso sobre síntomas confusionales como un efecto secundario indeseable de este medicamento. Se presenta el caso de una paciente que acudió con delirio después de la prescripción de trazodona 100 mg. La paciente requirió hospitalización pero, poco después de la interrupción de la trazodona, los síntomas desaparecieron sin medicación antipsicótica. A los 7 meses del episodio, la paciente permanecía asintomática.

The appropriate use of human albumin in a Brazilian University Hospital: therapeutic indication and dosage regimen

The objective of the study was to evaluate the use of human albumin in a Brazilian university hospital, in compliance with the institutional protocol and other clinical guidelines, taking into account the therapeutic indications and the dosage regimens. Data was obtained from the pharmacy dispensing records of human albumin, the requests for use it and, when available, the patient's records between January and October 2017. After evaluation the therapeutic indications and the dosage regimens were classified as "appropriate" and "inappropriate". The analysis of 98 requests showed that, when compared to the institutional protocol, 54 (55.1%) requests had an inappropriate therapeutic indication. However, when a comparison was made between 25 medical records (54 requests) and other clinical guidelines, it was observed that the therapeutic indication had none classified as inappropriate. In addition, 16 (29.7%) requests were considered inappropriate in relation to dosage regimens. From these results, it was possible to conclude that although the use of human albumin in the hospital was associated to a clinical protocol, it was outdated. Thus, it is possible to affirm that not only the adoption of a clinical protocol, but its periodical updating is an important strategy to promote the rational use of drugs.

Uso de antibióticos parenterales en el servicio de medicina interna de un hospital de tercer nivel de la ciudad de Bogotá / Parenteral antibiotics utilization in the internal medicine service of a third level hospital from Bogota city

Mediante un estudio observacional y de corte transversal, relacionado con el esquema terapéutico, se describió el consumo y las prácticas de prescripción de antibióticos parenterales en el servicio de medicina interna del Hospital Universitario La Samaritana de Bogotá. Se administraron 32,6 ddd/100 pacientes/día, siendo los grupos terapéuticos más prescritos: cefalosporinas, penicilinas y quinolonas. Los errores en el esquema terapéutico se presentaron en el régimen de dosificación, en la elección del medicamento y en la duración del tratamiento. Del presente estudio se extraen los primeros indicadores de consumo y prescripción para el servicio, estableciendo un punto de referencia para próximas evaluaciones.

A cross-sectional and observational study related with therapeutic plan, was described the utilization and prescription practices of parenteral antibiotics, in the internal medicine service of the Hospital Universitario La Samaritana E.S.E from Bogota city. Were administered 32.6 ddd/100 patients-day. The most prescribed therapeutic groups were: cephalosporins, penicillins and quinolones. The errors in the therapeutic plan were in: the dosification regimen, the drug selection and the therapy duration. From this study were extracted the first consumption and prescription indicators to the service, for establishing a reference point to next evaluations.