Consumo y buenas prácticas de preparación de medicamentos homeopáticos en un servicio farmacéutico comunitario / Consumption and good practices in the preparation of homeopathic medicines in a community pharmacy service

La Homeopatía es una modalidad terapéutica que se practica desde el siglo XIX, siendo reconocida por la Organización Mundial de la Salud. En Cuba, con el desarrollo de la Medicina Natural y Tradicional (MNT), el uso de la Homeopatía se ha extendido y se ha incrementado el consumo de sus medicamentos. Objetivo: Caracterizar el consumo y el cumplimiento de las Buenas Prácticas de Preparación de medicamentos homeopáticos. Métodos: Se realizó un estudio descriptivo transversal del tipo consumo, en la Farmacia Homeopática Provincial de Santiago de Cuba. Resultados: El 94,03% del total de las ventas, fue mediante recetas médicas, entre los 12 medicamentos homeopáticos más prescriptos estuvieron la Drossera, Sambucus y Belladona. La especialidad con más prescripciones fue la de Pediatría con el 53,32%, recibiéndose recetas de 12 Instituciones de salud de la provincia. Dentro de los errores detectados en las recetas sin calidad predominó en el 87,35% la omisión de las potencias y errores en la nomenclatura del medicamento. En la valoración del cumplimiento de las normas de Buenas Prácticas de Preparación se obtuvo la puntuación de 83 puntos de 100, clasificándose el cumplimiento en dicho servicio con la categoría de Bien. La dispensación de los medicamentos homeopáticos resultó ser adecuada en el 100 % de los casos. Conclusión: Se comprobó el amplio uso de esta terapéutica en el territorio. Se detectaron deficiencias en la calidad de las recetas médicas. La dispensación constituyó un factor de impacto positivo en los pacientes(AU)

Homeopathy is a therapeutic modality that has been practiced since the 19th century, been recognized by the World Health Organization. In Cuba, with the development of Natural and Traditional Medicine (NTM), the use of Homeopathy has spread and the consumption of its medicines has increased. Objective: To characterize the consumption and compliance with the Good Practices for the Preparation of homeopathic medicines. Methods: A cross-sectional descriptive study of the consumption type was carried out in the Provincial Homeopathic Pharmacy of Santiago de Cuba. Results: 94.03% of total sales were through medical prescriptions, among the 12 most prescribed homeopathic medicines were Drossera, Sambucus and Belladonna. The specialty with the most prescriptions was Pediatrics with 53.32%, with prescriptions received from 12 health institutions in the province. Among the errors detected in the prescriptions without quality, 87.35% were due to omission of potencies and errors in the nomenclature of the drug. In the evaluation of compliance with the standards of Good Preparation Practices, a score of 83 points out of 100 was obtained, classifying compliance in this service with the category of Good. The dispensing of homeopathic medicines was adequate in 100 % of the cases. Conclusion: The wide use of this therapy in the territory was verified. Deficiencies were detected in the quality of medical prescriptions. Dispensing was a factor of positive impact on patients(AU)

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.

Lufenuron no tratamento da dermatofitose em gatos? / Treatment of dermatophytosis in cats with lufenuron?

Due to discrepancies regarding the effectiveness of lufenuron in treating dermato-phytosis caused by Microsporum canis the effect of this drug was checked in 46 cats (30 with cutaneous lesions and 16 asymptomatic carriers) treated in the Veterinary Hospital of the Federal Rural University of Rio de Janeiro, Brazil. The diagnosis was based on Wood's lamp examination and fungal cultures. Biopsies were only performed in symptomatic animals. The animals were treated with lufenuron (120mg/kg every 21 days), for 4 times. The drug was efficient in 29 of the 30 affected felines and as well as in all of the asymptomatic carriers. The cat that did not respond, had received several dexameta-zone doses prior to the treatment with lufenuron. The drug was given to one animal during the first stages of pregnancy and no abnormalities or neonatal disorders were found in any of the kittens. None of the treated animals showed side effects. Twenty days after the last administration of lufenuron, 45 of the studied animals (98 percent) had negative fungal culture. The cost of treating dermatophytosis with lufenuron is a little higher than with ketoconazole, but the drug has some advantages regarding its practicability and security.The correct drug prescription and animal's medication as well as environmental decontamination are very important for the success of the treatment.

Em função de controvérsias sobre a eficácia do lufenuron no tratamento da dermatofitose causada por Microsporum canis, o efeito da droga foi avaliado em 46 gatos (30 com lesões cutâneas e 16 portadores assintomáticos) atendidos no Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro, Brasil. O diagnóstico foi estabelecido através da lâmpada de Wood, da cultura fúngica e, adicionalmente, na maioria dos animais sintomáticos, pela avaliação histopatológica da pele. Os animais foram tratados com 120mg/kg de lufenuron, a cada 21 dias (quatro doses); a droga mostrou-se eficaz no tratamento de 29 dos 30 felinos que apresentaram a forma clínica da dermatofitose, bem como no de todos os animais assintomáticos. O único felino que não teve cura clínica completa havia recebido várias doses de dexametasona antes do inicio do tratamento. Em um animal gestante, foram utilizadas duas doses do lufenuron e não foi observada qualquer alteração clínica e morfológica nos filhotes. Nenhum dos animais tratados teve qualquer reação adversa ao medicamento. Vinte dias após o último tratamento, o exame micológico resultou negativo em 45 dos felinos estudados (98 por cento). Embora o lufenuron tenha o custo um pouco mais elevado do que o do cetoconazol, é uma droga que apresenta praticidade e margem de segurança bem maiores. Vale ressaltar que o sucesso do tratamento está diretamente relacionado à correta utilização da droga, assim como a perfeita higienização do ambiente e dos utensílios dos animais.