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3.
Pharm. pract. (Granada, Internet) ; 14(4): 0-0, oct.-dic. 2016. tab
Artigo em Inglês | IBECS | ID: ibc-158874

RESUMO

Background: As oral contraceptive pills are available over the counter in pharmacies, pharmacists are professionally responsible for checking and informing patients about every aspect of taking these drugs. Simulated patient method is a new and robust way to evaluate professional performance of pharmacists. Objective: The aim of the present study was to evaluate the pharmacy practice of Iranian pharmacists regarding over-the-counter use of oral contraceptive pills using simulated patient method. Methods: Simulated patients visited pharmacy with a prescription containing ciprofloxacin and asked for oral contraceptive pills. The pharmacist was expected to ask important questions for using these drugs and to inform the patient about them properly. Moreover, the Pharmacists should advise patients in regard to the possible interaction. Results: Ninety four pharmacists participated in this study. In 24 (25.3%) visits, the liable pharmacist was not present at the time of purchase. Furthermore, In 13 (18.57 %) visits by the simulated patients, the liable pharmacists did not pay any attention to the simulated patients even when they asked for consultation. Twenty nine (41.43%) pharmacists did not ask any question during dispensing. Nausea was the most frequent described side effect by pharmacists (27 (38.57%)). Yet important adverse effects of oral contraceptive pills were not mentioned by the pharmacists except for few ones. Only twelve (17.14%) pharmacists mentioned the possible interaction. There was a significant relation between the pharmacists’ gender and detection of possible interaction (p value= 0.048). Conclusion: The quality of the pharmacists’ consultations regarding the over the counter use of oral contraceptive pills was not satisfactory and required improvement (AU)


No disponible


Assuntos
Humanos , Feminino , Adulto , Agentes Comunitários de Saúde/organização & administração , Anticoncepcionais Orais/normas , Anticoncepcionais Orais/uso terapêutico , Farmacêuticos/organização & administração , Assistência Farmacêutica/organização & administração , Prática Profissional/organização & administração , Simulação de Paciente , Anticoncepcionais Pós-Coito/uso terapêutico , Serviços de Saúde Comunitária/métodos , Serviços de Saúde Comunitária , Irã (Geográfico)
4.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 43(4): 174-178, sept.-dic. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-156939

RESUMO

Introducción: Los anticonceptivos son drogas para evitar el embarazo y mantener controlado el ciclo hormonal femenino. Los de segunda generación incluyen el levonorgestrel y los de tercera generación están compuestos por desogestrel o gestodeno. El objetivo de esta revisión sistemática y metaanálisis es conocer el aumento de riesgo de infarto de miocardio por uso de la segunda generación o de la tercera generación de anticonceptivos orales. Material y métodos: Revisión sistemática en Medline y Cochrane, desde uno de enero de 1996 a uno de junio de 2015, de estudios observacionales. El metaanálisis se realizó utilizando un modelo de efectos aleatorios. Los outcomes son el riesgo de infarto de miocardio debido al uso de anticonceptivos orales de segunda o tercera generación. Resultados: Cumplieron criterios de inclusión y control de calidad 4 estudios observacionales. Los resultados del metaanálisis para segunda generación por modelo de efectos aleatorios fue 1,0995, y para tercera generación, 0,8298, pero fueron no significativos; los de tercera generación frente a segunda generación fueron también no significativos con un valor de 0,7361. Conclusiones: No podemos sacar conclusiones del metaanálisis debido a que los resultados son no significativos, por lo que no podemos indicar que el riesgo de infarto de miocardio aumente por el uso de segunda o tercera generación de anticonceptivos orales


Introduction: Contraceptives are drugs taken to prevent pregnancy and maintain control of the female hormonal cycle. Second-generation contraceptives include levonorgestrel, while third-generation contraceptives are made with desogestrel or gestodene. The objective of this systematic review and meta-analysis is to determine the risk of myocardial infarction when using second- or third-generation oral contraceptives. Materials and methods: A systematic review of observational studies in Medline and Cochrane from 1 January 1996 to 1 June 2015. The meta-analysis was performed using a random effects model. The outcomes are the risk of myocardial infarction due to the use of second- or third-generation oral contraceptives. Results: The four observational studies met certain inclusion and quality control criteria. The results of the meta-analysis using the random effects model were 1.0995 for second-generation and 0.8298 for third-generation contraceptives, but these results were not significant. The result of the comparison between third- and second-generation products was also not significant, with a value of 0.7361. Conclusions: We were unable to draw conclusions from the meta-analysis because the results were not significant. We are therefore unable to indicate the whether the risk of myocardial infarction increases with the use of second- or third-generation oral contraceptives


Assuntos
Humanos , Feminino , Anticoncepcionais Orais/efeitos adversos , Infarto do Miocárdio/induzido quimicamente , Fatores de Risco , Desogestrel/efeitos adversos , Levanogestrel/efeitos adversos
5.
Pharm. pract. (Granada, Internet) ; 14(3): 0-0, jul.-sept. 2016.
Artigo em Inglês | IBECS | ID: ibc-156632

RESUMO

Background: Emergency hormonal contraceptives (EHC) are contraceptives used to prevent unintended pregnancy following unprotected sexual intercourse (USI) or contraceptive failure. The EHCs available without a prescription include medicines containing levonorgestrel (LNG) in more than 80 countries and, recently, based on an EU-switch ellaOne®, which contains ulipristal acetate (UPA). EHCs work by stopping or delaying ovulation. Those containing LNG can be used up to 72 hours after USI or contraceptive failure, while UPA can be used up to 120 hours. In the context of the UPA implementation process, Germany switched LNG to non-prescription status as well. Objectives: To develop recommendations, a protocol, and a continuing education program for pharmacists to assure quality when giving advice and dispensing EHCs in community pharmacies without a medical prescription. Methods: The recommendations were developed by an iterative process of drafting, recognizing, and discussing comments and proposals for amendments as well a seeking agreement with a number of stakeholders such as the Federal Ministry of Health (BMG), Federal Institute for Drugs and Medical Devices (BfArM), Federal Chamber of Physicians (BÄK), Drug Commission of German Physicians (AkdÄ), professional organizations/associations of gynaecologists, pharmaceutical OTC-industry as well as government-controlled, private, and church-based organizations and centres providing advice on sex education and family planning. Results: The recommendations were eventually endorsed by the BMG in consultation with the BfArM. Conclusions: The recommendations were made public, published in the professional journal and used in an uncounted number of continuing education programs based on the curriculum and provided by the State Chambers of Pharmacists (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Medicamentos sem Prescrição/farmacologia , Medicamentos sem Prescrição/uso terapêutico , Anticoncepcionais Orais/farmacologia , Anticoncepcionais Orais/uso terapêutico , Formulários como Assunto/normas , Anticoncepcionais Pós-Coito/classificação , Anticoncepcionais Pós-Coito/farmacologia , Anticoncepcionais Pós-Coito/uso terapêutico , Alemanha/epidemiologia , Boas Práticas de Dispensação , Postos de Medicamentos , Medicamentos de Venda Assistida/normas
6.
Eur. j. anat ; 20(3): 221-225, jul. 2016. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-154881

RESUMO

A 41-year-old woman was admitted to the emergency room with symptoms compatible with deep vein thrombosis affecting the left lower extremity and pulmonary thromboembolism. A CT scan was consistent with pulmonary emboli and thrombosis of the iliac veins extending to the inferior vena cava, which persisted even after correct systemic fibrinolytic therapy. For this reason, a venography was performed and local thrombolysis was administered. Venography revealed a compression of the left common iliac vein caused by the right common iliac artery, so that the patient was diagnosed with May-Thurner syndrome. The clinical features of this anatomical condition and sometimes lethal clinical syndrome are discussed


No disponible


Assuntos
Humanos , Feminino , Adulto , Síndrome de May-Thurner/complicações , Embolia Pulmonar/etiologia , Trombose Venosa/fisiopatologia , Anticoncepcionais Orais/efeitos adversos , Insuficiência Venosa/complicações , Fatores de Risco
7.
Matronas prof ; 17(1): 28-34, 2016.
Artigo em Espanhol | IBECS | ID: ibc-152703

RESUMO

OBJETIVO: Identificar los factores relacionados con la adherencia y el cumplimiento de las mujeres con los anticonceptivos hormonales orales (ACO). METODOLOGÍA: Revisión bibliográfica. Se realizó una búsqueda en las bases de datos PubMed, CINAHL, Cochrane Library, MEDES y ENFISPO en los últimos 10 años. RESULTADOS: Se seleccionaron un total de 35 artículos originales y una revisión bibliográfica. Los factores que mejoran el cumplimiento de los ACO son los conocimientos que tiene la mujer sobre la píldora, iniciar el método de forma inmediata y el apoyo de la pareja. Los factores que influyen en la adherencia son el coste de los ACO, la falta de conocimientos ante los olvidos y la práctica de descansos de la píldora. CONCLUSIONES: El consejo contraceptivo debe ser individualizado, teniendo en cuenta los factores que afectan a la adherencia y el cumplimiento


AIM: To identify the factors related with the adherence and compliance of women that use the oral contraceptives (OC). METHODOLOGY: Literature review. A search in PubMed, CINAHL, Cochrane Library, MEDES, and ENFISPO databases has been performed in the last 10 years. RESULTS: A total number of 35 original articles and a review were selected. The factors which improve the compliance of OC are the knowledge of women about the pill, "the quick start" contraceptive method and the partner support. The highlighted factors which concern the adherence are the OC cost, the shortage of knowledge facing oversights and the resting periods of pill. CONCLUSIONS: The contraceptive counselling must be personalized considering the factors which concern the compliance and adherence


Assuntos
Humanos , Feminino , Anticoncepcionais Orais/uso terapêutico , Comportamento Contraceptivo/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Adesão à Medicação , Individualidade
9.
Pharm. pract. (Granada, Internet) ; 13(2): 0-0, abr.-jun. 2015. tab
Artigo em Inglês | IBECS | ID: ibc-141535

RESUMO

Background: Previous studies show that provision of oral contraceptive pill (OCs) without a prescription is safe, feasible and effective and that users are interested in obtaining contraception in this way, especially if a pharmacist screening is involved. A recent national survey conducted in the Republic of Ireland has highlighted that unintended pregnancy resulting from the failure of OCs could be linked to poor compliance due to costs and difficulty of access. Objective: To evaluate views and attitudes of OC users towards the availability of OCs without a prescription in the Republic of Ireland. Methods: A cross sectional survey was conducted using an opportunistic sample of OC users aged 18 to 50 years. Sixty community pharmacists were recruited nationwide. Data were collected using self-completed questionnaires. The questionnaires comprised information on: demographic data, need of the service, views on the availability of OCs without prescription, advantages and concerns around the service, role of pharmacists and cost implications for private and public patients. Results: A total of 488 eligible OC users completed the survey. The majority of the respondents (71.7%;n = 350/488) reported to have missed a pill for reasons connected to the OCs prescription status and 55.5% (n = 268/488) of the respondents reported to have felt distressed on at least one occasion because they could not renew their OC prescription. A total of 87.9% (n = 429/488) of the respondents said they were in favour of OCs being available without prescription and 92% (n = 448/488) said they were likely to obtain OCs without rescription if available. Convenience and ease of access were indicated as the main advantages of availing of OCs without prescription, while safety was the biggest concern reported. Over 88% (n = 430/488) of the respondents indicated that pharmacists would be able to safely supply OCs without prescription. Private patients expected to save an average of 27.3% on their OC if obtained without prescription. Conclusions. OC users in the Republic of Ireland are in favour of OCs being available without prescription and are willing to obtain it this way, providing that pharmacists supply them according to protocols that facilitate the safety and the efficacy of the supply. An easier and more convenient access to OCs could also reduce the likelihood of missed pills and bring considerable savings to users (AU)


Antecedentes: Estudios previos mostraron que la provisión de contraceptivos orales (OC) sin receta es segura, factible y efectiva y que las usuarias están interesadas en obtener contracepción de este modo, especialmente si está involucrado el consejo farmacéutico. Una reciente encuesta conducida en la República de Irlanda ha subrayado que los embarazos indeseados resultado de un fallo de los OC podrían estas ligados a cumplimento bajo debido a costes y dificultad de acceso. Objetivo: Evaluar la visión y actitudes de las usuarias de OC sobre la disponibilidad de OC sin receta en la Republica de Irlanda. Métodos: Se realizó un estudio transversal con una muestra oportunista de usuarias de OC de 18 a 50 años. Se reclutaron 60 farmacias comunitarias en toda la nación. Se recogieron los datos en un cuestionario autocumplimentado. Los cuestionarios comprendían información sobre: datos demográficos, necesidad de servicio, visiones sobre la disponibilidad de los OC sin receta, ventajas y preocupaciones sobre el servicio, papel del farmacéutico e implicaciones para los pacientes públicos o privados. Resultados: Un total de 488 usuarios de OC elegibles completaron la encuesta. La mayoría de los respondentes (71,7%; n=350/488) reportaron haber omitido una píldora por razones relacionadas con el estado de prescripción de los OC y el 55,5% (n=268/468) de los respondentes reporto haber sentido desasosiego al menos en una ocasión por no poder renovar su prescripción de OC. Un total de 87,9% dijo que estaba a favor de que los OC estuviesen disponibles sin receta y el 92% (n=448/488) dijo que probablemente comprarían OC sin receta si estuviesen disponibles. La comodidad y la facilidad de acceso aparecieron indicadas como las ventajas principales de disponibilizar OC sin receta, mientras que la seguridad era la mayor preocupación. Más del 88% (n=460/488) indicó que los farmacéuticos serían capaces de distribuir de modo seguro los OC sin receta. Los pacientes privados esperaban ahorrar una media del 27,3% en sus OC si los obtenían sin receta. Conclusiones: Las usuarias de OC en la República de Irlanda están a favor de que los OC estén disponibles sin receta y están dispuestas a obtenerlos de este modo, aceptado que los farmacéuticos los proporcionen de acuerdo a protocolos que faciliten la seguridad y eficacia del suministro. Un modo más fácil y más cómodo de acceso a los OC podría también reducir la probabilidad de píldoras omitidas y traería considerables ahorros a las usuarias (AU)


Assuntos
Feminino , Humanos , Masculino , Anticoncepcionais Orais/uso terapêutico , Medicamentos sem Prescrição/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Gravidez não Desejada , Prescrições/normas , Irlanda , Inquéritos e Questionários/normas , Inquéritos e Questionários , Anticoncepcionais Orais/provisão & distribução , Estudos Transversais/métodos
10.
Rev. clín. med. fam ; 8(1): 66-70, feb. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-136760

RESUMO

Presentamos el caso de una adolescente de 16 años de edad que, estando previamente asintomática y sin historia clínica de haber padecido ninguna migraña, presenta de manera progresiva, en el plazo de una semana, una cefalea holocraneal de características pulsátiles, que no mejoraba con analgésicos a dosis altas. Ante la persistencia del cuadro y los criterios de alarma que presentaba fue fundamental el uso de la Resonancia Magnética Nuclear (RMN) para su diagnóstico (AU)


We report the case of a 16-year-old female teenager, previously asymptomatic and without a medical record of migraine-like headaches, who progressively developed a pulsating holocraneal headache, which did not improve with high doses of painkillers. Given the persistence of the clinical picture and the alarm criteria, the use of Nuclear Magnetic Resonance (RMN) was fundamental for achieving an accurate diagnosis (AU)


Assuntos
Adolescente , Feminino , Humanos , Cefaleia/complicações , Cefaleia/etiologia , Cefaleia , Transtornos da Cefaleia/etiologia , Imagem por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodos , Trombose Venosa/complicações , Etinilestradiol/efeitos adversos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Fatores de Risco , Fotofobia/complicações , Anticoncepcionais Orais/efeitos adversos , Diagnóstico Diferencial
11.
Prog. obstet. ginecol. (Ed. impr.) ; 58(1): 20-24, ene. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-131269

RESUMO

Presentamos el caso de una paciente de 18 años que consultó por oligomenorrea, flujo menstrual maloliente y dolor pélvico tipo cólico. Ante la sospecha de alteración menstrual por defecto en el tracto de salida se realizó ecografía ginecológica y resonancia magnética con el resultado de útero doble, hemivagina obstruida o ciega derecha acompañado de agenesia renal derecha, síndrome Herlyn-Werner-Wunderlich. Tras el diagnóstico se realizó escisión del septo y drenaje de las colecciones que suprimen la sintomatología de la paciente mejorando la capacidad reproductiva (AU)


We report the case of an 18-year-old woman who consulted for oligomenorrhea, chronic pelvic pain and malodorous vaginal discharge. Ultrasonography and magnetic resonance imaging demonstrated uterus didelphys with right-sided hematometrocolpos and absent right kidney (Herlyn-Werner- Wunderlich syndrome). The patient underwent resection of the septum and drainage of collections, with complete symptom resolution (AU)


Assuntos
Humanos , Feminino , Adulto Jovem , Síndrome de Werner/complicações , Útero/anormalidades , Útero , Oligomenorreia/complicações , Oligomenorreia , Dor Pélvica/complicações , Dor Pélvica/etiologia , Anticoncepcionais Orais/uso terapêutico , Imagem por Ressonância Magnética/métodos , Diagnóstico Precoce , Ultrassonografia Pré-Natal/métodos , Rim/anormalidades , Útero/fisiopatologia , Rim , Anamnese/métodos , Hirsutismo/complicações , Obesidade/complicações , Abdome/patologia , Abdome , Histerossalpingografia
12.
Pediatr. aten. prim ; 16(63): 219-223, jul.-sept. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-127989

RESUMO

La enfermedad tromboembólica venosa (ETEV) en edad pediátrica es infrecuente y su clínica variable; se relaciona con al menos un factor de riesgo (vía venosa central, trastornos de la coagulación, traumatismos, cirugía, enfermedades malignas o tratamiento con anticonceptivos orales). Los objetivos del tratamiento son prevenir la embolización y minimizar las complicaciones. Dada la gravedad de las complicaciones de la ETEV, es preciso tener presente esta posibilidad diagnóstica ante un paciente con factores de riesgo (AU)


Venous thromboembolism (VTE) in childhood is uncommon and clinically variable. It is related to at least one risk factor (central venous catheter, bleeding disorders, trauma, surgery, malignancy or treatment with oral contraceptives). The symptoms of pulmonary embolism are variable and nonspecific. The goals of treatment are to prevent embolization and minimize complications. Due to the severity of VTE complications, we must be aware of this possible diagnosis in a patient with risk factors (AU)


Assuntos
Humanos , Feminino , Adolescente , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamento farmacológico , Fatores de Risco , Embolia Pulmonar/fisiopatologia , Embolia Pulmonar , Transtornos da Coagulação Sanguínea/complicações , Anticoncepcionais Orais/efeitos adversos , Embolização Terapêutica/métodos , Embolização Terapêutica/tendências , Dor Abdominal/etiologia
13.
Cient. dent. (Ed. impr.) ; 11(2): 93-97, mayo-ago. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-126680

RESUMO

Introducción: Los anticonceptivos orales (ACO) forman parte del grupo de los anticonceptivos hormonales, estando su uso altamente extendido. Aunque tienen una elevada tasa de eficacia poseen efectos adversos a nivel sistémico y local. Objetivo: Determinar si las mujeres en tratamiento con anticonceptivos orales tienen mayor incidencia de complicaciones postoperatorias. Pacientes y método: Se llevó a cabo un estudio retrospectivo de casos y controles de todas las pacientes de uno de los centros del servicio del Máster de Cirugía Bucal e Implantología Hospital Virgen de la Paloma, entre los años 2006 y 2013. Se recopilaron historias clínicas de mujeres mayores de 18 años. Las variables recogidas fueron la toma o no de anticonceptivos orales y las complicaciones que se pudieran producir tras la cirugía. Se realizó un estudio estadís-tico descriptivo inferencial para hallar laodds ratio, utilizando el programa Epidat 3.1. Resultados: En el estudio se evaluaron 219 historias clínicas, descartándose 17 porestar incompletas. En el grupo de casos (n=10), cuatro pacientes padecieron complicaciones y del grupo control (n=192), 41. Se obtuvo una Odds Ratio de 2,45.Discusión:En la realización del presente estudio, cabe destacar la falta de artículos que relacionen el tratamiento con anticonceptivos orales y las complicacionesinmediatas postoperatorias. Además, sedeben mencionar dos posibles sesgos. Asaber, el pequeño tamaño muestral estudiado; y que al tratarse de medicamentos tan extendidos el profesional no pregunta por su toma al hacerla historia clínica. Conclusión:Las mujeres en tratamiento con anticonceptivosorales tienen un odds ratio de 2,45, lo que sugiere una mayor probabilidad de padecer complicaciones postoperatorias en el tratamiento implantológico; aunque el resultado es estadísticamente no significativo, por lo que debería ampliarse la muestra para poder verificar este resultado (AU)


Introduction: Oral contraceptives are part of the group of hormonal contraceptives, whose use is highly extended. Although they have a high rate of effectiveness, they have adverse systemic and local effects. Objective: To determinate whether women taking oral contraceptives have a higher incidence of postoperative complications. Patients and Methods: It was carried out a retrospective case-control study of all patients in one of the service centers of the Master of Oral Surgery and Implantology Virgen de la Paloma Hospital, between the years 2006-2013. Medical histories of women older than 18 were collected. The variables were whether taking oral contraceptives or not, and complications that may occur after surgery. Descriptive inferential statistical analysis to find the odds ratio was performed using the program Epid at 3.1.Results:The study evaluated 219 medical histories, 17 were rejected as incomplete. In the case group (n=10) 4 patients had complications and in the control group (n=192) 41. An odds ratio = 2,45 was obtained. Discussion: In the realization of the present study there is a lack of articles that relate taking oral contraceptives and immediate postoperative complications. In addition, we should mention two possible biases. Namely, the small sample size studied, and that since it is a so widespread drug, professional does not ask about it to make the medical history. Conclusion: Women taking oral contraceptives have an odds ratio of 2,45, suggesting a greater likelihood of developing post operative complications in implant treatment; although the result is not statistically significant, so the sample should be expanded to verify it (AU)


Assuntos
Humanos , Feminino , Anticoncepcionais Orais/uso terapêutico , Implantação Dentária , Complicações Pós-Operatórias , Estudos de Casos e Controles , Cicatrização
15.
Ars pharm ; 55(2): 32-41[2], abr.-jun. 2014. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-125919

RESUMO

Objetivo: El objetivo de este trabajo fue analizar la oferta, demanda y costos de los anticonceptivos orales disponibles en Argentina, así como también caracterizar la población usuaria y la forma de uso de los anticonceptivos parte de los mismos. Material y Método: Se realizó un estudio descriptivo y observacional donde se trabajó con un procedimiento normalizado analizando dispensaciones en un total de 42 farmacias comunitarias de Córdoba (Argentina). Resultados: 90 son los anticonceptivos hormonales orales disponibles, 81 % de los cuales son combinados. Más del 80% de las ventas se concentren solo en 3 laboratorios productores siendo paradójicamente la combinación más costosa (Drospirenona-Etinil Estradiol) la más dispensada. En más del 60% de los casos el anticonceptivo fue adquirido sin receta médica y sin cobertura de la seguridad social, lo cual fue, generalmente, compensado con descuentos adicionales que provenían en su mayoría de la farmacia. A pesar de contar la población en estudio, en su mayoría, con un nivel educativo medio-alto y experiencia en el uso de anticonceptivos, se detectó desconocimiento en los parámetros de uso y actitudes a tomar ante olvidos. Conclusiones: A pesar de la amplia oferta de anticonceptivos orales, la demanda de los mismos en farmacias comunitarias de la ciudad de Córdoba está fuertemente concentrada en los anticonceptivos orales combinados de mayor precio de venta en el mercado, existiendo deficiencias en el conocimiento por parte de los paciente respecto al modo adecuado de uso, con una fuerte tendencia a la repetición de una prescripción o automedicación a utilizar combinaciones de 3ra o 4ta generación sin que las mismas sean las más recomendadas


Aim: The aim of this study was to describe the supply and demand of oral contraceptives available in Argentina, characterize the user population and how the patients use contraceptives. Materials and Methods: We worked with a normalized procedure, analyzing 713 dispensations in 42 community pharmacies in Córdoba (Argentina). Results: The 90 oral contraceptives available in the Argentine pharmaceutical market, 81% of which correspond to combined oral contraceptive. More than 80% of the sales are concentrated in only 3 laboratories. Among combined oral contraceptive, the combinations of Drosperinone-Ethinylestradiol, those with the highest average price, were also the ones most chosen by the users. In over 60% of the cases they were purchased without a prescription and without social security coverage. This was offset by additional discounts coming mostly from the pharmacy outlets. Although most of the study population had an acceptable level of education and experience in the use of contaceptives, a certain lack of knowledge in the parameters of use and in the attitude to adopt when missing the daily dose was detected. Conclusions: Despite the broad range of oral contraceptives, the demand in community pharmacies is heavily concentrated in the combined oral contraceptive with higher price in the market, existing deficiencies in the knowledge from the patient regarding the proper way to use and there is a strong trend self-medication and use combinations of 3rd or 4th generation without the appropriate indications


Assuntos
Humanos , Feminino , Anticoncepcionais Orais/uso terapêutico , Serviços Comunitários de Farmácia/estatística & dados numéricos , Planejamento Familiar , Comportamento Contraceptivo/estatística & dados numéricos , Revisão de Uso de Medicamentos/estatística & dados numéricos , Automedicação/estatística & dados numéricos
17.
Rev. iberoam. fertil. reprod. hum ; 30(2): 30-40, abr.-jun. 2013. tab
Artigo em Espanhol | IBECS | ID: ibc-131145

RESUMO

Los anticonceptivos orales combinados han evolucionado aceleradamente durante las últimas décadas reduciendo los efectos adversos sin afectar la eficacia y ajustándose a las preferencias de las mujeres. Es importante conocer las percepciones y expectativas de las usuarias para mejorar la adherencia y disminuir los fallos de la anticoncepción. Para tal fin se realizó un estudio encuestal con una muestra de 389 usuarias entre los 18 y 45 años de edad en las 4 ciudades principales de Colombia, evaluando además de las variables sociodemográficas el conocimiento y las preferencias de las usuarias relacionadas con los beneficios adicionales de esta terapia anticonceptiva. La muestra estuvo integrada en su mayoría por mujeres pertenecientes a los estratos socio-económicos medio (62,7%) y alto (37,3%). El 40,9% de las participantes se encontraban en el grupo de 18 a 25 años, 43,0% en el de 26 a 35 años y 16,1% en el de 36 a 45 años. 58,4% de las participantes refirieron conocer al menos un beneficio adicional de los anticonceptivos orales y cuando se les pidió que ordenaran por importancia cinco atributos propuestos por el encuestador como potenciales efectos beneficiosos, se obtuvo para todos los grupos de edad el siguiente orden: 1) que no afecte el peso corporal (35,2%), 2) disminución de la dismenorrea (26,6%), 3) mejorar la calidad de la piel (20,1%), 4) disminución en duración y volumen del sangrado menstrual (13,3%) y 5) reducir las fluctuaciones del estado anímico (5%). Una asesoría anticonceptiva individualizada y completa, donde se evalúen el conocimiento previo de los potenciales efectos beneficiosos de los anticonceptivos orales, las expectativas y preferencias de usuarias contribuirán a disminuir las tasas de embarazos no planificados relacionados con el uso incorrecto o con la suspensión de la terapia (AU)


Combined oral contraceptives have evolved rapidly in recent decades to reduce side effects without affecting the efficacy and according to the preferences of women. It is important to understand the perceptions and expectations of users to improve adherence and reduce the failure of contraception. To this end we conducted a survey-based study within a sample of 389 users aged 18 and 45 years of age in 4 major cities of Colombia, to assess sociodemographic variables in addition to knowledge and preferences of users related to the additional benefits of this contraceptive therapy. The sample consisted mostly of women belonging to middle (62.7%) and high (37.3%) socioeconomic groups. 40.9% of participants were in the group of 18 to 25 years, 43.0% in the group of 26 to 35 years and 16.1% in the group of 36 to 45 years. 58.4% of participants reported knowing at least one additional benefit of oral contraceptives, and when they were asked to rank by importance five attributes proposed by the interviewer as potential beneficial effects was obtained for all age groups the following order: 1) that it does not affect body weight (35.2%), 2) reduction of dysmenorrhea (26.6%), 3) improve the quality of the skin (20.1%), 4) decrease in duration and volume of menstrual bleeding (13.3%) and 5) reduce mood fluctuations (5%). An individualized and comprehensive contraceptive counseling, which assesses the prior knowledge of the potential beneficial effects of oral contraceptives, expectations and preferences of users will contribute to reducing unplanned pregnancy rates associated with incorrect use or with early discontinuation of therapy (AU)


Assuntos
Humanos , Feminino , Comportamento Contraceptivo/tendências , Anticoncepcionais Femininos/uso terapêutico , Anticoncepcionais Orais/uso terapêutico , Colômbia , Comportamento do Consumidor , Preferência do Paciente
18.
Allergol. immunopatol ; 41(3): 169-175, mayo-jun. 2013. tab, graf
Artigo em Inglês | IBECS | ID: ibc-112802

RESUMO

Background: Emerging evidence suggests that sex steroid hormones may influence respiratory symptoms. The existing literature about the role of oral contraceptive pill (OCP) on respiratory disease is scarce and conflicting especially during the adolescent period. In this study, we aimed to investigate the effect of OCPs on current wheezing among adolescents and young adults. Methods: A questionnaire was administered face-to-face to adolescents and young women by a physician. The questionnaire included ISAAC survey-comprised questions on ever wheezing, current wheezing, allergic diseases, smoking history (active or passive), and family history of allergic diseases and questions on OCP usage status. The effect of OCPs on wheezing was evaluated by logistic regression analysis. Results: A total of 487 subjects aged between 11.3 and 25.6 years participated in the study and 196 (40.2%) reported that they had used OCPs. 7.4% of the participants had physician-diagnosed asthma and 10.3% of them were active smokers. It was detected that OCPs were associated with increased risk for current wheezing (odds ratio, 2.36; 95% CI, 1.25-4.47 adjusted for asthma and current smoker) and this risk was related with the usage during the past year. Conclusion: Young women taking oral contraceptives had a higher rate of current wheezing, suggesting that sex steroids may be of importance for respiratory health (AU)


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Anticoncepcionais Orais/efeitos adversos , Asma/induzido quimicamente , Sons Respiratórios , Fatores de Risco , Fumar/efeitos adversos
19.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 31(supl.2): 12-19, jun. 2013. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-179604

RESUMO

Rilpivirina (RPV) es un fármaco perteneciente a la familia de los inhibidores no nucleósidos de la transcriptasa inversa (INNTI), con potente actividad antiviral, aprobado para pacientes naïve, con perfil de efectos secundarios diferente a los INNTI de primera generación. Las interacciones farmacológicas producidas por RPV se deben a su efecto sobre el sistema CYP450, es sustrato de CYP3A4 y ligeramente inductor. Además, in vitro es inhibidor de la glucoproteína-P. RPV presenta interacciones farmacológicas clínicamente significativas, entre las que destacan los inhibidores de la proteasa, a excepción de darunavir y lopinavir potenciados, y los INNTI efavirenz y nevirapina. La toma de RPV junto con fármacos que aumentan el pH gástrico, como omeprazol, o los que inducen el CYP3A4, como rifampicina, puede causar reducciones significativas en las concentraciones de RPV y está contraindicada. El uso concomitante de RPV con un inhibidor del CYP3A4, por ejemplo claritromicina, puede provocar aumento de las concentraciones de RPV. Se recomienda la administración de RPV con alimentos para obtener mejor absorción y valores plasmáticos adecuados


Rilpivirine (RPV) is a nonnucleoside reverse transcriptase inhibitor (NNRTI) that has been approved for use in treatment-naïve patients and which has potent antiviral activity. Its adverse effects profile differs from that of first-generation NNRTs. The pharmacological interactions produced by RPV are due to its effects on the CYP450 system; RPV is a substrate and mild inducer of CYP3A4. Moreover, in vitro, RPV inhibits glycoprotein-P. RPV has clinically significant pharmacological interactions, especially with protease inhibitors (except boosted darunavir and lopinavir) and the NNRTIs efavirenz and nevirapine. Coadministration of RPV with drugs that increase gastric pH, such as omeprazole, or those inducing CYP3A4, such as rifampicin, can significantly reduce RPV concentrations and is contraindicated. The concomitant use of RPV with a CYP3A4 inhibitor (such as clarithromycin) can increase RPV concentrations. Administration of PRV with food is recommended to obtain better absorption and adequate plasma values


Assuntos
Humanos , Fármacos Anti-HIV/farmacocinética , Citocromo P-450 CYP3A/metabolismo , Indutores do Citocromo P-450 CYP3A/farmacocinética , Nitrilos/farmacocinética , Pirimidinas/farmacocinética , Inibidores da Transcriptase Reversa/farmacocinética , Fármacos Anti-HIV/uso terapêutico , Anti-Infecciosos , Anticonvulsivantes/farmacocinética , Inibidores do Citocromo P-450 CYP3A/farmacocinética , Anticoncepcionais Orais/farmacocinética , Fármacos Gastrointestinais/farmacocinética , Nitrilos/uso terapêutico , Bombas de Próton/farmacocinética , Pirimidinas/uso terapêutico , Inibidores da Transcriptase Reversa/administração & dosagem
20.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. impr.) ; 39(3): 175-178, abr. 2013. ilus
Artigo em Espanhol | IBECS | ID: ibc-111332

RESUMO

El médico de atención primaria debe conocer los factores de riesgo y sospechar la presencia de una tromboembolismo pulmonar (TEP) ante un cuadro clínico compatible. Presentamos 2 casos de TEP masivos en mujeres jóvenes sanas en las que la toma de etilnilestradiol asociado a acetato de ciproterona era el único factor de riesgo existente. Creemos necesario atender a las recomendaciones de la Agencia Española del Medicamento y prescribir aquellos anticonceptivos que aporten menos de 30 μg de etinilestradiol y un gestágeno de segunda generación (AU)


The Primary Care physician must know the risk factors and to suspect the presence of a pulmonary thromboembolism (PTE) when there is a compatible clinical picture. We present two cases of a massive PTE in young healthy women in whom the taking of ethinylestradiol combined with cyproterone acetate was the only existing risk factor. We believe that the recommendations of the Spanish Medicines Agency should be followed and prescribe those contraceptives that have less than 30ug of ethinylestradiol and a second generation gestagen (AU)


Assuntos
Humanos , Feminino , Adulto , Embolia Pulmonar/induzido quimicamente , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Fatores de Risco , Anticoncepcionais Orais/efeitos adversos , Embolia Pulmonar/fisiopatologia , Embolia Pulmonar , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/normas , Taquipneia/complicações , Artéria Pulmonar
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