[Pharmacological interactions: a professional challenge]. / Interacciones farmacológicas: un reto profesional.

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[Recommendations for the use of social networks by hospital pharmacists (12 advises that one should consider before jumping into the network)]. / Recomendaciones para el uso de las redes sociales para farmacéuticos de hospital (12 consejos que deberías tener en cuenta antes de lanzarte a la red).

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Application of the Technology Web 2.0 in a drug information centre.

OBJECTIVE: To develop a Web 2.0 resource map and select those that may be useful in a Drug Information Centre at a Hospital Pharmacy Department (CIMSF). METHOD: A multidisciplinary working group under the Biomedical Information Commission selected some of the Web 2.0 resources included in the Guía d'usos i estil a les xarxes Socials guide of the Catalonian Government. RESULTS: Six resources were selected: Netvibes, Delicious, Google groups, Google Docs, Slideshare and Twitter. These tools were used for 5 months to manage biomedical information for the medical staff, and to provide external visibility by providing information to other health professionals. More than a thousand hits were recorded on the portal Netvibes and more than 100 professionals followed CIMSF on Twitter. CONCLUSIONS: The Web 2.0 offers useful, user-friendly and cost-efficient tools which could be implemented in a CIMSF, while also enabling participation in external networks of pharmacotherapeutic interest, increasing its visibility to other professionals.

[Optimisation of the prescription of medication for patients undergoing elective surgery]. / Optimización del circuito de prescripción de medicamentos en pacientes con cirugía electiva.

OBJECTIVE: To draw up a document in which patients can note down their residential treatment and determine its usefulness. The level of compliance and assessment of the document can be quantified by the healthcare personnel. METHOD: Initially the medical prescription process was analysed in the preoperative stage. Its usefulness was later evaluated, analysing the percentage of patients who could benefit from it, through a questionnaire for the healthcare personnel. RESULTS: A residential medication document was drawn up and included in the documentation process at the preoperative stage. From a sample of 350 patients, 76.0 % took medication at home and 81.2 % of those used the document. The health personnel rated its usefulness as 4.51 and the safety of it at 4.38 in a scale of 1 to 5. The time saved was valued at 4.37; 4 being a saving of between 0 and 5 minutes, and 5 being a saving of between 5 and 10 minutes. DISCUSSION: The home medication document could overcome the problem of knowing exactly the home medication itself, and this could be the first step in therapeutic conciliation. According to the assessment by the healthcare personnel, it improves the usefulness and the efficiency of the process. According to our data, the time saved by the medical staff and nursing personnel fluctuates between 93-310 and 122-339 hours per year, respectively. Computerised, up-to-date clinical records accessed by both primary and specialised care, could further optimise the prescription process of medication in the perioperative stages.

Optimización del circuito de prescripción de medicamentos en pacientes con cirugía electiva / Optimisation of the prescription of medication for patients undergoing elective surgery

Objetivo: Elaborar un documento en el que los pacientes puedan anotar el tratamiento domiciliario y determinar su utilidad, así como cuantificar el nivel de cumplimiento y la valoración que del documento haga el personal sanitario. Método: Inicialmente, se analizó el circuito de prescripción médica en el preoperatorio. Posteriormente, se valoró su utilidad, y se analizó el porcentaje de pacientes que podían beneficiarse mediante una encuesta al personal sanitario. Resultados: Se editó un documento de medicación domiciliaria que se incluyó en el circuito de documentación del preoperatorio. De una muestra de 350 pacientes, el 76,0 % tomaba medicación domiciliaria, y el 81,2 % trajo el documento. El personal sanitario valoró su utilidad con un 4,51, y la seguridad en un 4,38, en una escala del 1 al 5. La diferencia de tiempo se valoró con un 4,37, en la que 4 supone un ahorro de entre 0 y 5 min, y 5, entre 5 y 10 min. Discusión: El documento de medicación domiciliaria permitiría superar el problema del conocimiento exacto de la medicación domiciliaria, y podría ser el primer paso para la conciliación terapéutica. Según la valoración del personal sanitario, mejora la utilidad y la eficiencia del circuito. Según nuestros datos, el ahorro del tiempo del personal médico y de enfermería oscilaría entre las 93 y las 310 h/año y las 122 y las 339 h/año, respectivamente. La historia clínica informatizada y actualizada, y con acceso desde la atención primaria y la especializada, podría mejorar aún más el circuito de prescripción de medicamentos en el perioperatorio (AU)

Objective: To draw up a document in which patients can note down their residential treatment and determine its usefulness. The level of compliance and assessment of the document can be quantified by the healthcare personnel. Method: Initially the medical prescription process was analysed in the preoperative stage. Its usefulness was later evaluated, analysing the percentage of patients who could benefit from it, through a questionnaire for the healthcare personnel. Results: A residential medication document was drawn up and included in the documentation process at the preoperative stage. From a sample of 350 patients, 76.0 % took medication at home and 81.2 % of those used the document. The health personnel rated its usefulness as 4.51 and the safety of it at 4.38 in a scale of 1 to 5. The time saved was valued at 4.37; 4 being a saving of between 0 and 5 minutes, and 5 being a saving of between 5 and 10 minutes. Discussion: The home medication document could overcome the problem of knowing exactly the home medication itself, and this could be the first step in therapeutic conciliation. According to the assessment by the healthcare personnel, it improves the usefulness and the efficiency of the process. According to our data, the time saved by the medical staff and nursing personnel fluctuates between 93-310 and 122-339 hours per year, respectively. Computerised, up-to-date clinical records accessed by both primary and specialised care, could further optimise the prescription process of medication in the perioperative stages (AU)

[Drug information management through the intranet of a hospital center]. / Original Breve Gestión de la información de medicamentos mediante la intranet de un centro hospitalario.

OBJECTIVE: This paper describes the methodology used for the implementation and validation of a network resource incorporated to the intranet of the Hospital, in order to retain and disseminate information from the Drug Information Center (DIC) of a pharmacy service in a hospital center. METHOD: A working group designed the structure, contents, memory needs, priority of access for users and a quality assessment questionnaire. RESULTS: The resource developed by the working group had a capacity of 70 Gb and its structure was based on HTML documents, including files with different format and 12 theme areas. Two levels of priority of access were established depending on the user and two persons were in charge of the resource. The questionnaire was delivered after three months of use. Sixty nine per cent of the users regarded the resource as very useful and 31%, as useful. The final structure, according to the results of the survey, had 11 theme areas. CONCLUSIONS: The use of the hospital Intranet in order to include and organize DIC information can be very simple and economic. Furthermore, the involvement of all the users in its design and structure can facilitate the practical use of this tool and improve its quality.

Gestión de la información de medicamentos mediante la intranet de un centro hospitalario / Drug information management through the intranet of a hospital center

Objetivo: En el presente trabajo se describe la metodología deimplantación y validación de un recurso de red incluido en la intranetdel Hospital, para almacenar y difundir la información delCentro de Información de Medicamentos (CIM) de un servicio defarmacia en un centro hospitalario.Método: Un grupo de trabajo diseñó la estructura, contenido,necesidades de memoria, prioridades de acceso de los usuarios yuna encuesta para evaluar la calidad.Resultados: El recurso obtenido de 70 Gb de capacidad seestructuró mediante documentos HTML incluyendo archivosde diferente formato con 12 áreas temáticas. Se establecieron2 niveles de prioridad de acceso según el usuario y dos responsablesdel recurso. La encuesta realizada tras tres meses de utilizaciónmostró que el 69% de los usuarios, consideró el recurso muyútil, y el 31% lo calificó de útil. La estructura final, según los resultadosde la encuesta fue de 11 áreas temáticas.Conclusiones: La utilización de la intranet del hospital paraincluir y estructurar la información del CIM puede realizarse deuna forma sencilla y económica. Además, la participación detodos los usuarios en su diseño y estructura, puede facilitar la utilidadpráctica de esta herramienta y aumentar su calidad

Objective: This paper describes the methodology used for theimplementation and validation of a network resource incorporatedto the intranet of the Hospital, in order to retain and disseminateinformation from the Drug Information Center (DIC) of a pharmacyservice in a hospital center.Method: A working group designed the structure, contents,memory needs, priority of access for users and a quality assessmentquestionnaire.Results: The resource developed by the working group had acapacity of 70 Gb and its structure was based on HTML documents,including files with different format and 12 theme areas.Two levels of priority of access were established depending on theuser and two persons were in charge of the resource. The questionnairewas delivered after three months of use. Sixty nine percent of the users regarded the resource as very useful and 31%, asuseful. The final structure, according to the results of the survey,had 11 theme areas.Conclusions: The use of the hospital Intranet in order toinclude and organize DIC information can be very simple and economic.Furthermore, the involvement of all the users in its designand structure can facilitate the practical use of this tool andimprove its quality

[Clinical and pharmacological databases for personal digital assistants]. / Bases de datos clínicas y farmacológicas para asistentes personales digitales.

Personal digital assistants (PDAs) are part of the new technologies applied to medicine, which could improve both access to and storage of distinct databases. The present article reviews some general technical features, as well as the utility of these devices for consulting specific pediatric, clinical and pharmacological databases. A search was performed in Medline (1999 to 2004) and of web pages that described the use of PDAs and a total of 46 useful applications were identified, including pediatric diagnostic and treatment guidelines, databases of diagnostic procedures, guidelines for antibiotic therapy in the pediatric and adult populations, databases to establish the diagnosis and treatment of patients in emergency and intensive care medicine, catalogues of general drugs with complete pharmacological data (indications, doses, adverse effects, interactions, toxicology, pregnancy, lactation), specific databases of neonatology, otorhinolaryngology and pediatric surgery, and medical calculator software. Each reference details the contents, source of the reference information, memory requirements, operating system, cost, web page for downloads and whether there is a test version. There is a wide variety of pediatrics software for PDAs. Once the quality of these databases has been assessed, each user should evaluate which application will be most useful depending on his or her needs.

Bases de datos clínicas y farmacológicas para asistentes personales digitales / Clinical and pharmacological databases for personal digital assistants

Los asistentes personales digitales (personal digital assistants, PDA) forman parte de las nuevas tecnologías aplicadas a la medicina, que pueden mejorar tanto el acceso como el almacenamiento de distintas bases de datos. En el presente trabajo se revisan algunas generalidades técnicas, así como la utilidad de estos dispositivos para la consulta de bases de datos específicas de pediatría, clínicas y farmacológicas. Se ha realizado una búsqueda en Medline (1999-2004) y de las páginas web que describen utilidades de los PDA, recopilándose un total de 46 aplicaciones útiles, del tipo: guías de diagnóstico y de tratamiento pediátricas, bases de datos de procedimientos diagnósticos, guías de terapéutica antimicrobiana en pediatría y también en el adulto, bases de datos para establecer el diagnóstico y tratamiento de pacientes en medicina de urgencia y cuidados intensivos, catálogos de medicamentos generales con fichas farmacológicas completas (indicaciones, dosis, efectos adversos, interacciones, toxicología, embarazo, lactancia), bases de datos específicas de neonatología, otorrinolaringología y cirugía pediátrica, y software calculador médico. Para cada referencia se muestra la descripción del contenido, fuente de información de referencia, necesidades de memoria, sistema operativo, coste, la página web de descarga y si hay versión de prueba. Como resultado se muestra que existe una amplia oferta de software médico especializado en pediatría para PDA, por lo que una vez contrastada la calidad de estas bases de datos, cada usuario debe valorar cuál puede ser la más útil en función de sus necesidades y de los aspectos descritos

Personal digital assistants (PDAs) are part of the new technologies applied to medicine, which could improve both access to and storage of distinct databases. The present article reviews some general technical features, as well as the utility of these devices for consulting specific pediatric, clinical and pharmacological databases. A search was performed in Medline (1999 to 2004) and of web pages that described the use of PDAs and a total of 46 useful applications were identified, including pediatric diagnostic and treatment guidelines, databases of diagnostic procedures, guidelines for antibiotic therapy in the pediatric and adult populations, databases to establish the diagnosis and treatment of patients in emergency and intensive care medicine, catalogues of general drugs with complete pharmacological data (indications, doses, adverse effects, interactions, toxicology, pregnancy, lactation), specific databases of neonatology, otorhinolaryngology and pediatric surgery, and medical calculator software. Each reference details the contents, source of the reference information, memory requirements, operating system, cost, web page for downloads and whether there is a test version. There is a wide variety of pediatrics software for PDAs. Once the quality of these databases has been assessed, each user should evaluate which application will be most useful depending on his or her needs

Estabilidad de las especialidades farmacéuticas termolábiles en distintas condiciones de temperatura / Stability of thermolabile pharmaceutical specialities under various temperature conditions

No disponible

[Drug utilization and recommended conditions for use in children]. / Utilización de medicamentos y condiciones de uso recomendadas en pediatría.

BACKGROUND: Studies carried out in other countries show that drugs are used in children outside the approved conditions, in a context in which investigation, information and authorization of medications in the pediatric population are scarce. OBJECTIVES: To evaluate the conditions of drug use recommended in children and variability in sources of drug information. METHODS: We performed a descriptive, retrospective study. Data on medication consumption in 1997 were obtained from a pediatric university hospital. Information on conditions of drug use in children was analyzed using a Spanish catalog of medications. This information was compared with that of a North American catalog for international reference. RESULTS: Most of the drugs used were of unrestricted (43; 47 %) or restricted (26; 28 %) pediatric use, but drugs that are not recommended (8; 9 %) or those with unspecified conditions of use in children were also used (15; 16 %). Approximately 12 % of the drugs were not identified in the North American catalog; of the remaining drugs, 60 % were of unrestricted pediatric use, 35 % of restricted use and 5 % were not recommended. CONCLUSIONS: A substantial proportion of drugs administered to hospitalized children are not recommended or their possible use in this population is not specified. It is worth encouraging research, having sources of information that help to make decisions, especially in conditions that have not been approved, and adapting regulatory attitudes, as far as possible, to the evidence and therapeutic needs.

Utilización de medicamentos y condiciones de uso recomendadas en pediatría / Drug utilization and recommended conditions for use in children

Antecedentes: Estudios realizados en otros países indican que en niños se utilizan fármacos en condiciones distintas a las aprobadas, en un contexto en que son escasas la investigación, información y autorización de medicamentos en población pediátrica. Objetivos: Evaluar las condiciones de uso recomendadas en pediatría para los fármacos utilizados en niños y la variabilidad de las fuentes de información sobre éstos. Métodos: Estudio descriptivo y retrospectivo. Se seleccionaron los datos de consumo de medicamentos en un hospital universitario pediátrico durante el año 1997. Se analizó la información sobre las condiciones de uso en pediatría de los fármacos utilizados a partir de un catálogo de medicamentos español. Esta información se comparó con la de un catálogo norteamericano de referencia internacional. Resultados: La mayor parte de los fármacos utilizados fueron de uso pediátrico no restringido (43 [47%]) o restringido (26 [28%]), pero también se utilizaron fármacos no recomendados (8 [9%]) o para los que no se especificaban condiciones de uso en niños (15 [16 %]). Alrededor del 12% de los fármacos no se identificaron en el catálogo norteamericano; de los restantes, el 60% de los fármacos fueron de uso pediátrico no restringido, el 35% de uso restringido y el 5% no recomendados. Conclusiones: En niños hospitalizados, una proporción relevante de los fármacos que se utilizan no se recomiendan o no se especifica su posible uso en población pediátrica. Sería conveniente incentivar la investigación, disponer de fuentes de información sobre terapéutica que ayuden a tomar decisiones, sobre todo en las condiciones no aprobadas, y que la actitud reguladora se ajuste en la medida de lo posible a las evidencias y necesidades terapéuticas (AU)

Errores de medicación en pediatría / Medication errors in pediatrics

No disponible

Anesthetic efficacy of eutectic prilocaine-lidocaine cream in pediatric oncology patients undergoing lumbar puncture.

OBJECTIVE: To evaluate the efficacy of eutectic mixture of local anesthetics 5% (Emla) in reducing pain associated with lumbar punctures in children. DESIGN: Prospective, double-blind, randomized, placebo-controlled trial. SETTING: University pediatric hospital. PATIENTS: Eleven pediatric oncology patients (mean age 6.6 y, range 4-16) who underwent 31 lumbar punctures. MAIN OUTCOME MEASURES: The analgesic effect was measured by using two methods. The first was a 10-point visual analog scale reported by the patient and the second was an 8-point behavioral pain scale assessed by the nurse who applied the cream. RESULTS: Emla cream was associated with significantly lower pain scores than those with placebo as measured by the patient when the puncture was successful on the first attempt (2.0 +/- 1.6 Emla group, 3.8 +/- 1.9 placebo group; p < 0.05). CONCLUSIONS: The use of Emla cream may reduce pain substantially only in patients who undergo a successful lumbar puncture on the first attempt.

Glutathione and cysteine in HIV-infected hemophiliacs.

A cross-sectional study was designed to determine whether plasma concentrations of glutathione and cysteine in HIV-infected hemophiliacs vary according to the progression of the disease and to compare them with those obtained in HIV negative hemophiliacs. Cysteine, total glutathione and glutathione disulphide were measured in plasma of HIV-infected hemophiliacs at different stages of HIV infection and in plasma of HIV-negative hemophiliacs. CD4 and CD8 T-cell counts, leukocyte and lymphocyte counts, beta 2-microglobulin and p24 antigen values were recorded for HIV positive hemophiliacs at the time of the study. The hemophiliac HIV-positive group showed a decrease in total glutathione levels (-18%) and an increase of glutathione disulphide (8.18 vs. 14.90%) compared to the HIV-negative group. The cysteine levels found in HIV-positive hemophiliacs were not different from those found in the HIV-negative group. There were no differences with statistical significance in total glutathione, glutathione disulphide and cysteine among HIV-infected hemophiliacs according to the different clinical stage of the disease (AIDS vs. non-AIDS). The interest of evaluating plasma concentrations of glutathione and cysteine in HIV-infected patients is limited from the point of view of considering them as markers of progression of the disease. Interest in a therapeutic strategy designed to replenish or normalize glutathione plasma levels is also limited.