RESUMO
Several reports have described a decrease in valproic acid (VPA) serum concentrations when carbapenem therapy is administered. The exact mechanism of this pharmacokinetic interaction is unknown, although several experimental studies have been carried out in animals. Because of these interactions, plasma concentrations of VPA in these patients should be monitored and, whenever possible, VPA or carbapenem therapy should be substituted by other drugs. We describe the cases of two epileptic children who simultaneously received meropenem and VPA. Concentrations of VPA decreased to subtherapeutic levels. We review the various mechanisms for this interaction proposed to date, as well as all reported cases.
Assuntos
Antibacterianos/farmacocinética , Anticonvulsivantes/farmacocinética , Tienamicinas/farmacocinética , Ácido Valproico/farmacocinética , Criança , Pré-Escolar , Interações Medicamentosas , Feminino , Humanos , Masculino , MeropenémRESUMO
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.
Assuntos
Redes de Comunicação de Computadores , Serviços de Informação sobre Medicamentos/organização & administração , Sistemas de Informação Hospitalar/organização & administraçãoRESUMO
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
Assuntos
Humanos , Redes de Comunicação de Computadores , Gestão da Informação/métodos , Serviços de Informação sobre Medicamentos/provisão & distribuição , Acesso à InformaçãoRESUMO
Se ha descrito que la administración de antibióticos carbapenémicos puede producir la disminución de las concentraciones plasmáticas de ácido valproico (VPA). El mecanismo por el que se produce esta interacción farmacocinética no está claro, a pesar de los estudios publicados en modelos animales. Dada la interacción, se aconseja la monitorización de concentración y la sustitución, siempre que sea posible, del VPA por otro antiepiléptico o del carbapenem por un antibiótico de otro grupo. Se describen los casos de 2 niños epilépticos que recibieron simultáneamente meropenem y VPA y en los que se observa una disminución de las concentraciones plasmáticas de VPA hasta niveles subterapéuticos. Se recogen los mecanismos propuestos para la interacción y los casos publicados hasta la fecha
Several reports have described a decrease in valproic acid (VPA) serum concentrations when carbapenem therapy is administered. The exact mechanism of this pharmacokinetic interaction is unknown, although several experimental studies have been carried out in animals. Because of these interactions, plasma concentrations of VPA in these patients should be monitored and, whenever possible, VPA or carbapenem therapy should be substituted by other drugs. We describe the cases of two epileptic children who simultaneously received meropenem and VPA. Concentrations of VPA decreased to subtherapeutic levels. We review the various mechanisms for this interaction proposed to date, as well as all reported cases
Assuntos
Criança , Pré-Escolar , Humanos , Antibacterianos/farmacocinética , Anticonvulsivantes/farmacocinética , Tienamicinas/farmacocinética , Ácido Valproico/farmacocinética , Interações MedicamentosasRESUMO
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