Impact of regulatory measures on antipsychotics drug consumption in Castilla y León, Spain.

OBJECTIVES: Antipsychotics are currently used to treat different diseases; even some off-labelled conditions are treated with this medication. Consumption and cost of antipsychotic drugs sharply increased in Spain after second-generation drugs were marketed; several regulatory measures were adopted to curb this trend. The aim of this study was to examine the impact of these measures upon the use and cost of antipsychotics. STUDY DESIGN: Study of drug use (SDU) from 1995 to 2012. Consumption and cost data were obtained from the CONCYLIA database; this database contains the retail community pharmacies sales of medicinal products reimbursed by the National Health System in Castilla y León (Spain). METHODS: Data are presented as defined daily doses per 1000 inhabitants per day (DID) and day treatment cost (DTC). RESULTS: First-generation antipsychotics prescriptions gradually decreased from 3.0 to 1.8 DID; meanwhile, prescriptions for second-generation antipsychotics considerably increased from 0.3 to 9.9 DID. The use of risperidone dropped after the marketing of its structural derivative paliperidone with a similar efficacy but with a substantially higher cost per day. In 2011 and thereafter, patients in Spain began to pay a part of the medications cost, but this did not decrease antipsychotics consumption. Global cost of antipsychotics only began to fall after measures were adopted to lower the price of medicines because of the economic collapse in Spain after May 2010. CONCLUSION: Several health policy measures have tried to reduce antipsychotics consumption in Spain, special ways of dispensing, marketing of generic drugs and special economic measures for patients. These measures eventually failed to avoid the increase in antipsychotics use. The cost only dropped when lowering prescription drug prices took place.

Interacción entre dronedarona y simvastatina identificada durante el seguimiento farmacoterapéutico en una farmacia comunitaria / Dronedarone interaction with simvastatin identified during a pharmacotherapeutic follow-up of patients in a community pharmacy

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Efecto del clorhidrato de mianserina sobre preparaciones de órgano aislado de cobaya y de rata "in vitro" / Effects of mianserin hydrochloride on isolated organ preparations of guinea-pig and rat "in vitro"

OBJETIVO. Estudiar las modificaciones inducidas por Mianserina en las respuestas del ileon aislado de cobaya a acetilcolina e histamina, conducto deferente de rata a noradrenalina y útero aislado de rata a histamina. MATERIAL Y MÉTODOS. Se utilizó ileon aislado de cobaya incubado en solución de Tyrode, conducto deferente de rata incubado en solución de Krebs- Henseleit y útero aislado de rata incubado en solución de Jalón. Se realizaron curvas dosis-efecto a acetilcolina, histamina y noradrenalina en ausencia y en presencia de mianserina y se calculó el pA2. RESULTADOS. La mianserina se comporta como antagonista de los neurotransmisores estudiados. Conclusión: La mianserina se comporta como fármaco escasamente estabilizador inespecífico de membrana (AU)

OBJETIVE. Study the modifications produced by mianserin in the responses of isolated guinea-pig to acetylcholine and histamine, rat vas deferens to noradrenalinee and rat uterus to histamine. MATERIAL AND METHODS. Guinea-Pig ileum incubated in Tyrode solution were used. Dose-effect curves to acetylcholine and histamine were made in absence and in the presence of mianserin. Rat vas deferens incubated in Krebs-Henseleit solution were used. Dose-effect curves to noradrenaline were made in absence and in the presence of mianserin. Uterus of rat incubated in Jalon solution were used. Dose-effect curves to histamine were made in absence and in the presence of mianserin, pA2 was calculated. RESULTS. Mianserin behave as antagonist of acethylcholine, histamine and noradrenaline. Conclusions: Mianserin acts as few unspecific membrane stabilizer (AU)