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1.
Farm. hosp ; 43(6): 182-186, nov.-dic. 2019. graf, tab
Artigo em Espanhol | IBECS-Express | ID: ibc-ET2-4337

RESUMO

Objetivo: Describir la situación actual del farmacéutico de hospital en las unidades de cuidados intensivos, su actividad asistencial, docente e investigadora. Método: Estudio multicéntrico, prospectivo mediante encuesta difundida por la Sociedad Española de Farmacia Hospitalaria, la cual constaba de varios apartados: datos personales y del hospital, características del hospital, implicación del farmacéutico en la unidad de cuidados intensivos y docencia. Resultados: Se obtuvieron 58 encuestas completadas. El número de farmacéuticos implicados en unidades de cuidados intensivos era 1 en el 77,6% de los casos, atendiendo una media de 30,8 camas (5-70). La experiencia en la unidad de cuidados intensivos del farmacéutico fue de 5 años de mediana (2 meses-25 años). La asistencia al pase de visita o cambios de guardia fue entre "nunca" en un 36,2% a "diariamente" en un 22,4%. El 93,1% de los encuestados reportaron dedicación a tiempo parcial en la unidad de cuidados intensivos. Respecto a actividades desarrolladas, entre el 40-60% gestiona estupefacientes, docencia en unidad de cuidados intensivos, conciliación y seguridad; entre el 60-80% abarca nutrición clínica, protocolización, optimización de antibióticos y farmacocinética, y un 84,5% realizan seguimiento farmacoterapéutico. Un 77,6% cuenta con formación sanitaria especializada, rotando los residentes en la unidad de cuidados intensivos en un 86% de los casos. Conclusiones: La mayor parte de los hospitales encuestados cuenta con un solo farmacéutico a tiempo parcial en estas unidades. Con objeto de mejorar la calidad de la atención farmacéutica del paciente crítico sería necesario ampliar la dedicación en tiempo y personal respecto a la situación actual y que más centros incluyan al farmacéutico en las unidades de cuidados intensivos hospitalarias


Objective: To describe the current situation of the hospital pharmacist in intensive care units and their activity in care, in teaching and in research. Method: Multicenter and prospective study through a survey disseminated by the Spanish Society of Hospital Pharmacy, which consisted of several sections: personal and hospital's data, hospital's characteristics, pharmacist's involvement in intensive care units and teaching. Results: A number of 58 completed surveys were obtained. The number of pharmacists involved in intensive care units was 1 in 77.6% of cases, assisting an average of 30.8 beds (5-70). Experience of pharmacists in the intensive care unit was 5 years on average (2 months-25 years). Visitor's pass assistance and shift changes were between "never" by 36.2% to "daily" by 22.4%. Out of respondents, 93.1% reported a part-time intensive care unit involvement. Regarding activities undertaken, between 40-60% of pharmacists manage narcotics, teaching at intensive care unit, conciliation and safety. Between 60-80%, pharmacists cover clinical nutrition, notarization, optimization of pharmacokinetics and antibiotics; and 84.5% perform pharmacotherapy follow-up. Out of the surveyed pharmacists, 77.6% have specialized medical training, rotating intensive care unit residents in 86% of cases. Conclusions: Most of the surveyed hospitals have one part-time pharmacist in these units. In order to improve the quality of pharmaceutical care of critically ill patients, it would be necessary to extend the involvement in time and staff, regarding the current situation, and a greater number of hospitals should include pharmacists in hospital intensive care units

2.
Farm Hosp ; 43(6): 182-186, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31705641

RESUMO

OBJECTIVE: To describe the current situation of the hospital pharmacist in intensive care units and their activity in care, in teaching  and in research. METHOD: Multicenter and prospective study through a survey  disseminated by the Spanish Society of Hospital Pharmacy, which  consisted of several sections: personal and hospital's data, hospital's  characteristics, pharmacist's involvement in intensive care units and  teaching. RESULTS: A number of 58 completed surveys were obtained. The  number of pharmacists involved in intensive care units was 1 in 77.6%  of cases, assisting an average of 30.8 beds (5-70). Experience of  pharmacists in the intensive care unit was 5 years on average (2  months-25 years). Visitor's pass assistance and shift changes were  between "never" by 36.2% to "daily" by 22.4%. Out of respondents,  93.1% reported a part-time intensive care unit involvement. Regarding  activities undertaken, between 40-60% of pharmacists manage  narcotics, teaching at intensive care unit, conciliation and safety.  Between 60-80%, pharmacists cover clinical nutrition, notarization,  optimization of pharmacokinetics and antibiotics; and 84.5% perform  pharmacotherapy follow-up. Out of the surveyed pharmacists, 77.6%  have specialized medical training, rotating intensive care unit residents  in 86% of cases. CONCLUSIONS: Most of the surveyed hospitals have one part-time  pharmacist in these units. In order to improve the quality of  pharmaceutical care of critically ill patients, it would be necessary to  extend the involvement in time and staff, regarding the current  situation, and a greater number of hospitals should include pharmacists  in hospital intensive care units.

3.
J Oncol Pharm Pract ; 25(3): 739-742, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29475405

RESUMO

Mitomycin C as a treatment for superficial bladder carcinomas and upper urinary tract tumours has been linked to local adverse events. Systemic toxicity has been documented for just a very few cases. This report presents a case of interstitial pneumonitis accompanied by myelosuppression in a 74-year-old patient after receiving the fifth administration of mitomycin C through a ureteral catheter as a treatment for left kidney pyelocaliceal urothelial carcinoma. Therefore, suspecting mitomycin C toxicity, urinary tract instillations were discontinued, and intravenous filgrastim and methylprednisolone were initiated. Currently, after five months since the last mitomycin C urinary tract instillation, the patient is still receiving filgrastim and corticosteroids. A moderate effort dyspnoea persists despite interstitial pulmonary infiltrates have presented a very important reduction. Pancytopenia has also persisted. Blood count and lung function monitoring would be appropriate in patients undergoing mitomycin C instillations, especially in those with established prior lung disease.


Assuntos
Antibióticos Antineoplásicos/efeitos adversos , Medula Óssea/efeitos dos fármacos , Neoplasias Renais/tratamento farmacológico , Doenças Pulmonares Intersticiais/induzido quimicamente , Mitomicina/efeitos adversos , Idoso , Feminino , Humanos
6.
Am J Health Syst Pharm ; 72(6): 479-82, 2015 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-25736943

RESUMO

PURPOSE: The physicochemical stability of frozen 1% voriconazole ophthalmic solution was evaluated. METHODS: Multiple batches of voriconazole 10-mg/mL eye drops were aseptically prepared in a laminar-airflow cabinet. One batch was analyzed immediately after preparation, and the rest were stored at -20 °C and analyzed using high-performance liquid chromatography at 30, 60, and 90 days to test their physicochemical stability and sterility. All samples were analyzed in triplicate. Additional analyses were performed to determine the solution's in vitro activity once thawed. The sterility of the 1% voriconazole solution was evaluated using blood-agar media and thioglycollate broth. Samples were incubated for 14 days and checked daily for signs of growth. Stability was defined as the absence of particles, color variation, or changes in pH and a remaining antifungal concentration of 90-110% of the initial concentration. RESULTS: All solutions remained clear and colorless throughout the study, and no precipitation or turbidity was observed in any of the batches, regardless of solution temperature. The pH and osmolarity of all batches remained essentially unchanged during storage at -20 °C and after thawing. No significant differences in concentration were observed during the storage at -20 or 5 °C. The voriconazole concentration remained within 10% of the initial concentration during the 90-day period of storage at -20 °C. The percentage of recovery was also optimal after thawing. CONCLUSION: Voriconazole 1% solution prepared for ophthalmic use was stable and retained antifungal activity when stored at -20 °C for 90 days. After thawing, this extemporaneously prepared formulation was stable at 5 °C for 14 days.


Assuntos
Antifúngicos/química , Composição de Medicamentos/métodos , Voriconazol/química , Antifúngicos/farmacologia , Cromatografia Líquida de Alta Pressão , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Congelamento , Humanos , Concentração de Íons de Hidrogênio , Soluções Oftálmicas , Temperatura Ambiente , Fatores de Tempo , Voriconazol/farmacologia
7.
Nefrología (Madr.) ; 33(3): 297-300, abr.-jun. 2013. tab
Artigo em Espanhol | IBECS | ID: ibc-114513

RESUMO

Introducción: Los inhibidores de mTOR (del inglés mammalian target of rapamycin), sirolimus y everolimus, utilizados como tratamiento inmunosupresor en el trasplante de órganos sólidos, pueden producir efectos adversos graves, como la neumonitis intersticial. Incidencia y presentación clínica: La incidencia de neumonitis intersticial se ha estimado entre el 4 % y el 11 %, aunque podría ser mayor. La mayoría de los casos publicados se ha producido en pacientes trasplantados renales en tratamiento con sirolimus. La presentación clínica es heterogénea, lo que dificulta el diagnóstico. Se acostumbra a observar alteraciones en la tomografía axial computarizada torácica, como opacidades en vidrio deslustrado. La fisiopatología es poco conocida. Sin embargo, se ha observado una mayor incidencia en pacientes con función renal alterada y en pacientes que habían recibido inhibidores de calcineurina previamente. La relación entre aparición de neumonitis y concentraciones plasmáticas de inhibidores de mTOR no está bien definida. Tratamiento: La suspensión del fármaco y la administración de dosis altas de corticoides parecen ser efectivos. Otras alternativas terapéuticas, aunque más discutidas, son la reducción de la dosis del inhibidor de mTOR y el cambio de sirolimus a everolimus. Conclusión: Se debe sospechar de neumonitis iatrogénica en pacientes trasplantados en tratamiento con inhibidores de mTOR y con síntomas respiratorios. Faltan datos concluyentes en cuanto a estrategias de tratamiento. Parece que everolimus podría ser mejor tolerado que sirolimus (AU)


Introduction: mTOR (mammalian target of rapamycin) inhibitors sirolimus and everolimus, used as immunosuppressants in solid organ transplantation, may cause severe adverse effects, such as interstitial pneumonitis. Incidence and clinical presentation: The estimated incidence of interstitial pneumonitis is 4-11% although it may be higher. Most reported cases have occurred in renal transplant recipients treated with sirolimus. Clinical presentation is heterogeneous, which makes diagnosis difficult. Abnormalities, such as ground glass opacities, are often found in computerised axial tomography scans of the chest. Physiopathology is not well-known. However, patients with abnormal renal function and those with previous calcineurin inhibitor treatment display a higher incidence. The relationship between pneumonitis and mTOR inhibitor plasma concentrations is not well defined. Treatment: Drug discontinuation and administration of high doses of corticosteroids seems to be an effective treatment. mTOR inhibitor dose reduction and replacing sirolimus with everolimus are other alternatives, but they are still under discussion. Conclusion: Iatrogenic pneumonitis must be suspected when a transplant recipient being treated with mTOR inhibitors presents respiratory symptoms. There is lack of conclusive data on treatment strategies. It appears that everolimus may be tolerated better than sirolimus (AU)


Assuntos
Humanos , Doenças Pulmonares Intersticiais/induzido quimicamente , Serina-Treonina Quinases TOR/efeitos adversos , Sirolimo/efeitos adversos , Imunossupressores/efeitos adversos , Fatores de Risco , Transplante de Órgãos , Complicações Pós-Operatórias
8.
Nefrologia ; 33(3): 297-300, 2013.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-23712219

RESUMO

INTRODUCTION: mTOR (mammalian target of rapamycin) inhibitors sirolimus and everolimus, used as immunosuppressants in solid organ transplantation, may cause severe adverse effects, such as interstitial pneumonitis. INCIDENCE AND CLINICAL PRESENTATION: The estimated incidence of interstitial pneumonitis is 4-11% although it may be higher. Most reported cases have occurred in renal transplant recipients treated with sirolimus. Clinical presentation is heterogeneous, which makes diagnosis difficult. Abnormalities, such as ground glass opacities, are often found in computerised axial tomography scans of the chest. Physiopathology is not well-known. However, patients with abnormal renal function and those with previous calcineurin inhibitor treatment display a higher incidence. The relationship between pneumonitis and mTOR inhibitor plasma concentrations is not well defined. TREATMENT: Drug discontinuation and administration of high doses of corticosteroids seems to be an effective treatment. mTOR inhibitor dose reduction and replacing sirolimus with everolimus are other alternatives, but they are still under discussion. CONCLUSION: Iatrogenic pneumonitis must be suspected when a transplant recipient being treated with mTOR inhibitors presents respiratory symptoms. There is lack of conclusive data on treatment strategies. It appears that everolimus may be tolerated better than sirolimus.


Assuntos
Imunossupressores/efeitos adversos , Doenças Pulmonares Intersticiais/induzido quimicamente , Sirolimo/análogos & derivados , Sirolimo/efeitos adversos , Serina-Treonina Quinases TOR/antagonistas & inibidores , Everolimo , Humanos
9.
Arch. bronconeumol. (Ed. impr.) ; 46(5): 244-254, mayo 2010. tab
Artigo em Espanhol | IBECS | ID: ibc-88017

RESUMO

Los macrólidos son antibióticos que además de su acción antibacteriana pueden presentar un cierto efecto antiinflamatorio por disminución de la actividad de las células inmunitarias y alteración de las células bacterianas.Ya en los años 80 se observó un aumento de la supervivencia en pacientes afectados de panbronquiolitis difusa después de tratarse con eritromicina. En la actualidad, el uso de macrólidos en diferentes enfermedades de carácter inflamatorio crónico ha aumentado significativamente. En la fibrosis quística, el asma, las bronquiectasias, entre otras, se han observado mejoras clínicas asociadas a la administración de macrólidos.Sin embargo, y a pesar del aparente beneficio clínico que parecen aportar, los resultados publicados hasta la fecha son controvertidos y no permiten obtener resultados concluyentes. Esto hace necesario realizar futuros ensayos clínicos para confirmar o rebatir el uso a largo plazo de estos fármacos, que no están exentos de efectos adversos, principalmente la aparición de especies bacterianas resistentes(AU)


The macrolides are antibiotics that, besides their anti-bacterial action, have an anti-inflammatory effect, by decreasing the activity of the immune cells and bacteria cell changes.An increase the survival of patients suffering from diffuse panbronchiolitis was already seen in the 1980s, after being treated with erythromycin. Currently, the use of macrolides in various chronic inflammatory diseases has increased significantly. Clinical improvements associated to the administration of macrolides have been observed in diseases such as, cystic fibrosis, asthma, and bronchiectasis.However, despite the apparent clinical benefit they seem to provide, the published results up until now are controversial and conclusive results are unable to be obtained. This means that further clinical trials are necessary to confirm or refute the long-term use of these drugs, which are not free of adverse effects, mainly the appearance of resistant bacteria(AU)


Assuntos
Humanos , Masculino , Feminino , Macrolídeos , Macrolídeos/uso terapêutico , Anti-Inflamatórios/classificação , Anti-Inflamatórios/imunologia , Anti-Inflamatórios/uso terapêutico , Antibacterianos/imunologia , Antibacterianos/uso terapêutico , Doenças Respiratórias/imunologia , Doenças Respiratórias/terapia , Bronquiolite/imunologia , Bronquiolite/terapia , Fibrose Cística/imunologia , Fibrose Cística/terapia , Asma/imunologia , Asma/terapia , Bronquiectasia/imunologia , Bronquiectasia/terapia , Doença Pulmonar Obstrutiva Crônica/imunologia , Doença Pulmonar Obstrutiva Crônica/terapia
10.
Arch Bronconeumol ; 46(5): 244-54, 2010 May.
Artigo em Espanhol | MEDLINE | ID: mdl-19962815

RESUMO

The macrolides are antibiotics that, besides their anti-bacterial action, have an anti-inflammatory effect, by decreasing the activity of the immune cells and bacteria cell changes. An increase the survival of patients suffering from diffuse panbronchiolitis was already seen in the 1980s, after being treated with erythromycin. Currently, the use of macrolides in various chronic inflammatory diseases has increased significantly. Clinical improvements associated to the administration of macrolides have been observed in diseases such as, cystic fibrosis, asthma, and bronchiectasis. However, despite the apparent clinical benefit they seem to provide, the published results up until now are controversial and conclusive results are unable to be obtained. This means that further clinical trials are necessary to confirm or refute the long-term use of these drugs, which are not free of adverse effects, mainly the appearance of resistant bacteria.


Assuntos
Anti-Inflamatórios/uso terapêutico , Pneumopatias/tratamento farmacológico , Macrolídeos/uso terapêutico , Transtornos Respiratórios/tratamento farmacológico , Anti-Inflamatórios/farmacologia , Farmacorresistência Bacteriana , Humanos , Macrolídeos/farmacologia
13.
Med Clin (Barc) ; 129(13): 501-3, 2007 Oct 13.
Artigo em Espanhol | MEDLINE | ID: mdl-17980119

RESUMO

BACKGROUND AND OBJECTIVE: Rumack's nomogram is usually used to indicate the treatment with N-acetilcysteine in the paracetamol poisoning, but it has several limitations. Paracetamol half-life elimination (t1/2) is approximately of 2 h with therapeutic doses and it increases to more than 4 h in patients with hepatotoxicity. The aim of this study was to determine the usefulness of estimated paracetamol t1/2 as greater than or inferior to 4 h by using a simple ratio in relation to the development of hepatotoxicity. PATIENTS AND METHOD: 21 patients with paracetamol overdose were admitted to Son Dureta Hospital (Palma de Mallorca) and Clínic Hospital (Barcelona) over 13 months. The estimated t1/2 is calculated using the quotient between 2 plasma paracetamol concentrations separated by 2 or more hours. RESULTS: We found a significant difference (p < 0.005) between the group with hepatotoxicity (n = 3; t1/2 = 8,5 h; range: 3,6 - 8,7 h); and without hepatotoxicity (n = 18; t1/2 = 2,4 h; (range: 1,6 - 4,3 h). We observed an agreement between positive ratio and a t1/2 > 4 h, and negative ratio with t1/2 < 4 h, bearing in mind that the quotient is obtained through mathematical equations. CONCLUSIONS: Rumack's nomogram should be complemented with t1/2 estimation in all cases of paracetamol poisoning, especially with those patients for whom we are not able to determine the time of ingestion at presentation or if there has been a multiple-timepoint ingestion.


Assuntos
Acetaminofen/metabolismo , Acetaminofen/envenenamento , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Nomogramas , Adulto , Overdose de Drogas , Feminino , Meia-Vida , Humanos , Masculino , Valor Preditivo dos Testes
14.
Med. clín (Ed. impr.) ; 129(13): 501-503, oct. 2007. tab
Artigo em Espanhol | IBECS | ID: ibc-72205

RESUMO

FUNDAMENTO Y OBJETIVO: El nomograma de Rumack seutiliza para indicar el tratamiento con el antídoto Nacetilcisteínaen la intoxicación por paracetamol, perotiene varias limitaciones de uso. La semivida de eliminación(t1/2) del paracetamol, que con dosis terapéuticases de unas 2 h, se incrementa hasta más de4 h en caso de hepatotoxicidad. El objetivo de estetrabajo ha sido validar la predicción de hepatotoxicidada partir de la estimación de la t1/2 como superior oinferior a 4 h obtenida mediante un simple cociente.PACIENTES Y MÉTODO: Se ha estudiado a 21 pacientescon sobredosificación de paracetamol que acudierona los Hospitales de Son Dureta de Palma de Mallorcay Clínic de Barcelona durante un período de 13meses. La estimación de la t1/2 se realizó medianteun cociente entre 2 determinaciones consecutivasde paracetamol en plasma, separadas por un intervalode tiempo de 2 h o más.RESULTADOS: Se observó una diferencia significativa(p < 0,005) en la t1/2 entre el grupo con hepatotoxicidad(n = 3; t1/2 mediana de 8,5 h; extremos: 3,6-8,7 h) y el grupo sin hepatotoxicidad (n = 18; t1/2mediana de 2,4 h; extremos: 1,6-4,3 h). Se hallóuna coincidencia entre cociente positivo y t1/2 superiora 4 h, y entre cociente negativo y t1/2 inferior a4 h, teniendo en cuenta que el cociente se obtuvoa través de ecuaciones matemáticas.CONCLUSIONES: Se propone que se complemente elnomograma de Rumack con la estimación de la t1/2en todos los casos de intoxicación por paracetamol enque se planteen dudas respecto a la indicación detratamiento con antídoto, y en aquellos en los que sedesconozca el tiempo transcurrido desde la ingestao cuando ésta haya sido fraccionada


Rumack’s nomogram isusually used to indicate the treatment with N-acetilcysteinein the paracetamol poisoning, but it hasseveral limitations. Paracetamol half-life elimination(t1/2) is approximately of 2 h with therapeutic dosesand it increases to more than 4 h in patients with hepatotoxicity.The aim of this study was to determinethe usefulness of estimated paracetamol t1/2 as greaterthan or inferior to 4 h by using a simple ratio inrelation to the development of hepatotoxicity.PATIENTS AND METHOD: 21 patients with paracetamoloverdose were admitted to Son Dureta Hospital (Palmade Mallorca) and Clínic Hospital (Barcelona)over 13 months. The estimated t1/2 is calculatedusing the quotient between 2 plasma paracetamolconcentrations separated by 2 or more hours.RESULTS: We found a significant difference (p < 0.005)between the group with hepatotoxicity (n = 3; t1/2 =8,5 h; range: 3,6 – 8,7 h); and without hepatotoxicity(n = 18; t1/2 = 2,4 h; (range: 1,6 – 4,3 h). Weobserved an agreement between positive ratio and at1/2 > 4 h, and negative ratio with t1/2 < 4 h, bearingin mind that the quotient is obtained through mathematicalequations.CONCLUSIONS: Rumack’s nomogram should be complementedwith t1/2 estimation in all cases of paracetamolpoisoning, especially with those patientsfor whom we are not able to determine the time ofingestion at presentation or if there has been amultiple-timepoint ingestion (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Insuficiência Hepática/induzido quimicamente , Acetaminofen/síntese química , Acetaminofen/farmacologia , Acetaminofen/toxicidade , Acetilcisteína/toxicidade , Acetilcisteína/uso terapêutico , Sensibilidade e Especificidade , Testes de Toxicidade/métodos , /diagnóstico , Antídotos/uso terapêutico
15.
Med. clín (Ed. impr.) ; 127(20): 770-773, nov. 2006. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-050587

RESUMO

Fundamento y objetivo: Las intoxicaciones agudas pueden atenderse inicialmente en ámbitos extrahospitalarios u hospitalarios muy diversos. La disponibilidad de antídotos en los servicios de farmacia hospitalarios y en los de urgencias hospitalarios y extrahospitalarios puede desempeñar un papel importante en el tratamiento de la intoxicación. Material y método: Se ha realizado un estudio descriptivo y transversal de la disponibilidad de antídotos en diversos ámbitos sanitarios de Cataluña. Entre abril y mayo de 2005 se envió una encuesta a 50 centros sanitarios (28 áreas básicas de salud, incluidas ambulancias medicalizadas, y 22 hospitales de distinto nivel asistencial) con el fin de evaluar la disponibilidad cualitativa (DCL) y cuantitativa (DCT) de antídotos. Resultados: En el ámbito extrahospitalario la DCL fue de un 82% para la atención primaria y de un 50% para las ambulancias medicalizadas. La DCT fue del 94% en las ambulancias, mientras que en la atención primaria se observaron diferencias entre áreas rurales (55%) y urbanas (33%). En los hospitales generales básicos, hospitales de referencia y hospitales de alta tecnología, la DCL fue del 39, el 54 y el 55%, y la DCT del 70, el 54 y el 54,5%, respectivamente. No tenían la disponibilidad deseada algunos antídotos que sólo están disponibles como fórmulas magistrales (albúmina, almidón, jarabe de ipecacuana o etanol para uso intravenoso) o que son medicamentos extranjeros (suero antiofídico, anticuerpos antidigitálicos o hidroxocobalamina), aun a pesar de que algunos de ellos son insustituibles. Conclusiones: Los ámbitos sanitarios de Cataluña no disponen de todos los antídotos necesarios para tratar cualquier intoxicación. Se ha constatado cierta heterogeneidad en cuanto a la composición de los botiquines de antídotos dentro de un mismo nivel asistencial. Las principales deficiencias corresponden a fármacos que actualmente están disponibles como fórmulas magistrales o que son medicamentos extranjeros


Background and objective: Acute poisoning can be treated in different hospital and extrahospital health services. Thus, availability of antidotes in hospital pharmacies, emergency departments and health centres play an important role in poisoning treatment. Material and method: This is a descriptive and transversal study of antidotes availability in different health services of Catalonia (Spain). From April to May 2005, a proper questionnaire was sent to 50 different health centres: 28 basic health centres (including medical ambulances) and 22 hospitals with a distinct medical complexity level, to assess the qualitative (QLA) and quantitative availability (QTA) of antidotes. Results: QLA resulted to be 82% in extrahospital health centres and 50% in medical ambulances. QTA was 94% for ambulances, whereas, in health centres, differences were observed between rural (55%) and urban (33%) areas. Regarding basic general hospitals (level 1), reference hospitals (level II) and high technology hospitals (level III) the QLA showed values of 39, 54 and 55%, respectively, and the QTA came about 70, 54 y 54.5%, in that order. Furthermore, lack of adequate stocking was observed for compounded formulations, such as albumin, starch, ipecacuanha syrup or IV ethanol, and for essential antidotes as snake antivenin, digoxin immune Fab or hydroxocobalamine. Conclusions: There is understocking of poisoning antidotes throughout the health services of Catalonia. Heterogeneity was observed between services with a medical complexity level. The main deficiencies are found in antidotes that, to date, are available as compounded formulations or imported from other countries


Assuntos
Humanos , Antídotos/provisão & distribução , Envenenamento/tratamento farmacológico , Serviços Médicos de Emergência/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Ambulâncias/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde
16.
Med Clin (Barc) ; 127(20): 770-3, 2006 Nov 25.
Artigo em Espanhol | MEDLINE | ID: mdl-17198663

RESUMO

BACKGROUND AND OBJECTIVE: Acute poisoning can be treated in different hospital and extrahospital health services. Thus, availability of antidotes in hospital pharmacies, emergency departments and health centres play an important role in poisoning treatment. MATERIAL AND METHOD: This is a descriptive and transversal study of antidotes availability in different health services of Catalonia (Spain). From April to May 2005, a proper questionnaire was sent to 50 different health centres: 28 basic health centres (including medical ambulances) and 22 hospitals with a distinct medical complexity level, to assess the qualitative (QLA) and quantitative availability (QTA) of antidotes. RESULTS: QLA resulted to be 82% in extrahospital health centres and 50% in medical ambulances. QTA was 94% for ambulances, whereas, in health centres, differences were observed between rural (55%) and urban (33%) areas. Regarding basic general hospitals (level 1), reference hospitals (level II) and high technology hospitals (level III) the QLA showed values of 39, 54 and 55%, respectively, and the QTA came about 70, 54 y 54.5%, in that order. Furthermore, lack of adequate stocking was observed for compounded formulations, such as albumin, starch, ipecacuanha syrup or IV ethanol, and for essential antidotes as snake antivenin, digoxin immune Fab or hydroxocobalamine. CONCLUSIONS: There is understocking of poisoning antidotes throughout the health services of Catalonia. Heterogeneity was observed between services with a medical complexity level. The main deficiencies are found in antidotes that, to date, are available as compounded formulations or imported from other countries.


Assuntos
Ambulâncias , Antídotos/provisão & distribução , Serviços Médicos de Emergência , Serviços de Saúde , Serviço de Farmácia Hospitalar , Envenenamento/terapia , Doença Aguda , Estudos Cross-Over , Humanos , População Rural , Espanha , Inquéritos e Questionários , População Urbana
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