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3.
Zhonghua Yi Shi Za Zhi ; 49(5): 276-280, 2019 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-31795594

RESUMO

Drug Indexes are of significance for investigation on ancient patent medicine industry. Herein, we compared Zhang Tongtai Wan San Gao Dan Quanlu (10th year of Jiaqing Reign, 1805), Ye Zhongde Tang Dan Wan Quanlu (4th year of Xianfeng Reign, 1854 and 5th year of Tongzhi Reign, 1866) and Hu Qingyu Tang Wan San Gao Dan Quanji(3th year of Guangxu Reign, 1877) to illustrate the business features of Hangzhou patent medicine industry in Qing Dynasty.The three pharmacies, Zhang Tongtai Tang, Ye Zhongde Tang and Hu Qingyu Tang, were all adept in utilizing ancient prescriptions that contained various preparations, emphasized commercial ethics and product qualities, distributed their products in flexible pattern and focused on distillation formula. Moreover, each of the three pharmacies exhibited their own characteristics in product types and commercialization.


Assuntos
Medicina Tradicional Chinesa , Farmácias , China , Comércio , Indústria Farmacêutica , História do Século XIX , Medicina Tradicional Chinesa/história , Medicamentos sem Prescrição , Farmácias/história
4.
Zhongguo Zhong Yao Za Zhi ; 44(21): 4560-4565, 2019 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-31872648

RESUMO

At present,the production equipment and process of Chinese patent medicines still have many problems including high energy consumption,low efficiency,high pollution,and low intelligence,which seriously hinder the transformation,upgrading and modernized development of traditional Chinese medicine industry. With the emergence of various new pharmaceutical technologies and the application of technologies of other fields in traditional Chinese medicine industry,the development of Chinese patent medicine has ushered in new opportunities. The processes such as pulverization,mixing,extraction,separation,concentration,drying and sterilization are unique for the production of Chinese patent medicine. These main features can be distinguished from the manufacturing process of chemical drugs,determining the characteristics of the production process and equipment of Chinese patent medicine. In this paper,each operation unit was mentioned to summarize and analyze the new equipment and new technologies with advantages and characteristics in recent years from the perspectives of definition,principle,classification and application. Among them,the automatic spray device of the mixer,the extraction and separation equipment of volatile oil,and the crane basket-type circulation extraction technology,composite multi-layer spiral vibration countercurrent drying,and vibration sterilization equipment all have rapid development in recent years,with great prospects in the production of Chinese patent medicines. In this paper,we also analyzed some problems existing in the production equipment and technology of Chinese patent medicine and the key factors restricting the development of Chinese patent medicine,discussed the transformation of Chinese patent medicine production from traditional to modern and from semi-automatic to intelligent,and put forward three suggestions to help Chinese patent medicine achieve the goal of improving quality,efficiency and green manufacturing in production.


Assuntos
Medicamentos de Ervas Chinesas , Tecnologia Farmacêutica , Medicina Tradicional Chinesa , Medicamentos sem Prescrição , Controle de Qualidade
5.
Zhongguo Zhong Yao Za Zhi ; 44(21): 4738-4744, 2019 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-31872672

RESUMO

Through the multi-dimensional mining and analysis of launched anti-influenza proprietary Chinese medicines,this paper explores the study of the prescriptions and pharmacodynamics of traditional Chinese medicines for influenza. We established a standardized database by collecting and excavating the launched Chinese patent medicines that clearly describe the treatment of influenza. Frequency analysis and association rules were used to analyze the frequency of Chinese patent medicines for the treatment of influenza in the aspects of dosage form,category and prescription drugs. The network module partitioning method was used to excavate the core drug combination for influenza. The relationship between functional nouns was used to construct a network of functional terminology and analyze the relationship between its main functions. The pharmacological characteristics quantitative method was used to analyze the pharmacological characteristics of three heat-clearing and detoxifying type Chinese patent medicines for influenza. This article shows the traditional Chinese medicine syndrome differentiation ideas and medication rules for influenza treatment in many aspects and from multiple perspectives,so as to provide a certain reference for the clinical application of proprietary Chinese medicines for influenza and the development of new influenza drugs.


Assuntos
Mineração de Dados , Medicamentos de Ervas Chinesas/uso terapêutico , Influenza Humana/tratamento farmacológico , Prescrições de Medicamentos , Humanos , Medicina Tradicional Chinesa , Medicamentos sem Prescrição
6.
Zhongguo Zhong Yao Za Zhi ; 44(19): 4277-4284, 2019 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-31872710

RESUMO

To explore the regularity of traditional Chinese patent medicines for the treatment of hyperlipidemia recorded in Newly Edited National Chinese Traditional Patent Medicines,the Composition Principles of Chinese Patent Drugs,New Drug Conversion Standard,the Compilation of National Standard for Traditional Chinese Medicines and Chinese Pharmacopoeia. Researchers extracted the information of prescriptions from these cases according to the inclusion and exclusion criteria. Then microsoft excel 2010 was used to conduct frequency statistics and count the frequency of traditional Chinese medicine. SPSS Clementine( ver.12. 0) and SPSS( ver. 18. 0)were adopted respectively for frequency analysis,association rules analysis,cluster analysis and factor analysis. Besides,KMO test and Bartlett spherical test were performed for factor adaptation test. Finally,a total of 173 traditional Chinese medicines were included,involving 94 Chinese patent medicine prescriptions. The frequency results of traditional Chinese medicine showed that there were 33 kinds of high-frequency traditional Chinese medicine,mainly including those for tonifying medicine,activating blood and resolving stasis and blood-stasis,and clearing damp. The association rules analysis found out 12 association rules of drug pairs,3-herb pairs of 25 and4-herb pairs of 6. Totally 11 medicine groups with relevance were respectively extracted by cluster analysis. KMO test and Bartlett spherical test indicated that the method was suitable for factor analysis and 11 common factors were respectively extracted by factor analysis. The association rules reflected the therapeutic method for tonify the liver and kidney,activating blood and resolving stasis. Cluster analysis and factor analysis showed the therapeutic method of Qi-enriching and Yin-nourishing,and the factor analysis focused more on removing blood stasis and dampness. The decision tree with hawthorn as the dependent variable reflects the importance of alisma orientalis and fructus schisandrae in the drug matching. In conclusion,data mining technique can comprehensively analyze the regularity of prescriptions of traditional Chinese patent medicine for hyperlipidemia,and is helpful for guiding the development of Chinese patent medicines and the clinical practice of traditional Chinese medicine.


Assuntos
Medicamentos de Ervas Chinesas , Hiperlipidemias , Prescrições de Medicamentos , Humanos , Medicina Tradicional Chinesa , Medicamentos sem Prescrição
7.
Zhongguo Zhong Yao Za Zhi ; 44(20): 4350-4353, 2019 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-31872644

RESUMO

Kangfu Xiaoyan Suppository is widely used in the treatment of gynecological inflammatory diseases. Long-term clinical application and a certain amount of research evidences show that Kangfu Xiaoyan Suppository can alleviate the clinical symptoms of pelvic inflammatory diseases,reduce the recurrence rate,and relieve sequelae,with a better safety and economic characteristics. As a type of nationally protected traditional Chinese medicine and type B medicine included in medical insurance,it has been selected as a Chinese patent medicine for rectal administration. It was included in the Guidelines for diagnosis and treatment of common gynecological diseases of traditional Chinese medicine published by the Chinese Academy of Traditional Chinese Medicine in 2012,the Pelvic inflammatory diseases diagnosis and treatment guidelines issued by the Infectious Diseases Collaborative Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association in 2014,and the group standard of Single use of traditional Chinese medicine/combined antibiot guidelines for clinical practice-pelvic inflammatory diseases of the Chinese Academy of Traditional Chinese Medicine in 2017. To further enhance clinicians' understanding of the drug and better guide its rational clinical use,experts from the field of gynecology of traditional Chinese and Western medicine were invited to develop and compile this expert consensus. This consensus takes full account of clinical evidences and expert clinical experience,and form recommendations for clinical problems based on evidences and consensus recommendations for clinical problems without evidence by nominal grouping method. The expert consensus is mainly formed in the consideration of six factors: quality of evidence,economy,efficacy,adverse reactions,patient acceptability and others. Based on clinical research evidences and expert experience,this consensus provides a preliminary reference for the clinical use of the drug in a concise and clear format. However,evidence-based support is still required in a large number of high-quality studies,and this consensus will be revised in the future according to new clinical problems and the update of evidence-based evidence in practical application.


Assuntos
Consenso , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa , Doença Inflamatória Pélvica/tratamento farmacológico , Feminino , Humanos , Medicamentos sem Prescrição , Supositórios
8.
Medicine (Baltimore) ; 98(50): e18335, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852128

RESUMO

BACKGROUND: Many people with cough variant asthma use Traditional Chinese Patent Medicine-Suhuang anti-tussive capsule to help reduce symptoms. However there is no systematic reviews had promising its efficacy and safety for cough variant asthma. METHODS: Four English databases (PubMed, Web of science, EMBASE, and Springer Cochrane Library) and 4 Chinese databases (Wanfang Database, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, and Chinese Biomedical Literature Database) were researched for the randomized controlled trials of Suhuang anti-tussive capsule for cough variant asthma. The search was limited to human studies, using the search keywords or free-text terms "cough," "cough variant asthma," "Suhuang Zhike capsul,""Suhuang anti-tussive capsul," and "randomized clinical trials." Two reviewers individually extracted data from the included randomized controlled trials (RCTs). Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. The primary outcomes include the frequency of asthma exacerbations during follow-up, asthmatic symptoms by validated instruments (including symptom scores, Likert scale, visual analogue scale). Lung function, serum immunoglobulin E, blood eosinophil count, phlegm eosinophil count, tumor necrosis factor-a, interleukin-1b, and adverse effects (numbers of participants experiencing each adverse events) will be assessed as the secondary outcome. Meta-analysis will be performed using RevMan5.3.5 software provided by the Cochrane Collaboration. RESULTS: This study will provide high-quality synthesis based on current evidence of Suhuang anti-tussive capsule treatment for cough variant asthma. CONCLUSION: This analysis will provide updated evidence for whether Suhuang anti-tussive capsule is an effective and safe intervention for cough variant asthma. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019139695.


Assuntos
Asma/tratamento farmacológico , Tosse/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos sem Prescrição/uso terapêutico , Adulto , Asma/complicações , Cápsulas/uso terapêutico , Tosse/etiologia , Feminino , Humanos , Masculino , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto , Resultado do Tratamento
9.
Rom J Ophthalmol ; 63(3): 297-305, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687635

RESUMO

Introduction: It is acknowledged that leading pharmaceutical companies lately spend more on marketing than they are investing in research and technology development. Romania registers one of the largest market growths in the pharmaceutical industry from Central and Eastern Europe, and it is one of the main investors on the advertising market. The rapid changes in the pharmaceutical landscape have demanded for organizations to re-evaluate their infrastructure and the information delivery methods, as well as cut through the clutter and build competitive advantages by using effective advertising. The dry eye is a commonly disease encountered worldwide, which is treated with the help of over-the-counter (OTC) artificial tear drops. Aim: The aim of this study was twofold: to determine the profile of the Romanian consumer who uses artificial tear drops and to assess the components of experiential marketing used in a TV advertisement, which have the highest influence on the consumer's perception of effective advertising. Material and method: We selected a TV advertisement that used the magical concept of the artificial tear drops in the shape of water in a desert area, suggesting an eye irritation. The instrument for data collection was a self-administered questionnaire based on the watched advertising spot about the OTC artificial tear drops. The sample was made up of 384 participants and the sampling method was the snowball technique. Moreover, a model using Structural Equation was validated in order to assess the established relationships between the experiential marketing components and the effectiveness of the OTC artificial tear drops advertising. Findings: The findings showed that the demographic profile of the OTC artificial tear drops consumer is a female, with the mean age of 39 years, who graduated from university, with an average income of 2500 RON (Romanian currency), single, and with an office job. The mean number of hours spent in front of a computer per day was 10. The structural equation model revealed that the component think experience has the highest direct influence on the consumer's perception of an advertisement about OTC artificial tear drops as being effective. Discussion: The pharmaceutical market is different from other markets in that the decision maker is not the purchaser except for the OTC drugs that do not require a receipt from a physician. Think experience focuses on rational decision-making and problem solving but in a creative way.


Assuntos
/métodos , Síndromes do Olho Seco/tratamento farmacológico , Lubrificantes Oftálmicos/farmacologia , Marketing/métodos , Medicamentos sem Prescrição , Adulto , Feminino , Humanos , Masculino , Estudos Retrospectivos , Romênia
10.
Medicine (Baltimore) ; 98(44): e17729, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689816

RESUMO

BACKGROUND: Premature ejaculation (PE) is a form of male sexual dysfunction. As people's lifestyle changes and the population ages, the incidence of PE continues to increase. Chinese patent medicines have been widely used in clinical practice as derivatives of traditional Chinese medicine (TCM). Many clinical trials have proven that Chinese patent medicine has a significant effect in the treatment of PE. In this systematic review, we aim to evaluate the effectiveness and safety of Chinese patent medicine for PE. METHODS: We will search for PubMed, Cochrane Library, AMED, Embase, WorldSciNet, Nature, Science online and China Journal Full-text Database, China Biomedical Literature CD-ROM Database, and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to September 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the RevMan 5.3 and Stata 13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of PE. ETHICS AND DISSEMINATION: This systematic review will evaluate the efficacy and safety of TCM for treating PE. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process Trial. TRIAL REGISTRATION NUMBER: PROSPERO CRD42017065316.


Assuntos
Medicina Tradicional Chinesa/métodos , Medicamentos sem Prescrição/uso terapêutico , Ejaculação Precoce/tratamento farmacológico , Adulto , Pesquisa Comparativa da Efetividade , Humanos , Masculino , Metanálise como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto , Resultado do Tratamento
11.
Presse Med ; 48(10): e273-e283, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31734048

RESUMO

OBJECTIVES: Self-medication for alleviating pain is very prevalent in most countries. While safe self-medication is supposed to be dependent on both patient's behaviour and pharmacist's counselling, little is known about the context of the delivery of analgesics available without prescription. The primary objective of the study was to define sociodemographic profiles and behaviours of patients seeking non-prescribed analgesics in French community pharmacies. Secondary objectives included the assessment of pharmacist management and identification of risk-associated patients. METHODS: This is a cross-sectional, national and multicentre study, including adults who asked for a prescription-free medication for acute or chronic physical pain. Information was collected through separate patient and healthcare professional (HCP) questionnaires. RESULTS: The analysis was based on 1215 and 1271 patient and HCP questionnaires, respectively, collected from 164 pharmacies. The patient population consisted in women and men (ratio 6:4), mainly (71%) under 60 years old. Headaches, rheumatologic and musculoskeletal pains were the most frequent reasons for getting analgesics, with a median pain intensity of 6 on a scale graded from 0 (no pain) to 10 (intolerable pain). The main reasons guiding self-medication were time saving, a well-known pain and a well-known product. The mean time allocated to delivery was 4.7minutes. Indications, dose and posology were almost systematically addressed by the pharmacy staff, while contra-indications, drug-drug interaction or safety were mentioned in around two-third of cases. The proportion of patients identified at risks due to an inappropriate context of self-medication was 15.5%. DISCUSSION AND CONCLUSIONS: This study shows a great heterogeneity of the population asking for non-prescribed analgesics in French community pharmacies. While pharmacists were able to identify patients at risks, a significant part may have 'slipped through the net'. The results support further studies to better define patient care pathway and optimize pharmacist-led medication.


Assuntos
Dor Aguda/tratamento farmacológico , Analgésicos/uso terapêutico , Dor Crônica/tratamento farmacológico , Medicamentos sem Prescrição/uso terapêutico , Farmacêuticos , Automedicação , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , França , Pesquisas sobre Serviços de Saúde , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Farmácias/estatística & dados numéricos , Tamanho da Amostra , Fatores Sexuais , Fatores Socioeconômicos
12.
Zhongguo Zhong Yao Za Zhi ; 44(14): 2896-2901, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31602831

RESUMO

In 2013,China pharmaceutical regulatory department issued guiduance on postmarketing drug safety monitoring for industry. It aimed to encourage industry to carry out postmarketing drug safety monitoring including hospital-based intensive monitoring of postmarketing Chinese patent medicine. Subsequently,more and more such kind of studies have been performed all over China. However,in view of the current situation in this field,the development of hospital-based intensive monitoring of postmarketing Chinese patent medicine lacks standardization,such as unreasonable design,omission of reports about adverse drug reactions,inadequate process of quality control,non-standardized interpretation of adverse reactions,etc. Therefore,it is necessary to formulate relevant technical specifications to guide this area. The developing of this technical specification refered to the international post-marketing safety monitoring model and advanced design concepts and methods. We developed it under the guidance of relevant laws,regulations and technical documents in China. Meanwhile the characteristics of Chinese patent medicines and the real situation in this area were considered. The aim of this technical specification is to obtain the incidence,type,degree and clinical manifestation of adverse drug reactions of Chinese patent medicines,to find new risk signals of adverse reactions,to identify risk factors,and to provide a basis for the formulation of risk management and control plans. This specification has been approved by China association of Chinese medicine which is numbered T/CACM011-2016.


Assuntos
Medicina Tradicional Chinesa , Medicamentos sem Prescrição , Vigilância de Produtos Comercializados , Sistemas de Notificação de Reações Adversas a Medicamentos , China , Hospitais
13.
Zhongguo Zhong Yao Za Zhi ; 44(14): 2932-2936, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31602835

RESUMO

Xiyanping Injection is a commonly used medicine in clinical treatment,which is recommended by many pediatric disease guidelines/consensus. However,the instraction is relatively simple and lack of guidance for clinical application,which affects the efficacy and brings safety risks. Therefore,more detailed clinical guidance is urgently needed. This consensus is formulated by clinical experts of traditional Chinese medicine and Western medicine in pediatrics. This consensus follows Manual for the clinical experts consensus of Chinese patent medicine which published by China Association of Chinese Medicine. The study identified clinical problems using clinical investigation,searched the literature based on PICO clinical problems,using GRADE system to carry out evidences evaluation,classification and recommendation,and adopted the nominal grouping method to reach expert consensus. The consensus combines evidence-based evidence with expert experience,sufficient evidence of clinical problems would lead to " recommendations",and clinical problems with insufficient evidence will lead to " consensus suggestions". This expert consensus recommends the indications,intervention time for treatment,route of drug administration,dose conversion,the indications of being used alone,suitability and taboos of medicine combination,and introduces the safety and clinical application,to provide reference for clinical using.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Criança , China , Consenso , Humanos , Injeções , Medicina Tradicional Chinesa , Medicamentos sem Prescrição , Pediatria
14.
Zhongguo Zhong Yao Za Zhi ; 44(14): 2943-2946, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31602837

RESUMO

Hugan Tablets is a Chinese patent medicine,it has the function of anti-inflammation and reducing transaminase. Based on questionnaire investigation of doctors and a systematic review of research literature on Hugan Tablets,using international clinical practice guidelines' developing methods,with the best available evidence and fully combining expert experience,and following the principle of " evidence-based,consensus-based and experience-based",Expert consensus statement on Hugan Tablets in clinical practice was developed by more than 30 multidisciplinary experts from the nationwide,aimed at guiding and standardizing the rational use of Hugan Tablets by clinicians and to improve clinical efficacy and safety. The expert consensus adopts internationally recognized recommendation criteria for classification of evidence: GRADE. The formation of expert consensus adopts the nominal group technique. Six main considerations are quality of evidence,curative effect,safety,economical efficiency,patient acceptability and other factors. If there is sufficient evidence,a " recommendation" is formed,using GRADE grid voting rule. If there isn' t sufficient evidence,a " consensus opinion" is formed,using majority counting rule. Focus on the indication,usage and dosage,drug use in special population and safety of Hugan Tablets,two recommendations and eight consensus opinions were put forward. Through expert meetings and correspondence,a nationwide consultation and peer review was conducted. This consensus applies to clinicians in hospitals and grass-roots health services,to provide guidance and reference for the rational use of Hugan Tablets.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Inflamação/tratamento farmacológico , Consenso , Humanos , Medicamentos sem Prescrição , Comprimidos
15.
BMC Health Serv Res ; 19(1): 536, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366363

RESUMO

BACKGROUND: Many low- and middle-income countries (LMIC) are moving towards enforcing prescription-only access to antibiotics. This systematic literature review aims to assess the interventions used to enforce existing legislation prohibiting over-the-counter (OTC) sales of antibiotics in LMICs, their impact and examine the methods chosen for impact measurement including their strengths and weaknesses. METHODS: Both PubMed and Embase were systematically searched for studies reporting on impact measurement in moving towards prescription only access to antibiotics in LMICs. The PRISMA methodological review framework was used to ensure systematic data collection and analysis of literature. Narrative data synthesis was used due to heterogeneity of study designs. RESULTS: In total, 15 studies were included that assessed policy impact in 10 different countries. Strategies employed to enforce regulations prohibiting OTC sales of systemic antibiotics included retention of prescriptions for antibiotics by pharmacies, government inspections, engaging pharmacists in the design of interventions, media campaigns for the general public and educational activities for health care workers. A variety of outcomes was used to assess the policy impact; changes in antimicrobial resistance rates, changes in levels of antibiotic use, changes in trends of antibiotic use, changes in OTC supply of antibiotics, and changes in reported practices and knowledge of pharmacists, medicine sellers and the general public. Differences in methodological approaches and outcome assessment made it difficult to compare the effectiveness of law enforcement activities. Most effective appeared to be multifaceted approaches that involved all stakeholders. Monitoring of the impact on total sales of antibiotics by means of an interrupted time series (ITS) analysis and analysis of pharmacies selling antibiotics OTC using mystery clients were the methodologically strongest designs used. CONCLUSIONS: The published literature describing activities to enforce prescription-only access to antibiotics in LMICs is sparse and offers limited guidance. Most likely to be effective are comprehensive multifaceted interventions targeting all stakeholders with regular reinforcement of messages. Policy evaluation should be planned as part of implementation to assess the impact and effectiveness of intervention strategies and to identify targets for further activities. Robust study designs such as ITS analyses and mystery client surveys should be used to monitor policy impact.


Assuntos
Antibacterianos , Comércio/legislação & jurisprudência , Aplicação da Lei , Legislação de Medicamentos , Medicamentos sem Prescrição , Comércio/estatística & dados numéricos , Países em Desenvolvimento , Humanos , Análise de Séries Temporais Interrompida
16.
Cuad. bioét ; 30(99): 199-207, mayo-ago. 2019.
Artigo em Espanhol | IBECS | ID: ibc-185235

RESUMO

El uso de fármacos durante el embarazo es esencial y beneficioso, pero resulta imprescindible consultar su seguridad. La evidencia científica disponible resulta pobre y de difícil interpretación. Las clasificaciones de riesgo (FDA, ADEC) han resultado demasiado simples y categóricas; conducen a percepciones imprecisas del riesgo y decisiones desafortunadas, como el abandono de la medicación o el aborto. Esto se ha puesto de manifiesto con los antidepresivos o el antirretroviral efavirenz. Si bien el aborto no está justificado, la desinformación contribuye aún más a aumentar el problema. La información tiende a obviar que no todo riesgo en embarazo es de tipo teratógeno, que la existencia de riesgo no implica probabilidad elevada, y que la naturaleza y probabilidad del riesgo varían según la etapa del desarrollo del embrión o feto. Existen situaciones especiales, como el uso de antineoplásicos, donde se necesita información muy adecuada para actuar a favor de la madre y del hijo. Con las clasificaciones categóricas en regresión, son necesarias innovaciones informativas, que deberían incluir: tipo de daño, si es agudo o crónico y si es reversible; probabilidad de que aparezca, riesgo según período del embarazo y nivel de evidencia. Las carencias de información sobre medicamentos en embarazo agravan la amenaza eugenésica sobre la vida de los no nacidos y las familias, y añaden riesgos para la salud de la mujer. Resulta un área de gran interés para la innovación en servicios y fuentes de información mejorados


Drug use in pregnancy is essential and beneficial, but it is needed to check their safety. Available scientific evidence is poor and difficult to interpret. Risk classifications (FDA, ADEC) have shown to be too simple and categorical; they lead to inaccurate perceptions of risk and unfortunate decisions, such as interrumption of medication, or abortion. This has become clear with antidepressants or the antiretroviral efavirenz. Although abortion is not justified, misinformation contributes even more to the problem. Information tends to obviate that not every risk in pregnancy is teratogenic, that the existence of risk does not imply high probability, and that the nature and probability of the risk vary according to the stage of development of the embryo or fetus. There are special situations, such as the use of antineoplastics, where very precise information is needed to act on behalf of the mother and the child. With categorical classifications in regression, informative innovations are necessary, which should include: type of damage, whether it is acute or chronic, reversible or irreversible; probability of occurrence, risk according to pregnancy period and level of evidence. The lack of information on medicines in pregnancy aggravates the eugenic threat on the lives of the unborn and families, and adds risks to women’s health. It is an area of great interest for innovation in services and improved information sources


Assuntos
Humanos , Feminino , Gravidez , Prescrições de Medicamentos , Tratamento Farmacológico/ética , Complicações na Gravidez/tratamento farmacológico , Gravidez/ética , Controle de Medicamentos e Entorpecentes/legislação & jurisprudência , Medicamentos sem Prescrição/uso terapêutico , Gestantes , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
17.
Zhongguo Zhong Yao Za Zhi ; 44(9): 1927-1937, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31342723

RESUMO

To assess the clinical efficacy of Yiqi Huoxue Chinese patent medicine for coronary heart disease with angina pectoris by using network Meta-analysis method. The relative randomized controlled trials( RCTs) of Yiqi Huoxue Chinese patent medicine for coronary heart disease with angina pectoris were retrieved from China National Knowledge Infrastructure( CNKI),Wan Fang,VIP and Chinese Biomedical Literature Database( CBM) in July 2018. Two researchers independently completed the literature screening,data extraction and quality evaluation according to the pre-determined inclusion and exclusion criteria,and the results were cross-checked.The data were analyzed by Win Bugs,and STATA software was used for plotting. Finally,114 RCTs were included,involving 7 Yiqi Huoxue Chinese patent medicines and 11 775 patients. Network Meta-analysis showed that the total effective rate for improvement in AP symptoms had 7 direct comparisons and 21 indirect comparisons,8 of which were statistically significant. The ECG improvement had 7 direct comparisons and 21 indirect comparisons,7 of which were statistically significant. In terms of the total effective rate of improvement in AP symptoms,the order of efficacy was as follows: Shensong Yangxin Capsules > Shexiang Baoxin Pills > Qishen Yiqi Dropping Pills > Tongxinluo Capsules > Wenxin Granules > Qishen Capsules > Naoxintong Capsules. In terms of ECG improvement,the order of efficacy was as follows: Shexiang Baoxin Pills > Tongxinluo Capsules > Naoxintong Capsules > Qishen Yiqi Dropping Pills> Wenxin Granules > Shensong Yangxin Capsules > Qishen Capsules. The results showed that Shensong Yangxin Capsules and Shexiang Baoxin Pills had certain advantages in the treatment of coronary heart disease with angina pectoris. Due to the small sample size,more studies were required to further verify the evidences.


Assuntos
Angina Pectoris/tratamento farmacológico , Doença das Coronárias/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , China , Humanos , Meta-Análise em Rede , Medicamentos sem Prescrição , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Ceska Slov Farm ; 68(2): 78-85, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31331177

RESUMO

Medicines for self-medication (over-the-counter, OTC) are available through pharmacies, in some countries they are also available in supermarkets and other outlets. The use of OTC in European Union countries shows some differences at national level, in pharmacies and in patients preference. This study aimed to completing the lists of marketed OTC in Czech Republic and Greece. Next topics are: finding out the real range of OTC products offered by pharmacies, finding and evaluating number of packages sold in pharmacies in 20 particular common OTC in 2016, and indentification of factors influencing the sales. Web pages of national drug authorities (Czech Republic, Greece) were searched to complete lists of marketed OTC in each country. Data on range of OTC drugs and sales of them were extracted from computer systems (Czech Republic) and other types of documents (Greece) kept in pharmacies. The percentage of the real range of OTC products in pharmacies was calculated as the ratio to the number of OTC in national lists. Numbers of sold packages were compared among pharmacies. Classification system ATC (anatomical/therapeutical/chemical) was employed to present findings in all parts of the research. The Czech list contained 1,160 of marketed OTC in 10 ATC (1st level), with the maximum in ATC R (243 drugs). The Greek list contained 1,254 OTC in 13 ATC (1st level), with the maximum in ATC D (272 drugs). In lists of both countries, there were detected 86 drugs identical in 9 ATC (1st level). At least one OTC in each of 10 listed ATC was found in Czech pharmacies as a part of range of products, the range of OTC in Greek pharmacies comprised 11 ATC. The highest sales (year 2016) were found in ATC R (drug ACC long tbl eff) in CR and in ATC A (drug: Imodium cps) in Greece. The differences in the range of OTC drugs and in their sales were found between Czech Republic and Greece, and between types of pharmacies inside each country. Factors influencing them were detected: ownership of the pharmacy, locality (number of inhabitants). OTC drugs pharmacy Czech Republic Greece.


Assuntos
Medicamentos sem Prescrição/provisão & distribução , Farmácias , República Tcheca , Grécia
19.
BMC Public Health ; 19(1): 971, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331304

RESUMO

BACKGROUND: 'Yaa Chud' is a non-prescribed poly-pharmaceutical pack containing several types of drugs, including antibiotics and steroids, which can be purchased over the counter in Thailand for self-medication. Although it is illegal, it is still available at some community outlets. This study aimed to understand access to and use of Yaa Chud at the community level in order to raise awareness on its usage and to provide policy recommendations to address the problem. METHODS: This study employed qualitative methods, including in-depth interviews with 18 drug suppliers and 16 community members, and six focus group discussions. It included inventories from 17 drug suppliers. Data were collected in selected communities of the Kanchanaburi Demographic Surveillance System, located in the western region of Thailand.Thematic analysis was based upon the Health Services Utilization Model and conducted using the Open Code qualitative software program. RESULTS: Overcrowding, long waiting times, and a perceived unwelcoming environment at public health-care service outlets were identified as factors that drive people into the private sector, where loose regulation of drug laws facilitates access and use of Yaa Chud. Migrants and older people were most likely to seek and use Yaa Chud, especially for mild illness. Availability, easy access through a user's network, low cost, and perceived effectiveness were identified as factors that enable access and use of Yaa Chud. CONCLUSIONS: Though illegal in Thailand, Yaa Chud is likely to remain available for self-medication by community members, due to the persisting demand by the elderly and migrant workers. There is an urgent need to replace these mixed medications with better choices. Safer Yaa Chud may be a preferred, first-line health-care option, which could help reduce congestion in the formal health-care setting. At the same time, enforcement of regulatory compliance needs to be continued in order to stop the supply of unsafe Yaa Chud.


Assuntos
Embalagem de Medicamentos , Medicamentos sem Prescrição/provisão & distribução , Medicamentos sem Prescrição/uso terapêutico , Automedicação , Adulto , Idoso , Feminino , Grupos Focais , Humanos , Legislação de Medicamentos , Masculino , Pessoa de Meia-Idade , Tailândia , Adulto Jovem
20.
Zhongguo Zhong Yao Za Zhi ; 44(12): 2644-2651, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31359735

RESUMO

In 2018,Standardization Department of China Association of Chinese Medicine invited methodologists with the background of evidence-based medicine to discuss and draft a series of standards for expert consensus on clinical practice of Chinese patent medicines. These standards have been made by reference to the published standards for developing expert consensus and clinical practice guidelines. These standards were made based on full consideration of the current evidence status and the history of clinical practice of Chinese patent medicines. These standards were composed of four parts,namely information summary items,normative general items,normative technical items and information supplementary items,including cover,content,preface,introduction,title,scope,basic Information of Chinese patent medicine,suggestions for clinical application,safety,conflict of interest,appendix,and references,so as to provides reference for improving the quality of expert consensus-based compilation and enhancing the applicability of expert consensus.


Assuntos
Medicina Tradicional Chinesa/normas , Medicamentos sem Prescrição/normas , China , Consenso , Medicina Baseada em Evidências , Humanos
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