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1.
BMC Health Serv Res ; 20(1): 913, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008384

RESUMO

BACKGROUND: Novel Coronavirus is a global pandemic affecting all walks of life and it significantly changed the health system practices. Pharmacists are at the front line and have long been involved in combating this public health emergency. Therefore, the study was aimed to explore pharmacy preparedness and response to prevent and control coronavirus disease 2019 (COVID-19). METHODS: A qualitative study was conducted in six pharmacies in Aksum, Ethiopia in May, 2020. We conducted six in-depth interviews with purposively selected key informants. Direct observation measures were made to assess the activities made in the medicine retail outlets for the prevention and control of the pandemic. Interview data were audio-recorded, translated and transcribed verbatim. Thematic analysis was employed to analyze the data and OpenCode version 4.02 software was used to facilitate the data analysis. RESULTS: The thematic analysis has resulted in seven major themes. Good preparedness measures were undertaken to control and prevent COVID-19. Study informants had good knowledge about the pandemic disease and reported they had used different resource materials to update themselves. Preparing of alcohol-based hand-rub, availing finished sanitizers and alcohol, and advising clients to maintain physical distancing were the major counseling information being delivered to prevent the disease. Some tendencies of irrational drug use and false claims of COVID-19 were observed at the beginning of the pandemic. Interview informants had reported they were working with relevant stakeholders and appropriate patient education and support were given to combat the pandemic. CONCLUSION: The study revealed necessary pharmacy services has been rendered to all clients. However, availability of drugs and medical supplies were scarce which negatively affected the optimal delivery of pharmacy services. The government and other responsible bodies should work together to solve such problems and contain the pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Assistência Farmacêutica/organização & administração , Farmacêuticos/psicologia , Pneumonia Viral/prevenção & controle , Adulto , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Etiópia/epidemiologia , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Preparações Farmacêuticas/provisão & distribução , Farmacêuticos/estatística & dados numéricos , Pesquisa Qualitativa
3.
Rev Assoc Med Bras (1992) ; 66Suppl 2(Suppl 2): 41-47, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965355

RESUMO

Since the outbreak of a cluster of patients with pneumonia of unknown cause in Wuhan, Hubei Province, China, in December 2019, the disease was later officially named coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), quickly spreading globally. Pregnant women and children are particularly vulnerable during disasters and emergencies. Comprehensive and applicable emergency preparedness and response are definitely important methods to prevent and contain the COVID-19 pandemic. The rational allocation of pharmaceutical resources plays an important role in the medical emergency plan. This paper aimed to share experiences for the allocation of pharmaceutical resources in hospitals focusing primarily on women and children during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Coronavirus , Centros de Saúde Materno-Infantil/organização & administração , Preparações Farmacêuticas/provisão & distribução , Pneumonia Viral , Alocação de Recursos/estatística & dados numéricos , Betacoronavirus , Criança , China , Feminino , Humanos , Pandemias , Gravidez
4.
Cochrane Database Syst Rev ; 8: CD012012, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32803893

RESUMO

BACKGROUND: A well-functioning routine health information system (RHIS) can provide the information needed for health system management, for governance, accountability, planning, policy making, surveillance and quality improvement, but poor information support has been identified as a major obstacle for improving health system management. OBJECTIVES: To assess the effects of interventions to improve routine health information systems in terms of RHIS performance, and also, in terms of improved health system management performance, and improved patient and population health outcomes. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE Ovid and Embase Ovid in May 2019. We searched Global Health, Ovid and PsycInfo in April 2016. In January 2020 we searched for grey literature in the Grey Literature Report and in OpenGrey, and for ongoing trials using the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov. In October 2019 we also did a cited reference search using Web of Science, and a 'similar articles' search in PubMed. SELECTION CRITERIA: Randomised and non-randomised trials, controlled before-after studies and time-series studies comparing routine health information system interventions, with controls, in primary, hospital or community health care settings. Participants included clinical staff and management, district management and community health workers using routine information systems. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed records to identify studies for inclusion, extracted data from the included studies and assessed the risk of bias. Interventions and outcomes were too varied across studies to allow for pooled risk analysis. We present a 'Summary of findings' table for each intervention comparisons broadly categorised into Technical and Organisational (or a combination), and report outcomes on data quality and service quality. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS: We included six studies: four cluster randomised trials and two controlled before-after studies, from Africa and South America. Three studies evaluated technical interventions, one study evaluated an organisational intervention, and two studies evaluated a combination of technical and organisational interventions. Four studies reported on data quality and six studies reported on service quality. In terms of data quality, a web-based electronic TB laboratory information system probably reduces the length of time to reporting of TB test results, and probably reduces the overall rate of recording errors of TB test results, compared to a paper-based system (moderate certainty evidence). We are uncertain about the effect of the electronic laboratory information system on the recording rate of serious (misidentification) errors for TB test results compared to a paper-based system (very low certainty evidence). Misidentification errors are inaccuracies in transferring test results between an electronic register and patients' clinical charts. We are also uncertain about the effect of the intervention on service quality (timeliness of starting or changing a patient's TB treatment) (very low certainty evidence). A hand-held electronic device probably improves the length of time to report TB test results, and probably reduces the total frequency of recording errors in TB test results between the laboratory notebook and the electronic information record system, compared to a paper-based system (moderate-certainty evidence). We are, however, uncertain about the effect of the intervention on the frequency of serious (misidentification) errors in recording between the laboratory notebook and the electronic information record, compared to a paper-based system (very low certainty evidence). We are uncertain about the effect of a hospital electronic health information system on service quality (length of time outpatients spend at hospital, length of hospital stay, and hospital revenue collection), compared to a paper-based system (very low certainty evidence). High-intensity brief text messaging (SMS) may make little or no difference to data quality (in terms of completeness of documentation of pregnancy outcomes), compared to low-intensity brief text messaging (low-certainty evidence). We are uncertain about the effect of electronic drug stock notification (with either data management support or product transfer support) on service quality (in terms of transporting stock and stock levels), compared to paper-based stock notification (very low certainty evidence). We are uncertain about the effect of health information strengthening (where it is part of comprehensive service quality improvement intervention) on service quality (health worker motivation, receipt of training by health workers, health information index scores, quality of clinical observation of children and adults) (very low certainty evidence). AUTHORS' CONCLUSIONS: The review indicates mixed effects of mainly technical interventions to improve data quality, with gaps in evidence on interventions aimed at enhancing data-informed health system management. There is a gap in interventions studying information support beyond clinical management, such as for human resources, finances, drug supply and governance. We need to have a better understanding of the causal mechanisms by which information support may affect change in management decision-making, to inform robust intervention design and evaluation methods.


Assuntos
Assistência à Saúde/organização & administração , Sistemas de Informação em Saúde/normas , Política Organizacional , Melhoria de Qualidade , Viés , Sistemas de Informação em Laboratório Clínico/organização & administração , Sistemas de Informação em Laboratório Clínico/normas , Computadores de Mão , Coleta de Dados/normas , Tomada de Decisões , Assistência à Saúde/normas , Serviços de Informação sobre Medicamentos/normas , Sistemas de Informação Hospitalar/normas , Testes de Sensibilidade Microbiana , Inovação Organizacional , Preparações Farmacêuticas/provisão & distribução , Ensaios Clínicos Controlados Aleatórios como Assunto , Envio de Mensagens de Texto/normas , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico
6.
Einstein (Sao Paulo) ; 18: eAO5314, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32785451

RESUMO

Objective To estimate the prevalence of use of drugs to treat gastrointestinal disorders, according to demographic, socioeconomic, and health characteristics of the Brazilian population. Methods This is a population-based survey that interviewed individuals residing in cities of the five regions in Brazil. The study sample was composed of 32,348 individuals aged 20 or more years. The profile of use of drugs for gastrointestinal disorders was evaluated considering the variables sex, age, healthcare plan, region, and number of chronic diseases. We also analyzed the frequency of individuals who declared using other drugs, besides those already employed for treatment of gastrointestinal disorders. Additionally, the estimated frequencies of the drug classes used were determined. Results The prevalence of use of drugs for gastrointestinal disorders in Brazil was 6.9% (95% confidence interval - 6.4-7.6), higher in females, among persons aged over 60 years, in those who had a private healthcare insurance, and presented with two or more chronic diseases. It was noted that 42.9% of the aged who used drugs for gastrointestinal disorders were also on polypharmacy. As to the classes of drugs, 82% corresponded to drugs for the food tract and metabolism, particularly proton pumps inhibitors. Conclusion The use of drugs for treatment of gastrointestinal disorders was significant among women and elderly. In this age group, consumption may be linked to gastric protection due to polypharmacy. This study is an unprecedented opportunity to observe the self-reported consumption profile of these drugs in Brazil and, therefore, could subsidize strategies to promote their rational use.


Assuntos
Uso de Medicamentos/estatística & dados numéricos , Medicamentos Essenciais/uso terapêutico , Gastroenteropatias/tratamento farmacológico , Acesso aos Serviços de Saúde/estatística & dados numéricos , Adulto , Idoso , Brasil , Cidades , Estudos Transversais , Medicamentos Essenciais/provisão & distribução , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Preparações Farmacêuticas/provisão & distribução , Medicamentos sob Prescrição/provisão & distribução , Fatores Socioeconômicos , Adulto Jovem
7.
J Manag Care Spec Pharm ; 26(8): 945-947, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32715960

RESUMO

The ever-vulnerable medication supply chain is being further strained by the COVID-19 pandemic. Pharmacists in all settings, including managed care, will need to prepare for a potential exacerbation of existing and new drug shortages in the midst of unprecedented crisis. We summarize the major issues, discuss potential mitigation strategies, and call on our colleagues to respond with the resilience necessary to protect our patients. DISCLOSURES: The authors declare no funding sources nor conflicts of interest.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Preparações Farmacêuticas/provisão & distribução , Farmácias/estatística & dados numéricos , Pneumonia Viral/tratamento farmacológico , Humanos , Pandemias , Farmácias/ética , Farmacêuticos , Serviço de Farmácia Hospitalar
8.
F1000Res ; 9: 225, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-612254

RESUMO

While the world is facing the urgency of the COVID-19 pandemic, policymakers must plan for the direct response to the outbreak while minimising its collateral impact. Maintaining the supply chain of pharmaceutical products is not only paramount to cover the immediate medical response but will be fundamental to reducing disruption of the healthcare delivery system, which requires constant medicines, diagnostic tools and vaccines for smooth functioning. In this equation, the role of the Indian pharmaceutical industry will not only be critical to meet the domestic need of over 1.3 billion inhabitants but will equally be important for the rest of the world, including wealthy economies. Preventing a significant disruption of the Indian pharmaceutical supply chain during the outbreak and preparing it for large scale production for COVID-19 therapeutic or preventive medical products will not only help India but will assist the global response to this outbreak.


Assuntos
Infecções por Coronavirus , Medicamentos Genéricos/provisão & distribução , Pandemias , Preparações Farmacêuticas/provisão & distribução , Pneumonia Viral , Betacoronavirus , Comércio , Indústria Farmacêutica , Humanos , Índia
9.
J Vet Emerg Crit Care (San Antonio) ; 30(4): 493-497, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32598096

RESUMO

BACKGROUND: The COVID-19 pandemic has presented veterinary emergency hospitals with unique challenges. Rapid online surveys represent an efficient way of collating responses to rapidly shifting circumstances. METHODS: Fifty, 24-h small animal emergency veterinary hospital representatives were recruited to participate in weekly surveys in April 2020 to catalog changes due to COVID-19 pandemic. KEY FINDINGS: The majority of emergency veterinary hospitals surveyed reported significant changes to day-to-day operations as a result of the COVID-19 pandemic. SIGNIFICANCE: Reporting of weekly survey results provides useful information on how emergency veterinary hospitals with similar challenges are responding to the COVID-19 pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Hospitais Veterinários/tendências , Pneumonia Viral/epidemiologia , Animais , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/etiologia , Gatos , Cães , Emergências/veterinária , Serviço Hospitalar de Emergência/tendências , Feminino , Furões , Hospitais Veterinários/economia , Masculino , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/etiologia , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Preparações Farmacêuticas/provisão & distribução , Inquéritos e Questionários , Estados Unidos/epidemiologia
10.
F1000Res ; 9: 225, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32566139

RESUMO

While the world is facing the urgency of the COVID-19 pandemic, policymakers must plan for the direct response to the outbreak while minimising its collateral impact. Maintaining the supply chain of pharmaceutical products is not only paramount to cover the immediate medical response but will be fundamental to reducing disruption of the healthcare delivery system, which requires constant medicines, diagnostic tools and vaccines for smooth functioning. In this equation, the role of the Indian pharmaceutical industry will not only be critical to meet the domestic need of over 1.3 billion inhabitants but will equally be important for the rest of the world, including wealthy economies. Preventing a significant disruption of the Indian pharmaceutical supply chain during the outbreak and preparing it for large scale production for COVID-19 therapeutic or preventive medical products will not only help India but will assist the global response to this outbreak.


Assuntos
Infecções por Coronavirus , Medicamentos Genéricos/provisão & distribução , Pandemias , Preparações Farmacêuticas/provisão & distribução , Pneumonia Viral , Betacoronavirus , Comércio , Indústria Farmacêutica , Humanos , Índia
11.
Farm Hosp ; 44(7): 17-20, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32533663

RESUMO

COVID crisis has abruptly broken into our hospitals, and many difficulties have  emerged, including those related to supply logistics. A huge number of new  patients, a fast internal reorganization process and many other changes were  suddenly established. These circumstances revealed the need to increase stocks  of drugs, both for basic treatment as well as for specific SARS-CoV-2 infection  management. At the same time, other problems (shortages, new and complex  purchasing procedures, etc.) surfaced, so they could risk safety along the  pharmacotherapeutic process. The main objective was to develop and implement all the necessary measures within the logistics circuit in order to ensure the  availability of medicines for patients, as safely and effectively as possible, during the Coronavirus crisis. Firstly, two pharmacists were appointed to coordinate the whole process, and a preliminary analysis of the following aspects was carried  out an estimation of needs to make an initial drug provisioning, a storage  feasibility study and a global analysis of the logistics process to detect critical  points. Three different circuits for medicines supply were established as some  drugs were operated by Agencia Española de Medicamentos y Productos  Sanitarios (AEMPS) or Servicio Madrileño de Salud (SERMAS), and others were  under no restrictions. For stocks control, inventory was frequently reviewed and  monitoring of prescription trends was implemented. For all new medicinal  products, compliance with security standards was reviewed and relabeling was  carried out if necessary. Criteria were defined for the storage of overstocks and  it was placed an isolated area for quarantined drugs. Shortages inevitably  occurred but their effects were partly mitigated by AEMPS and SERMAS. After  all, we consider that the implemented procedure for logistics management may  be reproducible, and the key points we have identified are the following: to  enhance our quality management system, to develop an Action Plan for  Healthcare Emergencies and to ensure the adequate training for all pharmacy  staff. Furthermore, we also should address other aspects: to establish storage  optimization strategies, to focus on a more advanced logistics management  model, as well as to take advantage of the extraordinary multidisciplinary  network, which has been consolidated during this COVID pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Preparações Farmacêuticas/provisão & distribução , Serviço de Farmácia Hospitalar/organização & administração , Pneumonia Viral , Antivirais/provisão & distribução , Antivirais/uso terapêutico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Planejamento em Desastres , Rotulagem de Medicamentos , Prescrições de Medicamentos/estatística & dados numéricos , Armazenamento de Medicamentos , Educação Continuada em Farmácia , Necessidades e Demandas de Serviços de Saúde , Humanos , Comunicação Interdisciplinar , Inventários Hospitalares , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , Gestão da Qualidade Total
12.
Farm Hosp ; 44(7): 32-35, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32533667

RESUMO

The Intensive Care Unit (ICU) of the University Hospital of Fuenlabrada was  forced to critically increase its capacity in the COVID-19 pandemic. The objective of this work is to describe the activities promoted by the pharmacist in the care  of the critically ill patient in this context. A new organizational structure was  designed, analyzing the tasks necessary to make the processes profitable. Two  pharmacists joined the critical patient care to help the pharmacist who was  already integrated in the ICU team. The development of the operational  structure was carried out on three levels. The healthcare activity highlights the  daily participation of pharmacists in the two clinical sessions in which the ICU  teams evaluated all cases and made decisions. This in turn facilitated the  pharmaceutical validation that was carried out in the critical units themselves. In addition, one of the pharmacists created the Immuno-COVID Committee, in  which they participated together with different specialists for therapeutic  decision-making in the most complex cases. On the other hand, the availability  of human and material resources allowed the implantation of centralized  elaboration in the Pharmacy Service of many intravenous mixtures, including  antibiotics elastomers Pumps for continuous infusion, and non-sterile  elaborations. In logistics management, in addition to the acquisition of COVID- 19 therapies, the reconciliation with nursing activity stands out. The physical presence of the pharmacist favored the detection of needs, the  availability in time of medications in the unit, including sterile and non-sterile  preparations, and coordination with the central pharmacy. In knowledge  management, the participation of the pharmacist in the working group for the  development of the hospital management protocol COVID-19 stands out. The  daily presence in the unit and the joint work with the entire multidisciplinary team demonstrate the value that the pharmacist can bring. In addition to  efficient resource management, support for clinical decision-making and  improvement actions, it provides the climate of inter-professional trust necessary to respond to the complexity of the critical patient and promote joint  projects.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Unidades de Terapia Intensiva , Pandemias , Farmacêuticos , Pneumonia Viral , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Infecções por Coronavirus/terapia , Cuidados Críticos , Tomada de Decisões , Gerenciamento Clínico , Equipamentos e Provisões Hospitalares/provisão & distribução , Necessidades e Demandas de Serviços de Saúde , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Preparações Farmacêuticas/provisão & distribução , Serviço de Farmácia Hospitalar/organização & administração , Comitê de Farmácia e Terapêutica/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Pneumonia Viral/terapia , Papel Profissional , Espanha/epidemiologia
13.
Farm Hosp ; 44(7): 36-39, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32533668

RESUMO

The COVID-19 pandemic is placing huge strain on health systems and professionals. Emergency departments and their pharmacy services have been the first to face this challenge before any other pharmacy units. This article provides a description of the experience of two public hospitals  located in the Autonomous Community of Madrid, Spain. Team working and  reciprocal trust have made it possible to meet the unprecedented demand for  health services and has facilitated rapid decision making. Strategies have been  developed to guarantee the availability, distribution and safe use of medications. Other strategies have included favoring communication within Emergency  Departments pharmacy services, and between these services and Emergency  Departments during the pandemic. Multidisciplinary cooperation and information  sharing have traditionally formed the base for efficient and quality work, along  with solid technologies that guarantee a safe use of medications. The crucial role of information and communication technologies during the pandemic may give  rise to a new model of pharmaceutical care, which should not replace face-to- face Emergency Department pharmacist support and advice. Promoting the re- humanization of healthcare and pharmacy services is essential. An adequate  technical training and the development of abilities such as flexibility, planning  and coordination skills, and an assertive communication and management of  emotions will be key to the successful management of unimaginable settings in  the future.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Serviço Hospitalar de Emergência/organização & administração , Unidades de Terapia Intensiva , Pandemias , Farmacêuticos , Pneumonia Viral , Competência Clínica , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Tomada de Decisões , Gerenciamento Clínico , Prescrições de Medicamentos/estatística & dados numéricos , Previsões , Necessidades e Demandas de Serviços de Saúde , Hospitais Universitários , Humanos , Controle de Infecções/organização & administração , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Comunicação Interdisciplinar , Sistemas de Medicação no Hospital/organização & administração , Equipe de Assistência ao Paciente , Preparações Farmacêuticas/provisão & distribução , Serviço de Farmácia Hospitalar/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Espanha/epidemiologia
14.
Farm Hosp ; 44(7): 40-42, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32533669

RESUMO

Since the implementation of the Antimicrobial Therapy Optimization Programme, hospital pharmacy specialists have collaborated with infectious disease specialists on a regular basis in most hospitals in Spain.  Cooperation between these professionals ensures the integrated management of patients with infectious diseases and the appropriate use of antimicrobials in  hospitals. The COVID-19 pandemic forced hospital pharmacists to abruptly  suspend all their structured activities and concentrate on the health crisis.  Realtime information sharing between different medicine specialties is an  effective strategy to generate and maintain treatment protocols adapted to each center, with continuous evidence-based modifications as new publications appear. Hospital pharmacies had to reorganize their activities to  respond to the pandemic. On the one side were patients with COVID-19, and on  the other were routine hospital pharmacy tasks, with the added difficulty of  adapting to individual protection measures. New communication and  collaboration strategies were adopted. Protocols were established for the  management of COVID-19 patients, with continuous changes; special  medications had to be prepared and distributed; circuits were designed for the  home- or institution-based care of patients; internal circuits were created to  minimize the movements of hospital staff and professionals caring for COVID-19  patients. The most effective antiviral drug and anti inflammatory therapy  remains elusive. In this scenario, hospital pharmacists emerge as a key player,  as they have a deep understanding of the mechanisms of action of drugs and  potential interactions. In a setting where experimental drugs preferably tested in clinical trials are being used, the role of hospital pharmacists in interdisciplinary  teams has become essential for the optimization of clinical outcomes.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Unidades Hospitalares , Comunicação Interdisciplinar , Pandemias , Equipe de Assistência ao Paciente , Farmacêuticos , Serviço de Farmácia Hospitalar/organização & administração , Pneumonia Viral , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Cuidados Críticos , Tomada de Decisões , Gerenciamento Clínico , Necessidades e Demandas de Serviços de Saúde , Hospitais Universitários , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Infectologia/organização & administração , Pacientes Internados , Unidades de Terapia Intensiva/organização & administração , Preparações Farmacêuticas/provisão & distribução , Comitê de Farmácia e Terapêutica/organização & administração , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Espanha/epidemiologia
17.
PDA J Pharm Sci Technol ; 74(4): 468-494, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32467176

RESUMO

This article reviews currently available scientific literature related to the epidemiology, infectivity, survival, and susceptibility to disinfectants of Coronaviruses, in the context of the controls established to meet good manufacturing practice (GMP) regulations and guidance, and the public health guidance issued specifically to combat the COVID-19 pandemic. The possible impact of the COVID-19 pandemic on the pharmaceutical supply chain is assessed and recommendations are listed for risk mitigation steps to minimize supply disruption to pharmaceutical drug products. Areas addressed include a brief history of the COVID-19 viral pandemic, a description of the virus, the regulatory response to the pandemic, the screening of employees, the persistence of the virus on inanimate surfaces, cleaning and disinfection of manufacturing facilities, the use of GMP-mandated personal protective equipment to counter the spread of the disease, the role of air changes in viral clearance, and approaches to risk assessment and mitigation. Biological medicinal products have a great record of safety, yet the cell cultures used for production can be susceptible to viruses, and contamination events have occurred. Studies on SARS-CoV-2 for it ability to replicate in various mammalian cell lines used for biopharmaceutical manufacturing suggests that the virus poses a low risk and any contamination would be detected by currently used adventitious virus testing. The consequences of the potential virus exposure of manufacturing processes as well as the effectiveness of mitigation efforts are discussed. The pharmaceutical supply chain is complex, traversing many geographies and companies that range from large multinationals to mid- and small-size operations. This paper recommends practices that can be adopted by all companies, irrespective of their size, geographic location, or position in the supply chain.


Assuntos
Infecções por Coronavirus/prevenção & controle , Desinfecção/métodos , Pandemias/prevenção & controle , Preparações Farmacêuticas/provisão & distribução , Pneumonia Viral/prevenção & controle , Animais , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Desinfetantes/química , Contaminação de Medicamentos/prevenção & controle , Indústria Farmacêutica/normas , Contaminação de Equipamentos/prevenção & controle , Humanos , Preparações Farmacêuticas/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Gestão de Riscos/métodos , Replicação Viral
18.
Encephale ; 46(3S): S14-S34, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32376004

RESUMO

The 2019-20 coronavirus pandemic (SARS-CoV-2; severe acute respiratory syndrome coronavirus 2) has dramatic consequences on populations in terms of morbidity and mortality and in social terms, the general confinement of almost half of the world's population being a situation unprecedented in history, which is difficult today to measure the impact at the individual and collective levels. More specifically, it affects people with various risk factors, which are more frequent in patients suffering from psychiatric disorders. Psychiatrists need to know: (i) how to identify, the risks associated with the prescription of psychotropic drugs and which can prove to be counterproductive in their association with COVID-19 (coronavirus disease 2019), (ii) how to assess in terms of benefit/risk ratio, the implication of any hasty and brutal modification on psychotropic drugs that can induce confusion for a differential diagnosis with the evolution of COVID-19. We carried out a review of the literature aimed at assessing the specific benefit/risk ratio of psychotropic treatments in patients suffering from COVID-19. Clinically, symptoms suggestive of COVID-19 (fever, cough, dyspnea, digestive signs) can be caused by various psychotropic drugs and require vigilance to avoid false negatives and false positives. In infected patients, psychotropic drugs should be used with caution, especially in the elderly, considering the pulmonary risk. Lithium and Clozapine, which are the reference drugs in bipolar disorder and resistant schizophrenia, warrant specific attention. For these two treatments the possibility of a reduction in the dosage - in case of minimal infectious signs and in a situation, which does not allow rapid control - should ideally be considered taking into account the clinical response (even biological; plasma concentrations) observed in the face of previous dose reductions. Tobacco is well identified for its effects as an inducer of CYP1A2 enzyme. In a COVID+ patient, the consequences of an abrupt cessation of smoking, particularly related with the appearance of respiratory symptoms (cough, dyspnea), must therefore be anticipated for patients receiving psychotropics metabolized by CYP1A2. Plasma concentrations of these drugs are expected to decrease and can be related to an increase risk of relapse. The symptomatic treatments used in COVID-19 have frequent interactions with the most used psychotropics. If there is no curative treatment for infection to SARS-CoV-2, the interactions of the various molecules currently tested with several classes of psychotropic drugs (antidepressants, antipsychotics) are important to consider because of the risk of changes in cardiac conduction. Specific knowledge on COVID-19 remains poor today, but we must recommend rigor in this context in the use of psychotropic drugs, to avoid adding, in patients suffering from psychiatric disorders, potentially vulnerable in the epidemic context, an iatrogenic risk or loss of efficiency.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Transtornos Mentais/tratamento farmacológico , Pandemias , Pneumonia Viral , Psicotrópicos/uso terapêutico , Fatores Etários , Antivirais/efeitos adversos , Antivirais/uso terapêutico , Biotransformação , Doenças Cardiovasculares/induzido quimicamente , Comorbidade , Continuidade da Assistência ao Paciente , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Citocromo P-450 CYP1A2/metabolismo , Interações Medicamentosas , Febre/induzido quimicamente , França/epidemiologia , Gastroenteropatias/induzido quimicamente , Humanos , Transtornos Mentais/induzido quimicamente , Transtornos Mentais/epidemiologia , Preparações Farmacêuticas/provisão & distribução , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Psicotrópicos/administração & dosagem , Psicotrópicos/efeitos adversos , Psicotrópicos/farmacocinética , Transtornos Respiratórios/induzido quimicamente , Medição de Risco , Abandono do Hábito de Fumar , Avaliação de Sintomas
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