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1.
Nihon Yakurigaku Zasshi ; 157(6): 406-410, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-36328548

RESUMO

Among the fields of medical treatments, pharmacological therapy is most the therapy that nurses are most concerned in. Under the clinical practical scenes, nurses are required to have high specialized knowledge and proper judgment ability. In the basic education of nursing care, in clinical pharmacology, we learn pharmacological therapy in terms of principal pharmacological efficacy and adverse effects, methods of administrations, and management methods of management. As pharmacology for nursing care, we lean comprehensive understanding of diseases, life style, and psychological situations. Under the actual nursing education following clinical scenes, in addition to these issues, we are required to learn knowledge and skill of performing safety pharmacological treatment of patients. It is important that we improve high specialized knowledge and proper judgment ability and we guarantee the quality of pharmacological treatments in accordance with patients safety. Especially in the university hospitals, Drug treatment using anti-cancer drugs and agents having serious side effects, and high-level clinical test drugs, are performed. Nurses are involved in the pharmacological treatment of patients as team with doctors and pharmacist. Therefore, the guarantee of pharmacological treatment is almost identical to the guarantee of quality of nursing care. In order that nurses are able to perform pharmacological treatments to patients safely, and obtain treatment efficacy, in addition to systematic and practical education, the promotion of communication of personnel interchange between clinical fields to a faculty is very useful, leading to establishment of motivation of continual education.


Assuntos
Educação em Enfermagem , Farmacologia , Humanos , Aprendizagem , Docentes
2.
Rev. Soc. Esp. Dolor ; 29(supl.1): 3-9, Nov. 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-211666

RESUMO

El papel del sistema endocannabinoide en la modulación de la nocicepción y en la interpretación de estas señales se conoce desde mediados del siglo pasado. Los trabajos desarrollados desde entonces han permitido profundizar en los mecanismos de acción implicados y así poder sintetizar diversos fármacos capaces de modular estas señales. Estos fármacos pueden ser agonistas, dirigidos a activar directamente receptores cannabinoides, pero pueden igualmente ser sustancias que modulen las enzimas encargadas de las síntesis y degradación de los endocannabinoides. Farmacológicamente se están estudiando, además, otras sustancias presentes en la planta Cannabis sativa, así como derivados sintéticos obtenidos a partir de estas, que pueden unirse, además de a los receptores antes mencionados, a otros tipos de receptores implicados en la fisiología de la nocicepción. Los resultados obtenidos hasta el momento demuestran eficacia en múltiples modelos animales de dolor, tanto agudo como crónico, tanto nociceptivo como neuropático, y abren vías de investigación para el tratamiento farmacológico del dolor crónico.(AU)


The role of the endocannabinoid system in the modulation of nociception and in the interpretation of those signals in known since the middle of the last century. The work carried out since then has made possible to better understand mechanisms of action involved and to synthesize different drugs able to modulate these signals. These drugs can be agonists, aimed at directly activating cannabinoid receptors, or substances that modulate the enzymes responsible for the synthesis and degradation of endocannabinoids. Pharmacologically, other substances present in the Cannabis sativa plant are also being studied, as well as synthetic derivatives obtained from these, which can bind, in addition to the aforementioned receptors, to other types of receptors involved in the physiology of the nociception. Results obtained to date demonstrate efficacy in multiple animal models of pain, both acute and chronic, both nociceptive and neuropathic, and offer new of research lines for the pharmacological treatment of chronic pain.(AU)


Assuntos
Humanos , Animais , Canabinoides , Receptores de Canabinoides , Nociceptividade , Ratos , Camundongos , Preparações Farmacêuticas , Farmacologia , Cannabis , Dor , Dor Crônica , Manejo da Dor
3.
Pharmacol Res Perspect ; 10(5): e01014, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36210650

RESUMO

The American Society for Pharmacology and Experimental Therapeutics (ASPET) held its annual meeting at the Experimental Biology 2022 conference in Philadelphia, PA on April 2-5, 2022. The authors provide a synopsis and discussion of each of the four sessions presented at the meeting under the ASPET Division for Pharmacology Education (DPE).


Assuntos
Farmacologia , Sociedades Médicas , Humanos , Estados Unidos
4.
Neurología (Barc., Ed. impr.) ; 37(8): 647-652, octubre 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-210172

RESUMO

Antecedentes: El bloqueo interatrial avanzado (BIA-a) es considerado un factor de riesgo independiente para infarto cerebral (IC). Nuestro objetivo fue analizar si el BIA-a predice recurrencia de IC en pacientes con infarto cerebral embólico de origen no determinado (ESUS).MétodosCiento cuatro pacientes con diagnóstico confirmado de ESUS fueron seguidos durante una mediana de 15 meses (RIQ 10-48). Los datos clínicos, las características de la onda P y presencia de BIA en electrocardiograma realizado durante el evento índice, fueron registrados. La interpretación de los electrocardiogramas se realizó de forma centralizada y ciega en (XXXX2). La recurrencia de ESUS fue el desenlace primario.ResultadosLa mediana de edad de los casos fue de 47 años (rango 19-85); 50% fueron mujeres. Se encontró BIA en 36 casos (34,6%); parcial (BIA-p) en 29 (27,9%) y BIA-a en 7(6,7%). Dieciséis pacientes (15,4%) presentaron IC recurrente; de los cuales 5 tenían BIA-p y 4 BIA-a (p=0,01;OR 9,44:IC 95% 1,88-47,46). La mediana de duración de la onda P fue mayor en pacientes con recurrencia (p=0,009). En el análisis multivariado de regresión logística, los factores de riesgo independientes para recurrencia de IC fueron: el BIA-a (p<0,001; OR 10,86:IC 95% 3,07-38,46), género masculino (p=0,028; OR 4,6:IC 95% 1,18-17,96) y la edad mayor a 50 años (p=0,039; OR 3,84:IC 95% 1,06-13,88); en riesgos proporcionales de Cox fueron: edad mayor a 50 años (p=0,002; HR 7,04:IC 95% 2,06–23,8) y duración de la onda P (por ms) p=0,007 (HR 1,02:IC 95% 1,01-1,04).ConclusionesEl BIA-a y edad mayor a 50 años predicen recurrencia de ESUS. (AU)


Background: Advanced interatrial block (IAB) is an independent risk factor for ischaemic stroke. This study aimed to analyse whether advanced IAB predicts recurrence of embolic stroke of undetermined source (ESUS).Methods104 patients with a confirmed diagnosis of ESUS were followed up for a median period of 15 months (interquartile range, 10-48). We recorded data on clinical variables, P-wave characteristics, and presence of IAB on the electrocardiogram. Electrocardiogram findings were interpreted by a blinded, centralised rater at (XXXX2). ESUS recurrence was the primary outcome variable.ResultsMedian age was 47 years (range, 19-85); 50% of patients were women. IAB was detected in 36 patients (34.6%); IAB was partial in 29 cases (27.9%) and advanced in 7 (6.7%). Sixteen patients (15.4%) presented stroke recurrence; of these, 5 had partial and 4 had advanced IAB (P = .01; odds ratio [OR] = 9.44; 95% confidence interval [CI], 1.88-47.46; relative risk [RR] = 4.62; 95% CI, 2.01-10.61). Median P-wave duration was longer in patients with stroke recurrence (P = .009). The multivariate logistic regression analysis identified the following independent risk factors for stroke recurrence: advanced IAB (P < .001; OR = 10.86; 95% CI, 3.07-38.46), male sex (P = .028; OR = 4.6; 95% CI, 1.18-17.96), and age older than 50 years (P = .039; OR = 3.84; 95% CI, 1.06-13.88). In the Cox proportional hazards model, the risk variables identified were age older than 50 years (P = .002; hazard ratio, 7.04; 95% CI, 2.06-23.8) and P-wave duration (per ms) (P = .007; hazard ratio, 1.02; 95% CI, 1.01-1.04).ConclusionsAdvanced IAB and age older than 50 years predict ESUS recurrence. (AU)


Assuntos
Humanos , Infarto Cerebral , Bloqueio Interatrial , Recidiva , Acidente Vascular Cerebral , Pacientes , Farmacologia
5.
Clín. investig. arterioscler. (Ed. impr.) ; 34(5): 245-252, Sep-Oct 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-207817

RESUMO

Objetivos: El estudio MEMOGAL (NCT04319081) está dirigido a evaluar cambios en la función cognitiva en pacientes tratados con inhibidores de la PCSK9 (iPCSK9). Se realiza primer análisis: 1) discutir el papel de los farmacéuticos hospitalarios durante de la pandemia, así como evaluar el impacto de la misma en el control lipídico; 2) análisis descriptivo; 3) eficacia en reducción de colesterol-LDL (c-LDL) de alirocumab y evolocumab; y 4) reportar seguridad de los iPCSK9. Material y métodos: Se trata de un análisis prospectivo en vida real de pacientes tratados por primera vez con iPCSK9 en la práctica clínica habitual e incluidos en su primera dispensación en las consultas de farmacia de 12 hospitales de Galicia desde mayo de 2020-abril de 2021. Los valores basales de c-LDL son los previos al inicio del tratamiento con iPCSK9 y como seguimiento los valores a los 6 meses. Resultados: Se incluyeron 89 pacientes. El 86,5% con enfermedad cardiovascular y un 53,9% intolerancia a las estatinas. Un 78,8% de los pacientes fueron tratados con estatinas de alta intensidad. Las estatinas más usadas fueron rosuvastatina (34,1%) y atorvastatina (20,5%). El nivel basal de c-LDL fue 148mg/dl y de 71mg/dl al seguimiento. Los pacientes tratados con alirocumab (n=43) presentaban valores basales de 144mg/dl y de 73mg/dl al seguimiento y con evolocumab (n=46) de 151mg/dl basal y 69mg/dl al seguimiento. La reducción de c-LDL fue para evolocumab 51,21% y alirocumab 51,05%. El 43,1% presentaba a los 6 meses valores>70mg/dl, el 19,4% entre 55 y 69mg/dl y el 37,5%<55mg/dl. Los pacientes que obtuvieron una reducción>50% de c-LDL fueron el 58,3%. Los eventos adversos presentados fueron: reacción en el lugar de inyección (n=2), mialgias (n=1), síntomas pseudogripales (n=1) y deterioro neurocognitivo (n=1).(AU)


Objectives: MEMOGAL study (NCT04319081) is aimed at evaluating changes in cognitive function in patients treated with PCSK9 inhibitors (PCSK9i). This is the first analysis: (1) discussion about the role of the Hospital Pharmacists during the pandemic, and also the assessment of the impact of COVID-19 in the lipid control; (2) descriptive analysis; (3) effectiveness in LDL cholesterol (LDL-c) reduction of alirocumab and evolocumab; (4) communicate PCSK9i safety. Material and methods: It is a prospective Real-World Evidence analysis of patients that take PCSK9i for the first time in the usual clinical practice, and they are included after the first dispensation in the public pharmacy consultations of 12 Hospitals in Galicia from May 2020 to April 2021. Baseline values of LDL-c are the previous values before taking PCSK9 and the follow-up values are in 6 months time. Results: 89 patients were included. 86.5% with cardiovascular disease and 53.9% with statin intolerances. 78.8% of the patients were treated with high intensity statins. Statins most used were rosuvastatin (34.1%) and atorvastatin (20.5%). Baseline value of LDL-c was 148mg/dL and the follow-up value was 71mg/dL. The baseline value of patients treated with alirocumab (N=43) was 144mg/dL and 73mg/dL in the follow-up. With evolocumab (N=46) was 151mg/dL in basaline and 69mg/dL in follow-up. The LDLc- reduction was 51.21% with evolocumab and 51.05% with alirocumab. 43.1% of the patients showed values >70mg/dL in six month time; 19.4% between 69mg/dl and 55mg/dL and 37.5% <55mg/dL. 58.3% of the patients achieved a reduction >50% of LDL-c. The adverse events were: injection point reaction (N=2), myalgias (N=1), flu-like symptoms (N=1) and neurocognitive worsening (N=1).(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Lipídeos , Vírus da SARS , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pró-Proteína Convertase 9 , Cognição , Farmacologia , Avaliação de Sintomas , Estudos Prospectivos , Arteriosclerose
8.
Aten. prim. (Barc., Ed. impr.) ; 54(8): 102367, Ago 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-205898

RESUMO

El uso de fármacos conlleva innegables beneficios en las personas mayores, pero no está exento de efectos indeseables. La deprescripción es el proceso de revisión sistemática de la medicación con el objetivo de lograr la mejor relación riesgo-beneficio en base a la mejor evidencia disponible. Este proceso es especialmente importante en mayores polimedicados, sobretratados, frágiles, con enfermedades terminales y en el final de la vida.La deprescripción debe hacerse de forma escalonada, estableciendo un seguimiento estrecho por si aparecen problemas tras la retirada. En la toma de decisiones es muy importante contar con la opinión del paciente y de los cuidadores, valorando los objetivos del tratamiento según la situación clínica, funcional y social del enfermo.Existen múltiples herramientas para facilitar a los clínicos la tarea de seleccionar qué fármacos deprescribir (criterios Beers, STOPP-START…). Los grupos farmacológicos más susceptibles de intervención son: antihipertensivos, antidiabéticos, estatinas, benzodiacepinas, antidepresivos, anticolinérgicos, anticolinesterásicos y neurolépticos.(AU)


The use of drugs has undeniable benefits to the elderly, but it is not exempt from undesirable effects. Deprescription is the process of systematic medication review with the target of achieving the best risk-benefit ratio based on the best available evidence. This process is especially important for polymedicated elderly patients as well as those overtreated, frail, terminally ill and at the end of life.The deprescription must be done in stages, establishing a close follow-up in case problems appear after withdrawal. In the decision-making process, it is very important to consider the patient and caregivers opinion, assessing the objectives of the treatment according to the clinical, functional and social situation of the patient.There are multiple tools to make it easier for clinicians to select which drugs to deprescribe (Beers criteria, STOPP-START…). The most susceptible to intervention pharmacological groups are: antihypertensives, antidiabetics, statins, benzodiazepines, antidepressants, anticholinergics, anticholinesterase agents, and neuroleptics.(AU)


Assuntos
Desprescrições , Idoso , Farmacologia , Tratamento Farmacológico , Preparações Farmacêuticas , Polimedicação , Comorbidade , Prescrição Inadequada/efeitos adversos , Envelhecimento , Atenção Primária à Saúde
9.
Acta odontol. Colomb. (En linea) ; 12(2): 105-114, Jul-Dec. 2022. graf
Artigo em Espanhol | LILACS | ID: biblio-1392740

RESUMO

El desarrollo de la interdisciplinariedad, a través del proceso de enseñanza aprendizaje enmarcado en el trabajo conjunto de la unidad curricular de Farmacología y las asignaturas clínicas de la Disciplina Principal Integradora de la carrera de Estomatología, resulta esencial para la sistematización de los contenidos de Farmacología y el desarrollo de habilidades teórico-prácticas en la prescripción racional de medicamentos de uso estomatológico por parte de estudiantes. En el presente ensayo se exponen los fundamentos teóricos que sustentan la estrategia didáctica diseñada para lograr lo antes expuesto. El análisis de los referentes teóricos existentes permitió precisar fundamentos filosóficos, sociológicos, psicológicos, pedagógicos, didácticos y de la educación médica cubana. Finalmente, se consideró que dichos fundamentos permitieron otorgar a la estrategia didáctica diseñada la estructura y coherencia necesarias y el carácter científico, con lo cual se contribuye a la formación integral de los estudiantes y, por consiguiente, al futuro egresado de la carrera de Estomatología.


The development of interdisciplinarity through the teaching-learning process between the Pharmacology curricular unit and the clinical subjects of the Main Integrative Discipline in the Stomatology career, is essential for the systematization of the essential contents of Pharmacology and to develop theoretical skills in the students' practices for the rational prescription of drugs for stomatological use. In this essay, the theoretical foundations that support a designed didactic strategy to achieve the above are exposed. The analysis of the existing theoretical references allowed to specify the philosophical, sociological, psychological, pedagogical, didactic and of Cuban Medical Education foundations. Finally, it was considered that these foundations allowed to give the designed didactic strategy the necessary structure and coherence and scientific character, thereby contributing to the comprehensive training of students and, consequently, of future graduates of the Stomatology career.


Assuntos
Farmacologia , Ensino , Medicina Bucal
10.
CPT Pharmacometrics Syst Pharmacol ; 11(11): 1399-1429, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35894182

RESUMO

Age-related central neurodegenerative diseases, such as Alzheimer's and Parkinson's disease, are a rising public health concern and have been plagued by repeated drug development failures. The complex nature and poor mechanistic understanding of the etiology of neurodegenerative diseases has hindered the discovery and development of effective disease-modifying therapeutics. Quantitative systems pharmacology models of neurodegeneration diseases may be useful tools to enhance the understanding of pharmacological intervention strategies and to reduce drug attrition rates. Due to the similarities in pathophysiological mechanisms across neurodegenerative diseases, especially at the cellular and molecular levels, we envision the possibility of structural components that are conserved across models of neurodegenerative diseases. Conserved structural submodels can be viewed as building blocks that are pieced together alongside unique disease components to construct quantitative systems pharmacology (QSP) models of neurodegenerative diseases. Model parameterization would likely be different between the different types of neurodegenerative diseases as well as individual patients. Formulating our mechanistic understanding of neurodegenerative pathophysiology as a mathematical model could aid in the identification and prioritization of drug targets and combinatorial treatment strategies, evaluate the role of patient characteristics on disease progression and therapeutic response, and serve as a central repository of knowledge. Here, we provide a background on neurodegenerative diseases, highlight hallmarks of neurodegeneration, and summarize previous QSP models of neurodegenerative diseases.


Assuntos
Doenças Neurodegenerativas , Doença de Parkinson , Farmacologia , Humanos , Doenças Neurodegenerativas/tratamento farmacológico , Farmacologia em Rede , Doença de Parkinson/tratamento farmacológico , Progressão da Doença , Modelos Teóricos
11.
Eur J Prev Cardiol ; 29(9): 1299-1300, 2022 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-35857863

Assuntos
Farmacologia , Humanos
12.
Clin Pharmacol Ther ; 112(2): 191-193, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35849717
13.
PLoS Comput Biol ; 18(7): e1010254, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35867773

RESUMO

Quantitative systems pharmacology (QSP) models and spatial agent-based models (ABM) are powerful and efficient approaches for the analysis of biological systems and for clinical applications. Although QSP models are becoming essential in discovering predictive biomarkers and developing combination therapies through in silico virtual trials, they are inadequate to capture the spatial heterogeneity and randomness that characterize complex biological systems, and specifically the tumor microenvironment. Here, we extend our recently developed spatial QSP (spQSP) model to analyze tumor growth dynamics and its response to immunotherapy at different spatio-temporal scales. In the model, the tumor spatial dynamics is governed by the ABM, coupled to the QSP model, which includes the following compartments: central (blood system), tumor, tumor-draining lymph node, and peripheral (the rest of the organs and tissues). A dynamic recruitment of T cells and myeloid-derived suppressor cells (MDSC) from the QSP central compartment has been implemented as a function of the spatial distribution of cancer cells. The proposed QSP-ABM coupling methodology enables the spQSP model to perform as a coarse-grained model at the whole-tumor scale and as an agent-based model at the regions of interest (ROIs) scale. Thus, we exploit the spQSP model potential to characterize tumor growth, identify T cell hotspots, and perform qualitative and quantitative descriptions of cell density profiles at the invasive front of the tumor. Additionally, we analyze the effects of immunotherapy at both whole-tumor and ROI scales under different tumor growth and immune response conditions. A digital pathology computational analysis of triple-negative breast cancer specimens is used as a guide for modeling the immuno-architecture of the invasive front.


Assuntos
Neoplasias , Farmacologia , Terapia Combinada , Humanos , Imunoterapia/métodos , Modelos Biológicos , Neoplasias/terapia , Farmacologia em Rede , Farmacologia/métodos , Microambiente Tumoral
14.
Sci Data ; 9(1): 393, 2022 07 11.
Artigo em Inglês | MEDLINE | ID: mdl-35821017

RESUMO

Heterogeneous biomedical pharmacological databases are important for multiple fields in bioinformatics. Hetionet is a freely available database combining diverse entities and relationships from 29 public resources. Therefore, it is used as the basis for this project. 19 additional pharmacological medical and biological databases such as CTD, DrugBank, and ClinVar are parsed and integrated into Neo4j. Afterwards, the information is merged into the Hetionet structure. Different mapping methods are used such as external identification systems or name mapping. The resulting open-source Neo4j database PharMeBINet has 2,869,407 different nodes with 66 labels and 15,883,653 relationships with 208 edge types. It is a heterogeneous database containing interconnected information on ADRs, diseases, drugs, genes, gene variations, proteins, and more. Relationships between these entities represent drug-drug interactions or drug-causes-ADR relations, to name a few. It has much potential for developing further data analyses including machine learning applications. A web application for accessing the database is free to use for everyone and available at https://pharmebi.net . Additionally, the database is deposited on Zenodo at https://doi.org/10.5281/zenodo.6578218 .


Assuntos
Biologia Computacional , Bases de Dados Factuais , Bioquímica , Gerenciamento de Dados , Medicina , Farmacologia , Software
15.
CPT Pharmacometrics Syst Pharmacol ; 11(8): 967-990, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35712824

RESUMO

Antibody-drug conjugates (ADCs) have gained traction in the oncology space in the past few decades, with significant progress being made in recent years. Although the use of pharmacometric modeling is well-established in the drug development process, there is an increasing need for a better quantitative biological understanding of the pharmacokinetic and pharmacodynamic relationships of these complex molecules. Quantitative systems pharmacology (QSP) approaches can assist in this endeavor; recent computational QSP models incorporate ADC-specific mechanisms and use data-driven simulations to predict experimental outcomes. Various modeling approaches and platforms have been developed at the in vitro, in vivo, and clinical scales, and can be further integrated to facilitate preclinical to clinical translation. These new tools can help researchers better understand the nature and mechanisms of these targeted therapies to help achieve a more favorable therapeutic window. This review delves into the world of systems pharmacology modeling of ADCs, discussing various modeling efforts in the field thus far.


Assuntos
Imunoconjugados , Farmacologia , Humanos , Imunoconjugados/farmacocinética , Modelos Biológicos , Farmacologia em Rede
16.
Int J Mol Sci ; 23(11)2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35683007

RESUMO

This editorial summarizes the 12 scientific papers published in the Special Issue "Physiology, Biochemistry, and Pharmacology of Transporters for Organic Cations 2 [...].


Assuntos
Bioquímica , Farmacologia , Cátions , Proteínas de Membrana Transportadoras
17.
J Med Chem ; 65(9): 6926-6939, 2022 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-35500041

RESUMO

Many critical decisions faced in early discovery require a thorough understanding of the dynamic behavior of pharmacological pathways following target engagement. From fundamental decisions on the optimal target to pursue and the ultimate drug product profile (combination of modality, potency, and compound properties) expected to elicit the desired clinical outcome to tactical program decisions such as what chemical series to pursue, what chemical properties require optimization, and what compounds to synthesize and progress, all demand detailed consideration of pharmacodynamics. Model-based target pharmacology assessment (mTPA) is a computational approach centered around large-scale virtual exploration of pharmacokinetic and pharmacodynamic models built early in discovery to guide these decisions. The present work summarizes several examples (use cases) from programs at GlaxoSmithKline that demonstrate the utility of mTPA throughout the drug discovery lifecycle.


Assuntos
Desenho de Fármacos , Farmacologia , Descoberta de Drogas
19.
Adicciones (Palma de Mallorca) ; 34(2): 110-127, may 2022. tab
Artigo em Inglês, Espanhol | IBECS | ID: ibc-202768

RESUMO

Aunque el correcto diagnóstico y manejo de los pacientes con esquizofrenia y un diagnóstico comórbido de trastorno por uso de sustancias (TUS) determinaría una disminución de la morbilidad y mortalidad en estos pacientes, el desarrollo de estrategias terapéuticas eficientes es todavía una asignatura pendiente. Presentamos recomendaciones sobre el manejo farmacológico y psicológico de estos pacientes siguiendo la estructura PICO (Paciente-Intervención-Comparación-Outcome/resultados). Realizamos una evaluación de la calidad de los estudios y un resumen de la evidencia para cada pregunta siguiendo las recomendaciones del grupo de trabajo GRADE («Grading of Recommendations, Assessment, Development and Evaluation»).(AU)


Although correct diagnosis and management of patients with schizophrenia and a comorbid substance use disorder (SUD) would determine a decrease in morbidity and mortality in these patients, development of efficient therapeutic strategies is still pending. We present recommendations on the pharmacological and psychological management of these patients following the ‘PICO’ structure (Patient-Intervention-Comparison-Outcomes). Evaluation of the quality of studies and summary of the evidence for each question was performed following the recommendations of the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) working group.(AU)


Assuntos
Humanos , Adulto , Guias de Prática Clínica como Assunto , Farmacologia , Esquizofrenia , Transtornos Relacionados ao Uso de Substâncias
20.
Adicciones (Palma de Mallorca) ; 34(2): [128-141], may 2022. tab, graf
Artigo em Inglês, Espanhol | IBECS | ID: ibc-202769

RESUMO

La concurrencia de depresión y un trastorno por uso de sustancias (TUS) en pacientes que presentan patología dual ha sido reconocida desde hace mucho tiempo como una consideración importante en la práctica clínica. Esta revisión sintetiza la evidencia de intervenciones farmacológicas y psicosociales para trastornos comórbidos de depresión y uso de sustancias y además proporciona recomendaciones clínicas respecto de las mejores intervenciones para tratar a estos pacientes. Se utilizó la mejor evidencia de ensayos controlados aleatorizados para evaluar las opciones de tratamiento. La fuerza de las recomendaciones se describió mediante el enfoque GRADE.(AU)


Co-occurrence of depression and a substance use disorder (SUD) in patients who present dual diagnoses has been long recognized as an important consideration in clinical practice. This review synthesizes the evidence of pharmacological and psychosocial interventions for comorbid depressive disorders and SUDs while providing clinical recommendations about the best interventions to address these patients. The best evidence from randomized controlled trials was used to evaluate treatment options. The strength of recommendations was described using the GRADE approach.(AU)


Assuntos
Guia de Prática Clínica , Farmacologia , Transtorno Depressivo , Transtornos Relacionados ao Uso de Substâncias
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