[Pharmaceutical follow up of antirretroviral treatment in outpatients]. / Seguimiento fármaco-terapéutico en pacientes ambulatorios con tratamiento anti-retroviral.

Adherence to antiretroviral therapy is key contributor to decreasing morbidity and mortality from HIV/ AIDS infection. However, it is affected by treatment-related factors including the multiple adverse reactions and interactions arising from chronic polypharmacy. In order to determine drug-related problems, 66 outpatients from Hospital Carlos Van Buren on antiretroviral therapy were monitored. 100 % had medication-related problems and 46.1% of those problems were related to the safety of the therapy. Hypertriglyceridemia associated to the combined use of both nucleoside reverse transcriptase inhibitor and a non-nucleoside reverse transcriptase inhibitor was the most frequent adverse reaction. Results show that pharmacological monitoring of patients on antiretroviral treatment is necessary for the early identification of drug-related problems and for the proposal of alternatives that promote therapeutic safety and efficacy.

Lack of Association between the IL6R Gene Asp358Ala Variant (rs2228145), IL-6 Plasma Levels, and Treatment Resistance in Chilean Schizophrenic Patients Treated with Clozapine.

Alterations in neuroinflammatory processes have been suggested to contribute to the development of Schizophrenia (SZ); one component of the inflammatory system that has been linked to this disorder is interleukin-6 (IL-6). The minor allele of rs2228145, a functional polymorphism in the IL-6 receptor gene, has been associated to elevated IL-6 plasma levels and increased inflammatory activity, making it an interesting candidate to study as a possible factor underlying clinical heterogeneity in SZ. We studied a sample of 100 patients undergoing treatment with clozapine. Their symptoms were quantified by Brief Psychotic Rating Scale; those with the lowest scores ("remitted") were compared with the highest ("clozapine treatment resistant"). We determined allelic frequencies for rs2228145 and IL-6 plasma levels. Our results do not support a role of IL-6 in response to treatment with clozapine. Further studies accounting for potential confounding factors are necessary.

Automedicación en clubes de adulto mayor de la ciudad de Valparaíso / Self-medication by elderly persons of seniors' clubs in Valparaiso (Chile)

La automedicación es el uso de medicamentos por iniciativa propia por parte de las personas, sin la asistencia de profesionales de la salud. Esta práctica cada día es más común, y puede convertirse en un problema de salud pública, que afecta la seguridad y eficacia de tratamientos prescritos especialmente en los adultos mayores. Objetivo: Determinar prevalencia y causas de automedicación en adultos mayores de la ciudad de Valparaíso. Método: Mediante un estudio prospectivo se encuestó con preguntas abiertas y cerradas a 357 adultos mayores de la ciudad de Valparaíso. Resultados: Se determinó una prevalencia de un 83,0 por ciento de automedicación en la población estudiada, cuya principal causa es “no me gusta ir al médico” (24 por ciento), además del uso de productos naturales en este grupo de pacientes. La principal causa de automedicación es el alivio del dolor; y a pesar de que el 88,2 por ciento de los pacientes declara conocer cómo usar el medicamento, un 49,3 por ciento manifiesta su necesidad de contar con ayuda profesional para elegir con qué automedicarse. Conclusiones: Comprobar que casi la mitad de los encuestados refiere requerir ayuda para automedicarse, brinda al equipo de la farmacia comunitaria una instancia para apoyar en forma activa a sus pacientes geriátricos, orientándolos con información. Además, su gran prevalencia dejó en evidencia la necesidad de velar por una promoción y comercialización responsable en medicamentos y productos naturales, orientada a satisfacer las necesidades de salud en forma individual, maximizando los beneficios terapéuticos y minimizando los riesgos de salud.

Introduction: Self-medication in elderly patients can be an important public health problem, especially since it can affect concomitantly taken prescribed medications. Aims: To determine the prevalence and factors associated with medication use without a prescription elderly persons of Valparaiso, Chile. Materials and Methods: Prospective, descriptive study carried out in a group of 357 elderly persons belonging to seniors' clubs in Valparaiso. Results: We found self-medication at a prevalence of 83.0 percent. The most common reason stated was "I do not like going to the doctor" (24 percent). Pain was the main condition for which individuals self-medicated. Importantly, self-medication using alternative medicine was detected in this group of patients. Despite 88.2 percent of patients claiming to know the action of the drug, 49.3 percent say they require help to choose the medicines with which to self-medicate. Conclusions: These results suggest an opportunity for the health team to provide education with respect to pathology and medicines. In addition, it highlights the responsibility required to ensure responsible drug marketing so that it is orients consumers to self-medicate responsibly.

Seguimiento fármaco-terapéutico en pacientes ambulatorios con tratamiento anti-retroviral / Pharmaceutical follow up of antirretroviral treatment in outpatients

Adherence to antiretroviral therapy is key contributor to decreasesing morbidity and mortality from HIV/ AIDS infection. However, it is affected by treatment-related factors including the multiple adverse reactions and interactions arising from chronic polypharmacy. In order to determine drug-related problems, 66 outpatients from Hospital Carlos Van Buren on antiretroviral therapy were monitored. 100 % had medication-related problems and 46.1% of those problems were related to the safety of the therapy. Hypertriglyceridemia associated to the combined use of both nucleoside reverse transcriptase inhibitor and a non-nucleoside reverse transcriptase inhibitor was the most frequent adverse reaction. Results show that pharmacological monitoring of patients on antiretroviral treatment is necessary for the early identification of drug-related problems and for the proposal of alternatives that promote therapeutic safety and efficacy.

La adherencia al tratamiento anti-retroviral es un pilar fundamental en la reducción de la morbi-mortalidad de la infección por VIH/SIDA. Sin embargo, se ve dificultada por ser un tratamiento que involucra numerosos medicamentos administrados de forma crónica, con posibilidad de presentar reacciones adversas y/o interacciones. Se realizó un seguimiento farmacoterapéutico a 66 pacientes ambulatorios con tratamiento anti-retroviral del Hospital Carlos Van Buren. El 100% de los pacientes presentó problemas relacionados con medicamentos, afectando en 46,1% a la seguridad de la terapia. La reacción adversa más frecuente fue hipertrigliceridemia, principalmente asociada al uso de dos inhibidores nucleosídico de la transcriptasa reversa con un inhibidor no nucleosídico de la transcriptasa reversa. Los resultados permiten concluir que la monitorización farmacológica de pacientes con tratamiento anti-retroviral identifica en forma precoz los problemas relacionados con medicamentos, favoreciendo la seguridad y eficacia de la terapia propuesta.