Resumen Objetivo: Establecer la prevalencia de las reacciones adversas a medicamentos que ocurren en el servicio de Diseño: Descriptivo de tipo corte transversal Lugar: Hospital Universitario Hernando Moncaleano Perdomo (HMP), Neiva-Colombia. Población: pacientes hospitalizados en el servicio Método: Recolección de datos con observación directa no participativa, siguiendo un modelo de farmacovigi-lancia activa. Se realizó la revisión documental de las historias clínicas. Resultados: De 303 pacientes hospitalizados en el servicio se obtuvieron 153 pacientes que presentaron RAM que correspondieron al 50% de la muestra. En los que la media de edad fue 63 +/-4,6. Las reacciones adversas a medicamentos (RAM) se agruparon por sistemas: el 27,4% afectó la piel, el13,8% el sistema gas-trointestinal, seguidos de sistema hematológico y cardíaco. Con respecto a los medicamentos relacionados con las RAM se dividieron en grupos: antimicrobianos en un 37,9%, seguido de antihipertensivos con un 17,3%, anticoagulantes en un 9,8%. Los tres medicamentos más frecuentes en su orden: vancomicina en un 6,6%, el enalaprilen un 6,6% y tramadol con un 5,3%. Al clasificar las RAM se encontró que el 53,6% correspondieron al tipo A y 46,4%al tipo B. Estas, representaron 71 casos del total, las más frecuentes fueron exantema en 39,4%, prurito 14,3%, la tos 11,2% y se presentó un caso de DRESS (Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome). Se documentaron 14 casos de RAM graves representadas en sangrado 35,8%, IRA en un 35,8 % entre otras. Los medicamentos relacionados con estas RAM fueron: warfarina 14,4%, igual que enoxa-parina y la vancomicina.

Our data suggest that one-third of the patients attending the emergency room of our hospital had a drug-related problem, highlighting the importance of considering drugs as a possible cause of health problems and the need for their more rational use.

Frequency of unlicensed and off-label drug prescriptions showed in the study is according to the literature and may be considered high. High-alert drugs, although low in frequency, can present risks due to the harmful effects they can produce in patients. Thus, the highlighted drugs in this study constitute a constant concern in hospitals.

The aim of this study was to assess drug use and costs before and after bariatric surgery (BS). A systematic review of the literature was carried out using the MeSH terms obesity, bariatric surgery, and drug costs for searches of 10 electronic databases up to July 2014. Data were extracted from the 11 studies (37,720 patients) that fulfilled the inclusion criteria. Where applicable, data were pooled by meta-analysis. The average number of drugs per patient decreased from 3.9 ± 1.86 before surgery to 1.75 ± 1.85 after surgery. Mean reduction in total cost of drugs was 49.8 % over a follow-up duration of 6-72 months. BS is effective for the improvement or resolution of comorbidities and significantly reduces drug use and costs.

Objective:To determine the frequency of prescriptions of off-label drugs and drugs not approved for pediatric use in primary health care in medium-sized municipality of Rio Grande do Sul, Brazil.Methods:Cross-sectional study with retrospective data collection, which analyzed prescriptions issued to 326 patients from August to December/2012 in two basic health units in the city of Viamão, state of Rio Grande do Sul. It included all prescriptions of patients whose medical records or service records were available and complete in relation to the date of presence, weight and date of birth. Off-label prescriptions were those which, in relation to the drug leaflet, showed dose different the recommended range, frequency of prescription and/or different form of administration and younger age than the indicated range. Descriptive statistics with absolute frequencies, means and standard deviations were used.Results:During the study period, a total of 731 drug prescriptions were issued and the frequency of off-label medications prescribed was 31.7%, especially antihistamines and antiasthmatics (32.3% and 31.5%, respectively). The main type of off-label prescription was dose (38.8%), followed by age range (31.5%) and frequency of administration (29.3%). Regarding the dose off-label prescription, overdose was more frequent (93.3%) than the underdose (6.7%). Prescriptions of unapproved drugs were not identified.Conclusions:The study showed that off label prescription is common in both assessed units. The observed percentage of off label prescription was higher than that reported by European studies carried out in primary care. On the other hand, the prescription of drugs not approved for children was not observed.

Problems in the processes of pain identification, measurement, and treatment have been found. Results suggest that there is a need for both an investment in continuing education of professionals and the development of protocols to optimize the analgesic therapy, thus preventing increased child suffering.

Resumo Este estudo objetivou caracterizar o nível de conhecimento dos pacientes em relação aos medicamentos prescritos em serviços odontológicos públicos de Porto Alegre, verificar existência de prescrições verbais e fontes individuais de informação sobre os mesmos. Com delineamento transversal, um questionário era aplicado após consulta em dois serviços de urgência odontológica. Dos 286 entrevistados, 164 (57%) eram do sexo feminino, com média de idade de 35 anos e de renda familiar de 3,5 salários mínimos. Observou-se um índice de aproximadamente 10% de prescrições verbais. Em relação às prescrições escritas (n = 258), 86% dos pacientes sabiam o nome do medicamento, 85% a frequência de doses, 66% a indicação terapêutica e 65% a dose. Apenas 20% e 9% sabiam informar sobre precauções e efeitos adversos, respectivamente. Através do escore utilizado, 55% da amostra apresentou um nível de conhecimento regular, 34% insuficiente e 11% bom. A principal fonte de informação sobre medicamentos foi a bula (40,7%). A maioria dos pacientes apresentou um nível de conhecimento suficiente a respeito das informações principais do tratamento, porém teriam dificuldade de conduzi-lo de forma adequada frente a alguma intercorrência.

No abstract