Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r) program, and frequencies were calculated. Results: 786 errors were observed, 63.9% (502) in Phase 2, and 36.1% (284) in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. Conclusion: guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes.
impairment, as well as the increase in hospital readmissions, in chronic complex patients. Purpose The objective of this study was to evaluate the anticholinergic risk in a sample of chronic complex patients and identify the responsible drugs. Material and methods Prospective, cross-sectional, descriptive and observational study that included chronic complex patients older than 65 years, polymedicated (>5 prescribed drugs) and admitted to an acute hospital in September 2018. The variables registered were: demographic data, prescribed drugs, anticholinergic risk index (AR), Charlson index and degree of preventability of anticholinergic drugs. The data was collected from the electronic medical record during the therapeutic conciliation at admission made by the pharmacist. The Anticholinergic Burden Calculator was used to calculate the AR. Results Twenty-four patients were included, with a mean age of 83 years (SD: 7). Of these, 16 (67%) were females. The average of the Charlson index was 6.75 (SD: 2.45). These patients were prescribed an average of 13 (SD: 5) drugs and, of these, an average of four (31%) anticholinergic drugs. According to the degree of AR, 11 patients (46%) had a high AR (AR >1), 11 (46%) medium and two (8%) low. The mean AR was 1.07 (SD: 0.81). One-hundred and eight prescriptions of anticholinergic drugs were registered, of which 12 (11%) were benzodiazepines, 12 (12%) antidepressants, five (5%) opioids, 11 (10%) diuretics, three (3%) urinary antispasmodics and 14 (13%) corticoids, among others. Sixty-seven per cent of patients had five or more anticholinergic drugs prescriptions. Based on the START/STOPP criteria, it was estimated that 27 prescriptions (25%) were avoidable in this group of patients. Conclusion The prevalence of AR was important in the sample of patients. The AR could be avoided or reduced in at least a quarter of the prescriptions. One-third of the prescriptions corresponded to drugs of group N in the ATC classification. It would be interesting to establish selection criteria for patients who can benefit from a pharmaceutical intervention to try to minimise the anticholinergic risk.
Filmes de quitosana com atividade antimicrobiana foram preparados pela incorporação de própolis verde (1, 2 e 4% p/v) na solução filmogênica de quitosana. Os filmes de quitosana-própolis verde foram caracterizados por microscopia óptica, análise térmica (TGA/DSC) e difração de raios X (DRX). Além disso, o grau de intumescimento, liberação de polifenóis, propriedades mecânicas e antimicrobianas também foram avaliadas. A resistência mecânica e a capacidade de absorção e água foram consideravelmente afetadas pela adição de plastificante (glicerol). Os filmes com própolis verde exibiram atividade contra Enterococcus faecalis e Staphylococcus aureus. Observou-se que a atividade antimicrobiana foi potencializada com o aumento da concentração de própolis verde. Os filmes de quitosana com própolis verde podem ter potencial aplicação como curativos.
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