Frequência de prescrições de medicamentos off label e não licenciados para pediatria na atenção primária à saúde em município do sul do Brasil

Gonçalves, Marcele Giacomin; Heineck, Isabela

doi:10.1016/j.rpped.2015.06.008

Cited by 27 publications

(20 citation statements)

References 26 publications

(32 reference statements)

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“…The increasing number of medications being approved to adults with potential use on Pediatrics,1 the need to treat clinically challenging diseases, and the ethical issues surrounding pediatrics research put children and adolescents at more risks associated to medication adverse events 23 To illustrate this scenario, a nested-cohort study conducted by Bellis and colleagues2 demonstrated that unapproved prescriptions were associated with an augmented hazard of having an adverse event (hazard ratio 1.30, 95%CI 1.20-1.30, p <0.001).…”

Section: Introductionmentioning

confidence: 99%

Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units

Okumura

Silva

Comarella

2016

Revista Paulista de Pediatria (English Edition)

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Objective:Clinical Pharmacy Services (CPS) are considered standard of care and is endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU).Methods:This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention.Results:Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non-optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs.Conclusions:Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications.

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Section: Introductionmentioning

confidence: 99%

Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units

Okumura

Silva

Comarella

2016

Revista Paulista de Pediatria (English Edition)

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“…No que diz respeito ao perfil das internações pediátricas, apesar de alguns estudos demonstrarem em geral uma maior prevalência de crianças do sexo feminino internadas em hospitais [10,13], o presente estudo evidenciou uma prevalência discreta do sexo masculino sobre o feminino, semelhante ao encontrado em um hospital europeu [28] e em outros hospitais do sul do brasil [29][30][31]. Em relação à média de dias de internação, os valores ficaram na mesma faixa descrita em um artigo de revisão sistemática que incluiu crianças hospitalizadas de todas as partes do mundo [20].…”

Section: Discussionunclassified

“…A dipirona monoidratada é um fármaco com efeitos analgésicos e antitérmicos, sendo por isso amplamente utilizada, já que o quadro febril é sintoma de diversas doenças, infecciosas ou não. Além disso, muitas vezes é utilizada para o alívio da dor, e figura entre os medicamentos mais prescritos na pediatria em diversos trabalhos nacionais, juntamente com o paracetamol e o ibuprofeno [1,29,30]. Esse fármaco é contraindicado em crianças com menos de três meses de idade e com menos de 5 kg [38], e apesar de possuir boa documentação para o uso pediátrico, sua segurança para essa população tem sido questionada em várias partes do mundo por possível associação com anemia aplásica e agranulocitose [31,39,40].…”

Section: Artigo Originalunclassified

Utilização de medicamentos em crianças internadas em um hospital geral

Martins

Uberti

Warpechowski

et al. 2017

Sci Med

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*** Medication use in children admitted to a general hospital ***AIMS: To describe the profile of medications used in children admitted to a general hospital.METHODS: A cross-sectional study was conducted with children aged 0 to 12 years, admitted to the Hospital Nossa Senhora da Conceição, in Tubarão, state of Santa Catarina, Brazil, between July 2013 and July 2014. The following data were collected: f age, sex, length of hospital stay, International Classification of Diseases codes for hospitalization, and medications used. The Anatomical Therapeutic Chemical classification system was used for the medications.RESULTS: The medical records of 1,603 children aged up to 12 years were analyzed. The hospital stay ranged from one to 115 days. The number of medications per admission ranged from one to 77, with an average of 9.84 medications per patient. A total of 211 different types of medications were used, most of which were classified as analgesic with central nervous system activity. Tonsillar hypertrophy and adenoid hypertrophy were the most prevalent disorders diagnosed among the 303 different International Classification of Diseases codes found in this study. Seven types of unlicensed medications and 23 drugs with some kind of restriction for pediatric use were prescribed.CONCLUSIONS: The average number of medications was high in hospitalized children, and the prescription of unlicensed drugs and those with some kind of restriction for pediatric use was an important factor. These data suggest poor attention to the risks and benefits of medication use in children – a relevant issue that requires continuous and intensive surveillance by different health professionals .

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“…The highest prevalence was antihistamines and antiasthmatics (32.3% and 31.5%, respectively), and the main type of off‐label prescription was dose (38.8%), followed by age range (31.5%), and the frequency of administration (29.3%). Regarding the dosage, overdose was more frequent (93.3%) than underdose (6.7%) …”

Section: International Perspective: Regulations and Frequency Of Off‐mentioning

confidence: 97%

Controversies in off‐label prescriptions in dermatology: the perspective of the patient, the physician, and the pharmaceutical companies

França

Litewka

2018

Int J Dermatology

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The term "off-label drug use" involves the prescription of medications for unapproved indications or in unapproved dosage, dosage form, or route of administration. Off-label medications are common in the management of dermatologic diseases. In the recent years, new indications for botulinum toxin, biologics, spironolactone, topical calcineurin, and topical vitamin D analogues emerged, and these drugs are being used off-label to treat a variety of conditions. The high cost and long time required for the approval discourage pharmaceutical companies from developing studies and pursuing the approval by regulatory agencies. Patients and physicians may have a different perspective regarding the off-label use of medications. The ethical discussion is based on the different opinions concerning the need for informed consent by the patient and how this could be applicable in the clinical practice.

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Frequência de prescrições de medicamentos off label e não licenciados para pediatria na atenção primária à saúde em município do sul do Brasil

Cited by 27 publications

References 26 publications

Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units

Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units

Utilização de medicamentos em crianças internadas em um hospital geral

Controversies in off‐label prescriptions in dermatology: the perspective of the patient, the physician, and the pharmaceutical companies

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