scholarly journals A relevância da atenção farmacêutica no manejo de reações adversas no tratamento oncológico: uma revisão sistemática / The relevance of pharmaceutical care in the management of adverse reactions in oncologic treatment: a systematic review

2021 ◽  
Vol 7 (12) ◽  
pp. 112754-112772
Author(s):  
Laiara Da Cruz Soares ◽  
Marlon Macedo Sena ◽  
Sandra Da Costa Peres ◽  
Shayna Vilaça Pinheiro
Keyword(s):  
Systematic Review ◽  
Pharmaceutical Care ◽  
Adverse Reactions ◽  
Oncologic Treatment

Introdução: a atenção farmacêutica visa a melhoria da qualidade de vida do paciente, através de um modelo de prática profissional voltada à farmacoterapia inclusive em tratamentos oncológicos, dos quais muitas vezes são desconfortáveis para o paciente devido aos seus efeitos adversos. O profissional farmacêutico, dessa forma, tem o papel de tornar o tratamento menos oneroso para os pacientes.Objetivo: este trabalho tem como objetivo descrever a importância da atenção farmacêutica no tratamento oncológico, relatando a importância do acompanhamento do profissional farmacêutico para adesão do tratamento e efeitos colaterais mais comuns relatados pelos pacientes. Metodologia: para alcançar os dados esperados será utilizado um estudo de revisão bibliográfica, através do método prisma, com artigos dos anos de 2015 a 2020. A atenção farmacêutica em usuários de tratamento oncológico, também proporciona orientações sobre as prescrições e esclarece as queixas e dúvidas técnicas referentes ao uso dos antineoplásicos. Desta forma, tem-se o intuito de demostrar que a presença do profissional farmacêutico na atenção ao paciente em tratamento oncológico visa essencialmente promover condutas de prevenção, promoção, reabilitação, recuperação, de forma segura e eficaz.Resultados: foram identificados ao todo identificados 233 trabalhos, sendo selecionados 22 trabalhos que correspondiam aos critérios de elegibilidade escolhidos. Os artigos foram divididos em relação à temática abordada respondendo os objetivos dispostos nessa pesquisa. Quanto as reações adversas reportadas por farmacêuticos, é observável a importância deste profissional devido seu conhecimento clínico em reconhecê-las e classificá-las em relação ao seu risco. O farmacêutico em maioria das intervenções aplicadas, obteve um grande sucesso em relação a melhora do tratamento do paciente e consequentemente qualidade de vida deste. A interação entre o farmacêutico e a equipe multiprofissional demonstrou-se ser de grande importância devido a facilidade de criar propostas de intervenção para os problemas relacionados a medicamentos identificados. Conclusão: o farmacêutico é um elemento crucial em oncologia quando se trata de identificar e reportar reações adversas de forma a otimizar tratamentos, diminuir desconforto e melhorar da qualidade de vida do paciente quando se há a comunicação ideal entre os profissionais da equipe oncológica.

scholarly journals AB0864 DO CORTICOSTEROIDS AND HYALURONIC ACID INJECTIONS CAUSE INFECTIONS? A SYSTEMATIC REVIEW OF LITERATURE ON ADVERSE EFFECTS AND INFECTION RATES OF INTRA-ARTICULAR CORTICOSTEROID AND HYALURONIC ACID INJECTIONS IN PATIENTS WITH KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1739.2-1739
Author(s):  
C. Hatzantonis
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Adverse Effects ◽  
Adverse Events ◽  
Knee Osteoarthritis ◽  
Adverse Reactions ◽  
Infection Rates ◽  
Management Options ◽  
Cochrane Reviews ◽  
Number Of Patients

Background:Knee osteoarthritis has been a leading cause of chronic pain and disability in our increasingly aging population. Conservative management options of physiotherapy and oral analgesics offer some relief, but delivery of intra-articular injections such as corticosteroids or hyaluronic acid has increasingly become the mainstay of pain management of knee osteoarthritis. In a clinical setting, intra-articular injections offer a means to delay a total knee replacement. Despite the abundance of literature on corticosteroids and hyaluronic acid, there is no known percentage of infection rates or adverse effects that clinicians may use to inform patients prior to obtaining consent for the injection.Objectives:To determine a rate of adverse events and infection rates in patients undergoing intra-articular injections of corticosteroids or hyaluronic acid.Methods:A systematic review of current literature including studies involving patients ranging from 45 patients (Carmona L, 2018) to Cochrane reviews of 1767 patients (Campbell Kirk, 2015). From these studies, the number of patients, adverse reactions (i.e. pain, erythema) and serious adverse reactions (infections) were calculated.Results:Within our study, there was a large variation of numbers of adverse effects of hyaluronic acid and corticosteroids amongst studies, with percentages as variable as 0-9.3%. Corticosteroids demonstrated 11-26% reduction of adverse events compared to hyaluronic acid. However, confidence intervals were found to not be statistically significant.Conclusion:Intra-articular injections of corticosteroids and hyaluronic acid, although deemed clinically effective, continue to demonstrate variable rates of adverse effects and infection amongst patients with progressive knee osteoarthritis.Disclosure of Interests:None declared

scholarly journals Profile and frequency of antiparkinsonian drugs adverse reactions: a systematic review and meta-analysis

2021 ◽  
Vol 13 (3) ◽  
pp. 75-81
Author(s):  
A. A. Tappakhov ◽  
T. E. Popova ◽  
A. I. Vasilev ◽  
T. G. Govorova ◽  
Yu. I. Khabarova ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Drug Reactions ◽  
Randomized Controlled ◽  
The Relationship ◽  
Ci Calculation ◽  
Antiparkinsonian Drugs

Objective: to assess the predictors and prevalence of adverse drug reactions (ADRs) associated with antiparkinsonian drugs.Materials and methods. 18 clinical studies and randomized controlled trials were included in the analysis. We combined all registered ADRs for each drug and made direct comparisons with odds ratio (OR) and 95% confidence interval (95% CI) calculation.Results and discussion. Levodopa/benserazide (LB) had the best safety profile among levodopa drugs. Levodopa/carbidopa (LC) compared with LB was associated with more frequent development of nausea (OR=2.8; 95% CI: 1.51–5.21), aggravation of parkinsonism (OR=4.44; 95% CI: 2.12–9.28) and dizziness (OR=3.32; 95% CI: 1.5–7.33; p=0.002). Piribedil had the lowest number of ADRs among dopamine receptor agonists. Dizziness was more common with pramipexole and ropinirole than with levodopa (OR=1.82; 95% CI: 1.21–2.74 and OR=1.65; 95% CI: 1.11–2.44 respectively). Increased daytime sleepiness and peripheral edema have also been associated with pramipexole. Arterial hypertension was present in 9.6% of patients prescribed with piribedil. Amantadine compared with pramipexole was associated with a higher risk of hallucinations (OR=2.27; 95% CI: 1.24–4.12) and constipation (OR=2.40; 95% CI: 1.14–5.05). Patients prescribed with selegeline had higher odds of dizziness (OR=3.40; 95% CI: 1.76–6.55) and hallucinations (OR=4.30; 95% CI: 1.83–10.09) compared to rasagiline.Conclusion. Based on the results, we propose a diagram of the relationship between ADRs and their frequency with antiparkinsonian drugs. We hope that the study will find clinical application and allow neurologists to consider the effectiveness and the expected risks of ADRs in the treatment of PD.

scholarly journals The Use of Aerosolized Ribavirin in Respiratory Syncytial Virus Lower Respiratory Tract Infections in Adult Immunocompromised Patients: A Systematic Review

2019 ◽  
Vol 55 (4) ◽  
pp. 224-235
Author(s):  
Lisa Avery ◽  
Charles Hoffmann ◽  
Karen M. Whalen
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Respiratory Syncytial Virus ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Adverse Reactions ◽  
Immunocompromised Patients ◽  
Syncytial Virus

Introduction: Respiratory syncytial virus (RSV)–associated lower respiratory tract infection (LRTI) is a concern in immunocompromised patients. Aerosolized ribavirin (RBV AER) is used for treatment of RSV LRTI; however, adverse events and rising drug costs remain a challenge for patient management. The purpose of this systematic review is to summarize the efficacy and adverse event profile of RBV AER for the treatment of hospitalized RSV LRTI in immunocompromised adult patients. Methods: A Medline/PubMed, Embase, Google Scholar, Clinicaltrials.gov, and Cochrane Library database search was conducted from 1966 to January 2019 for the use of RBV AER. Search strategy: [(ribavirin OR ICN1229) AND (“administration, oral” OR “oral” OR “administration, inhalation” OR “inhalation)] AND (“respiratory tract infection” OR “pneumonia”). Studies were reviewed if adult patients were hospitalized, immunocompromised, had RSV LRTI, received RBV AER, and included the outcome of mortality and/or adverse reactions. Methodological quality was assessed using the Cochrane Collaboration GRADE approach. Results: A total of 1787 records were identified and 15 articles met inclusion criteria: hematopoietic stem cell transplant (HSCT)/bone marrow transplant (n = 8), other malignancy/neutropenic (n = 2), solid organ transplant (n = 5). All of the trials are observational with a low quality rating; therefore, a meta-analysis was not performed. The 30-day mortality in studies that contain >10 patients with HSCT, malignancy, and transplant range from 0 to 15.4%, 6.3%, and 0 to 27%, respectively. Improved mortality was cited in 4 studies when RBV AER started before mechanical ventilation or within 2 weeks of symptom onset. Only 3 studies had comparative mortality data with RBV AER and RBV PO. Adverse reactions were reported in 5 studies and included psychiatric manifestations (anxiety, depression, feeling of isolation; n = 14), wheezing/bronchospasm (n = 6), snowflakes/hail blowing in face (n = 6), and precipitation in ventilator tubing (n = 5). Conclusion: There is a lack of high quality, comparative trials on the use of RBV AER for the treatment of RSV LRTI in adult hospitalized immunocompromised patients. There may be a mortality benefit when RBV AER is initiated early after diagnosis or prior to mechanical ventilation, but requires further study. Patient isolation and psychological effects must be weighed against the benefit of therapy.

scholarly journals Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies

2017 ◽  
Vol 7 (4) ◽  
pp. 141-157 ◽  
Author(s):  
Rafael G. dos Santos ◽  
José Carlos Bouso ◽  
Jaime E. C. Hallak
Keyword(s):  
Systematic Review ◽  
Family History ◽  
Adverse Reactions ◽  
Population Studies ◽  
Case Reports ◽  
Case Series ◽  
Lysergic Acid ◽  
Psychotic Illness ◽  
History Of ◽  
Low Incidence

Ayahuasca is a hallucinogen brew traditionally used for ritual and therapeutic purposes in Northwestern Amazon. It is rich in the tryptamine hallucinogens dimethyltryptamine (DMT), which acts as a serotonin 5-HT2A agonist. This mechanism of action is similar to other compounds such as lysergic acid diethylamide (LSD) and psilocybin. The controlled use of LSD and psilocybin in experimental settings is associated with a low incidence of psychotic episodes, and population studies corroborate these findings. Both the controlled use of DMT in experimental settings and the use of ayahuasca in experimental and ritual settings are not usually associated with psychotic episodes, but little is known regarding ayahuasca or DMT use outside these controlled contexts. Thus, we performed a systematic review of the published case reports describing psychotic episodes associated with ayahuasca and DMT intake. We found three case series and two case reports describing psychotic episodes associated with ayahuasca intake, and three case reports describing psychotic episodes associated with DMT. Several reports describe subjects with a personal and possibly a family history of psychosis (including schizophrenia, schizophreniform disorders, psychotic mania, psychotic depression), nonpsychotic mania, or concomitant use of other drugs. However, some cases also described psychotic episodes in subjects without these previous characteristics. Overall, the incidence of such episodes appears to be rare in both the ritual and the recreational/noncontrolled settings. Performance of a psychiatric screening before administration of these drugs, and other hallucinogens, in controlled settings seems to significantly reduce the possibility of adverse reactions with psychotic symptomatology. Individuals with a personal or family history of any psychotic illness or nonpsychotic mania should avoid hallucinogen intake.

scholarly journals The Effect of Ginkgo Biloba Dropping Pills on Hemorheology and Blood Lipid: A Systematic Review of Randomized Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-12
Author(s):  
Hong Chen ◽  
Cihang Zhou ◽  
Mingwei Yu ◽  
Shuo Feng ◽  
Yunfei Ma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Ginkgo Biloba ◽  
Whole Blood ◽  
Randomized Trials ◽  
Adverse Reactions ◽  
Assessment Tool ◽  
Blood Lipid ◽  
Cochrane Library ◽  
Control Group

Objective. A systematic review of randomized trials was performed to assess the effect of Ginkgo Biloba Dropping Pills (GBDP) on clinical hemorheology and blood lipid indicators. Methods. The data of the Embase, Cochrane Library, PubMed, Clinical Trials, China National Knowledge Infrastructure, the Wanfang database, the VIP database, and the Sinomed were retrieved by computers from the establishment of the database to March 27, 2018, and screened and extracted by two researchers according to inclusion and exclusion criteria. Cochrane 5.0 recommended bias risk assessment tool was used to evaluate the methodological quality of the included literature, and Revman 5.3 software were used for meta-analysis. Results. 10 literatures were finally selected in accordance with the standard. There were a total of 1201 cases, 608 cases in ginkgo biloba dropping pill group and 593 in routine treatment group. Compared with control group, GBDP significantly improved plasma viscosity [N=383, RR= - 0.45, 95%CI=(-0.86,-0.04), P=0.03], whole blood high shear [N=232, RR= - 0.92,95%CI=(-1.69, -0.16), P =0.02], whole blood low shear [N = 232, RR = - 2.22, 95% CI = (- 3.74, -0.7), P = 0.004], red blood cell specific volume [N =132, RR = - 4.55, 95% CI = (- 6.36, 2.73), P < 0.000 01], fibrinogen [N=243, RR=-0.60,95%CI=(-0.82,-0.39), P<0.00001], triglyceride [N=912, RR=-0.60,95%CI=(-1.12, -0.07), P =0.03], cholesterol [N=912, RR=-0.97,95%CI=(-1.41, -0.52), P <0.0001], low-density cholesterol [N=1100, RR=-0.72,95%CI=(-1.19, -0.25), P =0.003], and sensitivity analysis before and after of high-density cholesterol [N=1020, RR=0.08,95%CI=(-0.17,0.34), P =0.52] and [N=683, RR=0.27,95%CI=(0.13,0.42), P =0.0003]. And seven adverse reactions were reported. Conclusion. GBDP can improve hemorheology indexes, which is to reduce the blood viscosity, to improve blood lipid status, and to prevent and treat cardiocerebral and renal vascular diseases to a certain extent, with slight clinical adverse reactions. But our results were based on small amount of clinical studies with poor quality and insufficient evidence, which may lead to low credibility of conclusions. Therefore, more large-sample, multiple-center, randomized controlled clinical trials and related mechanisms researches are needed to obtain better clinical trial evidence in order to verify the further effectiveness and safety of GBDP on hemorheology.

scholarly journals Studies published in indexed journals on lawsuits for medicines in Brazil: a systematic review

2015 ◽  
Vol 31 (3) ◽  
pp. 451-462 ◽  
Author(s):  
Vanessa Santana Gomes ◽  
Tânia Alves Amador
Keyword(s):  
Systematic Review ◽  
Pharmaceutical Care ◽  
Quantitative Data ◽  
Rio De Janeiro ◽  
Access To Medicines ◽  
Class Action ◽  
Scientific Journals ◽  
Santa Catarina ◽  
Legal Representation ◽  
Legal Proceedings

The aim of this systematic review was to identify and characterize articles in indexed scientific journals with quantitative data surveys on administrative or legal proceedings for access to medicines. The SciELO, LILACS, MEDLINE via PubMed, Embase, and Scopus databases were used. We identified 45 articles, of which 17 were selected. The larger studies, each covering between 2,000 and 2,927 lawsuits, were done in the states of São Paulo, Rio de Janeiro, and Santa Catarina, Brazil. Eleven studies specified the type of legal representation, of which six examined cases with public attorneys and five with private attorneys. Only two studies reported whether the lawsuit was individual or class action, and in both the claims were individual. Since the majority of the medicines requested in the lawsuits were medium to high-cost, the review indicates that lawsuits contributed to the incorporation of these drugs into current pharmaceutical care in Brazil.

scholarly journals EXTEMPORANEOUS COMPOUNDING PRACTICE BY PHARMACISTS: A SYSTEMATIC REVIEW

2017 ◽  
Vol 9 (2) ◽  
pp. 42
Author(s):  
Susi Ari Kristina ◽  
Chairun Wiedyaningsih ◽  
Niken Nur Widyakusuma ◽  
Hardika Aditama
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Pharmaceutical Care ◽  
Systematic Literature Review ◽  
Dosage Forms ◽  
Hospital Pharmacies ◽  
The Stability

<p><strong>Objective: </strong>To identify the frequency and scope of extemporaneous compounding practice reported in community and hospital pharmacies.</p><p><strong>Method</strong><strong>s</strong><strong>:</strong><strong> </strong>A systematic literature review was undertaken to identify the prevalence of extemporaneous compounding practice in community and hospital pharmacies, including the reasons of providing compounding services.</p><p><strong>Results: </strong>Nine studies were identified and evaluated in which extemporaneous products prepared by pharmacist could be identified. Most of the studies record that prevalence of extemporaneous compounding practice is very low (less than 5%). Prescribing of compounded medicines occurs more frequently in paediatrics and for special patients’ need. The major types of extemporaneous compounding products were dermatological dosage forms and followed by oral solutions and oral suspensions. Reasons for providing compounding practice were to make a customised products that not available commercially and to provide full pharmaceutical care to patients. Issues about the stability of compounded products, accuracy in dose strength and lack of standardised protocol in extemporaneous compounding need to be addressed.</p><p><strong>Conclusion: </strong>Extemporaneous compounding practice are an essential part of pharmacist’ competency. These unique skills need to be preserved and regulations that cover rationalised compounding practice is necessary.</p>

scholarly journals Systematic Review and Meta-Analysis of the Tolerability and Hepatotoxicity of Antifungals in Empirical and Definitive Therapy for Invasive Fungal Infection

2010 ◽  
Vol 54 (6) ◽  
pp. 2409-2419 ◽  
Author(s):  
Jiun-Ling Wang ◽  
Chia-Hsuin Chang ◽  
Yinong Young-Xu ◽  
K. Arnold Chan
Keyword(s):  
Systematic Review ◽  
Liver Injury ◽  
Fungal Infection ◽  
Liver Enzyme ◽  
Antifungal Therapy ◽  
Invasive Fungal Infection ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Treatment Discontinuation

ABSTRACT To evaluate the tolerability and liver safety profiles of the systemic antifungal agents commonly used for the treatment of invasive fungal infection, we conducted a systematic review and meta-analysis of randomized controlled trials published before 31 August 2009. Two reviewers independently applied selection criteria, performed quality assessment, and extracted data. We used the beta-binomial model to account for variation across studies and the maximum likelihood method to estimate the pooled risks. We identified 39 studies with more than 8,000 enrolled patients for planned comparisons. The incidence rates of treatment discontinuation due to adverse reactions and liver injury associated with antifungal therapy ranged widely. The pooled risks of treatment discontinuation due to adverse reactions were above 10% for amphotericin B formulations and itraconazole, whereas they were 2.5% to 3.8% for fluconazole, caspofungin, and micafungin. We found that 1.5% of the patients stopped itraconazole treatment due to hepatotoxicity. Furthermore, 19.7% of voriconazole users and 17.4% of itraconazole users had elevated serum liver enzyme levels, although they did not require treatment discontinuation, whereas 2.0% or 9.3% of fluconazole and echinocandin users had elevated serum liver enzyme levels but did not require treatment discontinuation. The results were similar when we stratified the data by empirical or definitive antifungal therapy. Possible explanations for antifungal agent-related hepatotoxicity were confounded by antifungal prescription to patients with a high risk of liver injury, the increased chance of detection of hepatotoxicity due to prolonged treatment, or the pharmacological entity.

scholarly journals Teaching in pharmaceutical care: A systematic reviewTeaching in pharmaceutical care: A systematic review

2015 ◽  
Vol 9 (10) ◽  
pp. 333-346 ◽  
Author(s):  
Moreira de Souza Werlissandra ◽  
Rezende Mesquita Alessandra ◽  
Roberto Antoniolli Angelo ◽  
Pereira de Lyra Junior Divaldo ◽  
Barros da Silva Wellington
Keyword(s):  
Systematic Review ◽  
Pharmaceutical Care
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