Features and Ways to Ensure the Availability of Vital Pharmaceuticals for Pharmacy Organizations in the Context of the Covid-19 Pandemic

The article describes the features and ways of ensuring the availability of vital pharmaceuticals to pharmacy organizations in the context of the COVID-19 pandemic. It was noted that during the pandemic, pharmacists from all over the world made maximum efforts to ensure an uninterrupted and safe supply of medicines to patients, despite the unprecedented situation. The social distancing policy has been widely implemented to maintain the personal safety of patients and reduce the number of personal visits. Also, vital strategies and practices have been implemented in some foreign countries, including the supply of conventional medicines at state-subsidized prices, the maximum monthly supply of some prescription drugs has been provided and limits on the purchase of over-the-counter medicines have been set, home delivery of medicines to people at risk and people in isolation has been organized. The experience of pharmaceutical organizations during the pandemic has shown that it is necessary to monitor the predicted shortage of medicines, especially in regional pharmacies, as well as to control the workload in pharmacies and timely control of online orders of medicines to eliminate frustration and anxiety in patients who need life-saving medicines.

Effect of Virucidals On the Presence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Saliva

We read with interest the article by Belcaro G et.al. about the effect of virucidals on the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in saliva [1]. We would like to raise major concerns on several aspects of this pilot study, including clinical methodological limitations, the use of real-time reverse transcription polymerase chain reaction (rRT-PCR) analysis of saliva, and the interpretations and conclusions drawn from the data. In our opinion, the results do not support any antiviral effects of the study products (PhytoRelief, Benzydamine, Calyptol and Baicalin), which are available as over the counter medicines or products. We would like to caution that the evidence provided is insufficient to recommend the use of these oral natural plant extracts, or other drug products, for reducing SARS-CoV-2 virus load or reducing the risks of transmission of the disease.

Analysis of Monacolins and Berberine in Food Supplements for Lipid Control: An Overview of Products Sold on the Italian Market

The use of dietary supplements for the prevention and management of diseases associated with excess of lipids is spreading in Western countries. Supplements containing red yeast rice (RYR) and extracts from Berberis species, characterized, respectively, by the active compounds monacolin K (MK) and berberine (BBR), are sold in pharmacies as over the counter medicines (OTC) and in regular markets without the need of medical prescription and medical surveillance. However, MK is chemically identical to lovastatin, a drug commonly used to treat hypercholesterolemia, and is characterized by the same mechanism of action, pharmacokinetic profile and toxicity. On the other hand, although BBR-containing supplements are considered to be well-tolerated and safe, they frequently show poor standardization of active ingredients, and this could lead to lack of effects. In this work, with the aim to give an overview on the potency of RYR- and BBR-containing supplements available on the Italian market, we analyzed a pool of supplements bought from both local pharmacies and markets. Results confirm the data already published by other authors, showing scarce standardization of bioactives and discrepancy between the doses of bioactives reported by the manufacturers and the amounts resulting from analysis of the same products. Overall, our data represent a further proof that a strict legislation regulating the production and marketing of dietary supplements and a close monitoring of these products by food and drug regulatory organs is mandatory.

Drug allergy in children: what should you know?

Drug reactions cause 6.5 % of all hospital admissions. They develop with a rate of 15 % in patients who are trea­ted in hospitals. The risk of drug reactions should be considered in the differential diagnosis when any medical problem occurs in a person who uses medication. In children, the major difficulty in the diagnosis of drug allergy is differentiation of maculopapular drug eruptions from viral exanthem which is observed very commonly in this age group. In treatment of allergic reactions, the first step is to immediately discontinue the drug. Avoidance of using over-the-counter medicines and using drugs orally if possible are important in terms of prevention of drug allergies. Cross-reactivity between drugs with similar structure should be considered when choosing an alternative medication. Antihistamines, in particular dimetindene maleate — Edermik, can be used for the prevention and treatment of drug reactions at the outpatient stage.

The Effect of Changes in Cost Sharing on the Consumption of Prescription and over-the-Counter Medicines in Catalonia

Many universal health care systems have increased the share of the price of medicines paid by the patient to reduce the cost pressure faced after the Great Recession. This paper assesses the impact of cost-sharing changes on the propensity to consume prescription and over-the-counter medicines in Catalonia, a Spanish autonomous community, affected by three new cost-sharing policies implemented in 2012. We applied a quasi-experimental difference-in-difference method using data from 2010 to 2014. These reforms were heterogeneous across different groups of individuals, so we define three intervention groups: (i) middle-income working population—co-insurance rate changed from 40% to 50%; (ii) low/middle-income pensioners—from free full coverage to 10% co-insurance rate; (iii) unemployed individuals without benefits—from 40% co-insurance rate to free full coverage. Our control group was the low-income working population whose co-insurance rate remained unchanged. We estimated the effects on the overall population as well as on the group with long-term care needs. We evaluated the effect of these changes on the propensity to consume prescription or over-the-counter medicines, and explored the heterogeneity effects across seven therapeutic groups of prescription medicines. Our findings showed that, on average, these changes did not significantly change the propensity to consume prescription or over-the-counter medicines. Nonetheless, we observed that the propensity to consume prescription medicines for mental disorders significantly increased among unemployed without benefits, while the consumption of prescribed mental disorders medicines for low/middle-income pensioners with long-term care needs decreased after becoming no longer free. We conclude that the propensity to consume medicines was not affected by the new cost-sharing policies, except for mental disorders. However, our results do not preclude potential changes in the quantity of medicines individuals consume.

PHARMING EN ADOLESCENTES. CASO CLÍNICO

Objetivos. Presentación del concepto de pharming. Revisión de la bibliografía actual, epidemiología e implicaciones en el tratamiento. Discusión sobre el impacto en nuestra población de referencia y las posibles implicaciones en el diagnóstico y tratamiento. Material y métodos. Exposición de un caso de Pharming en adolescente. Revisión bibliográfica mediante búsqueda en PUBMED y EMBASE con las palabras clave: adolescents, drug abuse, over-the-counter medicines, prescription medication. Búsqueda en bases de datos epidemiológicas de nuestra región y de nuestro país. Resultados y conclusiones. El concepto de Pharming se refiere al uso de medicación con o sin receta, con una posología diferente a la recomendada y con un objetivo distinto al terapéutico, generalmente recreativo. El consumo suele realizarse acompañando a otros tóxicos. Se presenta el caso de un adolescente de 17 años con uso de levomepromazina y alcohol en contexto recreativo. Fue atendido en Urgencias hospitalarias en dos ocasiones por este motivo. Las primeras descripciones hablan del uso de fármacos sin receta, antitusígenos generalmente, pero en los últimos años se ha registrado el abuso de casi cualquier tipo de medicación, desde benzodiacepinas a estimulantes y medicación para el trastorno por déficit de atención con hiperactividad. Este efecto parece estar relacionado con un aumento de este tipo de prescripciones en la población y una mayor facilidad para el acceso a esta medicación. La importancia de este fenómeno radica en que puede suponer la puerta de entrada a otro tipo de consumos y también en la dificultad para su detección y tratamiento, por la facilidad de acceso a la sustancia. El conocimiento de este fenómeno por parte de los médicos que tratan a adolescentes, tanto en consultas como en Urgencias, y de los padres es necesario para prevenir la morbilidad y mortalidad asociadas al consumo de sustancias.