1,721,004 research outputs found
Il disattento Andrea:caso clinico
No full textSi tratta di un caso clinico di cardiotossicità da atomoxetina in un bambino di 11 anni affetto da un disturbo da deficit attentivo con iperattivita
Never say never: non c’è limite alla confusione
No full textSi tratta di un articolo che commenta la scelta di cambiare la composizione dei farmaci lasciando il vecchio nome commercial
Analisi critica dei dati prescrittivi italiani.
Full text linkIl capitolo descrive e commenta i dati prescrittivi italiani relativi ai farmaci oppioidi confrontandoli con i dati di altri Paesi europei e non. I dati, ricavati prevalentemente dall'OSMED mostrano come ancora oggi la prescrizione degli oppioidi sia più bassa in Italia rispetto ai principali paesi del mondo. In altri paesi esiste un problema di iper-prescrizione o per meglio dire di prescrizione non appropriata che sta portando a fenomeni di abuso, mentre nel nostro paese permane una situazione, ormai storica, di ipo-prescrizione. Questo fenomeno, che pone l'Italia in fondo alle classifiche per quanto attiene il trattamento del dolore cronico, è determinato da retaggi del passato da una scarsa conoscenza sui profili rischi/beneficio degli analgesici oppioidi. Permangono così timori ingiustificati che necessitano di essere fugati attraverso adeguati processi formativi
Il Monitor Facilitatore: ruolo attivo nella clinical governance e nella creazione di una cultura di farmacovigilanza, intesa come strumento per la tutela della salute pubblica e strategia di razionalizzazione della spesa ospedaliera .
No full textThe constant growth of public health expenditure is mainly due to population aging, scientific
and technological innovation, increasing demand for health. Adverse drug reactions (ADRs) lower
patients quality of life and increase costs of care, mainly in hospitals. Active pharmacovigilance
projects - as already being implemented in the USA - may contribute to cut such avoidable costs.
The present project innovation consists in employing pharmacovigilance as an additional tool to
reduce health expenditure, in a collaborative way. It is therefore necessary - also in our country
- to join resources and competencies at various levels (local, regional, national) to reach the common
target of public health protection. Our project considers 4 phases: fact-finding, engagement
of 8 hospital wards in Verona, expansion at regional level, national expansion. The “Facilitating
Monitor” should be the specific professional figure - funded by the hospital administration -
dedicated to pharmacovigilance at the hospital wards, to monitor and therefore prevent/decrease
ADRs, reducing the resulting length of stay. Prof. Minuz conducted a pivotal study to estimate the
number of ADRs due to medication errors, their causes, the preventability of the ADRs and the
consequent lengths of stay. We used the raw data coming from the study to calculate the costs for
229 in-patients who reported at least one ADR during a 146 days observation period. The total
avoidable cost, due to the increased length of stay for in-patients who experienced at least one
preventable ADR, was € 212,700 i.e. 8% of the hospitalization cost for in-patients who experienced
an ADR and 2% of the total cost of hospitalization. The results were extrapolated to obtain
the total annual saving in Verona university hospitals, which could be around € 8-9 millions
Martino ha sentito la voce di Dio: caso clinico
No full textSi tratta di un caso clinico di antibiomania da claritromicin
Rilevanza clinica e aspetti medico-legali delle interazioni tra farmaci
No full textDrug-drug interactions (DDIs) are an important issue of clinical pharmacology. A drug interaction occurs when the amount or the action of a drug is altered by the administration of another drug or multiple drugs. The result of a DDI can be the onset of an adverse drug reaction (ADR), the lack or the reduction of efficacy or the increase of a pharmacological effect. Apart from pharmaceutical interactions, DDIs are generally classified as pharmacokinetic or pharmacodynamic, according to the underlying mechanism. The majority of known DDIs involve the drug metabolism. The main risk factors for DDIs are age, polypharmacy, self-medication, concomitant diseases, narrow therapeutic range and dosage. In the literature most of the studies on DDIs focused on potential interactions and most data
about the epidemiology of actual DDIs are related to the out-inpatient settings with different incidences. In general the incidence of actual DDIs is lower than that of potential ones, however DDIs represent a significant proportion of ADRs, since the absolute number of patients involved is high. The use
of specific suggestions and recommendations could be effective in the reduction of ADRs from DDIs
Lormetazepam Addiction
No full textThis chapter focuses on lormetazepam addiction. Lormetazepam is a BDZ mainly used as sedative-hypnotic, has some specific pharmacological properties that differentiate it from other BDZs. In Italy, lormetazepam is the most commonly used BDZ, followed by lorazepam and alprazolam. However, it is very difficult to determine the use deriving from abuse, dependence, and addiction from consumption data only. Furthermore, these data do not take into consideration under-the-counter use. Despite guidelines recommending to limit the use of BDZs, lormetazepam included, to a few weeks, their consumption is often chronic and many people take these drugs for many years. Patients often take these drugs for a long period, because they are generally well tolerated and safe. Lormetazepam abuse, dependence, and addiction may appear after prolonged treatment. A drug-induced alteration in the GABA inhibitory regulation of DA neurons has been implicated for the neural basis of BDZ addiction. Some authors proposed that BDZs increase DA level through disinhibition. This disinhibition is dependent on the BDZ binding site on alpha1-containing GABAA receptors in the VTA. To our knowledge, there is limited evidence of specific addictive properties of lormetazepam in the scientific literature. In our experience, lormetazepam addiction is an increasingly common occurrence in Italy and its abuse concerns almost exclusively the drop formulation (84% of abusers). Some special features (such as the presence of 95% alcohol in the dropformulation) seem to facilitate its abuse. l Reports of lormetazepam abuse/dependence/addiction sent to the Italian pharmacovigilance system account for about 50% of the total BDZ abuse/dependence/addiction reports.The lack of data about lormetazepam addiction in the literature is probably because drop solution exists only in Italy and Spain. Research shows that combining medications for addiction treatment (e.g., flumazenil) with behavioral therapy is the best way to ensure success for most patients
La strana caduta a terra di Teresa: caso clinico
No full textSi tratta di una caso clinico di rabdomiolisi da farmac
IMPATTO DI UN CORSO DI FORMAZIONE A DISTANZA SULLA SEGNALAZIONE SPONTANEA DI REAZIONI AVVERSE DA FARMACI
No full textObiettivo del lavoro: verificare l'eventuale impatto di un corso di formazione a distanza accreditato sul sistema della segnalazione spontanea di reazioni avverse da farmac
Gli indomabili capelli di Marta: caso clinico
No full textSi tratta di un caso clinico di capelli impettinabili da antibiotic
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