Modification of solid dosage forms: survey in a hospital of the province of Córdoba
DOI:
https://doi.org/10.31053/1853.0605.v70.n3.20188Keywords:
modification of medicines, tablets, capsules, hospital of Córdoba, ArgentinaAbstract
Background: In the hospital setting is frequent to manipulate solid dosage forms (SDF, tablets 16and capsules), which can affect their physicochemical and biopharmaceutical properties, the pharmacoloeffect and sometimes to cause the appearance of undesirable side effects.
Objectives: To identify the medicines whose SDF is altered in a Hospital of Cordoba (Argentina), to determine how these modifications are made and to establish whether they were properly performed or not.
Methods: We retrospectively analyzed the prescriptions made between the 5th and the 11th of March of 2012 and identified impaired requesting SDF modifications. Open interviews were held with nurses and service visits to each hospital to determine how they manipulated the SDF.
Results: We analyzed 700 prescriptions for 113 patients, of which 61 (54%) had manipulations of the received SDF (49 for medical prescription, 7 because they had nasogastric tubes, 3 due to patient choice and 2 by nursing decision). Twenty three medicines were manipulated, but only 12 were correctly manipulated. The major changes were partition of tablets and grinding of tablets or microgranules and dispersible in water.
Conclusion: The SDF of several medicines is altered in the analyzed hospital, many times without medical indication and scientific justification. It would be appropriate to conduct training courses and establish closer collaborations between pharmacy and nursing units in the investigated hospital.
Downloads
References
Nissen LM, Haywood A, Steadman KJ. Solid medication dosage from modification at the bedside and in the pharmacy of Queensland Hospitals. J Pharm Pract Res 2009; 39:129-34.
Glass BD, Haywood A. Stability considerations in liquid dosage forms extemporaneously prepared from commercially available products. J Pharm Pharm Sci 2006; 9: 398-426.
Rua FJ. Administración de medicamentos: ¿se puede alterar la integridad de la forma farmacéutica? AFADHU Revista N° 2, julio de 2010. En: http://www.ifarcom.org/journalarticle/administracion-medicamentos-se-puede-alterar-integridad-forma-farmaceutica. pdf; consultado el 18/07/2012.
de Amuriza Chicharro N, Romero Jiménez RM, Valero Zanuy MA, Gomis Muñoz P, Herreros de Tejada A. Evaluación de las prácticas de administración de fármacos por sonda nasoentérica y enterostomía en pacientes hospitalizados. Nutr Hosp 2012; 27: 879-888.
Guía para la administración de medicamentos por sonda Nasogástrica. Servicio de Farmacia. Febrero de 2006. [serie online] En http://www.dep20.san.gva.es/especializada/servicios/farmacia/guias/guia_adm_medicamentos. pdf; consultado el 18/07/2012.
Gómez López L, Pinillos Pisón S. Guía pediátrica para la administración de fármacos por sonda de alimentación. Elsevier España S. L. Madrid, 2008. [serie online] En: http://www.senpe.com/GRUPOS/estandarizacion/GEP_SENPE_GuiaPedADM_FSA.pdf; consultadoel 22/07/2012.
Ley Nacional Nº 17132 Ejercicio de la Medicina, Odontología y Actividades auxiliares. (Enero 31, 1967)
Categoría y Actividades en los establecimientos [serie online]. En: http://www.cba.gov.ar/imagenes/fotos/sal_farm_normativas020606.pdf; consultado el 12-06-2011.
WHO Collaborating Centre for Drug Statistics Methodology. En: http://www.whocc.no/; consultado el 10/07/2012.
Administración Nacional de Medicamentos, Alimentos y Tecnología médica. [serie online] En: http://www.anmat.gov.ar/listados/Listado_Alto_Riesgo_08-2012.pdf; consultado el 25/09/2012.
Martínez López I, Puigventós F. Guía de administración de medicamentos por sonda nasogástrica [serie online], 2003. En: http://www.elcomprimido.com/FARHSD/basesguiaadmon_sng.pdf; consultado el 12/03/2012.
Ortega de la Cruz C, Villalba D, Damas M, García E. Guía para la administración de medicamentos a través de sonda nasogástrica. Farm Hosp 1991; 15:17-27.
Luna Vega T, Sorní Pérez I, Goyache Goñi MP, Marfagón Sanz N, Herreros de Tejada A. Técnica para la administración de medicamentos por sonda nasogástrica. Farm Hosp 1998; 22: 257-260.
Triturating drugs for administration in patients with difficulties in swallowing: evaluation of the drug lost. [serie online]. En http://www.ncbi.nlm.nih.gov/pubmed/21219531; consultado el 18/07/2012.
Hidalgo FJ, Delgado E, García Marco D, De Juana P, Bermejo T. Guía de administración de fármacos por sonda nasogástrica. Farm Hosp 1995; 19: 251-258.
Administración Nacional de Medicamentos, Alimentos y Tecnología Médica – ANMAT- Listado Oficial de Medicamentos Actualmente Comercializados (LOMAC). En: http://www.anmat.gov.ar/aplicaciones_net/applications/consultas/lomac/ ; consultado el 25/09/2012.
Blix HS, Viktil KK, Moger TA, Reikvam A. Drugs with narrow therapeutic index as indicators in the risk management of hospitalised patients. Pharmacy Practice 2010; 8: 50-55. En: http://scielo.isciii.es/pdf/pharmacin/v8n1/original5.pdf; consultado el 08/11/2012.
Downloads
Published
How to Cite
Issue
Section
License
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).
