AMBROXOL PEDIATRIA PDF

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A cross-sectional, descriptive and retrospective study was conducted in which an analysis was performed of the respiratory diseases and the prescriptions of 6 Primary Health Care paediatricians who worked in Area V of the Asturian Health Service in An evaluation was made on the suitability of these medications. An analysis was also made of the drug datasheet and clinical recommendations clinical guidelines, protocols or reports..

The mean age was 5 years old. There was a total of Off-label drugs were used in The prescribing was considered unsuitable in All of the prescription drugs in children under 6 years old were unsuitable.

Children should only receive drugs with a good risk and benefit ratio. Paediatricians should try to improve the information about paediatric drug use and spread this information to parents, doctors and nurses.. Estudio transversal, descriptivo y retrospectivo. During the last few years, there has been some controversy over the employment of anticatarrhal drugs, due to the use and non-prescription sale of many pharmaceutical drugs with uncertain therapeutic efficacy and a potential risk for intoxication in paediatric-aged patients.

In the year , the United States Food and Drug Administration issued a recommendation to avoid the administration of any drug to combat cough or catarrh in children under the age of two, due to the risk of side effects; their determination on the use of anticatarrhal drugs in children between the ages of two and eleven is still pending. The last National Health Survey in Spain, for the period —, observed that To this, we must add that the accidental ingestion of anticatarrhal drugs is still a frequent reason for consultation due to intoxication in Paediatric Emergencies, and that the use of drugs under different conditions than those authorised still occurs among paediatric patients.

In Spain the Ministry of Health qualifies as incorrect use the employment of these drugs under unauthorised conditions and warns about the legal risks that this practice involves. Based on these premises, we have considered it advisable to perform a study on the prescription profile of anticatarrhal drugs in Primary Care Paediatric consultations PC by collecting data from clinical records elaborated by the doctors who assist the paediatric population in our region.

This was a cross-sectional, descriptive, retrospective study, where the respiratory problems and their prescriptions were analysed by reviewing the clinical records using OMI-AP programme for electronic clinical records used in our autonomous community at health centres in six PC paediatric offices from the V Healthcare Area belonging to the Sanitary Service of the Principado de Asturias between 1 January and 31 December, The population is mainly urban, and a total of 31, children under the age of 14 were assisted in the year It comprises 14 basic health areas, with a total of 32 paediatricians.

Six offices with access availability during the afternoon, three days a month from Mondays to Fridays were randomly chosen 16 Mondays, 5 Tuesdays, 5 Wednesdays, 4 Thursdays and 6 Fridays. Frequency of the CIAP-1 codes associated to the use of anticatarrhal drugs. The suitability of prescribed treatments was assessed taking into consideration two aspects: 1.

The data that appeared in the data sheet available on the webpage of the Spanish Agency of Medicines and Medical Devices, or otherwise in the directions available in the formulary, of all those drugs used for respiratory system problems, including the following subgroups from the ATC classification: R01B corresponding to nasal decongestants of systemic use, and R05, which includes preparations for coughs and flu.

At the same time, the suitability of the prescribed treatments for the patients under study was assessed, following the recommendations of clinical guidelines, protocols, or otherwise the most updated bibliography available according to the clinical condition they presented with, sorting them in this manner according to whether it was considered unsuitable or suitable. The use of the drugs under analysis is not recommended in patients with asthma, severe bronchiolitis, severe bronchitis, flu, severe laryngitis, pneumonia, serous otitis media, severe sinusitis and whooping cough.

The statistical analysis was conducted using the computer program SPSS version For the comparisons between groups, we used the Chi-square test and the binary logistic regression analysis qualitative variables. A p value under 0. A total of patients was analysed in consultations for respiratory problems, with pharmacological prescriptions.

In consultations no prescriptions were made. In this article, anticatarrhal drugs were analysed In Of these drugs, 14 cough suppressants, 4 mucolytics and 5 from the others group had been prescribed in the previous visit and were not suspended. Distribution of prescribed active substances therapeutic subgroups R01B and R The most frequent diagnosis in this group was R74 Distribution of the anticatarrhal drugs by months.

Distribution by CIAP-1 codes of the anticatarrhal drugs. The average age of the patients was 5 years 1— months.

In the initial analysis that was conducted to assess the suitability taking into account clinical criteria and directions from the data sheet, These corresponded to Of these drugs, Drugs prescribed under unauthorised conditions in data sheet. In the patients diagnosed with R05 and R74, the treatment was unsuitable in 73 and We established a cut-off point at six years old, since this is the limit in which the use of this group of drugs would be considered as a potential alternative.

Thus, this treatment was considered unsuitable in children under the age of six in all cases. The analysis by means of logistic regression did not show statistically significant differences. Consultations for respiratory problems constitute the majority of the day-to-day caseload burden of PC paediatricians; they involve a high morbility rate and represent up to In general, severe respiratory problems are benign and self-limiting; their treatment consists of non-pharmacological and supportive measures.

However, there is a great variety of drugs that have been used to try to counteract the symptoms. Their use is not recommended as a general rule due to their uncertain efficacy and the significant risk of toxicity, mostly in children under the age of six. In our study, On the other hand, a high percentage of the medications used in children, both in Europe and in the United States, are not authorised for use in this age group. According to the data from the European Medicines Agency, in the — period the situation had not improved compared to previous years with regard to the amount of medication with paediatric information, which is approximately one third of authorised medications.

The most frequent cause was age under the authorised limit, which affected children under the age of two. The studies on off-label prescriptions are very heterogeneous in methodology, which hinders the comparison between results, something we observed in our sample and in other studies, such as the one by Olsson et al. In the rest of the cases, the reason was the absence of clinical indication, since anticatarrhal drugs are not indicated in patients with asthma, severe bronchiolitis, severe bronchitis, flu, severe laryngitis, pneumonia, serous otitis media, severe sinusitis and whooping cough.

For these reasons, we pose the question of whether the use of these drugs is suitable within our setting. In this sense, we must remember that in and for a rational use of medications, the World Health Organisation 33 established that it is essential to: a prescribe a suitable medication; b have it on disposal in a timely manner and at an affordable price; c dispense it under the right conditions, and d take the prescribed dose during the intervals and time prescribed.

Therefore, the right medication has to be effective and of suitable quality and innocuousness. In our study, the most prescribed subgroup of anticatarrhal drugs was cough suppressants. In general, it is a safe drug with broad therapeutic windows, but an overdose or toxic ingestion can cause acute side effects in the central nervous system and occasionally even death. When analysing the suitability of the prescriptions, we found that the majority of unsuitable treatments took place in the cases with R05 and R74 diagnosis, compared to the other diagnoses that were gathered; this was probably because they are the most frequent ones in relation to the use of these drugs.

Similarly, age was an important factor in these analyses. The highest percentages of unsuitable treatments, as expected, occurred in children under the age of six. A high level of prescriptions for anticatarrhal drugs and its inverse relation to age has been the standard in Spain for at least 30 years, and has been observed both in small-scale studies in offices and in population studies.

A few previous studies have found differences in the prescription of medications between paediatricians and general practitioners; the first were less inclined to prescribe anticatarrhal drugs in infants. Our study has limitations, in spite of having selected a random sample.

The size of the sample may or may not be representative of the prescriptions of anticatarrhal drugs made, but we consider that it does reflect the current situation, in which the use of these drugs is frequent in spite of their low efficacy and potential toxicity. The strength of our study is based on the gathering of prescription data through clinical records, and associated with a clinical diagnosis.

To conclude, we must emphasise that it is important that children only receive drugs of proven efficacy and with a favourable risk—benefit ratio. To avoid unsuitable prescriptions, apart from promoting education to convince paediatricians themselves, we must work with the parents, letting them know the real efficacy and the potential side effects of these drugs, so that a joint doctor—parent decision that is personalised for each case can be made.

The doctor's predisposition should be to not recommend this type of drugs, based on current available data. In this situation, the paediatrician should resort to those drugs that have a better security profile. The authors declare that there are no conflicts of interest. The authors thanked all the PC paediatricians of the Area V from the Sanitary Service of the Principado de Asturias for their daily work, availability and support in the performance of this study..

An Pediatr Barc. ISSN: Use of cold and cough medications prescribed in Primary Care clinics for children less than 14 years. Descargar PDF. Autor para correspondencia. Table 1. Frequency of the CIAP-1 codes associated to the use of anticatarrhal drugs.. Table 2. Material and methods A cross-sectional, descriptive and retrospective study was conducted in which an analysis was performed of the respiratory diseases and the prescriptions of 6 Primary Health Care paediatricians who worked in Area V of the Asturian Health Service in An analysis was also made of the drug datasheet and clinical recommendations clinical guidelines, protocols or reports.

Paediatricians should try to improve the information about paediatric drug use and spread this information to parents, doctors and nurses. Systemic cold and cough medicines. Palabras clave:.

Texto completo. Introduction During the last few years, there has been some controversy over the employment of anticatarrhal drugs, due to the use and non-prescription sale of many pharmaceutical drugs with uncertain therapeutic efficacy and a potential risk for intoxication in paediatric-aged patients.

Materials and methods Characteristics of the study This was a cross-sectional, descriptive, retrospective study, where the respiratory problems and their prescriptions were analysed by reviewing the clinical records using OMI-AP programme for electronic clinical records used in our autonomous community at health centres in six PC paediatric offices from the V Healthcare Area belonging to the Sanitary Service of the Principado de Asturias between 1 January and 31 December, Figure 1.

Figure 2. Table 3. The authors thanked all the PC paediatricians of the Area V from the Sanitary Service of the Principado de Asturias for their daily work, availability and support in the performance of this study. Casares Alonso, J. Un problema no resuelto. An Pediatr Barc , 78 , pp.

ATRAVESANDO LAS PUERTAS DEL AUTISMO TEMPLE GRANDIN PDF

[Study of the activity of ambroxol in children with aspecific bronchial hyperreactivity]

A cross-sectional, descriptive and retrospective study was conducted in which an analysis was performed of the respiratory diseases and the prescriptions of 6 Primary Health Care paediatricians who worked in Area V of the Asturian Health Service in An evaluation was made on the suitability of these medications. An analysis was also made of the drug datasheet and clinical recommendations clinical guidelines, protocols or reports.. The mean age was 5 years old.

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The pharmacology of ambroxol—review and new results

Background: Respiratory distress syndrome RDS is caused by a deficiency of pulmonary surfactant an active agent that keeps pulmonary alveoli open and facilitates the entry of air to the lungs, thus improving the oxygenation of the newborn. A number of interventions such as pulmonary surfactant and prenatal corticosteroids are used to prevent RDS. Ambroxol has been studied as a potential agent to prevent RDS, but effectiveness and safety has yet to be evaluated. Objectives: To evaluate the efficacy and safety of giving ambroxol to pregnant women who are at risk of preterm birth, for preventing neonatal RDS. Selection criteria: Randomised controlled trials RCTs comparing the administration of ambroxol given to pregnant women at risk of preterm birth versus placebo, antenatal corticosteroids betamethasone or dexamethasone , or no treatment. We did not identify any trials comparing ambroxol with dexamethasone corticosteroid in this review.

BABY HALDER ALO ANDHARI PDF

Ambroxol for Women at Risk of Preterm Birth for Preventing Neonatal Respiratory Distress Syndrome

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