medigraphic.com

2022, Number 2

<< Back Next >>

Rev Mex Anest 2022; 45 (2)

Evaluation of the prescription characteristics of major opioids dispensed by the pharmacies of a Latin American General Hospital

Covarrubias-Gómez A, Zavaleta-Monestel E, Villalobos-Madríz JA, Rodríguez-Miranda R, Díaz-Madríz JP, Serrano-Arias B, Meoño-Elizondo A, Zheng-Mok WY

Language: Spanish
References: 22
Page: 101-106
PDF size: 285.90 Kb.


ABSTRACT

Introduction: Opioids have been used for pain relief in various settings. Its use can promote undesirable effects. Industrialized countries are currently experiencing an opioid crisis. Objective: To characterize the prescription of major opioids considering the medical area that made the prescription and total dose in milligrams morphine equivalents (MME) at a general hospital in Latin America. Material and methods: A retrospective and observational study was carried out. The number of prescriptions for major opioids dispensed in the pharmacies of a general hospital in Latin America, between 2017 and 2020, were documented. Information was taken from the database of the Ministry of Health. Prescriptions containing non-opioid narcotic drugs and injectable Fentanyl were excluded. A standardization to MME was carried out to analyze the distribution of prescriptions. Results: The total number of prescriptions filled for major opioids was 5,366 prescriptions. Injectable morphine was the most prescribed drug (46%) and as an active principle it obtained 54% of all the prescriptions studied (considering all routes of administration). General medicine prescribed most prescriptions (48%), which represented 42% of the total MME. Conclusions: Morphine is the substance preferred by the doctors evaluated in this study, the parenteral route of administration is the most used. General medicine is the area that prescribes most of the opioids. It is pertinent to create educational policies on opioids; therefore, it is convenient to characterize the prescription qualitatively considering information such as the diagnosis and the daily doses used.


REFERENCES

  1. Duce TS, Rollán AB, López ME, Camarasa PJ. Terapéutica en Atención Primaria. Uso de los opioides en pacientes con dolor oncológico. SEMERGEN Soc Esp Med Rural GenEd Impr. 2007;33:520-528.

  2. Álvarez Y, Farré M. Farmacología de los opioides. Adicciones. 2005;17:21-40.

  3. Wilkerson RG, Kim HK, Windsor TA, Mareiniss DP. The opioid epidemic in the United States. Emerg Med Clin North Am. 2016;34:e1-23.

  4. Rutkow L, Vernick JS. Emergency legal authority and the opioid crisis. N Engl J Med. 2017;377:2512-2514.

  5. Center for Behavioral Health Statistics and Quality. Results from the 2011 NSDUH: Summary of National Findings, SAMHSA, CBHSQ [Internet]. Substance Abuse and Mental Health Services Administration. 2012 [cited 29 Mayo, 2021]. Available in: https://www.samhsa.gov/data/sites/default/files/Revised2k11NSDUHSummNatFindings/Revised2k11NSDUHSummNatFindings/NSDUHresults2011.htm

  6. Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in drug and opioid overdose deaths-United States, 2000-2014. Morb Mortal Wkly Rep. 2016;64(50-51):1378-1382.

  7. Murphy S, Kochanek KD, Xu J, Heron M. Deaths: final data for 2012. Natl Vital Stat Rep. 2015;63:1-117.

  8. Rudd RA, Seth P, David F, Scholl L. Increases in drug and opioid-involved overdose deaths-United States, 2010-2015. Morb Mortal Wkly Rep. 2016;65(50-51):1445-1452.

  9. Shulman J, Roodenburg E, DiMaria R. The opioid epidemic: spotlighting international efforts to address the crisis [Internet]. KPMG; 2018. Available in: https://assets.kpmg/content/dam/kpmg/ca/pdf/2018/04/the-opioid-epidemic.pdf

  10. Hedegaard H, Warner M, Miniño AM. Drug overdose deaths in the United States, 1999–2015. National Center for Health Statistics (USA), editor. 2017; Available in: https://stacks.cdc.gov/view/cdc/44356

  11. Christie C, Baker C, Cooper R, Kennedy PJ, Madras B, Bondi P. The president's commission on combating drug addiction and the opioid crisis. Wash DC US Gov Print Off. 2017.

  12. Gostin LO, Hodge JG Jr, Noe SA. Reframing the opioid epidemic as a national emergency. JAMA. 2017;318(16):1539-1540.

  13. Rutkow L, Vernick JS, Alexander GC. More states should regulate pain management clinics to promote public health. Am J Public Health. 2017;107(2):240-243.

  14. Instituto sobre Alcoholismo y Farmacodependencia. VI Encuesta Nacional sobre Consumo de Drogas en Población General 2015 [Internet]. IAFA; 2018. Disponible en: https://www.iafa.go.cr/images/descargables/investigaciones/Encuesta--Nacional-de-Drogas-2015.pdf

  15. Sandí BS, Sandí EL. Dependencia a opioides y su tratamiento. Rev Clínica Esc Med UCR-HSJD [Internet]. 2016;6(1). Disponible en: https://revistas.ucr.ac.cr/index.php/clinica/article/view/23063

  16. Vargas BA. Manejo no adecuado del dolor por cáncer en Costa Rica: ¿Un problema de formación académica? Acta Médica Costarricense [Internet]. el 22 de julio de 2020 [citado el 29 de mayo de 2021];56(2). Disponible en: http://actamedica.medicos.cr/index.php/Acta_Medica/article/view/835

  17. Arce BA, Chacón SW, Dobles UA, Méndez MJ, Ramírez AY, Salas AC. V encuesta nacional sobre consumo de sustancias psicoactivas en población de educación secundaria 2018. Instituto sobre Alcoholismo y Farmacodependencia. 2019, 80.

  18. Unidad de Información y Estadística Nacional sobre Drogas. Boletín Estadístico Enero 2021 [Internet]. ICD; 2021. Disponible en: https://www.icd.go.cr/portalicd/images/docs/uid/boletin_esta_uid/BE_2021/BE_UID_Ene-21.pdf

  19. Valverde Alfaro E, Arce Von Herold A. Caracterización demográfica de los pacientes con trastorno por uso de sustancias egresados del Hospital Nacional Psiquiátrico en el año 2011: Propuesta de terapia grupal de 4 sesiones en el manejo de consumo de drogas en pacientes que además padecen esquizofrenia o trastornos afectivos que estén hospitalizados en el Hospital Nacional Psiquiátrico [Tesis de postgrado]. San José: Universidad de Costa Rica; 2013.

  20. Ministerio de Salud Costa Rica. Salud oficializa y activa Receta Digital [Internet]. Ministerio de Salud Costa Rica. 2017 [citado el 29 de mayo de 2021]. Disponible en: https://www.ministeriodesalud.go.cr/index.php/noticias/noticias-2017/1130-salud-oficializa-y-activa-receta-digital

  21. International Narcotics Control Board. Narcotic Drugs: Estimated World Requirements for 2020 [Internet]. Austria: United Nations; 2020 p. 220-265. Available in: https://www.incb.org/documents/Narcotic-Drugs/Technical-Publications/2019/Narcotic_Drugs_Technical_Publication_2019_web.pdf

  22. Dowell D, Haegerich T, Chou R. CDC Guideline for prescribing opioids for chronic pain-United States, 2016. MMWR Recomm Rep [Internet]. 2016 [Cited 29 May 2021]; 65. Available in: https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm




2020     |     www.medigraphic.com