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PREFACE The Drug Supply and Management textbook is especially compiled to meet the demand of equipping students of the Pharmacy Department at Lac Hong University with vocabulary and reading comprehension ability This textbook is designed to help pharmacy – majored students build vocabulary and access pharmaceutical materials It introduces terms relating to pharmaceutical contexts which are widely used in pharmaceutical prescriptions, reports, journals, and studies In addition, it also enhances students‟ reading and translation skills through authentic reading texts with carefully planned activities In spite of the efforts to make it an efficient aid in the study of this ESP course, the compilers are aware of the deficiencies that remain in the textbook Needless to say, the compilers will greatly appreciate all positive contributions sent to the General English Department via generalenglishdept@lhu.edu.vn i TABLE OF CONTENTS Page PREFACE i TABLE OF CONTENTS ii UNIT Drug Information Cefixime Glipizide UNIT The pharmacological basis of Therapeutics 13 Certirizine 13 Betamethasone 19 UNIT The pharmacological basis of disease treatment 29 Omeprazole 29 Chlorpromazine 38 UNIT Leaflet 46 Augmentin 46 Amlodipin Stada 59 UNIT Pharmacovigilance 65 UNIT Good stockage practices 76 UNIT Pharmaceutical care 91 UNIT Improving global health by closing gaps in the development, distribution, and responsible use of medicines 99 UNIT Medical status reports 107 UNIT 10 Purchase Orders 142 UNIT 11 Pharmaceutical and Clinical Journals 149 GLOSSARY 182 REFERENCES 190 ii UNIT DRUG INFORMATION GUIDED STUDY CEFIXIME SCRUB UP Work in pairs Write the correct words or phrases given in the table under the corresponding pictures antibiotic vomit breast-feeding diarrhea rash sore throat dizziness patch diet a b c d e f g h i Work in pairs Match each phonetic spelling to one of the words or phrases above Try to say them to your partner a /ˌæntibaɪˈɒːtɪk/ _ c /sɔː θrəʊt/ _ e /ˈdɪzɪnəs/ _ b /ˌdaɪəˈriːə/ _ d /ˈvɒmɪt/ _ READING COMPREHENSION Read the passage below and decide if these sentences are true (T) or false (F) a Cefixim is always safe _ b An over dose of this medication sometimes causes death _ c This medication may have effects on stomach _ d Pregnant women must be careful with this drug _ e The dosage of children is based on age _ f This medication requires a medical prescription to be dispensed _ g If a patient missed a dose, he or she would take a double dose to catch up the missed dose _ Fill in each blank with a suitable word a Antibiotics not fight infections caused by cold and _ viruses b Do not stop taking the antibiotics early even if _ disappear after a few days c You should check with your doctor immediately if any of these side effects, such as stomach upset/pain, diarrhea, nausea, gas, headache, or _ occurs when taking cefixime d Because no information is available on the effect of cefixime on breast milk, you should consult your doctor before _ e Do not save any of the antibiotics for another _ unless told to so by your doctor f Keep cefixime out of the reach of _ and away from pets Translate the following sentences into Vietnamese a If you are taking the chewable tablets, chew thoroughly and then swallow b Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection c Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection) d This medication should be used only when clearly needed during pregnancy Discuss the risks and benefits with your doctor e Although most antibiotics probably not affect hormonal birth control such as pills, patch, or ring, some antibiotics may decrease their effectiveness Reading CEFIXIME Uses Cefixime is used to treat a wide variety of bacterial infections This medication is known as a cephalosporin antibiotic It works by stopping the growth of bacteria This antibiotic treats only bacterial infections It will not work for viral infections (e.g., common cold and flu) Unnecessary use or overuse of any antibiotic can lead to its decreased effectiveness How to use cefixime Take this medication by mouth with or without food as directed by your doctor, usually once a day For children, this medication may also be taken twice a day (every 12 hours) If you are taking the chewable tablets, chew thoroughly and then swallow The dosage is based on your medical condition and response to treatment For children, the dosage is also based on weight Antibiotics work best when the amount of medicine in your body is kept at a constant level Therefore, take this drug at evenly spaced intervals Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection Tell your doctor if your condition persists or worsens Side effects Stomach upset/pain, diarrhea, nausea, gas, headache, or dizziness may occur If any of these effects persists or worsens, notify your doctor or pharmacist promptly Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects Many people using this medication not have serious side effects Tell your doctor immediately if any of these rare but very serious side effects occur: severe stomach/abdominal pain, persistent nausea/vomiting, yellowing eyes/skin, dark urine, unusual tiredness, new signs of infection (e.g., persistent sore throat, fever), easy bruising/bleeding, change in the amount of urine, mental/mood changes (such as confusion) This medication may rarely cause a severe intestinal condition (Clostridium difficileassociated diarrhea) due to a resistant bacteria This condition may occur weeks to months after treatment has stopped Do not use anti-diarrhea products or narcotic pain medications if you have the following symptoms because these products may make them worse Tell your doctor immediately if you develop: persistent diarrhea, abdominal or stomach pain/cramping, or blood/mucus in your stool Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection) Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms A very serious allergic reaction to this drug is rare However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing This is not a complete list of possible side effects If you notice other effects not listed above, contact your doctor or pharmacist Precautions Before taking cefixime, tell your doctor or pharmacist if you are allergic to it; or to penicillins or other cephalosporin antibiotics (e.g., cephalexin); or if you have any other allergies This product may contain inactive ingredients, which can cause allergic reactions or other problems Talk to your pharmacist for more details Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, a certain intestinal disease (colitis) Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) The chewable form of this medication may contain aspartame If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame (or phenylalanine) in your diet, ask your doctor or pharmacist about using this medication safely This medication should be used only when clearly needed during pregnancy Discuss the risks and benefits with your doctor It is unknown if this medication passes into breast milk Consult your doctor before breast-feeding Interactions Drug interactions may change how your medications work or increase your risk for serious side effects This document does not contain all possible drug interactions Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist Do not start, stop, or change the dosage of any medicines without your doctor's approval Some products that may interact with this drug include: "blood thinners" (e.g., warfarin), live bacterial vaccines Although most antibiotics probably not affect hormonal birth control such as pills, patch, or ring, some antibiotics may decrease their effectiveness This could cause pregnancy Examples include rifamycins such as rifampin or rifabutin Be sure to ask your doctor or pharmacist if you should use additional reliable birth control methods while using this antibiotic This medication may cause false positive results with certain diabetic urine testing products (cupric sulfate-type) This drug may also affect the results of certain lab tests Make sure laboratory personnel and all your doctors know you use this drug Overdose If overdose is suspected, contact a poison control center or emergency room immediately Symptoms of overdose may include: severe vomiting, seizures Notes Do not share this medication with others This medication has been prescribed for your current condition only Do not use it later for another infection unless told to so by your doctor A different medication may be necessary in those cases Missed dose If you miss a dose, take it as soon as you remember If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule Do not double the dose to catch up Storage Store at room temperature away from light and moisture Do not store in the bathroom Keep all medications away from children and pets Do not flush medications down the toilet or pour them into a drain unless instructed to so Properly discard this product when it is expired or no longer needed Consult your pharmacist or local waste disposal company SELF-STUDY GLIPIZIDE READING COMPREHENSION Answer the questions about the text a How should glipizide be used? b Can glipizide cause upset stomach? c Will taking glipizide for diabetes make people gain weight? d Are people with type diabetes allowed to use glipizide? e What should people if they forget a dose? f What side effects can this medication cause? g What should people know about storage and disposal of this medication? Translate the following paragraphs into Vietnamese a Glipizide is used with a proper diet and exercise program to control high blood sugar in people with type diabetes It may also be used with other diabetes medications Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems Proper control of diabetes may also lessen your risk of a heart attack or stroke Glipizide belongs to the class of drugs known as sulfonylureas It lowers blood sugar by causing the release of your body's natural insulin b Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, thyroid disease, certain hormonal conditions (adrenal/pituitary insufficiency, syndrome of inappropriate secretion of antidiuretic hormone-SIADH), electrolyte imbalance (hyponatremia) c Store at room temperature away from light and moisture Do not store in the bathroom Keep all medications away from children and pets d Do not flush medications down the toilet or pour them into a drain unless instructed to so Properly discard this product when it is expired or no longer needed Consult your pharmacist or local company waste disposal Reading GLIPIZIDE Uses Glipizide is used with a proper diet and exercise program to control high blood sugarin people with type diabetes It may also be used with other diabetes medications Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems Proper control of diabetes may also lessen your risk of a heart attack or stroke Glipizide belongs to the class of drugs known as sulfonylureas It lowers blood sugar by causing the release of your body's natural insulin How to use glipizide Take this medication by mouth 30 minutes before breakfast or the first meal of the day as directed by your doctor, usually once daily Some patients, especially those taking higher doses, may be directed to take this drug twice a day The dosage is based on your medical condition and response to treatment To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose Follow your doctor's instructions carefully If you are already taking another anti-diabetic drug (such as chlorpropamide), follow your doctor's directions carefully for stopping the old drug and starting glipizide Colesevelam can decrease the absorption of glipizide If you are taking colesevelam, take glipizide at least hours before taking colesevelam Use this medication regularly to get the most benefit from it To help you remember, take it at the same time(s) each day Tell your doctor if your condition does not improve or if it worsens (your blood sugar levels are too high or too low) Side effects Nausea, vomiting, loss of appetite, diarrhea, constipation, upset stomach, headache, and weight gain may occur If any of these effects persist or worsen, tell your doctor or pharmacist promptly Reading Brazilian BJPS Journal of Pharmaceutical Sciences Vol 47, n 2, apr./jun., 2011 Evaluation of prescription indicators established by the WHO in Getulio Vargas — RS Andressa Tanise Vooss1*, Helissara Silveira Diefenthaeler1 'Regional Integrated University of Alto Uruguai and Missões (URI), Erechim Campus, Rio Grande Sul To evaluate the conditions of the services offered to the community regarding medications, the World Health Organization (WHO) has developed the Medication Use Indicators, among them Prescription indicators The objective of this study was to evaluate drug prescriptions in a Basic Health Care Center in Getulio Vargas - RS, according to the Prescription Indicators recommended by the WHO The data collection was performed with the use of a form and the prescriptions for June / July and November / December 2008 were evaluated The average number of drugs prescribed was 2.03, and 72.8% of the drugs were prescribed by generic name, 80.3% were on the list of essential drugs, 21.7% were antibiotics and 2.4% were injectable drugs The results were in accordance with WHO recommendations and were similar to those reported by other studies Uniterms: Medications/rational use Medications/prescription indicators World Health Organization/ medication use indicators Para avaliar as condicoes dos servicos prestados a populacao no que se refere aos medicamentos, a Organizacao Mundial da Saude (OMS) desenvolveu Indicadores uso de Medicamentos, entre eles os de Prescricao O objetivo da pesquisa foi avaliar prescricoes medicamentosas de usuarios de uma Unidade Basica de Saude municipio de Getulio Vargas - RS conforme os Indicadores de Prescricao preconizados pela OMS A coleta de dados foi realizada com uma ficha Para isso houve acesso as prescricoes atendidas no periodo de junho/julho e de novembro/dezembro de 2008 A media de medicamentos prescritos foi de 2,03, 72,8% dos medicamentos foram prescritos pelo nome generico, 80,3% constavam na lista dos medicamentos essenciais, 21,7% eram antibioticos e 2,4% injetaveis Observou-se que os resultados obtidos estao de acordo com os recomendados pela OMS e que foram similares a outros estudos Unitermos: Medicamentos/uso racional Medicamentos/indicadores de Prescricao Organizacao Mundial da Saude/indicadores uso de medicamentos INTRODUCTION The rational use of medications is a worldwide concern, and is therefore prominent among health care professionals Concerted efforts to readjust pharmaceutical actions and practices aiming at the rational use of medication are essential in today's society, in which drugs are the most used therapeutic resource Aiming to evaluate the conditions of the services offered to the population concerning medication, the World Health 176 Organization (WHO) developed Medication Use Indicators, including Prescription Indicators (Bernardi, Bieberbach, Thome, 2006) Prescription Indicators allow the therapeutic actions taken in similar institutions to be ascertained, enabling subsequent comparison of parameters between them, and to evaluate the population's medication needs and determine the most frequently used medications in a given place (Farias et al., 2007) In addition, these indicators allow identification of the prescription profile and quality of services offered to the population The prescription Indicators are as follows (Farias et al., 2007) Medication average per medical prescription Through this indicator it is possible to investigate polymedication, a major factor contributing to drug interactions and adverse reactions The educational and informational level of the person prescribing the medication may also be observed (Oliveira et al., 2009; Farias et al., 2007; Carmo, Nitrini, 2004; Santos, Nitrini, 2004; Bontempo et al., 2003; Cunha, Zorzatto, Castro, 2002) Percentage of medication prescribed with generic name This indicator allows the calculation of the number of prescriptions in which the drugs are prescribed with the generic name, as determined by the current National Drug Policy (NDP) of October 1998 Thus, it is possible to control drug costs in the health service, due to the fact that the drugs of general references are more expensive Also, it evaluates the marketing influence on the person prescribing drugs (Oliveira et al., 2009; Farias et al., 2007; Carmo, Nitrini, 2004; Santos, Nitrini, 2004; Bontempo et al., 2003; Cunha, Zorzatto, Castro, 2002) Percentage of prescribed drugs from list of essential drugs Besides controlling costs, the essential drugs list guarantees the treatment of the principal diseases of the population Percentage of prescribed antibiotics This indicator aims to evaluate the use of antibiotics in excess, a practice which contributes to bacterial dissemination and resistance (Oliveira et al., 2009; Farias et al., 2007; Carmo, Nitrini, 2004; Santos, Nitrini, 2004; Bontempo et al., 2003) Percentage of prescribed injectable drugs This indicator aims to evaluate the injectables in excess because their administration may have serious consequences when prescribed or applied wrongly, such as difficulty for case reversion in the event of anaphylactic reactions, adverse reactions, fiber necrosis, etc (Oliveira et al., 2009; Farias et al., 2007; Carmo, Nitrini, 2004; Santos, Nitrini, 2004) With these indicators, it is possible to swiftly and safely evaluate the attention given to health, but these indicators not quantify all the important aspects of drug use (Carmo, Farhat, Alves, 2003) Studies applying the WHO Prescription Indicators have been conducted in many cities in Brazil This has enabled evaluation of the conditions of the offered services concerning medication and also allowed comparison and identification of differences in the regions In many studies, the authors found good results regarding the Prescription Indicators, possibly as a consequence of the National Drug Policy and the holding of the Drugs and Pharmaceutical Assistance City conference (Farias et al., 2007) Nevertheless, the Prescription Indicators of many cities are still needed in order to compare the Pharmaceutical Assistance services among them The aim of this study was to evaluate the Prescription Indicators approved by the WHO in a Health Care Center in Getulio Vargas -RS This town has about 16,506 inhabitants and five Health Care Centers, which provide completely free medication distribution through a health assistance program of the government (Getulio Vargas, 2009) MATERIAL AND METHODS A transversal study design was used and the sample comprised all the medication prescriptions made out at a Health Care Center drugstore in Getulio Vargas - RS As the South of Brazil has a colder and more intense winter in comparison to other regions of the country, diseases such as respiratory illnesses are more often seen in this season Thus, a higher percentage of drug prescriptions is expected, particularly injectables and those containing antibiotics Aiming to compare the differences between the Prescription Indicators, it was chosen to evaluate prescriptions of two seasonal periods Therefore, the data was collected from prescriptions in June and July, 2008, which were the winter prescriptions, and in November and December, 2008, which were the summer prescriptions The data collection was done using a tailored form For this collection, the prescriptions made out during the specified period were assessed and therefore patients were not questioned The variables of interest in this study were: number of medications in each prescription, percentage of prescribed drugs with generic name, percentage of prescribed drugs on the list of the City's essential medications, percentage of prescribed antibiotics and injectables The data was analyzed on the statistical computer software program, SPSS (Statistical Package of the Social Sciences) v.16.0 for Windows To achieve this, distribution calculations were used (average and frequency) The Chi-squared and P tests were employed Differences with P< 0.05 were considered to be significant This research was approved by the Regional Integrada doAlto Uruguai e das Missoes - URI Campus de Ere-chim University Research Ethical Committee in Erechim, RS, under registration number 176/TCH/08 RESULTS In this study, 1,030 prescriptions were analyzed from a total of 2,090 medical prescriptions and 177 average number of medications per prescription was 2.03 Table I shows the number of medications in each prescription TABLE I - Number of medication in each prescription Number of N (prescriptions) % medications 488 47.4 236 22.9 164 15.9 97 9.4 30 2.9 11 1.1 0.1 0.1 0.1 10 0.1 Total 1030 100.0 The prescription of 189 different medications was observed, the most frequent being diclofenac sodium and acetaminofen, both corresponding to 36.5% of the total Other most frequently prescribed medications are shown in Table II TABLE II - Medications most frequently prescribed Medication N % Diclofenac sodium 50 mg 147 14.3 Acetaminofen 500 mg 120 11.7 Acetaminofen 200 mg/mL 108 10.5 Omeprazole 20 mg 95 8.9 Cephalexin 500 mg 75 7.3 Others 489 47.3 Total 1030 100 The more prevalent therapeutic categories included analgesics (22.2%), anti-inflammatory (14.3%) anti-ulcer (9.9%) and antibiotics (7.3%) The percentage of medications prescribed with the generic name was 72.8% and the percentage of prescribed medications appearing in the list of essential medication was 80.3% Antibiotics were prescribed in 21.7% of the prescriptions, and the prevalent antibiotics are shown in Table III TABLE III - Prevalent Antibiotics Medication N Cephalexin 500 mg 75 Amoxicilin 500 mg 46 Amoxicillin 250 mg 27 Cephalexin 250 mg 21 Neomycin 12 Others 42 Total 223 % 7.3 4.5 2.6 2.0 1.2 4.1 21.7 Only 25 prescriptions (2.4%), had injectables prescribed and no more than one injectable was prescribed in each prescription The predominant injectables are shown in the Table IV TABLE IV – Predominant injectables Medication Benzilpeniciliin benzathine Medroxyprogesterone 150 mg 178 N % 0.5 0.4 Piroxicam 40 mg Meloxicam 15 mg *Hydroxocobalamin/Dexamethasone/Dipyrone Others Total 25 0.4 0.3 0.2 0.6 2.4 * Injectable solution composition: each ampoule contains hydroxocobalamin (vit B12) 500 mg Each ampoule II contains 21- dexamethasone disodium phosphate 1.5 mg, dipyrone 500 mg, vehicle q.s.p mL Table V shows the differences found in prescriptions corresponding to the months of winter and summer TABLE V – Differences observed in prescriptions corresponding to Winter and Summer Winter Summer Number of prescriptions 534 496 Average no of medications 2.12 1.95 in each prescription % Generic name 72.0 73.6 % Essential medication list 80.0 80.4 % Antibiotics 23.4 19.8 % Injectables 3.0 1.8 DISCUSSION A total of 1,030 prescriptions were studied most of which had only one medication prescribed (47.4%) However, there were prescriptions (0.6%) in which more than medications were prescribed according to Table I Similarly, in the study of Oliveira et al (2009) it was observed that most prescriptions also had only one medication prescribed However, in the Ev, Guimaraes and Castro (2008) study, 34.27% of the prescriptions had one medication prescribed and 34.37% had medication prescribed, thus differing from the present study The average number of medications in each prescription was 2.03 and this is in accordance with the WHO's recommendation, which is or less We can conclude that there were no problems of polymedication and adverse reactions because the average medication in each prescription in this study was in accordance with WHO recommendations The medications most often prescribed in this study are shown in Table II The study by Colombo et al (2004), as did this study, found diclofenac and acetaminofen to be the most often prescribed, both corresponding to 22.6% Other studies report these results by pharmacologic groups, where the more often prescribed medications are those for the respiratory and nervous system (Girotto, Silva, 2006; Naves, Silver, 2005; Felicio, 2007; Farias et al , 2007) We observed in this study that the prevalent therapeutic categories are compatible with the medications most often prescribed: analgesics (22.2%) anti-inflammatory (14.3%), anti- tuberculosis (8.9%) and antibiotics (7.3%) and the difference between the prevalent pharmacologic categories in this, and the other studies cited, is clear, which may be attributed to the differences among the regions where the research was carried out and the pathologies that appeared in the population The percentage of medications prescribed with the generic name was 72.8% where the WHO establishes this at 100% This low percentage of prescribed medications with the generic name may be explained because of the high investment of the pharmaceutical industry in advertising their medications and this may influence prescribers Moreover, we should point out that some medications appear in the local list under their commercial name, which may deter professionals from using the generic name A total of 80.3% of the prescribed medications were from the list of the essentials medications which is in compliance with the percentage recommended by the WHO of 70% This indicator reveals that the standardized medications are being prescribed and are also covering most of the pathologies of the patients treated at the studied health care center Thus, it can be assumed that essential medications are accessible to the population Antibiotics were prescribed in 21.7% of the prescriptions and the most prevalent antibiotics are shown in Table III The problem with antibiotics use is the bacterial resistance caused when there is inappropriate or excessive use The indicator result is above the level approved by the WHO, which is 20% or less, but the figure found does not constitute excessive prescription Injectable medications were prescribed in 2.4% of the analyzed prescriptions and the predominant injectables are shown in Table IV The WHO establishes the prescription of 10% injectables, and the percentage found in this study fell below this level As observed in Table Colombo et al Marcondes Consedey WHO recommended Brasilia, DF (2005) Blumenau, SC (2004) Ponta Grossa, PR (2002) states: AC, AM, GO, PE, RJ (2000) - 1.5 2.3 1.8 2.6 2.11 2.0 or less 70.2 84.2 73.2 Not collected 71 69.42 100 68.2 58.4 91.9 85.3 82.4 87 68.02 70 21.7 28.1 22.0 21.1 26.4 12.5 33 39.21 2.0 or less 2.4 4.8 7.0 1.1 7.5 8.1 13 11.60 10 Girotto; Silva Franca, SP (2007) Ibipora PR (2006) 2.03 2.0 2.0 72.8 65.5 80.3 % Antibiotic % Injectables Cities Average no of medications per prescription %Generic name % Essential Medication List CONCLUSION This study showed that in the Health Care Center of Getulio Vargas - RS, where the study was carried out, most of the indicators analyzed were in accordance with the WHO's recommendations, except the percentage of medications prescribed with the generic name and the percentage of injectables However, these two indicators were in line with other studies performed in different Brazilian cities, which also showed good results compared with the WHO recommendations and with other health care centers analyzed TABLE VI - Comparison between studies conducted in different cities of Brazil Naves; Silver Felicio Authors V, the prescription of injectables in the Winter was almost double (40%), compared with the Summer, and this finding is in accordance with Farias et al (2007) study in which the percentage of injectables was 1.1% where this low percentage was attributed to the hot season of the year Other hypotheses for the low prescription of injectables may be because they appear in low quantities and varieties in the city's list of essential medications Although the prescription percentage of antibiotics and injectable drugs was found to be higher in the Winter, this difference was not significant (P>0.05) This result may suggest that there were no changes in the pattern of morbidity which justify a significant increase in the prescription of these drugs in the Winter However, the morbidity epidemiologic data was not collected for comparison Table VI provides a comparison between this study and other studies and reveals that the result for Prescriptions Indicators are similar among the different Brazilian cities, and bar some exceptions, all the studies were in accordance with the WHO's recommendations Our study Getulio Vargas, RS (2009) Farias et al Campina Grande, PB (2005) Brazilian cities, which also showed good results compared with the WHO recommendations and with other health care centers analyzed To adjust the percentage indicator of the prescribed medications with the generic name, prescribers must be aware of this and principally that the medications in the city's essential 179 medications list appear under their generic name in accordance with the NPD, whereas the commercial name is used in current lists These results allow the conclusion that through studies using the Prescription Indicators recommended by the WHO, it is possible to evaluate the conditions of the offered services concerning medications and also to compare and identify differences among regions Thus, it can be asserted that the Prescription Indicators can help the Heath Care Centers to obtain better organization and improve healthcare attention to the public REFERENCES BERNARDI, C.L.B.; BIEBERBACH, E W.; THOME, H.I Avaliacao da Assistencia Farmaceutica Basica nos Municipios de a Abrangencia da 17 Coordenadoria Regional de Saude Rio Grande Sul Saude Soc Sao Paulo, v.15, n.1, p.73-83, 2006 BONTEMPO, V.L.; COELHO, M.C.; CHAVES, J.G.; PEREIRA, L.A.M.; ANDRADE, W.W.; BRACCINI, C.M Analise das prescricoes geradas pelas equipes PSF e das Unidades de Atendimento Imediato, em dois distritos sanitarios municipio de Contagem/MG Bol Pneumol Sanit., v.11, n.2, p.17-24, 2003 BRASIL Portaria n° 3916, de 30 de outubro de 1998 Aprova a Politica Nacional de Medicamentos, cuja integra consta anexo desta Portaria Didrio Oficial da Unido, Brasilia, DF, 10 nov 1998 Available at: < http://e-legis.anvisa.gov br/leisref/public/showAct.php?id=751> Accessed on: 20 May 2009 CARMO, T.A.; FARHAT, F.C.L.G.; ALVES, J.M Indicadores de Prescricoes Medicamentosas: ferramentas para intervencao Saude Rev., v.5, n.11, p.49-55, 2003 CARMO, T.A.; NITRINI, S.M.O.O Prescricoes de medicamentos para gestantes: um estudo farmacoepidemiologico Cad Saude Publica, v.20, n.4, p.1004-1013, 2004 CENTRO BRASILEIRO DE INFORMAQAO SOBRE MEDICAMENTOS (CEBRIM) Promovendo o uso racional dos medicamentos: principais componentes Bol Farmacoterapeutica, v.8, n.1, p.38-43, 2003 COLOMBO, D.; HELENA, E.T.S.; AGOSTINHO, A.C.M.G; DIDJURGEIT, J.S.M.A Padrao de Prescricao de Medicamentos nas Unidades de Programa de Saude da Familia de Blumenau Rev Bras Cienc Farm., v.40, n.4, p.549-558, 2004 COSENDEY M.A.E Andlise da implantagdo Programa Farmdcia Bdsica: um estudo multicentrico em cinco estados Brasil Rio de Janeiro, 2000 366 f [Thesis of PhD 180 degree in Public Health Oswaldo Cruz Foundation/ National School of Public Health] CUNHA, M.C.N.; ZORZATTO, J.R.; CASTRO, L.L.C Avaliacao uso de medicamentos na Rede Publica Municipal de Saude de Campo Grande/MS Rev Bras Cienc Farm., v.38, n.2, p.215-227, 2002 EV, L.S.; GUIMARAES, A.G.; CASTRO, V.S Avaliagao das prescricoes dispensadas em uma Unidade Basica de Saude Municipio de Ouro Preto, Minas Gerais, Brasil Lat Am J Pharm., v.27, n.4, p.543-547, 2008 FARIAS, A.D.; CARDOSO, M.A.A.; MEDEIROS, A.C.D.; BELEM, L.F; SIMOES, M.O.S Indicadores de prescricao medica nas unidades basicas de Saude da Familia no municipio de Campina Grande, PB Rev Bras Epidemiol., v 10, n.2, p.149-156, 2007 FELICIO, N Farmacoepidemiologia da prescrigao e dispensagao de medicamentos na rede publica municipal de saude de Patos de Minas/MG Franca Franca, 2007 117 f [Dissertacao de Mestrado em Promocao de Saude Universidade de Franca] GETULIO VARGAS Geografia Available at: Accessed on: 01 jun 2009 GIROTTO, E.; SILVA, P.V A prescrigao de medicamentos em um municipio Norte Parana Rev Bras Epidemiol., v.9, n.2, p.226-234, jun 2006 MARCONDES, N.S.P A Assistencia Farmaceutica e o uso de medicamentos na zona urbana Municipio de Ponta Grossa Parana: estudo de caso Rio de Janeiro, 2002 170 f [Dissertacao de Mestrado em Saude Publica Universidade Estadual de Ponta Grossa/Fundacao Oswaldo Cruz] NAVES, J.O.S.; SILVER L.D Evaluation of pharmaceutical assistance in public primary care in Brasilia, Brazil Rev Saude Publica, v.39, n.2, p.223-230, 2005 OLIVEIRA, C.A.P.; MARIN, M.J.S.; MARCHIOLI, M.; PIZOLETTO, B.H.M.; SANTOS, R.V Caracterizacao dos medicamentos prescritos aos idosos na Estrategia Saude da Familia Cad Saude Publica, v.25, n.5, p 1007-1016, 2009 SANTOS, V.; NITRINI, S.M.O.O Indicadores uso de medicamentos prescritos e de assistencia ao paciente de servicos de saude Rev Saude Publica, v.38, n.6, p.819826, 2004 rd Received for publication on 03 August 2010 th Accepted for publication on 12 January 2011 Glossary 181 GLOSSARY Abbreviations: (n): noun (v): verb UNIT anti-diabetic drug: thuốc điều trị đái tháo đường aspartame (n): đường hóa học aspartame bacterial infection: nhiễm khuẩn birth control: phương pháp ngừa thai blood thinner: thuốc chống đông máu blood sugar: đường huyết blurred vision: thị lực giảm cephalosporin antibiotic: kháng sinh cephalosporin chewable tablet: thuốc nhai clostridium difficile: vi khuẩn gây bệnh tiêu chảy constipation (n): chứng táo bón cupric-sulfate-type: hợp chất hóa học đồng sulfat dark urine: nước tiểu màu đen diabetic urine testing: xét nghiệm tiểu đường electrolyte imbalance: cân chất điện giải false positive results: phản ứng dương tính giả increased urination: tăng tiểu tiện judge (v): chẩn đoán kidney damage: tổn thương thận medication (n): thuốc missed dose: liều nhỡ mouth (n): dùng đường uống persist (v): dai dẳng 182 (adj.): adjective (adv.): adverb phenylketonuria (n): bệnh phenylketone niệu (bệnh rối loạn di truyền) rifamycin (n): thuốc kháng sinh rifamycin seizure (n): bệnh động kinh (co giật) SIADH - syndrome of inappropriate antidiuretic hormone: hội chứng tiết hormon chống niệu khơng thích hợp stroke (n): đột quỵ thyroid (n): tuyết giáp upset stomach: bao tử khó chịu vaginal fungal infection: nhiễm nấm âm đạo viral infection (e.g., common cold, flu): nhiễm trùng virus cảm thông thường cúm worsen (v): trầm trọng hơn, tệ UNIT adrenal cortex: vỏ thượng thận allergic reaction: phản ứng dị ứng allergy (n): dị ứng amenorrhoea (n): kinh anaphylaxis (n): sốc phản vệ cataract (n): đục thủy tinh thể cream (n): thuốc bôi dạng kem difficulty urinating: tiểu tiện bình thường dissolve (v): tan disturbance of electrolyte: rối loạn nước điện giải drowsiness (n): chống váng dry mouth: khơ miệng epinephrine injector: dụng cụ tiêm thuốc gastrointestinal tract: hệ thống tiêu hóa herbal product: sản phẩm từ dược liệu hive (n): phát ban hyperhidrosis (n): tăng tiết mồ hôi hypokalaemic alkalosis: kiềm huyết giảm kali hypothalamic-pituaitary-adrenal axis: trục đồi-tuyến yên-thượng thận intramuscular injection: tiêm bắp (cơ) itching (n): ngứa manifest (adj): rõ ràng, hiển nhiên menstrual irregularity: rối loạn kinh nguyệt muscle relaxant: thuốc giãn muscle wasting: giảm khối lượng narcotic pain reliever: thuốc trị đau nhức có chứa narcotic neurological disturbance: rối loạn hệ thần kinh ocular (n): thị giác oedema (n): phù, nề ointment (n): thuốc bôi dạng mỡ osteoporosis (n): lỗng xương over-the-counter product: thuốc khơng kê toa papilledema: phù gai thị (phù gai mắt) plasma concentration: nồng độ huyết tương self-treat: tự điều trị skin thinning: teo da spontaneous fracture (n): gãy xương tự phát synthetic corticosteroid: corticode tổng hợp UNIT abdominal pain: đau dày angioedema (n): phù mạch antisychotic (n): loạn tâm thần arthralgia (n): đau khớp bipolar disorder: rối loạn lưỡng cực change in the amount of urine: vấn đề thay đổi lượng nước tiểu constipation (n): táo bón dark urine: nước tiểu màu đen decreased sexual ability: giảm khả tình dục difficulty urinating: tiểu bình thường endoscopically (adv): nội soi enlarged breast: ngực to căng eye/vision change: thay đổi thị lực family history of certain heart problem: tiền sử bệnh tim fast heartbeat: tim đập nhanh flatulence (n): đầy gastric carcinoma: ung thư dày gastric ulcer: loét dày H pylori (Helicobacter pylori): nhiễm trùng vi khuẩn H pylori gây hallucination (n): ảo giác hepatic encephalopathy: bệnh não gan hepatic failure: suy gan inability to produce sperm: không sản xuất tinh trùng liver problem: bệnh gan low levels of calcium in the blood: canxi máu thấp 183 malignancy (n): ác tính mental disorder: rối loạn tâm thần metabolized in the liver: sinh biến đổi gan mood disorder: rối loạn tâm trạng myalgia (n): đau nausea (n): buồn nôn NSAID (non-steroidal antiinflammatory drug): thuốc chống viêm không steroid prolonged hiccup: nấc cục kéo dài proton pump inhibitor: ức chế bơm proton pruritus (n): bệnh ngứa psychiatric medication: thuốc tâm thần retrospective epidemiological: phương pháp hồi cứu dịch tễ học schizophrenia (n): tâm thần phân liệt seizure (n): co giật shakiness (n): run rẩy skin discoloration: da nhợt nhạt somnolence (n): buồn ngủ upset stomach: khó chịu dày vertigo (n): chóng mặt vomit (n): nôn mửa UNIT active ingredient: hoạt chất acute exacerbations of chronic bronchitis: viêm phế mãn tính angina (n): bệnh đau thắt ngực anorexia (n): biếng ăn antianginal agent: thuốc chống đau thắt ngực arrhythmia (n): loạn nhịp tim autonomic nervous system: hệ thần kinh tự trị 184 beta-lactam antibacterial penicillin: kháng sinh nhóm beta-lactam penicillin bioavailability (n): sinh khả dụng blood and lymphatic system disorder: rối loạn hệ máu bạch huyết cardiac muscle: tim cardiac reserve: dự trữ tim thấp constipation (n): táo bón contractile process: trình co mạch contraindication (n): chống định creatinine clearance: độ thải creatinin dihydropyridine calcium antagonist: đối kháng calci thuộc nhóm dihydropyridin excipient (n): tá dược general description: mô tả chung genito-urinary tract infection: nhiễm khuẩn đường niệu-sinh dục geriatric and small frail individual: người già người gầy yếu gut flora: xuất ban dạng sởi haemodialysis: thẩm phân máu hepatic impairment: suy gan hepatobilirary disorder: rối loạn gan mật infection mononucleosis: tăng bạch cầu đơn nhân jaundice/hepatic dysfunction: rối loạn chức gan lower respiratory tract infection: nhiễm khuẩn đường hô hấp myocardial infarction: nhồi máu tim peripheral ischemia: thiếu máu cục ngoại vi potential gastrointestinal intolerance: không dung nạp qua đường tiêu hóa premature (n): trẻ sinh non recurrent tonsillitis: viêm amiđan tái phát renal impairment: suy thận septic abortion: nạo/sẩy thai nhiễm khuẩn smooth muscle: trơn sweat (n): tăng tiết mồ hôi syncope (n): ngất tachycardia (n): tim nhanh therapeutic concentration: nồng độ điều trị upper respiratory tract infection: nhiễm khuẩn đường hô hấp women with pre-term, premature rupture of the foetal membrace (pPROM): phụ nữ sinh non vỡ màng ối sớm therapeutic (adj.): thuộc phép chữa bệnh UNIT calibrate (v): hiệu chuẩn combustible (adj.): dễ cháy consignment (n): hàng hóa ký gửi cross-contamination (n) : nhiễm chéo inadvertent (adj.): thiếu thận trọng interval (n): khoảng thời gian ngắn tách biệt mix-up (n): tình trạng lộn xộn narcotic (n): thuốc làm ảnh hưởng đến tinh thần, ma túy pallet (n): ván nâng hàng pest control: kiểm sốt trùng pharmacopoeia (n): dược điển pressurized (adj.): áp suất cao quarantine (n): tình trạng biệt trữ radioactive (adj.): phóng xạ segregation (n): chia tách, cách li UNIT administrator (n): người quản lý anticipate (v): tiên đoán collaboration (n): hợp tác encompass (v): bao gồm essential (adj.): cần thiết spillage (n): đổ ra, lượng bị đổ vermin (n): sâu bọ, vật kí sinh inevitable (adj.): khơng thể tránh khỏi maintain (v): trì objective (n): mục tiêu pharmacovigilance (n): dược cảnh giác potency (n): hiệu lực potential (adj.): tiềm reaction (n): phản ứng risk (n): nguy cancer chemotherapeutic agents (n phr.): chất hóa học trị liệu ung thư congestive heart failure (n phr.): suy tim sung huyết covenantal (adj.): giao ước diabetes mellitus (n phr.): đái tháo đường dissemination (n): gieo rắt, phổ UNIT anticoagulant (n): thuốc chống đông asthma (n): hen suyễn biến hypertention (n): tăng huyết áp 185 immunization (n): tạo miễn dịch, chủng ngừa parenteral narcotics (n phr.): ma túy tiêm physiologically compromised (n phr.): nguy hiểm tiềm tàng theo sinh lý proactive (adj.): chủ động giải khó khăn dự trù procurement (n): thu mua respiratory failure (n): suy hô hấp smoking cessation (n): cai nghiện thuốc vulnerable (adj.): dễ bị tổn thương UNIT accessible (adj.): dễ sử dụng/tiếp cận accountability (n): trách nhiệm adhere (v): tuân theo commitment (n): cam kết diminish (v): giảm bớt encourage (v): khuyến khích imperative (adj.): bắt buộc innovative (adj.): có tính sáng kiến monitor (v): giám sát participation (n): tham gia proclaim (v): công bố professional (adj.): chuyên nghiệp provision (n): điều khoản responsibility (n): trách nhiệm responsible (adj.): có trách nhiệm select (v): chọn lọc sustainable (adj.): bền vững UNIT abdominal (adj.): thuộc bụng abortion (n): phá thai 186 abstinence (n): kiêng nhịn acupuncture (n): châm cứu acute disease (n): bệnh cấp acute respiratory illness (n): bệnh hơ hấp cấp tính agitation (n): xáo trộn alleviate (n): làm dịu, làm giảm amplify (v): mở rộng antenatal (adj.): trước sinh antidepressant (n): thuốc chống trầm cảm appetite (n): thèm ăn asthma (n): hen suyễn attenuatea (v): làm yếu bladder (n): bàng quang bleed (v): chảy máu cavitary leision (n): thương tổn khoang cervix (n): cổ tử cung cessation (n): việc ngừng chemotherapy (n): phép chữa hoá học chimeric vaccine (n): vac-xin khác mơ chronic disease (n): bệnh mạn tính circulation (n): lưu thông cirrhosis (n): bệnh xơ gan cognitive (n): nhận thức coil (n): mạch coil consequence (n): hậu constipation (n): táo bón contraception (n): tránh thai convulsion (n): rối loạn, biến động coronary heart disease (n): bệnh tim mạch vành craving (n): thèm muốn cue (n): gợi ý culture (n): cấy vi khuẩn dengue (n): bệnh đăng-gơ diagnose (v): chẩn đoán diptheria (n): bệnh bạch hầu disorientation (n): phương hướng disparity (n): chênh lệch, cách biệt dyspnea (n): khó thở encephalitis (n): viêm não endimicity (n): tính địa phương epidemic (n): bệnh dịch esophagus (n): thực quản excess (n): mức exposure (n): tiếp xúc, phơi bày flatulence (n): đầy fluid (n): chất lỏng hepatitis (n): viêm gan hygiene (a,n): vệ sinh immunize: gây miễn dịch impact (n): ảnh hưởng incubation (n): ủ bệnh inequity (n): tính khơng cơng influenza (n): bệnh cúm insecticide (n): thuốc trừ sâu insomnia (n): chứng ngủ intern (v): giam giữ intervention (n): can thiệp irritability (n): tính cáu kỉnh irritation (n): sưng tấy malaria (n): bệnh sốt rét maternal (adj.): thuộc mẹ, phía mẹ menstrual (n): kinh nguyệt midwife (n): bà đỡ, bà mụ miscarriage (n): sẩy thai monovalent (n): đơn trị mortality (n): tỉ lệ/số người tử vong mucosal (adj.): thuộc niêm mạc neurologic (adj.): thuộc thần kinh neurotransmitter (n): chất dẫn truyền thần kinh onset (n): xâm nhập over the counter: không kê đơn pancreas (n): tuyến tụy paralysis (n): chứng liệt percutaneous (n): da pertussis (n): chứng ho lâu ngày pharmacological (n): dược lý prevalence (n): lây lan primary care (n): chăm sóc ban đầu prioritize (v): ưu tiên propagate (v): sinh sôi nảy nở psychiatric (adj.): thuộc bệnh tâm/tinh thần rash (v): phát ban receptor (n): thụ thể recombinant (n): gien tái kết hợp relapse (v): tái phạm, tái phát repellent (n): thuốc làm giảm sưng respiratory (n): hô hấp saliva (n): nước bọt seizure (n): tai biến seminal (n): tinh dịch sequalae (n): dị chứng, dị tật seropositive (n): huyết dương tính serum (n): huyết sewer (n): cống solvement (n): dung môi spastic (n): co cứng sputum (n): đờm stay hydrated: giữ nước stigma (n): vết nhơ stroke (n, v): đột quỵ substance (n): chất sudden infant death syndrome: hội chứng đột tử trẻ em surveillance (n): giám sát, theo dõi 187 sustained release tablet: viên phóng thích kéo dài symptom (n): triệu chứng syndrome (n): hội chứng taper (v): dần ngừng lại, giảm dần tetanus (n): bệnh uốn ván toxic (n, a): độc transfusion (n): truyền máu transplantation (n): cấy ghép vaporizer (n): bình phun veginal (adj.): thuộc âm đạo vertebrate (n): động vật có xương sống vinegar (n): dấm viral (adj.):thuộc vi-rút UNIT 10 adhere to: tôn trọng, tuân theo authorize (v): uỷ quyền Chamber of Commerce: Phòng Thương Mại Consignee (n): người mua discrepancy (n): không quán dispute (n, v): tranh cãi party (n): bên remit (v): miễn giảm UNIT 11 academia (n): giới hàn lâm ample: nhiều phong phú ampoule (n): ống thuốc tiêm analgesics (n): thuốc giảm đau anaphylactic (adj.): mẫn cảm animistic (adj.): thuộc thuyết linh antibiotic (n): thuốc kháng sinh antihistamine (n): thuốc kháng histamin morbidity (n): hoành hành bệnh tật 188 anti-inflammatory (n): thuốc kháng viêm approachability (n): tính đến gần ascertain (v): làm sáng tỏ asthma (n): bệnh hen suyễn attire (n): trang phục bureaucratic (adj.): quan liêu composite (n): hợp chất contamination (n): nhiễm bẩn contraceptive (n): thuốc ngừa thai deficiency (n): thiếu hụt demographics (n): nhân học deter (v): ngăn cản diabete (n): bệnh đái đường diploma (n): chứng dispenser (n): người phân phối/bào chế thuốc theo đơn dissemination (n): phổ biến dress code (n): quy định trang phục druggist (n): dược sĩ elucidate (v): làm sáng tỏ emulsion: nhủ tương enclave (n): vùng đất lọt đất nước khác epidemiology (n): dịch tễ học garner (v): thu hurdle (n): rào cản, chướng ngại infant (n): trẻ sơ sinh informant (n): người cung cấp tin injectable (n): thuốc dạng tiêm integrity (n): tính tồn vẹn inventory (n): kiểm kê latex glove: găng tay y tế leprosy (n): bệnh hủi malnourished (n): bị suy dinh dưỡng militia (n): dân quân mortar (n): cối giã narcotic (n): thuốc mê obstetrician (n): bác sĩ khoa sản ointment (n): thuốc mỡ optimal (adj.): tối ưu otoscope (n): ống soi tai outpatient (n): người bệnh ngoại trú pathology (n): bệnh lý pestle (n): chày polymedication (n): việc sử dụng nhiều loại thuốc đặc trị predominantly (adv.): phần lớn presciber (n): người kê đơn prescription (n): đơn thuốc prevailing (adj.): thịnh hành, phổ biến proactive (adj.): tiên phong thưc referendum (n): cuôc trưng cầu dân ý respiratory (adj.): thuộc hô hấp reversion (n): quyền thu hồi sampling unit (n): đơn vị mẫu societal (adj.): thuộc xã hội stethoscopoe (n): tai nghe surmise (v): đoán syringe (n): ống tiêm tender (v): bỏ thầu terminology (n): thuật ngữ therapeutic (adj.): thuộc phép chữa bệnh traumatic (n): chấn thương unmet (n): không thoả mãn unsustainable (adj.): chống đỡ, biện hộ ventilate (v): thơng gió 189 REFERENCES [1] Bruton, L L., Chabner, B A., & Knollmann, B C (2011) Goodman and Gilman’s the Pharmacological Basics of Therapeutics (12th ed.) The McGraw-Hill Companies, Inc [2] McCarter, S (2012) Medicine (Vol 1) New York: Oxford University Press [3] Sweetman, S C (2009) Martindale: The Complete Drug Reference (36th ed.) Pharmaceutical Press [4] http://www.ahfsdruginformation.com [5] http://www.ajpcr.com [6] http://www.ncbi.nlm.nih.gov [7] http://www.ncbi.nlm.nih.gov/pubmed [8] http://www.pharmacypractice.org [9] http://www.who.int 190 ... too rapidly may cause cardiovascular collapse Hypersensitivity reactions have occurred with corticosteroids, mainly when applied topically Adverse effects occur, in general, fairly equally with... steeply if dosage increases much above physiological values, traditionally considered to be about 7.5 mg daily of prednisolone or its equivalent (see Uses and Administration, below, for equivalent... orally once daily, adjusted as required The majority of patients are effectively controlled by doses in the range 20 to 120 mg daily, but doses up to 120 mg three times daily have been used Daily

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