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МЕДИЦИНА И ЗДОРОВЬЕ
UDC 616-05/051: 577.16.04 + 616-035
Moroz V.A., D.Sci.Med, professor Department of Clinical Pharmacology and Clinical Pharmacy
National Pharmaceutical University
Ukraine, Kharkiv THE PROBLEMS OF CHOICE A PARTICULAR VITAMIN PREPARATION IN THE PHARMACY
С целью оценки рациональности подбора витаминных препаратов в условиях аптеки проанализирована структура приобретения их пероральных форм (простые и комбинированные) 106-тью посетителями одной из городских аптек. Нерациональный подбор определенного препарата выявлен в 32,1% случаев (длительный прием жирорастворимых витаминов, использование повышенных доз аскорбиновой кислоты при патологии вен конечностей, сахарном диабете, а также при беременности и кормлении грудью, бесконтрольное применение витамина D пожилыми и проч.). Повышение рациональности приема витаминов требует более тщательного подбора их дозировки и сроков использования. Ключевую позицию занимает информирование пациентов фармацевтом аптеки при проведении фармацевтической опеки.
Ключевые слова: гиповитаминоз, витаминные препараты, эргокальциферол, ретинол.
In order to assess the rationality of vitamin preparations choice in a pharmacy analyzed the structure of purchase of its oral forms (simple and combined) one hundred and six visitors one of the city pharmacy. Irrational selection of a particular drug was detected in 32.1% of cases (prolonged intake of fat-soluble vitamins, the use of high doses of ascorbic acid at pathology of veins of the extremities, at diabetes mellitus, as well as during pregnancy and lactation, uncontrolled use of vitamin D at elderly, etc.). Increasing the intake of vitamins rationality requires a careful selection of the dosage and timing of use. The key position is to informing the pharmacist of patients during pharmaceutical care.
Keywords: vitamin deficiencies, vitamin preparations, ergocalciferol, retinol.
Statistics show that 12-56% of population of developed countries have the multi-vitamin deficiency, leading to a decrease in resistance to viral and bacterial agents increase the risk of various diseases, and one-third of the world's population is marked the so-called "hidden vitamin deficiencies". This is the basis for a significant amount of consumption of pharmaceutical vitamin preparations, which in recent years, retains a strong position in the price and quantitative terms [1-3].
At the same time, it should be remembered that vitamins in some cases are unsafe drugs that can cause a number of side effects [3, 4]. Since they all belong to the group of non-prescription drugs, special role to ensure their safety and rational
reception given to the pharmacist. Competent receiving correction of vitamin preparations with regard to age, comorbidities, and patient conditions is an important task during high-quality pharmaceutical care. The aim of our study was to investigate the clinical and pharmaceutical aspects of the choice of vitamin preparations pharmacy visitors, followed by the development of recommendations to improve its rationality.
Material and Methods: Conducted a survey of 107 visitors to city pharmacy who purchased vitamin preparations (oral dosage form) for themselves. In the questionnaire items were identified passport details, purchase motivations, disease or condition that requires the vitamins, awareness regarding dosage and side effects of vitamins, presence of comorbidities and some others.
Results and discussion: Among acquired preparations nearly half (45.3%) was multivitamins various compositions with different dosage ingredients with mineral supplements and without them.
Retinol (vitamin A) have bought nine visitors. The two of them had chronic pyelonephritis, and elderly patients had recently (3 months ago) myocardial infarction. In all these cases retinol is contraindicated to receive. Another patient took the vitamin for the second month, which wasted due to retinol accumulation and increased risk of side effects. Retinol also acquired three women of childbearing age who, based on the questionnaire, had not been informed about the teratogenicity of vitamin A [3, 5].
Ascorbic acid (vitamin C) has acquired 31 visitor. Among them were 16 women of childbearing age, and four were in various stages of pregnancy. Two of them had intended take ascorbic acid thrice a day on 500 mg that exceeds the permissible daily dose of 1 g and may adversely affect fetal development. Another nine people buy vitamin C not only for themselves but also for children. In the two cases were acquired chewable tablets of 500 mg that is clearly higher than the recommended dose for children. Another five people suffer from diabetes mellitus. At the same time, two of them believed that ascorbic acid has a hypoglycemic effect and take it to the higher doses. This right could lead to a breach of the degree of disease compensation. Six respondents had varicose veins with thrombophlebitis. Three of them are had intended continue already begun receiving ascorbic acid in increased dose that significantly raised the risk of thrombophlebitis exacerbation. Four more patients had a history of symptoms of kidney stones, and two of them would like to buy vitamin C with high dose, the use of which may have contributed to formation of stones [4, 6].
Ergocalciferol (vitamin D) purchased at the pharmacy 11 people, five of whom were older than 65 years. In the latter case, the vitamin D is not recommended due to increased calcium deposition in arterial walls. Another two patients with a history of urolithiasis the drug contributed to her relapse. Three of the respondents have a history of duodenal ulcer, which also pointed to the need to restrict its use. Two more visitor ergocalciferol took more than one month, increasing the risk dangerous degree of hypervitaminosis [1, 7]. Seven pharmacy visitors buy tocopherol (vitamin E). Three of them had severe cardiovascular
disease (arterial hypertension, chronic heart failure), exacerbation of which could be caused by the vitamin usage. One of these patients also took medication more than one month, increasing the likelihood of adverse effects [4, 8].
Forty-eight people were buying multivitamins. Acquired products 23 titles with different dosage, however, a low dose of vitamins, composing them, provide a better level of patient safety. At the same time in six cases (12.5%), duration of administration was more than one month. This has contributed to the accumulation of vitamins A, E, D and K, which may cause number side effects.
The study of acquisition motives of vitamin preparations showed that the core group of 47 people (44.3%) were persons who assign vitamins themselves. Nineteen (17.9%) - on advertising in the media, and another 28 (26.4%) - on the advice of persons without medical education (relatives, friends, neighbors, colleagues, etc.). Only 12 (11.3%) have bought the drug based on the principle of rationality. Usually in this case medical professional within existing co-morbidities and information about possible side effects recommended the preparation. Thus, the overall awareness of patients on vitamin preparations wore superficial that determines to large number of cases random selection of particular preparation. In general, the irrational use of vitamins mainly refers to the monopreparations (vitamin A - 44.4%, vitamin C - 38.7%, vitamin D - 45.4%, vitamin E - 42.8%) and to a lesser extent to the multivitamin where this rate was 16.7%.
Conclusions: 1) The structure of vitamin preparations, acquired in an average city pharmacy, 54.7% were monocomponent preparations, and 45.3% - a multivitamin. 2) Irrational use of vitamins found in 32.1% of cases. For multivitamins, it was 16.7%. Choice of vitamin preparations on basis of sufficient information installed in 11.3% of cases. About their possible side effects have information only 8.7% of patients. 3) The most important to improve the rational use of vitamins appears to inform about the peculiarities of their use pharmacist based on rigorous implementation of pharmaceutical care.
References:
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УДК 613.65
Ляшенко А.А. старший преподаватель кафедра физической культуры Наквасина С.Н. студент 3 курса факультет клинической психологии Оренбургский государственный медицинский университет
Россия, г. Оренбург ЗНАЧЕНИЕ ДВИГАТЕЛЬНОЙ АКТИВНОСТИ ДЛЯ ОРГАНИЗМА И УНИВЕРСАЛЬНЫЕ СПОСОБЫ ЕЕ ОБЕСПЕЧЕНИЯ Аннотация. Статья посвящена проблеме двигательной активности организма. Обоснованы предпочтительные способы ее обеспечения с учетом состояния здоровья. Даны рекомендации по организации двигательной активности.
Ключевые слова: двигательная активность, легкая атлетика, ходьба, бег, плавание.
Lyashenko A.A.
Senior Lecturer of Department of physical education
Orenburg state medical university Russia, Orenburg Nakvasina S.N. student
3rd course, faculty of clinical psychology Orenburg state medical university Russia, Orenburg
THE IMPORTANCE OF PHYSICAL ACTIVITY FOR ORGANISM AND UNIVERSAL WAYS OF ITS ENSURE
Abstract. The article is dedicated to the problem of organism physical activity. Explain the preferable ways of its ensure, taking into consideration health status. Giving recommendations how to organize physical activity.
Keywords: physical activity, Athletics, walk, course, swimming.
