Interactions between drugs and drug-nutrient in enteral nutrition: a review based on evidences

Introduction: Enteral nutrition (EN) provides calories, macronutrients and micronutrients in adequate quantity and quality to meet the patient's needs. Some drugs when crushed and diluted may have their properties altered, including the reduction of bioavailability causing the reduction of the serum concentration of the drug; tube obstruction; drug-drug interaction or drug-nutrient interaction. Methods: The study was conducted through review of submitted articles in the databases of the Virtual Health Library (VHL): MEDLINE (National Library of Medicine, USA), Lilacs (Latin American and Caribbean Literature on Health Sciences) PUBMED - NCBI (National Center for Biotechnology Information) and COCHRANE. Results: For this survey, 42 articles were identified during database searching. After applying the inclusion and exclusion criteria, 08 articles were selected, obtained from the MEDLINE and Lilacs. Discussion: Some interactions were found such as the aluminium hydroxide and lactulose with the enteral nutrition, which may result in a precipitation and reduction of drug bioavailability. Mineral oil will alter the absorption of fat-soluble vitamins and reduces the tube light. Others results were found as phenytoin, warfarin, captopril and furosemide with enteral nutrition may reduce the maximum serum concentration. Conclusion: Drug interactions are more common in day-to-day activities than health professionals may suppose. Knowledge on the matter may also assist in reducing cases of obstruction of tubes, through which enteral nutrition and medications are administered. Thus, the multidisciplinary team, acting together, may have more beneficial effects to the patient.

Inclusion of salt form on prescription medication labeling as a source of patient confusion: a pilot study

Background: It has been estimated that 10,000 patient injuries occur in the US annually due to confusion involving drug names. An unexplored source of patient misunderstandings may be medication salt forms. Objective: The objective of this study was to assess patient knowledge and comprehension regarding the salt forms of medications as a potential source of medication errors. Methods: A 12 item questionnaire which assessed patient knowledge of medication names on prescription labels was administered to a convenience sample of patients presenting to a family practice clinic. Descriptive statistics were calculated and multivariate analyses were performed. Results: There were 308 responses. Overall, 41% of patients agreed they find their medication names confusing. Participants correctly answered to salt form questions between 12.1% and 56.9% of the time. Taking more prescription medications and higher education level were positively associated with providing more correct answers to 3 medication salt form knowledge questions, while age was negatively associated. Conclusions: Patient misconceptions about medication salt forms are common. These findings support recommendations to standardize the inclusion or exclusion of salt forms. Increasing patient education is another possible approach to reducing confusion.

Validity and reliability of the Cyber-aggression Questionnaire for Adolescents (CYBA)

Cybercrime is a growing and worrisome problem, particularly when it involves minors. Cyber-aggression among adolescents in particular can result in negative legal and psychological consequences for people involved. Therefore, it is important to have instruments to detect these incidents early and understand the problem to propose effective measures for prevention and treatment. This paper aims to design a new self-report, the Cyber-Aggression Questionnaire for Adolescents (CYBA), to evaluate the extent to which the respondent conducts aggressions through a mobile phone or the internet and analyse the factorial and criterion validity and reliability of their scores in a sample of adolescents from Asturias, Spain. The CYBA was administered to 3,148 youth aged between 12 and 18 years old along with three self-reports to measure aggression at school, impulsivity, and empathy. Regarding factorial validity, the model that best represents the structure of the CYBA consists of three factors (Impersonation, Visual-sexual Cyber-aggression, and Verbal Cyber-aggression and Exclusion) and four additional indicators of Visual Cyber-aggression-Teasing/Happy Slapping. Regarding criterion validity, the score on the CYBA correlates positively with aggression at school and impulsivity and negatively with empathy. That is the way cyber-aggression correlates with these three variables, according to previous empirical evidence. The reliability of the scores on each item and factor of the CYBA are adequate. Therefore, the CYBA offers a valid and reliable measure of cyber-aggression in adolescents.