Neutral Protamine Hagedorn insulin prescription's in Primary Health Care, Santa Clara Municipality, 2023

Authors

  • Eliezer Alemán-Fernández Universidad de Ciencias Médicas. Facultad de Tecnología de la Salud. Farmacia Principal Municipal de Santa Clara. Villa Clara, Cuba. https://orcid.org/0000-0002-6507-1761

Abstract

Introduction: Diabetes is a disease of a chronic nature which occurs when the body loses its ability to produce the insulin needed to use it effectively. Type 1 diabetes mellitus is characterized by destruction of pancreatic beta cells in genetically predisposed individuals and the consequent deficiency in insulin production while type 2 diabetes mellitus results from the combination of insulin resistance along with inadequate secretion of it. In both cases, the insulin medication is used to ensure control of the disease.
Objective:
To characterize the prescription profile of Neutral Protamine Hagedorn insulin vial in Santa Clara Community Pharmacy.
Methods:
An observational, retrospective, descriptive and cross-sectional investigation was conducted that corresponded with a medications use study, of prescription-indication type of the medication Neutral Protamine Hagedorn insulin vial in September 2023. The universe was 852 patients and the sample was 26 patients with NPH insulin vial prescription, the sampling was simple random and the results were presented in tables using absolute numbers and percentages. The principle of confidentiality of the reviewed information and certificates for controlled medications was respected.
Results:
The female sex predominated (76.92 %), older than 50 years (84.62 %), arterial hypertension as a comorbidity (76.92 %), 4 or more medications (61.54 %) and the combination with glibenclamide, metformin, enalapril, captopril, carvedilol, acetylsalicylic acid, hydrochlorothiazide and levothyroxine sodium were the most clinically important drug interactions.
Conclusions: The prevalence in the prescription of Neutral Protamine Hagedorn insulin vial is similar to that found in some previous studies, being more representative from the 5th decade of life and more frequent in the female sex.

DeCS: INSULIN, ISOPHANE; DIABETES MELLITUS; DRUG PRESCRIPTIONS; DRUGS OF SPECIAL CONTROL; PRIMARY HEALTH CARE.

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Author Biography

Eliezer Alemán-Fernández, Universidad de Ciencias Médicas. Facultad de Tecnología de la Salud. Farmacia Principal Municipal de Santa Clara. Villa Clara, Cuba.

Especialista Comercial Farmacia Principal Municipal de Santa Clara

References

1. Organización Mundial de la Salud [Internet]. Ginebra: OMS; 2023 [citado 01 Ago 2023]. Diabetes, datos y cifras. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/diabetes

2. Mancusi C, Izzo R, di Gioia G, Losi MA, Barbato E, Morisco C. Insulin resistance the hinge between hypertension and type 2 diabetes. High Blood Press Cardiovasc Prev [Internet]. 2020 [citado 21 Ago 2023];27(6):515-26. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/32964344

3. Barber TM, Kyrou I, Randeva HS, Weickert MO. Mechanisms of insulin resistance at the crossroad of obesity with associated metabolic abnormalities and cognitive dysfunction. Int J Mol Sci [Internet]. 2021 [citado 22 Ago 2023];22(2):546-61. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/33430419

4. Beck JK, Cogen FR. Outpatient Management of Pediatric Type 1 Diabetes. The Journal of Pediatric Pharmacology and Therapeutics [Internet]. 2015 [citado 01 Ago 2023];20(5):344-57. Disponible en: https://www.jppt.org/doi/abs/10.5863/1551-6776-20.5.344

5. Hasanbegovic S, Obarcanin E, Hasanbegovic E, Begic N. Impact of Insulin Delivery Method on Hypoglycemia Incidence in Pediatric Type 1 Diabetes Mellitus Patients. Med Arch [Internet]. 2017 [citado 19 Ago 2023];71(6):391-5. Disponible en: https://doi.org/10.5455/medarh.2017.71.391-395

6. Rodríguez EG, Michahelles C. Análogos de insulina de acción prolongada versus insulina NPH en diabetes mellitus. Rev Soc Peru Med Interna [Internet]. 2018 [citado 01 Sep 2023];31(3):104-9. Disponible en: http://www.revistamedicinainterna.net/index.php/spmi/article/view/25/24

7. World Health Organization. Model List of Essential Medicines-22nd List [Internet]. Geneva: WHO; 2021 [citado 15 Sep 2023]. Disponible en: https://iris.who.int/bitstream/handle/10665/345533/WHO-MHP-HPS-EML-2021.02-eng.pdf

8. Ministerio de Salud Pública. Formulario Nacional de Medicamentos [Internet]. La Habana: Ecimed; 2018 [citado 10 Sep 2023]. Disponible en: https://instituciones.sld.cu/hospmiguelenriquez/files/2018/01/Formulario-nacional-de-medicamentos.pdf

9. Jimenez Montero JG, Villegas Barakat M, Carvajal Solórzano ML. Conceptos Actuales de la Terapia Con Insulina. Revista Ciencia Y Salud [Internet]. 2022 [citado 20 Ago 2023];6(3):65-78. Disponible en: https:// doi.org/10.34192/ cienciaysalud.v6i3.416

10. American Diabetes Association. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standard of Medical Care in Diabetes-2020. Diabetes Care [Internet]. 2020 [citado 04 Ago 2023];43(Suppl 1):S37-S47. Disponible en: https://diabetesjournals.org/care/article/43/Supplement_1/S37/30855/4-Comprehensive-Medical-Evaluation-and-Assessment

11. Garber AJ, Handelsman Y, Grunberger G, Einhorn D, Abrahamson MJ, Barzilay JI, et al. Declaración de consenso de la Asociación Americana de Endocrinólogos Clínicos y el Colegio Americano de Endocrinología sobre el algoritmo integral de manejo de la Diabetes tipo 2– Resumen Ejecutivo 2020. Práctica Endocr [Internet]. 2020 [citado 04 Ago 2023];26(1):107-39. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32022600/

12. American Diabetes Association. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2021. Diabetes Care [Internet]. 2021 [citado 17 Ago 2023];44(Suppl 1):S111-S124. Disponible en: https://diabetesjournals.org/care/article/44/Supplement_1/S111/31020/9-Pharmacologic-Approaches-to-Glycemic-Treatment

13. Asenjo-Alarcón J. Polifarmacia en pacientes con diabetes tipo 2 e hipertensión arterial atendidos en un hospital provincial. Revista Finlay [Internet]. 2022 [citado 09 Sep 2023];12(4):[aprox. 6 p.]. Disponible en: https://revfinlay.sld.cu/index.php/finlay/article/view/1203

14. Cruz-Aranda JE. Manejo de la hipertensión arterial en el adulto mayor. Med Int Méx [Internet]. 2019 [citado 14 Ago 2023];35(4):515-24. Disponible en: https://www.scielo.org.mx/pdf/mim/v35n4/0186-4866-mim-35-04-515.pdf

15. Álpizar Cortes JE, Angeles Lozano KL, Ávila Ballesteros D, Luna Calva LL, Torres Cano WD, Olvera Hernández EG, et al. Identificación de interacciones medicamentosas potenciales en pacientes geriátricos. JONNPR [Internet]. 2020 [citado 16 Ago 2023];5(9):998-1009. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S2529-850X2020000900998

16. Alwhaibi M. Potentially Inappropriate Medications Use among Older Adults with Comorbid Diabetes and Hypertension in an Ambulatory Care Setting. J Diabetes Res [Internet]. 2022 [citado 26 Ago 2023];15(9):1511. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35586116/

17. Hughes CM. One size fits all? How to optimize the prescribing of appropriate polypharmacy in chronic diseases, using a behavioral approach – a United Kingdom perspective. Expert Rev Clin Pharmacol [Internet]. 2022 [citado 16 Ago 2023];15(5):497-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35762041/

18. Remelli F, Ceresini MG, Trevisan C, Noale M, Volpato S. Prevalence and impact of polypharmacy in older patients with type 2 diabetes. Aging Clin Exp Res [Internet]. 2022 [citado 22 Ago 2023];34(9):1969-83. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35723858/

19. Ascar GI, Hespe CB, Hernández MM. Relación entre polifarmacia y número de médicos consultados por pacientes ancianos. Revista cuba farm [Internet]. 2015 [citado 04 Ago 2023];49(3):491-501. Disponible en: http://www.medigraphic.com/cgibin/new/resumen.cgi?IDARTICULO=65733

20. Abbas A, Al-Shaibi S, Sankaralingam S, Awaisu A, Kattezhathu VS, Wongwiwatthananukit S, et al. Determination of potential drug–drug interactions in prescription orders dispensed in a community pharmacy setting using Micromedex® and Lexicomp®: a retrospective observational study. Int J Clin Pharm [Internet]. 2022 [citado 04 Ago 2023];44(2):348-56. Disponible en: https://link.springer.com/article/10.1007/s11096-021-01346-8

21. Arroyo-Gámez FA, Heyerdahl-Viau I, Pérez-Sánchez R, Prado-Galbarro FJ, Sánchez-Herrera K, Martínez-Núñez JM. Potenciales interacciones medicamentosas en un centro de salud público de México. Rev cuba farm [Internet]. 2023 [citado 04 Ago 2023];56(2):e892. Disponible en: https://revfarmacia.sld.cu/index.php/far/article/view/892

22. Saturno-Hernández PJ, Poblano-Verástegui O, Acosta-Ruiz O, Bautista-Morales AC, Gómez-Cortez PM, Alcántara-Zamora JL, et al. Prescripción potencialmente inapropiada en adultos mayores en México. Rev Saude Pública [Internet]. 2021 [citado 04 Ago 2023];55(80):1-12. Disponible en: https://www.revistas.usp.br/rsp/article/view/193668

23. Utami PR, Octavia DR. Study of potencial interactions of oral antidiabetic drugs in patients with type 2 diabetes mellitus with comorbidities: A retrospective study. Pharmacy Education [Internet]. 2022 [citado 04 Ago 2023];22(2):200-6. Disponible en: https://doi.org/10.46542/pe.2022.222.200206

24. May M, Schindler Ch. Clinically and pharmacologically relevant interactions of antidiabetic drugs. Ther Adv Endocrinol Metab [Internet]. 2016 [citado 04 Ago 2023];7(2):69-83. Disponible en: https://journals.Sagepub.com/doi/abs/10.1177/2042018816638050

25. Zuñiga A, Vera Franco V, Bucaram J, González J, Cáceres L. Antidiabéticos orales y su interacción con medicamentos modificadores de enfermedad. Rev virtual Soc Parag Med Int [Internet]. 2020 [citado 26 Ago 2023];7(1):107-11. Disponible en: https://doi.org/10.18004/rvspmi/2312-3893/2020.07.01.107-111

26. Biondi B, Kahaly GJ, Robertson RP. Thyroid Dysfunction and Diabetes Mellitus: two closely associated disorders. Endocr Rev [Internet]. 2019 [citado 06 Ago 2023];40(3):789. Disponible en: https://www.ncbi.nlm.nih.gov./pmc/articles/PMC6507635/

Published

2024-02-06

How to Cite

1.
Alemán-Fernández E. Neutral Protamine Hagedorn insulin prescription’s in Primary Health Care, Santa Clara Municipality, 2023. Arch méd Camagüey [Internet]. 2024 Feb. 6 [cited 2025 Sep. 11];28:e9890. Available from: https://revistaamc.sld.cu/index.php/amc/article/view/9890

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Original Articles