Facultad de Ciencias Químicas-Tesis Maestrías

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Browsing Facultad de Ciencias Químicas-Tesis Maestrías by Author "Peñaherrera Wilches, María Eugenia"

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    Eficacia y seguridad de terapia triple de furoato de fluticasona, vilanterol, umeclidinio (Trelegy ellipta®) frente a otras terapias en el tratamiento de la enfermedad obstructiva crónica: revisión sistemática y metanálisis
    (Universidad de Cuenca, 2022-10-21) Zea Izquierdo, Daniela Salomé; Teixeira Leite Lourenço Da Silva, Paulo Roberto; Peñaherrera Wilches, María Eugenia
    Introduction: Trelegy ellipta® is a drug indicated for maintenance treatment in adult patients with moderate to severe chronic obstructive pulmonary disease (COPD). This medicine is composed of fluticasone furoate, umeclidinium, and vilanterol (FF/UMEC/VI) in a dose of 100 μg/62.5 μg/25 μg, respectively. The objective of this investigation was to demonstrate, by reviewing the scientific evidence, whether triple therapy is more effective and safer than different dual therapies in patients with COPD. Methodology: A systematic review was carried out following the PRISMA statement. The PubMed and Cochrane Library databases were consulted, considering all the articles available up to March 30, 2022 and taking into account the application of the inclusion and exclusion criteria. The variables chosen to measure the efficacy of the treatments were: the change in forced expiratory volume in the first second (FEV1) and values in the Saint George Respiratory Questionnaire (SGRQ). The safety of the treatments was evaluated by the number of adverse reactions grouped into cardiac disorders, infections, respiratory disorders, and nasopharyngitis. The retrieved papers were assessed for methodological quality and risk of bias in the studies. For the statistical analysis, the statistical package SIMFIT (v.7.2.7 University of Manchester) and the Review Manager (RevMan) systematic review program (v.5.4.1 Cochrane) were used. The heterogeneity of the studies to be compared was analyzed using the I2 and Q statistical tests. The fixed effects methodology was applied to the homogeneous studies and the random effects methodology to the heterogeneous studies. Results: Four studies were included in the analysis that found a significant improvement (p<0.05) in FEV1 (Forced expiratory volume in one second) in subjects treated with triple FF/UMEC/VI therapy compared to dual treatments. of Fluticasone Furoate/Vilanterol (FF/VI), Budesonide/Formoterol (BUD/FOR) and Budesonidad/Formoterol with Tiotropium (BUD/FOR + TIO). No difference was observed between triple therapy with a single inhaler and triple therapy with two inhalers. The changes in the value of the SGRQ showed a greater decrease in favor of the triple treatment compared to the other treatments. Regarding safety, triple treatment only presented significantly more adverse effects in cardiac disorders compared to treatment with FF/VI and in infections compared to treatment UMEC/VI. In the other cases, it was found that there are no significant differences in the triple treatment in terms of the aforementioned adverse reactions. Conclusion: The FF/UMEC/VI triple treatment presents greater efficacy and equal safety, with the exception of cardiac disorders and infections than the other dual treatments used in COPD. However, more clinical trials are required to assess the efficacy and safety of COPD treatment with triple therapy versus dual therapy
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    Evaluación de la actividad antioxidante y antiinflamatoria del extracto de Desmodium molliculum
    (Universidad de Cuenca, 2023-03-01) Sarmiento Pacurucu, Josué; Peñaherrera Wilches, María Eugenia
    Desmodium molliculum, in Ecuador, “Hierba del infante”, is an Andean plant traditionally used to treat inflammatory processes. This study was established to investigate the antioxidant activity of its extrats using the in vitro techniques: Folin-Ciocalteu, ABTS, DPPH and FRAP, the anti-inflammatory activity in vivo using the croton oil-induced ear edema assay and the granuloma induced by cotton pellet assay, the toxicity in the Artemia salina model and molecular characterization of D. molliculum and D. adscendens with the barcodes: trnH-psbA, rbcL, matK, ITS1 and ITS2. There was no significant difference (p < 0.05) between the polyphenol content of the crude extract of D. molliculum (DMC) and the defatted extract (DMD) (30.1 ± 1.1 mg AG/g dry plant). Both extracts contained caffeic acid according to the TLC. DMD showed the highest antioxidant activity in the ABTS (1.16 ± 0.001 mg TE/mg) and FRAP (0.39 ± 0.01 mg TE/mg) assays and D. adscendens showed the lower activity. Of all the extracts, DMD (250 mg/kg) had the highest percentage of inhibition (34.5 ± 6.3%) in the ear edema assay, and repeated administration (6 days) of the same inhibited 35.43 ± 6.9% of inflammation by cotton pellet, and was not different (p < 0.05) from dexamethasone (36.77 ± 5.9%). DMD was shown to be nontoxic (LC50= 5980.39 µg/mL) in the Artemia salina model. The defatted extract had the highest antioxidant and anti-inflammatory activity among the extracts tested, possibly because it had a less complex matrix that facilitated polyphenols activity and had a greater impact on the subchronic model of inflammation, probably due to the periodicity of the test. Caffeic acid may have contributed to the activity of the extract. Finally, molecular analysis confirmed that the species analyzed were different. The trnH-psbA, matK and ITS1 markers were the most apt to discriminate at the species level between the accessions used considering the bootstrap value.
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    Evaluación de los conocimientos, actitudes y prácticas de farmacovigilancia a los farmacéuticos de hospitales públicos y privados registrados en la unidad zonal de farmacovigilancia, Coordinación Zonal 6 – Ecuador
    (Universidad de Cuenca, 2023-05-24) Monge Cruz, María del Cisne; Peñaherrera Wilches, María Eugenia
    Adverse drug reactions are recognized as one of the causes of morbidity and mortality in patients admitted to a hospital being a very important factor for patient safety. The activities of health professionals related to pharmacovigilance are important elements to promote the safe use of medications. The aim of this study was to evaluate the knowledge, attitudes and practices of hospital pharmacists regarding pharmacovigilance in public and private health establishments registered in the Zonal Unit of Pharmacovigilance, Zonal Coordination 6. The validated Nisa questionnaire (Nisa, et, al 2018) was used, which was applied to 36 pharmaceutical professionals who agreed to participate in the study. The results were obtained by applying descriptive statistics through measures of central tendency, frequency distribution and measures of variability. Regarding knowledge of pharmacovigilance, 61% of pharmacists know the basics of this activity; 58% have a positive attitude towards this activity, and 58.3% of the participants have not reported an adverse drug reaction in their practice as such. Seventy-five percent considered that patient safety is a factor that encourages the reporting of adverse drug reactions and 36.1% found some factors that discourage the practice. In addition, the main weaknesses in the daily practice of pharmacovigilance were identified and a training program was developed through a video. In conclusion, the study identified sufficient knowledge and attitudes in pharmacovigilance, but not in the practice of pharmacovigilance. It is suggested that the pharmacist should be part of the multidisciplinary health team in order to strengthen the reporting of adverse drug reactions.
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    Uso de antibacterianos en el área de clínica del Hospital José Carrasco Arteaga
    (2013) Peñaherrera Wilches, María Eugenia; Juárez Eyzaguirre, José Roger
    The aim of the present study was to describe the prescribing patterns and use of antibacterial drugs in the Clinic Area of José Carrasco Arteaga Hospital during the period August 07 - November 07 - 2012, in order to compare with the Infectious Diseases Guide 2011-2012 of PAHO-WHO and propose the implementation of Pharmacotherapy follow-up of antibacterial drugs. An observational longitudinal prospective study was carried out in the Clinic Area of the hospital. The daily review of patient history forms was done (994) in order to find those with antibacterial drug prescriptions (325). After that, a complete descriptive statistical analysis was performed. Different therapeutic protocols were found and compared with those of the pattern guide. 32, 7% of the total patient history forms had an antibacterial drug in their prescriptions. Prevalent infectious diseases were: pneumonia, urinary tract infection and soft tissue infections. In relation to the type of antibacterial drug used, there was 31% of coincidence between the prescriptions in the hospital and those of the pattern guide; 57% of the daily prescribed dose was the same as the pattern guide, 35% was inferior and 8% was superior to it. Ceftriaxone, ampicillin/sulbactam and ciprofloxacin were the most frequent antibiotics used or prescribed. In conclusion, different and many therapeutic protocols were used in this study to treat infection diseases. It was suggested that the hospital normalize therapeutic protocols for infection diseases and also it was proposed Pharmacotherapy follow-up of antibacterial drugs.