A indústria farmacêutica no Brasil: um estudo do impacto socioeconômico dos medicamentos genéricos

Recently, some countries outside the Triad (Japan, Europe and the United States) have assumed an important role in the pharmaceutical scenario, as large producers, among them stand out Brazil. In the 90s, there were major institutional transformations and the pharmaceutical industry has undergone a reverse specialization process, because liberalization has discouraged production of pharmaceutical chemicals and dependence of imports increased. The law of generics medicines in 1999 emerged as an attempt to increase the population's access to medicines equivalent to ones with brand, with more affordable prices. As a result of this law there was a strengthening of the national capital and a major attraction for foreign companies to brazilian market. This study aims to assess the development trajectory of the country, showing how path-dependence has culminated in greater empowerment of national pharmaceutical industries after the Generics Law in 1999

Avaliação cefalométrica das alterações do perfil facial naturais e induzidas pelos aparelhos de Herbst e Bionator no tratamento da má oclusão de classe II, divisão 1ª

The aim of this study was to evaluate the facial profile changes due to natural growth and induced by Herbst appliance and Bionator in the treatment of Class II, division 1 malocclusion. In order to do that, we used a sample of 90 lateral radiographs of 45 individuals in pre-pubertal stage, divided up in two experimental groups and one control. The first group, composed of 15 brazilian individuals, with initial mean age of 9.4 years, was treated with the Herbst appliance for a period of seven months. The second experimental group consisting of 15 brazilian individuals, initial mean age of 9.9 years has gone through bionator therapy for an average period of 21 months. The control group of 15 individuals, who were not treated orthodontically, comes up from the Burlington Growth Centre, University of Toronto, Canada. The intragroup comparison was performed using the Student t test and intergroup comparisons by ANOVA complemented by the Bonferroni test. The results have shown that only the group treated with the Herbst appliance presented significant changes in facial profile with improvement of its convexity and lower lip protrusion.

Alterações dentoesqueléticas verticais e horizontais induzidas pelo ativador elástico Aberto de Klammt

The aim of this study was to evaluate the vertical and horizontal dentoskeletal changes induced by the Klammt Open Elastic Activator in the treatment of the Class II Division 1 malocclusion. The sample of 34 children was divided into two groups of 17 subjects each (ten girls, seven boys), matched by age and gender and with an initial mean age of 8.5 years. The data was analyzed using a Student's t-test for intragroup and intergroup comparison. The results showed that the appliance promoted dentoalveolar restriction of the maxilar growth within normal anteroposterior and vertical growth of the maxillary apical base; increment in the vertical displacement the mandibular symphysis associated with normal horizontal growth of the mandible; palatal tipping of the upper incisors; restriction of the anterior migration of the upper molars; greater eruption pattern and normal anterior displacement of the lower incisors and molars. It was concluded that Klammt appliance induce changes that are predominantly horizontal dentoalveolar in upper arch and vertical dentoalveolar in lower arch and vertical skeletal changes in the mandible.

Avaliação das alterações dentárias e esqueléticas induzidas pelo uso do aparelho de Herbst no tratamento da classe II na dentadura mista: Revisão sistemática

Objective: evaluate the immediate dental and skeletal changes induced by the Herbst appliance on early treatment of Angle´s Class II malocclusion. Material and Method: several electronic databases such as Scopus, Pub Med, Medline, Cochrane Library, Lilacs and Scielo were searched. The abstracts that fullfilled the selection criteria were selected and those that did not provide enough information about these criteria were selected but the final decision of including them or not on the research, was taken after the complete reading of the article. The selection criteria were: clinical studies with Class II individuals, both male and female, with initial age of 7 to 10 years, treated with the Herbst appliance that analysed the dental and/or skeletal changes evaluated on lateral cephalometric radiographs; researches where the treatment performed did not involve extractions or surgical interventions; studies that included patients without syndromes or health concerns and articles published in English or Portuguese. Results and Conclusions: five articles were selected. The articles showed that significant changes happened in the mandibular sagittal lenght, on facial convexity angle, on maxillo-mandibular relationship, on retroclination of the upper incisors and on distal movement of the upper molars, on proclination of the lower incisors and on extrusion of the lower molars. The appliance exerted a limited effect on the anterior relocation of the maxillary complex and on facial heights. However, more studies about the performance of the Herbst appliance on early treatment of Class II are needed.

Formação do técnico de enfermagem para administração segura de medicamentos: proposição de tecnologia educacional virtual

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Notificações espontâneas de eventos adversos a medicamentos hospitalares: estudo piloto

Introduction: Post-marketing surveillance of drugs aims to detect problems related to safety, effectiveness and quality. The identification of adverse drug events (ADE) is made, mainly, by health professionals´ spontaneous reporting. This method allows risk communication in pharmacovigilance and contributes for market regulation. Objective: To estimate the prevalence of adverse drug reaction (ADR) and the suspicions of therapeutic failure (TF) reported by health professionals; to verify the active principle and type of drugs related to ADE, seriousness, causality, production mechanism and clinical manifestation of the events identified. METHODS: A cross-sectional study was performed in a teaching and public hospital which integrates the Sentinel Hospital Network, in 2008. ADR seriousness was classified according to intensity (mild, moderate, serious and lethal); drugs associated with ADE were categorized according to type (brand name drugs and non-brand name drugs); causality was imputed with Naranjo algorithm and the mechanism of occurrence was analyzed according to Rawlins e Thompson definitions (A or B). Results: There were 103 ADE reports in the period, of which 39 comprised TF and 64 ADR. Nurses reported the most ADE (53.4%). The majority of ADR were classified as type A (82.8%), mild (81.3%), possible (57.8%), according to causality assessment, and related to brand name drugs (20/35). Human immunoglobulin, docetaxel and paclitaxel were the drugs frequently associated with ADR. TF arising from no-brand name drugs (26/29), regarding, mainly, midazolam and ganciclovir. Conclusion: The results of the ADE report contribute for proposition of trigger tools for intensive monitoring of drug safety, as well as for the supplier qualification and for the improvement of quality products.

Medicamentos inadequados para idosos na estratégia da saúde da família

The ageing process can change the pharmacodynamics and pharmacokinetics parameters. Therefore, some medications are considered potentially inappropriate (PIM) for the elderly people, since they can increase the likelihood of occurrence of adverse drug events. The objectives are to estimate the frequency of use of PIM in the elderly people, with potentially hazardous drug interactions (PHDI) and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. A cross-sectional study was performed in a Health Family Strategy (region of Araraquara, SP), between January and February/2012. The medical records of patients aged ≥60 years, that use at least one drug, were consulted for identification of PIM, according to the Beers criteria. The MPI identified were classified considering the Anatomical Therapeutic Chemical Classification System (ATC) and the essentiality of the drug (safety, effectiveness, quality and cost parameters) The inclusion criteria were met by 358 elderly, being that 93 of them (26%) had taken at least one PIM. Of the 114 different drugs prescribed for elderly, ten were classified as PIM, of which four of them act on the central nervous system, four on cardiovascular system and two on the digestive tract. Seven MPI are essential medicines, belonging to national list of essential drugs (RENAME-2010). Fourteen drug interactions were identified, of which two are PHDI (fluoxetine/amitriptyline and digoxin/hydrochlorothiazide).After the PI, there was no change in medical prescriptions of patients with PIM use or with DI. Medical prescriptions of elderly attended in the Health Family Strategy show pharmacotherapeutic safety problems, of which may be responsible for health hazardous for this age group. Although the intervention carried out by letter had been ineffective for the adherence of doctors in prescribing safe alternatives, wide dissemination of the lists that contain PIM and PHDI is need, as well as the inclusion of safer equivalents in RENAME, in order to contribute for rational use of drugs.

Avaliações farmacoeconômicas em vigilância de medicamentos

The study aimed to identify pharmacoeconomic studies in pharmacovigilance and to observe the economic outcomes in post-marketing surveillance. Therefore, a bibliographic survey was performed in databases Lilacs, PubMed/ Bireme. The search strategy was done by using scientific health descriptors [ "adverse drug reaction reporting systems " OR " medication errors " OR "product surveillance, postmarketing" OR " sentinel surveillance" ] AND [ " cost-benefit analysis" OR "cost efficiency analysis " OR " costs and cost analysis " OR " hospital costs " OR " cost-effectiveness " OR " cost-effectiveness evaluation " OR " drug costs " ]. Manuscripts published in the last 10 years were selected. We chose 13 articles, of which 12 corresponded to cost-benefit analysis and only one to cost-effectiveness assessment. In only one study there was no economy, all the other ones generated savings, ranging from 13.7 to 30% in spending valued service. Surveillance actions were: continuing education; active search through tracking devices and / or implementation of round; teamwork and multidisciplinary deployment; computerized security services management, enabling traceability of information and alerts. The results of the proposed actions have led to the prevention of adverse drug reactions, to decline of risks to the patient, to the reduction of inappropriate prescriptions, as well as the length of hospital stay spending valued service. Surveillance actions were: continuing education; active search through tracking devices and / or implementation of round; teamwork and multidisciplinary deployment; computerized security services management, enabling traceability of information and alerts. The results of the proposed actions have led to the prevention of adverse drug reactions, to decline of risks to the patient, to the reduction of inappropriate prescriptions, as well as the length of hospital stay

A importância da atenção farmacêutica após a verificação da qualidade microbiológica de medicamentos contendo paracetamol encontrados em algumas residências de Américo Brasiliense - SP

It is known that a high microbial count can compromise the stability of medicines, thus reducing their therapeutic efficacy. This work tried to demonstrate that the microbial contamination can be directly related to the inadequate handling of the medicines stored in homes, making it possible to draw strategies to reduce the possible risks of medical therapy offering correct information and advising. The objective of this work was to evaluate the quality of the medicines containing paracetamol found in the residences of Américo Brasiliense-SP, using the microbial analysis of non-sterile method described in the Brazilian Pharmacopoeia (1988). The medicine samples (30 samples) were obtained directly from the interviewed local residents, who had received new medicine bottles of the same product. An analysis of viable microorganisms (bacteria and fungus) was carried out to identify pathogens found in the collected samples. Although 90% of the analyzed samples have shown some microbial contamination, the results indicated the absence of pathogenic microorganisms, and the total count of viable microorganisms was below the maximum value for non-sterile (104 UFC/g or mL). It was also verified that the local residents stored the medicines in appropriate places, according to the orientations received when they bought the medicines in pharmacies and drugstores, showing the importance of information for the correct use and conservation of pharmaceuticals.

Acesso, segurança e uso de medicamentos por usuários

The present study aims to identify families who have stock and are making use of medications, as well as assess the conditions of storage, security and use of these drugs. The study was conducted in a city of São Paulo, the interviews were conducted in households enrolled in one of ten units of the Estratégia de Saúde da Família (ESF) that the city provides and the sample was defined by means of stratified random sampling (134households, IC 95%). Data collection was conducted through interviews with a semistructured questionnaire during the first half of 2011. We interviewed 118 (88.0%) households, of which 112 (95.0%) had medications that were stored n insecure or inadequate places in 75.4% of households, non-prescription self-medication was a common practice in 46 (47 4%) households, and lack of identification and security of medications stored was observed in 60 (53.6%) households. Most households had stock of medicines, which were done improperly or unsecure, or have specialties with lack of identification and security, which can lead to poisoning or e ineffective therapy. The Pharmaceutical Assistance under SUS lacks social initiatives, with actions directed for medications users, which can be supplied by the presence of the pharmacist in the ESF, essential for the promotion of racional use of medicines, that, through the Pharmaceutical Care, can identify, correct and prevent possible problems related to drugs.

Avaliação de células germinativas e células de Sertoli em modelo experimental de criptorquidia e orquidopexia

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Associação de antibióticos e terapia fotodinâmica antimicrobiana para o controle de Acinetobacter baumannii

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Bulas e Cartelas de Medicamentos: Possíveis soluções de leiturabilidade através do Design Gráfico

The package inserts for drugs represent the main source of written information provided to patients, but the deficiency in the page layouts of informational texts (readability), the excess of information and use of techno-scientific language hamper the effectiveness of communication between the author (manufacturer) and player (patient) in addition to the physiological conditions of patients are often elderly. This article discusses these issues from theoretical predictions, and proposes solutions to the adequacy of information graphics package inserts of drugs and facilitating the identification of drug cards.