Determinação espectrofotométrica de hexametilenotetramina (HMT) em medicamentos, utilizando ácido cromotrópico e forno de micro-ondas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Desenvolvimento de metodologia simplificada para análise de hexametilenotetramina (hmt) em medicamentos contendo corantes em sua formulação

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Terminologia de incidentes com medicamentos no contexto hospitalar

Incidentes com medicamentos geram problemas aos pacientes e custos adicionais ao sistema de saúde. A variedade de termos utilizada para comunicá-los propicia divergências nos resultados de pesquisas e confundem notificadores. Objetivou-se revisar os termos utilizados para descrever estes incidentes confrontando-os com as conceituações/definições oficiais disponíveis. Pesquisaram-se as bases PubMed, MEDLINE, IPA e LILACS para selecionar estudos publicados entre janeiro de 1990 e dezembro de 2005. Selecionaram-se 33 publicações. Verificou-se que a terminologia supranacional recomendada para descrever incidentes com medicamentos é insuficiente, mas que há consenso de uso das expressões em função do gênero do incidente. O termo Reação Adversa a Medicamento é mais utilizado quando não se verifica intencionalidade. A expressão Evento Adverso a Medicamento foi mais usada quando se descreviam incidentes durante a hospitalização; e Problema Relacionado a Medicamento foi mais utilizada em estudos que avaliaram atenção/cuidados farmacêuticos (uso/falta do medicamento). Ainda assim, a linha divisória entre essas três categorias não é clara e simples. Futuros estudos das relações entre as categorias e investigações multidisciplinares sobre erro humano podem subsidiar a proposição de novas conceituações.

Utilização de medicamentos e fatores associados: um estudo de base populacional no Município de Campinas, São Paulo, Brasil

Este artigo analisa a prevalência da utilização de medicamentos segundo variáveis demográficas, socioeconômicas e de comportamentos relacionados à saúde, identificando fatores associados ao uso por meio de estudo transversal de base populacional, com 941 pessoas de 18 anos ou mais residentes em Campinas, São Paulo, Brasil. A amostragem foi realizada em múltiplos estágios, estratificada e por conglomerados. Utilizou-se o teste qui-quadrado, foram estimadas as razões de prevalência ajustadas por sexo e idade e os respectivos IC95%. Desenvolveu-se modelo de regressão múltipla de Poisson ficando associados ao uso: sexo feminino, idade de 40 anos e mais, morbidade referida nos últimos 15 dias e número de doenças crônicas. Os medicamentos mais consumidos foram para os sistemas cardiovascular e nervoso, e os fitoterápicos. A prevalência de uso de medicamentos em Campinas encontrou-se inferior à maioria dos estudos. Por meio de inquéritos de saúde locais espera-se conhecer o perfil de uso dos medicamentos pela população e garantir intervenções mais direcionadas para a Política de Assistência Farmacêutica.

Análise do conteúdo de propagandas de medicamentos psicoativos

O objetivo do estudo foi descrever as figuras humanas retratadas nas propagandas de medicamentos psicoativos quanto ao gênero, a idade, a etnia e o contexto social. Foi realizada análise de conteúdo de 86 impressos publicitários inéditos divulgados em Araraquara (SP) no ano de 2005. A associação entre as categorias foi analisada usando o teste exato de Fisher. Houve predomínio de mulheres (62,8%), sendo quatro vezes mais freqüentes que os homens em propagandas de antidepressivos e ansiolíticos. A maioria era constituída de jovens adultos (72%), de etnia branca (98,8%). As pessoas estavam em lazer (46,5%), em suas casas (29%) ou em contato com a natureza (16,2%). A mensagem transmitida foi que os medicamentos tratam sintomatologias subjetivas de desconforto do dia-a-dia, induzindo a um apelo irracional que pode refletir na prescrição medicamentosa.

Assessment of pharmacotherapeutic safety of medical prescriptions for elderly residents in a long-term care facility

The present study aimed to estimate the prevalence of elderly using potentially inappropriate medications (PIM) and with occurrence of potentially hazardous drug interactions (PHDI), to identify the risk factors for the prescription of PIM and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. Therefore, a cross-sectional study was performed in a long-term care facility in São Paulo State, between December/2010 and January/2011. The medical records of the patients >= 60 years old who took any drugs were consulted to assess the pharmacotherapeutic safety of the medical prescriptions, in order to identify PIM and PHDI, according to the Beers (2003) and World Health Organization criteria, respectively. PI consisted of a guidance letter to the physician responsible for the institution, with the suggestions of safer equivalent therapeutics. Approximately 88% of the elderly took at least one drug, and for 30% of them the PIM had been prescribed. Most of the PIM identified (53.4%) act on the central nervous system. Among the 13 different DI detected, 6 are considered PHDI. Polypharmacy was detected as a risk factor for PIM prescription. After the PI there was no change in medical prescriptions of patients who had been prescribed PIM or PHDI. The data suggests that PI performed by letter, as the only interventional, method was ineffective. To contribute it a wide dissemination of PIM and PHDI among prescriber professionals is necessary for the selection of safer treatment for elderly. Additionally, a pharmacist should be part of the health care team in order to help promote rational use of medicines.

COMPARACAO ENTRE MEDICAMENTOS ORAIS ATRAVES DAS TAXAS SERICAS DE GLICOSE, AMILASE, ACIDOS GRAXOS LIVRES E LIPOPROTEINAS DE ALTA DENSIDADE (HDL-COLESTEROL) NOS DIABETICOS DE AMBOS OS SEXOS, DA REGIAO DE ARARAQUARA, NAO-DEPENDENTES DE INSULINA

A study was carried out, on both sexes, to determine the effects of chlorpropamide (DIABINESE) and glibenclamide (DAONIL) on patients with Type II diabetes using as metabolic parameters the following serum: glucose, amilase, high density lipoprotein cholesterol, free fatty acids. The results indicated that both drugs were potentially similar in relation to glycemia, high density lipoprotein cholesterol, and free fatty acids, in both sexes. Chlorpropamide was significantly more effective in reducing amilase activity in male diabetics than glibenclamide. The above mentioned hypoglycemiants did not reduce glycemia to basic levels in either masculine or feminine groups of diabetics.

Avaliação da prescrição médica em pediatria, baseada nos indicadores do uso de medicamentos selecionados pela oms em municipio do interior do estado de São Paulo

The World Health Organization (WHO) recommends that prescriptions of medicaments must be one parameter utilized to know how the medication is used by people. To do so, one specific methodology has been indicated, that is, the selected indicators of the use the medicaments. We applied this methodology with the aim of presenting a descriptive study of the physician prescription in Pediatric Clinic of the Health Basics Units. The results obtained are: the average number of medicaments prescribed with prescription was 2.6; the percentage of the medicaments prescribed with the generic name was 32%; the percentage of the prescriptions with antibiotics was 44.6%; the percentage of the prescriptions with injections was 10.4%; the percentage of the medicaments prescribed that are part of the municipal list was 22.8%, 27.5% for the program Dose Certs of the secretary of the State of São Paulo, and 50.4% by adding by adding the two lists. The essentiality of the medicaments prescribed may be considered very low, because only 32.6% appear in the RENAME. The percentage of the medicaments really dispensed was 39.9%. The medicaments more prescribed, according to the classification of the Anatomic-Therapeutic-Chemical (ATC), were the ones which acted in Respiratory System (26.8%), followed by anti-infectives for systemic use (16.4%) and by medicaments with acted in Alimentary tract and metabolism (15.8%). The conclusion is that the prescribers are moved by commercial influence of the drug makers, first because of the low prescription of medicaments by their generic name, second by the low number of medicaments effectively dispensed and then the low concordance between the ones prescribed and the ones included in the lists patterned by Tabatinga and by the State of São Paulo.

Análise retrospectiva da toxicidade de gotas otológicas, medicamentos tópicos nasais e orofaríngeos registrada na Grande São Paulo.

BACKGROUND: Retrospective analysis of human toxicity files involving topical medicines for treatment of upper airways diseases (eardrops, topical nasal medicines, lozenges, drops and sprays for oropharyngeal affections). METHODS: Thirty-four brands of eardrops, 48 of topical nasal medicines and 22 of tablets, lozenges and sprays for oropharyngeal affections were selected, from a total of 104 products available in Brazil. We analyzed the registries in the electronic database from the Poison Control Centre of São Paulo (CCI-Jabaquara), Brazil, for the period from January 1996 through December 2000. The cases related to selected pharmaceuticals were collected. RESULTS: 10,823 cases of human toxicity caused by medicines were voluntarily reported to CCI-Jabaquara. Topical medicines for treatment of upper airways diseases accounted for 291 cases (2.68%), from which 240 (82.5%) represented poisoning; 12 (4.1%) involved ear drops, 268 (92%), topical nasal medicines and 11 (3.9%), topical medicines for oropharyngeal affections. Among topical nasal medicines, vasoconstrictors predominated (233 cases), and among medicines for oropharyngeal affections, it was tetracaine (four cases). Considering age distribution, toxicity predominated significantly in children aged from 1 to 4 years (p=0.0003). The main causes of toxicity were: accidental intake of medicines (43%) and error in drug administration (14.8%). Hypereflexia and vomiting were the most frequent symptoms related to toxicity. CONCLUSIONS: There was significant incidence of systemic toxicity due to eardrops, topical nasal and oropharyngeal medicines in children 1 to 4 years-old, whose main cause was accidental intake of these medicines.

Aderência e formação do biofilme por Staphylococcus aureus ao polietilenotereftalato (PET) usado como embalagem para acondionamento de medicamentos e cosméticos

The polyethylene terephthalate (PET) is used for package drugs and cosmetics. The aim of this research was examine by scanning electron microscopy (SEM) a Staphylococcus aureus attachment and biofilm formation on a polyethylene terephthalate (PET) surface and hydrophobicity of S. aureus by adherence to hydrocarbons. A suspension of S. aureus was prepared in Mueller-Hinton broth and, coupons of polyethylene terephthalate were incubated for 30 minutes, two, 24 and 48 hours, 15 and 30 days. Afteron the coupons were removed and prepared for scanning electron microscope analysis. The attachment and biofilm formation was observed on the surfaces of PET. The SEM revealed adhesion and biofilm formation on PET surfaces. The hydrophobicity test classified S. aureus as hydrophobic.

Consumo de medicamentos por idosos segundo prescrição médica em Jaú-SP

This study was carried out in order to identify the interactions that occur most often between prescribed drugs as they are taken by elderly patients attending municipal public health centers in the city of Jaú, São Paulo State, Brazil. It is known that older people frequently have to live with chronic health problems, which oblige them to use the health service a great deal and to consume large quantities of medicines. When concomitant diseases are present, and polytherapy is being applied, the likelihood of adverse reactions and interactions between drugs increases. The population under study consisted of 148 persons aged 65 or more who frequented the pharmacy at the Núcleo de Gestão Assistencial (Municipal Health Centre, NGA25) in Jaú, between August and December 2004. Data were collected from medical prescriptions, the independent variables being the age and sex of the patient. For each patient, the pharmacological classes of drugs taken and drug-drug interactions were recorded. It was found that the mean numbers of drugs consumed were 3.8 among women and 3.9 among men. In terms of age, the highest number of drugs (4.2) was used in the group aged 75 to 84 years. The most frequently prescribed classes, in decreasing order, were: antihypertensives, 25.0%, heart drugs, 15.5%, diuretics, and anti-diabetic drugs, 10.7%. It was concluded that the classes most involved in drug-drug interactions were heart drugs, diuretics and antihypertensives. The most problematic active constituents were digoxin, amiodarone, frusemide, captopril, propranolol and nifedipine.

Excipientes de medicamentos e as informações da bula

Aim: To evaluate the presence of preservatives, dyes, sweeteners and flavouring substances in 73 pharmaceutical preparations of 35 medicines for oral administration, according to drug labeling information about the excipients. Methods: 35 medications were selected, both over-the-counter and prescription durgs, marketed in Brazil. The sample included: analgesic/antipyretic, antimicrobial, mucoregulatory, cough and cold, decongestant, antihistamine, bronchodilator, corticosteroid, antiinflammatory and vitamin medications. We collected data on 73 preparations of these drugs, according to drug labeling information regarding preservatives, dyes, sweeteners and flavourings. Results: Methylparaben and propylparaben were the most common preservatives found (43% and 35.6% respectively). The most common sweeteners were: sucrose (sugar) (53.4%), sodium saccharin (38.3%) and sorbitol (36.9%). Twenty-one medicines (28,7%) contained two sweeteners. Colourless medicines predominated (43.8%), followed by those with sunset yellow dye (FD&C yellow no. 6) (15%). Five products (6.8%) contained more than one colour agent. Tartrazine (FD&C yellow no. 5) was present in seven preparations (9.5%). Fruit was the most common flavouring found (83%). Labelings of drugs which contained sugar frequently omitted its exact concentration (77%). Of the four labelings of medicines which contained aspartame, two did not warn patients regarding phenylketonuria. Conclusions: Omission and inacuracy of drug labeling information on pharmaceutical excipients may expose susceptible individuals to adverse reactions caused by preservatives and dyes. Complications of inadvertent intake of sugar-containing medicines by diabetics, or aspartame intake by patients with phenylketonuria may also occur.

Estudo da bula de medicamentos: Uma análise da situação

This study was carried out in the city of Araraquara (SP, Brazil), where 1829 people selected randomly from 42 districts were interviewed with regard to their use of medicines, in particular whether and how they read the insert information sheet and the most frequently read items and problems encountered in the text. Surveys were performed in two stages, the first when package inserts were regulated in Brazil by Portaria SVS 110/1997 (Ministry of Health directive) and the second after the new regulation (RDC 140/2003) came into force. Out of 1829 people interviewed, 1597 reported using some medicine. The markedly similar results in both stages of the research pointed to the difficulties encounteved in reading the package inserts, due to the small letters, the obscure language and the massive amount of information. This paper shows that package inserts of medicines need to be simpler, so the patients have an idea of the importance of the medicine and are able to realize soon any problem that might appear due to the use of the medicine and what action they should take. Furthermore, it will be helpful to the evaluation of the package inserts of medicines, elaborated in conformity with RDC 140, if they work effectively as a source of information and guidance for the patient are not simply given a new layout, while maintaining items that impede their understanding and use.

Qualidade dos medicamentos contendo dipirona encontrados nas residências de Araraquara e sua relação com a atenção farmacêutica

Many studies had described the morbi-mortality related to medicines. As for the strategies to reduce the possible risks for medicine therapy is very important to readvise the pharmaceutical activity, once the pharmacist has potential for constitute an essential part for the solution of problems related to the utilization of medicines. The purpose of this work was to demonstrate that the therapeutic subdosage and the microbiological contamination may be directly involved with the inappropriate manipulation of medicines stored in residences. Liquid dosage forms containing dipyrone market in Brazil and stored at homes in Araraquara (SP) were analyzed regarding quantitative and microbiological analysis. Only in 57% from 128 samples analyzed the drug quantity was in accordance. Moreover, 26.2% from 128 samples analyzed presented S. aureus, E. coli and Salmonella sp. These results demonstrated clear reduction in their quality, as well as the presence of molds and/or bacteria in some medicines that still agreed with the expirations dates, showing the importance of the pharmacist in advising the correct use and store of medicines.