Contribuição do uso de medicamentos para a admissão hospitalar

According to the Word Health Organization, adverse drug reactions (ADR) are any harmful and non intentional answer which occurred in doses normally used in human beings. The ADR can be responsible for 2.4% to 11.5% of hospital admissions. Therefore, this study aimed at knowing the admitted patient's demographic profile due to possible ADR, identifying the most frequent drugs and complaints, and evaluating the incidence of hospital admission related to drug use. Patients who were 18 years old or more and were admitted during a period of one month to a medical clinical of a general hospital were interviewed for one month about drug use before being admitted, as well as regarding to the complaint which led them to hospital. These information were analyzed according to official data, like MICROMEDEX® and WHO criteria as well. It was observed that the admission due to drug use occurred in most part of the cases in elderly [47.5% (66/139)] and women [62% (87/139)]. The most frequent drugs used were: omeprazole (16), analgesics (31), antihypertensive (31), simvastatin (7) and formoterol fumarate (6), and the symptoms were normally associated to the digestive (20.5%), circulatory (20.2%), respiratory (18.2%) and central nervous systems (13.9%). It was estimated that 15.5% (139/897) of the hospital admission occurred possibly due to the drug use. The data found by present study suggests some strategies in order to prevent ADR in the context of primary health care services, such as monitoring drug therapy, manly for patients with chronic diseases, elderly and polimedicated people; and pharmaceutical care including dispensation and purchasing of the drugs, a lot of them dispensed over the counter (OTC).

Análise dos aspectos legais das prescrições de medicamentos

This article describes a survey of prescriptions dispensed in drugstores and pharmacies in the city of Araraquara in the state of São Paulo, Brazil, in May 2006. Their contents were assessed for compliance with the laws in force on drug prescription and dispensing. A total of 1,335 prescriptions were examined: 40 (3%) were unsigned, 212 (15.9%) did not contain the prescribing physician's stamp, 170 (12.7%) were undated. There were prescriptions containing corrections (4.6%), and written in code (4.4%). Only 58.8% were legible and easy to understand; nevertheless all of them were dispensed. Some did not specify the name of the patient (7.2%). On how to use the medication prescribed, not a single prescription contained all the information required by law. Specifically, 7.6% lacked information on dosage, 54.3% on presentation, 33.6% on how to take the drug, and 51.2% on duration of treatment. The data show a general failure to comply with the laws on drug prescription and dispensing. Incomplete information on the drugs and their correct use could lead to irrational use and errors in medication. The lack of prescribers' signature and stamp, date of emission and name of patient can lead to fraudulent and counterfeit prescriptions. Thus, the data found point to the need for capacitation of prescribing and dispensing professionals and the importance of the role of professional associations in guiding their members.

Farmacología en la tercera edad: Medicamentos de uso continuo y peligros de la interacción medicamentosa

Introduction: It was observed a considerable growth of elderly people. They are who use more medicines. The physiological changes associated with the age advancing can make pharmacokinetic and pharmacodynamic alterations. The cognitive decline, physical limitations and associate chronic pathology affect the medications appropriately use ability. Aims: Based in a literature review, appoint the main pharmacological groups prescribed to the elderly and the drug-drug interaction risks. Conclusion: The most of elderly use continually at least 3 medicines, the most prescribed are to cardiovascular and psychic diseases treatment.

Análise multivariada na determinação do risco de erosão em solos sob irrigação

The objective of this work was to verify the application of cluster analysis to evaluate soil erosion risk for different soil classes, soil slopes and soil managements. The study was conducted in a 33 ha section of a large field located in Carmo do Rio Claro County, MG, Brazil. The field had been managed in a corn/bean rotation under conventional tillage and under coffee plantation for seven years, both under sprinkle irrigation. Soil samples were obtained at every 10 m at 0.20 m depth along a transect of 1050 m. Soil erosion risk (A), natural potential erosion (PN), and erosion expectation (EE) were determined and submitted to a cluster and principal component analysis. The application of clustering analysis showed high correlation between the clusters and soil types. With clustering analysis plus principal components analysis, it was possible to identify groups of high and low soil erosion expectation, showing that the areas with higher soil erosion expectation are correlated to the soil class, soil slope and soil management. Among the studied variables, the natural potential erosion (PN) showed to be the most important factor to identify different soil erosion groups. The cluster analysis showed that 98% of the variables were classified within each group, and that they should be managed differently due to the soil erosive potential of each group,.

Análise multivariada de microbacias em relação ao tipo de solo

The objective of this work was to study the dimensional parameters of the drainage net using 12 third-order ramification hydrological watersheds: 4 watersheds per soil unit (LVA, RL and RQ). The soil distinction was realized using ''t'' test to verify the orthogonal contrast among three soil averages and the grouping analysis and mean components. The results showed that the multivariance analysis was not able to discriminate three soils using the dimensional analysis. The t test of this isolated variable allowed discriminating RQ soil from LVA and RL soil units; but it was not sensitive to discriminate the LVA soil and RL unit.

Acesso a medicamentos essenciais em farmácias e drogarias do Município de Araraquara

A survey to determine the availability of 20 essential medicines for the diseases with highest prevalence in primary health care was conducted in the city of Araraquara. The presence and the price of these medicines in private sector pharmacies and drugstores of the city were recorded. Two forms, recommended by the WHO, were used in the survey, one for availability and the other for prices. The drugs most commonly available in pharmacies and drugstores were: propranolol (90.5%), captopril (96%) and ranitidine (96%), while the least available were ferrous sulfate (27%), beclomethasone (33.8%) and ibuprofen (41.9%). The drugs that showed the greatest variation among the prices charged were: propranolol (97.1%), hydrochlorothiazide (96.4%) and glibenclamide (95.0%), while the least variable were salbutamol (30.8%) and trimethoprim-sulfamethoxazole (30.2%). Generic drugs, which were half (10) of those assessed, had the lowest prices. The indicators of access, referring to the ability of patients to acquire drugs for the treatment of major diseases at the primary health care level, showed that no establishment stocked all 20 essential drugs and that wide variations existed in their prices, undermining their availability to drug users, whose only sources are pharmacies and drugstores. These data demonstrate the importance of the popular pharmacy to improve the access to medicines, by lowering the cost and increasing the availability of the items selected for the National List of Essential Drugs (RENAME).

Estudo clínico randomizado e aberto para avaliação de eficácia e superioridade dos medicamentos EF028 aerossol, EF028 creme e Andolba® frente ao tratamento controle e comparativo de não inferioridade entre os medicamentos EF028 aerossol, EF028 creme e Andolba® para avaliação de eficácia na redução da sintomatologia dolorosa

Aim: This study aimed to evaluate the efficacy of a new topical drug (EF028) in two separate presentations (aerosol and cream) in a comparative way with the already registered medication, Andolba® (benzocaine, benzoxiquina chloride benzeconio, menthol) and the negative control (hygiene), in the analgesic efficacy after episiotomy wound, reducing the requirement for systemic medication. Methods: 60 patients were voluntary post normal vaginal childbirth with episiotomy, were divided into four groups to comparatively assess the action of the product EF028 (cream and aerosol), Andolba® and soap, the efficacy of decreasing painful symptoms from daily use for 2 times a day for seven days. Clinical assessments and subjective pain occurred daily until the third postoperative day and on the 7th postoperative day. Results: The results showed that the drugs promoted a reduction of painful symptoms and there was no statistically significant difference (p <0.05) between presentations of drug EF028 (cream and aerosol) and Andolba® and the three products were significantly higher (p <0.05) to the control. Conclusions: The evaluated drugs EF028 aerosol, EF028 cream and Andolba® had similar efficacy in relieving the painful symptoms of the perineal region in postoperative episiotomy can be considered as indication for postoperative episiotomies. © Copyright Moreira Jr. Editora.

Estudos de medicamentos biosimilares

In Brazil, the registration of new drugs is carried out only when the regulatory agency (Anvisa, acronym in Portuguese) is fully satisfied with the evidence of their quality, efficacy and safety, presented by a pharmaceutical industry that strive for this registration. With the patent expiration, pharmaceutical companies are attracted to produce biological medicines called biosimilar or biogenerics or simply generics, whose approval may result in reduced treatment costs. But it is necessary that the biosimilar be, at least, equally efective and safe and without contaminants in relation to the original. Recent consensus guidelines aim to establish criteria for efcacy and safety of these medicines. Preclinical studies in vitro and in vivo, the origin of raw materials and clinical studies phase I, II and III are recommended for biosimilar medicine registration in the international market. Low molecular weight heparins are found in this situation. In this review we specifcally addressed this type of medicine, which could serve as a benchmark for other biosimilar medicines.

Estudo de perfil de dissolução dos medicamentos de referência, genérico e similar contendo cefalexina na forma farmacêutica cápsula

With recent advances in technology and research into drug delivery, the modernization of tests and greater emphasis on the predictability of therapeutic effect by means of in vitro tests, the dissolution test and the study of dissolution profiles are gaining more and more importance. Though introduced initially as a way of characterizing the release profile of poorly soluble drugs, dissolution tests are currently part of pharmacopoeial monographs on almost all the oral solid pharmaceutical forms. The objective of this study was to determine the dissolution profile (percent drug dissolved versus time) of the pioneer brand, generic and similar pharmaceutical capsules containing 500mg cephalexin. Three pharmaceutical brands (reference, generic and similar) were subjected to the dissolution test and in vitro dissolution profiles were recorded. From the results of the dissolution test, it was concluded that the samples met the acceptance criterion, as no difference was observed in the percentage of the drug dissolved in a standard time. The dissolution profile indicated that this medicine, in this pharmaceutical form, dissolves readily (85% of the drug dissolved in 15 minutes) and the curves showed great similarity, suggesting that the 3 brands are pharmaceutically equivalent.

Fluorescência da clorofila-a e variação da simetria como ferramentas de investigação de plantas sob estresse

Environmental disturbances in various systems and individuals can result in a tendency for fluctuating asymmetry, which consists of a non-directional deviation from symmetry of a bilateral structure in a normally distributed population. Individuals unable to exhibit plastic responses to developmental disorders that occur at random, either genetic or environmental, may exhibit slight deviations from symmetry in organs with bilateral structure such as leaves. Thus analyzing plants by the morphological pattern of symmetry of the leaves has become an effective tool to describe the developmental of plants under stress conditions. This study aimed to analyze if the pattern of symmetry can be used as a tool to investigate the stress level to which a plant is subjected, using ultraviolet-C radiation (UV-C) as source of stress. We determined the leaf symmetry deviations (sd), the average length (AL) and the maximum width of the lamina (MWL) and the fluorescence parameters of chlorophyll-a in leaves of young plants of G. max subjected to 0, 30, 60, 120 or 240 minutes per week of UV-C during four weeks, submitting the values to ANOVA and Tukey test (p <0.05). The results showed significant reductions in AL and MWL, significant increase in sd in leaves irradiated and a drop in potential quantum yield of photosystem II (PSII) and in the photosynthesis performance index (IP). The analysis of leaf symmetry showed high correlation with the stress level to which plants were submitted, being an important analysis to ascertain the fitness of the plant because it is a noninvasive method and easy to perform.

Análise multivariada aplicada em bacias hidrográficas no município de Botucatu-SP

As imagens aerofotogramétricas de uma região registram os vários aspectos da paisagem, destacando a cobertura vegetal, a rede de drenagem e principalmente o relevo do terreno conjunto que caracterizam unidades morfométricas denominadas bacias hidrográficas. Neste trabalho aplicaram-se técnicas fotointerpretativas e estatística multivariada a variáveis do relevo, medidas em bacias hidrográficas de terceira ordem de ramificação pertencentes à bacia do rio Tiête no município de Botucatu-SP, com o objetivo de agrupar bacias segundo graus de similaridade, bem como inferir sobre a representatividade da distribuição espacial dos agrupamentos em relação ao Mapa Pedológico do Estado de São Paulo, da Embrapa de 1999. Foram utilizadas fotografias aéreas verticais, escala nominal aproximada 1:30000, (2005), cartas planialtimétricas escala 1:50000 e Mapa Pedológico do Estado de São Paulo. Foram estudadas 06 bacias hidrográficas de 3aordem de ramificação, situada na região fisiográfica denominada frente da cuesta abrangendo as unidades de solo Neossolos Litólicos (RL) e Latossolos Vermelhos distrófico (LVdf), sendo esta última predominante na área de estudo. O conjunto de variáveis de relevo mostrou-se eficiente no agrupamento das bacias conforme as unidades de solos ocorrentes, concordando com as unidades identificadas no Mapa Pedológico.

Polimorfismo na produção de medicamentos

Polymorphism can cause quality deviations during the production of medicines and can influence their effectiveness. Therefore, an understanding of this phenomenon and its implications opens a wide field of possibilities to be explored in the pharmaceutical field, including the emergence of new paradigms and tools for the quality assurance of medicines. This paper presents an introduction to basic aspects of the polymorphism phenomenon and its implications for the production and control of medicines, with emphasis on drug polymorphs.

Contaminação das águas por resíduos de medicamentos: Ênfase ao cloridrato de fluoxetina

The objective of this paper was to review data on residues of medical products in aquatic environments and at wastewater treatment plants. Secondarily the paper presents a discussion about the need for a good management of drugs residues and effluents generated by this sector. Bringing the evidences of environmental possible damages reported by ecotoxicity data on the effects of fluoxetine to Vibrio fischeri and H. azteca, aquatic organisms daily exposed to environmental contaminants. From the results we observed that 0.3 mg.l-1 of fluoxetine hidrochloride induced lethality to H. azteca and 30 mg.l-1 reduced the luminescence of Vibrio fischeri. This assay evidenced higher toxicity when we used the generic product.

Análise das propagandas dos medicamentos isentos de prescrição veiculadas em revistas para prescritores na área médica

This article presents an analysis of the quality of advertisements for over-the-counter (OTC) drugs addressed to the medical profession, based on the new Anvisa resolution RDC 96 (17/12/2008). For this analysis, 16 volumes of the Brazilian Journal of Medicine (RBM) were collected, from August 2009 to December 2010. To investigate the quality of the adverts, we prepared a questionnaire divided into three parts. In total, 160 advertisements were found, of which 27 were related to drugs exempt from prescription, from 9 laboratories. It was observed that none of the advertisements complied fully with the new rules, as required by legislation (RDC 96/08), with violations ranging from identification of the advert to prohibitions of human figures and subjective messages. Therefore, it was concluded that there is a need to implement more effective monitoring, so as to improve the quality of the adverts, so they can be used as a reliable source of information and update by prescribers.

Composição de cores através da calibração radiométrica e fotométrica de LEDs: Teoria e experimento

In the present work, the basic concepts of radiometric, photometric and colorimetric calibration are presented, which were applied to three light-emitting diodes (LEDs) used to compose the different color sensations that the human eye perceives in the visible region of the electromagnetic spectrum. In this sense, an experimental setup comprising a LED drive circuit and a home-made integrating sphere was assembled for the initial radiometric and photometric calibration as well as to obtain a set of intensity and spectral combinations associated to different colorimetric CIE (Commission Internationale de l'Eclairage) coordinates. The reader can, therefore, understand, in a simple manner, the process of color composition inside a color monitor or display picture element (pixel ). © Sociedade Brasileira de Física.