Estoque domiciliar de medicamentos na comunidade ibiaense acompanhada pelo Programa Saúde da Família

É grande o uso e a disponibilidade de medicamentos no meio doméstico. Um estoque domiciliar de medicamentos pode influenciar nos hábitos de consumo dos moradores, favorecendo a automedicação e a reutilização de prescrições. Este estudo objetivou estudar o estoque de medicamentos na comunidade Ibiaense acompanhada pelo Programa Saúde da Família (PSF). Buscou-se descrever as características dos usuários, as condições de armazenamento, as classes terapêuticas e formas farmacêuticas, a procedência dos medicamentos e o custo dos medicamentos provenientes do Sistema Público de Saúde. Foram visitados 285 domicílios, no período de julho a setembro de 2004. Verificou-se que a média de medicamentos por domicílio foi de 8,4 e que 93,5% das famílias entrevistadas apresentaram pelo menos um medicamento em estoque. Os medicamentos estocados em maior número foram: analgésicos (11,15%), seguidos dos diuréticos (6,42%), antibacterianos para uso sistêmico (5,82%), antiinflamatórios (5,08%) e os antiácidos (4,10%). Embora seja considerável o número de medicamentos estocados nos domicílios, foi pequeno o número de medicamentos sem prescrição médica procedentes do Sistema Público de Saúde , sendo este um reflexo favorável dos serviços de Assistência Farmacêutica do Município. Por outro lado, foi verificado um elevado percentual de medicamentos adquiridos em farmácias sem a devida prescrição médica, 41,6%. Este percentual sugere uma inserção de medicamentos adquiridos por automedicação. Foi encontrado um percentual de 18,5% de medicamentos vencidos. O estoque domiciliar resulta de prescrições com quantidades superiores ao necessário para o tratamento (20%) , não cumprimento do tratamento prescrito (17%), aquisição por conta própria (9%) no Sistema Público de Saúde. O estudo sugere a necessidade de orientação dos usuários em relação a utilização e armazenamento dos medicamentos, de sistematização dos registros de dados com perspectiva de auxílio na gestão dos recursos, além de oferecer subsídios para adoção de decisões vinculadas ao processo de planejamento e execução das ações na Assistência Farmacêutica.

"Educação e saúde: reflexões sobre a arte do dialogo amoroso entre enfermos e homeopatas"

Esta dissertação analisa a relação existente entre o modelo médico dominante na sociedade moderna e o surgimento contra-hegemônico de outras racionalidades médicas alternativas. Tento mostrar como estes outros modelos médicos têm a intenção de superar o reducionismo biomédico, através do desenvolvimento de processos terapêuticos alternativos, que se têm convertido em novas soluções para o “complexo-sofrente” que constitui o ser humano. Inclui uma reflexão crítica que em uma pesquisa realizada do final de 90 a meados de 91, colheu depoimentos em entrevistas com profissionais homeopatas e pacientes do serviço de Homeopatia do CSECSF, da ENSP/FIOCRUZ (Centro de Saúde-Escola Germano Sinval Faria, Escola/Nacional de Saúde Pública, Fundação Oswaldo Cruz). Procurou-se enfatizar a questão da Educação e Saúde, como geratriz de transformações conceituais e vivenciais: a saúde, a doença, a cura e a relação médico-paciente. Assim como, dar destaque à ação “educativa” específica de fazer homeopático – o processo de “singularização” (“não há doenças e sim, doentes”), que envolve os atores sociais do ato médico homeopático.

Preparação e avaliação de cápsulas gastro-resistentes de diclofenaco de sódio

Cápsulas resistentes ao trato gastrintestinal são freqüentemente usadas com diversos propósitos. Estas cápsulas promovem eficácia farmacológica e farmacocinética de substâncias que são instáveis, ou irritantes para a mucosa gástrica. O diclofenaco de sódio é um antiinflamatório não-esteróide, que, por ser muito utilizado, despertou o interesse do setor magistral para sua manipulação. Porém, o fármaco é irritante para a mucosa gástrica, havendo necessidade de se empregar substâncias capazes de proteger o meio gástrico da ação do medicamento e uma alternativa para o setor magistral é a manipulação de cápsulas gastro-resistentes. Estas cápsulas devem resistir, sem alteração, à ação do suco gástrico, mas desagregar-se rapidamente no suco intestinal. O objetivo deste trabalho foi preparar cápsulas na concentração de 50 mg/cápsula de diclofenaco de sódio formiladas ou revestidas com acetoftalato de celulose ou com Eudragit L100 na máquina de revestimento entérico “Enteric Coating Machine” PCCA ou manualmente. Foram analisados os resultados considerando o perfil de dissolução das formulações. Observou-se que as cápsulas revestidas na máquina com Eudragit L100 e com acetoftalato em acetona revestidas na máquina e manualmente mostraram bons resultados quanto à dissolução, porém, não apresentaram boa aparência no caso das cápsulas de cor vermelha. Quanto às cápsulas revestidas com formol, estas apresentam boa aparência, mas não deram bons resultados no teste de dissolução.

Relacionamento com médicos como estratégia de marketing da indústria farmacêutica

O marketing de relacionamento (MR) é uma das principais formas de melhoria no gerenciamento das relações das empresas com seus clientes e também parceiros. Definido como um conjunto de atividades com o objetivo de desenvolver e dar continuidade às relações entre a empresa e seus clientes, o MR trata da criação de uma base de relacionamento e integração em todas as fases do relacionamento. Na indústria farmacêutica, caracterizada por estratégias mercadológicas particulares, entre as quais se destaca a mudança de foco do consumidor final para o médico (que prescreve o medicamento), o MR é utilizado de forma constante, sendo disponibilizados altos investimentos nesta área. Com base neste contexto, este trabalho busca investigar a relação entre os incentivos da indústria farmacêutica, caracterizados pelas práticas de MR, e a quantidade de receitas prescritas pelos médicos. Assim, o objetivo central da pesquisa é identificar se o investimento desta indústria em MR junto aos médicos faz com que receite mais o produto. Para tanto, foi realizada uma pesquisa exploratória, utilizando dados secundários de um grande laboratório farmacêutico de nível mundial. Estes dados referem-se a uma amostra de 98 médicos de uma determinada especialidade que foram atendidos pelo Laboratório. Foram testadas as variáveis referentes às práticas de MR – visitas, amostras, congressos, coquetéis e outros, utilizando-se testes de regressão linear. Os resultados comprovaram que os médicos que recebem mais incentivos prescrevem mais receitas. Também foi verificado que existe uma relação positiva entre as práticas de MR e a quantidade de receitas prescritas, sendo que a concessão de inscrições em congressos influencia este resultado de forma mais significativa.

Desenvolvimento e validação de métodos analíticos para determinação do cloridrato de epinastina em comprimidos revestidos

O cloridrato de epinastina é um agente não sedativo, antagonista H1 da histamina, utilizado no tratamento da asma ou como anti-histamínico, comercializado no Brasil na forma farmacêutica comprimido revestido com o nome de Talerc ®. Embora, seja um medicamento amplamente comercializado não há referências relativas aos métodos de análise da forma farmacêutica. Este trabalho teve como objetivos o desenvolvimento e a validação de métodos analíticos para o controle de qualidade do cloridrato de epinastina nos comprimidos revestidos, bem como a realização de estudos preliminares de estabilidade térmica e de fotoestabilidade e determinação da cinética de reação do anti-histamínico em estudo.A análise qualitativa do cloridrato de epinastina foi realizada por ressonância magnética nuclear de próto n, determinação da faixa de fusão, espectrofotometria na região do infravermelho e do ultravioleta, cromatografia em camada delgada e por cromatografia a líquido de alta eficiência. Para análise quantitativa, foram validados os métodos por espectrofotometria na região do ultravioleta derivada de primeira ordem e por cromatografia a líquido de alta eficiência. A validação foi efetuada de acordo com as guias de validação disponíveis na literatura. No estudo preliminar de estabilidade térmica utilizou-se a forma farmacêutica submetida a temperatura de 80 °C por 10 dias. A fotoestabilidade foi realizada em câmara de luz ultravioleta de 254 nm por um período de 18 horas. Os métodos qualitativos foram úteis para identificação do cloridrato de epinastina. Os métodos quantitativos propostos foram validados de acordo com os parâmetros analíticos preconizados, podendo ser perfeitamente intercambiáveis. O estudo preliminar de estabilidade térmica não apresentou degradação da amostra nas condições de análise empregadas. O estudo de fotoestabilidade apresentou degradação intensa obedecendo uma cinética de reação de primeira ordem.

Efeito da salinidade da água do mar no rendimento, composição e atividades biológicas de frações polissacarídicas da Chlorophyta Caulerpa cupressoides var. flabellata

Seaweeds sulfated polysaccharides have been described as having various pharmacological activities. However, nothing is known about the influence of salinity on the structure of sulfated polysaccharides from green seaweed and pharmacological activities they perform. Therefore, the main aim of this study was to evaluate the effect of salinity of seawater on yield and composition of polysaccharides-rich fractions from green seaweed Caulerpa cupressoides var. flabellata, collected in two different salinities beaches of the coast of Rio Grande do Norte, and to verify the influence of salinity on their biological activities. We extracted four sulfated polysaccharides-rich fractions from C. cupressoides collected in Camapum beach (denominated CCM F0.3; F0.5; F1.0; F2.0), which the seawater has higher salinity, and Buzios beach (denominated CCB F0.3; F0.5; F1.0; F2.0). Different from that observed for other seaweeds, the proximate composition of C. cupressoides did not change with increased salinity. Moreover, interestingly, the C. cupresoides have high amounts of protein, greater even than other edible seaweeds. There was no significant difference (p>0.05) between the yield of polysaccharide fractions of CCM and its CCB counterparts, which indicates that salinity does not interfere with the yield of polysaccharide fractions. However, there was a significant difference in the sulfate/sugar ratio of F0.3 (p<0.05) and F0.5 (p<0.01) (CCM F0.3 and CCB F0.5 was higher than those determined for their counterparts), while the sulfate/sugar ratio the F1.0 and F2.0 did not change significantly (p>0.05) with salinity. This result suggested that the observed difference in the sulfate/sugar ratio between the fractions from CCM and CCB, is not merely a function of salinity, but probably also is related to the biological function of these biopolymers in seaweed. In addition, the salinity variation between collection sites did not influence algal monosaccharide composition, eletrophoretic mobility or the infrared spectrum of polysaccharides, demonstrating that the salinity does not change the composition of sulfated polysaccharides of C. cupressoides. There were differences in antioxidant and anticoagulant fractions between CCM and CCB. CCB F0.3 (more sulfated) had higher total antioxidant capacity that CCM F0.3, since the chelating ability the CCM F0.5 was more potent than CCB F0.5 (more sulfated). These data indicate that the activities of sulfated polysaccharides from CCM and CCB depend on the spatial patterns of sulfate groups and that it is unlikely to be merely a charge density effect. C. cupressoides polysaccharides also exhibited anticoagulant activity in the intrinsic (aPTT test) and extrinsic pathway (PT test). CCB F1.0 and CCM F1.0 showed different (p<0,001) aPTT activity, although F0.3 and F0.5 showed no difference (p>0,05) between CCM and CCB, corroborating the fact that the sulfate/sugar ratio is not a determining factor for biological activity, but rather for sulfate distribution along the sugar chain. Moreover, F0.3 and F0.5 activity in aPTT test was similar to that of clexane®, anticoagulant drug. In addition, F0.5 showed PT activity. These results suggest that salinity may have created subtle differences in the structure of sulfated polysaccharides, such as the distribution of sulfate groups, which would cause differences in biological activities between the fractions of the CCM and the CCB

Síntese e caracterização do poli(ácido láctico) para potencial uso em sistemas de liberação controlada de fármacos

With the advances in medicine, life expectancy of the world population has grown considerably in recent decades. Studies have been performed in order to maintain the quality of life through the development of new drugs and new surgical procedures. Biomaterials is an example of the researches to improve quality of life, and its use goes from the reconstruction of tissues and organs affected by diseases or other types of failure, to use in drug delivery system able to prolong the drug in the body and increase its bioavailability. Biopolymers are a class of biomaterials widely targeted by researchers since they have ideal properties for biomedical applications, such as high biocompatibility and biodegradability. Poly (lactic acid) (PLA) is a biopolymer used as a biomaterial and its monomer, lactic acid, is eliminated by the Krebs Cycle (citric acid cycle). It is possible to synthesize PLA through various synthesis routes, however, the direct polycondensation is cheaper due the use of few steps of polymerization. In this work we used experimental design (DOE) to produce PLAs with different molecular weight from the direct polycondensation of lactic acid, with characteristics suitable for use in drug delivery system (DDS). Through the experimental design it was noted that the time of esterification, in the direct polycondensation, is the most important stage to obtain a higher molecular weight. The Fourier Transform Infrared (FTIR) spectrograms obtained were equivalent to the PLAs available in the literature. Results of Differential Scanning Calorimetry (DSC) showed that all PLAs produced are semicrystalline with glass transition temperatures (Tgs) ranging between 36 - 48 °C, and melting temperatures (Tm) ranging from 117 to 130 °C. The PLAs molecular weight characterized from Size Exclusion Chromatography (SEC), varied from 1000 to 11,000 g/mol. PLAs obtained showed a fibrous morphology characterized by Scanning Electron Microscopy (SEM)

Desenvolvimento de uma formulação cólon específica visando o tratamento da colite ulcerativa

Micro and nanoparticulate systems as drug delivery carriers have achieved successful therapeutic use by enhancing efficacy and reducing toxicity of potent drugs. The improvement of pharmaceutical grade polymers has allowed the development of such therapeutic systems. Microencapsulation is a process in which very thin coatings of inert natural or synthetic polymeric materials are deposited around microsized particles of solids or around droplets. Products thus formed are known as microparticles. Xylan is a natural polymer abundantly found in nature. It is the most common hemicellulose, representing more than 60% of the polysaccharides existing in the cell walls of corn cobs, and is normally degraded by the bacterial enzymes present in the colon of the human body. Therefore, this polymer is an eligible material to produce colon-specific drug carriers. The aim of this study was to evaluate the technological potential of xylan for the development of colon delivery systems for the treatment of inflammatory bowel diseases. First, coacervation was evaluated as a feasible method to produce xylan microcapsules. Afterwards, interfacial cross-linking polymerization was studied as a method to produce microcapsules with hydrophilic core. Additionally, magnetic xylan-coated microcapsules were prepared in order to investigate the ability of producing gastroresistant systems. Besides, the influence of the external phase composition on the production and mean diameter of microcapsules produced by interfacial cross-linking polymerization was investigated. Also, technological properties of xylan were determined in order to predict its possible application in other pharmaceutical dosage forms

Investigação farmacoepidemiológica do uso do clonazepam no distrito sanitário leste em Natal-RN

Prescription errors are the most serious type of medication errors found in the health system. The main purpose of this study was to evaluate the quality of clonazepam prescriptions. A descriptive and observational study with retrospective data collection was conducted at 30 community pharmacies in Natal/RN, Brazil, after informed consent was obtained from the pharmacists. A sample of 313 prescription notifications was randomly collected in October 2009. They were analyzed for legible handwriting and completeness. During the study, one researcher, two pharmacists, and one pharmacy undergraduate student evaluated patient and purchaser identification, pharmaceutical form, dosing regimen, administration route, and prescription by generic name. This research was approved by the institutional Ethics Committee. Among the 313 collected notifications, only 44.1% were legible. A total of 55.91% (175/313) had at least one illegible item, 100% contained incomplete information, and 97.12% (304/313) contained one or more abbreviations. The proportion of illegible handwriting related to the patient s identification (p=0.0001) was statistically significantly greater than that related to the drug purchaser s identification (p=0.0004). Contrary to legal requirements, prescriptions with the generic name accounted for 13.42% (42/313) of the total. All the examined notifications were handwritten. Prescription errors, which potentially can have serious consequences, have been evaluated worldwide, although little is known about this subject as it relates to community pharmacies. This study showed high percentages of prescribing problems, which justifies the development of future research about medication errors in community pharmacies and education activities for prescribers

Avaliação da publicidade de medicamentos veiculada nas principais emissoras de rádio de Natal-RN

Drugs advertising is one of the most important marketing resources used by the pharmaceutical industry to induce people to buy these products although they do not have the real necessity to use them. The purpose of this article is to evaluate drugs advertisings transmitted on radio stations in Natal/RN, from October 2007 to September 2008. Were collected 228 advertising pieces, where, 21 were different among themselves and corresponded to 15 drugs. The results showed that 73,3% of the drugs ads were announced on AM station and 26,7% on FM station. The majority of the drugs were constituted of analgesics (26%), following by antiacids, vitamins, phitotherapics (13% each). The legal analysis showed that each advertising had some kind of infraction. The omission of the registration number happened in each advertising, following by the totally lack of contraindications (95,2%) and contraindications DCB/DCI (76,2%). In 42,9% advertisements were observed the relation between drugs use and physique/intellectual/emotional/sexual performance and/or beauty and 33% of them had abusive exploration of illnesses. The obligatory warning was omitted in 28,6% and the offer of financial bonus happened in 9,5% cases. The content analysis demonstrated that the most persuasion and convincing elements observed were indicatives of consumption appeal (34,2%). The study indicates the necessity of the topic drugs advertisements to be treated in a wide context, that is, to be discussed as a public health concern. Although the advertising regulation and inspection is the State responsibility , this should be shared with the advertising agency, pharmaceutical industry and media. Furthermore, it is indispensable to inform and to conscience the population of their rights in such mistaken situation

Controle de qualidade físico-químico e biodisponibilidade relativa em ratos de suspensões orais de naproxeno sódico obtidas de farmácias de manipulação na cidade do Natal RN

Compounded medicines have been reported by the ANVISA due to decreased of the therapeutic response or toxicity of these formulations. The aim of this work was to investigate the physicochemical quality control among naproxen sodium oral suspensions 25 mg/mL obtained from six compounding pharmacies (A, B, C, D, E and F) and the manufactured suspension (R). In the quality control test, the tests of pH, content, homogeneity, volume and physical and organoleptic characteristics were performed according to the Brazilian Pharmacopoeia. The analytical method for determination of naproxen in suspensions was validate. This method showed excellent precision, accuracy, linearity and specificity. In the content test the suspensions B, C and E showed lower value and the F suspension showed a high value of the content. The products C and E were disapproved in the description of the physical and organoleptic characteristics test. In the pH test, three suspensions were outside specifications (C, E and F). Only the products R, A and D showed satisfactory results in these tests and therefore they were approved for relative bioavailability test. The R, A and D suspensions were orally administered to Wistar rats and the blood samples were taken at time intervals of 10, 20, 40, 60 min, 3, 4, 6, 24 and 48 h. The plasma samples were immediately stored at 80 ºC until analysis of HPLC. The bioanalytical method validation showed specificity, linearity (R2 0.9987), precision, accuracy, good recovery and stability. The chromatographic conditions were: flow rate of 1.2 mL.min-1 with a mobile phase of acetonitrile : sodium phosphate buffer pH 4.0 (50:50, v/v) at 280 nm, using a C18 column. The confidence interval of 90% for the Cmax and AUCt ratio was within the range of 80 - 125% proposed by the FDA. Only one suspension, obtained from the compounding pharmacy D, was considered bioequivalent to the rate of absorption under the conditions proposed by this study. Thus, the results indicate the need for strict supervision from the relevant authorities to ensure the patient safety and the quality of compounded drugs by pharmacies

Desenvolvimento de emulsões contendo óleos vegetais para uso cosmético

The fat acid esters and tocopherolic derivatives are of great economic interest in many industries. The sunflower oil, which had its rich constitution in these composites, is a very interesting raw material source for the job in some sectors as bio-carburants, bio-lubrificants, bio-surfactants, dispersing agents, food industries, medicines and cosmetics. A system emulsified steady from this oil can wide be used in the therapeutical one, therefore it is of easy acceptance for the patient, for being pharmaceutical forms that allow a better medicine administration. The chemical composition characteristics, rich in unsaturad fat acid and tocopherolic derivatives, the sunflower oil, make of the emulsified systems contend this oil a proposal promising for formularizations of pharmaceutical and cosmetic use with antirust and photoprotection. The general objective of this work was to apply the HLB beddings to determine the sunflower oil critical HLB and, from this, to be able to evaluate the ideal mixture of the constituent of this system through the study of the ternary diagrams for the determination of the ratio of constituent that will generate the emulsion most steady

Desenvolvimento e validação de método analítico para determinação de teor de ácido gálico e catequina no fitoterápico sanativo® por cromatografia líquida de alta eficiência

The herbal medicine Sanativo® is produced by the Pernambucano Laboratory since 1888 with indications of healing and hemostasis. It is composed of a fluid extract about Piptadenia colubrina, Schinus terebinthifolius, Cereus peruvianus and Physalis angulata. Among the plants in their composition, S. terebinthifolius and P. colubrina have in common phenolic compounds which are assigned most of its pharmacological effects. The tannins, gallic acid and catechin were selected as markers for quality control. The aim of this study was the development and validation of analytical method by HPLC/UV/DAD for the separation and simultaneous quantification of gallic acid (GAC) and catechin (CTQ) in Sanativo®. The chromatographic system was to stationary phase, C-18 RP column, 4,6 x 150 mm (5 mm) under a temperature of 35 ° C, detection at 270 and 210 nm. The mobile phase consisted of 0.05% trifluoroacetic acid and methanol in the proportions 88:12 (v/v), a flow rate of 1 ml/min. The analytical method presented a retention factor of 0.30 and 1.36, tail factor of 1.8 and 1.63 for gallic acid and catechin, respectively, resolution of 18.2, and theoretical plates above 2000. The method validation parameters met the requirements of Resolution n º 899 of May 29, 2003, ANVISA. The correlation coefficient of linear regression analysis for GAC and CTQ from the standard solution was 0.9958 and 0.9973 and when performed from the Sanativo® 0.9973 and 0.9936, the matrix does not interfere in the range 70 to 110 %. The limits of detection and quantification for GAC and CQT were 3.25 and 0.863, and 9.57 and 2.55 mg/mL, respectively. The markers, GAC and CQT, showed repetibility (coefficient of variation of 0.94 % and 2.36 %) and satisfactory recovery (100.02 ± 1.11 % and 101.32 ± 1.36 %). The method has been characterized selective and robust quantification of GAC and CTQ in the Sanativo® and was considered validated

Avaliação do status de zinco e da expressão gênica de metalotioneínas em pacientes com aterosclerose tratados com rosuvastatina

The study had as objective to evaluate the zinc status by means of dietary intake, zinc in plasma and in erythrocytes and the metallothionein gene expression in patients with atherosclerosis in use of rosuvastatin. The research involved 27 adult and elderly patients of both genders with atherosclerosis that were treated with rosuvastatin (10mg/day) during 4 months. We performed the dosage of lipids, glucose, AST and ALT, ultrasensitive C-reactive protein (hsCRP), plasmatic and erythrocyte zinc and 1 and 2 metallothionein gene expression. The assessment of body mass index (BMI) and abdominal circumference (AC) was performed, besides the analysis of dietary intake of patients. The majority of the evaluated patients presented overweight, before and after the treatment, with no significant difference between the times of the study. It was identified that the AC was significantly reduced in the group (p<0.05) after the intervention. The majority of the patients had intake below the recommendation of calories and fibers and above recommendation of proteins. The mono and polyunsaturated fats were adequate for the majority of the patients, however, the saturated fat and cholesterol were consumed in excess by a great part of the individuals. The intake of zinc was inadequate, being noticed an inadequacy of 100% in the male gender and of 84% in the female. After the treatment with rosuvastatin there was a significant reduction in the total cholesterol (TC) and LDL-c (p<0.01) and no alterations were observed in the HDL-c and triacylglycerols. It was also verified that the reduction of glycemia (p<0.05) and of hsCRP (p<0.01). The analysis did not demonstrate significant differences in the plasmatic and erythrocyte zinc concentration after the treatment. There was, after the treatment, reduction of the MT1F gene (p<0.05) without, however, occurring significant alterations in the MT2A gene. The treatment with rosuvastatin was effective in the reduction of TC and LDL-c, and promoted the reduction of inflammatory marker hsCRP. The zinc in the plasma and erythrocyte was not altered by the use of the medication and there was a reduction in the MT1F gene, possibly due to the reduction of inflammation. The majority of patients presented inadequate intake of zinc and this inadequacy did not have relation with the mineral parameters in plasma and erythrocytes or with the metallothionein gene expression