Estilo de vida e saúde de um grupo de idosos de Franca, SP

The increase of elderly population in Brazil and all around the world shows the need of reviewing the health cares in order to get a better quality of life. Objective: To evaluate lifestyle and health care of elderly participants of UNATI, Franca, SP. Methods: Sixty elderlies answered a questions about socio-economic issues, health care, food consumption habits and lifestyle, after, they were submitted to anthropometric and laboratory tests. Results: There was a prevalence of women (85%), aged between 60-69 years old (60%), up to high school (60%), retired (65%), income up to 5 minimum wage (73.4%). Most seniors assessed medical care (65%) were in use of long-term medicines (78.3%), they reported to control blood pressure (80%) and to not smoke (100%). About 71.7% people believed to have a healthy diet, 97% took meals at home, 85% chose and prepared their own food, 65% had 5-6 meals/day, 63% drank 1L of water/day, 90% had bowel function and 43.3% practices a regular physical activity. Only 13.3% have done hormone replacement therapy, 18.3% take dietary supplements and 21.7% drink alcoholic drinks. The participants presented a BMI of 27.49 ± 4.5kg/m², prevalence of overweight and eutrophy, which values decreased with age. Leg circumference (LC) (36.27 ± 3.84 cm), Arm circumference (AC) (31.39 ± 4.08 cm) and triceps skinfolds (TS) (20.58±7.54mm) values were suit in most cases (96.7, 85 and 83.3%, respectively). Serum total cholesterol values were 198.53 ± 35.2mg/dL, 55% were considered optimum. About 63.3% and 68.3% of the elderlies, respectively, presented a high density lipoproteins (HDL) (53.58± 10.9mg/dL) and triglycerides (TG) (143.97 ± 92.37mg/dL) according to the recommendation and 51.7% of the elderlies had normal glycemia, 38.3% had risk and 10% showed high blood glucose, indicating diabetes. Conclusion: Many elderlies had body mass index (BMI) above normal, indicating overweight or obesity, but the participants can be considered healthy because of AC, LC and TS values, diet habits, health care and lifestyle.

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.

Assessment of the quality evaluation of compounded fluconazole capsules marketed in the region of Araraquara (SP, Brazil)

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

Validation of analytical methodology for quantification of cefazolin sodium by liquid chromatography

A reversed-phase high performance liquid chromatography method was validated for the determination of cefazolin sodium in lyophilized powder for solution for injection to be applied for quality control in pharmaceutical industry. The liquid chromatography method was conducted on a Zorbax Eclipse Plus C18 column (250 x 4.6 mm, 5 μm), maintained at room temperature. The mobile phase consisted of purified water: acetonitrile (60: 40 v/v), adjusted to pH 8 with triethylamine. The flow rate was of 0.5 mL min-1 and effluents were monitored at 270 nm. The retention time for cefazolin sodium was 3.6 min. The method proved to be linear (r2 =0.9999) over the concentration range of 30-80 µg mL-1. The selectivity of the method was proven through degradation studies. The method demonstrated satisfactory results for precision, accuracy, limits of detection and quantitation. The robustness of this method was evaluated using the Plackett–Burman fractional factorial experimental design with a matrix of 15 experiments and the statistical treatment proposed by Youden and Steiner. Finally, the proposed method could be also an advantageous option for the analysis of cefazolin sodium, contributing to improve the quality control and to assure the therapeutic efficacy

Controle de qualidade e obtenção de extratos de espécies vegetais do cerrado brasileiro com potencial etnofarmacológico

ANVISA (National Health Surveillance Agency) has published in recent years, laws that regulate the stages of the control of plants derivatives, including tests of macro and microscopic botanical identification, phytochemical determination, tests of authenticity and purity, microbiological testing, among other parameters. All the analytical procedures of plant drugs control required by law must be based on the Brazilian Pharmacopoeia, other Pharmacopoeias recognized by ANVISA or quality control guides of plant species published by the World Health Organization (WHO). This study aimed to evaluate some pharmacognostic, phytochemical screening and microbiological control of plant species of the Brazilian cerrado, which have indicated ethnopharmacological: Byrsonima intermedia (Bi), Bauhinia holophylla (Bh) and Myrcia bella (Mb). In addition, certain parameters were determined for obtaining extracts from plants sprayed and dried. These data are important to obtain new scientific information from Brazilian plants with therapeutic potential.

Influence of Darunavir: β-cyclodextrin complex on the solubility of Darunavir

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Extratos secos padronizados: tendência atual em Fitoterapia

Data shows that the use of the medicinal plants in industrialized countries represents around 20% of the total medical prescriptions. Considering the need to establish a safe phytotherapic practice, specially when the evidence based medicine is a current tendency, phytotherapic medicines can no longer justify any doubts regarding its safety and efficacy. So, proof of efficacy and safety must result preferably from properly conducted clinical trials, although the legislation exempts such studies for traditional or well established phytotherapics. In this article, benefits and advantages of standardized dry extracts used in phytotherapic medicines instead of powder drugs and dry extracts are analyzed and discussed. The study reveals as main conclusive remark, that adequate clinical trials are essential to promote this therapeutical practice.

Development and validation of a stability-indicative turbidimetric assay to determine the potency of doxycycline hyclate in tablets

The doxycycline (DOX) is a broad-spectrum antibiotic used in several countries. This drug is part of the list of medicines to the SUS (Unified Health System), a model of health care in Brazil. This study describes the development and validation of a microbiological assay, applying the turbidimetric method for the determination of DOX, as well as the evaluation of the ability of the method in determining the stability of DOX in tablets against acidic and basic hydrolysis, photolytic and oxidative degradations, using Escherichia coli ATCC 10536 as micro-organism test and 3×3 parallel line assay design, with nine tubes for each assay, as recommended by the Brazilian Pharmacopoeia. The developed and validated method showed excellent results of linearity, selectivity, precision, accuracy and robustness. The assay is based on the inhibitory effect of DOX using Escherichia coli ATCC 10536. The results of the assay were treated by analysis of variance and were found to be linear (r= 0.9986) in the range from 4.0 to 9.0μg/mL, precise (repeatability R.S.D.= 0.99 and intermediate precision was confirmed by statistical analysis the mean values obtained from analysis by different analysts) and exact (97.73%). DOX solution exposed to direct UV light, alkaline and acid hydrolysis and hydrogen peroxide causing oxidation were used to evaluate the specificity of the bioassay. Comparison of bioassay and liquid chromatography showed differences in results between methodologies. The results showed that the bioassay is valid, simple and useful alternative methodology for DOX determination in routine quality control.

Doxycycline hyclate: a review of properties, applications and analytical methods

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

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.

Regulatory issues on pharmacovigilance in Latin American countries

Pharmacovigilance is responsible for monitoring the safety of medicines in normal clinical use andduring clinical trials. Legal requirements for pharmacovigilance in some Latin American countries (Argentina, Brazil, Chile, Paraguay and Uruguay) were reviewed. Disparities in the legal framework among the countries are observed being those for marketing authorization holders one of the most evident. Theactive rol of the universities and drug information centers for/of pharmacovilance seems to be a positivecommon point. Legal requirements regarding pharmacovigilance of biosimilar medicines, is still a pointto be developed.

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.

Farmácia magistral: sua importância e seu perfil de qualidade

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

Plantas medicinais: indicação popular de uso no tratamento de hipertensão arterial sistêmica (HAS)

The aim of this study is to investigate the spontaneous use of medicinal plants by volunteer patients in the treatment of hypertension and to determine the most used plants in this situation. Data were collected through a questionnaire and a semi-structured guided interview applied to patients from a health center in the Midwest region of the state of Sao Paulo, Brazil. Quantitative analysis identified a high number of hypertensive patients spontaneously using herbal treatment. The referred plants were identified by the Herbarium Botu and researched in the literature as to their therapeutic actions. The biggest mistake was observed in the misuse of the Bilberry for the treatment of hypertension, which reveals that health professionals and the community in general should be more careful. As a result we have published an informative booklet, with emphasis on hypertension concepts and on the use of medicinal plants as an alternative therapy method for this disease in order to provide scientific knowledge and scientific research evidence to this practice.

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.