Mirian Parente Monteiro

Uso de medicamentos contínuos e fatores associados em idosos de Quixadá, Ceará

OBJECTIVE To analyze polypharmacy (daily use of two or more) of continuous use medication and its associated factors in the elderly. METHODS A cross sectional study conducted with elderly individuals living in an urban area of the municipality of Quixadá, Ceara, Brazil from May to December, 2009. The sample consisted of 384 individuals who were 60 years old or older and users of continuous medication. The variables studied were sociodemographic, economical, and health characteristics related to use of medications. For the analysis of the association between the dependent variable polypharmacy of continuous-use medication and the independent variables a logistic regression model was developed. RESULTS Results showed a predominance of females, between 60 and 69 years old, married, with incomplete elementary school education, non-paid job, family income of one minimum salary, living in their own home and together with up to three individuals. A prevalence of 70.6% of polypharmacy in the elderly was found, and it was higher in women (66.4%). Factors positively associated with the use of two or more continuous-use medication were: family income over one minimum salary (OR 2.83; CI95% = 1.54-5.32); two or more self-reported chronic conditions (OR 17.71; CI95% = 9.80-31.990) and self-perception of regular to poor quality of life (OR 2.85; CI95% = 1.60-5.07). CONCLUSIONS The study observed a practice of polypharmacy of continuous-use medications in the elderly with family income over one minimum wage, two or more chronic conditions and self-perception of regular to poor quality of life. Such status leads to questions on social, cultural, economic and health aspects.

Reações adversas causadas por fármacos que atuam no sistema nervoso: análise de registros de um centro de farmacovigilância do Brasil

BACKGROUND: The morbi-mortality by the use of medicines is a major health problem. The drug adverse reactions may result in death, increased hospitalizations and healthcare costs. OBJECTIVES: Describe and analyze reports of suspected adverse reactions caused by drugs that act on the nervous system (SN-ADR), registered in the database of the Pharmacovigilance Centre of Ceara, from January 1997 to March 2008. METHODS: All the NS-ADRs were classified according to criteria of the World Health Organization. The causality between the drug administered and the adverse reaction was established, as well as the analysis regarding to the severity of the reaction. RESULTS: The Centre recorded 176 notifications of RAM-SN. The most of the reactions occurred in the hospital. The main reporter was the pharmacist. All the RAM-SN were classified as possible (n = 110), probable (n = 37) and definite (n = 17). With regard to severity, the NS-ADRs were considered: light (n = 21), moderate (n = 127), serious (n = 15) and fatal (n = 1). The fatal case was reported by physician, and involved anesthetic drugs. In general the adverse reactions observed were caused predominantly by analgesics, anesthetics and antiepileptics. DISCUSSION: The data demonstrate the potential values of accessing to a local system of pharmacovigilance to report possible risks with the use of nervous system drugs.CONTEXTO: A morbimortalidade por uso de medicamentos e um grande problema de saude. As reacoes adversas a medicamentos podem resultar em obito, aumento de internacoes hospitalares e dos custos com a saude. OBJETIVOS: Descrever e analisar as notificacoes de suspeitas de reacoes adversas causadas por medicamentos que atuam no sistema nervoso (RAM-SN), registradas no Centro de Farmacovigilância do Ceara, de janeiro de 1997 a marco de 2008. METODOS: As RAM-SN foram classificadas segundo os criterios da Organizacao Mundial da Saude. Uma relacao de causalidade entre o farmaco administrado e a reacao adversa identificada foi realizada, bem como a analise da reacao quanto a gravidade. RESULTADOS: Foram registradas 176 notificacoes de RAM-SN. A maioria (n = 145; 82,4%) ocorreu no ambiente hospitalar. O principal notificador foi o farmaceutico. As RAM-SN foram classificadas como: possiveis (n = 110), provaveis (n = 37) e definidas (n = 17). Quanto a gravidade, foram consideradas: leves (n = 21), moderadas (n = 127), graves (n = 15) e fatais (n = 1). O caso fatal foi notificado por medico e envolveu medicamentos anestesicos. Geralmente, as reacoes adversas observadas foram causadas predominantemente por analgesicos, anestesicos e antiepilepticos. DISCUSSAO: Os dados demonstram o valor potencial de se ter acesso a sistemas de farmacovigilância local para registrar possiveis riscos com o uso de farmacos.

Ações de Farmacovigilância no Nordeste do Brasil: uma análise de 10 anos de trabalho em prol da segurança no uso de medicamentos

Pharmacovigilance in the Northeast of Brazil: an analysis of 10 years of work in favor of safety in the use of medicines

ABORDAGEM TERAPÊUTICA E SUA RELAÇÃO ENTRE AS CARACTERÍSTICAS SOCIAIS E ECONÔMICAS DE CRIANÇAS NOS CENTROS DE ATENÇÃO PSICOSSOCIAL INFANTOJUVENIS

ABSTRACT Objective: To analyze the therapeutic approach and its relationship with the economic and social characteristics and the care of children in Centers for Psychosocial Attention. Methods: Descriptive study with a sample of 294 children monitored in two Centers for Psychosocial Attention to Children and Adolescents in Fortaleza, Ceará, Northeast Brazil. The study was conducted from February to December, 2012. Participants were accompanied by their parents or caregivers. Data were collected in a structured questionnaire containing social, economic and care variables. The bivariate analysis used the χ2 test to test the association between variables. Results: In this study, 292 children aged 3-12 were selected, following the order of attendance at the service, most of them male (74.3%) and belonging to social classes D and E (89.3%). The most frequent diagnosis referred to by the caregivers was mental disorders. Three different therapeutic approaches were identified: pharmacological approach (44.5%); non-pharmacological approach (11.6%); association of both techniques (43.8%). For all therapeutic approaches, there was association with the variable living situation (p=0.021), as well as with the variables, “improving” with the treatment (p=0.002) and “problems” with the treatment (p=0,004). Conclusions: It was possible to highlight that the associated therapeutic approach (pharmacological and non-pharmacological treatment) provides more benefits to children. Therefore, associating the medicines to the psychotherapeutic practices may be recommended as a strategy in the mental health policy directed to children and adolescents.

Conhecimento e grau de satisfação dos farmacêuticos usuários de um Centro de Informação Sobre Medicamentos (CIM) - doi:10.5020/18061230.2005.p185

The Drug Information Center of Federal University of Ceara (CIM-UFC) serves the health professionals as well as the population through the provision of objective, unbiased, evidence-based information on a variety of pharmacy topics. The present study had the purpose of evaluating the awareness and satisfaction level of pharmacists, users of the services provided by the CIM-UFC. A quantitative, descriptive and cross-sectional study was conducted from May to June, 2005, in which, there were interviewed 53 (62.3%) pharmacists in 26 health care units registered in CIM-UFC. The results revealed that concerning to the awareness and use of CIM-UFC, all professionals reported to know the Center and its services, due mainly, to the University itself during the time that they were Pharmacy students. To 14 (21.6%) of the interviewed professionals, the Center’s informative bulletin was the responsible for introducing CIM-UFC and its services to them. Among the professionals that had used the CIM-UFC services (n=41), 34 (82.9%) reported that the information was provided in a timely manner for being applied; 39 pharmacists (95.1%) confirmed that the informations were clear; 38 (92.7%) said that the answers were objective and 33 (80.5%) considered the answers to be complete. By the performed evaluation, it is concluded that the CIM-UFC has its work recognized by pharmacists of the referred health care unities. The Center has been providing its services with quality, thus obtaining satisfaction from the users, contributing, in this way, for the rational drug use.