RESUMO
The objective of this study was to evaluate the effects of different protocols (P1, P2, and P3) of boldenone undecylenate (BU) and stanozolol (ST) on markers of liver and kidney function and variables of oxidative stress in these organs. For this, 54 male Wistar rats were divided into nine groups of six animals each. Each animal received intramuscularly 5.0 mg kg-1 of BU or ST once a week for 4 weeks (P1); 2.5 mg kg-1 of BU or ST once a week for 8 weeks (P2); and 1.25 mg kg-1 of BU or ST once a week for 12 weeks (P3). For each protocol, a control group was used, and they received 0.1 ml of olive oil intramuscularly. Blood and fragments of liver and kidney were collected for alanine aminotransferase activity (ALT), alkaline phosphatase, albumin, creatinine, cholesterol, total protein, triglycerides, urea, reactive oxygen species, thiobarbituric acid reactive substances, total thiols, and glutathione evaluation. The results show that the BU in doses of 5 (day 30) and 2.5 mg kg-1 (day 60) changes the ALT seric activity, possibly showing a hepatotoxic effect. High doses of BU may lead to increased levels of cholesterol (protocol P1) possibly due to inhibition of the normal steroid biosynthesis process. All protocols used caused changes in the redox balance of the organs studied (except in the liver, protocol P2), which indicates that these drugs might be harmful even at low doses.
Assuntos
Rim/metabolismo , Fígado/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Congêneres da Testosterona/efeitos adversos , Congêneres da Testosterona/farmacologia , Animais , Biomarcadores/metabolismo , Rim/patologia , Fígado/patologia , Masculino , Ratos , Ratos WistarRESUMO
This study evaluated the effects of curcumin and/or insulin on antioxidant enzyme activity in blood, liver, and kidney, as well as on lipid peroxidation and delta aminolevulinic dehydratase (δ-ALA-D) activity, and a histopathological analysis of streptozotocin-induced diabetic rats. The animals were divided into six groups (n = 6): control/saline (C); control/curcumin (CCur); diabetic/saline (D); diabetic/insulin (DIns); diabetic/curcumin (DCur); and diabetic/insulin/curcumin (DInsCur). After 30 days of treatment with curcumin and/or insulin, the animals were sacrificed and the liver, kidney, and serum were used for experimental determinations. Results of histopathological analysis showed that the treatment with insulin ameliorate renal and hepatic lesions from both DIns and DInsCur groups. TBARS levels were significantly increased in serum, liver, and kidney in D group and the administration of curcumin and insulin prevented this increase in DIns and DCur groups. The activities of catalase (CAT), superoxide dismutase, and δ-ALA-D presented a significant decrease in the liver and kidney D group when compared to C group (P < 0.05). The animals treated with curcumin and insulin presented an increase of CAT activity, revealing a positive interaction between both substances. The treatments with curcumin or insulin prevented oxidative stress in blood, through modulation of enzymatic antioxidant defenses. These findings contributed to the comprehension that antioxidants from medicinal plants could be used as adjuvant in the treatment of this endocrinopathy and not as single therapy.
Assuntos
Curcumina/administração & dosagem , Diabetes Mellitus Experimental/metabolismo , Insulina/administração & dosagem , Rim/metabolismo , Fígado/metabolismo , Estresse Oxidativo , Animais , Glicemia/análise , Peso Corporal , Catalase/sangue , Diabetes Mellitus Experimental/sangue , Rim/enzimologia , Peroxidação de Lipídeos , Fígado/enzimologia , Masculino , Sintase do Porfobilinogênio/metabolismo , Ratos , Ratos Wistar , Estreptozocina , Superóxido Dismutase/metabolismoRESUMO
Bacterial cystitis is a common clinical problem among cats and dogs and is one of the main reasons for the administration of antimicrobials. This can cause serious damage to public and animal health, as this practice facilitates the selection of bacteria that are multidrug-resistant to antibiotics. In this context, it is urgent to understand and validate therapeutic modalities that complement antimicrobial treatment in cystitis cases. Ozone therapy has been proposed by scientists owing to the various mechanisms of action in a range of pathologies, both in human and animal medicine. This paper describes the bactericidal action of two different protocols of bladder irrigation with ozonized saline solution (59 µg/mL) in a paraplegic canine with recurrent bacterial cystitis caused by Proteus spp. In the first protocol, the bladder instillations were applied once a day for three consecutive days while in the second, successive lavages were performed throughout the day until a significant reduction in the presence of bacteria in the urine sediment. In this study, we were able to demonstrate that repeated bladder instillation within 24 hours was the most effective treatment for Proteus compared to a single instillation on successive days.
Assuntos
Cistite , Solução Salina , Animais , Cães , Humanos , Gatos , Solução Salina/uso terapêutico , Cistite/tratamento farmacológico , Cistite/microbiologia , Cistite/patologia , Resultado do Tratamento , ProteusRESUMO
INTRODUCTION: Physiologically, feline platelets are more reactive and prone to aggregation, which interferes with platelet counts using automated counters and manual methods. The use of aminoglycoside amikacin in association with EDTA has proven to be efficient in preventing platelet aggregates in cases of pseudo thrombocytopenia (PTP) in people. OBJECTIVES: This study evaluated the efficacy of amikacin in preventing platelet aggregation in EDTA-containing feline blood samples and investigated the possible effects on hematologic measurands. MATERIALS AND METHODS: Blood samples (1.0 mL) collected from 100 healthy cats were stored in two EDTA tubes: 0.5 mL in a microtube containing 10 µL of 250 mg/mL amikacin (EDTA-AMK group) and 0.5 mL in a microtube containing only K2 EDTA 10% (EDTA group). A CBC was executed with an automated impedance blood analyzer, and a microscopic examination of the blood smears was performed. RESULTS: Platelet clumps were observed in 56% of samples from the EDTA group and 5% of samples from the EDTA-AMK group. Platelet counts (PLT), plateletcrit (PCT), and WBC counts were significantly higher (P < .001) in the EDTA-AMK group compared withi the EDTA group. CONCLUSIONS: Amikacin prevents platelet aggregation in feline venous blood samples and does not cause clinically relevant changes in other hematologic measurands. To our knowledge, this is the first report showing the use of amikacin in preventing platelet aggregation in feline blood samples. Based on this study, amikacin could be added to EDTA collection tubes for complete blood counts in cats.
Assuntos
Doenças do Gato , Trombocitopenia , Amicacina/farmacologia , Animais , Gatos , Ácido Edético/farmacologia , Humanos , Agregação Plaquetária , Contagem de Plaquetas/métodos , Contagem de Plaquetas/veterinária , Trombocitopenia/diagnóstico , Trombocitopenia/veterináriaRESUMO
We investigated the adverse effects of the anabolic androgenic steroids (AAS) boldenone (BOL) and stanazolol (ST) on the enzymatic antioxidant systems of the rat liver. Male Wistar rats were divided in three protocols (P): PI, 5 mg/kg BOL or ST once a week for 4 weeks; PII, 2.5 mg/kg BOL or ST once a week for 8 weeks; PIII, 1.25 mg/kg BOL or ST once a week for 12 weeks. AAS were administered intramuscularly (0.2 ml, olive oil vehicle) once a week in all protocols. Activities of the enzymes glutathione peroxidase (GPx), glutathione S-transferase (GST), and glutathione reductase (GR), superoxide dismutase (SOD), catalase (CAT), were investigated. We assessed the content of hydrogen peroxide (H2O2), glycogen and lactate; and enzyme markers of neutrophils (myeloperoxidase, MPO) and macrophages (NAGase). PI and PII altered the SOD and CAT activities and increased the H2O2 content. PI led to increases in the MPO and NAGase activities. In contrast, changes in GPx, GST and, GR were observed under PII and, to a greater extend, under PIII. Following PIII, GPx, GR, and GST exhibited reduced activities. All protocols altered the glycogen and lactate content. The use of high doses of AAS for a short duration first alters SOD/CAT activity. In contrast, at lower doses of AAS for long periods is associated with changes in the glutathione system. Protocols with high doses of AAS for a short duration exert the most deleterious effects on redox status, markers of cellular infiltration, and the metabolic functioning of hepatic tissues.
Assuntos
Antioxidantes/metabolismo , Glicogênio/metabolismo , Ácido Láctico/metabolismo , Fígado/efeitos dos fármacos , Fígado/enzimologia , Estanozolol/farmacologia , Testosterona/análogos & derivados , Acetilglucosaminidase/metabolismo , Animais , Relação Dose-Resposta a Droga , Fígado/metabolismo , Peroxidase/metabolismo , Ratos , Ratos Wistar , Testosterona/farmacologia , Fatores de TempoRESUMO
This study aimed to evaluate nucleoside triphosphate diphosphohydrolase (NTPDase) and adenosine deaminase (ADA) activities in lymphocytes from rats supplemented or not with curcumin 30â¯days prior to experimental infection with Trypanosoma evansi. Thirty-two adult male Wistar rats were divided in four groups. The pre-infection group 20 (PreI20) received orally 20â¯mg/kg of curcumin and pre-infection group 60 (PreI60) received orally 60â¯mg/kg of curcumin for 30â¯days prior inoculation with T.â¯evansi. The infected e non-infected control groups received only oral vehicle for 30â¯days. Trypanosoma evansi infected groups were inoculated intraperitoneally with 0.2â¯ml of blood with 1â¯×â¯106 parasites. After inoculation the treatment of the groups continued until the day of euthanasia (15â¯days). The results showed that curcumin pre-treatment, with both doses, reduced (Pâ¯<â¯.05) NTPDase and increased (Pâ¯<â¯.05) ADA activity in lymphocytes of treated groups when compared to untreated and infected animals (control). The results of this study support the evidence that the regulation of ATP and adenosine levels by NTPDase and ADA activities appear to be important to modulate the immune response in T.â¯evansi infection, once the treatment with curcumin maintained the NTPDase activity reduced and enhanced ADA activity in lymphocytes. It is possible to conclude that the use of curcumin prior to infection with T.â¯evansi induces immunomodulatory effects, favoring the response against the parasite.
Assuntos
Nucleotídeos de Adenina/metabolismo , Adenosina Trifosfatases/metabolismo , Curcumina/metabolismo , Imunomodulação/efeitos dos fármacos , Tripanossomíase/metabolismo , Ração Animal/análise , Animais , Curcumina/administração & dosagem , Dieta/veterinária , Suplementos Nutricionais/análise , Relação Dose-Resposta a Droga , Linfócitos/parasitologia , Masculino , Distribuição Aleatória , Ratos , Ratos Wistar , Trypanosoma/fisiologiaRESUMO
Objetivo: investigar o estado da arte das publicações científicas ampliadas voltadas para a dinamização da ciência. Método: pesquisa qualitativa de cunho integrativo nas seguintes bases de dados Web of Science, Library, Information Science and Technology Abstracts e Scopus via Portal Periódicos Capes, Dimensions, PLOS ONE, Base de Dados Referencial de Artigos de Periódicos em Ciência da Informação e Scientific Eletronic Library Online no período de junho de 2022. Resultados: onze artigos divididos em duas categorias: caracterização das publicações ampliadas e infraestrutura de suporte para as publicações ampliadas. Conclusão: apesar de multivariadas, as publicações ampliadas possuem características peculiares que as tornam objetos digitais compostos e dinâmicos e com melhor experiência para o usuário. Os artigos apontam que não há infraestrutura de suporte nas plataformas de periódicos e quando encontrado, se apresenta simples e com poucos recursos.
Objectives: to investigate the state of the art of expanded scientific publications aimed at boosting science. Method: qualitative research of an integrative nature in the following databases: Web of Science, Library, Information Science and Technology Abstracts and Scopus via Portal Periodicals Capes, Dimensions, PLOS ONE, Reference Database of Journal Articles in Science of Information and Scientific Electronic Library Online in the period of June 2022. Results: eleven articles divided into two categories: characterization of expanded publications and support infrastructure for expanded publications. Conclusion: Despite being multivariate, expanded publications have peculiar characteristics that make them composite and dynamic digital objects with a better user experience. The articles point out that there is no support infrastructure on journal platforms and when found, it is simple and with few resources.
Objetivos:investigar el estado del arte de las publicaciones científicas ampliadas destinadas al impulso de la ciência. Método: investigación cualitativa de carácter integrador em las siguients bases de datos: Web of Science, Library, Information Science and Technology Abstracts y Scopus vía Portal Periodicals Capes, Dimensions, PLOS ONE, Reference Database of Journal Articles in Science of Information y Scientific Electronic Library Online en el período de junio de 2022. Resultados:once artículos divididos em dos ctegorías: caracterización de publicaciones expandidas e infraestructura de soporte para publicaciones expandidas. Conclusión: a pesar de ser multivariadas, las publicaciones expandidas tienen características peculiares que las convierten em objetos digitales compuestos y dinâmicos com uma mejor ecperiencia de usuário. Los artículos señalan que no existe uma infraestructura de apovo em las plataformas de revistas y cuando se encuentra es sencilla y com pocos recursos.
Assuntos
Enfermagem , Comunicação e Divulgação Científica , Publicação Periódica , Publicação de Acesso Aberto/tendênciasRESUMO
The aim of this study was to assess if the dose and exposure duration of the anabolic androgenic steroids (AAS) boldenone (BOL) and stanazolol (ST) affected memory, anxiety, and social interaction, as well as acetylcholinesterase (AChE) activity and oxidative stress in the cerebral cortex (CC) and hippocampus (HC). Male Wistar rats (90 animals) were randomly assigned to three treatment protocols: (I) 5 mg/kg BOL or ST, once a week for 4 weeks; (II) 2.5 mg/kg BOL or ST, once a week for 8 weeks; and (III) 1.25 mg/kg BOL or ST, once a week for 12 weeks. Each treatment protocol included a control group that received an olive oil injection (vehicle control) and AAS were administered intramuscularly (a total volume of 0.2 ml) once a week in all three treatment protocols. In the BOL and ST groups, a higher anxiety level was observed only for Protocol I. BOL and ST significantly affected social interaction in all protocols. Memory deficits and increased AChE activity in the CC and HC were found in the BOL groups treated according to Protocol III only. In addition, BOL and ST significantly increased oxidative stress in both the CC and HC in the groups treated according to Protocol I and III. In conclusion, our findings show that the impact of BOL and ST on memory, anxiety, and social interaction depends on the dose and exposure duration of these AAS.
Assuntos
Acetilcolinesterase/metabolismo , Anabolizantes/farmacologia , Androgênios/farmacologia , Comportamento Animal/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Agressão/efeitos dos fármacos , Anabolizantes/administração & dosagem , Androgênios/administração & dosagem , Animais , Relação Dose-Resposta a Droga , Hipocampo/efeitos dos fármacos , Hipocampo/patologia , Masculino , Ratos Wistar , Estanozolol/administração & dosagem , Estanozolol/farmacologia , Territorialidade , Testosterona/administração & dosagem , Testosterona/análogos & derivados , Testosterona/farmacologiaRESUMO
The present study was conducted to analyze the adverse effects of the anabolic steroids boldenone (BOL) and stanazolol (ST) in the reproductive function of male rats. These molecules were administered using three different protocols. In Protocol I, BOL and ST were administered in a higher dose than what is recommended but for a short period. In Protocol II, a moderate dose of these compounds was applied for an intermediate period, whereas in Protocol III a reduced dose was administered but for an extended period. Notably, Protocol I and III resulted in increased levels of reactive oxygen specimens (ROS [I, p < 0.01] [III, p < 0.001)]) and nitrite plus nitrate (NOx [I, p < 0.01] [II, p < 0.01] [III,p < 0.05]), respectively, whereas non-protein thiols (NPSH) levels were decreased only after Protocol III (p < 0.01). Myeloperoxidase activity was significantly increased after treatment with BOL in protocol II (p < 0.01) and III (p < 0.05) than with ST in protocol III (p < 0.05). Boldenone and ST also caused a significant up-regulation in the levels of serum testosterone when protocols I (p < 0.01) and II (p < 0.05) were performed. There were also visible histopathological alterations in the testes induced by treatment with BOL, namely degenerative changes primarily characterized by a decrease in the germinal epithelium. Together, these results suggest that the administration of BOL or ST exerts a significantly harmful effect in the testes of male rats. Moreover, all the treatment protocols used in this study induced deleterious effects on the testes, as indicated by the different biochemical parameters investigated. However, only the protocols of longer exposure time (II and III) induced morphological changes compatible with infertility.
Assuntos
Anabolizantes/efeitos adversos , Estanozolol/efeitos adversos , Testículo/efeitos dos fármacos , Testosterona/análogos & derivados , Animais , Relação Dose-Resposta a Droga , Masculino , Nitrosação , Estresse Oxidativo/efeitos dos fármacos , Peroxidase/metabolismo , Ratos Wistar , Espécies Reativas de Oxigênio/análise , Testículo/química , Testículo/patologia , Testosterona/efeitos adversos , Testosterona/sangue , Fatores de TempoRESUMO
Peripheral inflammatory stimuli may activate a brain neuroinflammatory processes with consequences in brain function. The present study investigated if anthocyanins (ANT) consumption was able to prevent the memory loss, the neuronal damage, and the neuroinflammatory processes triggered by the intraperitoneal lipopolysaccharide (LPS) administration. C57BL6 male mice were treated with ANT (30-100 mg/kg by gavage). With a single dose or during 10 days, before be challenged with LPS (250 µg/kg intraperitoneally single administration), a classical inductor of inflammation. The data obtained showed that ANT was able to confer protection against the memory impairment after 10 days of ANT treatment (100 mg/kg). This phytonutrient also prevented the hypothermia episode induced by LPS. Moreover, ANT prevented the increase in protein carbonyl, NOx, and MDA levels in the hippocampus and cerebral cortex (4 and 24 h) in animal challenged with LPS. ANT showed a protective effect on the increase in the pro-inflammatory cytokines content, especially Interleukin (IL)-1ß, tumoral necrosis factor-α and on the reduction of IL-10 induced by LPS. ANT 100 mg/kg prevented the infiltration of peripheral immune cells in the hippocampus at 24 h post-LPS administration. In parallel, LPS increased the activity of myeloperoxidase in cortex and hippocampus, and ANT prevented this effect, also reducing microglia (Iba-1) and astrocyte (GFAP) immunoreactivity. Thus, our data support that ANT are a promising therapeutic component against brain disorders associated with process of neuroinflammation. Graphical Abstract á .
Assuntos
Antocianinas/uso terapêutico , Inflamação/tratamento farmacológico , Transtornos da Memória/tratamento farmacológico , Animais , Antocianinas/farmacologia , Córtex Cerebral/enzimologia , Córtex Cerebral/patologia , Hipocampo/enzimologia , Hipocampo/patologia , Hipotermia Induzida , Inflamação/complicações , Mediadores da Inflamação/metabolismo , Lipopolissacarídeos/administração & dosagem , Masculino , Transtornos da Memória/complicações , Camundongos Endogâmicos C57BL , Modelos Biológicos , Neuroglia/efeitos dos fármacos , Neuroglia/metabolismo , Neuroglia/patologia , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Neurônios/patologia , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/uso terapêutico , Estresse Oxidativo/efeitos dos fármacos , Peroxidase/metabolismo , ATPase Trocadora de Sódio-Potássio/metabolismoRESUMO
Enquadramento: A terapêutica medicamentosa hospitalar possui potencial para incidentes e, neste sentido, é preciso intercetar situações que possam comprometer a segurança do doente. Objetivo: Investigar as potenciais interações medicamentosas favorecidas pela sobreposição de medicamentos programados por enfermeiros nas prescrições de doentes numa unidade de internamento hospitalar. Metodologia: Estudo descritivo, transversal, de análise documental com abordagem quantitativa, de 260 prescrições medicamentosas de doentes adultos. As potenciais interações medicamentosas foram identificadas por meio da ferramenta Drug Interaction Checker (Medscape®). Resultados: Foram analisadas 3066 doses, com concentração de 4 horários, evidenciando uma padronização institucional de horários. A taxa de erros de omissão foi 5,44%. As interações medicamentosas com gravidade moderada foram as mais frequentes, destacando-se as combinações de lopinavir/clonazepam e diazepam/tramadol. Conclusão: Os erros de omissão e as interações podem ser minimizados com ferramentas de apoio à decisão clínica e reconfiguração do processo de trabalho.
Background: Hospital drug therapy has the potential for incidents, thus it is necessary to identify situations that may compromise patient safety. Objective: To investigate potential drug-drug interactions caused by the overlapping of medications planned by nurses in the patients' prescriptions at a hospital inpatient unit. Methodology: Descriptive, cross-sectional study of documentary analysis with a quantitative approach, of 260 prescriptions for adult patients. Potential drug- interactions were identified using the Drug Interaction Checker (Medscape®). Results: A total of 3066 doses were analyzed, with a concentration of 4 schedules, showing an institutional standardization of schedules. The omission error rate was 5.44%. Drug-drug interactions of moderate severity were more frequent, especially lopinavir/clonazepam and diazepam/tramadol combinations. Conclusion: Omission errors and interactions can be minimized with tools to support clinical decision and reconfiguration of the work process.
Marco contextual: El tratamiento farmacológico hospitalario tiene el potencial de provocar incidentes y, por ello, es necesario interceptar las situaciones que puedan comprometer la seguridad del paciente. Objetivo: Investigar las posibles interacciones de medicamentos favorecidas por la superposición de los medicamentos programados por los enfermeros en las recetas de los pacientes en una unidad hospitalaria. Metodología: Estudio descriptivo, transversal, de análisis documental, con enfoque cuantitativo, de 260 recetas de medicamentos de pacientes adultos. Se identificaron posibles interacciones entre los medicamentos mediante la herramienta Drug Interaction Checker (Medscape®). Resultados: Se analizaron 3066 dosis, con una concentración de 4 horarios, lo que mostró una estandarización institucional de los horarios. La tasa de errores de omisión fue del 5,44%. Las interacciones de medicamentos de gravedad moderada fueron las más frecuentes, de entre las cuales destacaron las combinaciones de lopinavir/clonazepam y diazepam/tramadol. Conclusión: Los errores por omisión y las interacciones pueden reducirse al mínimo con herramientas de apoyo a las decisiones clínicas y la reconfiguración de los procesos de trabajo.
Assuntos
Segurança do Paciente , Erros de Medicação , Enfermagem , Interações Medicamentosas , Sistemas de Medicação no HospitalRESUMO
RESUMO Objetivo: investigar na literatura evidências sobre interações advindas de prescrições de medicamentos de pacientes adultos internados. Método: Trata-se de uma revisão integrativa da literatura, realizada por meio de seis etapas. A coleta de dados ocorreu em julho de 2020, nas bases de dados da BDENF, LILACS via BVS, CINAHL, SCOPUS, Web of Science via Portal Periódicos Capes e SciELO, com os descritores drug interactions, drug prescriptions e patient safety. Selecionaram-se 18 produções no recorte temporal de 2008 a 2020. Resultados: dos artigos selecionados, dez eram estudos nacionais e oito internacionais. As unidades de terapia intensiva e emergência foram os cenários mais investigados. Os resultados foram categorizados em três eixos temáticos: prescrições e interações medicamentosas; aprazamento e interações medicamentosas; intervenções e interações medicamentosas. Conclusão: as interações medicamentosas possuem altas taxas, principalmente nas prescrições medicamentosas com polifarmácia e em unidades críticas. As intervenções com software para apoio à decisão clínica e presença do farmacêutico clínico obtiveram resultados positivos e significativos.
RESUMEN Objetivo: investigar en la literatura evidencias sobre interacciones provenientes de prescripciones de medicamentos de pacientes adultos hospitalizados. Método: se trata de una revisión integradora de la literatura, realizada através de seis etapas. La recolección de datos ocurrió en julio de 2020, en las bases de datos de la BDENF, LILACS vía BVS, CINAHL, SCOPUS, Web of Science vía Portal Periódicos Capes y SciELO, con los descriptores drug interactions, drug prescriptions y patient safety. Fueron seleccionadas 18 producciones en el recorte espacio temporal de 2008 a 2020. Resultados: de los artículos seleccionados, diez eran estudios nacionales yocho internacionales. Las unidades de cuidados intensivos y urgencias fueron los escenarios más investigados. Los resultados fueron categorizados en tres ejes temáticos: prescripciones e interacciones medicamentosas; plazos e interacciones medicamentosas; intervenciones e interacciones medicamentosas. Conclusión: las interacciones medicamentosas poseen altas tasas, principalmente en las prescripciones medicamentosas con polifarmacia y en unidades críticas. Las intervenciones con software para el apoyo a la decisión clínica yla presencia del farmacéutico clínico obtuvieron resultados positivos y significativos.
ABSTRACT Objective: to investigate evidence in the literature about interactions arising from drug prescriptions of hospitalized adult patients. Method: this is an integrative literature review carried out through six steps. Data collection took place in July 2020, in the BDENF, LILACS via BVS, CINAHL, SCOPUS, Web of Science via Capes Periodicals Portal and SciELO databases, using the descriptors drug interactions, drug prescriptions and patient safety. Eighteen productions were selected in the time frame from 2008 to 2020. Results: of the articles selected, ten were national and eight international studies. Intensive care and emergency units were the most investigated scenarios. The results were categorized into three thematic axes: prescriptions and drug interactions; scheduling and drug interactions; interventions and drug interactions. Conclusion: drug interactions occur at high rates, mainly in cases of drug prescriptions associated with polypharmacy and in critical units. Interventions with software to support clinical decision and the presence of a clinical pharmacist brought significant and positive results.
Assuntos
Prescrições de Medicamentos , Interações Medicamentosas , Segurança do Paciente , Preparações Farmacêuticas , Hospitais , Pacientes Internados , Enfermeiras e EnfermeirosRESUMO
A terapêutica medicamentosa tem predomínio no ambiente hospitalar, apresenta-se em um contexto com inúmeras possibilidades para incidentes e assim, mais desafiador para interceptar situações que comprometam uma assistência de qualidade. O enfermeiro possui a responsabilidade sobre o processo de medicação e ocupam papel essencial na detecção e prevenção das interações medicamentosas ao adequar os horários durante o aprazamento. Este estudo teve por objetivo investigar as potenciais interações medicamentosas favorecidas pela sobreposição de medicamentos aprazados por enfermeiros nas prescrições de pacientes em unidade de internação clínica. Trata-se de um estudo descritivo, transversal, de análise documental com abordagem quantitativa com 260 prescrições medicamentosas. Foram selecionadas, por conveniência, prescrições de pacientes adultos de duas unidades de internação clínica de um hospital universitário localizado no Rio de Janeiro durante o mês de setembro de 2019. Os dados foram analisados por meio de estatística descritiva através do Microsoft Excel e as potenciais interações medicamentosas foram identificadas por meio da ferramenta Drug Interactions (Medscape®). Foi aprovado pelo Comitê de Ética em Pesquisa, da referida instituição sob o parecer: 3.556.571. Foram 3066 doses analisadas com concentração de quatro horários (10h, 18h, 22h e 06h) evidenciando aprazamento institucional padronizado. A via oral foi a mais predominante (74%). Os motivos para a omissão de dose foram: 60,3% sem justificativas, 22,8% não havia o medicamento ou não era padronizado e em 5,3% das doses, o horário estava ausente e as principais classes envolvidas foram: aparelho digestivo e metabolismo (38,6%), anti-infecciosos gerais para uso sistêmico (15,9%) e sistema nervoso (15,3%). A taxa de erros de medicação foi 5,44. Quanto ao tipo de prescrição, houve predomínio de prescrições pré-digitadas (n=194, 74,61%), apenas 3 (1,15%) foram escritas à mão e 63 (24,23%) foram mistas. As interações medicamentosas potenciais com menor gravidade foram ácido valproico/ isoniazida e carbonato de cálcio/ aspirina ambos com 19,7%, com gravidade moderada foram lopinavir/ clonazepam (11,9%) e diazepam/ tramadol (7,3%) e com risco grave foram isoniazida/ omeprazol (12,3%) e com 2,8% rifampicina/ dexametasona. A equipe de enfermagem deve considerar o cuidado centrado no paciente com aprazamento mais próximo às necessidades individuais, inclusive na preservação do sono e evitando a sobreposição medicamentosa, comunicação verbal e escrita adequada, a utilização de bases de dados como ferramenta de apoio à decisão clínica, realização da dupla checagem, elaboração de um guia de aprazamento, bem como um ambiente reservado para sua realização e a configuração do processo de trabalho quanto à organização, distribuição e acondicionamento dos medicamentos de forma adequada.
Drug therapy is predominant in the hospital environment, presenting itself as a context subject to numerous incidents possibilities, therefore, it's more challenging to intercept situations that compromise the quality of care. The nurse is responsible for the medication process and plays an essential role in detecting and preventing drug interactions by the adjustment of the schedules during the scheduling. The aim of this study was to investigate the potential drug interactions favored by overlapping of medications scheduled by nurses in patients' prescriptions at a clinical inpatient unit. This is a descriptive cross-sectional study of document analysis, through a quantitative approach with 260 drug prescriptions. For convenience, the prescriptions selected were those from adult patients from two inpatient units of a university hospital located in Rio de Janeiro, during September 2019. Data were analyzed through descriptive statistics using Microsoft Excel, and the potential drug interactions were identified using the Drug Interactions tool (Medscape®). The present work was approved by the Ethics and Research Committee of the mentioned institution under the peer review: 3,556,571. There were 3066 analyzed doses, with a concentration of four hours (10h, 18h, 22h and 06h) showing standardized institutional schedule. The oral route was the most predominant (74%). The reasons for dose omission were: 60.3% without justification; in 22.8%, there was no medication, or it was not standardized; and, in 5.3% of doses, the time was absent. The main classes involved were: digestive tract and metabolism (38.6%), general anti-infectives for systemic use (15.9%) and nervous system (15.3%). The medication error rate was 5.44. Regarding the type of prescription, there was a predominance of preset prescriptions (n=194, 74.61%); only 3 (1.15%) were handwritten, and 63 (24.23%) were mixed. The potential drug interactions with lower severity were valproic acid/ isoniazid and calcium carbonate/ aspirin, both with 19.7%; those with moderate severity were lopinavir/ clonazepam (11.9%) and diazepam/ tramadol (7.3%); and the ones with severe risk were isoniazid/ omeprazole (12.3%) and rifampicin/ dexamethasone (2.8%). Nursing staff must consider patient-centered care by adopting a medication schedule closer to the patient's individual needs, including sleep preservation and avoiding drug overlap; a proper verbal and written communication; the use of databases as a clinical decision support tool; double checking; the elaboration of a scheduling guide, as well as a reserved environment for its accomplishment; and the configuration of the work process regarding the organization, the distribution and a proper packaging of the medications.
Assuntos
Prescrições de Medicamentos , Enfermagem , Interações Medicamentosas , Segurança do Paciente , Erros de Medicação , Sistemas de Medicação no Hospital , Rifampina , Tramadol , Omeprazol , Brasil , Dexametasona , Clonazepam , Diazepam , Lopinavir , Isoniazida , Anti-InfecciososRESUMO
Um potro da raça crioula, com dois anos de idade, foi encaminhado ao Hospital Veterinário da Universidade Federal de Santa Maria (UFSM) apresentando aumento de volume na região da patela esquerda e claudicação manifestada ao trote. Os exames físico e radiográfico identificaram a presença de uma lesão envolvendo o osso subcondral na tróclea lateral do fêmur, característica de uma osteocondrose. Trata-se do primeiro relato de osteocondrose em um potro da raça Crioula.
A two-year-old Criollo foal was referred to the Veterinary Teaching Hospital of the UFSM presenting joint effusion on the left stifle joint. Physical and radiographic examination revealed the presence of osteochondreal fragmentation located at the lateral throclea ridge of the femur characterizing osteochondrosis in the stifle joint.
Assuntos
Animais , Masculino , Fêmur , Cavalos , Osteocondrite/veterinária , Patela , TíbiaRESUMO
Descreve-se, neste trabalho, um surto de dermatofitose eqüina no Sul do Brasil. Cinqüenta e oito animais jovens (55,2 por cento) apresentavam lesões clínicas características da enfermidade. O diagnóstico micológico realizado pela presença do fungo nos pêlos, associado às características macro e micromorfológicas das colônias isoladas em meio de cultivo, permitiram a classificação do dermatófito como Trichophyton equinum var. equinum.
One outbreak of dermatophytosis in horses is described in south Brazil. Fifty eight young animals (55.2 percent) presented clinical signs of the disease. The mycological diagnosis was realized through the presence of fungus in the hair, associated with the macro and micromorphologic characteristics of the isolated colonies in agar also allowed the dermatophyte´s classification as Trichophyton equinum var. equinum.