Differential expression of drug resistance genes in CD146 positive dental pulp derived stem cells and CD146 negative fibroblasts.

INTRODUCTION: The stem cell portion of the dental pulp derived cultures (DPSCs) showed a higher resistance to cytotoxic effect of restorative dental materials compared to pulpal fibroblasts (DPFs). Here, we aimed to compare the expression of some drug resistant genes between these cells. METHODS AND MATERIALS: To separate DPSCs from DPFs, we used magnetic cell sorting technique based on CD146 expression. To assess the stem cell properties, the positive and negative portions underwent colony forming assays and were induced to be differentiated into the adipocytes, osteoblasts, hepatocytes, and neural cells. Cell surface antigen panels were checked using immune fluorescence and flow-cytometry techniques. The mRNA expression of 14 ABC transporters including ABCA2, ABCB1, ABCB11, ABCC1, ABCC2, ABCC3, ABCC4, ABCC5-2, ABCC5-4,ABCC5-13, ABCC6, ABCC10, ABCC11, and ABCG2 genes was assessed, using quantitative RT-PCR technique. RESULTS: Only the CD146 positive portion could be differentiated into the desired fates, and they formed higher colonies (16.7 ± 3.32 vs. 1.7 ± 1.67, p < .001). The cell surface antigen panels were the same, except for CD146 and STRO-1 markers which were expressed only in the positive portion. Among the ABC transporter genes studied, the positive portion showed a higher expression (approximately two-fold) of ABCA2, ABCC5-13, and ABCC5-2 genes. CONCLUSION: Dental pulp stem cells which can be separated from dental pulp fibroblasts based on CD146 expression, express higher levels of some drug resistance genes which probably accounts for their features of more resistance to cytotoxic effects of some dental materials. This needs to be more validated in future.

Avaliação in vitro de novos produtos na diminuição da permeabilidade dentinária antes e após desafios ácidos / In vitro evaluation of new products in regarding dentin permeability reduction before and after acid challenge model

Objetivo: avaliar in vitro a efetividade de aplicações sucessivas de diferentes produtos utilizados para o tratamento da hipersensibilidade dentinária cervical na redução da permeabilidade dentinária, assim como avaliar a resistência destes produtos a desafios ácidos. Material e métodos: foram utilizados 72 terceiros molares humanos íntegros para a preparação de 72 amostras, que foram ligadas a um sistema de pressão hidráulica para mensurar a permeabilidade dentinária após os seguintes passos: 1) preparação da amostra; 2) tratamento com ácido fosfórico a 37% durante 30 segundos; 3) cinco aplicações dos produtos testados; 4) primeiro desafio ácido; 5) segundo desafio ácido; e 6) terceiro desafio ácido. As amostras foram divididas aleatoriamente em seis grupos (n=12), de acordo com os tratamentos propostos: Desensibilize Nano P, Clinpro XT, dentifrício Colgate Sensitive Pró-Alívio, dentifrício Duraphat, dentifrício Sensodyne Repair e após restauração com resina composta (grupo-controle). Conclusão: que todos os produtos testados foram capazes de promover a redução da permeabilidade dentinária significativamente, sendo que os grupos Clinpro XT, Desensibilize Nano P e controle mantiveram esses níveis reduzidos estatisticamente até o terceiro desafio ácido, enquanto que os dentifrícios Duraphat, Sensodyne Repair e Colgate Sensitive Pró-Alívio mantiveram essas reduções estatisticamente significativas até o segundo desafio ácido.

Objective: to evaluate in vitro the effectiveness of successive applications of different products used for the treatment of cervical dentinal hypersensitivity, reducing dentin permeability, as well as to evaluate the resistance of these products, acids challenges. Material and methods: 72 intact human third molars were used for the preparation of 72 samples were bound to a hydraulic pressure system to measure the dentin after the following steps: 1) sample preparation; 2) treatment with 37% phosphoric acid for 30 seconds; 3) 5 applications of the products tested; 4) first challenge acid; 5) second challenge acid; 6) third challenge acid. The samples were randomly divided into 6 groups (n=12) according to the proposed treatments: Desensibilize Nano P, Clinpro XT, toothpaste Colgate Sensitive Pro-Relief, Duraphat toothpaste, toothpaste Sensodyne Repair and after restoration with composite resin (control group). Conclusion: all products tested were able to significantly promote the reduction of dentin, and the Clinpro XT groups Desensibilize Nano P and control these reduced levels remained statistically to the third challenge acid, while toothpaste Duraphat, Sensodyne Repair and Colgate Sensitive Pro-Relief kept these statistically significant reductions to the second challenge acid.

Management of Patients With Cardiovascular Implantable Electronic Devices in Dental, Oral, and Maxillofacial Surgery.

The prevalence of cardiovascular implantable electronic devices as life-prolonging and life-saving devices has evolved from a treatment of last resort to a first-line therapy for an increasing number of patients. As these devices become more and more popular in the general population, dental providers utilizing instruments and medications should be aware of dental equipment and medications that may affect these devices and understand the management of patients with these devices. This review article will discuss the various types and indications for pacemakers and implantable cardioverter-defibrillators, common drugs and instruments affecting these devices, and management of patients with these devices implanted for cardiac dysrhythmias.

Novel anticoagulants: general overview and practical considerations for dental practitioners.

Currently, 4 novel Direct Oral Anticoagulants (DOACs) were approved by the FDA. This review focuses on these agents and proposes a matrix for the general dentists to assess bleeding risk in dental management of patient on DOACs. The outline covers the pharmacology of DOACs (rivaroxaban, apixaban, edoxaban and dabigatran), bleeding complications, risk associated with discontinuation, monitoring/reversal, and implications for the dental practitioners. A total of 18 randomized controlled trials were identified with mixed results in regards to the risk for bleeding. Considering the pharmacology of DOACs and challenges in monitoring and reversing their effect, the dentist should consider carefully the management of patients on DOACs as it may differ from patients on conventional anticoagulants. Based on the type of dental procedure and the medical risk assessment, several general treatment approaches can be considered: continue DOACs, time dental treatment as late as possible after the last DOACs dose, discontinue DOACs for 24hrs, or discontinue DOACs for 48hrs. Based on the current reported dental literature, limited dental surgery may benefit from the first 2 conservative options. However, this needs to be proven in comparative clinical trials.

Análise farmacológica e legal de prescrições odontológicas de antibióticos: um estudo transversal / Pharmacological and legal analysis of antitibiotic dental prescriptions: a cross-sectional study

Cirurgiões-dentistas têm a prerrogativa de prescrever medicamentos como adjuvantes ao tratamento odontológico. Em 2011, com a promulgação da Resolução de Diretoria Colegiada no 20 da Agência Nacional de Vigilância Sanitária - ANVISA, antibióticos se tornaram medicamentos sujeitos a prescrição especial. Este estudo transversal descritivo buscou conhecer o ato prescricional dos cirurgiões-dentistas quanto aos antibióticos, identificar os mais prescritos, determinar se houve erro no atendimento das determinações legais e identificar erros na prescrição profilática. Foram analisadas prescrições odontológicas de antibióticos aviadas na maior rede de drogarias de Belo Horizonte, Minas Gerais, de 1º de julho de 2011 a 30 de junho de 2012. No período da coleta de dados havia 75 lojas em funcionamento. Foi possível recuperar informações sobre as prescrições de 69 delas (Taxa de retorno=92,0%). Para o universo, 31.105 prescrições, foi realizado um sorteio da amostra, com cálculo baseado na estimativa de proporções (50% de proporção estimada de prescrição com erro, 5% de precisão e nível de confiança de 95%). Foram sorteadas 434 prescrições, pela técnica de amostragem aleatória simples. Após exclusão daquelas com repetição de prescritor e/ou de paciente, foram analisadas 366 prescrições. A precisão recalculada para este montante foi igual a 5,09%. Após dupla digitação no programa Epi-Data foi criado um banco de dados no programa SPSS. A pesquisa foi submetida e aprovada pelo Comitê de Ética em Pesquisa da UFMG. Os resultados das análises demonstraram que a maioria dos antibióticos prescritos pertence ao grupo das penicilinas (71,9%) e dos macrolídeos (17,6%). Também foram prescritos, em menor proporção, antibióticos para aplicação cutânea e vários outros, incluindo antifúngicos, além de associações: amoxicilina com ciprofloxacino e com clindamicina...

Dentists have the prerogative to prescribe drugs as adjuncts to dental treatment (BRASIL, 1966). In 2011, with the enactment of the Collegiate Board Resolution no.20 of the National Health Surveillance Agency - ANVISA, antibiotics became drugs subject to special prescription. This descriptive cross-sectional study aimed to know the limitation act of dentists as to antibiotics, identify the most prescribed, determine if there was an error in meeting the legal requirements and identify errors in prophylactic prescription. Dental antibiotic prescriptions filled in the largest drugstore chain in Belo Horizonte, Minas Gerais were analyzed from 1 July 2011 to 30 June 2012. In the period of data collection there were 75 stores in operation. It was possible to retrieve information about the prescriptions of 69 of them (return rate = 92%). For the study of 31,105 prescriptions, there was a draw of the sample, with calculation based on estimated proportions (50% of estimated proportion with prescription error, 5% precision and 95% of confidence level). 434 prescriptions were selected by the simple random sampling technique. After excluding those with repeating prescriber and / or patient, 366 prescriptions were analyzed. The accuracy recalculated for this amount was equal to 5.09%. After double entry in Epi-Date program it was created a database in the SPSS software. The research was subjected and approved by the Ethics Committee of UFMG. The results of analysis showed that most prescribed antibiotics belong to the group of penicillins (71.9%) and macrolides (17.6%). Also were prescribed, to a lesser extent, antibiotics for topical application and several others, including antifungal, in addition to associations: amoxicillin with ciprofloxacin and clindamycin. In 27.9% of the prescriptions there were errors in spelling or disobedience to the determination to follow the Brazilian Common Denomination (DCB)...

Dental treatment for the pregnant patient / Atendimento odontológico à paciente gestante

Dental treatment of pregnant women should be accomplished with safety. Consequently, the dental professional should evaluate its real need and risks for the mother and child. This paper reports through a literature review, the caution with the clinical dental procedures commonly performed and possible risks of the therapeutic agents used, allowing the dentist to evaluate the treatment and the drug to be administered to the pregnant women

O tratamento odontológico da gestante deve ser realizado com segurança, e para isto deve-se avaliar a real necessidade de sua execução e os riscos que o mesmo poderá trazer para a mãe e para o bebê. Este artigo relata, com base em uma revisão de literatura, os cuidados com os procedimentos clínicos comumente realizados no consultório odontológico e os possíveis riscos dos agentes terapêuticos utilizados, permitindo ao clínico avaliar o tratamento e a droga a serem administrados às gestantes.

ANMAT, los productos de uso odontológico y la investigación clínica / ANMAT, medical devices for dental applications and clinical trials

Compete a la Adminsitración Nacional de Medicamentos, Alimentos y Tecnología Médica (AMMAT) garantizar que los medicamentos, alimentos y dispositivos médicos a disposición de la población posean eficacia, seguridad y calidad. Dentro de su estructur, la Dirección Nacional de Productos Médicos es la encargada de controlar, fiscalizar; evaluar y vigilar los de uso odontológico. Simultáneamente, es responsabilidad del odontólogo verificar que los productos que utiliza estén aprobados por la ANMAT e informar, dentro del sistema denominado de odontovigilancia, las dificultades y efectos no deseados derivados de su utilización. De particular importancia, dentro de las disposiciones de la ANMAT, es la relacionada con las condiciones en las que deben llevarse a cabo los ensayos clínicos de productos médicos. Su contenido relacionado con las responsabilidades, la elaboración de protocolos de investigación y otros aspectos deben tenerse en cuenta en el momento de solicitar la conformidad para encarar la evaluación de productos en su fase de desarrollo.

Role of topical drugs in treatment of oral mucosal diseases. A literature review.

Few topical formulations have been designed specifically to treat oral mucosal diseases. Local drug delivery may provide a more targeted and efficient option than systemic delivery for diseases of the oral mucosa. The permeability to the topical drugs differs according to the thickness of the epithelium and the extent of keratinization. The loss of the permeability barrier in the oral mucosa, due to ulceration or erosion, leads to rapid diffusion of the drug into tissues as compared to the intact areas of the mucosa. Oral mucosal delivery has the potential to treat many different conditions and diseases, such as oral cancer, mucositis, lichen planus, herpes simplex, candidiasis, recurrent aphthous stomatitis, vesiculo-bullous diseases, neuropathic pain and salivary dysfunction. Each therapy requires distinct penetration and drug retention profiles in order to optimize treatment and minimize side effects. In this paper, topical medications are discussed, as these are advantageous for the treatment of oral mucosal lesions with fewer side effects.

Drug allergies and implications for dental practice.

Adverse reactions to medications prescribed or administered in dental practice can be worrying. Most of these reactions are somewhat predictable based on the pharmacodynamic properties of the drug. Others, such as allergic and pseudoallergic reactions, are generally unpredictable and unrelated to normal drug action. This article will review immune and nonimmune-mediated mechanisms that account for allergic and related reactions to the particular drug classes commonly used in dentistry. The appropriate management of these reactions will also be addressed.

Drug therapy for the pregnant dental patient.

Providing needed dental treatment, managing oral infection, and controlling pain are essential functions of dentists for helping patients maintain overall health during pregnancy. Medications commonly required for dental care consist of local anesthetics and associated vasoconstrictors, centrally and peripherally acting analgesics, sedative and anxiolytic agents, and antibiotics. Therapeutic drugs routinely used in dental practice are selected because of their known safety and effectiveness. However, for a pregnant patient requiring dental care, the agents routinely prescribed should be reevaluated for potential risks to the mother and/or fetus. The decision to administer a specific drug requires that the benefits outweigh the potential risks of the drug therapy. This article reviews and updates the recommendations for using dental therapeutic agents, thereby enabling general practitioners to select the safest drugs when treating pregnant dental patients.

Oral local drug delivery and new perspectives in oral drug formulation.

Modern pharmaceutical science has provided us with a wide range of substances to be administered with a wide large variety of dosage forms. Local drug delivery systems have been used for a long time; in particular, for the local therapy of diseases affecting the oral cavity. Although these diseases are often extremely responsive to local therapy, the mouth often presents various difficulties in the application of topical compounds (owing to saliva and the mouth's different functions), resulting in a short retention time of dosage forms with a consequent low therapeutic efficacy. To resolve these limitations, research today concentrates on the development of bioadhesive formulations. This review focuses on the permeability features of oral mucosa, the rationale of oral local drug delivery, and new potential bioadhesive local delivery systems. Furthermore, the most promising mucoadhesive systems proposed to locally treat oral diseases are discussed.

Avaliação da utilização de anestésico tópico para instalação de mini-implantes ortodônticos / Evaluation of the use of tropical anesthetics for installation of orthodontic mini-implants

Objetivos: o objetivo deste trabalho foi avaliar a eficiência do uso de anestésico tópico para inserção de mini-implantes utilizados como meio de ancoragem esquelética em Ortodontia. Material e Métodos:o anestésico tópico a base de lidocaína 20% em gel foi utilizado para inserção de mini-implantes em 40 pacientes em tratamento com aparelhos fixos. A idade média dos pacientes era 23,58 anos. Os pacientes responderam a um questionário com quatro perguntas de múltipla escolha, avaliando a aceitabilidade e o desconforto durante a anestesia e a colocação do mini-implante. Os dados foram avaliados em porcentagem e pelo teste qui-quadrado para avaliação do dimorfismo sexual. Resultados: 92,5% dos pacientes relataram que não sentiram nenhum incômodo durante a aplicação do anestésico tópico e apenas7,5% sentiram uma leve dormência, o que mostra que o anestésico teve boa aceitação pelos pacientes. Em relação ao procedimento de instalação dos mini-implantes, somente 20% dos indivíduos da amostra relacionaram a dor (independente da intensidade) como a sensação mais desagradável durante todo o procedimento de colocação do mini-implante.Entretanto, 47,5% dos pacientes não sentiram dor alguma e apenas10% dos pacientes sentiram dor intensa. Houve diferença entre os gêneros apenas com relação à sensação mais desagradável durante todo o procedimento, sendo que a maioria das mulheres (55%) relatou não ter sentido nada desagradável, comparando com apenas 40% dos homens. Conclusão: a instalação de mini-implantes com anestésico tópico se mostrou viável e eficiente, podendo ser uma alternativa, mas são necessários mais estudos e comparações com outros métodos de anestesia.

Objectives: the objective of this study was to evaluate the efficiency of the use of topical anesthetics for insertion of miniimplants used as skeletal anchorage in orthodontics. Material and methods: the topical anesthetics based in lidocaine gel 20% was used to the insertion of mini-implants in 40 patients in treatment with fixed appliances. The mean age of the patients was 23.58 years. Patients answered to a questionnaire with 4 multiple choice questions, evaluating the acceptability and discomfort of the patients during anesthetics and placement of mini-implant. Data were evaluated by percentage and by the chi-square test to evaluate the sexual dimorphism. Results:92.5% of the patients reported that did not feel any discomfort during the application of the topical anesthetics, and only 7.5% felta slight dormancy, what shows that the anesthetics presented good acceptance by the patients. In relation to the procedure of installation of mini-implants, only 20% of the subjects related pain (regardless ofthe intensity) as the more unpleasant sensation during the procedure of placement of the mini-implant. However, 47.5% of the patients did not feel any pain and only 10% of the subjects felt intense pain. There was difference between sexes only regarding the more unpleasant sensation during the procedure, and the majority of the females (55%)reported not to feel any unpleasant sensation, comparing with only 40% of the males. Conclusion: the installation of mini-implants with topical anesthetics proved to be feasible and effective, it could bean altemative, but more studies and comparisons with other type of anesthesia are necessary.

Overclock ortodôntico: superando os limites da movimentação dental / Orthodontics Overclock: overcoming the limits of tooth movement

Nos computadores pessoais, o overclock é um processono qual uma maior velocidade de processamento é conseguida atravésde configurações e instruções diretas para o hardware, superando oslimites de desempenho originais. As técnicas que visam aumentar avelocidade do movimento dentário induzido e, consequentemente, otratamento ortodôntico são aqui chamadas de overclock ortodôntico. Aduração prolongada do tratamento ortodôntico foi considerada o fatormais desconfortável do tratamento por 45% por pacientes, em estudosrealizados no Brasil e na Ásia. Esse também é um dos principaisfatores que desmotivaram o paciente adulto a iniciar o tratamentoortodôntico". O tempo aumentado de tratamento pode ser atribuídoà forma de geração da força ortodôntica (fios ortodônticos); ao meiode transferência das forças ao ligamento periodontal (braquetes eacessórios); ou ainda à insuficiente mobilização biológica para osfenômenos de reabsorção, essenciais à movimentação ortodôntica.Este trabalho buscou discutir as técnicas de intervenção na biologiae na mecânica do movimento ortodôntico com o objetivo de reduzir otempo total do tratamento. Pôde-se concluir que as intervenções feitaspara reduzir a intensidade da força necessária para o movimento e oaumento dos níveis de mediadores inflamatórios estão associadas aoaumento da taxa de movimento. A inflamação, no entanto, tem vantagense desvantagens, pois enquanto pode ser benéfica para acelerar amovimentação e a remodelação óssea, pode ser causadora de perdasperiodontais e da estrutura dentária.

On personal computers, overclocking is a processwhereby a higher processing speed is achieved through directinstructions and settings for hardware, surpassing the originalperformance limits. The techniques that aim to increase the speed oftooth movement and consequently the orthodontic treatment are hereinreferred to as orthodontic overclocking. The prolonged duration oforthodontic treatment was considered the single most uncomfortabletreatment for 45% of patients in studies conducted in Brazil and Asia1'2. This was also one of the main factors that discourage the adultpatient starting orthodontic treetment". The increased of treatmenttime can be attributed to the form of generation of orthodontic force(orthodontic wiresJ through the transfer of forces to the periodontalligament (brackets and accessoriesJ ar the insufficient mobilization forthe biological phenomena of resorption, essential to the orthodonticmovement. This paper discusses intervention techniques in biologyand mechanics of orthodontic movement, aiming to reduce the totaltreatment time. It can be concluded that interventions designed toreduce the amount of force required for movement and increasedlevels of inflammatory mediators are associated with increased rate ofmovement. Inflammation, however, has advantages and disadvantages,as it may be beneficial to accelerate the movement and bane turno ver,can cause loss of periodontal and tooth structure.

Biologics in oral medicine: principles of use and practical considerations.

Oral Diseases (2012) 18, 525-536 Biologic therapies are relatively innovative treatments aimed at modulating lymphocytes or cytokines. There are currently three broad classes of biologic therapies, tumour necrosis factor-alpha inhibitors, lymphocyte modulators and interleukin inhibitors; all are increasingly used in the treatment of inflammatory immune-mediated conditions, and several have potential applications in oral medicine. Guidelines for their use in licensed indications (e.g. rheumatoid arthritis, psoriasis, inflammatory bowel disease) include recommendations and guidance for patient selection and subsequent monitoring with discussion of potential adverse effects. An understanding of these is important when managing patients receiving biologic therapy for systemic disease, and compliance is essential in any use in oral medicine. Key aspects of current guidance are presented with particular emphasis on their relevance to clinicians working within oral and maxillofacial medicine/pathology/surgery and in specialist practice.

Further reliability and responsiveness of the Chronic Oral Mucosal Diseases Questionnaire.

OBJECTIVE: To test the reliability and responsiveness of the Chronic Oral Mucosal Diseases Questionnaire (COMDQ), in measuring the quality of life (QofL) in patients with chronic oral mucosal conditions. METHODS: A random sample of 160 patients with the following chronic oral mucosal conditions, recurrent aphthous stomatitis, oral lichen planus, the more common vesiculobullous conditions (mucous membrane pemphigoid and pemphigus vulgaris) and orofacial granulomatosis received a copy of the COMDQ. A subset of 100 patients received the questionnaire on two further occasions, 2 weeks and 3 months later. Statistical tests were carried out to evaluate the test-retest reliability and responsiveness of this instrument. RESULTS: This study has demonstrated that the COMDQ has good test-retest reliability with an intraclass correlation coefficient of 0.81 and is responsive to changes in the patients' overall conditions. CONCLUSION: In conclusion, this study has further demonstrated the reliability and responsiveness of the COMDQ in assessing QofL in patients with chronic oral mucosal diseases.

Efeito de um sistema de liberação controlada de cloredixidina para o controle de placa e gengivite / Effect of chlorhexidine in a controlled release system for plaque control and gingivitis

Pacientes submetidos a tratamento com aparelhos fixos estão sujeitos a apresentar alterações periodontais significativas. Os acessórios ortodônticos adaptados às coroas dentárias dificultam a manutenção da higiene bucal ao criando um aumento significativo de superfícies retentivas, favorecendo o acúmulo do biofilme bacteriano. Caracterizando um desequilíbrio na microflora local contribuindo para o desenvolvimento de alterações periodontais. O objetivo deste estudo foi comparar a efetividade de um novo sistema de liberação controlada de clorexidina na formulação 0,6% e tratamento profilático no controle da placa e gengivite em pacientes ortodônticos. Este estudo foi constituído de 29 indivíduos provenientes de clínicas do Curso de Especialização em Ortodontia da Faculdade de Odontologia da Universidade Federal de Minas Gerais com diagnóstico de gengivite...

Influência de fármacos na movimentação dentária induzida / The influence of drugs on orthodontic tooth movement

A Ortodontia está fundamentada na habilidade do profissional em produzir umacontrolada movimentação dos dentes através do osso alveolar, a partir da aplicação da forçaortodôntica. Entretanto, a movimentação ortodôntica pode ser influenciada por vários fatores,dentre eles, o uso de medicamentos. Em vista do exposto, o objetivo deste trabalho foirealizar uma revisão narrativa da literatura sobre a influência de fármacos ou suplementos namovimentação dentária induzida. Como a maior parte dos trabalhos foi realizada com animaise não com humanos e há grande variabilidade entre as metodologias, não se pode afirmarcategoricamente sobre qualquer modificação na movimentação ortodôntica causada poralgum tipo de fármaco que o paciente utilize durante o tratamento ortodôntico. Vislumbra-se,futuramente, atuar na taxa da movimentação ortodôntica com o auxílio de medicamentos.

Orthodontics is based on the professional's ability to produce a controlledteeth movement in alveolar bone through the application of orthodontic force. However, theorthodontic movement may be influenced by several factors, including the use of medicines.Due to it, the aim of this study was to perform a narra tive literature review on the effectsof drugs on experimental tooth movement. As most experimental studies were done withanimais instead of humans and there is a great variability among the methodologies, stetementscannot yet be done about any change in tooth movement caused by some kind ofmedication took by patients during orthodontic treatment. We envision in the future actingon orthodontic tooth movement with the aid of drugs.

Farmacovigilancia: estudiode las reacciones adversas a medicamentos (RAM) / Pharmacovigilacia: study of the adverse reactions to drugs

La Farmacovigilancia tiene como objeto proporcionar información sobre la seguridad de los medicamentos que se encuentran en el mercado con el fin de asegurar que la relación riesgo/beneficio sea favorable. El propósito de este trabajo fue analizar los reportes de Farmacovigilancia recibidos y así permitir cuantificar las RAM. Se realizó un estudio retrospectivo de las notificaciones recibidas en el periodo agosto de 2008 hasta agosto de 2009. Se recibieron 100 reportes observando un aumento en el tiempo, refiriéndo se la mayoría a efectos adversos, siendo menor la falta de eficacia. El rango de edades reportadas fue de 19-80 años. El fármaco más reportado fue Enalapril, la mayoría de los reportes hace referencia a la vía oral y que tras el inconveniente con la medicación se debió realizar tratamiento. La mitad de las planillas vienen incompletas. La mayoría de las reacciones adversas a medicamentos fueron leves y se resolvieron sin secuelas. Para las comunicaciones se utilizó la Ficha de Farmacovigilancia, la cual se puso a disposición de los Profesionales y alumnos de los últimos años de la carrera de Odontología.

Pharmacovigilance is intended to provide information on the safety of the drugs found in the market in order to ensure that the risk/benefit ratio is positive. The purpose of this paper was analyzing pharmacovigilance reports received and thus allow the RAM to quantify. A retrospective study of the notifications received during the period was conducted August 2008 until August provide received 100 reports noting an increase in the time, referring the most adverse effects, the lack of effectiveness being lower. The reported ages range was 19-80 years. The most reported drug was Enalapril, the majority of the reports refers to the mouth and that after the problem with the medication should carry out treatment. Half of the forms are incomplete. The majority of adverse drug reactions were mild and resolved without sequelae. Pharmacovigilance data, which was put at the disposal of professionals and students in the last years of the career of dentistry was used for communications.

Potentially serious drug-drug interactions among community-dwelling older adult dental patients.

OBJECTIVES: Reducing adverse drug events, including those resulting from drug-drug interactions, will be a health safety issue of increasing importance for dental practitioners in the coming decades as greater numbers of older adults seek oral health care. The purpose of this study was to identify prescription drugs with the potential for serious interactions and estimate prevalent use among older adults visiting the dentist. STUDY DESIGN: The Medicare Current Beneficiary Survey is an ongoing series of nationally representative surveys of Medicare beneficiaries. Potentially serious drug interactions were selected with the use of published work by Partnership to Prevent Drug-Drug Interactions. Drug interactions were identified and prevalence estimates made for community-dwelling older adults visiting the dentist. Analyses were completed to test associations between sociodemographic and health-related variables and the use of prescription drugs with the potential for serious interactions. RESULTS: Overall, 3.4% of those visiting the dentist were estimated to have been prescribed drugs with the potential for a serious drug interaction. Drugs commonly prescribed in dentistry with the potential for serious interactions include the benzodiazepines, macrolide antibiotics, and nonsteroidal antiinflammatory analgesics. CONCLUSIONS: Understanding potentially harmful drug combinations, their clinical consequences, and the frequency with which implicated drugs are being prescribed will assist practitioners in clinically managing patients and avoiding inappropriate prescribing.