Ketoprofen hypersensibility and idiosyncratic response - a case report.

Context: Ketoprofen is widely used to remove pain. A steady increase on allergic reactions and photoallergic contact dermatitis related to ketoprofen has been reported when there is topical use. However, there are few documented cases of hypersensitivity when it is administered systemically.Objective: Present a case of hypersensitivity reaction after systemic administration of ketoprofen for pain control in nephritis crisis.Case description: A 43-years-old Caucasian man diagnosed with renal colic (kidney lithiasis), who was initially treated with 100 mg of tramadol (IV), followed by 4 mg of thiocolchicoside (IM) which caused no relief. Then 100 mg of ketoprofen was administered (IV). Right after the patient began to show hypersensitivity reaction type I characterized by intense coughing, rhinitis, angioedema, periorbital edema, rash, and scleral jaundice.Discussion and conclusion: Maybe it was a case of drug-induced liver disease, however therapeutic dosages of all administered drugs only once. The mechanisms involved were not investigated, but may be the result of allergic and immunologic aspects caused by ketoprofen and facilitated by a history of hypersensitivity to other NSAIDs as reported by the patient. As for jaundice can be attributed to drug toxicity since laboratory parameters did not reveal any evidence of liver disease.

Implicações clínicas do uso de AINES em pacientes hipertensos: interações medicamentosas na odontologia / Clinical implications of NSAIDS use in hypertensive patients: drugs interactions in dentistry

Objetivo: Abordar as interações medicamentosas de interesse para a Odontologia entre os fármacos anti-hipertensivos (AH), mais utilizados pelos pacientes, e os medicamentos mais prescritos pelos alunos e profissionais, os Anti-Inflamatórios Não Esteroidais (AINEs). Método: Foi realizado um levantamento em 620 fichas de prontuários de pacientes atendidos nas clínicas do curso de Odontologia da Universidade Federal do Maranhão, no período de 2013 a 2017. Os dados obtidos foram tabulados e submetidos à análise estatística descritiva. Resultados: A classe de fármacos mais utilizada pelos pacientes com alterações sistêmicas foi a dos anti-hipertensivos (AH) (61,9%), sendo os mais usados a losartana (49,1%), captopril (19,29%), hidroclorotiazida (14,03%), atenolol (10,52%), anlodipina (8,77%) e enalapril (8,77%). Dentre os medicamentos mais prescritos pelos alunos e profissionais estavam os AINEs, como o paracetamol (78,28%), ibuprofeno (26,84%), dipirona (24,49%), nimesulida (13,42%) e diclofenaco (3,35%). Conclusão: O mecanismo de interação entre essas duas classes de medicamentos é do tipo farmacodinâmico de efeito, podendo reduzir a resposta anti-hipertensiva dos fármacos. Acredita-se estar relacionada principalmente à inibição das prostaglandinas renais pelos AINEs. Entretando, o uso a curto prazo (3-5 dias) não oferece riscos significativos aos pacientes com Hipertensão Arterial controlada.

Objetives: Approach the drug interactions that matter to Dentistry between the antihypertensive medicines (AH), more used by patients, and the drugs that are more prescribed by the Dentistry, the non-steroidal anti-inflammatory drugs (NSAIDs). Method: It was realized a survey study in 620 medical records of patients who were assisted in the University of Maranhão Dentistry School's dental offices, in the period from 2013 to 2017. The data were tabulated and submitted to descriptive statistical analysis. Results: The class of drugs more used by patients with systemic alterations was the antihypertensive medicines (AH) (61,9%), being more used the losartan (49,1%), captopril (19,29%), hidroclorotiazide (14,03%), atenolol (10,52%), anlodipine (8,77%) and enalapril (8,77%). Among the more prescribed by students and professionals were the NSAIDs, like acetaminofeno (78,28%), ibuprofen (26,84%), metamizol (24,49%), nimesulide (13,42%) and diclofenac (3,35%). Conclusion: The mechanism of interaction between these two classes of medicines is of the pharmacodynamic effect type, which may reduce the antihypertensive response of the drugs. It is believed to be mainly related to the inhibition of renal prostaglandins by NSAIDs. However, short-term use (3-5 days) does not offer significant risks to patients with controlled hypertension.

Effects of stingless bee propolis on experimental asthma.

Bee products have been used empirically for centuries, especially for the treatment of respiratory diseases. The present study evaluated the effect of treatment with a propolis hydroalcoholic extract (PHE) produced by Scaptotrigona aff. postica stingless bee in a murine asthma model. BALB/c mice were immunized twice with ovalbumin (OVA) subcutaneously. After 14 days, they were intranasally challenged with OVA. Groups P50 and P200 received PHE by gavage at doses of 50 and 200 mg/kg, respectively. The DEXA group was treated with intraperitoneal injection of dexamethasone. The OVA group received only water. The mice were treated daily for two weeks and then they were immunized a second time with intranasal OVA. The treatment with PHE decreased the cell number in the bronchoalveolar fluid (BAL). Histological analysis showed reduced peribronchovascular inflammation after treatment with PHE especially the infiltration of polymorphonuclear cells. In addition, the concentration of interferon- γ (IFN- γ ) in the serum was decreased. These results were similar to those obtained with dexamethasone. Treatment with S. aff postica propolis reduced the pathology associated with murine asthma due an inhibition of inflammatory cells migration to the alveolar space and the systemic progression of the allergic inflammation.

O uso dos antibióticos em periodontia / The use of antibiotics in periodontal treatments

Os antibióticos têm sido utilizados como adjuntos na eliminaçäo dos microrganismos associados à etiologia da doença periodontal em pacientes que näo respondem à terapia convencional. Dos vários medicamentos utilizados, as tetraciclinas, o metronidazol e o ciprofloxaxin säo os que têm demonstrado maior efetividade no tratamento das infecçöes periodontais. Atualmente, sua administraçäo pode ser feita de modo individual ou associado, por via sistêmica ou aplicaçäo local. Este trabalho propöe uma revisäo da literatura sobre a terapêutica antimicrobiana em Periodontia, abordando aspectos sobre a etiologia da doença e as drogas mais utilizadas, considerando o metronidazol e o ciprofloxacim com antibióticos, embora sejam de origem sintética

Aplicabilidade das vacinas como meio de prevençäo das doenças infecto-contagiosas em Odontologia / Applicability of vaccines in Dentistry as a means to prevent infectious diseases

O presente trabalho tem por objetivo discutir a conscientizaçäo, a viabilidade e a necessidade da imunizaçäo do profissional da Saúde, mais especificamente da equipe odontológica, frente às doenças infecto-contagiosas (principalmente aquelas que constam no calendário oficial do Ministério da Saúde, no plano da imunizaçäo em Saúde Pública), às quais o dentista está sujeito: difteria, sarampo, caxumba, rubéola, tétano, tuberculose, hepatites B, C, D, e influenza. Algumas dessas doenças já säo consideradas erradicadas ou quase erradicadas, mas, por motivos outros, reaparecem. Com o aumento epidemiológico da AIDS, tanto algumas doenças infecto-contagiosas aparecem como infecçöes oportunistas, quanto as pesquisas säo aprofundadas e descobrem-se novas vacinas para diferents infecçöes por vírus, entre eles o vírus da hepatite B, uma das doenças de maior ocorrência entre os profissionais da Saúde