Análise técnica das bulas dos antibióticos utilizados no tratamento da tuberculose / Technical analysis of the leaflets of antibiotics used in the treatment of tuberculosis

Objetivo: Descrever a apresentação das informações presentes nas bulas dos antibióticos utilizados no tratamento da tuberculose conforme as exigências da ANVISA. Metodologia: Trata-se de um estudo exploratório, descritivo e reflexivo da estrutura e conteúdo das bulas adquiridas através do site da Agência Nacional de Vigilância Sanitária. Verificou-se se os itens apresentados são aqueles exigidos pela portaria regulamentadora. As informações destinadas ao paciente foram refletidas, buscando compreender se essas são objetivas, organizadas e escritas numa linguagem compreensível ao público. Resultados: Detectou-se, na estrutura geral, a ausência de alguns tópicos preconizados pela portaria regulamentadora. Na seção de informação aos pacientes notou-se ausência de algumas informações, bem como informações com variado grau de precisão, a exemplo da ausência da ação esperada do medicamento, imprecisão nos cuidados de armazenamento, e uso de frases subjetivas como 'refeições leves' e 'problemas no sangue'. Conclusão: O desenvolvimento desse estudo corrobora com outras pesquisas realizadas, onde algumas exigências legais não foram cumpridas. É possível inferir que as bulas atendem a maioria dos requisitos, porém, necessitam de adequações. Salienta-se a importância dos profissionais de saúde esclarecerem dúvidas sobre o uso desses antibióticos aos seus usuários, e assim contribuir para uma terapia medicamentosa de sucesso

Objective: Describe the presentation of the information present in the package inserts of the antibiotics used in the treatment of tuberculosis as required by ANVISA. Methodology: This is exploratory, descriptive and reflective study of the structure and content of the package inserts acquired through the website of the National Sanitary Surveillance Agency. It was verified that the items presented are those required by the regulatory authority. The information destined to the patient was reflected, trying to understand if these are objective, organized and written in a language understandable to the public. Results: In the general structure, we detected the absence of some topics recommended by the regulatory decree. In the section of information to the patients it was noticed absence of some information, as well as information with varied degree of precision, such as absence of expected drug action, inaccuracy in storage care, and use of subjective phrases such as 'light meals' and 'blood problems'. Conclusion: The development of this study corroborates with other researches carried out, where some legal requirements were not fulfilled. It is possible to infer that the package inserts meet most requirements, but still require adjustments. It is important to emphasize the importance of health professionals to clarify doubts about the use of these antibiotics to their users, and contribute to the successful drug therapy.

Medicamentos comumente prescritos na odontologia e suas principais interações medicamentosas: revisão de literatura / Usual medications used in dentistry and its major medicals interactions: a literature review

Este artigo trata de uma revisão bibliográfica sobre a avaliação dos medicamentos comumente prescritos na odontologia e suas principais interações medicamentosas. Os objetivos incluíram avaliar os medicamentos comumente prescritos pelo cirurgião-dentista e observar como suas possíveis interações medicamentosas podem influenciar no atendimento dos pacientes na clínica odontológica. A metodologia utilizada foi uma pesquisa bibliográfica, por meio da consulta de livros e de busca em bases de dados eletrônicos. Diariamente o cirurgião-dentista depara-se com casos de infecção, dor e processos inflamatórios na clínica odontológica, devendo sanar os problemas que acometem a cavidade oral e causam esses desconfortos ao paciente. Sendo assim, o profissional necessita de amplo conhecimento sobre farmacologia e interações medicamentosas para que o tratamento seja efetivo e não ocorra piora do estado clínico do paciente. O conhecimento dessas interações capacita o cirurgião-dentista a minimizar o risco de interações medicamentosas através de um ajuste da dosagem ou mudança do esquema posológico. Concluiu-se que é de extrema importância o conhecimento do cirurgião-dentista sobre as medicações que prescreve em sua prática clínica, a fim de evitar as possíveis interações medicamentosas e tornar, dessa forma, suas prescrições medicamentosas seguras para o paciente(AU)

This article deals with a literature review on the evaluation of commonly prescribed medications in dentistry and its main drug interactions. The objectives included evaluating the medications commonly prescribed by the dental surgeon and observing how their possible drug interactions may influence patient care in the dental clinic. The methodology used was a bibliographical research, through the search of books and search in electronic databases. Every day the dental surgeon is faced with cases of infection, pain and inflammatory processes in the dental clinic, and must cure the problems that affect the oral cavity and cause these discomforts to the patient. Therefore, the professional needs extensive knowledge about pharmacology and drug interactions so that the treatment is effective and does not worsen the patient's clinical status. Knowledge of these interactions enables the dental surgeon to minimize the risk of drug interactions by adjusting the dosage or changing the dosing schedule. It was concluded that it is extremely important the surgeon-dentist's knowledge about the medications that he prescribes in his clinical practice, in order to avoid possible drug interactions and thus, make his medication prescriptions safe for the patient(AU)

Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units / Relação entre o uso seguro de medicamentos e Serviços de Farmácia Clínica em Unidades de Cuidados Intensivos Pediátricos

Abstract Objective: Clinical Pharmacy Services (CPS) are considered standard of care and is endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU). Methods: This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention. Results: Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non-optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs. Conclusions: Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications.

Resumo Objetivo: Serviços de Farmácia Clínica (SFC) são considerados um padrão de atendimento à saúde e são endossados pela Joint Commission International, pela American Academy of Pediatrics e pelo American College of Clinical Pharmacy. No Brasil, experiências isoladas vêm surgindo discretamente e a importância desses serviços para o cuidado de crianças e adolescentes tem levado a resultados interessantes, mas que certamente são sub-relatados. Este artigo tem como objetivo discutir o efeito da implantação de um SFC à beira do leito em uma Unidade de Cuidados Intensivos Pediátricos (UCIP) brasileira. Métodos: Este é um estudo transversal, feito em uma UCIP de hospital da comunidade com 12 leitos, em Campo Largo, Brasil. Foram incluídos indivíduos com<18 anos internados em UCIP para análise descritiva, quando receberam uma intervenção do SFC. Resultados: De 53 pacientes acompanhados, foram detectados 141 Problemas Relacionados a Medicamentos (PRM) evitáveis que foram resolvidos em conjunto com os médicos (89% de aceitação de todas as intervenções). As intervenções mais comuns para melhorar a terapia medicamentosa foram: prevenção de soluções intravenosas incompatíveis (21%) e doses inadequadas (17% devido a doses baixas e altas). Entre os dez principais medicamentos associados à PRM, cinco eram antimicrobianos. Ao analisar a correlação entre o PRM e tempo de permanência na UCIP, verificamos que 74% de todas as variações no tempo de permanência eram associadas com o número de PRM. Conclusões: Reações adversas a medicamentos devido a PRM evitáveis podem ser prevenidas por SFC em uma colaboração multifacetada com outros profissionais de saúde. Tais problemas podem ser evitados por meio de estratégias ativas e baseadas em evidências para reduzir a morbidade relacionada a medicamentos.

Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units. / Relação entre o uso seguro de medicamentos e Serviços de Farmácia Clínica em Unidades de Cuidados Intensivos Pediátricos.

OBJECTIVE: Clinical Pharmacy Services (CPS) are considered standard of care and they are endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU). METHODS: This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention. RESULTS: Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non-optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs. CONCLUSIONS: Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications.

Virulence properties and antimicrobial susceptibility of Shiga toxin-producing Escherichia coli strains isolated from healthy cattle from Paraná State, Brazil.

The presence of Shiga toxin-producing Escherichia coli (STEC) strains in feces samples of cattle was determined using the cytotoxicity assay on Vero cells and a screening PCR system to detect stx genes. The STEC isolates were serotyped, tested for antimicrobial susceptibility, and analyzed for virulence genes using multiplex PCR. The verocytotoxin-producing E. coli - reverse passive latex agglutination (VTEC-RPLA) assay was also used to detect Shiga toxin production. The frequency of cattle shedding STEC was 36%. The isolates belonged to 33 different serotypes, of which O10:H42, O98:H41, and O159:H21 had not previously been associated with STEC. The most frequent serotypes were ONT:H7 (10%), O22:H8 (7%), O22:H16 (7%), and ONT:H21 (7%). Most of the strains (96%) were susceptible to all antimicrobial agents tested. Shiga toxin was detected by the VTEC-RPLA assay in most (89%) of the STEC strains. The frequency of virulence markers was as follows: stx1, 10%; stx2, 43%; stx1 plus stx2, 47%; ehxA, 44%; eae, 1%; and saa, 38%. Several strains belong to serotypes associated with human disease, and most of them carried a stx2-type gene, suggesting that they represent a risk to human health. The screening PCR assay showed fewer false-negative results for STEC than the Vero-cell assay and is suitable for laboratory routine.