Resultados negativos associados à medicação em idosos hipertensos e diabéticos / Negative results associated with medication in hypertensive and diabetic elderly / Resultados negativos asociados a la medicación en ancianos hipertensos y diabéticos

Objetivo: identificar e analisar resultados negativos associados à medicação em idosos diabéticos e hipertensos. Método: estudo quantitativo e exploratório, com base na metodologia Dáder de seguimento farmacoterapêutico. Realizado de junho a dezembro de 2017, por meio de visita domiciliar, com auxílio de agentes comunitários de saúde, no território de uma ESF, no sul do Brasil. Foram acompanhados 12 usuários, diagnosticados com diabetes mellitus e hipertensão arterial sistêmica, com idade superior a 65 anos. Resultados: segundo a metodologia Dáder de seguimento farmacoterapêutico foram encontrados 271 resultados negativos associados à medicação, destes 22,1% por necessidade (100% problema de saúde não tratado), 50,5% por efetividade (70,1% inefetividade não quantitativa e 29,9% inefetividade quantitativa) e 27,4% por segurança (52,7% inseguridade quantitativa e 47,3% inseguridade não quantitativa). Através dos resultados encontrados foram sugeridos 42 intervenções pelos especialistas. Conclusão: considerando que a existência de resultados negativos associados à medicação se tornam importantes agravos para a saúde pública, a atenção farmacêutica se apresenta como uma alternativa eficaz na busca por melhores resultados clínicos, sendo capaz de promover saúde e prevenir agravos.

Objective: to identify and analyze negative results associated with the use of medication in diabetic and hypertensive elderly. Method: quantitative and exploratory study, based on Dáder methodology of pharmacotherapeutic followup. The study was performed from June to December 2017, through home visits, with the help of community health agents, in the territory of an FHS, in southern Brazil. Twelve users were diagnosed with diabetes mellitus and systemic arterial hypertension, aged over 65 years. Results: according to the Dáder methodology of pharmacotherapeutic follow-up, 271 negative results associated with medication were found, of which 22.1% by necessity (100% untreated health problem), 50.5% by effectiveness (70.1% non-quantitative ineffectiveness and 29.9% quantitative ineffectiveness) and 27.4% for safety (52.7% quantitative insecurity and 47.3% nonquantitative insecurity). Through the results found, 42 interventions were suggested by the experts. Conclusion: Considering that the existence of negative results associated with medication become important public health problems, pharmaceutical attention is an effective alternative in the search for better clinical results, being able to promote health and prevent diseases.

Objetivo: Identificar y analizarlos resultados negativos asociados a la medicación en ancianos diabéticos e hipertensos. Método: estudio cuantitativo y exploratorio, basado en la metodología Dáder de seguimiento farmacoterapéutico. Se realizó de junio a diciembre de 2017, a través de visita a domicilio, con la ayuda de agentes comunitarios de salud, en el territorio de un FHS, en el sur de Brasil. Doce usuarios fueron diagnosticados de diabetes mellitus e hipertensión arterial sistémica, mayores de 65 años. Resultados: de acuerdo con la metodología Dáder de seguimiento farmacoterapéutico, se encontraron 271 resultados negativos asociados con el medicamento, de los cuales 22.1% por necesidad (100% de problemas de salud no tratados), 50.5% por efectividad (70.1% de ineficacia no cuantitativa y 29.9% de ineficacia cuantitativa) y 27.4% para la seguridad (52.7% de inseguridad cuantitativa y 47.3% de inseguridad no cuantitativa). A través de los resultados encontrados fueron sugeridos 42 intervenciones, por los expertos. Conclusión: considerando que la existencia de resultados negativos asociados con la medicación se convierten en problemas de salud importantes, la atención farmacéutica es una alternativa efectiva en la búsqueda de mejores resultados clínicos, siendo capaz de promover la salud y prevenir problemas de salud.

Cross-Generational trans Fat Consumption Favors Self-Administration of Amphetamine and Changes Molecular Expressions of BDNF, DAT, and D1/D2 Receptors in the Cortex and Hippocampus of Rats.

Amphetamine (AMPH) is an addictive psychostimulant drug whose use has been related to neurotoxicity. Experimentally, AMPH increases anxiety-like symptoms, showing addictive properties. In the last decades, the growing consumption of processed foods has provided an excess of saturated and trans fats in detriment of essential fatty acids, which may modify the lipid profile of brain membranes, thus modifying its permeability and dopaminergic neurotransmission. Here, we assessed the influence of brain incorporation of different fatty acids (FA) on AMPH self-administration. Three groups of young male rats were orally supplemented from weaning with a mixture of soybean oil (SO, rich in n-6 FA) and fish oil (FO, rich in n-3 FA), hydrogenated vegetable fat (HVF, rich in trans fatty acids--TFA), or water (control group). These animals were born from dams that were supplemented with the same fat from pregnancy to lactation. Anxiety-like symptoms and locomotor index were assessed in elevated plus maze and open-field (OF), respectively, while brain molecular expressions of dopaminergic receptors, dopamine transporter (DAT), and BDNF were determined in the cortex and hippocampus. HVF increased the frequency of AMPH self-administration and was associated with reinforcement and withdrawal signs as observed by increased anxiety-like symptoms. Contrarily, SO/FO decreased these parameters. Increased BDNF protein together with decreased DAT expression was observed in the hippocampus of HVF group. Based on these findings, our study points to a harmful influence of trans fats on drug addiction and craving symptoms, whose mechanism may be related to changes in the dopaminergic neurotransmission.