RESUMO
Abstract Medicinal chemistry made it possible for pharmacists to propose pharmacodynamics and pharmacokinetics explanations of many existing drugs. Moreover, medicinal chemistry education provides pharmacy students with a reasonable understanding of drug physicochemical properties, mechanism of action (MOA), side effects, metabolism and structure-activity relationship (SAR). This paper highlights the importance of these medicinal chemistry key elements in understanding other pharmacy core courses, mainly pharmacology and clinical therapeutics. Such elements can be utilized as a tool for pharmacists while training or counseling their patients on the use of their treatments. Different new examples from the literature have been incorporated in this paper to show how chemical structures of existing drugs can provide essential information about main concepts in the education of pharmacology and clinical therapeutics, and the key structural elements for the discovery and development of other same class drugs.
RESUMO
A Doença Pulmonar Obstrutiva Crônica tem como característica principal a limitação ao fluxo aéreo, não sendo totalmente reversível, mas podendo ser prevenida e tratada. As repercussões sistêmicas da doença podem levar a internação hospitalar por consequências de características próprias da doença e inflamação nas vias aéreas. A pesquisa objetiva conhecer as principais repercussões sistêmicas e a terapêutica utilizada em pacientes, com Doença Pulmonar Obstrutiva Crônica, internados em uma unidade hospitalar. Trata-se de um estudo prospectivo, quantitativo e documental, realizado em um Hospital Público de referência na assistência a patologias cardiopulmonares, composto por pacientes de ambos os sexos internados com diagnóstico de Doença Pulmonar Obstrutiva Crônica confirmado no prontuário. As variáveis analisadas estiveram relacionadas à história clínica (etilismo, tabagismo, doenças associadas), as repercussões sistêmicas (fraqueza muscular, perda de peso e retenção CO2), as complicações clínicas (desconforto e infecção respiratória), a terapêutica clínica (oxigenoterapia, ventilação não invasiva e ventilação mecânica) e terapêutica fisioterápica. Utilizou-se a estatística descritiva. Foram coletados dados de 31 prontuários de pacientes com Doença Pulmonar Obstrutiva Crônica, 21(68%) do sexo feminino e 10(32%) do sexo masculino com média de idade de 66,5 anos. As repercussões sistêmicas mais presentes foram: retenção de CO2 19(61%), fraqueza muscular 13(42%) e perda de peso 12(39%). No que se refere à terapêutica clínica, farmacológica e fisioterápica foram utilizados: oxigenoterapia 30(97%), corticóides 25(81%), broncodilatadores 23(74%), antibióticos 20(65%), e alguns utilizaram VNI 5 (16%) e, 23(74%) tinham indicação de fisioterapia. Constatou-se que as principais repercussões sistêmicas foram a retenção de CO2, fraqueza muscular e perda de peso. As terapêuticas utilizadas foram propostas para melhorar e/ou reverter os sintomas apresentados pelos pacientes a fim de reduzir o tempo de internamento e morbimortalidade.
The chronic obstructive pulmonary disease (COPD) is characterized chiefly by the airflow limitation and is not fully reversible, but can be prevented and treated. The systemic effects of the disease can lead to hospitalization for consequences of characteristics of the disease and airway inflammation. Objective: To know the main effects and systemic therapy used in patients with COPD admitted to a hospital. Methodology: A prospective, quantitative and documentary. Performed in a public hospital reference in assisting cardiopulmonary pathologies. Composed of patients of both sexes admitted with diagnosis of COPD confirmed in the medical record. The variables analyzed were related to clinical history (alcoholism, smoking, associated diseases), the systemic effects (muscle weakness, weight loss and CO2 retention), the clinical complications (discomfort and respiratory infection), clinical therapy (oxygen, ventilation is not and invasive mechanical ventilation) and physiotherapy treatment. We used descriptive statistics. Results: Data were collected from medical records of 31 patients with COPD, 21 (67.7%) females and 10 (32.2%) were male with a mean age of 66.5 years. The systemic effects were more present: CO2 retention 19 (61.2%), muscle weakness 13 (41.9%) and weight loss 12 (38.7%). With regard to medical therapy, physical therapy and drug were used: oxygen 30 (96.7%), corticosteroids, 15 (80.6%), bronchodilators 23 (74.1%), antibiotics 20 (64.5%) and some used NIV 5 (15.1%) and 23 (74.1%) were referred for physiotherapy. Conclusion: It was found that the main effects were systemic CO2 retention, muscle weakness and weight loss. The treatments used were proposals to improve and / or reverse the symptoms of the patients in order to reduce the length of stay and mortality.