RESUMO
El objetivo de este estudio fue caracterizar la prescripción de los medicamentos ansiolíticos utilizados en población de adultos mayores institucionalizados en el hogar de ancianos de Pinar del Río durante el año 2017.Se realizó un estudio descriptivo transversal, con recogida de datos retrospectiva, sobre prescripción de medicamentos ansiolíticos en la población de adultos mayores institucionalizados en el hogar de ancianos, se analizó la forma de utilización de los medicamentos, su indicación y prescripción con elementos de esquema terapéutico y factores que condicionan los hábitos de prescripción. Se trabajó con el universo (U= 98) de estudio el cual estuvo conformado por el total de pacientes institucionalizados, que estaban consumiendo ansiolíticos. Se revisaron las historias clínicas individuales y se confeccionó un modelo de recolección de datos.El medicamento más consumido por los adultos mayores fue el nitrazepam (41,8 %), siendo este a su vez el más consumido por el sexo masculino, no así para el femenino que resultó ser el clorodiazepóxido (64,6 %), el grupo de edad que más predominó fue el de 60-69 años, asimismo los viudos y el nivel educacional primario, el 79,5 % de los ancianos consume otros medicamentos que poseen interacción farmacocinética. El profesional que más indicó fue el médico de familia, la prescripción e intervalos entre dosis fue adecuada, la prescripción se consideró no racional.La prescripción de ansiolíticos en la población objeto de estudio, disminuye a medida que aumenta la edad, los más consumidores son los del sexo masculino y los institucionalizados por abandono familiar, esto apunta a la necesidad de continuar trabajando desde el nivel primario de atención dado que es de donde proceden estos ancianos.
The objective of this study was to characterize the prescription of anxiolytic medications used in the institutionalized elderly population at the Pinar del Río Nursing Home during 2017.A cross-sectional descriptive study was carried out, with retrospective data collection, on the prescription of anxiolytic medications in the population of institutionalized older adults in the Nursing Home, the form of use of the medications, their indication and prescription with elements of the therapeutic scheme was analyzed and factors that condition prescription habits. We worked with the universe (U = 98) of the study, which was made up of the total number of institutionalized patients who were consuming anxiolytics. Individual medical records were reviewed and a data collection model was created.The drug most consumed by older adults was nitrazepam (41.8%), this in turn being the most consumed by males, not so for females, which turned out to be chlorodiazepoxide (64.6%), the group The most prevalent age group was 60-69 years, likewise widowers and primary educational level, 79.5% of the elderly consume other drugs that have pharmacokinetic interaction. The professional who indicated the most was the family doctor, the prescription and intervals between doses were adequate, the prescription was considered non-rational.The prescription of anxiolytics in the population under study decreases as age increases, the most consumers are those of the male sex and those institutionalized due to family abandonment, this points to the need to continue working from the primary level of care since that is where these elders come from.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Prescrições de Medicamentos , Ansiolíticos/uso terapêutico , Clordiazepóxido/uso terapêutico , Instituição de Longa Permanência para Idosos , Nitrazepam/uso terapêutico , Casas de Saúde , Epidemiologia Descritiva , Estudos Transversais , Estudos Retrospectivos , Distribuição por Sexo , Distribuição por IdadeRESUMO
In a retrospective study we assessed the outcome of the criptogenic and symptomatic forms of West syndrome and evaluated the efficacy of adrenocorticotropic hormone, vigabatrin, prednisone, valproate and nitrazepam in the spasms control. Seventy patients were follwed up by 2 years. Twelve (17%) were criptogenics and 58 (83%) symptomatics. In criptogenic group significantly more patients were in regular school classes and with normal motor development, better control of seizure, less tendency to evoluate to Lennox Gastaut syndrome and 83. 3% had control of spasms (72.4% of patients from symptomatic group had control of spasms). Adrenocorticotropic hormone and vigabatrin were the most efective drugs, with 68.75% and 60% of spasms control, respectivelly, when used as first line of therapy and 75% and 50%, respectivelly, as second line of therapy.
Assuntos
Hormônio Adrenocorticotrópico/uso terapêutico , Anticonvulsivantes/uso terapêutico , Glucocorticoides/uso terapêutico , Prednisona/uso terapêutico , Espasmos Infantis/tratamento farmacológico , Adolescente , Adulto , Criança , Pré-Escolar , Eletroencefalografia , Feminino , Seguimentos , Humanos , Masculino , Nitrazepam/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Ácido Valproico/uso terapêutico , Vigabatrina/uso terapêuticoRESUMO
Em estudo retrospectivo avaliamos a evoluçao clínica e eletrencefalográfica das formas criptogênica e sintomática da síndrome de West e analisamos a eficácia do hormônio adrenocorticotrófico, vigabatrina, prednisona, ácido valpróico e nitrazepam no controle dos espasmos. Participaram do estudo 70 pacientes, acompanhados por período maior que 2 anos. Doze (17 por cento) eram criptogênicos e 58 (83 por cento) sintomáticos. O grupo criptogênico apresentou percentagem significativamente maior de pacientes que frequentavam escola regular e desenvolvimento motor normal, melhor controle das crises epilépticas, tendência menor a evoluir para síndrome de Lennox Gastaut e 83,3 por cento tiveram controle completo dos espasmos (72,4 por cento dos pacientes do grupo sintomático obtiveram controle completo dos espasmos). O hormônio adrenocorticotrófico e a vigabatrina foram as drogas mais eficazes, controlando 68,75 por cento e 60 por cento dos espasmos, respectivamente, quando utilizados como droga de primeira escolha e 75 por cento e 50 por cento, respectivamente, como drogas de segunda escolha
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Hormônio Adrenocorticotrópico/uso terapêutico , Anticonvulsivantes/uso terapêutico , Glucocorticoides/uso terapêutico , Prednisona/uso terapêutico , Espasmos Infantis/tratamento farmacológico , Eletroencefalografia , Seguimentos , Nitrazepam/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Ácido Valproico/uso terapêutico , Vigabatrina/uso terapêuticoRESUMO
Acute effects of oral flunitrazepam (0.5 and 1 mg), nitrazepam (5 and 10 mg) and placebo were assessed on direct (free recall of words and prose, stem-cued recall) and indirect (stem and fragment completion) memory tasks. Fifty health volunteers took part in this double-blind, independent group study. The relative effects of the two benzodiazepines (BZs) on memory revealed a different pattern from their effects on alertness, indicating that their amnesic effects are not totally secondary to their sedative effects. The higher dose of flunitrazepam impaired free recall of words and prose but not cued recall, while neither drug affected the two indirect tasks. Differences in drug effects on the direct and indirect memory tasks were discussed in terms of resource demands of the various tests. We conclude that whether BZs impair performance on memory tasks depends more on the cues given at retrieval than the retrieval instructions (direct/indirect). The implications for this in terms of BZ amnestic effects are drawn out for contextual encoding deficits induced by BZs.
Assuntos
Sinais (Psicologia) , Flunitrazepam/farmacologia , Memória/efeitos dos fármacos , Nitrazepam/farmacologia , Administração Oral , Adolescente , Adulto , Método Duplo-Cego , Feminino , Flunitrazepam/administração & dosagem , Humanos , Masculino , Nitrazepam/administração & dosagemRESUMO
Behavioral categories were measured in rats left on an elevated plus-maze for 5 min, in addition to the traditional measures. Four independent factors emerged from a factor analysis. The variables that loaded highly and positively on Factor 1, seemingly related with anxiety, were: number of entries onto open arms, time spent on open arms, percentage of open/total arm entries, percentage of time on open arms, scanning over the edge of an open arm, and open arm end-exploring. The time spent on enclosed arms loaded highly, but negatively on the same factor. Risk-assessment from an enclosed arm also loaded negatively on Factor 1. Number of enclosed arm entries, total number of arm entries and rearing loaded highly on Factor 2, probably related to motor activity. However, the total number of entries also loaded on Factor 1, being thus a mixed index. Similarly, the number of open arm entries loaded on both Factors 1 and 2. As expected, the variables having high loads on Factor 1 were changed to one direction by administration of two anxiolytics (nitrazepam and midazolam) and to the opposite direction by two anxiogenic drugs (pentylenetetrazol and FG 7142). Such pattern of drug effects was not observed with the remaining variables.
Assuntos
Ansiedade/psicologia , Comportamento Animal/efeitos dos fármacos , Animais , Ansiolíticos/farmacologia , Ansiedade/induzido quimicamente , Depressores do Apetite/farmacologia , Carbolinas/farmacologia , Comportamento Exploratório/efeitos dos fármacos , Agonistas de Receptores de GABA-A , Masculino , Midazolam/farmacologia , Atividade Motora/efeitos dos fármacos , Nitrazepam/farmacologia , Pentilenotetrazol/farmacologia , Ratos , Ratos WistarRESUMO
Existen numerosas substancias, de estructura química diversa que han sido utilizadas como inductoras de sueño. Sin embargo, debido a que producen efectos colaterales indeseables, constantemente son substituidas por fármacos de reciente creación. Este trabajo se llevó a cabo con el propósito de analizar el efecto sobre el sueño de una beta lactama de 1.5 benzodiazepina, administrada intraperitonealmente (0.9 mg/kg) a ratas wistar. Los resultados indican que esta substancia incrementa de manera significativa, tanto al sueño lento como al paradójico a expensas de la vigilia. La lactancia de la primera fase de sueño paradójico, se prolonga significativamente. Se concluye que esta substancia facilita la presencia de sueño, manifestándose su acción durante un período relativamente largo
Assuntos
Animais , Ratos , Barbitúricos/antagonistas & inibidores , Benzodiazepinas/antagonistas & inibidores , Diazepam/farmacologia , Eletromiografia/métodos , Flurazepam , Hipnóticos e Sedativos/farmacologia , Nitrazepam , Pentobarbital/farmacocinética , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Sono , TemazepamRESUMO
El propósito de este trabajo fue analizar el efecto de un derivado de la benzodiazepina sobre el ciclo vigilia-sueño, que no había sido estudiado. Para este propósito, se le administraron a ratas Wistar 0.9 mg/kg de un derivado clorado de la beta lactama de 1,5 benzodiazepina por vía intraperitoneal, analizando su acción mediante diez horas de registro poligráfico contínuo. Los resultados muestran que esta substancia disminuye el estado de vigilia e incrementan ligeramente el sueño lento y, de manera estadísticamente significativa (p<0.05), el sueño paradójico. Asimismo, la latencia de la primera fase de sueño paradójico se reduce de manera importante. Estos hallazgos indican que la substancia, analizada bajo las condiciones experimentales descritas, facilita la inducción y el mantenimiento del sueño
Assuntos
Ratos , Benzodiazepinas/administração & dosagem , Benzodiazepinas/efeitos adversos , Benzodiazepinas/farmacocinética , Diazepam/administração & dosagem , Diazepam/efeitos adversos , Diazepam/farmacocinética , Eletromiografia/classificação , Eletromiografia/estatística & dados numéricos , Eletromiografia/métodos , Nitrazepam/administração & dosagem , Nitrazepam/efeitos adversos , Nitrazepam/farmacocinética , Sono REM , Sono REM/fisiologia , Sono , Sono/fisiologia , Vigília/efeitos dos fármacos , Vigília/fisiologiaAssuntos
Humanos , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Hormônio Adrenocorticotrópico/uso terapêutico , Carbamazepina/uso terapêutico , Clonazepam/uso terapêutico , Etossuximida/uso terapêutico , Fenitoína/uso terapêutico , Nitrazepam/uso terapêutico , Fenobarbital/uso terapêutico , Primidona/uso terapêutico , Ácido Valproico/uso terapêuticoAssuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Ansiolíticos , Nitrazepam , Sono , Método Duplo-CegoRESUMO
Mogadon as a parenteral solution was employed for treating status epilepticus (15 cases), intermitent epileptic seizures (10 cases), Lennox syndrome (14 cases), myoclonic seizures (5 cases) and absences (6 cases). The dosage layed between 3,3 mg and 10 mg according to each individual case. Status epilepticus and intermitent seizures disappeared following the injection and so did the irritative EEG alterations. Remission was observed in 10 Lennox cases while the remaining 4 improved. Mogadon abolished myoclonic seizures, in some cases beyond 6 hours. In simple absence improvement was also evident, although more shortlived than in myoclonic seizures. Sleepiness was side-effect, occurring in some cases.
Assuntos
Epilepsia/tratamento farmacológico , Nitrazepam/uso terapêutico , Eletroencefalografia , Epilepsias Mioclônicas/tratamento farmacológico , Epilepsias Parciais/tratamento farmacológico , Epilepsia Tipo Ausência/tratamento farmacológico , Feminino , Humanos , Infusões Parenterais , Masculino , Nitrazepam/administração & dosagem , Nitrazepam/farmacologia , Estado Epiléptico/tratamento farmacológicoRESUMO
The electroencephalographic findings observed in twenty-nine patients with Lennox-Gastaut syndrome were related with prognosis of the epileptic manifestations. The presence of slow spike-wave complexes with preponderance of spike over the slow wave and the presence of fixed complexes in spite of the medical treatment, are related with poor prognosis for the epileptic manifestations.
Assuntos
Eletroencefalografia , Epilepsia Tipo Ausência/diagnóstico , Hormônio Adrenocorticotrópico/uso terapêutico , Criança , Pré-Escolar , Clonazepam/uso terapêutico , Epilepsia Tipo Ausência/tratamento farmacológico , Feminino , Humanos , Lactente , Masculino , Nitrazepam/uso terapêutico , PrognósticoRESUMO
The therapeutics results with the use of different drugs (diazepam, nitrazepam, clonazepam, diphenylhydantoin, barbiturates--phenobarbital and primidone--, sodium dipropylacetate and ACTH) in twenty-nine patients with Lennox--Gastaut syndrome are carefully analysed. The effect of each drug on seizures (tonic, tonic-clonic, clonic, myoclonic or myoclonic-atonic, atonic and atypical absences) during the first month of each treatment is discussed. The "specific" use of each drug on the various forms of epileptic seizures is determined and the possibility of crisis control with reduction of the drugs dosage is verified.