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1.
Pharmaceutics ; 16(9)2024 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-39339146

RESUMO

This study evaluated the efficacy of semisolid systems (gels) and films containing a combination of metronidazole (MTZ) and metronidazole benzoate after scaling and root-planing (SRP) for periodontitis. In total, 45 patients with stage I or II periodontitis were enrolled and divided into 3 groups: 1-SRP-control; 2-SRP + Film with MTZ; 3-SRP + Gel with MTZ. The pH of gingival crevicular fluid (GCF) before/after treatments, MTZ concentrations, and drug release using high-performance liquid chromatography were investigated. The effects were evaluated by longitudinal monitoring of clinical parameters (probing depth-PD, clinical attachment level-CAL, and bleeding on probing-BP). MTZ and MTZ-benzoate concentrations in the periodontal pocket and pH showed no statistical difference after application. SRP + Gel presented the lowest CAL values. For SRP + Film and SRP + Gel, higher PD values were observed at T0 compared to all groups. A relevant reduction in BP was observed in SRP + Film and SRP + Gel groups at all times compared to T0. Both therapies improved periodontal health compared to SRP alone, reducing PD and BP, and increasing CAL for the gel group, suggesting they are promising for periodontal disease treatment.

2.
J Appl Oral Sci ; 30: e20210538, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476115

RESUMO

Molar incisor hypomineralization (MIH) is often accompanied by dental hypersensitivity and difficulty in achieving effective analgesia. OBJECTIVE: This study evaluated the effectiveness of preemptive analgesia in children with severe MIH, post-eruptive enamel breakdown, and hypersensitivity. METHODOLOGY: Ibuprofen (10 mg/kg child weight) or placebo was administered, followed by infiltrative anesthesia and restoration with resin composite. Hypersensitivity was evaluated in five moments. The data were analyzed using the chi-square test, Fisher's exact test, and t-test. RESULTS: Preemptive analgesia provided benefits for the treatment of severe cases of MIH, with an increase in the effectiveness of infiltrative anesthesia and improved patient comfort during the restorative procedure. CONCLUSION: Preemptive analgesia has shown efficacy in reducing hypersensitivity during restorative dental procedures, evidencing the significance of this study for patients with MIH and hypersensitivity.


Assuntos
Analgesia , Anestésicos , Hipoplasia do Esmalte Dentário , Criança , Hipoplasia do Esmalte Dentário/terapia , Humanos , Ibuprofeno/uso terapêutico , Dente Molar , Prevalência
3.
Braz Oral Res ; 35: e131, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34932660

RESUMO

This study showcases the clinical efficacy of mucoadhesive patches designed for the buccal delivery of lidocaine and prilocaine hydrochlorides (1:1, 30 mg/patch). Such patches were developed for needle-free pre-operative local anesthesia in dentistry, aiming at mitigating the use of infiltrative anesthesia for medium-complexity clinical procedures. The patches were manufactured encompassing drug-release, mucoadhesive and backing layers, all prepared through film casting using biocompatible materials. Fifty-eight (n = 58) adult patients (65% women and 35% men) were randomly selected and included in a one-arm open clinical prospective cohort study. The average age of the subjects was of 50 years. The majority (59%) of the subjects, mostly women (82%), reported needle-phobia or anxiety due to dental procedures, which was assessed through a questionnaire approved by the ethical council for human use in research. The patches were positioned in the gingival region of the teeth involved in the procedure (86% on the maxillary and 14% on the mandibular bone). Two anesthetic patches were applied on each patient: one in the vestibular region and another in the palate/lingual portion, and these patches remained attached to the placement sites throughout the procedures. Concerning the dental procedures performed, 40% were cavity preparations and dental restorations of medium cavities; 29% staple facilities; 10% gingival retractions; 9% subgingival scrapings; 3% gingivalplasties; 3% supragingival preparations; 3% occlusal adjustments; and 2% subgingival preparations. In 90% of the cases, it was not necessary to complement with conventional infiltrative local anesthesia during the procedures. Patients did not report any discomfort or side effect during or after the administration of the patches. Among the cases in which there was the need for complementation, 50% were cavity preparations and dental restorations; 33% supragingival preparations; and 17% gingivoplasties. The complementary anesthesia volume was of 0.63 ± 0.23 mL and women corresponded to 83% of the participants who needed such intervention. Furthermore, in most cases, the patch was capable of initiating the anesthesia within a short time frame (5 minutes) and reaching the maximum anesthetic effect within 15 and 25 min, lasting at least 50 min. Undesirable side effects were not reported either 2 h after the administration or within the 6-month follow-up. Therefore, the anesthetic patches developed provide needle-free, painless, safe, and patient/dentist-friendly advances in performing routine medium-complexity dental procedures.


Assuntos
Anestesia Dentária , Anestésicos Locais , Adulto , Anestesia Local , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prilocaína , Estudos Prospectivos , Resultado do Tratamento
4.
J. appl. oral sci ; J. appl. oral sci;30: e20210538, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1375716

RESUMO

Abstract Molar incisor hypomineralization (MIH) is often accompanied by dental hypersensitivity and difficulty in achieving effective analgesia. Objective: This study evaluated the effectiveness of preemptive analgesia in children with severe MIH, post-eruptive enamel breakdown, and hypersensitivity. Methodology: Ibuprofen (10 mg/kg child weight) or placebo was administered, followed by infiltrative anesthesia and restoration with resin composite. Hypersensitivity was evaluated in five moments. The data were analyzed using the chi-square test, Fisher's exact test, and t-test. Results: Preemptive analgesia provided benefits for the treatment of severe cases of MIH, with an increase in the effectiveness of infiltrative anesthesia and improved patient comfort during the restorative procedure. Conclusion: Preemptive analgesia has shown efficacy in reducing hypersensitivity during restorative dental procedures, evidencing the significance of this study for patients with MIH and hypersensitivity.

5.
Rev. ciênc. farm. básica apl ; Rev. ciênc. farm. básica apl;42: 1-12, 20210101.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1177729

RESUMO

Objectives: To systematically evaluate the effects of hydroxypropyl methyl cellulose (HPMC) type (E5LV, E15LV, and K100LV); plasticizer type (glycerol and mannitol), plasticizer loading (0.12 and 0.24% w/w); and loading of prilocaine and lidocaine hydrochlorides combined at 1:1 ratio (0 and 47 mg/cm2) in the mechanical properties of buccal films. Methods: A quality by design (QbD) approach based on a full factorial design (3 x 23) and complementarily multivariate statistical tools i.e., principal component analysis (PCA), response surface methodology (RSM), and correlation matrix were used in this pursuit. The thickness, elongation at break, tensile strength, force at break, and Young`s modulus of the anesthetic buccal films obtained by solvent casting were assessed. Results: The QbD, PCA and RSM altogether demonstrated that all studied formulation variables, mainly the drug loading, affect the mechanical properties of the films at different significance levels. The multivariate analysis yielded the modelling of elongation at break, tensile strength, and force at break, which significantly correlated with each other. The drugs exerted a synergic plasticizing effect on the films, and the use of HPMC K100 LV (with greater hydroxypropyl substitution degree and viscosity) and mannitol favored their elasticity and resistance. Furthermore, the majority of the films fulfilled the requirements for buccal administration due to their softness and mechanical resistance. Conclusion: Mannitol is suitable plasticizer for manufacturing HPMC anesthetic buccal films with improved mechanical properties. These results are a step forward in the rational development of formulations for the replacement of needles in dentistry

6.
Colloids Surf B Biointerfaces ; 136: 1193-201, 2015 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-26590633

RESUMO

Iontophoresis is a strategy to increase the penetration of drugs through biological membranes; however, its use has been underexplored in mucosa. The aim of this work was to investigate the influence of iontophoresis in the mucosal penetration of prilocaine hydrochloride (PCL) and lidocaine hydrochloride (LCL), which are largely used in dentistry as local anesthetics, when combined in the same formulation. Semisolid hydrogels containing these drugs either alone or in combination were developed at two different pHs (7.0 and 5.8) and presented adequate mechanical and mucoadhesive properties for buccal administration. The distribution coefficients between the mucosa and the formulations (Dm/f) and the in vitro mucosa permeation and retention rates were evaluated for both PCL and LCL. At pH 7.0, the combination of the drugs decreased the Dm/f of PCL by approximately 3-fold but did not change the Dm/f of LCL; iontophoresis increased the permeation rate of PCL by 12-fold and did not significantly change LCL flux compared with the passive permeation rate of the combined drugs. Combining the drugs also resulted in an increase in both PCL (86-fold) and LCL (12-fold) accumulation in the mucosa after iontophoresis at pH 7.0 compared with iontophoresis of the isolated drugs. Therefore, applying iontophoresis to a semisolid formulation of this drug combination at pH 7.0 can serve as a needle-free strategy to speed the onset and prolong the duration of buccal anesthesia.


Assuntos
Amidas/química , Anestesia/métodos , Bochecha , Iontoforese/métodos , Humanos , Mucosa Bucal/química , Sais
7.
Rev. bras. farmacogn ; 28(1): 118-123, Jan.-Feb. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-898739

RESUMO

ABSTRACT A validation study of a reverse-phase high-performance liquid chromatographic assay for the quantification of two furanocoumarins (psoralen and bergapten) in soft extract obtained from Brosimum gaudichaudii Trécul, Moraceae, roots was conducted. The developed method was sensitive, rapid, reproducible, easy and precise, and showed linearity (r > 0.99) in the range of 10-64 µg/ml for psoralen, and 9-56 µg/ml for bergapten. It also showed a good efficiency for the photodegradation analysis of psoralen and bergapten in the soft extract. The photostability results showed that the Higuchi model presented the best fitting to the obtained data. Both chemical markers showed stability over 2.6 days, suggesting potential applications of the extract in obtaining intermediate products from this plant material. Furanocoumarins take around 30 min to be activated by UV light, reaching the maximum biological potential. Thus, the results obtained to the Higuchi model, corresponding to 2.6 days of stability, shows feasibility with future applications of these chemical markers.

9.
Arq Bras Endocrinol Metabol ; 56(2): 120-7, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22584565

RESUMO

OBJECTIVE: To analyze drug prescriptions for insulin and oral antidiabetic drugs in type 1 and type 2 diabetes mellitus patients seen in the Brazilian Public Healthcare System (Unified Health System - SUS) in Ribeirao Preto, SP, Brazil. SUBJECTS AND METHODS: All the patients with diabetes seen in the SUS in the western district of Ribeirao Preto, SP, Brazil between March/2006 and February/2007 were included in the study. RESULTS: A total of 3,982 patients were identified. Mean age of the patients was 60.6 years, and 61.0% were females. Sixty percent of the patients were treated with monotherapy. Doses of oral antidiabetic drugs were lower in monotherapy than in polytherapy. Ten patients received doses of glibenclamide or metformin above the recommended maximum doses, and in elderly patients there was no reduction in drug doses. CONCLUSION: Monotherapy with oral antidiabetic drugs was the predominant procedure, and the doses were not individualized according to age.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Prescrições de Medicamentos/normas , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Administração Oral , Análise de Variância , Brasil , Atenção à Saúde , Diabetes Mellitus/classificação , Quimioterapia Combinada/estatística & dados numéricos , Feminino , Glibureto/administração & dosagem , Humanos , Masculino , Metformina/administração & dosagem , Pessoa de Meia-Idade , Vigilância da População
10.
Arq Bras Endocrinol Metabol ; 55(9): 686-91, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22231970

RESUMO

OBJECTIVE: To analyze the costs related to visits and drug prescription in outpatients with type 2 diabetes mellitus assisted by a pharmaceutical care service. SUBJECTS AND METHODS: A prospective and experimental study was carried out. Seventy one patients were divided into two groups: control and pharmaceutical care. Patients in the pharmaceutical care group were followed up monthly by a single clinical pharmacist. RESULTS: The pharmaceutical care group had a statistically significant reduction in costs of metformin and emergency department visits, and increased costs with their family physicians. On the other hand, the control group had a statistically significant increase of 21.3% in the general costs of treatment and visits. CONCLUSION: The pharmaceutical care group maintained the same costs related to drugs and visits, while the control group showed a significant increase in general costs.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Custos de Cuidados de Saúde/estatística & dados numéricos , Hipoglicemiantes/economia , Conduta do Tratamento Medicamentoso/economia , Idoso , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/economia , Medicina de Família e Comunidade/economia , Feminino , Glibureto/economia , Glibureto/uso terapêutico , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/economia , Insulina/uso terapêutico , Masculino , Metformina/economia , Metformina/uso terapêutico , Pessoa de Meia-Idade , Estudos Prospectivos
11.
Ciênc. Saúde Colet. (Impr.) ; Ciênc. Saúde Colet. (Impr.);18(10): 3015-3022, Out. 2013. tab
Artigo em Inglês | LILACS | ID: lil-686803

RESUMO

The scope of this paper was to analyze the profile of medical consultations and drugs used for the treatment of comorbidities in patients with diabetes attended in the Brazilian Unified Health System. This was a pharmaco-epidemiological cross-sectional study conducted between March 2006 and February 2007 All patients with diabetes attended in the western sanitary district of Ribeirao Preto in the state of São Paulo were included in the study. The types of medical attendance (primary, secondary and emergency care) and the drugs prescribed for the treatment of comorbidities were analyzed. The drugs were classified according to the Anatomical Therapeutic Chemical Classification System and 3,198 patients were identified. The mean age was 60.4 years and more than 55% of the patients were 60 years or older. The cardiovascular drugs most used were captopril or enalapril (60%). About 40.6% of the patients used acetylsalicylic acid in platelet antiaggregant doses. The patients had an average of 5.1 medical consultations per year (primary care, secondary care and emergency care). The utilization of statins and acetylsalicylic acid was less than that reported in the literature and the data indicate a high prevalence of admission to emergency care.


Analisar o perfil de consultas médicas e de medicamentos para o tratamento de comorbidades em pacientes com diabetes atendidos no Sistema Único de Saúde. Estudo farmacoepidemiológico e transversal realizado de mar/2006 a fev/2007. Foram incluídos no estudo portadores de diabetes atendidos no Distrito Sanitário Oeste de Ribeirão Preto (SP), sendo analisadas as consultas médicas realizadas na atenção primária, secundária e emergência, além dos medicamentos prescritos para tratamento de comorbidades associadas ao diabetes. Foram identificados 3.198 pacientes, com idade média de 60,4 anos e aproximadamente 55,0% idosos. Os medicamentos do sistema cardiovascular foram os mais prescritos, sendo que 60,0% dos pacientes utilizavam captopril ou enalapril. Além disso, 40,6% dos pacientes faziam uso de ácido acetilsalicílico em dose antiagregante plaquetário. Em relação às consultas médicas, os pacientes apresentaram média de 5,1 visitas ao ano, na atenção primária, na atenção secundária e no atendimento de emergência. A utilização de ácido acetilsalicílico e estatina foram menores do que a relatada na literatura e os dados indicam uma alta prevalência de admissão no atendimento de emergência.


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações do Diabetes/terapia , Diabetes Mellitus/terapia , Encaminhamento e Consulta , Estudos Transversais , Estudos Retrospectivos
13.
Rev. ciênc. farm. básica apl ; Rev. ciênc. farm. básica apl;33(1)abr. 2012.
Artigo em Português | LILACS | ID: lil-655410

RESUMO

A crescente utilização de psicotrópicos na atualidade pode ser caracterizada pela medicalização da sociedade, aliada às pressões mercadológicas da indústria farmacêutica e ao envelhecimento da população, porém os medicamentos desta classe provocam tolerância, dependência e reações adversas quando utilizados inadequadamente. Sendo assim, o presente trabalho avaliou a utilização de benzodiazepínicos e antidepressivos em pacientes atendidos pelas farmácias do sistema único de saúde (SUS) de Ribeirão Preto-SP. O estudo pode ser classificado como descritivo, retrospectivo e observacional, realizado no Distrito de Saúde Oeste de Ribeirão Preto-SP, com população estimada de 140.000 habitantes. Foram incluídos 5.946 usuários que receberam benzodiazepínicos e/ou antidepressivos, pelo menos em uma oportunidade, junto às farmácias do sistema público de saúde durante o período de 01/05/2006 a 30/11/2006. A coleta dos dados referentes ao tratamento farmacológico, à freqüência de retirada dos medicamentos, além das variáveis sociodemográficas e do acesso aos serviços de saúde foi realizada junto ao sistema informatizado da Secretaria Municipal de Saúde da Prefeitura de Ribeirão Preto-SP, denominado Hygia. A prevalência de utilização de psicotrópicos, nessa população, foi de 5,7%, com predominância do gênero feminino. A aderência dos usuários ao tratamento, avaliada segundo a freqüência de retirada destes medicamentos junto às farmácias, foi reduzida. As doses prescritas dos antidepressivos e benzodiazepínicos foram semelhantes para adultos e idosos. Diante dos resultados, fica evidente a necessidade de intervenção para racionalizar a utilização dos psicotrópicos junto ao serviço público de saúde brasileiro.


The increasing use of psychotropic drugs can be stimulated by the medicalization of society, combined with the marketing pressures from the pharmaceutical industry and a population aging, but benzodiazepines and antidepressants cause tolerance, dependence and adverse reactions when improperly used. Therefore, the objective of this study was to evaluate the use of these drugs in patients treated in pharmacies of public health in a Brazilian city. This descriptive, retrospective and observational study was conducted in the West Health District of Ribeirao Preto-SP, which has an estimated population of 140,000 inhabitants. The study included 5946 users who have received benzodiazepines and / or antidepressants, at least one occasion, in the pharmacy?s public health system during the period of 01/05/2006 to 30/11/2006. The data related to drug treatment, frequency of withdrawal from drugs, demographic variables and access to health services was collection at the computerized system of the Municipal Health Department of Ribeirão Preto, called Hygia. The use?s prevalence of psychotropic drugs in this population was 5.7%, with female predominance. The users? adherence to treatment, evaluated according to frequency of withdrawal from these drugs to pharmacies, was reduced. Prescribed doses of antidepressants and benzodiazepines were similar for adults and seniors. Given the results, it is evident the need for intervention to rationalize the use of psychotropic drugs and sometimes with the Brazilian public health service.


Assuntos
Humanos , Masculino , Feminino , Antidepressivos/administração & dosagem , Farmacoepidemiologia , Sistema Único de Saúde , Uso de Medicamentos/tendências
14.
Arq. bras. endocrinol. metab ; Arq. bras. endocrinol. metab;56(2): 120-127, Mar. 2012. graf, tab
Artigo em Inglês | LILACS | ID: lil-622532

RESUMO

OBJECTIVE: To analyze drug prescriptions for insulin and oral antidiabetic drugs in type 1 and type 2 diabetes mellitus patients seen in the Brazilian Public Healthcare System (Unified Health System - SUS) in Ribeirao Preto, SP, Brazil. SUBJECTS AND METHODS: All the patients with diabetes seen in the SUS in the western district of Ribeirao Preto, SP, Brazil between March/2006 and February/2007 were included in the study. RESULTS: A total of 3,982 patients were identified. Mean age of the patients was 60.6 years, and 61.0% were females. Sixty percent of the patients were treated with monotherapy. Doses of oral antidiabetic drugs were lower in monotherapy than in polytherapy. Ten patients received doses of glibenclamide or metformin above the recommended maximum doses, and in elderly patients there was no reduction in drug doses. CONCLUSION: Monotherapy with oral antidiabetic drugs was the predominant procedure, and the doses were not individualized according to age.


OBJETIVO: Analisar as prescrições medicamentosas dos antidiabéticos orais e insulina em pacientes portadores de diabetes melito tipo 1 e tipo 2 atendidos pelo Sistema Único de Saúde (SUS) em Ribeirão Preto, SP, Brasil. SUJEITOS E MÉTODOS: Todos os pacientes com diabetes atendidos no distrito sanitário oeste de Ribeirão Preto, SP, do SUS, entre março/2006 e fevereiro/2007, foram incluídos no estudo. RESULTADOS: Foram identificados 3.982 pacientes com diabetes. Idade média dos pacientes foi de 60,6 anos e 61,0% do gênero feminino. Sessenta por cento foram tratados com monoterapia. A dose dos antidiabéticos foi menor em monoterapia quando comparada à politerapia. Dez pacientes receberam doses de glibenclamida e metformina acima da dose máxima recomendada. Além disso, em pacientes idosos, não houve redução da dose. CONCLUSÃO: A monoterapia com antidiabéticos orais foi prevalente e não houve individualização da dose de acordo com a faixa etária.


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diabetes Mellitus/tratamento farmacológico , Prescrições de Medicamentos/normas , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Administração Oral , Análise de Variância , Brasil , Atenção à Saúde , Diabetes Mellitus/classificação , Quimioterapia Combinada , Glibureto/administração & dosagem , Metformina/administração & dosagem , Vigilância da População
15.
Braz. j. pharm. sci ; 47(2): 231-240, Apr.-June 2011. tab
Artigo em Inglês | LILACS | ID: lil-595811

RESUMO

Due to the considerable increase in public expenditure with health issues, mainly regarding drugs, several countries, including Australia and England, have already implemented, or are in the process of discussing the adoption of measures to ensure the quality of health care provided to the population. One of the less harmful strategies, rarely used in Brazil, is the adoption of economic techniques applied to health, more specifically, pharmacoeconomic analysis. This paper aims to contribute to the dissemination of concepts and techniques of economic analysis with a view to incorporate these into policy decisions of expenditure rationalization and the search for clinical efficiency. It includes a literature review covering the types of costs and benefits in health issues, the methodologies of pharmacoeconomic analysis, cost-minimization, cost-benefits, cost-effectiveness and cost-utility analysis, as well as its main characteristics, advantages, disadvantages and applicability.


Em razão do aumento considerável no gasto público com saúde, principalmente no que tange a medicamentos, vários países, como Austrália e Inglaterra, já implementaram ou estão em fase de discussão da adoção de medidas visando garantir a qualidade do atendimento prestado à população. Uma das estratégias menos danosas, mas ainda incipiente no Brasil, é a adoção de técnicas de análises econômicas, mais especificamente, a avaliação farmacoeconômica. Neste contexto, este trabalho visa contribuir com a disseminação dos conceitos e técnicas de análises econômicas com a perspectiva de que possam ser incorporadas nas decisões políticas de racionalização dos gastos e na busca da eficiência clínica. Para tanto, este artigo apresenta uma revisão bibliográfica contemplando os tipos de custos e benefícios em saúde, as metodologias de análise farmacoeconômicas, quais sejam: análise de minimização de custo, de custo-benefício, de custo-efetividade e de custo-utilidade, assim como suas principais características, vantagens, desvantagens e aplicabilidades.


Assuntos
Farmacoeconomia , Custos de Cuidados de Saúde , Estudos de Avaliação como Assunto/análise , Formação de Conceito , Custos e Análise de Custo/métodos , Economia e Organizações de Saúde/tendências
16.
Arq. bras. endocrinol. metab ; Arq. bras. endocrinol. metab;55(9): 686-691, dez. 2011. tab
Artigo em Inglês | LILACS | ID: lil-610475

RESUMO

OBJECTIVE: To analyze the costs related to visits and drug prescription in outpatients with type 2 diabetes mellitus assisted by a pharmaceutical care service. SUBJECTS AND METHODS: A prospective and experimental study was carried out. Seventy one patients were divided into two groups: control and pharmaceutical care. Patients in the pharmaceutical care group were followed up monthly by a single clinical pharmacist. RESULTS: The pharmaceutical care group had a statistically significant reduction in costs of metformin and emergency department visits, and increased costs with their family physicians. On the other hand, the control group had a statistically significant increase of 21.3 percent in the general costs of treatment and visits. CONCLUSION: The pharmaceutical care group maintained the same costs related to drugs and visits, while the control group showed a significant increase in general costs.


OBJETIVO: Analisar os custos relacionados a medicamentos e consultas em pacientes portadores de diabetes melito tipo 2 acompanhados por um programa de atenção farmacêutica. SUJEITOS E MÉTODOS: Estudo prospectivo e experimental foi realizado em 71 pacientes, os quais foram divididos em dois grupos: atenção farmacêutica e controle. Os pacientes do grupo atenção farmacêutica foram acompanhados mensalmente por um farmacêutico clínico. RESULTADOS: O grupo atenção farmacêutica apresentou redução estatisticamente significativa no custo da metformina e nas visitas de pronto atendimento e aumento no custo das consultas de atenção primária. Por outro lado, o grupo controle apresentou elevação estatisticamente significativa nos custos gerais de tratamento farmacológico e nas consultas em geral na ordem de 21,3 por cento. CONCLUSÃO: O grupo atenção farmacêutica apresentou manutenção dos custos relacionados a consultas e medicamentos, enquanto o grupo controle apresentou aumento destes.


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /tratamento farmacológico , Custos de Cuidados de Saúde/estatística & dados numéricos , Hipoglicemiantes/economia , Conduta do Tratamento Medicamentoso/economia , Estudos de Casos e Controles , /economia , Medicina de Família e Comunidade/economia , Glibureto/economia , Glibureto/uso terapêutico , Hipoglicemiantes/uso terapêutico , Insulina/economia , Insulina/uso terapêutico , Metformina/economia , Metformina/uso terapêutico , Estudos Prospectivos
17.
Rev. bras. cardiol. (Impr.) ; 23(3): 171-177, mai.-jun. 2010. tab, graf
Artigo em Português | LILACS | ID: lil-568619

RESUMO

Fundamentos: Os inibidores da enzima conversora da angiotensina são frequentemente prescritos para o tratamento da hipertensão arterial sistêmica e da insuficiência cardíaca congestiva. Os dois primeiros representantes dessa classe, o captopril e o enalapril, constam na Relação Nacional de Medicamentos Essenciais devido à eficácia clínica, segurança comprovada e custo-efetividade. Objetivo: Analisar os padrões de prescrição de captopril e de enalapril para os usuários do Sistema Único de Saúde no Distrito Sanitário Oeste de Ribeirão Preto. Métodos: Realizou-se um levantamento no banco de dados da Secretária Municipal de Saúde de Ribeirão Preto para quantificar os usuários do Sistema Único de Saúde que receberam a prescrição de captopril e do enalapril, a frequência de dispensação e analisaram-se os esquemas terapêuticos no peródo entre 01/03/2006 e 28/02/2007. Os dados foram submetidos à análise de variância e aos teste t de Student e de comparações múltiplas de médias. Resultados: Identificou-se que 9560 pacientes utilizaram os inibidores da enzima conversora da angiotensina, sendo quedestes, 46,57% utilizaram captopril, 45,74% enalapril e 7,69% os dois fármacos simultaneamente ou não. A idade média dos usuários foi 61 anos e a utilização desses agentes aumentou progressivamente com o aumento da faixa etária. As doses médias prescritas de captopril foram 69,9mg/dia e de enalapril, 21,35mg/dia e um total de 41,57% dos pacientes apresentaram risco de apresentar interação medicamentosa. Conclusões: Atualmente, existe uma preferência deprescrição de inibidores da enzima conversora da angiotensina em unidades públicas de saúde devido à sua relevânciaterapêutica para o tratamento de doenças crônicas.


Background: Angiotensin-converting enzyme inhibitors are often prescribed for the treatment of systemic arterialhypertension and congestive heart failure. The first two repesentatives of this class, enalapril and captopril, are inthe National Essential Drugs List because of their clinical efficacy, proven safety and cost effectiveness. Objective: To analyze the prescription patterns ofcaptopril and enalapril for Government Health System users in the West Public Health District of Ribeirão Preto, São Paulo State. Methods: A survey was conducted of the Ribeirão PretoMunicipal Health Bureau database, in order to quantify Government Health System users receiving prescriptionsfor captopril and enalapril, with dispensing frequency and therapeutic schemes between 01/03/2006 and28/02/2007. The data underwent variance analysis and Student t tests, with multiple mean comparisons. Results: 9,560 patients were identified as taking angiotensin-converting enzyme inhibitors, of whom 46.57% took captopril, 45.74% enalapril and 7.69% both medications, either simultaneously or not. The averagepatient age was 61 years and the use of these agents rose progressively with increasing age. The mean doses prescribed were 69.9 mg/day for captopril and 21.35 mg/day for enalapril, with 41.57% of patients at risk for potential drug-drug interactions.Conclusion: Currently, there is a preference for prescribing ACE inhibitors at public health units in Ribeirao Preto due to their therapeutic relevance for thetreatment of chronic diseases.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Captopril/administração & dosagem , Enalapril/administração & dosagem , Sistema Único de Saúde , Hipertensão/complicações , Insuficiência Cardíaca/diagnóstico
18.
Braz. j. pharm. sci ; 46(3): 473-481, July-Sept. 2010. ilus, tab
Artigo em Inglês | LILACS | ID: lil-564913

RESUMO

The solubility behavior of drugs remains one of the most challenging aspects in formulation development. Solid Dispersion (SD) has tremendous potential for improving drug solubility. Although praziquantel (PZQ) is the first drug of choice in the treatment of schistosomiasis, its poor solubility has restricted its delivery oral route. In spite of its poor solubility, PZQ is well absorbed in the gastrointestinal tract, but large doses are required to achieve adequate concentration at the target sites. The aim of this study was to improve the solubility and dissolution rate of PZQ and to evaluate its intestinal absorption. SDs were formulated with PEG-60 castor oil hydrogenated (CR-60) using a fusion and evaporation method. Pure PZQ and physical mixtures (PM) and PZQ-CR-60 (2:1; 1:1; 1:2 ratios) were compared as regards their solubility, dissolution and intestinal absorption. The experimental results demonstrated the improvement in the solubility, dissolution rate and intestinal absorption. In addition, the solubility behavior showed pH dependency and that the solubility of PZQ was slower in acidic medium than in neutral and basic mediums. The increase in PZQ solubility of the SD with the CR-60 could be attributed to several factors such as improved wettability, local solubilization, drug particle size reduction and crystalline or, interstitial solid solution reduction.


A solubilidade de fármacos ainda é um dos principais desafios no desenvolvimento de formulações farmacêuticas. As dispersões sólidas (DS) apresentam grande potencial para melhorar a solubilidade de fármacos. O praziquantel é o fármaco de primeira escolha no tratamento da esquistossomose, contudo a baixa solubilidade em água restringe seu uso à administração pela via oral. Apesar da baixa solubilidade, o PZQ é bem absorvido através do trato gastrintestinal, mas doses orais elevadas são requeridas para garantir concentrações suficientes de fármaco para o tecido alvo. O objetivo deste estudo foi melhorar a solubilidade, a dissolução e avaliar a absorção do PZQ. As DS foram formuladas com óleo de castor hidrogenado - PEG 60 (CR-60), pelo uso dos métodos de fusão e evaporação do solvente. PZQ puro, mistura física (MF) e DS de CR-60-PZQ (1:2; 1:1; 2:1) foram comparados quanto à solubilidade, dissolução e absorção intestinal. Os resultados experimentais mostraram aumento na solubilidade, na taxa de dissolução e na absorção intestinal do PZQ nas DS. A solubilidade do PZQ foi maior em meio ácido, mostrando uma dependência do pH. O aumento na solubilidade do PZQ nas DS com CR-60 foi atribuída a fatores como aumento da molhabilidade, solubilização local, redução granulométrica e redução da cristalinidade ou, ainda, a ocorrência de uma solução sólida intersticial.


Assuntos
Fenômenos Químicos/estatística & dados numéricos , Dissolução/métodos , Emulsificantes , Óleo de Rícino/análise , Praziquantel/farmacologia , Hidrogenação , Interpretação Estatística de Dados
19.
Braz. j. pharm. sci ; 45(1): 37-48, jan.-mar. 2009.
Artigo em Português | LILACS | ID: lil-525770

RESUMO

O sistema de saúde nacional, impulsionado por contextos econômicos restritivos, passou por uma reestruturação organizacional na década de 1990, voltada à atenção primária. Apesar das reformas, a incidência de diabetes mellitus ainda atinge elevadas proporções. Devido à alta morbi-mortalidade, a prevenção dessa morbidade tem-se tornado foco atual, fazendo-se necessário o desenvolvimento de programas eficazes e viáveis ao Sistema Único de Saúde, tais como ênfase na prevenção primária, controle da incidência e complicações da doença. Para que isso ocorra, o modelo da atenção atual prestada ao paciente deve ser modificado, priorizando a atenção primária, com a substituição do modelo médico-hegemônico por uma equipe interdisciplinar, onde o farmacêutico, como membro da equipe, possa prover seus serviços, minimizando assim impactos sociais, humanísticos e econômicos que a doença acarreta para a sociedade. O objetivo da presente revisão foi abordar a temática do diabetes mellitus e as dificuldades do controle associado à ineficácia da logística adotada, principalmente no Sistema Único de Saúde.


The Brazilian Health Care System stimulated for restrictive economic contexts had passed for reorganization in the decade of 1990, directed mainly to the primary attention. Although the reforms, the incidence of diabetes mellitus still reaches epidemic levels. The diabetes prevention has become actual preoccupation due the high morbimortality that accompanies this disease, becoming necessary the development of efficient and viable programs for Brazilian Public Health system such as emphasis in the primary prevention, control of the diseases incidence and complications. To obtain this goal, the current model of attention given to the patient must be modified, prioritizing the primary attention and a replacement of the hegemonic medical model for another one, formed by an interdisciplinary team, where the pharmacist as a member could offer his/her services should occur, thus minimizing social, humanistic and economic impacts that the diabetes causes for the society. The aim of this present revision is to approach the diabetes mellitus, the difficulties for its control associated with the adopted ineffective system, mainly in the Brazilian Public Health System.


Assuntos
Diabetes Mellitus/terapia , Atenção Primária à Saúde , Sistema Único de Saúde/tendências , Assistência Farmacêutica , Pesquisa sobre Serviços de Saúde
20.
RBCF, Rev. bras. ciênc. farm. (Impr.) ; RBCF, Rev. bras. ciênc. farm. (Impr.);44(4): 601-612, out.-dez. 2008. tab
Artigo em Português | LILACS | ID: lil-507910

RESUMO

Atenção Farmacêutica, prática recente da atividade farmacêutica, prioriza a orientação e o acompanhamento farmacoterapêutico e a relação direta entre o farmacêutico e o usuário de medicamentos. Na maioria dos países desenvolvidos a Atenção Farmacêutica já é realidade e tem demonstrado ser eficaz na redução de agravamentos dos portadores de patologias crônicas e de custos para o sistema de saúde. No Brasil, esta atividade ainda é incipiente e alguns fatores dificultam sua implantação, entre outros, a dificuldade de acesso ao medicamento por parte dos usuários do Sistema Único de Saúde (SUS), Unidades Básicas de Saúde sem farmacêutico e a ausência de documentação científica que possibilite demonstrar aos gestores do sistema público e privado que a implementação da Atenção Farmacêutica representa investimento e não custo. Por outro lado, sendo nova atividade do profissional farmacêutico, torna-se primordial que as instituições de ensino farmacêutico promovam adaptações curriculares, de modo a fornecer o conhecimento formal necessário ao desempenho desta atividade. Esta revisão discute a Atenção Farmacêutica nos países em que esta se encontra mais evoluída e teve como base a busca de artigos publicados nos periódicos indexados no MedLine/Pubmed (www.ncbi.nlm.nih.gov/PubMed) até 31/12/2007. Com a revisão bibliográfica foi possível comparar com outros países as dificuldades encontradas no Brasil, para a implantação e implementação da Atenção Farmacêutica e as perspectivas para a sedimentação dessa prática no futuro.


The Pharmaceutical Care, recent practice of the pharmaceutical activity, prioritizes the orientation and the pharmacotherapeutic follow up, besides direct relation among the pharmacist and the medicine's user. In most developed countries the Pharmaceutical Care is already a reality and has demonstrated efficacy in the reduction of aggravation in the chronical diseases and in the cost of the health system. In Brazil, this activity is still incipient due to the difficulty of access to the medicines by the users of the Health System, absence of pharmacists in the Basic Units of Health and absence of scientific documentation that may demonstrate to the managers of the public and private system of Health that the implementation of Pharmaceutical Care represent investment and not cost. However, for being a new activity of the pharmacist, it is demanding that the pharmaceutical education institutions promote the necessary adaptations, providing the formal knowledge for the practice of this activity. This paper discuss the Pharmaceutical Care in countries that present more evolution in your desenvelopment according with MedLine/Pubmed (www.ncbi.nlm.nih.gov/PubMed). This article compared the difficulties of the Brazil and others countries for the implantation of Pharmaceutical Care and the prospect for the future.


Assuntos
Controle de Medicamentos e Entorpecentes/tendências , Sistemas de Saúde , Assistência Farmacêutica , Brasil , Literatura de Revisão como Assunto
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