Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-06-29T13:48:24Z No. of bitstreams: 1 DanielleAlvesdeMeloDissertacao2016.pdf: 4128229 bytes, checksum: 28e21c5211a6e622f8da59c8d83da663 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-06-29T13:48:59Z (GMT) No. of bitstreams: 1 DanielleAlvesdeMeloDissertacao2016.pdf: 4128229 bytes, checksum: 28e21c5211a6e622f8da59c8d83da663 (MD5) / Made available in DSpace on 2017-06-29T13:48:59Z (GMT). No. of bitstreams: 1 DanielleAlvesdeMeloDissertacao2016.pdf: 4128229 bytes, checksum: 28e21c5211a6e622f8da59c8d83da663 (MD5) Previous issue date: 2016-03-21 / The aging of the world population is a challenge for health systems. Faced with the aging profile change, with the elderly population steadily increasing, it is necessary strategies to ensure healthy aging. One of the strategies for the aging quality is the use of various drugs, known as polypharmacy. However, the drugs, besides interact with each other, may interact with other factors such as consuming alcohol. The objective was to evaluate the concomitant use of poly pharmacy and alcohol by elderly of the Granja do Torto-D.F neighborhood, through a questionnaire of MEEN and another one structured. It is concluded that from the 202 elderly respondents, 130 (64%) use polypharmacy. However among those, only 16 people (8%) make concomitant use of alcohol. The low percentage may be related to the assistance that the elderly receive in the local health center, with the attendance of a multidisciplinary team. The constant monitoring of the public and the increase awareness of health condition and the risks of consuming alcohol and various drugs, enables the reduction of risks to the health and helps to maintain healthy habits. / O envelhecimento da popula????o mundial traz grandes desafios para os sistemas de sa??de. Frente ?? mudan??a do perfil do envelhecimento, com a popula????o idosa aumentando continuamente, ?? necess??rio estrat??gias que garantam o envelhecimento saud??vel. Uma das estrat??gias visando o envelhecimento com qualidade ?? o uso de variados medicamentos, conhecida como polifarm??cia. Entretanto, os medicamentos, al??m de interagirem entre si, podem ter intera????o com outros fatores, como a ingest??o de bebidas alco??licas. O objetivo do trabalho foi avaliar o uso concomitante de poli farm??cia e bebidas alco??licas por idosos do bairro Granja do Torto, Distrito Federal por meio de aplica????o de question??rio MEEN e outro estruturado. Conclui-se que dos 202 idosos entrevistados, 130 (64%) fazem uso de polifarm??cia. Entretanto entre estes apenas 16 pessoas (8%) fazem uso concomitante de bebidas alco??licas. O baixo percentual que pode estar relacionado com a assist??ncia que esses idosos recebem no posto de sa??de local, com atendimento de uma equipe multidisciplinar. O acompanhamento constante deste p??blico e o esclarecimento acerca da condi????o de sa??de e dos riscos do consumo de ??lcool e variados medicamentos possibilita diminui????o de riscos para a sa??de e auxilia a manter h??bitos de vida saud??veis.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-04T21:05:46Z No. of bitstreams: 1 HalineTerezaMatiasDeLimaCosta_DISSERT.pdf: 2192045 bytes, checksum: fd4867171ed1080dec47c90260404de7 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-11T23:11:44Z (GMT) No. of bitstreams: 1 HalineTerezaMatiasDeLimaCosta_DISSERT.pdf: 2192045 bytes, checksum: fd4867171ed1080dec47c90260404de7 (MD5) / Made available in DSpace on 2017-10-11T23:11:45Z (GMT). No. of bitstreams: 1 HalineTerezaMatiasDeLimaCosta_DISSERT.pdf: 2192045 bytes, checksum: fd4867171ed1080dec47c90260404de7 (MD5) Previous issue date: 2017-06-30 / INTRODU??O: Diversos estudos t?m mostrado que um n?mero significativo de medicamentos prescritos a pacientes pedi?tricos s?o off-label ou n?o licenciados, mas existe pouca informa??o sobre o uso destes medicamentos em unidades de terapia intensiva neonatal (UTIN), assim como estudos sobre fatores de risco para potenciais intera??es medicamento-medicamento (IMM). OBJETIVO: Identificar a prescri??o de medicamentos off-label e n?o licenciados utilizados em rec?m-nascidos (RN) hospitalizados em UTIN, al?m de avaliar frequ?ncia de IMM e seus fatores de risco. METODOLOGIA: Coorte prospectiva, no qual foram inclu?dos neonatos admitidos consecutivamente na UTIN da Maternidade Escola Janu?rio Cicco com pelo menos um medicamento prescrito e tempo de interna??o superior a 24 horas. Dados cl?nicos e farmacoterap?uticos dos neonatos foram coletados durante toda a interna??o, sendo a classifica??o dos medicamentos em off-label e n?o licenciados realizada de acordo com crit?rios da Food and Drug Administration atrav?s da base DrugDex-Micromedex?, a qual tamb?m foi utilizada na classifica??o das IMM, cujos fatores de risco foram identificados por regress?o log?stica. RESULTADOS: Entre agosto de 2015 e agosto de 2016 foram analisados 17421 itens medicamentosos em 3935 prescri??es de 220 neonatos, dos quais 96,4% foram expostos a medicamentos off-label e 66,8% a n?o licenciados. Mais de 70% dos prematuros e RN com menos de 2000g foram submetidos ? farmacoterapia com medicamentos off-label e mais de 50% aos n?o licenciados. Os anti-infecciosos para uso sist?mico foram o grupo farmacol?gico mais prescrito de forma off-label,sendo o fentanil (n=1358) e a gentamicina (n= 1197) os medicamentos com maior preval?ncia de uso off-label para RN. A cafe?na (n=1226) foi o medicamento n?o licenciado mais prescrito, seguido pelos agentes cardiovasculares (n=648) modificados pela enfermagem. Em 42,3% (n= 1665) das prescri??es foram detectadas IMM, cujos fatores de risco para IMM importantes foram o n?mero de medicamentos (OR 1,60, p<0,001), parto ces?reo (OR 2,68, p=0,06) e idade gestacional (OR 1,03, p= 0,002). CONCLUS?ES: RN em terapia intensiva ? submetido ? alta taxa de prescri??o e exposi??o a medicamentos off-label e n?o licenciados, sendo os mais frequentes os anti-infecciosos de uso sist?mico e os medicamentos atuantes no sistema nervoso, e tamb?m uma elevada incid?ncia de IMM, consistindo o n?mero de medicamentos prescritos, parto ces?reo e a idade gestacional os principais fatores de risco para IMM. / INTRODUCTION: Several studies have shown that a significant number of drugs prescribed to pediatric patients are off-label or unlicensed, but there is little information about the use of these drugs in neonatal intensive care units (NICUs), as well as studies about risk factors for drug-drug interactions (DDI). PURPOSE: To evaluate the use of off-label and unlicensed drugs in a Brazilian NICU of a teaching maternity hospital specialized in high risk pregnancy, and the frequency of DDI and associated risk factors. METHODS: A prospective cohort study was conducted between august 2015 and august 2016. All newborns admitted consecutively in the NICU of the Maternity School Janu?rio Cicco for over 24 hours and who had at least one medication prescribed were included. Demographic and clinical data were collected, as well as all medications prescribed during hospitalization. The classification of off-label and unlicensed drugs for the neonatal population according to the Food and Drug Administration criteria was done based on the DrugDex-Micromedex? database, which was also used for the classification of DDI. Logistic regression was used for the analysis of risk factors. RESULTS: A total of 17421 prescriptions items were analyzed in 3935 prescriptions of 220 newborns, of whom 96.4% were exposed to off-label medications and 66.8% to unlicensed drugs. More than 70% of premature and neonates with birth weight less than 2000g were submitted to off-label medicines and more than 50% to unlicensed. The anti-infectives for systemic use were the most prescribed off-label pharmacological group and the drugs most frequently classified as off-label for newborn were Fentanil (n= 1358) and gentamicin (n= 1197). Caffeine (n = 1226) was the most prescribed unlicensed drug, followed by cardiovascular agents (n= 648) modified by nursing. DDIs were found in 42,3% (n= 1665) of prescriptions , with number of drugs (OR 1.60, p<0,001), cesarean delivery (OR 2.68, p = 0,06) and gestational age (OR 1.03, p = 0,002) as risk factors for major DDI. CONCLUSION: Neonates in intensive care units have a high rate of prescriptions and exposure to off-label and unlicensed drugs, with antimicrobials for systemic use and drugs action on nervous system as the most frequently prescribed, as well as a high incidence of DDI, with number of medicines, cesarean delivery and gestational age being risk factors for major DDI.

Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-06-26T23:09:15Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) laura_roberta_sa_ferreira.pdf: 1184127 bytes, checksum: 423bdfb7f8d380519ba2c16211b2795b (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2018-07-18T12:50:54Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) laura_roberta_sa_ferreira.pdf: 1184127 bytes, checksum: 423bdfb7f8d380519ba2c16211b2795b (MD5) / Made available in DSpace on 2018-07-18T12:50:54Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) laura_roberta_sa_ferreira.pdf: 1184127 bytes, checksum: 423bdfb7f8d380519ba2c16211b2795b (MD5) Previous issue date: 2017 / Os erros envolvendo medicamentos podem ocorrer em qualquer fase do processo hospitalar, ou seja, na prescri??o, dispensa??o ou na administra??o. O in?cio do ciclo da medica??o ? a prescri??o, o m?dico deve especificar a terapia e condutas mais adequadas por escrito, levando em considera??o principalmente o uso racional de medicamentos. Quando a prescri??o n?o ? executada de maneira adequada pode contribuir de forma direta com os problemas relacionados a erros de medica??o. O presente trabalho foi realizado em uma Institui??o de sa?de em Diamantina com objetivo de avaliar a efetividade do servi?o realizado pela farm?cia cl?nica; identificar o perfil dos pacientes atendidos pelas cl?nicas m?dica e neurol?gica; os tipos e as frequ?ncias de erros que ocorrem na etapa da prescri??o e identificar os tipos de intera??es medicamentosas e suas frequ?ncias. Ap?s a implanta??o do servi?o de farm?cia cl?nica, em um ano o servi?o de an?lise de prescri??o proporcionou uma queda de +/- 40% das inadequa??es nas prescri??es. O perfil dos pacientes internados nas cl?nicas m?dica e neurol?gica da Institui??o em Diamantina foi de homens idosos que fazem uso de polifarm?cia. E devido ao grande n?mero de medicamentos nas prescri??es, as mesmas apresentaram 66,46% de intera??es medicamentosas, e as intera??es medicamentosas mais frequentes foram do tipo moderada (presentes em 59,76% das prescri??es) e menor (presentes em 20.12% das prescri??es). A inadequa??o mais frequente foi relacionada ao hor?rio de administra??o dos medicamentos. Tamb?m foi verificado que as prescri??es dos pacientes idosos, em sua maioria, apresentaram medicamentos da lista de Beers. Portanto, a realiza??o deste trabalho foi importante para promo??o do uso racional de medicamentos na Institui??o, al?m disso, mostrou a efetividade do servi?o que foi implantado na Institui??o. / Disserta??o (Mestrado) ? Programa de P?s-gradua??o em Ci?ncias Farmac?uticas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / Mistakes involving medications can occur at any stage of the hospital process, that is, during prescription, dispensing, or administration. The beginning of the medication cycle is the prescription, when physicians must specify the most appropriate therapy and conduct in writing, taking into account the rational use of medications. When prescription is not performed properly, it may contribute directly to problems related to medication errors. The present study was carried out in a health institution in Diamantina, with the objective of: identifying the profile of patients attended by the medical and neurological clinics; The types and frequencies of medication errors that occur in the prescription step; To identify the types of drug interactions and their frequencies; Evaluate the impact of polypharmacy on patient?s health and use the results of the research to analyze the effectiveness of the institution's clinical pharmacy service. The profile of the patients hospitalized in the medical and neurological clinics of the institution in Diamantina was of elderly men who use the polypharmacy, and also, due to the large number of medications in the prescriptions, the most frequent inadequacies were moderate and minor drug interactions. It was also verified that the prescriptions of these patients had, in their majority, medicines found in the list of Beers. After the implementation of the clinical pharmacy service, in one year of the prescription analysis service, a fall of +/- 40% of the inadequacies in the prescriptions of the medical and neurological clinics was observed. Therefore, the accomplishment of this work was important to promote the rational use of drugs in the institution, and in addition, it showed the effectiveness of the service implanted in the institution.