II SIMPOSIO INTERNACIONAL DE
ATENÇÃO FARMACÊUTICA
LOCAL DE REALIZAÇÃO:
MONREALE HOTEL RESORT
POÇOS DE CALDAS/MG
APRESENTAÇÃO DO EVENTO
A área de ciências farmacêuticas é dinâmica e apresenta-se em constante
desenvolvimento; novas tendências, novos conhecimentos e novas pesquisas fazem parte do
cotidiano do estudo farmacêutico. Nesse contexto, a Atenção Farmacêutica tem-se destacado
como um resgate da essência do profissional farmacêutico. Trazendo à sociedade novamente a
importância das ciências farmacêuticas no cuidado com o paciente e não somente na produção de
medicamentos.
Em 1990, Hepler & Strand estabeleceram que “a missão principal do farmacêutico é prover
a atenção farmacêutica, que é a provisão responsável de cuidados relacionados a medicamentos
com o propósito de conseguir resultados definitivos que melhorem a qualidade de vida dos
pacientes” (BISSON, 2007).
A Atenção Farmacêutica compreende, além da terapia medicamentosa, decisões sobre a
medicação de cada paciente. Isso envolve a seleção dos fármacos, doses, vias e métodos de
administração; monitorização terapêutica; informações ao paciente e à equipe multidisciplinar de
saúde; e o aconselhamento do cliente, visto que o alcance dos objetivos terapêuticos depende
muito dele próprio, o qual pode ter dificuldade de adesão ao tratamento medicamentoso, ou
responder imprevisivelmente ao mesmo devido às diferenças biológicas. Vê-se, então, a
necessidade de uma relação de confiança entre farmacêutico e paciente em um acompanhamento
farmacoterapêutico, tendo-se o consentimento pleno do paciente e autorização formal para o
farmacêutico exercer suas atividades.
A Universidade Federal de Alfenas, antiga Escola de Farmácia e Odontologia de Alfenas,
tem uma história de mais de 96 anos contribuindo para a formação de profissionais farmacêuticos
no Brasil. Com a preocupação constante de formar profissionais capacitados, atualizados e
preparados para o mercado de trabalho com qualidade e conhecimento científico a UNIFAL-MG
mais uma vez procura trazer sua contribuição ao ensino farmacêutico promovendo o II Simpósio
Internacional de Atenção Farmacêutica da UNIFAL-MG. Aliando nosso corpo docente e
pesquisadores farmacêuticos respeitados do Brasil, Espanha e Portugal; buscamos a realização
de um evento de qualidade que possa fornecer a alunos de graduação, pós-graduação e
profissionais as novas pesquisas e metodologias empregadas na pesquisa do acompanhamento
farmacoterapêutico, o cuidado e preocupação com a recuperação da qualidade de vida do
paciente, serviços esses prestados pela Atenção Farmacêutica.
COMISSÃO ORGANIZADORA
Coordenação do evento:
Dra. Magali Benjamim Araújo – Coordenadora e Diretora da Faculdade de Ciências Farmacêuticas da UNIFAL-MG
MsC. Luciene Alves Moreira Marques – Coordenadora e Professora de Atenção Farmacêutica
Comissão Científica:
Dra. Sandra Maria Oliveira Morais Veiga
Dr. Diogo Teixeira Carvalho
Avaliadores:
Amanda Latércia Tranches Dias
Amilton Marques
Claudia Fegadolli
Danielle Aparecida Ferreira de Oliveira
Diogo Pilger
Diogo Teixeira Carvalho
Francisca Sueli Monte
Lara Cristina Silva
Luisa Barbosa Messora
Luiz Carlos do Nascimento
Luiz Henrique Amarante
Marcelo Aparecido da Silva
Milena Carla Espósito
Ricardo Radighieri Rascado
Sandra Maria Oliveira Morais Veiga
Sinezio Inácio da Silva Júnior
Thaís Rodrigues Penaforte
Vanessa Bergamin Boralli Marques
Verônica Ferreira Magalhães
Comissão de Patrocínio:
Dra. Lara Cristina Silva
Acadêmicos:
Anali Duarte Ortigoso Carbi
Clara Gavião Prado
Cristiane Carneiro Oliveira
Danielle Taira Konichi
Flávia Cunha Loyola Elias
Gabriel Tavares do Vale
Gabriella Farina Câmara
Glenda Pessoa Lacerda
Jaqueline Angélica Dionizio
Luana Amaral Pedroso
Luciana Viana Rezende
Marcela Campelo Rodrigues Silva
Marcela Cardoso de Oliveira
Nadielle Gonçalves Siqueira
Osiel Américo de Oliveira
Rafael Alves Moura
Rafael Brianti Pizi
Tatiane Rodrigues Nassar
Vanessa Souza Reis
Verônica Muniz Couto
Comissão Geral de Integração:
Renata Barbosa
Anelise Ribeiro
Lênin Machado
Comissão de Infra-estrutura:
MsC. Amilton Marques
MsC. Verônica Ferreira Magalhães
Renato Dias D’Andrea
Apoio:
001
EPIDEMIOLOGICAL PROFILE OF ASTHMATIC PATIENTS ASSISTED BY PROAICA IN A BASIC
HEALTH UNIT
BRENA MUNIZ CHAVES1,5, NAYARA OTAVIANO DINIZ1,5, CRISTIANE RODRIGUES DE SOUSA2, ARACI
DIÓGENES BRAGA2, LIVIA FALCÃO LIMA1,5, NADIR KHEIR3,5, DAVID WOODS4,5, ÂNGELA PONCIANO1,5,
HENRY PABLO REIS1,5, MARTA MARIA FONTELES1,5, LUZIA IZABEL MOREIRA DA SILVA1,5
1
Universidade Federal do Ceará (UFC); 2Centro de Assistência à Criança; 3Qatar University; 4Otago University; 5Centro
de Estudos em Atenção Farmacêutica(CEATENF)
Educational aspects are important to asthma control and make part of pharmaceutical care practice. This study aimed to
delineate the epidemiological profile of patients with asthma linked to PROAICA (Program of integrated care for the
asthmatic child) in order to establish better planning of educational actions. The Center of Pharmaceutical Care Studies
established a Pharmaceutical Care Unit (PCU) in the Child Care Center, Fortaleza-CE. Patients were recruited during
medical consultation through referral to PCU, where they received additional guidance on environmental control
measures, pharmacotherapy and the correct use of inhaler devices. A total of 78 patients were followed up from
September 2010 to February 2011. A pharmacotherapeutic form was used to collect data from patients. A high
percentage of patients were male (66.7%, n=52), and had the mother as caregiver (74.4%, n=58). The age of patients
ranged from 4 to 18 years, with a mean of 12.5 years. With regard to severity, 70.6% of the patients had intermittent
27.4% mild persistent asthma and 2% moderate persistent asthma. Rhinitis was associated with asthma in 92.5% of the
cases. Most patients (80.4%) had the first asthma episode before the age of one year. There were reports of absences
from school due to asthma attacks (15.4%, n=12) as well as to exercise intolerance (10.3%, n=8). During the follow up,
16% (n=13) of the patients had adverse reactions to drugs. Our findings were able to guide the development of
educational interventions, according to the characteristics and needs of the studied population such as caregivers,
through talks about rhinitis and asthma, distribution of folders about adverse reactions of used drugs and games for
children and teenagers.
Financial support: CNPq;Pró-Reitoria de Extensão/UFC.
002
USE OF MEDICINES IN HYPERTENSION PATIENTS` FAMILIES IN AN AREA CARED BY “FAMILY
HEALTH PROGRAM” IN ALFENAS-MG.
RAFAEL ALBANO DA SILVA1, DIMITRIA LAGANÁ1, SUELI LEIKO TAKAMATSU GOYATÁ1. SINÉZIO
INÁCIO DA SILVA JÚNIOR1,
1
Universidade Federal de Alfenas, UNIFAL-MG.
Family health strategy is the basis for primary health care in Brazil. The maximum effectiveness of this strategy will
only be achieved if the family itself undertakes self-care and prevention, in addition to being the focus of a
multidisciplinary health team. The aim of this research was to investigate the pharmacoepidemiological profile of the
hypertensive patients’ families in an area cared by the Family Health Program (FHP) in Aparecida II neighborhood,
Alfenas-MG. A cross-sectional, descriptive and quantitative study was conducted. The preliminary results (80 out of
141 households) indicated that 1.2 people per household make use of medicines, due to allegations of 25 diseases,
especially: hypertension (51.1%); “thyroid” (8.7%); “heart” (4.3%), diabetes (4.3%), “stomach” (4.3%), bronchitis
(2.2%), “blood circulation” (2.2%), “cholesterol” (2.2%). The majority make chronic use of medicines: less than 1 year
(14.1%); 1 to 5 years (38.0%); 6 to 10 years (29.6%); 11 to 15 years (8.5%); more than 15 years (9.7%). In 63.8% of the
households teas and phythoterapics were used for health treatments (without medical advice); in 20% of the households
the use of homeopathic medicine as well as in 38.8% the use of psychotropics were reported respectively. Self
medication was practiced in 56.3% of the households, in most cases motivated by pain (67.6%) and flu (25.5%). In
36.7% of the surveyed households adverse reactions to medication were reported. The results suggest practice of
polypharmacy. The risk of self-medication associated with polypharmacy emphasize the importance of pharmaceutical
care, although most of the reported respondents’ (77.5%) feeling was enlightened by the FHP team "about the use of
medicine".
003
A MODEL FOR THE FUTURE CONDUCT OF PHARMACOVIGILANCE BASED ON CLINICAL
PHARMACY AND PHARMACEUTICAL CARE: AN APPLICATION IN ONCOLOGY
MARÍLIA BERLOFA VISACRI1, CINTHIA MADEIRA DE SOUZA1, PAMELA PASCHOA FAUSTINO1, CRISTINA
ROSA BARBOSA2, SILVIA GRANJA3, CATARINA MIYAKO SATO3, MECIA DE MARIALVA DEMOCH3,
CARMEN SILVIA PASSOS LIMA4, PATRÍCIA MORIEL1.
1
Faculdade de Ciências Médicas, Universidade Estadual de Campinas, UNICAMP;
HC/UNICAMP;
2
Hospital de Clínicas,
The pharmacovigilance (PH) model is based mainly on spontaneous adverse drug reaction (ADR) reporting but this has
been proved ineffective because of under-reporting. The objective of the research has been to demonstrate the
complexity of the actions in PH and how it interrelates with Pharmaceutical Care (PC) and Clinical Pharmacy in
Oncology, proposing a model that reduces underreporting. This is a prospective study, held in 2010, divided in three
phases in a University Hospital: 1) Survey of notifications of ADRs, occurring in oncology patients, in the hospital’s PH
section (n=33); 2) Monitoring Chemotherapy Session (MCS) (n=50); 3) PC in head and neck cancer in the Clinical
Oncology Ambulatory (n=32). The ADRs obtained from the survey were classified according to action mechanism,
severity and causality (by Naranjo Algorithm); the adverse effects of chemotherapy were investigated using a
questionnaire and some effects were classified according to Common Toxicity Criteria; for the pharmacotherapeutic
follow-up with head and neck cancer patients the Pharmacist´s Workup of Drug Therapy method was used. A total of 10
notifications (30.3%) of ADR were found , related with oncology patients: 8 were classified as type B (80%), 4 as
severe (40%) and 6 as possible (60%). During the MCS 5 cases of grade III nausea were observed in patients treated
with cisplatin (83.3%),an important information for the PC in head and neck cancer. Drug interactions (56,7%) and
ADRs (34,6%) were the drug related problems mostly observed during pharmacotherapeutic follow-up. More, 3
notifications (30%) in the PH section occurred due to the MCS and 1 (10%) due to the PC. The proposed model reduces
the phenomenon of under-reporting because the clinical pharmacist is the best professional to detect, report and educate
health staff on adverse drug reactions.
Financial support: FAEPEX; CNPq.
004
ACCOUNT OF EXPERIENCE: PHARMACO-THERAPIC EDUCATION FOR GROUPS OF INSULINDEPENDENT DIABETIC PATIENTS CARED BY THE FAMILY HEALTH PROGRAMME (PSF) IN THE
CITY OF ALFENAS - MG
RENATA CUNHA DE RESENDE1, MARIA RITA ALVES BARBOSA DE PAIVA1, MARCELO JOSÉ DIAS1,
MARIA HELENA MAGALHÃES2, DIANA MARA DE SOUZA CARVALHO2, WALNÉIA APARECIDA DE
SOUZA3, MARCIA HELENA MIRANDA CARDOSO PODESTÁ3
1
Health Family Resident Pharmacists at the Federal University of Alfenas-MG; 2 Pharmacists with the Brazilian
National Health Service (SUS); 3 Associate Lecturer at the Federal University of Alfenas-MG
Health bodies have become convinced that Education is the most effective measure on the road to achieve prevention,
diagnosis and diabetes control. The PSF corresponds to the primary level of attention and thus is the priority as a
location for undertaking actions which promote health and prevent the consequences of the poor control of diabetes.
The Pharmacist acts promoting the rational use of medicines and the maintenance of effectiveness and safety of the
treatment. The goal of this work is the promotion of Health Education for those who have diabetes mellitus and are
insulin-dependent, as cared by the PSF, guiding them on the correct use of the medicines. The work is being carried
out in the PSF of the city of Alfenas. The methodological strategy used is the exposure through dialogue with groups,
dramatization, practical activities, rounds of discussions and accounts of experiences. The materials used are: insulin
and the elements for its application, selectors for the places of insulin application, illustrative leaflets with basic
information on the control of diabetes. At the end a glucose test is done, using a glucose meter. The Pharmacist is taking
up the forefront position, in the fight for promoting health, as this is the professional with the qualifications to
undertake laboratory tests and digital glycemia, apart from advising on the correct use of medication. It is necessary to
train health workers so that they can be educators about diabetes, as one of the biggest challenges that health
professionals face is to convince the diabetic person himself to be an agent of changes in himself, something which can
be achieved only through education.
005
ADHERENCE TO TREATMENT FOR PATIENTS WITH SHORT BOWEL SYNDROME: A COMPARISON
BETWEEN DIRECT AND INDIRECT METHODS
IAHEL MANON DE LIMA FERREIRA, NATHALIE DE LOURDES SOUZA DEWULF, SELMA FREIRE DE
CARVALHO DA CUNHA.
Faculty of Medicine de Ribeirão Preto, University of de São Paulo.
The short bowel syndrome (SBS) is a rare condition that occurs when the patient has less than 200 cm of functional
small bowel associated with a remarkable loss of absorption capacity. Adherence to treatment assess the correspondence
of the patient's behavior with a health professional prescription or recommendation, and can be measured by direct
methods (e.g., measurement of serum levels of the substance) or by indirect methods (e.g., questionnaires). The
objective was to compare adherence to vitamin supplementation by assessing serum levels of folic acid and vitamins A,
B12, C and E; and the Morisky Test in patients with SBS followed by the Hospital of the Medicine College of Ribeirão
Preto – University of São Paulo. The study was approved by the Institution’s Ethics Committee and was conducted for
18 months with all eligible patients (n=10), in accordance with the inclusion criteria: receive cycles of PN and use of
vitamin supplementation at home. Upon discharge, patients were invited to participate in the study and were performed
the first sample for determination of the vitamin status. In subsequent hospital readmission, the Morisky Test was
applied and the second sample for the determination of the vitamin status was performed. In between hospitalizations,
there was no change in the status of the folic acid vitamin and vitamins A, B12 and C, with a reduction in the vitamin E
serum (p=0.03). Regarding the Morisky Test, 40% of patients shown more adherence and 60% shown less adherence.
Although adherence to treatment according to the Morisky Test was low, it is estimated that the assessment through this
instrument underestimates adherence, because it relies on a negative answer of the questions. Thus, even considering
the absorptive deficiencies of patients with SBS, it is believed that these patients had an adherence greater than the 40%
obtained by Morisky Test, because except for vitamin E, no significant changes were observed in the analyzed vitamins
serum.
Financial support: FAPESP.
006
ADVERSE DRUG REACTIONS IN PATIENTS WITH MENTAL DISORDER
VANESSA SOUZA REIS, GABRIEL TAVARES DO VALE, RAFAEL ALVES MOURA, SAMIR ANTONIO
RODRIGUES ABJAUDE, LUCIENE ALVES MOREIRA MARQUES, RICARDO RADIGHIERI RASCADO
UNIFAL – MG. Faculty of Pharmaceutical Sciences
When a drug is developed, tests which are called clinical trials are made in human beings. These trials have many
limitations, so it's important to have post-marketing surveillance, which will study and evaluate adverse drug reactions
(ADR), technical complaints, and related risks. The pharmacovigilance uses notifications as a tool to detect ADRs,
technical complaints and prescription errors. This notification can be voluntary, where the individual seeks a
notification center or an active search, where the researcher chooses a specific group of drug users who are subject to
suffer adverse reactions and follow them up during their drug treatment in order to detect ADRs occurred during
treatment. The objective of this study was to detect the existence of ADR in patients diagnosed with mental disorders
(MD) (CID-10 categories F30 F-39) at the Centro de Atenção Psicossocial de Alfenas (CAPS); classify adverse reaction
by gravity and causality; provide information about the appropriate use of psychotropic drugs. Were selected 16 patients
(5 men and 11 women) diagnosed with MD. Interviews were conducted with questionnaires with the patients or family
members. In the analysis of ADRs reported by patients Naranjo algorithm was applied. The follow up of these patients
was made through pharmaceutical care to promote rational use of drugs. Among the interviewed patients, 56.25% made
use of polytherapy. 81.25% reported some suspected ADR. After analysis of suspected RAM it was found that only
3.77% were classified as defined according to the Definition of Causal Relationship of Naranjo et al. All were classified
as mild according to severity. Our results demonstrate that these patients have adverse reactions, being mostly mild
reactions, which require pharmaceutical guidance on how to use correctly.
Financial support: CNPq
007
ADVERSE DRUG REACTIONS TO POTENTIALLY INAPPROPRIATE MEDICATIONS FOR USE IN THE
ELDERLY: A CROSS-SECTIONAL STUDY IN A BRAZILIAN MUNICIPALITY.
MONARA NATANA IDEM1, PAULO ROQUE OBRELI NETO2, JESSIKA CAROLINE VIEIRA1, WALDEREZ
PENTEADO GAETI2, ROBERTO KENJI NAKAMURA CUMAN2
1
Faculdades Integradas de Ourinhos, FIO; 2Universidade Estadual de Maringá, UEM-PR.
Some drugs are classified as potentially inappropriate for use in elderly people (PIM), when their potential risks exceed
the expected benefits, and for which safer therapeutic alternatives exist. The aim of this study was to evaluate the
prevalence of adverse drug reactions (ADRs) in the elderly, caused by the consumption of PIM. A cross-sectional study
was carried out between January 2010 and April 2010, in a basic health unit (BHU) in a Brazilian municipality (Salto
Grande) in the State of Sao Paulo. Elderly patients (> 60 years) consuming at least one PIM (according to the Beers
Criteria) were included in the study. Data were collected from prescription database of the BHU. The occurrence of
ADRs was assessed by six previously trained clinical pharmacists, using clinical and laboratory parameters. Causality
assessment was performed by the Naranjo algorithm. Seriousness of ADRs was assessed by the World Health
Organization's definition. A total of 329 elderly patients were included in the study. The prevalence of ADRs was
12.8% (n = 42 patients), with a mean of 0.2 ADRs per patient (ranged 0-4). According to the Naranjo algorithm, 73.8%
ADRs were probable, 19.0% ADRs were possible and 7.2% ADRs were doubtful. Referring to seriousness, most of the
ADRs were classified as minor (64.3%), followed by moderate (31.0%) and severe (4.7%). The prevalence of ADRs to
PIMs in our sample was high, indicating the need of new strategies to follow-up the pharmacotherapy of elderly
patients.
Financial support: Fundação de Apoio ao Desenvolvimento Científico (FADEC).
008
ADVERSE REACTIONS TO ACID
PHARMACOVIGILANCE SYSTEM
IOXITALAMIC:
A
CASE
REPORT
OF
HOSPITAL
LIANA SILVEIRA ADRIANO1,2,3; EUDIANA VALE FRANCELINO3; GRACE MENDES DE DEUS1; MARIA
ZENAIDE MATOS ALBUQUERQUE2
1
Departamento de Gerência de Risco Sanitário Hospitalar, 2Departamento de Farmácia Hospitalar, Hospital Infantil
Albert Sabin (HIAS-CE), 3Departamento de Farmácia, Universidade Federal do Ceará (DEFA/UFC)
Ioxitalamic Acid (IA) is an ionic monomeric iodinated radiographic contrast media, used for image enhancement in
computed tomography (CT). It is related to cases of Adverse Drug Reactions (ADRs) that include tachycardia or
bradycardia; sensation of warmth; urticaria; dizziness; headache; cough and dyspnea; pulmonary edema;
hypersensitivity reactions, including anaphylaxis. In February / 2011, the Pharmacovigilance service developed at
“Hospital Infantil Albert Sabin” (HIAS-Fortaleza / CE), under the approval of the Ethics Committee, reported the
occurrence of an event of ADR after the use of the contrast. A patient, AKAL, male, eleven years old, was admitted
with a history of severe headache, with a suspicion of brain abscess. A CT scan was performed, using the contrast with
IA (30U) intravenously administered. After the procedure, the patient returned to the hospital emergency where clinical
symptoms of ADR were observed: cough, respiratory distress, hyperemia of the sclerotic and the cervical region. An
intervention was performed administrating Hydrocortisone and Adrenaline, achieving improvement symptoms. The
reaction was classified by the Ceará Pharmacovigilance Centre as probable and moderate (WHO), because it had a
reasonable temporal sequence after drug administration and intervention was necessary. As a pharmacist intervention, a
card registry of ADR was delivered to the patient's mother, that alerts of the presented reaction. The identification and
understanding of ADRs, followed by preventive measures, is crucial to the success of the activity of Pharmacovigilance
in hospitals.
Financial support: UFC; HIAS-CE; SESA-CE.
009
ANALYSIS OF PSICOTROPHIC PRESCRIPTIONS IN RELATION TO BRAZILIAN COMMON NAME
(DCB) BY PRESCRIBERS IN A PHARMACY
JEAN LEANDRO DOS SANTOS1; CAROLINA MAGALHÃES BRADBURY1
1
NAF – Núcleo de Atenção Farmacêutica - Universidade Estadual Paulista – Faculdade de Ciências Farmacêuticas –
Araraquara.
On February 10, 1999 the generic drugs act (Act No. 9787)was ruled. This law is part of a government policy that aims
to stimulate competition and variety of market supply of drugs, reduce prices, and facilitate people's access to treatment.
The generic drug can be interchangeable with the concerned reference drug. According to RDC No. 10, 2 January 2001,
topic 6.1, "the requirements by the responsible professional must adopt the Common Brazilian Name-DCB, or, failing
that, International Nonproprietary Name, INN" under the National Health System - SUS. According to the same RDC
in private health services "limitation is at the discretion of the responsible professional and can be performed under the
generic or brand name, which should point out, when necessary, restrictions on interchangeability."The pharmacist is
the only person authorized to guide consumers on medicines in a pharmacy, as well as suggesting a generic alternative
if any”. In this work, the retained psychotropic medications prescriptions of a drugstores were analyzed during the year
2010 using the DCB, or using the brand name medicines. Among the 1520 analyzed prescriptions, 61.1% were
prescribed using the brand name, even with the existence of interchangeable generic medicines available, 37 (24.3%)
were prescribed using the DCB. Among 61.1% that use brand name, 22.5% come from the Municipal Health Secretary
that must prescribe using only DCB. This study allows tracing more adequate strategies in the future in order to
improve prescribers’ adherence according to Brazilian laws.
Financial Support: MEC.
010
ANALYSIS OF SELF-MEDICATION IN TECHNICAL HEALTH SCHOOL STUDENTS IN THE CITY OF
BOA ESPERANÇA-MG
ANTÔNIO R. LOPES1, MATHEUS F. RIOS1, ALEXANDRE G. ZUBA1, JOÃO CLAUDIO F. S. MACHADO1,
MÁRCIA HELENA M. C. PODESTA1, OLINDA MARIA G. C. VILAS BOAS1, ERIC B. FERREIRA1, LUCIANO M.
S. SIQUEIRA2, WALNÉIA A. SOUZA1
1
The Federal University of Alfenas - Faculty of Pharmaceutical Sciences (Unifal-MG). 2Alfenas University (UnifenasMG)
The knowledge of the pattern of the use of medicines contributes to the implementation of educational actions that aim
at reducing risks and damages to the health of the population. This study aimed at assessing the prevalence of selfmedication among Pharmacy and Nursing technical courses’ students of a Technical School located in the city of Boa
Esperança, Minas Gerais state (MG). An exploratory and descriptive study was carried out on the habit of using
medicines with 98 students aged from 15 to 30, during the month of November 2009. A questionnaire was used to
investigate the prevalence of self-medication, the drugs which were used the most, their major indication sources, the
use of medicines with alcoholic beverages, and also the possibility of these young people to be indicating medicines to
other people. The results were evaluated through mean and standard deviation of the mean. The use of medicines
occurred with 89.0% of the students and in 78.5% of the cases there was self-medication. The pharmacological groups
that were consumed the most were painkillers (65.5%) for women and cold and flu medicines for men (62.9%),
whereas painkillers were the drugs used the most (57.9%). The prevalence of self-medication among women (63%) was
higher than in men (37%). The relation between age and self-medication showed a higher prevalence among students
over 21 years old, where 91% of them were self-medicating themselves. The use of medicines due to family members’
advice (40.4%) showed to be a factor of significant influence in self-medication. There was similarity between the
reasons that led people to take the medicines on their own account and those who advised their use. Therefore, it is
concluded that self-medication is frequent among these students. Thus, health education is an important measure to
minimize such risks.
011
ANALYSIS OF THEORETICAL POTENTIAL DRUG INTERACTIONS IN ICU PRESCRIPTIONS AT A
UNIVERSITY HOSPITAL (CAMPINAS, SP)
ALINE TEOTONIO RODRIGUES1, RAFAELA PIMENTEL1, NATHÁLIA VANCE1, MÉCIA DE MARIALVA2,
SILVIA GRANJA2, SIMONE CRISTINA MODA BATTAGLINI2, ANA PAULA DEVITE CARDOSO
GASPAROTTO3, CRISTINA BUENO TERZI COELHO3, ANTONIO LUIS EIRAS FALCÃO3, PATRICIA MORIEL1,
PRISCILA GAVA MAZZOLA1
1
3
Department of Clinical Patology - Faculty of Medical Sciences (FCM), Unicamp, 2 Pharmacy Service HC-Unicamp,
Intensive Care Unit (ICU) HC-Unicamp
The occurrence of adverse drug reactions (ADR) in hospitalized patients has recently been associated with a significant
increase in days spent in hospital, costs, morbidity and occasionally in patient’s mortality. The possibility of an ADR
occurring could be correlated with the number of drugs per prescription and with the presence of potential drug
interactions between medical prescriptions. The objective of this research was to assess the frequency of Theoretical
Potential Drug Interactions (TPDI) between prescriptions made at the Intensive Care Unit (ICU) of a Public Hospital
(Hospital de Clínicas - Unicamp), to quantify and classify them based on severity level, thus identifying a pattern with
the most frequent TPDI in the hospital unit mentioned above. During the period from January to March of 2011, 190
prescriptions of 95 patients were collected. The studied group was selected randomly from patients over 18 years who
had been hospitalized for over 48 hours in adult ICU. In each prescription, there were 4 to 45 types of drugs, with an
average of 14,0±4,2 per prescription, while there were 143 types of drugs. A total of 992 Theoretical Potential Drug
Interactions varied from 0 to 34, resulting in an average of 5,2±5,4 TPDI per prescription. An amount of 992 TPDI were
classified as contraindicated (43), major (303), moderate (526) and minor (120), using the Micromedex® database. This
research collaborates in the delimitation of the pharmacotherapy procedures used in intensive care, demonstrating that
there is a high incidence of Theoretical Potential Drug Interactions with them. It also highlights the Clinical
Pharmacist’s contribution in this area, helping the multidisciplinary team reduce the risks in drug therapy.
Financial support: Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPQ
012
ANTINEOPLASTICS-INDUCED ADVERSE REACTIONS: OVERVIEW
HELAINE CARNEIRO CAPUCHO1, FELIPE DIAS CARVALHO2, FERNANDO SANTA CECÍLIA ARTUZO2,
LÍLIAN DE ANDRADE SÁ1, ALINE MARIA BONINI MOYSÉS1, REGINA CÉLIA GARCIA DE ANDRADE2
1
Hospital das Clínicas de Ribeirão Preto, HCFMRP-USP; 2Universidade de São Paulo, FCFRP-USP
Antineoplastics drugs have great potential to cause adverse drug reactions (ADR) due to their therapeutic properties and
mechanisms of action. The objective of the present exploratory and descriptive study was to meet the profile of
antineoplastics-induced adverse drug reactions that impair outpatients at the Chemotherapy Center in a teaching
hospital in the northeast of São Paulo state. Thus, ADR classification (type A or B), causality according to Naranjo
algorithm, involved medicines, genre and age groups of patients who experienced ADR were identified from
spontaneous notifications reported to the Chemotherapy Center and sent to the hospital’s Risk Management Service
(RMS) during the period from January 1st, 2010 to December 3rd, 2010. From 122 ADR reports received by RMS in
2010, 70 (57,38%) were about antineoplastics and were reported by Chemotherapy Center. Among these, 61 (87,14%)
were classified as type A and 9 (12,86%) as type B. From causality assessment, 1 (1,43%) was classified as doubtful, 55
(78,57%) were as possible, 14 (20%) as probable and none was determined as definite. Among the most usual
antineoplastics ,present at analyzed notifications, 32 (45,71%) were taxanes (Docetal or Paclitaxel), 16 (21,43%) were
platinum agents (Carboplatin, Oxaliplatin or Cisplatin) and 8 (11,43%) were monoclonal antibodies (Rituximab,
Trastuzumab ou Cetuximab). Regarding patients, 56 (80%) were female and 14 (20%) were male, 5 (7,14%) belonged
to age group from 2 to 14 years old (children), 57 (81,43%) were between 15 to 65 years old (adults) and 8 (11,43%)
were more than 65 years old (elderly). Considering the potential of antineoplastics to cause ADR and the influence of
age groups, genre and clinical conditions whenever an adverse drug reaction occurs, it is extremely important to follow
up oncologic patients to achieve prevention, detection and treatment of ADR, moreover, the clinical pharmacist’s
participation at an oncological multidisciplinary team is crucial.
013
HOW PHARMACEUTICAL CARE MAY CONTRIBUTE TO DETECT AND CONTROL ARTERIAL
HYPERTENSION AND DIABETES. DAY OF HEALTH – ACTIVITY PERFORMED IN A PHARMACY
MAGISTERIAL LOCATED IN THE MUNICIPALITY OF NILÓPOLIS IN RIO DE JANEIRO STATE.
DEBORAH MARQUES DA SILVA, ROBERTO REZENDE DA SILVA, LIZIENE DE SOUZA ARRUDA, DAYSE
JOSE LUIZ DOS PASSOS, REGINA CÉLIA ABOSSAMRA ALVARENGA E TANIA MARIA LEMOS MOUÇO.
Elevated blood pressure represents a risk factor for cardiovascular diseases, with medical costs and high economic
partners, for illnesses related to hypertension, a high frequency of hospitalizations and a high mortality rate are
accounted. Diabetes Mellitus (DM) is not a single disease, but a heterogeneous group of metabolic disorders that have
hyperglycemia in common. Its chronic nature, the severity of its complications and the necessary steps to control them
make DM a very costly disease, not only for affected individuals and their families, but also for the health system. This
study aims to show the pharmacist’s actions with pharmacy users in order to detect and prevent chronic diseases,
especially hypertension and diabetes mellitus, in addition to promoting the reapprochement of the professional in
society, and serving as a screening test for Pharmacotherapeutic follow-up service offered by the pharmacy. The Social
Action takes place in the days and times scheduled every 45 days, previously scheduled with users of the pharmacy.
Professional pharmacists, specialists in pharmaceutical care and academics participate in it. Specific forms are used for
screening and informational brochures. We present results as the data related to the action occurred on August 7, 2010.
From the 48 enrolled patients, 12% presented elevated blood glucose, 39% had their blood pressure, 58% of patients
had a BMI ≥ 25. Considering the total enrolled patients, 40% were referred to drug therapy follow-up and 12% for
emergency medical service. The pharmacists used their knowledge and skills to provide the patients a choice of care
and follow featuring the pharmacy as a health facility.
014
ASSESSMENT OF KNOWLEDGE ABOUT ORAL CONTRACEPTIVES AMONG HEALTH AREA
STUDENTS FROM THE UNIVERSITY OF ALFENAS-MG
THAIS BAPTISTELLA FELIPE1, PATRÍCIA TEATIN JULIATO1, SAMIR ANTONIO RODRIGUES ABJAUDE1,
RICARDO RADIGHIERI RASCADO1.
1
Universidade Federal de Alfenas, UNIFAL-MG; Faculdade de Ciências Farmacêuticas.
Introduction: With the advancement of medicine and the emergence of new concepts of birth control , the latter has
advanced considerably in recent years and today there are over one hundred types of hormone-based contraceptives
available in Brazil. The analysis of knowledge of contraceptive methods in most studies, is very subjective and does not
consider any information about how to use them, their side effects, indications and contraindications. Objective: To
determine if there is an increase in knowledge about oral contraceptives during the undergraduate course, comparing
students of the first period and last period in health fields. We want to examine whether the university somehow adds
knowledge about this subject. Methods: From August to November 2010 136 questionnaires were applied to students
from first and last period of the courses of Pharmacy, Biological Sciences, Dentistry and Nutrition. The questionnaire
asks questions that measure the degree of knowledge about contraceptives. Results: We found in this project that 53%
of the students are in the age between 17 and 20 years and 98% have no children. 48% of the university’s health care
students use birth control pills, and of these 67% reported some type of adverse reaction. We also observed that there
was no significant change between the two analyzed periods in relation to the use of oral contraceptives. Conclusion:
We found that this project prove that the students despite experience the sexuality in a safe, the university was not a
differential in knowledge for this subject.
Financial support: PROBIC - Scholarship Program for Scientific Initiation of Unifal-MG
015
ASSESSMENT OF PSYCHOTROPIC DRUG PRESCRIPTIONS ADMINISTRED IN PRIMARY HEALTH
SERVICES (APS) IN THE CITY OF ALFENAS, MG
CAROLINE VIEIRA FIGUEIREDO1, MARIA RITA ALVES BARBOSA DE PAIVA2, RENATA CUNHA DE
RESENDE2, MARIA HELENA MAGALHÃES4, OLINDA MARIA GOMES DA COSTA VILAS BOAS3, WALNÉIA
APARECIDA DE SOUZA3, MÁRCIA HELENA MIRANDA CARDOSO PODESTÁ3.
1
Academic at the Federal University of Alfenas-MG; 2Family Health Residence Academics at the Federal University of
Alfenas -MG.; 3Associate Lecturers at the Federal University of Alfenas-MG; 4Pharmacists in the Brazilian National
Health Service.
The use of psychotropic drugs has increased in the last decades. This growth has been attributed to the increase in the
frequency of psychiatric disorder diagnoses in the population and to the new therapeutic indications of the already
existing psychotropic drugs. As psychotropic drugs can present significant, adverse reactions, knowing the profile of the
users and which are the most prescribed medications is of utmost relevance. The goal of this work is to describe the
consumption of psychotropic drugs as dispensed in the APS and to analyze their prescriptions, which are standardized
by the Health Department of the City of Alfenas. The methodology used was an observational and descriptive study,
transversal and retrospective, on the use of psychotropic drugs based on the prescription of medications. A total of
4,313 prescriptions were studied , as dispensed for two months at the Medication Central Office (CDM) of the city of
Alfenas, totalling 5,842 psycho-related drugs were dispensed. From the 4,313 prescriptions, 65% were given to female
patients, and 35% were to male patients. The age bracket that received the most prescriptions ranged from 20 to 59
years (69%). The medical speciality that was the most prescribed was general practice (53%). The three most prescribed
medicaments were Fluoxetine (17%), Clonazepam (13%) and Amitriptyline (12%). Mono-therapy was observed in 72%
of the prescriptions. This study yielded knowledge on how doctors deal with the prescribing of psychotropic drugs in
APS, and will help in the preparation of future Health Education actions in primary services.
016
ASSESSMENT OF THE PERCEPTION OF DRUGS IN THE PHARMACY ATTENDANT OF THE WEST
SERIDÓ MICROREGION
MONIQUE GOMES DANTAS, ALAINE MARIA DOS SANTOS SILVA, HELLYSON FIDEL ARAÚJO DE
OLIVEIRA, ANDREZZA DUARTE FARIAS, RAND RANDALL MARTINS
Federal University of Campina Grande - UFCG, Health and Education Center - CES.
Despite the obligation of the pharmacist presence during all hours of pharmacies and drugstores operation (Law No.
5991, Cap.VI, Article 1) in some regions there is an absence, or the emphasis on administrative tasks. In this context,
the pharmacy attendant’s assumed crucial role in the relationship with the patient and it is important to evaluate his
profile and perception of pharmacotherapy. In the period from January to February 2011, a questionnaire was applied to
33 attendants from 31 pharmacies in seven cities in the West Seridó Region-RN. A female predominance was observed
(72%), with an average age of 35 years and mostly with high school education (72%). 81% consider their knowledge
about medicines sufficient and when questioned about the ways of learning, 66% reported that they acquired it through
practice. It was observed that 69.9% indicated drugs casually, 45% believe in the highest quality reference drug and
66.6% consider it difficult to regulate the interpretation of the prescription. The orientation is about the most common
mode of use (63.6%). There is poor knowledge about drugs and lack of training among the interviewd attendants.
Improving his knowledge is the best way to reduce risk and improve care population.
017
CAN INTERCHANGEABILITY AMONG THERAPEUTIC
QUALITY OF LIFE?
EQUIVALENTS
BEATRIZ MARIA PEREIRA GIROLINETO1, VERIANO ALEXANDRE
SAKAMOTO2, LEONARDO RÉGIS LEIRA PEREIRA1
CHANGE
PACIENT´S
JUNIOR2, AMÉRICO
CEIKI
1
Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, 2Faculdade de Medicina de
Ribeirão Preto, Universidade de São Paulo
Epilepsy is the most common serious neurological disorder worldwide, characterized by recurrent and unprovoked
seizures that result from an abnormal and excessive electrical activity in the cortex cerebral. A better comprehension of
epilepsy promoted, in the late of twentieth century, the development of new antiepileptic drugs, such as lamotrigine.
However, 30% of epileptic patients do not respond adequately to pharmacological treatment and are considered to be
refractory. This research evaluated the possible interference of interchangeability among therapeutic equivalents of LTG
in quality of life of refractory epileptic patients. The study was divided into three periods of 42 days, and in each period
an equivalent therapeutic LTG was randomly dispensed (two similar - formulation A and B and the reference product
formulation C). The mean dose of LTG was 5.5 mg/kg/day. The formulation A of the LTG showed better results in the
quality of life of epileptic patients than formulations B and C. In addition, the formulation A of LTG promoted
significant improvements in the domains of sociability and emotional aspects of QOLIE-31, these results were possible
due to small number of seizures and no occurrence of side effects. The presence of side effects tends to be more
decisive in the reduced quality of life of refractory epileptics when compared to variations in the numbers of seizures or
changes in plasma concentrations. The results demonstrate that, independent from the prescribed drug,
interchangeability among therapeutic equivalents is more decisive for the success of the control of epilepsy.
Financial support: CAPES
018
CLINICAL PROTOCOLS FOR MINOR DISORDERS TO COMMUNITY PHARMACY
CLEBERSON ROSA LIMA SANTOS1, JOSIANE DE FÁTIMA GÁSPARI DIAS1, CAMILA KLOCKER COSTA1,
CASSYANO JANUÁRIO CORRER1 E GISLENE MARI FUJIWARA1
1
Universidade Federal do Paraná, UFPR
The treatment of minor disorders in community pharmacies through over-the-counter (OTC) drugs indication and nonpharmacological orientations is one of the pharmacist´s competences, and is provided by the Brazilian laws. However,
despite the large number of publications available on the measures to be adopted in cases of minor disorders, there is
still difficulty in extrapolating these measures to pharmaceutical practice. The aim of these protocols is to assist and
facilitate the professional in the proper pharmaceutical orientation. So, the School Pharmacy from Universidade Federal do
Paraná has developed clinical protocols for minor disorders. These protocols were divided into five subsequent topics,
among them, the description of the physiopathology, symptoms, anamnesis, non-pharmacological and pharmacological
treatment, with orientations about the posology and duration of treatment. For the development of these protocols
books, official literature, Brazilian laws, medical guidelines and scientific papers have been used, in order to produce
reliable and easy to read supporting material . In practice, these protocols prove to be viable due to the use of keys
containing closed questions, yes or no answers, in their first phase, which lead the pharmacist to set the appropriate
referral to be followed, and in a second phase, the best research of the disorder and patient advice, through open
questions.
019
CLINICAL ASSESSMENT OF THE QUALITY OF LIFE OF HYPERTENSIVE ELDERLY PATIENTS IN
TWO HEALTHCARE UNITS FROM VARGINHA-MG.
ANTÔNIO R. LOPES1, ALINE A. RODRIGUES1, MARCELA M. CAOVILA1, TATTYANA S. FERREIRA1, ERIC B.
FERREIRA1, MÁRCIA HELENA M. C. PODESTÁ1, LUCIANO M. SIQUEIRA JUNIOR2, WALNÉIA A. SOUZA1
1
The Federal University of Alfenas - Faculty of Pharmaceutical Sciences (Unifal-MG), 2Alfenas University (UnifenasMG)
The assessment of the quality of life in hypertensive patients requires instruments that broach all the aspects involving
hypertension. Since the elderly represent a heterogeneous population, mainly those in advanced age, presenting several
associated pathologies. Thus, the evaluation of factors that influence quality of life of hypertensive elderly patients may
help to plan more effective strategies for treating this population. Therefore, this study aims to analyze the quality of
life of hypertensive elderly patients treated at two healthcare programs in the city of Varginha, MG. An exploratory and
transversal study was carried out with forty elderly patients, between August and September 2009. The implements
used for the data collection were: population characteristics according to the socio-demographic and clinical data, as
well as the Medical Outcomes Short-Form Health Survey (SF-36). The quality of life of obese and overweight patients,
making use of polypharmacy, and uncontrolled blood pressure was compared to normal patients. The data were
analyzed by the non parametric test of Wilcoxon at the significance level of 10% and Student test (5%). Of the studied
patients, 75% were women and the age range was from 60 to 69. All values obtained in eight domains of the SF-36
were below 60%, which means low quality of life. There was no association among blood pressure levels, age, risk
factors, polypharmacy, obesity/overweight and quality of live. In relation to blood pressure, 60% had the systolic or
diastolic blood pressures (147.5 mmHg and 82.5 mmHg, respectively) uncontrolled and 40% had the systolic and
diastolic blood pressures (121.43 mmHg and 78.57 mmHg) controlled. As polypharmacy, 65% made use of that.
Through the body mass index it was observed that 77.5% were overweight and obese. The results showed the clinical
relevance of educational interventions from the healthcare staff.
020
CLINICAL PHARMACY AND PHARMACEUTICAL CARE: PROPOSAL OF CONCEPTUAL MAP
TÁBATA PERES CARDOSO, ROGÉRIO CARDOSO DE CASTRO
Centro Universitário de Rio Preto - UNIRP
In the last few decades, much was published regarding Clinical Pharmacy and Pharmaceutical Care but there still exist
few consensuses on the interfaces of these concepts and the activities of each one of them as well as the correlation of
these with Pharmaceutical Assistance. It is given credit that such situation creates difficulties in the process of teachlearning in this area, mainly for those students who have the first contact with the subject during graduation in
pharmacy. Thus, the objective of this work was to carry through a literature revision, mainly in Brazilian tertiary
sources, regarding the interfaces, of the correlation with the Pharmaceutical Assistance and of the components of
Clinical Pharmacy and Pharmaceutical Care and to present them in the form of a conceptual map to assist in the process
of teach-learning in this area. The investigative process consisted of the construction of conceptual maps from the texts
of each one of the consulted sources. As a result, similarities and differences between the diverse constructed maps had
met. On the basis of the consensuses between the consulted sources, a conceptual map with the Pharmaceutical
Assistance at the top was constructed. Amongst the diverse components of the Pharmaceutical Assistance, the Clinical
Pharmacy emerges as the one which makes rational drug use objective. From the arm of the Clinical Pharmacy, they
had derived two sources, one nominated as collective tools and another as individual tools. In the arm of the collective
tools, there was Pharmacoepidemiology with its two sources, Pharmacovigilance and Drug Utilization Studies, and all
the other tools that give support to the standardization and drug selection as, for example, Pharmacoeconomics. In the
arm of the individual tools, five of the six components cited in the Brazilian Consensus of Pharmaceutical Care had
been enclosed: Dispensation, Pharmaceutical Orientation, Health Education, Pharmaceutical Attendance and
Pharmacotherapy Accompaniment. Besides these, there were such hospitals which had enclosed services of clinical
pharmacists as Pharmacokinetic Monitoring and Active Pharmaceutical Intervention. The construction of this
conceptual map allowed to conclude that, inspite of the discrepancies found in literature, it is possible to reach a
consensus from the main Brazilian sources on the subject. Thus, one gives credit that, beyond the pedagogical
contribution, this map serves as stimulation and support for quarrels on the subject.
021
CONTRIBUTION OF A PHARMACOEPIDEMIOLOGICAL STUDY ON DEVELOPING PRACTICES OF
HEALTH EDUCATION
REBECA O.L.SILVA1, MILENA BORGES1, TAIS N.CHRYSOSTOMO1, LÚCIA H.T.R.PEREIRA2, CLÁUDIA
S.VASSIMON2, REGINA CÉLIA G. ANDRADE1.
1
Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP; 2Secretaria Municipal de Saúde de Ribeirão Preto
The irrational use of medicines and lack of guidance are largely responsible for the appearance of severe adverse
reactions. The concomitant use of allopurinol and angiotensin II converting enzyme inhibitors (ACEi), for example,
could cause Stevens Johnson Syndrome (SJS), a severe skin reaction, which can be fatal. Pharmacoepidemiological
studies are important tools for the diagnosis of rational and safe use of medicines. Therefore, the purpose of this study
of drug utilization, was to analyze data on the concomitant use of the drugs mentioned above and to propose strategies
for health education in order to inform the user population, as well as professionals who are in contact with these users,
about the potential risks of this association. For this end, data from the computerized system "Hygia" of the Municipal
Health Department of Ribeirão Preto (SP, Brazil) were used. In a second step, the relevant information was extracted
for making pamphlets for the medication users and health professionals. The results show that 52.3% (2,061) of the
population that use allopurinol (43,851), with a mean age of 61.3 years, were more exposed to the risk of developing
the SSJ, since they are simultaneously using ACEi and allopurinol. The majority of users (48.9%) became more
exposed for a period of three months. The adopted strategies were preparing health education pamphlets containing
information about the SSJ, the combination of the drugs in question, and images that illustrate the skin reactions;
moreover, these materials were distributed at health units around the city. Finally, the conducted
pharmacoepidemiological study achieved the goals, finding relevant data that served as an important tool to get closer
to the user and health professionals, ensuring greater safety and proper use of drugs.
022
DETERMINING FACTORS OF CHANGES IN INITIAL ANTIRETROVIRAL THERAPY IN THE AIDS
REFERRAL HOSPITAL OF CEARÁ
TAINÁ OSTERNO VASCONCELOS1, DENISE GIRÃO LIMAVERDE LIMA2,3, BRUNA ESMERALDO
OLIVEIRA1,4, MARTA MARIA DE FRANÇA FONTELES1,3,4
1
Centro de Estudos em Atenção Farmacêutica, Universidade Federal do Ceará(CEATENF/UFC); 2Hospital São José de
Doenças Infecciosas(HSJ); 3Escola de Saúde Pública do Ceará(ESP-Ce); 4Mestrado em Ciências
Farmacêuticas/Farmácia Clínica e Atenção Farmacêutica(UFC)
Brazil standardizes and ensures free access to antiretroviral therapy (ART). The goal of this study is to investigate the
factors which determine changes to the initial ART in patients treated in the AIDS referral hospital of Ceará. The
descriptive and exploratory study used the analysis of the forms for initiation or changes of treatment during 2008
which were followed up during the first year of treatment. The data were analyzed with SPSS and Epi Info programs,
using ANOVA and exact test of the contingency coefficient, with significance of p<0,05. Of the 301 patients who
began ART, 22,1% (n=68) had changes in the first year. Most of these patients were male, aged between 20 and 39
years and had only one change in initial ART (86,8%; n=59). Records of patients with two or three initial ART regimen
changes were observed. Zidovudine was the most replaced drug, followed by lopinavir/ritonavir and efavirenz. There
was a significant association between changes of initial regimens with the occurrence of adverse reactions (p<0,001).
Although the majority of patients in our study had only one change in their initial ART in the first year of treatment,
further studies in this context are required as there is evidence that patients who remain on initial ART for more than
one year have fewer therapeutic failures and more successful treatment outcomes.
Financial support : CNPq, REUNI/CAPES, ESP-Ce, HSJ, UFC
023
DRUG-RELATED PROBLEMS IN DIABETES MELLITUS CARRIERS
MILENE FRANCISCHINELLI, HELEN PALMIRA MIRANDA DE CAMARGO, FÁTIMA CRISTIANE LOPES GOULARTE
FARHAT
Universidade Metodista de Piracicaba, UNIMEP
Diabetes mellitus (DM) is one of the most prevalent chronic diseases in the world and it is estimated that in 2025 there
will be 380 million diabetics in the adult population. To achieve the desired therapeutic results and blood glucose control,
many patients make use of medication and need effective and safe products as well as health conducts. This article aims to
describe the socio-economic, clinical and drug-related problems (DRPs) of 16 DM carriers, in their first interview by the
Pharmaceutical Care Service of the Pharmacy School of Unimep, Piracicaba/SP, Brazil. We conducted a cross-sectional
study, approved initially by the Research Ethics Committee of the UNIMEP (n° 18/10), using the Minnesota methodology
for the identification of DRPs. Most users were aged over 60, female, married, low education level, income from 1 to 3
minimum wages and no health insurance. Regarding lifestyle, 69% did not exercise, 63% did not smoke and did not drink
alcohol. The first pharmaceutical interview revealed 56% of the users presenting HbA1c values greater than 6.5%, of
which 78% exposed DRP associated to medicine adherence. This kind of DRP had corresponded for 88% of the total
identified DRPs, considering an average of 1.75 DRP/user. The main cause of no adherence was related to wrong dose
administration. The DM carriers used to intake 6 (± 3, s.d.) medicines and 44% of them used at least two medicines for the
DM control. These results clearly revealed the importance of pharmaceutical care as a strategy to improve health
education, drug adherence and, finally, to achieve an optimum HbA1c value. The next step is going on a longitudinal study
with these DM carriers submitted to pharmaceutical care and evaluating the same variables after at least three months of
following-up.
Financial support: FAPIC/UNIMEP.
024
DYSLPIDEMIA IN CHILDREN AND ADOLESCENTS: INFORMATION FOR PREVENTION
ANA PAULA ZATTA BEDIN1, CAROLINE MENSOR FOLCHINI2, CASSYANO JANUARIO CORRER1,
RODRIGO BATISTA DE ALMEIDA2
1
Universidade Federal do Paraná (UFPR), Curitiba (PR); 2Instituto Federal do Paraná (IFPR), Palmas (PR)
Coronary atherosclerosis is the main cause of death in developed and developing countries, reflecting its magnitude as a
world health problem. Many risk factors are associated with this condition, as inactivity, food intake above the
recommended, tobacco consumption, stress and dyslipidemia. This work aimed to identify studies that evaluated the
relation between cardiovascular risk factors and coronary atherosclerosis in children and adolescents, by offering
support to health care professionals. This study was sought through electronic (Scielo and Lilacs) and hand searchers.
The search was restricted to English and Portuguese languages. Many papers showed anatomopathological evidences in
the beginning of atherosclerosis in infancy and adolescence, associated with dyslipidemia, which can be a coronary
heart disease risk factor in adulthood. The data may provide insights to health care professionals regarding the
underlying causes of the cardiovascular disease. The importance of pharmacological treatment of dyslipidemia is clear,
but there isn’t a consensus among researchers about the onset time of this strategy. In conclusion, children and
adolescents with alterations in plasmatic lipid levels should be followed by health professionals to prevent
cardiovascular problems. In addition, pharmacists should provide objective information to the patients and encourage
them to change their life styles, before clinical manifestation of cardiovascular disorders.
025
EDUCATIONAL INTERVENTIONS FOR PROMOTION OF PHARMACOVIGILANCE IN HOSPITALS
FABIANA ROSSI VARALLO, CAROLINA COSTA DE PAULA, CAROLINE PAGOTTO, TATIANE BOMFIM
RIBEIRO, CLEÓPATRA DA SILVA PLANETA, PATRÍCIA DE CARVALHO MASTROIANNI
Universidade Estadual Paulista “Júlio de Mesquita Filho”, Campus de Araraquara
Spontaneous reporting (SR) of adverse drug reaction (ADR) allows detecting serious and unexpected reactions.
However, the major limitation of this method is the under-reporting of the cases. Therefore, a bibliographic survey was
performed in the PAHO, LILACS and PUBMED databases, from November/2010 to January/2011, to identify the
primary studies written in English, Spanish and Portuguese which developed educational interventions (EI) in hospitals
to stimulate SR of ADR by health professionals. The health science descriptors applied for this search were: “education,
continuing” AND “ADR reporting systems”;”education, medical” AND “ADR reporting systems”; and the key-words:
“intervention” AND “spontaneous adverse drug reaction reporting”; “ADR spontaneously reported” AND
“pharmacovigilance” AND “hospital”. A manual search was carried out in the reference sections of selected papers, in
order to look for other relevant publications. The contents of the selected manuscripts were analyzed in order to identify
the developed techniques of EI, as well as their impact on the attitudes of health professionals (ADR report). 67 articles
were identified, of which 17 contemplated the inclusion criteria. After the content analysis eight papers were considered
eligible for the research. The techniques of EI were designed for physicians, pharmacists and nurses and they included:
lectures to elucidate the concept of pharmacovigilance and ADR, the importance of spontaneous reporting, as well as
memory cards distribution, with the telephone number of the pharmacovigilance team and the syntheses of the content
displayed in the presentations. Data show that the EI for health professionals significantly increased the absolute
number (0.9-8.0 fold) or the rate (5.9-10.0 fold) of SR of ADR and improved their quality (description of serious and
unexpected ADR, as well as those related to new drugs and with high imputability degree).Therefore, the EI are
effective for the promotion of pharmacovigilance in hospitals, contributing in drug safety analysis, rational use of drugs
and patient safety.
026
THE EFFECT OF A 36-MONTH PHARMACEUTICAL CARE PROGRAM ON THE CORONARY HEART
DISEASE RISK IN ELDERLY DIABETIC AND HYPERTENSIVE PATIENTS
PAULO ROQUE OBRELI NETO1, JOICE CRUCIOL2, ROBERTO KENJI NAKAMURA CUMAN1
1
Universidade Estadual de Maringá, UEM-PR; 2Universidade Estadual de Londrina, UEL-PR.
Coronary heart disease (CHD) accounts for 7 million deaths per year around the world, most of them involving elderly
individuals. This study aimed to examine the effect of a pharmaceutical care (PC) program on the CHD risk in elderly
diabetic and hypertensive patients. A total of 200 elderly (> 60 years) diabetic and/or hypertensive patients were
recruited into a randomized, controlled, prospective clinical trial with a 36-month follow-up, developed in a basic
health unit in a municipality in the Brazilian State of Sao Paulo. The intervention group received PC from clinical
pharmacists (according to the Pharmacotherapy Workup), whereas the control group received their usual care from the
medical and nursing staff. A range of clinical measurements were evaluated. The Framingham scoring method was used
to estimate changes in the 10-year CHD risk scores of all the patients. A total of 194 patients completed the study.
Significant reductions (p<0.05) in the mean values (baseline vs. 36 months) for the systolic blood pressure
[156.7mmHg vs 133.7mmHg; p<0.01], hemoglobin A1C [7.7% vs 7.0%; p<0.01], triglycerides [206.0mg/dL vs
152.5mg/dL; p<0.01], high-density lipoprotein cholesterol [55.5mg/dL vs 65.5mg/dL; p<0.01] and total cholesterol
[202.5mg/dL vs 185.9mg/dL; p<0.01] were observed in the intervention group, whereas no significant changes were
verified in the control group. The mean Framingham risk prediction score in the intervention group was 6.8% (5.9-7.8)
at baseline, and decreased to 4.5% (3.9-5.0) (p <0.01) after 36 months, but remained unchanged in the control group.
The pharmaceutical care program resulted in better clinical measurements and reduced the CHD risk scores.
Financial support: Fundação de Apoio ao Desenvolvimento Científico (FADEC).
027
ELABORATION OF DRUG USE PROFILE BY CUSTOMER COMMUNITY PHARMACIES IN THE
TAQUARA REGION (RJ): A PRELIMINARY STUDY
FABIANE RAMOS FERREIRA BERNARDO1,2, FELIPE DA SILVA GONÇALVES2, RENATA GONZALEZ
RIBEIRO2
1
Hospital Federal de Bonsucesso, HFB-RJ; 2Instituto Racine, Curso de Atenção Farmacêutica-RJ.
Currently the use of medicines has become an important tool in promoting population health, either because of a large
arsenal of available therapies, or by the stimulation of the consumption of these products promoted by the
pharmaceutical industry. In this context, studies in pharmacoepidemiology and pharmacovigilance are essential to
monitor the actions and methods that involve the entire universe of the use of medicines in its various stages. As the
largest distribution channels for drugs are the pharmacies, this paper aimed to conduct a study on prescription drug sales
in 02 community pharmacies in the region of Taquara in the state of Rio de Janeiro, aiming to obtain data on the usage
profile of drugs in this specific population. Information was collected through the registration of purchases carried out
in the check-outs of the pharmacies in the period from 01/11/2009 to 30/04/2010, totaling 282.242 customers served.
About 70% of the sold products were medicines and 30% were not medicines in a total universe of 393.885 dispensed
items. It was observed that in the top 10 best-selling drugs, 07 are part of a program “Aqui Tem Farmácia Popular”,
which suggest the influence of government policies on sales of these products. Among the 10 most dispensed
antihypertensive medicines the biggest seller was Mal.Enalapril (3,21%), followed by Atenolol (2,26%) and
Hydrochlorothiazide (1,69%). As for the hypoglycemic medicines, the main were Cl.Metformin (1,94%),
Glibenclamide (0,80%) and Glimepiride (0,18%). With respect to anti-inflammatory, Diclofenac (1,89%) was the most
commonly used, followed by AAS 100mg (1,04%) and AAS 500mg (0,61%). As for antibiotics the picture is the
following: Cephalexin (0,63%), Amoxicillin (0,53%) and Neomycin+Bacitracin (0,31%). The production of scientific
data on the profile of drug utilization in specific populations is vital for the implementation of public policies aimed at
promotion, prevention and recovery of health.
028
EVALUATING THE USE OF EMERGENCY CONTRACEPTION AMONG STUDENTS
EDUILZA CRISTINELE RIBEIRO NEVES, NATHÁLIA GONÇALVES CALDEIRA, LEILA DA SILVA AZEVEDO
University José do Rosário Vellano, UNIFENAS Campus Varginha- MG
The Emergency Contraception, popularly known as the morning-after pill is inserted in the resources available to
women, that can be used after failure of another contraceptive method, after unprotected sexual intercourse or in cases
of rape. The use of the morning-after pill has become high among the academic, which is very worrying as it is to be
used sporadically. The research objective was not only to determine the percentage of students who have already used
the drug but also to understand why it was used and the knowledge about side effects after use. The research followed
the ethical guidelines established by law and has obtained approval and authorization by the Ethics Committee. In
statistical analysis 55.78% of the respondents used the method, and 23.70% used this method only once, 37.03% twice,
three times 14.81% and 24.44% used this method several times. The search showed a worrying outcome in relation to
the use of reason, 80% of the respondents used the method because they had intercourse without using another method
of contraception, showing its high percentage of the practice of less safe sex, which increases the possibility of sexually
transmitted diseases. It was concluded that consumption of emergency contraception is relatively high among the
academic and the concern among the respondents is greater with pregnancy than with possible STDs. The morning-after
pill can be an effective method if used correctly, but should not be used irresponsibly.
029
EVALUATION OF A PHARMACEUTICAL CARE PROGRAM ON PHARMACOTHERAPY ADHERENCE
IN ELDERLY DIABETIC AND HYPERTENSIVE PATIENTS.
ALESSANDRA NEGRI DA CRUZ1, ROBERTO CUMAN2, PAULO ROQUE OBRELI NETO2
1
Faculdades Integradas de Ourinhos, FIO; 2Universidade Estadual de Maringá, UEM-PR
Patient adherence to pharmacotherapy is a complex but important factor in achieving positive clinical outcomes for
chronic diseases. This study aimed to evaluate the effect of a pharmaceutical care (PC) program on pharmacotherapy
adherence in elderly diabetic and hypertensive patients. A total of 200 elderly (> 60 years) diabetic and/or hypertensive
patients were recruited into a randomized, controlled, prospective clinical trial with a 36-month follow-up, developed in
a basic health unit (BHU) in a municipality in the Brazilian State of Sao Paulo. The intervention group patients received
PC from clinical pharmacists (according to the Pharmacotherapy Workup), whereas the control group patients received
their usual care from the medical and nursing staff. Adherence was assessed at the baseline and after 36 months of
follow-up, using two different methods: the Morisky-Green (MG) test and the computerized dispensed medication
history. Chi-square tests were used for categorical variables, a p-value of < 0.05 was considered statistically significant.
Significant improvements in the pharmacotherapy adherence were verified for the intervention group according to the
MG test (50.5% of adherent patients at baseline vs 83.5% of adherent patients after 36 months; p < 0.01) and the
computerized dispensed medication history (52.6% of adherent patients at baseline vs 83.5% of adherent patients after
36 months; p < 0.01); no significant changes were verified in the control group. The results obtained indicated the
effectiveness of pharmaceutical care on improving pharmacotherapy adherence in elderly diabetic and/or hypertensive
patients attended in this BHU.
Financial support: Fundação de Apoio ao Desenvolvimento Científico (FADEC).
030
EVALUATION OF EFFECTIVENESS OF PHARMACEUTICAL CARE IN PATIENTS WITH DEPRESSION:
PRELIMINARY RESULTS
LUCIENE ALVES MOREIRA MARQUES1, JOSÉ CARLOS FERNANDES GALDUROZ2, ANA REGINA NOTO2,
MARIA ROSANA FERNANDES3
1
Postgraduate student, Doctorate in Psychobiology at Federal University of São Paulo-UNIFESP, 2Department of
Psychobiology Teachers: Co-advisor and advisor, UNIFESP; 3Psychiatrist, University of Alfenas, UNIFENAS
Some studies have demonstrated the effectiveness of Pharmaceutical Care (PC) through pharmacotherapeutic follow-up
(PF) in patients with heart failure, diabetes, hypertension and dyslipidemia. However, there are few studies that evaluate
the effectiveness of PF in depression. The objective of this research is to evaluate the effectiveness of PC by
pharmacotherapeutic follow-up in accordance with the Program Dáder among patients diagnosed with depression. We
selected 60 patients starting treatment who were randomized into control group (CG) and intervention group (IG). The
questionnaires beliefs, compliance, Beck inventories and Dáder questionnaire were applied. The IG patients were
followed-up for 6 months, receiving PF. Each month, patients in the CG and IG were evaluated for drug related
problems and negative clinical results were presented as well as the score in the Beck inventory (BDI). Data were
analyzed using descriptive statistics and the Wilcoxon test and Mann Whitney. Partial results (n = 22, CG = 10 and IG =
12) showed that the BDI score in the CG was reduced from 21.5 to 17.2 (p = 0.1311) and, in anxiety, an increase of
18.3 to 20.3 (p = 0.4797). In IG, the BDI scores decreased from 25.5 to 12.08 (p=0.0014) and, in relation to anxiety,
increased from 29.58 to 11.5 (p=0.0011). Comparing the CG with the IG, for the BDI, there was no statistically
significant difference. In relation to anxiety, there was a significant difference (p = 0.0375). These preliminary results
suggest that the role of the pharmacist may be important to improve the effectiveness of treatment of patients with
depression.
031
EVALUATION OF PHARMACEUTICAL CARE FOR HYPERTENSIVE PATIENTS IN THE CONTEXT OF
UNIFIED HEALTH SYSTEM
SAMILLA MOREIRA MARQUES1, MARCONI RICARDO DUPIM2, DELBA FONSECA SANTOS1, MARIANA
LINHARES3, JOSÉLIA FRADE4, RENATA ALINE DE ANDRADE1
1
Universidade Federal dos Vales do Jequitinhonha e Mucuri, UFVJM; 2Secretaria Municipal de Saúde de Diamantina MG; 3Universidade Federal de São João Del Rei, UFSJ; 4Ministério da Saúde.
The pharmaceutical care is responsible for monitoring drug treatment with the goal of achieving satisfactory results in
health, improving the quality of life of patients. The pharmaceutical care as a practice requires concern with process
variables, especially those concerning the quality of life and patient satisfaction. This is why this must be monitored so
that we can evaluate the effectiveness of the implemented service. In this context, the present study had objective to
evaluate indicators of process (% of drug related problems (DRPs) detected and % of patients who presented DRPs
resolved), results (% of patients who have reduced blood pressure - BP) and humanistic (patients' perception about
pharmaceutical care) of a service of pharmaceutical care in Basic Pharmacy in Diamantina, MG, aiming at monitoring
hypertensive patients, users of the Health System. The results achieved by pharmacotherapeutic monitoring of 23
hypertensive patients were evaluated during August to December 2010, by the Dáder method. All patients presented
some DRP and 66% of identified DRPs were resolved, the most frequent were adverse drug reactions. On the
evaluation of the patients who participated in three or more pharmaceutical consultations (12 in 23), 58% (7 in 12)
showed reduction in BP values. Another interesting fact was that 58% of these patients expressed satisfaction with the
service through the conversation that happened spontaneously, such as: "I felt that I improved well after I came here"; "I
trust you, I know that here is good for my health."; "I'm feeling much better now after you helped me..."; "I
liked you invited me again. This is very good for our health..." These results demonstrate that the service promoted an
improvement of life for the patients served and constituted an efficient alternative for the rationalization of
pharmacotherapy in the context of Unified Health System.
Financial support: FAPEMIG; PET-Saúde UFVJM.
032
EVALUATION OF THE INTERFERENCE OF ANTIRETROVIRAL THERAPY ON ROUTINE ACTIVITIES
OF LIFE IN HIV+ PATIENTS ATTENDING A SPECIALIZED CARE SERVICE IN FORTALEZA-CEARA
LÍVIA FALCÃO LIMA1,5, CATARINE LOUREIRO1,5, KARLA MAGALHÃES2,5, HENRY PABLO REIS1,5,
FRANCISCA ANA MARIA LEITE2, NADIR KHEIR3,5, DAVID WOODS4,5, LUZIA IZABEL MESQUITA1,5,
ANGELA PONCIANO1,5, MARTA MARIA FONTELES1,5
1
Universidade Federal do Ceará(UFC); 2Centro de Especialidades Médicas José de Alencar(CEMJA); 3Qatar
University; 4Otago University; 5Centro de Estudos em Atenção Farmacêutica(CEATENF)
Individuals with VIH/SIDA can stay healthy for many years, but society or even people who contract the virus still have
little or no knowledge about this condition. Such individuals may experience hostility or rejection from friends and
family. The aim of this study was to evaluate the interference of antiretroviral therapy (ART) on routine activities of life
in HIV+ patients who started treatment and participated in a pharmaceutical care program at the Medical Specialties
Center Dr. José de Alencar (CEMJA), Fortaleza-Ceará. From December 2008 to August 2010, 45 patients completed a
pharmacotherapeutic follow up (PF) based on the Dáder method. For each patient, the PF was planned to last nine
months, with at least one monthly meeting, which occurred when the antiretroviral drugs were dispensed. The data were
entered and analyzed using EpiInfo, version 3.5.1. When asked about the interference of antiretroviral drugs on routine
activities of life, a significant number (42.2%) reported that ART had ‘little’ influence on this. The presence of adverse
events was cited by 14 patients as the main reason for interference. Most patients (60%) reported no difficulties in
receiving antiretroviral drugs. The responsibility for administering the drug was performed individually by 75.6% of
patients. Total family support for treatment was confirmed by only 37.8% of those interviewed. Although most patients
reported ‘little’ interference of ART with their routine and affirmed that they are mainly responsible for their own
treatment, few received family support. This indicates possible disruption in relationships and the need for specialized
services especially focusing on the problems of acceptance and treatment adherence.
Financial support: UFC; CNPq.
033
EVALUATION OF THE USE OF DRUGS IN ELDERLY PATIENTS THROUGH THE CONCEPTS OF
PHARMACOVIGILANCE AND PHARMACOEPIDEMIOLOGY BASIC HEALTH UNIT IN THE DISTRICT
IV CPA - CUIABÁ - MT
TIAGO SOBRAL DAMIÃO1, SAULO SCHMIDT DA SILVA1, TAINÁ KREUTZ1, CRISTIANO CARDOSO DE
ANDRADE1, ACACIA LIVIA SOBRAL2
1
Universidade de Cuiabá, UNIC; 2Prefeitura Municipal de Cuiabá
The federal council of pharmacy in Brazil has defined resolutions that provide a continuity of care to individual
patients, assessing adverse effects, chronic and acute, as well as the risks of drug treatment in the general population or
in small groups of patients. Recent research has shown that the prevalence of elderly in Brazil is around 12%. The
objective of this research was to identify the main drugs used by the local population, thus analyzing the problems
related to drugs (PRM's), and the need for appropriate pharmaceutical care. This study evaluated 40 elderly volunteers 33 women and 7 men - through interviews about the drugs used and possible PRM's. Among the main drugs prescribed
for chronic use, there are : antihypertensives, NSAIDs, insulin, oral hypoglycemic agents. Of the 40 patients, 31
(77.5%) make use of polytherapy, seven (17.5%) used alone and two (5%) did not use drugs chronically. Among the
interviewed subjects in 24 (60%) cases we found MRP's, and 20 (83.33%) of these problems were related to
inappropriate use of medication, 3 (12.5%) were related to non compliance of treatment and one (4.17%) was related to
the medication associated with the treatment prescribed. From these data, we provide information on the proper use of
drugs. The lack of pharmaceutical care appropriate for elderly patients is directly related to the majority of identified
PRM's, so we conclude that the absence of the pharmacist in primary health care is a public health problem, since this is
the professional most qualified to perform an adequate pharmaceutical attention minimizing PRM's.
034
INFORMATION ABOUT ANTIDEPRESSANT DRUGS IN BRAZIL
ANA PAULA ZATTA BEDIN1, CAROLINE MENSOR FOLCHINI2, RODRIGO BATISTA DE ALMEIDA2
1
Universidade Federal do Paraná (UFPR), Curitiba (PR); 2Instituto Federal do Paraná (IFPR), Palmas (PR)
Symptoms of mood disorders are controlled by antidepressant drugs. Many factors contributed for non-adherence to
antidepressant medicine treatment, as, the fact that clinical effects require weeks or even months to be manifested, and
the occurrence of side effects. Pharmacists and physicians need access to full information about products with
antidepressant indication, to provide objective advices on medicines and their use, contributing to optimized drug
treatment and to prevent drug-related problems. This work aimed to evaluate information concerning antidepressant
drugs from “Dicionário de Especialidades Farmacêuticas – 2010/11” (DEF 2010/11). From the time when the original
DEF was published in 1972, 39 revisions have been distributed; the current version is the 2010. Pharmacists and
doctors across the country have adopted this literature as source of medicine information. The data of antidepressants
were evaluated using as parameters the World Health Organization (WHO) criteria for drug information available in a
document entitled Criterios Éticos para la Promoción de Medicamentos. The WHO criteria should guide all
informative material about drugs and medicines. This work disclosed 124 antidepressant registers on DEF 2010/11,
including one herbal product, based on 22 different molecules. Most parts of medicines presented partial data; only one
product, Valdoxan®, showed all information. The results are expressed as proportional values. The highest values of
drug information were about generic name and manufacturer (100.00%) and pharmacological effects (88.70%).
Indication, dosage information, contraindication and types of formulation were included in 15.32% of descriptions.
Precautions and drug interactions were included in 14.51%; side effects in 13.70%; pharmaceutical preparation in
9.67%; via of administration in 4.83%; overdose in 3.22%. Finally, mechanism of action and storage conditions were
present just in 2.41% of products. This work demonstrated that DEF is not attempting the WHO criteria, concerning
drug information. These results emphasize the importance of good materials as an independent and credible source of
medicine information, collaborating to illness prevention and health promotion.
035
INFORMATIVES AND FOLDERS IN THE PHARMACEUTICAL ORIENTATION AT THE SCHOOL
PHARMACY UFPR
CHRISTIANE DE CÁSSIA LIMA1, KARINA KONELL1, VITOR AUGUSTO TEVES DE BORTOLI SANTOS1,
JOSIANE DE FÁTIMA GÁSPARI DIAS1, CAMILA KLOCKER COSTA1 E GISLENE MARI FUJIWARA1
Universidade Federal do Paraná, UFPR1
The pharmacist should promote health education and know all about his competences, which include much more than
dispensing drugs. So, the pharmacist has to be able to assist his patients through orientations about the habits of life,
complications of diseases and drug treatments, and prevention of diseases. One way of achieving these aims is through
the development of instructional materials to be delivered to patients during their service at the pharmacy. The School
Pharmacy from Universidade Federal do Paraná (UFPR) develops an extension project entitled "Pharmaceutical Care"
which follows the methodology Dáder and conducts interviews and monitoring pharmaceutical care for patients seen at
Hospital de Clínicas in UFPR, employees of the university and the general community. Thus, the School Pharmacy
UFPR had prepared educational informatives and folders that facilitate the understanding of the disease by the patient,
because the language used was easy to understand and illustrative images lined in books, instead of official literature,
medical guidelines and scientific papers. The informatives have been prepared based on data collected during
interviews with patients participating in the project, where possible drug-related problems and bad habits of life have
been identified. The subjects chosen for the organization of the folders had approached the doubts raised by the
interviewed patients and users who seek the services of the School Pharmacy.
036
IS CLINICAL PHARMACY IMPORTANT ON CLINICAL OUTCOME AND ON ECONOMY FOR HIVPOSITIVE OUTPATIENTS?
PATRÍCIA MORIEL; CAROLINE DE GODOI REZENDE COSTA; RENATA CAVALCANTI CARNEVALE;
NATÁLIA CAVALHEIRO BRAZ; MICHELE TAMI. TANAKA; LUANA DA SILVA BALEEIRO;
VALÉRIA DE SOUZA SANTOS HOLSBACK; PRISCILA GAVA MAZZOLA.
Depto Patologia Clínica, Faculdade de Ciências Médicas, Curso de Farmácia, UNICAMP, Campinas, SP, Brazil.
Clinical pharmacy plays an important role when it comes to patient’s compliance to the prescribed treatment, resulting
in a more efficient therapy. This study aims to demonstrate the influence of clinical pharmacy on economy and clinical
outcome in HIV positive patients from Hospital Dia (HC/UNICAMP). Patients were randomized in: Group I (control
group; n=25) and Group II (that went through a pharmaceutical appointment, based on PWDT method; n=25). Patients
were matched regarding sex and CD4. Clinical development of patients was analyzed based on their weight,
Hemoglobin, CD4 and viral load (VL) exams results, and the economic aspects based on the costs of medical
consultations, nurse attending, procedures, laboratory exams and hospitalizations, both obtained on the patient’s
medical charts. Average ages from Group I and II were 42.7±10.6 and 43.2±10.4 respectively; male percentage was
60%. Although there were no differences on the clinical exams results during 6 months, patients who completed one
year of study (eighteen patients in each group) showed a positive variation on VL in group II. Before the intervention,
group II had 11 patients with VL<50, after 1 year 15 patients had VL<50 in contrast to group I (12 patients with VL<50
in the beginning and after 1 year, 9 patients with VL<50). Group II generated costs with medical consultations, nurse
attending, procedures, laboratory exams and hospitalizations 32% lower than Group I, leading to estimated saving of
R$165.63/patient (about US$100,00, on current currency). These data indicate that the pharmaceutical intervention
improved the patient’s clinical results and reduced costs to the health service.
Financial support: CAPES; FAPESP; CNPq/PIBIC.
037
MEDICATION THERAPY MANAGEMENT METHOD IN ONCOLOGY CLINIC
JAQUELINE OLIVEIRA VANCIM; MARINA MOREIRA SUAVINHA; REBECA OLIVEIRA LEITE SILVA;
CARLA LIBRALI TOSTES; FLÁVIA ALVES DE TOLEDO; RITA DE CÁSSIA LIMA; PAULA ANDRADE
FIGUEIREDO
Instituto Oncológico de Ribeirão Preto – InORP
Medication Therapy Management (MTM) is the process where the pharmacist is responsible for needs of the patients
related to the medicines, through detection, assessment and resolution of Drug Therapy Problems (DTP), in a
systematic, continuous and documented way. The goal is to improve the quality of life of the patient with defined
results. RDC 220/2004 created of Antineoplasic Therapy Multidisciplinary Group, which boosted the presence of the
pharmacist in the monitoring of cancer patients. This practice allows the pharmacist to detect possible suspicious DTP
in order to seek ways of reducing the adverse reactions that affect the majority of patients treated with chemotherapy
agents. The objective was the development of MTM method applicable to the outpatient in an Oncology Clinic. A
critical review of the methods of Pharmaceutical Care: Dader, SOAP, PWDT, TOM and PCNE and survey of
advantages and disadvantages of each method adapting with the reality of localization. The project of monitoring
pharmacotherapy mainly based on the Dader method with adjustments for the model to be the most appropriate way as
possible for an Oncology Clinic. The proposal is monitoring the phases: Introduction to the patient, medicine in use
study phase, identification of DTP, intervention phase, outcome of interventions and monitoring phase. The
development of a MTM method contributes to a better treatment outcome, allowing early intervention for resolution of
DTP as well as preventive actions. It is essential that the method be adapted to the needs of the service so as to achieve
better patient compliance and therefore better results.
038
MEDICINAL PLANTS OFTEN USED FOR GASTRINTESTINAL DISEASES IN RIVERSIDE COMMUNITY
OF VÁRZEA GRANDE – MT
TAINA KREUTZ1, TIAGO SOBRAL DAMIÃO1, ANGELA MARCIA SELHORST E SILVA BESERRA1
1
Universidade de Cuiabá, UNIC.
The approach combines ethnopharmacological information from the users of medicinal flora studies with chemical/
pharmaceutical, and allows you to create hypotheses about the pharmacological activities and active substances
responsible for the reported therapeutic actions. The objective of this research was to conduct the study of medicinal
plants (MPs) in the treatment of gastrointestinal disorders (CIOs), more specifically, gastric ulcer, gastritis and diarrhea
in the riverside community of Várzea Grande-MT (RCVG). The survey was conducted by a questionnaire administered
interviewing the residents (n = 9) of RCVG. From the information obtained, we identified the relationship of plants
commonly used in the treatment of CIOs, and other data. Respondents had a mean age of 59 years (1 ♀ ♂ and 8), with
43% having a high school degree. The MPs cited were: Lafoensia pacari (20%), Bauhinia glabra (20%), Momordica
charantia, Psidium guajava, Strychnos pseudoquina, Clusia Nemorosa, Plectranthus barbatus and Hyptis suaveolens
(10% each). The most used is the stem (36%), prepared as an infusion (33%), 1/day (43%), orally (100%) until “the
pain ends” (100%). Pregnancy accounted for 67% of use restriction. 56% obtain these MPs in the bush / native, with no
special criteria for the collection (78%). All reported that they learned to use medicinal plants with their ancestors.
Peptic ulcer, gastritis and diarrhea are the most common CIOs worldwide, and traditional medicine uses plants from
ancient times to treat these diseases. Studies on antiulcer activity in animal models of L. pacari, M. charantia, S.
pseudoquina and P. barbatus already been conducted and the use of P. guajava in cases of diarrhea was tested in
rodents. More detailed pharmacological and toxicological studies are needed about these popularly used medicinal
species in CIOs.
039
NEGATIVE OUTCOMES ASSOCIATED WITH MEDICATION OF SAFETY IN THE PHARMACEUTICAL
CARE SERVICE OF INSTITUTO PAULISTA DE GERIATRIA E GERONTOLOGIA – IPGG
THIAGO VINÍCIUS NADALETO DIDONE, FABÍOLA CANEDO YUGAR, HUGO INÁCIO APARECIDO DE
MEDEIROS, DANIEL COELHO DA SILVA, GRAZIELA LUPPI, CRISTIANE DE MELO MARTINEZ,
MARISTELA FERREIRA CATÃO CARVALHO
Instituto Paulista de Geriatria e Gerontologia “José Ermírio de Moraes” – IPGG
Adverse Drug Reactions (ADR) are common in the elderly in the ambulatory clinical setting due to age-related
alterations in pharmacokinetics and pharmacodynamics and a great number of prescribed drugs. The objective of the
research was to quantify and classify the Negative Outcomes associated with Medication (NOM) of safety observed in
the Pharmaceutical Care (PC) service of IPGG. It was an observational retrospective study; PC practice data was
collected from june/2010 to march/2011 using Information Technology department and medical record.
Pharmacotherapy follow-up was assessed using the Third Consensus of Granada on Drug Related Problems (DRP) and
NOMs. The tool to investigate the ADRs was Naranjo algorithm and the 2003 updated Beers criteria were used to
identify Potentially Inappropriate Drugs (PIM). During this period, 411 patients received PC; 184 had at least one NOM
of which 18.5% involved safety problems, and 68.4% of these were quantitative. The average age was 72.0±8.0 years,
82.4% were women and the prescribed drugs mean was 7.7±3.0. There were 77 different types of drugs. Of all safety
problems, 91.2% were associated with at least one ADR and they were classified on DRP as follows: probability of
adverse effects (60.5%), wrongly administrated drug (13.2%), inappropriate dose, dosage schedule and/or duration
(10.5%), duplicity (7.9%), non-compliance (5.3%), and other health problems (2.6%). Out of the 26 drugs involved
with ADRs, 4 were PIMs, and a possible case of ADR due to nifedipine pills excipient was identified. ADRs were
classified as unlikely (11.4%), possible (28.6%), probable (54.3%) and certain (5.7%). The drugs mostly associated
with the NOMs of safety were metformin (11.9%), donepezil (7.1%), alendronate (7.1%) and ciprofibrate (7.1%). The
study was able to identify the safety problems which occurred allowing the improvement of PC practice.
040
OFF-LABEL USE OF MEDICINES: UNUSUAL OR UNDERREPORTED PRACTICE?
FELIPE DIAS CARVALHO1, HELAINE CARNEIRO CAPUCHO2, FERNANDO SANTA CECÍLIA ARTUZO1,
REGINA CÉLIA GARCIA DE ANDRADE1
1
Universidade de São Paulo, FCFRP-USP; 2Hospital das Clínicas de Ribeirão Preto, HCFMRP-USP
Off-label use of medicines (OLUM) is a practice that uses medicines in unapproved dosage, posology, route of
administration, age group or therapeutic indication in a country and also when there are not package inserts included in
medicines, not necessarily leading to an inappropriate use although it may pose health risks to users. This exploratory
and descriptive study aimed to evaluate the occurrence of several types of OLUM (dosage, posology, route of
administration, age group and therapeutic indication) in a tertiary care level teaching hospital in northeast of the São
Paulo state, assessing spontaneous notifications received by the hospital’s Risk Management Service (RMS) between
march 1st, 2009 and march 31st, 2011. The obtained data were quantified and classified by OLUM types reported and
the presence of high-alert medication. From a total of 1345 analyzed notifications, only 10 were classified as OLUM,
considering technical complaints, off-label use, adverse reaction and prescription mistake. Among these, none was
related as dosage or posology, 5 (50%) were related to the route of administration, 2 (20%) to age group, 1 (10%) to
therapeutic indication and 2 (20%) both route of administration and therapeutic indication. All OLUM notifications
were reported only by two pharmacists and 5 (50%) of them were related to high-alert medication. Thus, at the studied
hospital: (i) at least three types related to OLUM occurred, including high-alert medication off-label use; (ii) there is
underreport of notification concerning OLUM, in this study, which is not in accordance with some studies that show
OLUM notifications as a usual practice on tertiary care level teaching hospital; (iii) there is also lack of knowledge
and/or awareness by health professionals to the importance of reporting OLUM to the RMS; (iv) spontaneous
notification assessment was not an effective method to achieve the purposes of this study, which could have been
achieved by carrying out an active search for OLUM directly from medical prescriptions and medical records.
041
ORIENTATION ABOUT THE RATIONAL USE OF MEDICINE FOR STUDENTS OF ELEMENTARY
SCHOOL FROM ALFENAS CITY
NICOLE RODRIGUES DA SILVA, SAMIR ANTONIO RODRIGUES ABJAUDE, RICARDO RADIGHIERI
RASCADO
University of Alfenas, UNIFAL-MG; Faculty of Pharmaceutical Sciences.
Introduction: The EDUCEFAL project is based on EDUCANVISA’s proposal for the National Agency for Sanitary
Surveillance (ANVISA) to stimulate changes in habits and attitudes which are harmful to health, performed in the
school community. We got the academic's involvement with the promotion of health and pharmaceutical care.
Objectives: We provide all the things to raise the awareness about rational use of medicines and health promotion for
elementary school students. Methods: Between April and November 2010 the following steps were developed: 1.
External contacts with ANVISA’s General Management of Advertisment Monitoring to request for materials and to
transmit the information collected by the project. 2. Creation of educational materials about rational medicine use. 3.
Application of the themes in the primary schools’ classrooms. 4. Organization of educational events in the center of
Alfenas. Results: Participation in a Campaign on rational use of medicine held on 05 May 2010 in Alfenas. Lectures to
86 students in the 5th year of E. E. Professor Lambert Levindo, school from the municipality of Alfenas. Creating and
distributing educational materials. Presentation of videos. Group dynamics. Exposure of healthcare products.
Conclusion: The initial steps to adopt healthier lifestyles in pursuit of quality of life are based on knowledge and critical
evaluation, promoted by the educational activity. And teaching about health should not be an exclusive task of the
teacher, but of the whole community. To learn something is not enough, we have to transform our knowledge into
actions. Then, the EDUCEFAL’S mission was stimulating, encouraging young people in the school community to be
aware about the risks of misuse of medicine and other relevant matters about health.
042
ORIENTATION MODEL ABOUT MEDICINES FOR THE ELDERLY: THE LUDIC GAME IS ON
PRISCILLA ALVES ROCHA, YARA CRISTINA FERREIRA, DANIEL SANCHEZ MELERO, VANUSA BARBOSA
PINTO
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, HCFMUSP
Health Education is an important tool to improve the understanding of the pharmacological treatment. The use of games
among groups associated with orientation programs can boost up learning, well-being, mind stimulus and the
integration between groups, especially the elderly. The aim of this work was to develop a program of direction about
medicines and evaluate its effectiveness by patients’ outcome. A pharmaceutical orientation program was designed with
15 meetings, developed with groups of 15 subjects and with duration of 60 minutes, applied fortnightly and based on
two themes: “General Information and medication care” and “Treatment of the main diseases that affect the elderly”. A
game was designed for each meeting to facilitate the overall comprehension of the desired theme, such as “Guessing
Games for Pharmaceutical Forms”, “Ostheoporosys Crossword”, “Hypertension Domino” and “Diabetes Word Search”,
among others. By the end of the program, a satisfaction survey was applied and a printout, validated by Lyra et al, 2006,
adapted by the team and collaborators and associated with a questionnaire that assessed the used tools with open-ended
questions, the subjects´perception of the games and the pharmacist´s performance. Fifty-eight senior subjects
participated in four different meetings. When inquired about satisfaction with the pharmaceutical team, 100% of the
participants answered “Always Satisfied”; the benefits pointed out with the used tools were: “the facilitation of
memorization and learning”, “fun”, “the dynasmism of the activity”, “it arises the interest on this issue”; when it came
to the pharmacist´s performance, the highlighted overall opinion was: “necessary professional to direct the medication
intake, “intermediary professional between patient and physician”, “professional that is prepared and has the knowledge
to talk about drugs”.The use of games in meetings was considered adequate in the learning development of medicines,
contributing to other aspects, such as the facilitating of memorization, making the educational process easier and more
pleasant, which therefore contributes to a better relation between pharmacist and drug taker.
043
PHARMACEUTICAL CARE AND CLINICAL RESULTS IN THE ARTERIAL HYPERTENSION CARRIERS
HELEN PALMIRA MIRANDA DE CAMARGO, FÁTIMA CRISTIANE LOPES GOULARTE FARHAT
Universidade Metodista de Piracicaba, UNIMEP
In all over the world the percentage of blood pressure control is inadequate and represents social and economic impact
in health care. Pharmaceutical Care represents a practice that searches to identify, prevent and solve drug-related
problems and has been a good strategy to improve the patient’s understanding about the illness and its control. The
objective of this research was to evaluate if pharmaceutical care contributes to medicine adherence and to the control of
the blood pressure of 17 arterial hypertension carriers who were followed up for three months in a Pharmaceutical Care
Service in UNIMEP Pharmacy School, Piracicaba/SP, Brazil, and it was previously approved by the Committee of
Ethics in Research of the UNIMEP. The methodology used to adherence evaluation was MedTake test and to
pharmacotherapeutic follow up was PWDT (Minnesota), and the data were statistically analyzed at the level of
significance of 5%. Of the 17 patients, the majority were female (76%), superior of 60 years (65%), with basic
education (88%), with family antecedents of hypertension (71%), sedentary (71%) and obesity (47%). The patients
presented medium of two co-morbidities and 6 medicines in use to general care. Approximately 94% have per capita
income up to 2 minimum wages and 71% use their own income to total or complementary acquisition of their
medicines, which have been in use for more than 5 years (82%). In the first pharmaceutical interview, 53% of patients
showed non adherence to antihypertensive drugs; 18% showed normal pressure, 35% hypertension level 1, 41%
hypertension level 2 and 6% hypertension level 3. After three months, the non-adherence to treatment was reduced to
12% (p<0,01) and corroborated the positive findings in blood pressure control (p<0,01), when 35% of the patients
showed normal pressure, 41% hypertension level 1, 12% hypertension level 2 and 12% hypertension level 3. The
therapeutical complexity index was not significantly altered during the period. In conclusion, within three months, the
pharmaceutical care showed positive effects on blood pressure control and on drug adherence of these arterial
hypertension carriers.
Financial Support: FACIS/UNIMEP
044
PHARMACEUTICAL CARE AND FACTORS INVOLVED IN DRUG NON-ADHERENCE IN ARTERIAL
HYPERTENTION CARRIERS
HELEN PALMIRA MIRANDA DE CAMARGO, FÁTIMA CRISTIANE LOPES GOULARTE FARHAT
Universidade Metodista de Piracicaba - UNIMEP
In Brazil the percentage of blood pressure control is inadequate and poor adherence to treatment is increasingly asking
for strategies to revert this condition. Adherence with the pharmacotherapeutical recommendations is influenced by
many factors and determines effectiveness of treatment. This study presents the findings related to drug non-adherence,
and the influence of pharmaceutical care on that, of 17 arterial hypertension carriers who were attended in the
Pharmaceutical Care Service of UNIMEP Pharmacy School, Piracicaba/SP, Brazil, and was previously approved by the
Committee of Ethics in Research of the UNIMEP. To identify the reasons for non-adherence, during the first interview
and after three months of pharmaceutical care, the patient’s report was classified into the five dimensions of adherence
proposed by the World Health Organization. The results showed that factors related to the patient were the most
important reason for non-adherence, present in 15 (88%) of patient’s report in the first interview and in 8 (47%) after
three months. Among them, forgetfulness (44%; 13%), lack of perceived need for treatment (38%; 19%), lack of
perceived risk that the disease brings to health (38%, 13%) and lack of understanding on the recommendations of
treatment (19%; 0%) were observed. The factors related to the treatment were present in 5 (29%) of patient’s report in
the first interview and in 3 (18%) after three months; socioeconomic factors were described in 4 (24%) and after in 2
(12%); factors related to health professionals and system appeared in 4 (24%) and after in no (0%) patient’s report; and
factors related to the disease were present in 1 (6%) patient and after in no one (0%) also. In conclusion, the main factor
related to non-adherence to pharmacotherapy in these arterial hypertension carriers were related to poor understanding
about the illness and its treatment, and the pharmaceutical care was proved to be a good strategy to influence this
condition positively(p<0,01).
Financial Support: FAPIC/UNIMEP
045
PHARMACEUTICAL CARE AS A STRATEGY FOR THE RATIONAL USE OF DRUGS IN MEDICAL
SPECIALTIES CENTER OF VÁRZEA GRANDE – MT
TIAGO SOBRAL DAMIÃO1, SAULO SCHMIDT DA SILVA1, TAINÁ KREUTZ1, CRISTIANO CARDOSO DE
ANDRADE1, ACACIA LIVIA SOBRAL 2
1
Universidade de Cuiabá, UNIC; 2Prefeitura Municipal de Cuiabá
The elderly population in Brazil has grown substantially, following the trend that has already occurred in developed
countries, however this brings increasing challenges to services and health professionals. With the population aging
some diseases have an increased prevalence, such as chronic degenerative diseases and hypertension, which often
require prolonged or continuous drug therapy. All these health problems are associated with the older age of this
population group, the elderly are the main consumers of drugs in the society. The aim of this study is to assess the
knowledge of this group of people on pharmaceutical care, demonstrate the need for an appropriate pharmaceutical care
and then evaluate the degree of acceptance by the population for this service. The methodology in this study was 50
elderly people - 35 women and 15 men between 60 and 75 years - through interviews about pharmaceutical care and
rational use of medicines. Among all respondents, 40 (80%) have 8 or more years of schooling, 24 (48%) have heard
about pharmaceutical care and 8 (16%) were able to define in their own words the meaning of pharmaceutical care. In
addition 36 (72%) patients were not informed about the appropriate ways to use their medication and 32 (64%) were
using the drugs incorrectly. After concluding the interviews and the pharmaceutical care, guiding them to the correct
ways of using drugs in this group of volunteers, 50 (100%) of them said to be very important to have an appropriate
pharmaceutical care for the promotion and maintenance of health in Brazil. Thus the pharmaceutical care to the elderly
is of paramount importance, since it promotes through guidelines and monitoring rational use of pharmaceutical drugs,
treatment adherence, as a consequence, improving local health.
046
DOMICILIARY PHARMACEUTICAL CARE AT PUBLIC HEALTH SYSTEM: UNIFAL’S PHARMACY
STUDENT’S EXPERIMENT - ALFENAS MG.
LUANA AMARAL PEDROSO3; VALÉRIA MARIA DAS DORES HEYDEN2; MÁRCIA HELENA MIRANDA
CARDOSO PODESTÁ1; OLINDA MARIA GOMES DA COSTA VILAS BOAS1; TALITA AMARAL MACHADO3;
LUCIANO MARTINS DE SIQUEIRA JUNIOR4; ERIC BATISTA FERREIRA3; WALNÉIA APARECIDA SOUZA1
1
Professors at the Pharmaceutical Science Faculty, 2Pharmacist from the Pharmaceutical Science Faculty, 3Students
from the Pharmaceutical Science Faculty, 4Student from University of Alfenas (UNIFENAS)-MG, Federal University
Alfenas (UNIFAL)-MG
Pharmaceutical care enables the approaching to the potential socio-cultural and family relationship difficulties when
facing their vulnerabilities and production of citizenship. The domiciliary visit may be considered as one of the
transverse axis of the Brazilian healthcare system, which professes universality, integrality and equity. This study aims
to promote pharmaceutical care at the UAPS through domiciliary visits. It was performed by the pharmacy students of
the 6th period at UNIFAL-MG during their curricular training at the UAPS in Alfenas - MG. 50 patients were followedup by means of domiciliary visits during the year of 2010. The tools used for the pharmacotherapeutic follow-up were
the Dáder Method, the genogram and Fodor et al.’s (2005) test of adhesion to treatment. The socio-demographic
characterization of the patients was of 72.5% females, average age 69, composed by 40% married. There was a
predominance of polypharmacy. The most used medicines were the anti-hypertension drugs as inhibitors of ECA
(90%). The prevailing chronic conditions were blood hypertension (100%), diabetes (52.5%) and dyslipidemia (35%).
The average systolic and diastolic blood pressure at the beginning were 140.9/83.9, and then 138.1/81.7 mmHg. The
genogram was a graphic instrument which allowed the students to identify the family structure and its relationship,
showing the conflicts that generate the diseasing process. The Unifal-MG Pharmacy Course training at the UAPS in
Alfenas-MG has presented an opportunity for the insertion of its students in SUS, with the aim of promoting
humanization, solidarity and citizenship.
047
PHARMACEUTICAL CARE FOR HYPERTENSIVE AND DIABETIC PATIENTS IN THE CONTEXT OF
FAMILY HEALTH STRATEGY
SAMILLA MOREIRA MARQUES, MARCONI RICARDO DUPIM2, DELBA FONSECA SANTOS1, MARIANA
LINHARES3, JOSÉLIA FRADE4, RENATA ALINE DE ANDRADE1
1
Universidade Federal dos Vales do Jequitinhonha e Mucuri, UFVJM; 2Secretaria Municipal de Saúde de Diamantina MG; 3Universidade Federal de São João Del Rei, UFSJ; 4Ministério da Saúde.
The pharmaceutical care can be defined as the direct interaction between the pharmacist and the user in order to rational
pharmacotherapy and an alternative for reducing drug related problems (DRPs). In this context, the objective of this
project was to perform the pharmaceutical care services for diabetic and hypertensive patients registered in Family
Health Strategies of Diamantina. Twenty-three patients were selected over the age 45 years old which used more than
three drugs. Data were collected according to the method Dáder. All volunteers included in the service were
hypertensive, 17% were also diabetic. Evaluation of pharmacotherapeutic profile of patients showed that 48% used
between 5 and 10 drugs, 35% between 3 and 5 and 17% more than 10 drugs. For treatment of hypertension was
observed
that
diuretics were used by 74%
of
patients and ACE
inhibitors used by 70%, corresponding to classes of drugs most used. The identification and analysis of DRPs has found
that 74% of patients had adverse drug reactions, 64% had problems with adherence to therapy, 52% had potential drugfood interactions, 35% used unnecessary medication, 35% administered the drug incorrectly, 22% had a potential
interaction between drugs and 17% required additional therapy. The interventions in 91,3% of patients was made by
health education, in 83% changing the time of the drug, 57% of patients were sent to other health professionals, in 43%
was made nutritional education, 35% gave it an incentive to practice physical exercise, in 13% of patients a letter was
sent to the prescriber, in 13% it was necessary to dispense the correct drug and in 4% intervention was conducted with a
caregiver. These results demonstrated the importance of service to optimize the use of drugs and their rational use. Also,
could subsidize health actions in context of the Family Health Strategy.
Financial support: FAPEMIG.
048
PHARMACEUTICAL CARE IN HEAD AND NECK CANCER: IDENTIFICATION OF DRUG RELATED
PROBLEMS AND PHARMACEUTICAL INTERVENTIONS
MARÍLIA BERLOFA VISACRI1, CINTHIA MADEIRA DE SOUZA1, INDIRA VALADÊ CARVALHO1, LUCIANA
LYRA1, MARIANA BEATRIZ BENEDETTI MARINUCCI1, CRISTINA ROSA BARBOSA2, MECIA MARIALVA
DEMOCH2, CARMEN SILVIA PASSOS LIMA1, PATRÍCIA MORIEL1.
1
Faculdade de Ciências Médicas, Universidade Estadual de Campinas, UNICAMP;
HC/UNICAMP; São Paulo, Brazil.
2
Hospital de Clínicas,
The head and neck cancer is a disease that arises in the nasal cavity, sinuses, lips, mouth, salivary glands, throat or
larynx. It consists of the sixth most common cancer worldwide. The objective of the research was supply the service of
Pharmaceutical care to head and neck cancer patients, all users of a University Hospital of Campinas city, identifying
drug related problems (DRP) and doing pharmaceutical interventions, in the period of june/2010-march/2011. It has
been followed 27 patients, who have been realized cisplatin treatment and radiotherapy, 96.3% are male, 81.4% white,
aged 59.0 ± 10.1 years. The methodology used was Pharmacist´s Workup of Drug Therapy of pharmacotherapeutic
follow up. It has been made 2.22 ± 1.57 outcome and the patients were followed for 2.26 ± 1.51 chemotherapy cycles.
The medicine mostly used was dipyrone (14.07%). Yet, the average number of medicines in the first visit were 2.59 ±
1.59 and, during the treatment, 5.52 ± 3.81. It has been found 151 drug related problems (6,07 per patient): 0,51 ± 0,70
DRP of necessity, 1.41 ± 1.74 of effectiveness, 3.63 ± 3.88 of security and 0.93 ± 1.24 of adhesion. Regarding the
effectiveness, the drug classes more involved were analgesics and antiemetics. Regarding the security, 62 cases of
adverse drug reactions were identified. In the research, it has been found potential drug interactions (3 contra-indicate, 3
major, 14 moderate and 8 minor). During the study, there were 24 pharmaceutical-physician interventions and 124
pharmaceutical-patient interventions. This study shows the importance of a clinical pharmacist in multidisciplinar staff,
while are found many problems related to the patient pharmacotherapy and most of them were prevented and resolved.
049
PHARMACEUTICAL CARE OF PATIENTS IN THE PHARMACIST OFFICE SCHOOL CAMPUS
UNIFENAS VARGINHA
LEILA DA SILVA AZEVEDO, DEYSE LARA COELHO
Universidade José do Rosário Vellano - UNIFENAS, Campus of Varginha
The Pharmaceutical Care is the practice in which the patient is the main beneficiary of the actions of the pharmacist.
Pharmacotherapy monitoring, a component of pharmaceutical care, is a process in which the pharmacist is responsible
for the user needs related to medicine, detecting, preventing and resolving Drugs Therapy Problems (DTP). This form
of operation has the aim to achieve defined outcomes in pharmacotherapy of patient's seeking to improve the quality of
life of the user. The aim of this study was to evaluate the process of pharmaceutical care developed at the School of
Pharmaceutical office UNIFENAS Campus of Varginha. The methodology for the monitoring of patients was Dáder
Methodology adapted. Students from first to fourth period of the pharmacy course Informative Caution, a service
created with the objective to educate patients about health care and disease and the students from the fifth to eighth
period practiced the activities of pharmaceutical care. It has treated 55 patients (65.4% female and 34.5% male) aged
between 37 and 80 years old. The average number of medications used per patient was 5.7. The most frequent diseases
were hypertension (78.1%), diabetes (34.5%), depression (21.8%) drop (16.3%), hypercholesterolemia (12.7%) and
cardiac disease (10.9 %). 34.5% have only one DTP, DTP 21.8% two and 18.2% over two DTP. The most frequent DTP
was 6, followed by DTP 1, 4 and 3. The interventions were mostly directly with patients, but interventions with the
prescriber also occur. It was concluded that the methodology was effective in monitoring patients and that is very useful
in improving their quality of life, since many problems were identified and resolved.
050
PHARMACEUTICAL CARE TO PATIENTS WITH MOOD DISORDER
RAFAEL ALVES MOURA1, GABRIEL TAVARES DO VALE1, VANESSA SOUZA REIS1, RICARDO RADIGHIERI
RASCADO1, MARIA ROSANA FERNANDES2, LUCIENE ALVES MOREIRA MARQUES1
1
UNIFAL – MG. Faculty of Pharmaceutical Sciences, 2UNIFENAS
The depression is considered one of the ten main causes of incapacitations in the world, limiting the social, personal
and physical behavior. However, a little group of people receive the correct treatment and proper orientation. The
objective of this research was to evaluate Pharmaceutical Care’s impact on the pharmacotherapy’s effectiveness. 19
patients were chosen, being 5 men and 14 women, aged between 15 and 82 years old, with mental disorder treatted at
Centro de Atenção Psicossocial de Alfenas (CAPS) and at Ambulatório Vila Esperança. Home visits were made and
during these, pharmaceutical guidelines were provided, clarifying questions of patients, providing information about
adverse reactions, drug interactions, duration of treatment and the importance of adherence to it. Also, it was applied the
social-economic-cultural form and Beck Depression Inventory, to characterize the sample and evaluate the effectiveness
of pharmacotherapy. Most patients are married or single, catholic with elementary education. Comparing the scores in
the first and at the last application of the Beck Depression Inventory, one sees an improvement in Depression Inventory
for 61,11% of patients. Notice that the pharmaceutical care applied to patients during this work has influenced the
improvement of the depressed state of most patients. The pharmacist can play an important role in pharmaceutical care
of patients with mental disorders assisting in solving problems and negative clinical results related to Medicine,
contributing to treatment adherence and improved quality of life of patient.
051
PHARMACEUTICAL CARE TO SENILE DEPRESSION PATIENTS IN CAMPOS GERAIS, BRAZIL.
ELAINE APARECIDA DA SILVA1, LUIZ HENRIQUE AMARANTE2
1
UNIVERSIDADE FEDERAL DE ALFENAS, UNIFAL-MG, 2UNIVERSIDADE FEDERAL FLUMINENSE, UFF
Depression is a mental disorder that affect anyone at any age. However, the incidence of senile depression is increasing
and becoming an important problem of public health. The differences in the symptomatology of senile depression
reinforce the arguments that there are different types of depression among the various groups of age. Additionally, the
elderly patients are in a situation of continued losses, the decline in the social and family support, loss of occupational
and the economic status, the greater frequency of physical illness and disability, inducing a significant lowering of
mood. During the aging process, it is more often the onset of degenerative diseases or physical incapability that
produces physical symptoms of depression. The objective of the present study was to determine whether an implement
of the Pharmaceutical Care could improve the life quality of the depressive-elderly patients that lives in Campos Gerais,
MG. Brazil. For this purpose, we applied a questionnaire to the elderly people investigating the prescription of the
antidepressants used to alleviate mood disorders and their efficacy and adverse effects. It was found that drug
prescription is not differentiated. Geriatricians and psychiatrists have been prescribed de same antidepressant for both
the young and the elderly people. The most prescribed antidepressants were: citalopram 20%, sertraline 20%,
venlafaxine 20%, nortriptilin 26.6%, fluoxetine 6.6% and amitriptyline 6.6%. The selective serotonin re-uptake
inhibitor was the most prescribed and the most effective class of antidepressants to the senile-depression patients and it
was regarded as first choice. However, 26.6% of the interviewed related that already used another medication
prescribed by the different doctors for the same sickness. At this point, the Pharmaceutical Care is essential, since it
relieves of the selection, guide line and promote the correct use of the medications for the senile depression.
052
PHARMACEUTICAL GUIDANCE TO PEOPLE WITH DEPRESSION USERS OF MUNICIPAL HEALTH
SYSTEM OF PARAGUAÇU-MG, BRAZIL
LUCIENE ALVES MOREIRA MARQUES1, JOSÉ CARLOS FERNANDES GALDUROZ2, ANA REGINA NOTO2
1
Postgraduate student, Doctorate in Psychobiology at Federal University of São Paulo-UNIFESP, 2Department of
Psychobiology Teachers: Co-advisor and advisor, UNIFESP
Depression is considered one of the ten leading causes of disability worldwide, limiting the physical, social and
personal development. The objective of this study was to characterize patients with depression treated in the Polyclinic
Paraguaçu-MG, Brazil, and provide pharmaceutical guidance on disease and drug therapy. We selected 19 patients
whose clinical history and diagnosis were consistent with depression, aged 18-75 years old. The patients (100%
women) were invited to attend the Polyclinic for a consultation with the pharmaceutical researcher. Of these, 10
attended. After signing the informed consent, patients answered questions about their socio-economic-cultural and the
compliance questionnaire. The form of pharmacotherapeutic history Dáder Program was applied to collect information
about pharmacotherapy. One hundred percent were catholic, 60% housewives, and 40% had incomplete primary
education. Sixty percent had depression a few months ago and 50% relapse. The most commonly used drugs were
tricyclic antidepressants (60%) followed by SSRIs (50%) as a patient using two antidepressants. Benzodiazepines were
used by 80% of patients. Forty percent have hypertension, dyslipidemia, and hypothyroidism (20% each) and rhinitis,
osteoarthritis and fibromyalgia (10% each). Fifty percent of patients had some side effects: sexual dysfunction,
sedation, and increased appetite (10% each), dryness of mouth (20%). Only two patients complained of ineffectiveness.
Regarding compliance, 40% reported having some type of difficulty (guilt, difficulty in swallowing) and by test of
Morisky et al. (1986), the 40% of patients had high adherence, moderate and low level of adherence in 60% of cases.
The guidelines provided were related to adherence, proper administration of medications, and management of unwanted
effects on depression, since 100% of patients had no information about the disease. These results allow to conclude the
need for pharmaceutical care targeted to women diagnosed with depression, since all the participants reported
significant gaps in knowledge. The pharmaceutical care can provide better therapeutic results, and detailed studies on
the effectiveness of pharmaceutical care deserve to be made.
053
PHARMACEUTICAL INTERVENTIONS IN MENTAL HEALTH SERVICES: A SYSTEMATIC REVIEW
ROSA CAMILA LUCCHETTA, PATRICIA DE CARVALHO MASTROIANNI.
Departamento de Fármacos e Medicamentos, Faculdade de Ciências Farmacêuticas, UNESP/Araraquara.
Mental disorders affect 10% of adults worldwide, generating clinic, humanistic and economic impacts, which can be
minimized with appropriate therapies, such as pharmacotherapeutic follow-up of the patients by a health team and
solving negative outcomes associated with medications. A systematic review was performed in BIREME and PUBMED
databases, until October/2010, in order to identify the studies which developed pharmaceutical interventions in mental
health services and estimated their results. The search was carried out using the follow health science descriptors:
Pharmaceutical Care, Pharmaceutical Services, Medication Adherence, Pharmacists, Mental Health, Mental Health
Services, Mental Health Assistance, Community Mental Health Services, Mentally Ill Persons and Mental Disorders.
206 manuscripts were identified, of which 185 contemplated the exclusion criteria. After the content analysis of the
eligible manuscripts, only five developed PI. All of them were conducted in the second level of health care, with
individual approach, through: therapy follow-up (3), educational interventions by letters to physicians and patients (1),
presence or remote pharmaceutical counseling and inclusion of therapy with nicotine transdermal patch (1). The data,
such as adherence promotion and solving drug related problems, were positive for the therapeutic. Although there are
few indexed and available studies of PI (none in Brazil), the findings are positive. However, it is necessary that the PI
monitor the clinical parameters, the habit changes, the improvement in the quality of life and the pharmacoeconomic
aspects, in order to assess their impact.
Financial support: Academic and Extension Scholarship I.
054
PHARMACOEPIMIOLOGIC STUDY OF POTENCIAL DRUG INTERACTIONS IN A BRAZILIAN
HOSPITAL
ROGÉRIO CARDOSO DE CASTRO, JULIANA LUCAS, NATÁLIA JULIANA PADUAN
Centro Universitário de Votuporanga - UNIFEV
Drug interactions are special types of pharmacological answers, in which the effect of one or more drugs are modified
by the simultaneous or previous administration of others, or through the concomitant food administration. The
phenomenon of the drug interaction constitutes in the present time one of the most important subjects of the
pharmacology and for the practical clinic of the professionals of the health. The undesirable interactions are the ones
that determine reduction of the contrary resulted effect or to the waited one, increase in the incidence and the gamma of
adverse effect and the cost of the therapy without increment in the therapy benefit. The incidence of drug interactions
oscillates between 3 and 5% for patients in use of some medications, increasing 20%, or more yet in sick people using
10 to 20 drugs. As the hospitalized patient receives, on average, the 6 to 8 drugs, the importance of the problem is seen
there. This work had as objective to describe the potential drug interaction between drugs prescribed to the patients of a
beneficent hospital of a city from the São Paulo state northwestern. It was a transversal pharmacoepidemiology study in
which they had been collected given data from charts of patients interned in one determined period. From the total
analyzed charts, at least one met potential drug interactions in 74% of them. As in some charts they had been found
more than what an interaction, in the total had been detected 490 potential drug interactions. Thus, this work
demonstrated the existence and characterized the problem of the drug interactions in the hospital in question. With this,
one expects that this is divulged between the administrative and clinical authorities of the hospital and, in this way,
serves of support to the implantation of action for, the least, to minimize the problem.
055
PHARMACOLOGICAL PROBLEMS IN PATIENTS RECEIVING INITIAL ANTIRETROVIRAL THERAPY:
AN APPROACH IN SECONDARY HEALTH CARE
SARAH DE CARVALHO FREITAS ALVES1,6, KARLA DO NASCIMENTO MAGALHÃES1,2; HENRY PABLO
LOPES CAMPOS E REIS1,6, MARAIZA ALVES TEIXEIRA1,5,6, NADIR KHEIR3,5,6, DAVID WOODS4,5,6, LUZIA
IZABEL MESQUITA MOREIRA DA SILVA1,6, ANGELA MARIA DE SOUZA PONCIANO1,6, MARTA MARIA DE
FRANÇA FONTELES1,5,6
1
Universidade Federal do Ceará (UFC); 2Centro de Especialidades Médicas José de Alencar (CEMJA); 3Qatar
University; 4Otago University; 5Instituto Nacional de Ciência e Tecnologia para Inovação Farmacêutica (INCT_if);
6
Centro de Estudos em Atenção Farmacêutica (CEATENF)
Since AIDS was discovered, many advances have been made in better understanding its therapeutic. This work aimed to
investigate pharmacological problems related to antiretroviral therapy (ART) in HIV+ patients under initial ART
attended by Medical Specialties Center José de Alencar in Fortaleza-Ceará. A descriptive and prospective study was
carried out, where each patient acted as their own control. The survey was conducted from December 2008 to August
2010, using Dáder method for pharmacotherapy follow up. Pharmacological problems (PP) related to antiretroviral
were identified and classified according to an adapted version of the II Consensus of Granada. The data were analyzed
with Epi Info and Sigma Plot programs, setting the significance level at p <0.05. Of the 47 interviews conducted, 45
patients completed the follow up. A total of 643 PP related to antiretroviral drugs was observed. PP-5 (category:
qualitative security) was the most prominent followed by PP-4 (category: quantitative effectiveness) and PP-1
(category: needs of patients about the drug). The most frequently prescribed antiretroviral drugs were Zidovudine +
Lamivudine, Lopinavir + Ritonavir and Efavirenz and were also the most involved in problems related to the
pharmacological safety and effectiveness. Our findings suggest that the main obstacles and difficulties experienced by
HIV+ patients on ART are related to the adverse reactions of these drugs, which contribute to lower adherence to
treatment in secondary health care.
Financial support: UFC; CNPq; INCT_if.
056
POPULAR KNOWLEDGE ABOUT REFERENCE, GENERIC AND SIMILAR DRUGS, IN SILVIANÓPOLIS
COUNTY, STATE OF MINAS GERAIS, BRAZIL.
LUANA JÉSSICA DE PAIVA1, RAFAEL MACHADO FELIX DE LIMA2, VALDOMIRO VAGNER DE SOUZA1,3
1
Universidade do Vale do Sapucaí / UNIVÁS, 2Faculdades Integradas ASMEC / UNISEP, 3Centro Universitário de
Itajubá / FEPI.
Ever since the government’s decision on the sale of medicine at more affordable prices to the population, there has been
a decline in the knowledge about pharmacotherapy. Simultaneously, the precariousness in the pharmaceutical care
offered has been verified, in conjunction with sales of drugs without a prescription. This paper aims mainly to analyze
the level of knowledge of the population of a municipality in southern Minas about reference, generic and similar drugs,
as well as verifying the main sources of information about them. The research was carried out at three different
drugstores in the city of Silvianópolis where a questionnaire containing evaluative questions was applied to the patients,
so as to assess the population’s knowledge level. Of the 150 patients participating in the survey, only 15% correctly
answered questions about reference drugs. However, 51% of patients correctly answered questions about generic drugs
and 23% did so about similar drugs. As for sources of patient information, answers amounted as follows: TV (23%),
drugstores (15%), newspapers (11%), never had any information (11%), doctors (9%), magazines (5%), talking with
friends (4%), books (1%) and other sources of information (21%). After analysis, it is possible to infer that the patients
interviewed have little knowledge about medicines. Such fact suggests a precarious pharmaceutical care dispensed at
drugstores in the town in question. In the face of the results fared, a change in behavior or even in the methods of
guidance given to the patient is initially suggested. Another way to strengthen the role of the pharmacist is to hold
refresher courses aimed at increasing their motivation in acting in patient care. Future policy measures could be
discussed, aiming at minimizing the influence of television in the patients’ pharmacotherapy.
057
POTENTIALLY SEVERE DRUG-DRUG INTERACTIONS: AN OBSERVATIONAL
COMMUNITY PHARMACIES IN THE NORTH OF PARANÁ, BRAZIL.
STUDY
IN
ALESSANDRA NEGRI1, ANA LUIZA CARVALHO FREITAS1, MONARA NATANA IDEM1, MARIA DAS
GRAÇAS GUIMARÃES1, VALÉRIA ANDRADE1, PAULO ROQUE OBRELI NETO2
1
Faculdades Integradas de Ourinhos, FIO; 2Universidade Estadual de Maringá, UEM-PR
In the Brazilian community pharmacies the use of computerized drug-interaction alert systems are scarce. This can
expose the patients to severe drug-drug interactions (DDIs). The aim of this study was to estimate the prevalence and
the profile of potential DDIs rated as severe in prescriptions retained in community pharmacies. All prescriptions
dispensed between September 2010 – March 2011 in community pharmacies of three municipalities in the north of
Paraná were analyzed. A potential DDI was defined as the presence of a minimum 5-day overlap in days supply for
drugs in interacting pair. We used two computerized drug-interaction alert systems (Drugs® and DrugDigest®) to
identify potential DDIs rated as major. During the study 10,828 prescriptions were retained. The prevalence of potential
DDIs rated as major by the two computerized drug-interaction alert systems was 9.09% (n = 984 individuals). The
mean age of exposed subjects was 60.51 years (SD = + 8.02), and 731 (74.29%) were female. Digoxin, amiodarone,
acetylsalicylic acid, hydrochlorothiazide, fluoxetine, simvastatin, diclofenac and warfarin were the active substances
most frequently involved in potentially severe DDIs. These substances were responsible for 83.09% of all potential
severe DDIs. A substantial number of clinically important potential DDIs were identified, particularly among female
elderly. Awareness of the most commonly occurring potential DDIs can help community pharmacists prevent coadministration of these potentially dangerous medication combinations.
Financial support: Fundação de Apoio ao Desenvolvimento Científico (FADEC).
058
PREDICTORS OF NON-ADHERENCE AMONGST ELDERLY PATIENTS: A CROSS-SECTIONAL STUDY
IN A BASIC HEALTH UNIT, SALTO GRANDE, SAO PAULO STATE.
ANA LUIZA DE CARVALHO FREITAS1, PAULO ROQUE OBRELI NETO2, JESSIKA CAROLINE VIEIRA1,
WALDEREZ PENTEADO GAETI2, ROBERTO KENJI NAKAMURA CUMAN2
1
Faculdades Integradas de Ourinhos, FIO; 2Universidade Estadual de Maringá, UEM-PR.
Earlier studies showed that an estimated 20 – 50% of patients do not take their medication as prescribed and are said to
be non-adherent. This study aimed to evaluate predictors of non-adherence amongst elderly patients. A cross-sectional
study was carried out between May 2009 and September 2009, in a basic health unit (BHU) in Salto Grande, Sao Paulo
State. Eligible criteria included age > 60 years and diagnoses of two or more chronic condition. A total of 815 patients
attended the eligible criteria. A sample size of 120 patients was random selected to carry out a study with a margin error
of 10%. The Morisky-Green test was used to assess the adherence rates. A questionnaire was used to identify
demographic (age, sex), health (number of diseases diagnosed) and drug therapy (number of drugs consumed) data of
the patients. Logistic regression analysis was used to study predictors of non-adherence. The results are shown as odds
ratios (OR) with 95% confidence interval (CI). The prevalence of non-adherent patients was 49.2% (n = 59 patients).
The mean age of non-adherent patients was 63.2 years (SD = + 6.6), and 64 (53.3%) were male. Multivariate analysis
show diagnosis of four or more chronic condition (OR = 1.27 [95%CI 1.09-1.63]) and consume of five or more drugs
(OR = 1.42 [95%CI 1.20-1.71]) were associated with non-adherence to drug therapy. The knowledge of predictors of
non-adherence could help the health services to develop individualized practices to improve adherence to drug therapy
in elderly patients.
Financial support: Fundação de Apoio ao Desenvolvimento Científico (FADEC).
059
PREDICTORS OF POTENTIAL DRUG-DRUG INTERACTIONS AMONGST ELDERLY BRAZILIANS IN
THE PRIMARY PUBLIC HEALTH CARE SYSTEM
PAULO ROQUE OBRELI NETO1, ALESSANDRO NOBILI2, JOICE CRUCIOL3, CAMILO GUIDONI4, ANDRÉ DE
OLIVEIRA BALDONI4, ROBERTO KENJI NAKAMURA CUMAN1
1
3
Universidade Estadual de Maringá, UEM-PR; 2Instituto di Ricerche Farmacologiche “Mario Negri” - Milano;
Universidade Estadual de Londrina, UEL-PR; 4Universidade de São Paulo, USP-SP
Elderly present a high prevalence for potential drug-drug interactions (DDIs), which cause roughly 2.8 percent of all
hospitalizations in older. The aim of this study was to investigate predictors of potential DDIs (rated as major or
moderate) in elderly patients attending the public primary health care system in the Ourinhos micro-region, Sao Paulo
State, Brazil. A retrospective case-control study was carried out between November 2009 and April 2010, with a
sample of 12,343 elderly (> 60 years). The selected sample was divided according to the presence of drug therapies
with at least one or more potential DDIs (5,855 cases) and those receiving drug therapies with no potential DDIs (6,488
controls). The data about drug therapy were collected from prescriptions database and medical records. Logistic
regression analysis was used to study predictors of potential DDIs. The results are shown as odds ratios (OR) with 95%
confidence interval (CI). Multivariate analysis show drug therapy regimens prescribed by two or more prescribers (OR
= 1.39 [95%CI 1.17-1.67), prescription of three or more drugs (OR = 3.21 [95%CI 2.78-3.59), prescription of two or
more drugs that act on citochrome P-450 (OR = 2.24 [95%CI 2.07-2.46]), and prescription of Anatomic Therapeutic
Codes B (OR = 1.89 [95%CI 1.05-2.08]) and C (OR = 4.01 [95%CI 3.55-4.57]) were associated with potential DDIs.
The knowledge of these predictors of potential DDI could help public health services to develop preventive practices
and policies to avoid such events.
Financial support: Fundação de Apoio ao Desenvolvimento Científico (FADEC).
060
PREVALENCE AND TREATMENT OF INTESTINAL PARASITES IN PATIENTS FROM HOSPITAL
UNIVERSITÁRIO JULIO MULLER DE CUIABÁ – MT IN 2010.
TAINA KREUTZ, TIAGO SOBRAL DAMIÃO, CRISTIANO CARDOSO DE ANDRADE
Universidade de Cuiabá, UNIC
A collection of data was done to determine the prevalence of intestinal helminths disease in patients from University
Hospital Julius Muller (HUJM) located in Cuiabá-MT, of the months of February, June and October of 2010 and the
study was made specially to promote the patient’s health. During these months 637 patients with ages among 1 to 85
years were submitted to parasitological analysis 8 (1.23%) positive helminths results were obtained: Strongyloides
stercoralis (0.63%); Hymenolepis nana (0.15%); Ascaris lumbricoides (0.15%); Ancylostoma duodenale (0.32%). In
February, 188 (100%) exams were performed and two cases (1.06%) showed parasites. The results showed
Strongyloides stercoralis and Hymenolepis nana. In June, 216 (100%) were performed and 2 cases (0.92%) showed
parasites being them Ascaris lumbricoides and Strongyloides stercoralis. In October, we obtained 233 (100%) patients
results, and of these, 4 patients (1.71%) were positive for helminths. The results showed 2 Ancylostoma duodenale
results and 2 Strongyloides stercoralis. The drugs are standardized by the hospital Albendazole, Ivermectin,
Mebendazole, Praziquantel, Thiabendazole. In February, patients with Strongyloides stercoralis and Hymenolepis nana
were treated with 100 mg every 12 hours for three days. In June, the patient with Ascaris lumbricoides was treated with
Albendazole 400 mg single dose and the patient with Strongyloides stercoralis was treated with Ivermectin dose of 200
micrograms/kg. In October, the patients with Ancylostoma duodenale were treated with Mebendazole 100 mg 12 hours
for three days, patients with Strongyloides stercoralis were treated with Thiabendazole single dose 50 mg/kg. All
patients obtained the cure due to the pharmaceutical assistance by controlling the drug administration and the hygiene.
The dosage, the rational use of medicines and pharmaceutical services provided to patients was essential for there to be
effective cure of disease. It is verified the need of adopting effective treatment with the objective of promoting the
patient health.
061
PRIMARY PREVENTION AND EARLY DETECTION OF ARTERIAL HYPERTENSION IN HIGH SCHOOL
STUDENTS RESIDENTS IN ALFENAS-MG
ANALI DUARTE ORTIGOSO CARBI1, ELIS FERREIRA SOUZA1, MÁRCIA HELENA MIRANDA CARDOSO
PODESTÁ2, OLINDA MARIA GOMES DA COSTA VILAS BOAS2, WALNÉIA APARECIDA DE SOUZA2, ERIC
BATISTA FERREIRA3
1
Universidade Federal de Alfenas-MG, 2 Departamento de Farmácia da UNIFAL-MG, 3 Instituto de Ciências Exatas da
UNIFAL-MG
Hypertension represents one of the main public health problems since it affects various population groups. It is a
chronic condition with multifactorial causes that manifest silently, so it is essential identify the risk factors associated to
high blood pressure levels, especially in younger population, in order to intervene early on them and minimize future
heart disease. Hypertension is closely related to genetic and environment factors and, when it occurs during long
periods, causes lesions in the arteries walls of the brain, heart, kidney and retina, resulting in acceleration of
atherosclerosis and increasing the probability of occurrence of angina and myocardial infarction. Primary prevention
will be more effective and will have higher impact if conducted at an age range in which the disease prevalence is not
complete. The aim of this study was determinate the prevalence of arterial hypertension, associated to cardiovascular
risk factors, in teenagers between 14 to 19 years old, high school students and residents in Alfenas, MG. The
methodology was performed by periodics measurements of blood pressure, height and body weight, abdominal
circumference and body mass index calculation. Besides that, questionnaries were applied to relate the results obtained
with lifestyle and social-economic conditions to each individual. Thereby, it was noticed that 21.96% of the evaluated
teenagers have arterial hypertension and 9.46% are classified as borderline arterial pressure carriers. Therefore, it was
concluded that is necessary to clarify to the teenagers the importance of a healthy nutrition and regular physical activity,
and how these influence the arterial pressure, in order to change their lifestyle and be multipliers of information on their
familiar and social environment.
062
RETENTION OF ANTIMICROBIAL PRESCRIBING: ENSURES THE SAFETY OF THE HEALTH
SYSTEM. AND THE PACIENT?
LIZIENE DE SOUZA ARRUDA, DEBORAH MARQUES DA SILVA, VIVIAN DA SILVA FURTADO,
ELISANGELA DE ASSIS FERREIRA, FERNANDA MIRANDA DE ARAÚJO.
The use and inappropriate prescriptions of antibiotics have been instrumental in increasing rates of antimicrobial
resistance. The National Agency for Sanitary Surveillance (ANVISA) issued the Resolution No. 44, October 26, 2010,
regulating the sale of antibiotics only with the retention of prescriptions submitted in duplicate. The objective is to
analyze antibiotic prescriptions dispensed at a pharmacy in the city of Rio de Janeiro, in accordance with Resolution
No. 44/10. We analyzed 336 antibiotic prescriptions dispensed in the period from November 28, 2010 to February 28,
2011. Then they were selected according to the following criteria for the analysis: Model requirements (single and
special control), duration of treatment constant in prescriptions, dosage and quantity sufficient for treatment. The results
obtained in november/2010 were: a) special control prescriptions (45%), b) simple recipes (55%). In December/2010:
a) prescriptions for special controls (61.9%), b) simple recipes (38.1%). In january/2011: a) prescriptions for special
controls (69.4%), b) simple recipes (30.6%). In february/2011: a) prescriptions for special controls (63.5%), b) simple
recipes (36.5%). Regarding the duration of treatment prescribed in recipes: in november/10 (70%), December/2010
(79.4%), january/11 (82.7%) and february/11 (79.4%). As to the data related to the prescribed dosage prescriptions:
november/10 (10%), December/2010 (96.8%), january/11 (99%) and february/11 (95.2%). When compared to the
required quantity dispensed with, we find the following scenario: november/10: sufficient (55%), left (35%) and
absence (10%); december/10: sufficient (46.5%) , left (40.6%) and absence (12.9%); january/11: sufficient (45.9%), left
(22.4%) and absence (31.6%); february/11: sufficient (34.9%), left (39.7%) and absence (25.4%). We conclude that it is
not enough to retain the right prescription for the dispensing of antibiotics. Regulatory measures are needed to ensure:
the rational use of antimicrobials, the disposal of household medicines and prescriptions containing treatment time and
dosage for the antimicrobial treatment.
063
ROLE PLAYING (TRIAD: PHARMACIST-PATIENT-OBSERVER): A STRATEGY FOR DEVELOPING
PHARMACISTS’ COMMUNICATION SKILLS
LIANA SILVEIRA ADRIANO1, ANDRÉA CASTRO PORTO1, LAÍS GONÇALVES ROLIM1, NIRLA RODRIGUES
ROMERO1, MARTA MARIA DE FRANÇA FONTELES1
1
Departamento de Farmácia, Universidade Federal do Ceará (DEFA/UFC)
The practice of Pharmaceutical Care (PC) requires development of communication skills in order to improve the
relationship between pharmacist and patient. In this context, this study aimed to describe and analyze aspects of
communication skills obtained while using role play (triad: pharmacist-patient-observer). It was utilized in pharmacy
undergraduate students as part of the PC program at the Federal University of Ceará, Brazil. In March 2011, the
students were divided into groups each with three members (triads). Each group received a problem –
situation/scenario, a prescription and a check list sheet with parameters for analyzing the communication skill between
the pharmacist and patient. This was graded as Great, Good, Fair or Poor. The scenarios involved an interview
conducted according to the Dader method at the time of first dispensing of medicines in community pharmacy and
ambulatory care. Patient types included those with hypertension (pregnant and elderly) and young patients with asthma.
The students took turns in the roles of: patient (who presents prescription); pharmacist (who conducts the
interview/dispensing); observer (who evaluates the interview through the check list). Each cycle of role playing lasted
around 10min. Photographs of this training will be provided during the presentation. From the check list sheet (n = 39),
it was observed that the main parameters classified as Fair and Poor were ‘service offering of PC’(38,5%),
‘transmission of further information’ (41%), ‘checking the patient's understanding through feedback and counseling
provided’ (25,6%) and availability for further contact (38,5%). Based on the difficulties observed, activities may be
undertaken to improve cognitive aspects, attitude and skills applied to the practice of PC. Financial support: UFC.
064
SAFETY ASSESSMENT OF MEDICAL PRESCRIPTIONS FOR ELDERLY IN LONG-TERM CARE
INGRID STEPHANIE STEIN AMBIEL, LUANA ORLANDELLI NANCI, FABIANA ROSSI VARALLO, PATRICIA
DE CARVALHO MASTROIANNI
Universidade Estadual Paulista “Julio de Mesquita Filho”, Campus de Araraquara
Aging process is characterized by physiological alterations, which can promote changes in pharmacokinetics and
pharmacodynamics parameters. Therefore, several drugs or classes of drugs are considered potentially inappropriate
(PIM) for elderly. The present study aimed to: estimate the prevalence of elderly who take PIM; identify the PIM taken,
the potentially hazardous drug interactions (PHDI) and the risk factors for the prescription of PIM; as well as evaluate
the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. A cross-sectional
study was performed in a public long-term care in Sao Paulo State, between December/2010 and January/2011. The
medical records of the patients ≥60 years old who took any drugs were consulted to assess the pharmacotherapeutic
safety of the medical prescriptions, in order to identify PIM and PHDI, according to the Beers (2003) and World Health
Organization criteria (2004), respectively. PI consisted of a guidance letter to the doctor responsible for the institution,
with suggestions of safer equivalent therapeutics. 88.1% of elderly took at least one drug. Of them, 29.2% had PIM in
their prescription, being the most prevalent the diazepam. Most PIM identified (53.4%) act on the central nervous
system and 50.0% are essential medicines, according to RENAME 2010. Among the 13 DI detected, 46.1% are
considered PHDI. Polypharmacy was detected as a risk factor for PIM prescription. After the PI no one suggestion was
adopted. The quality of medical prescription for elderly residents in long-term care is questionable, once approximately
1/3 of patients had taken PIM and PHDI. PI had no impact, once non-adherence to the suggestions of safer therapeutic
equivalents occurred due to the drugs proposed are not available in public health services. Assessment of medical
prescriptions should be prioritized for elderly who use polypharmacy and psychotropic drugs, since they could be
considered risk factors for medication errors (PIM prescription) and negative outcomes associated with medicines.
065
STUDY ON USE OF ORAL ANTIDIABETICS IN MUNICIPAL HEALTH SERVICE OF RIBEIRÃO PRETO SP, BRAZIL, FROM 2005 TO 2009
FRANCINE VIEIRA ANTUNES1, TAÍS NADER CHRYSOSTOMO1, LÚCIA H. T. R. PEREIRA2, CLÁUDIA S.
VASSIMON2, REGINA CÉLIA GARCIA ANDRADE1
1
Faculdade de Ciências Farmacêuticas de Ribeirão Preto – USP; 2Secretaria Municipal de Saúde de Ribeirão Preto
At the last decades, there were being expressive changes in the profile of diseases due to the world population aging.
Because of that, chronic diseases, like Diabetes, have been received great attention and the consumption of classes of
drugs whish treat this pathology have increased and DDD is an important tool to measure this increase. The Defined
Daily Dose (DDD) is a measure of comparison that represents the average daily dose of each drug in its primary
indication. This pharmacoepidemiological study aims to understand the consumption profiles of oral antidiabetic drugs
dispensed to the population who uses the Health Care System of Ribeirao Preto in the period from 2005 to 2009. This is
a retrospective longitudinal study using secondary data analysis of drug standardized by the Division of Pharmacy and
Diagnostics Support of the Municipal Health Department of Ribeirão Preto (MHD-RP). There has been analyzed three
medications: metformin 500mg, glibenclamide 5mg and gliclazide 5mg and data were expressed as mean and DDD.
The Metformin consumption at the period of the study increased 2.64 times, from 7.30 DDD/1000 inhabitants/day to
19.28. While that glibenclamide ranged from 9.88 to 14.07 DDD/1000 inhabitants/day, which represents an increase of
1.4. Gliclazide also features low power of consumption and although increased the consumption during the study
period, did not reach a unit at the measure scale. Thus, the growing consumption of oral antidiabetics in the MHD-RP
can be partly explained by the increasing prevalence of DM2 in Ribeirão Preto, SP, Brazil, which ranged from 12.1% in
1998 to 15.0% in 2006.
Financial support: PIC-USP-Santander
066
TELEPHARMACY: PHARMACEUTICAL CARE IN REMOTE AREAS OF THE BRAZILIAN AMAZON
RAIN FOREST
FLAVIA NATHIELY SILVEIRA FACHEL1,2, RICARDO BERTOGLIO CARDOSO1,2, HELENA WILLHELM
OLIVEIRA1,2, THAIS RUSSOMANO1,2, MARLISE ARAÚJO DOS SANTOS1,2
1
Pontifícia Universidade Católica do Rio Grande do Sul, PUCRS; 2Centro de Microgravidade, FENG/PUCRS
The continental dimensions of the Brazilian territory often means there is a lack of direct access to expert health
services in remote communities. Telepharmacy, one of the areas of Telemedicine, allows health teams and patients to
have virtual contact with remote pharmacists, improving healthcare quality in rural and remote locations. The
Telemedicine Laboratory of the Microgravity Centre/FENG at PUCRS University coordinates eHealth projects aimed
at making available specialized assistance to remote communities. The objective of this project was to facilitate the
provision of pharmaceutical care within the Manaus region of Brazil, via Telepharmacy. A multidisciplinary group of
students, professors and health professionals was assembled and divided into two working teams. Group A travelled to
remote communities in order to interview patients, acquire data and transmit it to Group B. Group B were responsible
for ensuring the technical maintenance of tools and the analysis of all received data. A total of 111 patients were
interviewed. 45 patients (40.5%) were taking no medication of any kind and 66 patients (59.5%) were taking either a
medication and/or medicinal plant, of which 29 (43.9%) were taking more than one. Of those, 5 (17.2%) had drug
interaction problems. Among the 66 patients, 2 (3%) had some level of drug adverse effect and 32 (48.5%) had
pharmacotherapy interventions suggested. The importance of pharmaceutical assistance through Telepharmacy in order
to enable an adequate orientation and follow up of pharmacotherapies is clear, improving the efficiency and quality
control of patient care.
067
THE HEALTH CARE FOR SICKLE CELL DISEASE: A LITERATURE REVIEW
JEAN LEANDRO DOS SANTOS1; MARIANA MOREIRA DE LIMA1; VANESSA FERNANDES DOS SANTOS1;
MARCELA MARQUES1; STEFANIA VESPOLI1 ; SUELLEN SUSAN DE GODOY MARANE1 ; KARINA
PEREIRA BARBIERI1
1
NAF – Núcleo de Atenção Farmacêutica - Universidade Estadual Paulista – Faculdade de Ciências Farmacêuticas –
Araraquara.
The treatment of Sickle Cell Disease (SCD) by patients present many problems come from the lack of disease
knowledge and inadequate use of available medicines. Strategies that promote the appropriate drug use and monitoring
of SCD patients are urgent to improve the quality of life. This work aims to evaluate the researches performed with
Health Care in Sickle Cell Disease in the literature in order to rethink more adequate methods to follow its patients.
This research is a descriptive study based on a retrospective analysis of the literature using the databases available by
CAPES-Brazil. It was found in 67 articles in CAPES portal periodicals on the topic "health care in sickle cell anemia".
Of these, the majority of them (31%) involved children care. The most researched topic was the perception of patients
relating to health service (30%0 and the symptoms treatment (13%) being the pain represented the mostly related
researches (10%). Other topics covered were: diagnosis (7.4%), treatment (4.4%), genetic counseling (4.5%), public
health policies (1.5%), and psychological aspects of patients (15%) between others. Since 1983, the average of
publication is 2.3 papers / year on the subject “health care in sickle cell disease” and only two papers published in
English were held in Brazil. No work involving pharmaceutical care was found. This study demonstrates the need to
intensify efforts to develop specific care to patients with sickle cell disease that may include actions involving the
pharmaceutical care mainly those related to health education.
Financial Support: MEC.
068
THE USE OF BENZODIAZEPINES IN THE ELDERLY IN A FAMILY HEALTH STRATEGY
MARCOS LUCIANO PIMENTA PINHEIRO1, ALEX ROGÉRIO DAS CHAGAS1, PAULO CELSO PRADO
TELLES FILHO1.
1
Universidade Federal dos Vales do Jequitinhonha e Mucuri, UFVJM.
Benzodiazepines are drugs that may cause risks to the elderly. The purpose of this study was to verify and analyze the
prevalence of the use of benzodiazepines among elderly patients enrolled in a Family Health Strategy in Diamantina,
Minas Gerais, Brazil. This descriptive study was performed with 27 elderly individuals, from May to July 2010, using a
semi-structured questionnaire. A descriptive analysis of the data was performed. Results show that most participants
were between 71 and 75 years old (25.92%), female (88.88%) and had incomplete primary education (66.66%). The
most common drugs were: Diazepam (37.03%), Clonazepam (25.92%), Bromazepam (18.51%) and Alprazolam
(11.11%). Of all participants, 88.90% had prescriptions for their medication and 11.10% did not. Among those with
prescriptions, 33.33% did not comply with recommendations. There is a need to reorganize the working process at the
studied institution to promote an adaptation of the prescriptions and a more effective compliance.
069
THE USE OF GENOGRAM AS AN INSTRUMENT FOR UNDERSTANDING THE HEALTH/ILLNESS
PROCESS IN FAMILY DYNAMICS
LÍLIA DE OLIVEIRA MONTEIRO1, LUANA AMARAL PEDROSO1, OLINDA MARIA GOMES DA COSTA
VILAS BOAS2, WALNÉIA APARECIDA DE SOUZA2, MÁRCIA HELENA MIRANDA CARDOSO PODESTÁ2
1
Academic of Graduation Course in Pharmacy, Universidade Federal de Alfenas-MG.
Pharmaceutical Sciences, Universidade Federal de Alfenas-MG.
2
Adjunt Professor of
To know the relationship that develop within a familiar context, the determined genetic conditions and the factors that
interfere in the health/illness process are of great importance in the work of health professionals. The Family Genogram
is an instrument for the comprehension of that process. This study had as objective depict the experience of the use of
this as instrument and evaluate its effectiveness. 70 genograms were evaluated, they have been made by two groups of
academics of the 6th period from the Pharmacy course of UNIFAL-MG, which worked as interns at Public Health
System during the year of 2010. The genograms made in the first semester of 2010, when the instrument was used by
the first time, were compared with the ones made in the second semester. The genograms without enough information
(n=45) were remade through in home family visits. From the 70 families visited, most of the interviewed were female
(78,6%), age ranging from 61 to 80 years old. There was a significant percentage of illiterate patients (30%). It has been
made 32 (73%) and 13 (50%) genograms, on the first and second semesters respectively. Most of the genograms
repeated were concentrated in poorer districts of Alfenas, as Pinheirinho neighborhood, where 92% of them were
remade. The genogram is an instrument of simple construction and interpretation, however this study found that age,
education level and socioeconomic conditions are factors that can interfere with the correct construction.
070
THEORETICAL POTENTIAL DRUG INTERACTIONS EVALUATION IN A HOSPITAL SPECIALIZED IN
WOMEN'S HEALTH
,
,
1,
ALINE CRUZ1 JARBAS BERNARDINO1 VIVIANE LUCIA BERALDO NICE MARIA OLIVEIRA SILVA2,
ADÉLIA CORINA ALVES BERNARDES2; ANA ELISA RIBEIRO SILVA2; ROBERTA PARO CARVALHO2,
PRISCILA GAVA MAZZOLA1.
1 Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, UNICAMP, 2 Pharmacy
Service, Hospital da Mulher Prof. Dr. José A. Pinotti (CAISM), UNICAMP.
Potential drug interactions (PDI) are an important factor to be considered during the drug treatment of any patient,
because they can significantly interfere with the outcome. Amongst the parameters that influence the prevalence of PDI
in medical prescriptions, stand out polypharmacy, patient age and the period that it remained hospitalized. The aim of
this study was to evaluate these parameters in prescriptions for patients treated in 3 inpatient units at Women's Hospital
Professor Dr. Jose Aristodemo Pinotti, to trace their profiles on the Theoretical Potential Drug Interactions (TPDI),
which could be predictable and described in the literature. The research was approved by the Research Ethics
Committee of the Faculty of Medical Sciences of the State University of Campinas (nº 1232/2010). During three
months every electronic prescriptions were assessed by subjecting them to the interactive system DrugReax System ™,
which is part of the Thomson Micromedex. A total of 2997 prescriptions were evaluated, the prevalence of TPDI major
or contraindicated in prescriptions was 51.2%. It was observed that 39.2% of patients had at least one TPDI in the
prescriptions during the hospitalization period. It was observed that the average TPDI in prescriptions increases
progressively according to the number of hospitalization days, number of prescribed medications and patients' age. The
main drugs involved in major and contraindicated TPDI identified were Amitriptyline, Metoclopramide and
Midazolam. The TPDI identified in this work are theoretical and have not been verified whether they actually occurred.
For greater patient safety it is necessary that the pharmacist to monitor and to watch out for PDI, at the first sign of its
occurrence, proper management must be done in order to preserve patient health and ensure success of
pharmacotherapy.
Financial support: CNPQ; SAE/UNICAMP
071
THERAPEUTIC GROUP FOR TOBACCO SMOKERS IN THE CITY OF ALFENAS - MG
MARCELO JOSÉ DIAS SILVA1, GISELLY GIANINI PELEGRINI2, KÁTIA REJANE RODRIGUES3, MARIA RITA
ALVES BARBOSA DE PAIVA1, RENATA CUNHA RESENDE1, MÁRCIA HELENA MIRANDA CARDOSO
PODESTA1, WALNÉIA APARECIDA DE SOUZA1
1
Universidade Federal de Alfenas- MG; 2SMS Head of Office, Alfenas-MG; 3Pulmonologist.
Tobacco smoking is now known as an addiction that exposes the individual to numerous toxic substances. The
Municipal Health Department of Alfenas, through the Family Health Program (FHP) and the Clinic Dr. Plínio do Prado
Coutinho develop many activities in pursuit of tobacco control and intend to reduce the number of smokers among the
FHP patients and employees of the Alfenas City Hall. It has been applied the Program “Stopping Smoking Without
Mysteries” that use cognitive-behavioral approach associated to drug therapy, which is under responsibility of the
pharmacist. There are four weekly sessions with specific themes. After the first four sessions, other non arranged
meetings are scheduled, aiming to prevent relapse. The program began in August 2009, with seven City Hall
employees, and of these, four did not smoke at the time of the fourth session. In October a second group began with
five participants and of these four did not smoke at the time of the fourth session. In 2010, there was participation of 69
patients of some FHP. Most of the patients, with mean age of 45,63±1,74 years old, came to the program spontaneously
(72%) and 28% were referred by a physician. Almost all patients (95%) were in action stage regarding the motivation to
stop smoking. Drug was indicated to 90.91% of the patients, and of these, 81.82% were not smoking at the fourth
session. The support groups serve the purpose of surpass obstacles to the cessation of smoking. The proposal to assist
the employees of an institution and patients of FHP to stop smoking is a challenge, requiring availability and creativity
of professionals involved.
072
UNINTENDED PREGNANCIES: USE OF ORAL CONTRACEPTIVES WITH AMOXICILLIN
MILENA BORGES1, TAIS N.CHRYSOSTOMO1, REBECA O. L. SILVA1, LÚCIA H.T.R.PEREIRA2, CLÁUDIA
S.VASSIMON2, REGINA CÉLIA G. ANDRADE1
1
Faculdade de Ciências Farmacêuticas de Ribeirão Preto - USP; 2Secretaria Municipal de Saúde de Ribeirão Preto
Currently, about a hundred million women worldwide are taking oral contraceptives (OC), and this reversible
contraception method is the most effectively one. However, the simultaneous use of this method of prevention with
other drugs, including antibiotics (AB), can affect its effectiveness. The aim of this study was to estimate the exposure
to risk of unintended pregnancy in users of the Brazilian Health Care System in Ribeirão Preto, because of the
concomitant use of oral contraceptives and amoxicillin. Data from exposure to unwanted pregnancy in women in their
childbearing (10-49 years) were obtained from the computerized system "Hygia" of the Municipal Health Department
of Ribeirão Preto (MHD-RP) and analyzed according to age, seasonality and district area of health. Of the total of
14,262 women using oral contraceptives, 1,443 (10.1%) used amoxicillin concurrently at least once during the study
period (April/2008 to March/2010). The average age of these women was 26.6 years and 52.0% were between 20 and
29. The North District had a higher rate of concurrent cases (39.0%). Moreover, there was a seasonal pattern, since the
fall and winter had higher intake of amoxicillin among women who used oral contraceptives. In order to promote
greater safety and quality in the prevention of unplanned pregnancy, it is evident the need for educational action to
advice women and health professionals about this risk. For this, it must be stressed to patients the importance of using
other contraceptive methods when OC and AB are administered concomitantly.
073
UNIVERSITY EXTENSION PROGRAM: EDUCATION ABOUT DE CORRECT USE OF MEDICINES
RUTINÉIA DE FÁTIMA MICHELETTO1, MÁRCIA MENDES RUIZ CANTANO2, TAÍS
CHRYSOSTOMO2, DEISY MONTORO BERTOLUCCI2, REGINA CÉLIA GARCIA DE ANDRADE2
NADER
1
Faculdade de Medicina de Ribeirão Preto, FMRP-USP; 2Faculdade de Ciências Farmacêutica de Ribeirão Preto,
FCFRP-USP
The Socio-Cultural Assistance Program of Students of Pharmacy in Faculty of Pharmaceutical Sciences of Ribeirão
Preto at University of São Paulo was established in 2004 and is attracting students of pharmacy for social education,
through the application of their learning in a real context. This program allows understanding the role of the pharmacist
as a promoter agent of health in the community. The aim is to bring undergraduates students scientific and technical
knowledge for teenagers from poor communities and transmit it to them in a clear and simple language, using dynamic
tools. To this end, workshops about correct use of medicines were held to adolescents aged between 11 to 15 years old,
who are attended at the Center for Assistance to Children and Adolescents "Adão do Carmo Leonel" of the Department
of Social Services of Ribeirao Preto, SP, Brazil. The first workshop was engaged in the production of a poster with
different places in a residence where drugs are usually stored and teenagers had to identify them as appropriate or not.
Another poster had drud in different forms and shapes, mixed with sweets and candies with similar formats and
teenagers had to choose which of them were drugs. Another activity on the same theme was the presentation of a
packing of medicine with all items required, to explain information contained in each. At the last workshop was held a
theater that had dispensation common situations, such as an expired or forged prescription, drug interactions, antibiotic
use and dispensing for children. This program is an important encouragement for the undergraduates students because
enhances their communication with the population, preparing them to practice as professionals as well as providing
greater knowledge for the community, that reduces the harm caused by misuse of drugs.
Financial support: Programa “Aprender com Cultura e Extensão” – Pró- Reitoria de Cultura e Extensão -USP
074
USE OF PACKAGE INSERTS FOR MEDICINES MANIPULATED IN THE SCHOOL PHARMACY FROM
UNIVERSIDADE FEDERAL DO PARANÁ (UFPR)
VITOR AUGUSTO TEVES DE BORTOLI SANTOS1, CHRISTIANE DE CÁSSIA LIMA1, KARINA KONELL1,
JOSIANE DE FÁTIMA GÁSPARI DIAS1, CAMILA KLOCKER COSTA1 E GISLENE MARI FUJIWARA1
1
Universidade Federal do Paraná, UFPR
The action of dispensing medicines should be come with fast and important orientations for the beginning or
continuation of a pharmacotherapeutic treatment. However, in elapsing of the treatment it is common the forgetfulness
of the information reviewed by the doctor or by the pharmacist, could appear relative doubts to the medicine and the
possible adverse reactions. In those cases, the patient falls back on the package inserts when he is making use of
industrialized medicines. Nevertheless, when taking into consideration the compounding medicines, users are forced to
look for an answer in other means, which often presents incorrect information. In this context, the School Pharmacy
from UFPR has elaborated package inserts for the compounding medicines commonly dispensed in the pharmacy, using
specific literature. They are simple package inserts, easy understanding, with language and letter size accessible to
users. The described topics are adapted from the standard model of package inserts defined by national legislation RDC
nº 47/09, from Agência Nacional de Vigilância Sanitária (ANVISA), containing indication, dosage, against indications,
medicines interactions, conditions that demand evaluation of risks and benefits, adverse effects and other important
considerations. The development of those package inserts intended to improve the pharmaceutical assistance and
orientation in compounding pharmacies, because they are made available along with compounding medicines.
075
WORKSHOP ON HEALTH CARE FOR TEENAGERS BY STUDENTS OF BIOCHEMISTRY PHARMACY
RUTINÉIA DE FÁTIMA MICHELETTO1, MÁRCIA MENDES RUIZ CANTANO2, TAÍS
CHRYSOSTOMO2, DEISY MONTORO BERTOLUCCI2, REGINA CÉLIA GARCIA DE ANDRADE2
NADER
1
Faculdade de Medicina de Ribeirão Preto, FMRP-USP; 2Faculdade de Ciências Farmacêutica de Ribeirão Preto,
FCFRP-USP
Adolescence is a stage in life that information about health are needed, to build a healthy profile for adult life, and, for
that, there are some strategies that are essential for the transmission and access of effective information to this
population. With the goal of bringing knowledge to the community, students of Socio-Cultural Assistance Program of
Students of Pharmacy in Faculty of Pharmaceutical Sciences of Ribeirão Preto at University of São Paulo, developed
activities which were capable of conveying information about health to society, and, at the same time, improving their
own communication skills. For that, workshops about health were held for 20 teenagers at the Center for Assistance to
Children and Adolescents "Adão de Carmo Leonel “of the Department of Social Services of Ribeirao Preto, SP, Brazil.
The activities addressed topics on nutrition, hygiene, mental health and prevention of diseases like dengue fever,
intestinal worms, mouth diseases, diabetes, hypertension and obesity. For the workshop were used technique of hand
washing and relaxation, food pyramid, and theaters, dynamic groups and studies of case. These activities gave greater
health knowledge for teenagers and improved learning about language skills and communication for the students in
pharmacy.
Financial support: Programa “Aprender com Cultura e Extensão” – Pró- Reitoria de Cultura e Extensão -USP
076
WORKSHOPS OF PHARMACEUTICAL CARE IN THE MUNICIPALITIES OF MINAS GERAIS: THE
IMPORTANCE FOR STREAMLING THE SCHEDULING OF MEDICINES
ALESSANDRA CAROLINE DOMINGOS DE FIGUEIREDO1; KATHIAJA MIRANDA SOUZA1; MARINA
MORGADO GARCIA1; EUNICE GERMANO VILLELA1.
1
Secretaria de Estado de Saúde– SES-MG, Superintendência de Assistência Farmacêutica –SAF/SES
Since 2010 all the municipalities of Minas Gerais, Brazil began to perform the scheduling of medicines purchased by
the Basic Component SES-MG, through an informatized system of management from the State Pharmaceutical
Assistance, SIGAF. Computer´s programming has allowed better monitoring from applications to the drugs by SAF. It
was noted that many counties conducted the lineup in an irrational way, without taking into account the real demand
and local epidemiological reality, generating an impact on planning for SES MG, affecting the supply and distribution
of medicines. In order to guide the conduct of a rational programming, avoiding loss of drugs in stock, shortages and
explaining the importance of using SIGAF as a tool to support pharmaceutical care, SAF has organized a project
orientation and awareness among health professionals from mining municipalities. It was conducted by pharmaceuticals
from SAF, workshops with the attendence of pharmaceuticals from the municipalities. The workshop has promoted
guidance on how to perform rational drug program and its importance. The use of SIGAF as a tool for management of
pharmaceutical care was also addressed in the workshops. Participation in the workshops led to better understanding the
municipalities in relation to drug programs offered by the SES, mostly for the strategic component. The pharmacist had
the opportunity to actually be inserted into the care of patients enrolled in these programs from the programming to the
dispensation of medication. The SIGAF has proven to be an effective tool in obtaining data that can serve as a basis for
rational planning, and enable more timely and monitoring applications.
077
CEFAL - CETER OF PHARMACOVIGILACE OF THE UIFAL-MG: TWO YEARS OF EXPERIECE
SAMIR ANTONIO RODRIGUES ABJAUDE, ARIANE BARBOZA ZANETTI, EVANDRO COUTI MALAGUTI,
NICOLE RODRIGUES DA SILVA, THAÍS BAPTISTELLA FELIPE, VANESSA SOUZA REIS, VICTOR DOUGLAS
SANTOS AGUILAR, LUCIENE ALVES MOREIRA MARQUES, RICARDO RADIGHIERI RASCADO
University of Alfenas, UNIFAL-MG; Faculty of Pharmaceutical Sciences.
Pharmacovigilance (PV) is defined as the science of detection, assessment, understanding and prevention of adverse
effects or drug related problems. To contribute to the health of the population and promote Rational Drug Use (RDU)
was established CEFAL, whose specific objectives are: to provide academic information in the area of PV; guide
children as RDU; offer students a most important area of research and training of health professionals to make
notifications in PV, and create a Program Notification Adverse Drug Reactions and technical defects, contributing to
ANVISA. We created forms of notification, the website and e-mail within the site UNIFAL-MG, flyers to advertise the
project, preparation of periodic newsletters and alerts. Training was conducted of the technical staff of the Pharmacy
School (UNIFAL-MG) and scholars CEFAL; and lectures at the institution and interested organizations to promote the
importance of communications in the PV. The receipt of voluntary reporting and analysis of reports, preparation of the
response letter to the notifier and routing notifications to ANVISA. Discussion of articles and information about the PV.
The CEFAL lectured to 450 students and 170 children, 10 developed scientific researches received a total of 48 reports
analyzed 38% adverse reaction, and 62% are technical defects. Certainly, the headache has played its role as a promoter
of the shares in VF in universities and aims to work to spread knowledge about rational drug to all academics and health
professionals Alfenas - MG and region. This study demonstrates the necessity of notifications in VF to ensure that
marketed drugs do not cause harm to human health.
Financial support: Probext (Programme of Grants an Extension Project).
078
CLOSE UP NO ONE IS NORMAL: PHARMACEUTICAL CARE FOR PEOPLE WITH MENTAL
DISORDERS
GABRIEL TAVARES DO VALE1, VANESSA SOUZA REIS1, RAFAEL ALVES MOURA1, ANA ELISA PEREIRA
VALIAS BRUZIGUES1, ELIS FERREIRA SOUZA1, HENRIQUE DIPE DE FARIA1, NAYARA RAGI BALDONI2,
TANIA MARA RODRIGUES SIMÕES2, LUCIENE ALVES MOREIRA MARQUES1
1
Faculdade de Ciências Farmacêuticas UNIFAL – MG,
2
Faculdade de Nutrição UNIFAL-MG
Therapeutic Residential Service (STR) is based on homes that supply housing needs for people with severe mental
disorders, and no home support. The goal of the project is to evaluate the pharmacotherapeutic profile, blood glucose
and pressure of the SRT users, and offer some pharmacotherapeutic advice to improve their quality of life. The group
made home visits, checked blood pressure and glucose, and talked with the caregivers. We analyzed medicine storage
and, finally, applied a questionnaire for the collection of the following data: medication history, date of birth,
socioeconomic data, and laboratory test results. The Afenas SRT has eight residences that support patients with mental
disorders. We have currently completed these visits and attended a total of 60 users. Blood pressure and capillary blood
glucose were measured during the visits. These practices were carried out only with users who accepted the assessment.
Based on the results, we observed that 5.5% of the patients had high blood pressure (over 130/90 mmHg), and 8.3%
refused the tests. None of the patients tested had glucose values above 140 mg/dL. Approximately 28% of the residents
refused the glucose test. The patients use psychoactive drugs, and it is common knowledge that many of these drugs
have significant adverse effects, some of them related to metabolic syndrome (MS), which increase the risk of
developing cardiovascular diseases. Association between the metabolic syndrome and mental illness is explained by a
multifactor cause, which not only involves drug treatment and others factors, but also patient lifestyle. One of the
solutions to improve the situation of patients with psychiatric disorders is to conduct studies that can improve the
quality of pharmaceutical care.
Financial support: PROBEXT-UNIFAL
079
DRUG THERAPY PROBLEMS IN A NURSING HOME FACILITY
MARIANA MARTINS GONZAGA DO NASCIMENTO; MARIANA LINHARES PEREIRA; CARLOS ALAN
CANDIDO DIAS JÚNIOR; BRUNA ASSIS VIANA; FABIANE CRISTINA COSTA; DANIELLY BOTELHO
SOARES; RINALDO EDUARDO MACHADO OLIVEIRA; MARINA MENDES OLIVEIRA.
Federal University of São João Del-Rei (UFSJ)
The elderly population is growing rapidly, and represents today 10% of Brazilian total population. This demographic
alteration is due to the rise of life expectancy, and epidemiologic transition, which involves the reduction on the
incidence of infectious and parasitary diseases and the increase of chronic degenerative diseases prevalence, typical of
the elderly and related to their physiopathologic changes. These developments on the demographic and epidemiologic
profile of the nation, cause a swelling on the health demand for specialized services for the elderly (like nursing homes
- NH), and for drugs. The high drug consumption among elderly patients is commonly associated to the incidence of
Drug Therapy Problems (DTP) that put their health at risk. Taking this into consideration, this observational study was
carried in a NH of Divinopolis, MG-Brazil. All the drug prescriptions of the institution were reviewed to identify
potential DTP which were accounted when the following problems were detected: (1) therapeutic duplicity (TD), which
is the prescription of two drugs with the same Anatomical-Therapeutic-Chemical classification; (2) sub-dose or overdose; (3) Potentially Inappropriate Medication (PIM) according to the Beers Criteria; and (4) drug-drug or food-drug
interactions. The DTP identified were classified by the PWDT method. 44 prescriptions of 44 elderly were reviewed
(100%), and 17 TD, 18 sub-dosage, 1 over-dosage, 20 PIM, 52 drug-drug and 10 food-drug interactions were identified,
corresponding to 118 potential DTP (2,7 DTP/elderly). After their classification, the most commonly identified DTP
involved the drug indication (36 DTP1 – unnecessary drug) and effectiveness (36 DTP4 – low dosage), followed by
safety DTP (28 DTP5 – Adverse drug reaction/ 17 DTP6 – high dosage). Despite not evaluating clinical results of the
drug therapy, the high number of potential DTP detected traces a very intricate scenario and indicates the existence of a
low level pharmacotherapy prescribed to the nursing home residents. It shows the need of the pharmacist work towards
elderly drug therapy upgrade not only by direct clinic action but also as a knowledge forecaster to improve geriatric
prescription’s quality in nursing homes.
080
EMOTIONAL FIRST AID: A DEMAND OF DEPRESSED PATIENTS IN THE PHARMACEUTICAL CARE.
LARA CRISTINA SILVA; LUCIENE ALVES MOREIRA MARQUES
Universidade Federal de Alfenas, UNIFAL-MG.
Depression is consistently (two weeks or longer) feel down or blue, and can change the way to feel, physical health and
appearance, social activities, and the ability to handle every day decisions and pressures. This disease includes
emotional problems and sometimes Pharmacists need to act as emotional first aid. The aim of this work is to present to
Pharmacist the person-centered therapy by psychologist Carl Rogers. This approach can contribute to prepare the
Pharmacist heart to these emotional demands of depressed patients. Carl Rogers based the person-centered therapy in
three inner attitudes: unconditional positive regard, empathy and congruence. This aids patients in finding their own
solutions to their problems. The therapist's role is that of a facilitator and to provide a therapeutic relationship. The first
attitude is unconditional positive regard. The therapist accepts the patient unconditionally, without judgment,
disapproval or approval. This facilitates increased self-regard in the patient, as they can begin to become aware of
experiences in which their view of self-worth was distorted by others. Empathy is an understanding of the patient's
internal frame of reference. It is necessary to try and to see their point of view even though you may not agree with it.
For example, to be empathic is the ability to put yourself in the place of another who is depressed over the death of a
pet cat, even though you hate cats. Other important attitude is the congruence or genuineness of the therapist within the
therapeutic relationship. The therapist is deeply involved him or herself - they are not "acting" - and they can draw on
their own experiences (self-disclosure) to facilitate the relationship. In Rogers’ words: “It is only by providing the
genuine reality which is in me, that the other person can successfully seek for the reality in him”. This approach offers
for patient the opportunity to explore difficult feelings. To be listened to in confidence, and accepted without prejudice,
it can alleviate general distress, despair and suicidal feelings. Often to be listened to is enough to help someone through
a time of distress. Even just showing that you are there for them, and that you know they are going through a
distressing time, can in itself be a comfort. This approach can contribute to prepare Pharmacist to manage emotional
demands of depressed patients.
081
EPIDEMIOLOGICAL PROFILE OF ASTHMATICS PATIENTS ASSISTED BY PROAICA IN A BASIC
HEALTH UNIT
BRENA MUNIZ CHAVES1,5, NAYARA OTAVIANO DINIZ1,5, CRISTIANE RODRIGUES DE SOUSA2, ARACI
DIÓGENES BRAGA2, LIVIA FALCÃO LIMA1,5, NADIR KHEIR3,5, DAVID WOODS4,5, ÂNGELA PONCIANO1,5,
HENRY PABLO REIS1,5, MARTA MARIA FONTELES1,5, LUZIA IZABEL MOREIRA DA SILVA1,5
1
Universidade Federal do Ceará(UFC); 2Centro de Assistência à Criança; 3Qatar University; 4Otago University; 5Centro
de Estudos em Atenção Farmacêutica(CEATENF)
Educational aspects are important to asthma control and take a part to pharmaceutical care practice. This study aimed to
delineate the epidemiological profile of patients with asthma linked to PROAICA (Program of integrated care for the
asthmatic child) in order to establish better planning of educational actions. The Center for Studies in Pharmaceutical
Care established a Pharmaceutical Care Unit (PCU) in the Child Care Center, Fortaleza-CE. Patients were recruited at
the time of medical consultation through referral to PCU, where they receive additional guidance on environmental
control measures, pharmacotherapy and about the correct use of inhaler devices. A total of 78 patients were followed up
during September 2010 to February 2011. A pharmacotherapeutic form was used to collect data from patients. A high
percentage of patients were male (66.7%, n=52), and had the mother as caregiver (74.4%, n=58). The age of patients
ranged from 4 to 18 years, with a mean of 12.5 years. With regard to severity, 70.6% of the patients had intermittent
27.4% mild persistent asthma and 2% moderate persistent asthma. Rhinitis was associated with asthma in 92.5% of
cases. Most patients (80.4%) had the first episode of asthma before one year of age. There were reports of absences
from school due to asthma attacks (15.4%, n=12) as well as to exercise intolerance (10.3%, n=8). During the follow up,
16% (n=13) of patients had adverse reactions to drugs. Our findings were able to guide the development of educational
interventions, according to characteristic and needs of population studied such as, to caregivers, talks about rhinitis and
asthma, folders about adverse reactions of drugs used and games to children and teenagers. Support: CNPq;Pró-Reitoria
de Extensão/UFC.
082
EVALUATION OF THE KNOWLEDGE, PROVISION AND APPLICABILITY OF PHARMACY SERVICES
IN SAO PAULO, BRAZIL
VANESSA RESCIA 1, GISELE BERTOLLI SUZUKI 1, ALESSANDRA MARA DA SILVEIRA CAPPELARO 1
1
Universidade Bandeirante de São Paulo - UNIBAN
Pharmaceutical care, a professional practice in the context of pharmaceutical assistance, is the responsible provision of
drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life. These outcomes are
cure of a disease; elimination or reduction of a patient's symptomatology; arresting or slowing of a disease process; or
preventing a disease or symptomatology. This process requires a clinical pharmacist to review a patient's medication
with reference to the doctor's diagnoses, laboratory tests and patient's information. The clinical pharmacist must
therefore work very closely with the doctor and patient in order to gain a correct understanding of the relevance and
impact of the various medications on the patient's pathology. According to RDC No. 44/2009 (ANVISA), in addition to
dispensing, the Pharmacies are requested to provide the following pharmacy services: Pharmaceutical care of the
establishment or delivery Pharmaceutical care, scouting physiological parameters (blood pressure and body
temperature), measurement of biochemical parameter (CBG), medication administration (injectables and inhalants).
Within this context, the objective of this study was to examine the practice of Pharmaceutical Services with a focus on
Pharmaceutical care, evaluating the knowledge, practice and the provision of such services. The methodology used was
research with 100 professional providers of Pharmacy Care in Pharmacies in the State of São Paulo, through
questionnaire. What can be observed was: 100% known pharmaceutical services, 71% obtained knowledge during the
graduation, 100% considered important to include this practice and about obstacles to the provision of services: 65%
think the short time available, 7% demonstrate low motivation and 29% to a low offer of courses on the subject as an
obstacle, but 57% believe that such services can generate an increase in the movement of the Pharmacies (marketing
strategy).
083
PHARMACEUTICAL ATTENTION ON CONGENITAL INFECTIOUS DISEASES
MARÍLIA REGINA SILVA MARQUES; SANDRA MARIA OLIVEIRA MORAIS VEIGA
Universidade Federal de Alfenas, Unifal-MG.
Whereas congenital infectious diseases (DIC) represent serious public health problems, this literature (books, articles
and scientific databases) aimed to support the pharmaceutical attention in DIC. Toxoplasmosis, rubella,
cytomegalovirus, syphilis, hepatitis B and C and HIV are the major DIC, and the degree of impairment depends on the
baby during pregnancy at which infection occurred. Moreover, the use of medicines during pregnancy also involves
risks, creating technical and ethical challenges. Rubella is a major cause of congenital anomalies, particularly in heart
and inner ear; Congenital syphilis can lead to miscarriage, stillbirth or perinatal death. Serology routine, early and late
pregnancy, and the correct treatment had reduced the number of babies with congenital syphilis, cytomegalovirus
infection can affect the fetal liver, congenital toxoplasmosis can affect the brain and vision, acute hepatitis occurs when
in the first trimester of pregnancy, the rate of transmission to the fetus is about 10% and 80% to 90% in the third
quarter, the administration of AZT (zidovudine) to HIV positive mothers from 14 weeks gestation, reduces the risk of
contamination of the fetus to less than 2%, genital herpes can be transmitted to the newborn in vaginal delivery.
Moreover, if any co-infection with HIV, the fetus can develop HSE. Reflection on the role of the pharmacist, a health
professionals more accessible to the population and the link between patient and physician. The pharmacist has close
relationships with their customers, so it should guide the mother on the prevention and control of DIC and warn them
about the importance of serology in antenatal care, previous vaccination against rubella and hepatitis B, and complete
schedule or tetanus booster. The pharmacist in the promotion, protection and restoration of health of mothers and
fetuses. Guides for the prevention of Sexually Transmitted Diseases; acts in the early diagnosis and appropriate
treatment of DIC, always evaluating the risk-benefit and ensuring adherence to treatment, and effectively contributes to
the reduction of various complications resulting from DIC.
084
PHARMACEUTICAL ATTENTION ON THE USE OF ORAL CONTRACEPTIVES
SABRINA CARVALHO QUEIROZ; SANDRA MARIA OLIVEIRA MORAIS VEIGA.
Universidade Federal de Alfenas, Unifal-MG.
Oral contraceptives (OCs) are used by more than 100 million women worldwide and represent one of the methods more
effectively. However, adverse effects, mild or serious, make them often contraindicated, and imply an abandonment or
discontinuance. Other problems are the frequent doubts regarding the use, menstrual cycle day pack should be started,
time management, what to do in case of forgetfulness and how to proceed if menstrual period after taking some pills.
This study was conducted with 32 women using oral contraceptives, clients of a drugstore in Brasilia, Brazil. The
project was approved by the ethics committee of Unifal-MG. We conducted interviews with the clients who agreed to
participate. Then they were instructed on the correct schedule of administration, potential drug interactions, problems
related to use of OCs and there was clarification of doubts. Found that oral contraceptive used by more study population
levonorgestrel (microvlar ®, Ciclo21 ®, Nordette ®). Improper use of oral contraceptives was observed by more than
half the women surveyed (56.25%), and reported: oblivion, administration at various times of day and wrong breaks
between packs. 71.9% of women were unaware of potential drug interactions related to OCs; We found that 43.7% of
clients interviewed had used emergency contraception. Yet we found abuse, or the replacement of the usual methods for
the same. Pharmaceutical care in the use of oral contraceptives is extremely important, concerns the sexual and
reproductive rights of women and promotes the proper use and aware of these medicines.
085
PHARMACEUTICAL CARE TO GERIATRIC PATIENTS IN OURO PRETO
BRUNNO SILVA BAYLAO, CRISTIANE DE PAULA REZENDE, ELZA CONCEIÇÃO DE OLIVEIRA
SEBASTIÃO
The safe and appropriate use of medicines is an essential element in maintaining quality of life of elderly. For this
achievement is feasible follow-up drug use, through which the pharmacist detects prevents and resolves problems
related to the use of Medicines (PRM) of a continuous, systematic and documented in collaboration with their
own patients and their healthcare team. The objective of this project, in existence since 2006 and interconnected to the
Elderly Program: Vitality and Citizenship, was to perform Pharmaceutical Care service in geriatrics, to delineate the
socio-population of research subjects to determine the most common PRM, intervene in a supporting role in the clinic
for other health professionals, with In order to improve pharmacotherapy and quality of life of patients. The data
collection instrument was a semi-structured questionnaire. Were Data on the drugs used and pharmacotherapeutic
history through consultation at the Center for Pharmaceutical Health UFOP. In consultations Blood pressure was
measured in addition to the pharmacotherapeutic evaluation, and when necessary, pharmaceutical intervention was
involved. Were followed 60 elderly between March to October 2010, 15% men and 85% women. Of these 45% are
between ages 56 to 65 years. Among the 60 elderly, 43% use above three drugs which implies involvement in your
health. According above, 53% of subjects with hypertension and 17% are carriers of diabetes. Given the high
percentage of hypertensive patients, was given a lecture on hypertension. It is concluded that the PRM can be detected
arising from own use of the drug, the attitudes of patients and even prescribers. Specific intervention strategies can
pharmaceutical minimize the high incidence of PRM predictable and lead to the elevation of quality of life of geriatric
patients.
086
PHARMACIST IN PSF: THE REALITY IS THAT CALLS FOR PIAUÍ RATIONAL USE OF MEDICINAL
PLANTS
VIVIANNE RODRIGUES AMORIM¹; HÉLIO DE BARROS FERNANDES²
¹ Pharmaceuticals, Master’s degree in Pharmacology - UFPI; Specialist in Family Health - UNIPOS, Pos- Graduating in
Pharmaceuticals Management Assistance – UFSC; ² Master’s degree in Pharmacology - UFPI
Piauí state has a rich quantity of vegetable species, furthermore, there are a strong folk culture about use of medicinal
plants. Despite this, there is no counselling about the racional use of this natural products. Family Health Program
(PSF) is a federal assistencial program and is formed by a multi profissional team. This word aims inform about use of
medicinal plants viability inside strategy program of family health and show the importance of pharmacist inclusion in
PSF. The data were obtained in health periodics between 1999 and 2010 regarding the socio-economic situation of
population of Piauí and laws that rule pharmacists, Medicament National Policy, Medicinal Plants National Policy,
Pharmacy code of ethics and Health Unic System guideline (SUS). Piaui is a state of federation with high poverty
index. Since 1988, with SUS creation, the federal government, together with municipal and state governments, actuates
to improve the health system. This improvement is marked by creation of PSF. Portaria nº 2982 (2009) includes
phytoterapics use in health Basic Attention. The pharmacist inside the new pharmaceutical context adds efforts together
with others health professionals and the community to advance in health promotion. Is viable the medicinal plants use
and pharmacist inclusion in Family Health Program.
087
PHARMACOTHERAPEUTIC FOLLOW-UP IN THE MICROREGION OF MURIAÉ, MG, BRAZIL
RAFAEL AGUIAR CAPOBIANGO1, LUIZ HENRIQUE AMARANTE2, MARCELO SILVA SILVÉRIO3
1
FACULDADE DE MINAS – FAMINAS, 2UNIVERSIDADE FEDERAL FLUMINENSE - UFF,
REGIONAL JOÃO PENIDO - FHEMIG
3
HOSPITAL
According to the Third Granada Consensus, Drug-Related Problems (DRPs) is an event or circumstance involving drug
therapy that potentially interferes with desired health outcomes or causes adverse drug reaction. DRPs have a
hierarchical structure with three main categories: need, effectiveness and safety. The purpose of the present study was to
investigate diseases and pharmacotherapy more often between community pharmacy users in the microregion of
Muriaé, MG, Brazil. To become evident the possible DRPs, from August to November of 2008 it was a
pharmacotherapeutic follow-up in 110 patients in the related microregion. The use of two drugs, at least, was the
criterion to include participants in the study. The project was approved by the Ethics Committee of the Faculdade de
Minas – FAMINAS. The results show that 27,28% of the patients had less than 30 years old, 20% was between 31 and
40 year old, 14,55% between 41 and 50 year old and 38,19% was more than 51 years old. 62% of the patients was
female and 38% male. The more frequent diseases were high blood pressure (24,54%), anxiety (20,90%), sleeplessness
(16,36%), allergy (15,45%), hiperlipemia (10,90%) and hypothyroidism (4,54%). The most frequently used drugs were
captopril an hydroclorotiazide (high blood pressure), diazepam (anxiety), clonazepam (sleeplessness),
dexclorfeniramine, loratadine and prednisone (allergy), sinvastatine (hiperlipemia) and levotiroxine (hypothyreoidism).
The results showed that the drugs were correctly prescribed in accordance by National Formulary Therapeutics (2008).
The DRPs was observed in 47% of the patients and the more frequently DRPs was DRP 1 (33,87%), DRP 2 (43,54%),
DRP 3 (12,90%), DRP 4 (6,47%) and DRP 5 (3,22%). Most incidents of DRP happened with the patients that were over
51 years old. An effective Pharmaceutical Care program reduces the high frequency of DRP, especially related to
irrational use of medications by the elderly.
088
RESPONSIBLE DRUG DISPOSAL - AN ENVIRONMENTAL PUBLIC HEALTH PROBLEM
ALESSANDRA MARA DA SILVEIRA CAPPELARO 1,2,VANESSA CRISTINA RESCIA 1
1
Universidade Bandeirante Brasil, Docentes do curso de Farmácia,
proprietária.
2
Farmad’oro – Farmácia de Manipulação, Sócia-
The expired products or an oddment of unused medicines after treatment become environmental waste. Dustman or
who used to seek their survival in places known as "dump" (who make a living by scavenging through garbage)
become vulnerable to drug poisoning, in which small doses of medications can be fatal meanly to small children and
animals. Some drug compounds have inhibitory activity of bacteria that lives in environment and this may result in no
degradation of domestic waste in landfills and also can contaminate ground and water. Several researches have shown
that water we consume has traces of several drugs, even after treatment. The good news is that these values are also
found very low and insignificant to human health, but if we continuous neglect this contamination, probably in the near
future we will have water with high levels of drugs. The objective of this study was to raise public’s attention to the
risks of disposing of leftover or expired products in domestic sewage or waste, also educate them about the importance
of in adopting proper attitudes toward environment, and furthermore, encourage them to collect and recycle the waste.
Based on literature review, it was elaborated educational materials and with information to the public; changes were
done in respective jurisdictions named PGRSS (Plan of waste management of health services), and it was created of a
regular collection of expired products and leftover medicines; It was performed statistical processing analysis of receipt
of medicine disposals; plastic bags were replaced for recyclable paper bags with non-toxic glue based on corn and ink
water-based. It was observed during the program, a strong support for adhesion of pharmacy costumers who collected
medicines from their neighborhood and their families, these people had some difficulties to take their own collection
due to restricted location of their residence were unable to take the collection station because of their restricted location.
It was noted from the kind of medicines collected, that there was a large number of controlled medicines, antibiotics
and hormones. The medications were received and their descriptions were recorded in a proper form, thus, generating
data for statistical analysis. This research raised other important concerning points such as what kind of medicines the
population tends to keep in their in-house pharmacy. These results showed that population proved to be opened, well
informed, and concerned about the need for implementation of projects aiming to protect the environment and public
health. The expansion of this project and, consequently, an increasing in the number of collection points of for expired
products or remains oddments is necessary.
089
THE IMPORTANCE OF ABC MEDICATION CURVE IN PIAUI STATE HEALTH ESTABLISHMENTS
ILBERTO PEREIRA DA SILVA ¹, VIVIANNE RODRIGUES AMORIM²
¹Pos- Graduating in Management Services and Health System, UVA; ²Pharmaceuticals, Master’s degree in
Pharmacology - UFPI; Specialist in Family Health - UNIPOS, Pos-Graduating in Pharmaceuticals Management
Assistance – UFSC
The ABC drugs curve is a Pareto’s proposed method that the help to control the medicines stock and medical hospital’s
supplies. The Piauí has been one of the national health references even among the State Government programs which
involve drugs so, The Popular Pharmacy program of the Brazil, The Exceptional Drugs Program and the Primary Care
Medicines Program are between them. Quantitative and qualitative approach to documentary Theory through academic
sites that collect data; besides of scientific articles, laws and guidelines; and on data provided by SESAP between 2009
and 2010. The exceptional drugs share group A (5% are about items and 80% are about financial resources), the
hospital medications and primary care participate of the groups B (15% about items and 15% of the financial
resources) and C (80% are about items and 5% describe funds). The analyzed data demonstrate that the ABC Curve
model about drugs take easy like a tool to improve services provided by the Pharmaceutical Care SESAPI.
090
EVALUATION OF DEPRESSIVE AND ANXIETY SYMPTOMS IN PATIENTES TAKING ANTIULCER
DRUGS
LUCIENE ALVES MOREIRA MARQUES; KASSANDRA ELFRIDA PAULIELLO
Universidade Federal de Alfenas, UNIFAL-MG
Many dyspeptic patients are emotionally distressed. In several cases, the symptoms of dyspepsia disappear when
anxiety or depression is controlled. The purpose of the present study was to elaborate the profile of users of antiulcerative drugs and investigate whether such medications were associated with mental disorders. A descriptive research
was carried out in the city of Alfenas, Minas Gerais (MG) from October to December 2010 with one hundred users of
anti-ulcerative drugs, including visitors, students and employees of the Campus of Unifal- MG who obtain their drugs at
the Farmácia-Escola. The instruments used in data collection were: questionnaire, Beck Depression Inventory and Beck
Anxiety Inventory. The data were analyzed using Software Epi Info Version 3.3 (05.10.2004). The statistical test used to
measure the associations was the Chi-square test with a significance level of 5%. The study sample was mostly formed
by women, and the majority of the participants were white young adults aged 20-40 years, married and catholic. Also,
most of them had children and a family income between 1 and 3 minimum wages, lived in their own houses downtown
and had completed higher education. The findings of the present study suggest that more than half of the studied
population (56%) has been abusing of anti-ulcerative medications (for more than one year) and nearly 10% use the drug
without professional advice or prescription (self-medication). Also, more than half of the participants had symptom
recurrence or worsening, and a strong association was obtained (p <0.05) between the repetition or worsening of gastrointestinal symptoms and the occurrence of anxiety symptoms, suggesting an emotional cause for the digestive problem,
which should be treated. Intervention measures should be adopted to make it possible to diagnose these mental
disorders and reduce the risks inherent to the chronic use of anti-ulcerative drugs or self-medication.
INDICE
SOBRENOME
PÁGINA
A
ABJAUDE, S. A. R.
ADRIANO, L. S.
AGUILAR, V. D. S.
ALBUQUERQUE, M. Z. M.
ALEXANDRE JÚNIOR, V.
ALMEIDA, R. B.
ALVARENGA, R. C. A.
ALVES, S. C. F.
AMARANTE, L. H.
AMBIEL, I. S. S.
AMORIM, V. R.
ANDRADE, C. C.
ANDRADE, R. A.
ANDRADE, R. C. G.
ANDRADE, V.
ANTUNES, F. V.
ARAÚJO, F. M.
ARRUDA, L. S.
ARTUZO, F. S. C.
AZEVEDO, L. S.
006, 014, 041, 077
008, 063
077
008
017
024, 034
013
055
051, 087
064
086, 089
033, 045, 060
031, 047
012, 021, 040, 065, 072, 073, 075
057
065
062
013, 062
012, 040
028, 049
B
BALDONI, A. O.
BALDONI, N. R.
BALEEIRO, L. S.
BARBIERI, K. P.
BARBOSA, C. R.
BATTAGLINI, S. C. M.
BAYLAO, B. S.
BEDIN, A. P. Z.
BERALDO, V. L.
BERNARDES, A. C. A.
BERNARDINO, J.
BERNARDO, F. R. F.
BERTOLUCCI, D. M.
BORGES, M.
BRADBURY, C. M.
BRAGA, A. D.
BRAZ, N. C.
BRUZIGUES, A. E. P. V.
059
078
036
067
003, 048
011
085
024, 034
070
070
070
027
073, 075
021, 072
009
001, 081
036
078
C
CALDEIRA, N. G.
CAMARGO, H. P. M.
CANTANO, M. M. R.
CAOVILA, M. M.
CAPOBIANGO, R. A.
CAPPELARO, A. M. S.
CAPUCHO, H. C.
CARBI, A. D. O.
CARDOSO, R. B.
CARDOSO, T. P.
CARNEVALE, R. C.
CARVALHO, D. M. S.
CARVALHO, F. D.
CARVALHO, I. V.
CARVALHO, M. F. C.
028
023, 043, 044
073, 075
019
087
082, 088
012, 040
061
066
020
036
004
012, 040
048
039
CARVALHO, R. P.
CASTRO, R. C.
CHAGAS, A. R.
CHAVES, B. M.
CHRYSOSTOMO, T. N.
COELHO, C. B. T.
COELHO, D. L.
CORRER, C. J.
COSTA, C. G. R.
COSTA, C. K.
COSTA, F. C.
CRUCIOL, J.
CRUZ, A. N.
CRUZ, A.
CUMAN, R. K. N.
CUNHA, S. F. C.
070
020, 054
068
001, 081
021, 065, 072, 073, 075
011
049
018, 024
036
018, 035, 074
079
026, 059
029
070
007, 026, 029, 058, 059
005
D
DAMIÃO, T. S.
DANTAS, M. G.
DEMOCH, M. M.
DEUS, G. M.
DEWULF, N. L. S.
DIAS JÚNIOR, C.
DIAS, J. F. G.
DIAS, M. J.
DIDONE, T. V. N.
DINIZ, N. O.
DUPIM, M. R.
033, 038, 045, 060
016
003, 048
008
005
079
018, 035, 074
004
039
001, 081
031, 047
F
FACHEL, F. N. S.
FALCÃO, A. L. E.
FARHAT, F. C. L. G.
FARIA, H. D.
FARIAS, A. D.
FAUSTINO, P. P.
FELIPE, T. B.
FERNANDES, H. B.
FERNANDES, M. R.
FERREIRA, E. A.
FERREIRA, E. B.
FERREIRA, I. M. L.
FERREIRA, T. S.
FERREIRA, Y. C.
FIGUEIREDO, A. C. D.
FIGUEIREDO, C. V.
FIGUEIREDO, P. A.
FOLCHINI, C. M.
FONTELES, M. M. F.
FRADE, J.
FRANCELINO, E. V.
FRANCISCHINELLI, M.
FREITAS, A. L. C.
FUJIWARA, G. M.
FURTADO, V. S.
066
011
023, 043, 044
078
016
003
014, 077
086
030, 050
062
010, 019, 046, 061
005
019
042
076
015
037
024, 034
001, 022, 032, 055, 063, 081
031, 047
008
023
057, 058
018, 035, 074
062
G
GAETI, W. P.
GALDUROZ, J. C. F.
GARCIA, M. M.
GASPAROTTO, A. P. D. C.
007, 058
030, 052
076
011
GIROLINETO, B. M. P.
GONÇALVES, F. S.
GOYATÁ, S. L. T.
GRANJA, S.
GUIDONI, C.
GUIMARÃES, M. G.
017
027
002
003, 011
059
057
H
HEYDEN, V. M. D.
HOLSBACK, V. S. S.
046
036
I
IDEM, M. N.
007, 057
J
JULIATO, P. T.
014
K
KHEIR, N.
KONELL, K.
KREUTZ, T.
001, 032, 055, 081
035, 074
033, 038, 045, 060
L
LAGANÁ, D.
LEITE, F. A. M.
LIMA, C. C.
LIMA, C. S. P.
LIMA, D. G. L.
LIMA, L. F.
LIMA, M. M.
LIMA, R. C.
LIMA, R. M. F.
LINHARES, M.
LOPES, A. R.
LOUREIRO, C.
LUCAS, J.
LUCCHETTA, R. C.
LUPPI, G.
LYRA, L.
002
032
035, 074
003, 048
022
001, 032, 081
067
037
056
031, 047
010, 019
032
054
053
039
048
M
MACHADO, J. C. F. S.
MACHADO, T. A.
MAGALHÃES, K. N.
MAGALHÃES, M. H.
MALAGUTI, E. C.
MARANE, S. S. G.
MARIALVA, M.
MARINUCCI, M. B. B.
MARQUES, L. A. M.
MARQUES, M. R. S.
MARQUES, M.
MARQUES, S. M.
MARTINEZ, C. M.
MARTINS, R. R.
MASTROIANNI, P. C.
MAZZOLA, P. G.
MEDEIROS, H. I. A.
MELERO, D. S.
MESQUITA, L. I.
MICHELETTO, R. F.
MONTEIRO, L. O.
010
046
032, 055
004, 015
077
067
011
048
006, 030, 050, 052, 077, 078,
080, 090
083
067
031, 047
039
016
025, 053, 064
011, 036, 070
039
042
032
073, 075
069
MORIEL, P.
MOUÇO, T. M. L.
MOURA, R. A.
MOYSÉS, A. M. B.
003, 011, 036, 048
013
006, 050, 078
012
N
NASCIMENTO, M. M. G.
NANCI, L. O.
NEGRI, A.
NEVES, E. C. R.
NOBILI, A.
NOTO, A. R.
079
064
057
028
059
030, 052
O
OBRELI NETO, P. R.
OLIVEIRA, B. E.
OLIVEIRA, H. F. A.
OLIVEIRA, H. W.
OLIVEIRA, M. M.
OLIVEIRA, R. E. M.
007, 026, 029, 057, 058, 059
022
016
066
079
079
P
PADUAN, N. J.
PAGOTTO, C.
PAIVA, L. J.
PAIVA, M. R. A. B.
PASSOS, D. J. L.
PAULA, C. C.
PAULIELLO, K. E.
PEDROSO, L. A.
PELEGRINI, G. G.
PEREIRA, L. H. T. R.
PEREIRA, L. R. L.
PEREIRA, M. L.
PIMENTEL, R.
PINHEIRO, M. L. P.
PINTO, V. B.
PLANETA, C. S.
PODESTÁ, M. H. M. C.
PONCIANO, A. M. S.
PORTO, A. C.
054
025
056
004, 015, 071
013
025
090
046, 069, 071
071
021, 065, 072
017
079
011
068
042
025
004, 010, 015, 019, 046, 061,
069, 071
001, 032, 055, 081
063
Q
QUEIROZ, S. C.
084
R
RASCADO, R. R.
REIS, H. P. L. C.
REIS, V. S.
RESCIA, V. C.
RESENDE, R. C.
REZENDE, C. P.
RIBEIRO, R. G.
RIBEIRO, T. B.
RIOS, M. F.
ROCHA, P. A.
RODRIGUES, A. A.
RODRIGUES, A. T.
RODRIGUES, K. R.
ROLIM, L. G.
ROMERO, N. R.
RUSSOMANO, T.
006, 014, 041, 050, 077
001, 032, 055, 081
006, 050, 077, 078
082, 088
004, 015, 071
085
027
025
010
042
019
011
071
063
063
066
S
SÁ, L. A.
SAKAMOTO, A. C.
SANTOS, C. R. L.
SANTOS, D. F.
SANTOS, J. L.
SANTOS, M. A.
SANTOS, V. A. T. B.
SANTOS, V. F.
SATO, C. M.
SEBASTIÃO, E. C. O.
SILVA JÚNIOR, S. I.
SILVA, A. E. R.
SILVA, A. M. S.
SILVA, D. C.
SILVA, D. M.
SILVA, E. A.
SILVA, I. P.
SILVA, L. C.
SILVA, L. I. M. M.
SILVA, M. J. D.
SILVA, N. M. O.
SILVA, N. R.
SILVA, R. A.
SILVA, R. O. L.
SILVA, R. R.
SILVA, S. S.
SILVA BESERRA
SILVÉRIO, M. S.
SIMÕES, T. M. R.
SIQUEIRA JÚNIOR, L. M.
SOARES, D. B.
SOBRAL, A. L.
SOUSA, C. R.
SOUZA, C. M.
SOUZA, E. F.
SOUZA, K. M.
SOUZA, V. V.
SOUZA, W. A.
SUAVINHA, M. M.
SUZUKI, G. B.
012
017
018
031, 047
009, 067
066
035, 074
067
003
085
002
070
016
039
013, 062
051
089
080
055, 081
071
070
041, 077
002
021, 037, 072
013
033, 045
038
087
078
010, 019, 046
079
033, 045
001, 081
003, 048
061, 078
076
056
004, 010, 015, 019, 046, 061,
069, 071
037
082
T
TANAKA, M. T.
TEIXEIRA, M. A.
TELLES FILHO, P. C. P.
TOLEDO, F. A.
TOSTES, C. L.
036
055
068
037
037
V
VALE, G. T.
VANCE, N.
VANCIM, J. O.
VARALLO, F. R.
VASCONCELOS, T. O.
VASSIMON, C. S.
VEIGA, S. M. O. M.
VESPOLI, S.
VIANA, B. A.
VIEIRA, J. C.
VILAS BOAS, O. M. G. C.
006, 050, 078
011
037
025, 064
022
021, 065, 072
083, 084
067
079
007, 058
010, 015, 046, 061, 069
VILLELA, E. G.
VISACRI, M. B.
076
003, 048
W
WOODS, D.
001, 032, 055, 081
Y
YUGAR, F. C.
039
Z
ZANETTI, A. B.
ZUBA, A. G.
077
010