Patients’ perception and use of medicinal plants for chronic disease in a community from Rio Grande do Sul / Percepção dos pacientes e uso de plantas medicinais para doenças crônicas em comunidade do Rio Grande do Sul

The popular use of medicinal plants to treat health problems is well known and disseminated from generation to generation, but little is known about toxicity and interactions. Therefore, this work aims to verify the perception about the use of medicinal plants for chronic patients in a community located in Rio Grande do Sul. A cross-sectional study was carried out with chronic diseases’ patients from the municipality of Novo Hamburgo, RS that are users of medicinal plants. Sociodemographic data, clinical characteristics and aspects related to the use of medicinal plants were evaluated for 100 users of medicinal plants, predominantly female (90%) and mean age was 54.8 years. Most have incomplete elementary education (55%) and 95% of those interviewed receive a monthly family income of 1 to 3 minimum wages. There were 318 citations of plant species, of which 63 were different types. The most used were chamomile (Matricaria chamomilla L, 9.4%), lemon grass [Cymbopogon citratus (DC.) Stapf, 8.4%), pennyroyal (Mentha pulegium L., 6.2%) and macela [Achyrocline satureioides (Lam.) DC., 5%]. Regarding the preparation method, 52% of the patients performed infusion, 39% decoction, 7% decoction and infusion and 2% consumed in the mate. Most of the results on the medicinal plants used are consistent with the findings in the literature and it is noticed that a great part of interviewees knows that, even being natural products, medicinal plants may be dangerous

Determination of oxidative stress parameters in fluoxetine users

Fluoxetine (FLU), a selective serotonin reuptake inhibitor, is the first line in depression treatment and it is involved in oxidative stress (OE). Thus, this study aimed to analyze the OE parameters in patients diagnosed with depression and treated with FLU. Were evaluated 121 volunteers divided into two groups: 58 fluoxetine users (with major depression) and 63 non-fluoxetine users (control group, without major depression). The OE was evaluated by determining the levels of malondialdehyde (MDA), total antioxidant power (FRAP) and activity of antioxidant enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD). MDA, FRAP, GPx and SOD were dosed in plasma. The influence of age, smoking, alcoholism, comorbidities, use of another drugs and antioxidants in the OE were evaluated. The results were compared between the groups. In relation to the fluoxetine daily dose, MDA presented higher levels in patients using 20 mg daily FLU when compared to the control group, as well as the activity of the GPx enzyme and the FRAP levels. In this way, the use of fluoxetine may interfere with the OE parameters, causing an increase in OE levels

Avaliação da qualidade de vida em portadores de doenças crônicas no sul do Brasil / Quality of life evaluation in patients with chronic diseases in southern Brazil

Este artigo avalia a qualidade de vida (QV) em portadores de doenças crônicas não transmissíveis (DCNT) no Vale do Sinos, sul do Brasil, e verifica quais os fatores que interferem na sua QV. Foi realizado um estudo transversal com portadores de DCNT, avaliando dados referentes às características gerais, sócio-demográficas e clínicas. A QV foi avaliada pelo Whoqol- Bref, a adesão à farmacoterapia através da escala de Morisky-Green (MG) e Brief Medication Questionnaire (BMQ) e a atividade física através do questionário Internacional de Atividade Física (IPAC) versão curta. Foram avaliados 229 portadores de DCNT (191 mulheres e 38 homens, com 62±11 anos). A maioria dos pacientes era não tabagista (83,41%), não etilista (99,13%), irregularmente ativos A e B (27,6; 26,3% respectivamente) e apresentavam sobrepeso (41,5%). Os escores de QV foram maiores no domínio psicológico (17,6±3,06) e menores no domínio meio ambiente (14,05±2,29). Quanto à adesão à terapia medicamentosa no teste de MG, 56,2% foram classificados como não aderentes, sendo 31,6% não aderentes intencionais. Em relação ao BMQ evidenciou-se um equilíbrio entre provável adesão e baixa adesão (27,5%). Observou-se correlação positiva entre a prática de atividade física e os escores de QV. Neste estudo a prática de atividade física representou significativamente uma melhora nos domínios de qualidade de vida, trazendo à tona a importância de hábitos de vida mais saudáveis

Possíveis interações medicamentosas em pacientes polimedicados de Novo Hamburgo, RS, Brasil

A expectativa de vida da população mundial tem aumentado e consequentemente, tem ocorrido aumento no nível de doenças crônico degenerativas e acréscimo no uso concomitantemente de medicamentos, caracterizando a polifarmácia, o que aumenta o risco de interações medicamentosas (IM). Desta forma, este trabalho teve como objetivo identificar possíveis IM entre os medicamentos utilizados por um grupo de pacientes polimedicados de Novo Hamburgo, RS. Foi realizado um estudo transversal com voluntários de um projeto de pesquisa durante sua entrevista inicial. Foram avaliados dados sócio-demográficos, patologias, medicamentos utilizados e suas IM. As doenças de base foram classificadas de acordo com o código internacional de doenças (CID-10) e os medicamentos utilizados classificados conforme os padrões Anatomical Therapeutic Chemical (ATC). As IM foram identificadas e classificadas conforme literatura e pelo sistema Micromedex®. Participaram do estudo 67 pacientes (62±9 anos, maioria do sexo feminino,74,6%), sendo que 76,1% dos pacientes apresentaram probabilidade de desenvolverem algum tipo de IM. Ao todo foram identificadas 157 possíveis IM, sendo 3,0±2,2 interações por paciente. Destas, 69,4% foram consideradas moderadas, 19,8% graves e 10,8% leves. 51,6% das interações ocorrem por mecanismo farmacodinâmico, 31,9% farmacocinético e 16,5% apresentam ambos mecanismos. A IM mais prevalente foi entre ácido acetilsalicílico e hidroclorotiazida. A maioria das IM identificadas foi do tipo grave ou moderada, com riscos consideráveis à saúde do paciente. Assim, as IM identificadas podem comprometer a segurança do paciente, evidenciando a relevância deste tema e a necessidade de avaliar e monitorar a terapêutica medicamentosa

Analysis of Adherence to Fluoxetine Treatment through its Plasma Concentration

Abstract Depression plays an important role in non-adherence to medical recommendations. Fluoxetine is a first line of depression treatment. This study aimed to evaluate adherence to drug therapy in fluoxetine users by different methods. A cross-section study was conducted with 53 depressed patients on fluoxetine for at least six months. Drug therapy adherence was assessed by validated questionnaires [Brief Medication Questionnaire (BMQ) and Morisky-Green test (MG)] and by the blood concentration of fluoxetine and its active metabolite norfluoxetine. Blood samples were taken before the daily first dose of fluoxetine. The plasmatic concentration of fluoxetine and norfluoxetine indicated that 58.5% volunteers were within the recommended therapeutic range and thus considered adherent to drug therapy. However, questionnaires indicated a non-adherent majority: 41.5% patients had a high degree of adherence in MG and only 13.2% were adherent to pharmacological treatment in BMQ. Most fluoxetine users showed a plasma concentration of fluoxetine and norfluoxetine within the therapeutic range, despite the low adherence to the drug therapy evaluated by the questionnaires. Thus, we suggest that plasma levels of fluoxetine and norfluoxetine could be used as the main method to check adherence to treatment

Analysis of Adherence to Fluoxetine Treatment through its Plasma Concentration

Depression plays an important role in non-adherence to medical recommendations. Fluoxetine is a first line of depression treatment. This study aimed to evaluate adherence to drug therapy in fluoxetine users by different methods. A cross-section study was conducted with 53 depressed patients on fluoxetine for at least six months. Drug therapy adherence was assessed by validated questionnaires [Brief Medication Questionnaire (BMQ) and Morisky-Green test (MG)] and by the blood concentration of fluoxetine and its active metabolite norfluoxetine. Blood samples were taken before the daily first dose of fluoxetine. The plasmatic concentration of fluoxetine and norfluoxetine indicated that 58.5% volunteers were within the recommended therapeutic range and thus considered adherent to drug therapy. However, questionnaires indicated a non-adherent majority: 41.5% patients had a high degree of adherence in MG and only 13.2% were adherent to pharmacological treatment in BMQ. Most fluoxetine users showed a plasma concentration of fluoxetine and norfluoxetine within the therapeutic range, despite the low adherence to the drug therapy evaluated by the questionnaires. Thus, we suggest that plasma levels of fluoxetine and norfluoxetine could be used as the main method to check adherence to treatment