Use of the Brazilian People’s Pharmacy Program by older adults

ABSTRACT OBJECTIVE To assess the prevalence and factors associated with the use of the expanded Brazilian People’s Pharmacy Program among older adults and the reasons for not using it. METHODS In this population-based cross-sectional study conducted in the urban area of Pelotas, RS, Southern Brazil, we evaluated 1,305 older adults (aged 60 years or over) who had used medication in the last 15 days. Independent variables were socioeconomic factors, economic status, household income in minimum wages, educational attainment in years of schooling and occupational status. Demographic variables were sex, age, marital status, and self-reported skin color/race. Poisson regression was employed to analyze the factors associated with the use of the program. RESULTS The prevalence of use was 57.0% whilst the prevalence of knowledge of the program was 87.0%. In individuals aged 80 years or over, use of the program was 41.0%. As to the origin of the prescriptions used by older adults, 46.0% were from the Brazilian Unified Health System. The main reasons for not using the program were: difficulty in getting prescriptions, medication shortage, and ignorance about the medications offered and about the program. Higher age, lower income, presence of chronic diseases, and use of four or more medications were associated with use of the program. CONCLUSIONS It is necessary to expand the knowledge and use of the Brazilian People’s Pharmacy Program, especially among older adults, and to improve the dissemination of its list of medications to users and physicians. Thus it will be possible to reduce spending on long-term medications, which are especially important for this population

Exposure to misoprostol and hormones during pregnancy and risk of congenital anomalies Exposição ao misoprostol e hormônios durante a gravidez e risco de anomalia congênita

This study evaluated the association between use of misoprostol and other drugs to induce menstruation, and congenital anomalies. A sample of 4,856 pregnant women 20 years and older were enrolled consecutively in prenatal services in the Unified National Health System, in six Brazilian State capitals. Data on socio-demographics and use of medicines were obtained using an interview from the 21st to 28th week of pregnancy. Other data, including information on delivery and diagnosis of congenital anomalies by the attending neonatal physician were obtained from patient charts. Potential confounders were adjusted by logistic regression. Use of drugs to induce menstruation was reported by 707 women (14.6%), of whom 120 (17%) reported use of misoprostol. After adjusting for the study center, a positive association was observed between misoprostol and congenital anomalies (OR = 2.64; 95%CI: 1.03-6.75); a positive association was also observed for sex hormones (OR = 2.24; 95%CI: 1.06-4.74). The results suggest that the use of misoprostol or sex hormones during pregnancy increases the risk of congenital anomalies.<br>Este estudo avalia a associação do uso do misoprostol e de outros produtos utilizados para induzir a menstruação com anomalia congênita. Foram arroladas consecutivamente 4.856 mulheres com vinte anos de idade ou mais, procedentes de serviços de pré-natal do Sistema Único de Saúde em seis capitais brasileiras. Dados sócio-demográficos e o uso de medicamentos foram obtidos por meio de entrevista, entre a 21ª e a 28ª semanas de gestação. Outros dados, incluindo informações sobre o parto e o diagnóstico de anomalia congênita, realizado pelo médico que assistiu o recém-nascido, foram obtidos no prontuário. Potenciais confundidores foram ajustados por meio de regressão logística. O uso de produtos para induzir a menstruação foi relatado por 707 gestantes (14,6%), das quais 120 (17%) referiram-se ao misoprostol. Após ajustamento para o centro de realização da pesquisa, foi verificada uma associação positiva entre misoprostol e anomalias congênitas (RC = 2,64; IC95%: 1,03-6,75); para hormônios sexuais também foi verificada uma associação positiva (RC = 2,24; IC95%: 1,06-4,74). Os resultados sugerem que o uso de misoprostol ou hormônios sexuais durante a gravidez aumenta o risco de anomalia congênita

Lithium attenuates behavioral and biochemical effects of neuropeptide S in mice

Neuropeptide S (NPS) and its receptor NPSR comprise a recently deorphaned G-protein-coupled receptor system. There is a body of evidence suggesting the involvement of NPS in wakefulness, anxiety, locomotor activity and oxidative stress damage. Considering that mood stabilizers block the stimulatory effect of psychostimulants in rodents, the present study aimed to investigate the effects of the pretreatment with lithium and valproate on the hyperlocomotion evoked by NPS. Another relevant action induced by lithium and valproate is the neuroprotection against oxidative stress. Thus, aiming to get further information about the mechanisms of action of NPS, herein we evaluated the effects of NPS, lithium and valproate, and the combination of them on oxidative stress damage. Behavioral studies revealed that the pretreatment with lithium (100 mg/kg, i.p.) and valproate (200 mg/kg, i.p.) prevented hyperlocomotion evoked by NPS 0.1 nmol. Importantly, the dose of valproate used in this study reduced mouse locomotion, although it did not reach the statistical significance. Biochemical analyses showed that lithium attenuated thiobarbituric reactive species (TBARS) formation in the striatum, cerebellum and hippocampus. NPS per se reduced TBARS levels only in the hippocampus. Valproate did not significantly affect TBARS levels in the brain. However, the combination of mood stabilizers and NPS blocked, instead of potentiate, the neuroprotective effects of each one. No relevant alterations were observed in carbonylated proteins after all treatments. Altogether, the present findings suggested that mainly the mood stabilizer lithium evoked antagonistic effects on the mediation of hyperlocomotion and protection against lipid peroxidation induced by NPS

Prevalência e fatores associados com o consumo de substâncias psicoativas por acadêmicos de enfermagem da Universidade de Passo Fundo Prevalence and factors associated with psychoactives substances consumption for academics of nursing of the University of Passo Fundo

Com o objetivo de estimar a prevalência de consumo de substâncias psicoativas e seus determinantes entre acadêmicos de enfermagem da Universidade de Passo Fundo (RS), realizou-se estudo transversal com 266 alunos, maiores de dezoito anos, que responderam o questionário do Centro Brasileiro de Informações Sobre Drogas Psicotrópicas. Empregou-se estatística descritiva, qui-quadrado e regressão logística múltipla para análise de dados. A prevalência de uso na vida, no ano e no mês foi maior para álcool, tabaco, benzodiazepínicos e estimulantes. Da amostra, 94% consumiram álcool na vida, 90% no ano e 79% no mês, sendo 14% caracterizado como uso pesado. As alunas consumiram mais benzodiazepínicos e estimulantes que os alunos. Os maiores de 20 anos de idade e os do sexo feminino evidenciaram menor chance de consumo de álcool no mês e aqueles com renda familiar mensal superior a dez salários mínimos apresentaram maior chance de consumo de maconha (OR: 1,92), cocaína (OR:4,63) e inalantes (OR:7,02). O padrão de consumo de substâncias psicoativas assemelha-se ao encontrado em outros grupos de universitários, salvo os benzodiazepínicos e estimulantes, sugerindo-se uma avaliação mais aprofundada desse consumo.<br>The objective of this epidemiologic transversal cut study was to investigate the consumption of psychoactive substances and their determinants between the nursery academics of the University of Passo Fundo, Rio Grande do Sul State. 266 students, aging more than eighteen years old answered a questionnaire of the Brazilian Center of Information about Psychoactive Drugs. A descriptive statistics, qui-square and multiple logistics regression were carried out for the data analysis. Of the sample, 94% had consumed alcohol in the life, 90% in that year and 79% in that month, 14% were characterized as heavy users. The girls had consumed benzodiazepines and stimulants more than the boys. The ones aging 20 year and more and females had evidenced minor possibility of alcohol consumption in the month and those with a monthly family income lower than ten salaries presented a greater possibility of marijuana (OR: 1.92), cocaine (OR:4.63) and inhalants (OR:7.02) consumption. The standard of psychoactive substance consumption is similar than the one found in other groups of colleges student, except for the benzodiazepines and stimulants, suggesting itself a deeper evaluation of this consumption