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Authors
Abstract(s)
O presente trabalho contempla três capítulos. O primeiro capítulo diz respeito ao projeto
de investigação elaborado para obtenção do grau de Mestre em Ciências Farmacêuticas, que se
intitula: “Estudo da eficácia do Ácido Tranexâmico como agente hemostático em doentes
submetidos a artroplastia total primária de joelho e anca”. Os capítulos 2 e 3 remetem para os
relatórios de estágio curricular em farmácia comunitária e farmácia hospitalar, respetivamente.
O capítulo 1 expõe o estudo realizado com o objetivo de avaliar a eficácia de um protocolo
de administração profilática de ATX, implementado no Centro Hospitalar Universitário da Cova
da Beira, administrado a doentes submetidos a artroplastia total primária de joelho e anca. Foram
incluídos no presente estudo um total de 198 doentes intervencionados previamente e
subsequentemente à implementação do protocolo, mais precisamente entre junho de 2018 e
março de 2020. Foi feita uma consulta dos seus processos clínicos e colhidos os respetivos dados
demográficos e parâmetros laboratoriais no pré e pós-operatório, sempre que disponíveis. Desta
forma, foi possível analisar a eficácia da administração do ATX através da análise comparativa da
queda dos níveis de hemoglobina, número de eritrócitos e plaquetas, e da necessidade de recorrer
a transfusões com concentrado de eritrócitos para reestabelecer o volume de sangue perdido. Para
a amostra de doentes intervencionada ao joelho posteriormente à implementação do protocolo,
verificou-se uma diminuição na queda dos níveis de hemoglobina e número de eritrócitos de
30,26% e 33% comparativamente com o período homólogo, respetivamente. Já em relação aos
doentes intervencionados à anca, essa diminuição foi de 2,42% e 10% para os dois parâmetros
analíticos em questão. No que toca à necessidade de efetuar transfusões com concentrado de
eritrócitos, nos doentes intervencionados ao joelho a taxa de transfusão passou de 18% para 2%
após implementação do protocolo de ATX, enquanto que nos doentes intervencionados à anca
não se verificou nenhuma alteração, constatando-se uma taxa de 12% antes e após implementação
do mesmo. De um modo geral, este estudo permitiu evidenciar a eficácia do protocolo de
administração profilática de ATX aos doentes submetidos às cirurgias em questão, contribuindo
para um menor tempo de internamento e recuperação mais célere.
O segundo capítulo concerne às atividades por mim desenvolvidas durante o estágio em
farmácia comunitária na Farmácia Moderna Tortosendense, sob a orientação da Doutora Maria
Octávia Vaz e toda a sua equipa técnica, assim como a caracterização geral do modo de
funcionamento da farmácia e das responsabilidades imputadas ao farmacêutico na prática da sua
atividade profissional.
O capítulo 3 é referente ao estágio realizado em farmácia hospitalar, nos Serviços
Farmacêuticos Hospitalares do Centro Hospitalar Universitário da Cova da Beira, sob a
orientação da Doutora Olímpia Fonseca, encontrando-se nele exposto o seu modo de
funcionamento e as atividades por mim desempenhadas aquando do período de estágio.
The present work includes three chapters. The first chapter concerns the research project designed to obtain a Master's degree in Pharmaceutical Sciences, entitled: "Study of the efficacy of Tranexamic Acid as a hemostatic agent in patients undergoing total primary knee and hip arthroplasty. Chapters 2 and 3 refer to the curricular internship reports in community pharmacy and hospital pharmacy, respectively. Chapter 1 presents the study conducted in order to evaluate the effectiveness of a protocol for prophylactic administration of ATX, implemented at the University Hospital Center of Cova da Beira, administered to patients undergoing knee and hip total primary arthroplasty. A total of 198 patients were included in the present study, before and after the implementation of the protocol, more precisely between July 2018 and March 2020. A consultation of their clinical files was performed and the respective demographic data and laboratory parameters were collected pre and postoperatively, whenever available. Thus, it was possible to analyze the efficacy of ATX administration by comparing the drop in hemoglobin levels, number of erythrocytes and platelets, and the need to resort to transfusions with erythrocyte concentrate to reestablish the volume of blood lost. For the knee patient sample intervened after the implementation of the protocol, there was a decrease in the drop of hemoglobin levels and number of erythrocytes of 30.26% and 33% compared to the same period, respectively. In relation to the patients intervened at the hip, this decrease was 2.42% and 10% for the two analytical parameters in question. Regarding the need to perform transfusions with erythrocyte concentrate, in knee interventional patients the transfusion rate decreased from 18% to 2% after implementation of the ATX protocol, while in hip interventional patients there was no change, with a rate of 12% before and after implementation. In general, this study showed the efficacy of the protocol of prophylactic administration of ATX to patients undergoing the surgeries in question, contributing to a shorter hospitalization time and faster recovery. The second chapter concerns the activities developed by me during my internship in community pharmacy at Farmácia Moderna Tortosendense, under the guidance of Dr.ª Maria Octávia Vaz and her entire technical team, as well as the general characterization of the way the pharmacy works and the responsibilities attributed to the pharmacist in the practice of his professional activity. Chapter 3 refers to the internship held in hospital pharmacy, in the Hospital Pharmaceutical Services of the University Hospital Center of Cova da Beira, under the guidance of Dr.ª Olímpia Fonseca, and is exposed in it its mode of operation and the activities performed by me during the internship period.
The present work includes three chapters. The first chapter concerns the research project designed to obtain a Master's degree in Pharmaceutical Sciences, entitled: "Study of the efficacy of Tranexamic Acid as a hemostatic agent in patients undergoing total primary knee and hip arthroplasty. Chapters 2 and 3 refer to the curricular internship reports in community pharmacy and hospital pharmacy, respectively. Chapter 1 presents the study conducted in order to evaluate the effectiveness of a protocol for prophylactic administration of ATX, implemented at the University Hospital Center of Cova da Beira, administered to patients undergoing knee and hip total primary arthroplasty. A total of 198 patients were included in the present study, before and after the implementation of the protocol, more precisely between July 2018 and March 2020. A consultation of their clinical files was performed and the respective demographic data and laboratory parameters were collected pre and postoperatively, whenever available. Thus, it was possible to analyze the efficacy of ATX administration by comparing the drop in hemoglobin levels, number of erythrocytes and platelets, and the need to resort to transfusions with erythrocyte concentrate to reestablish the volume of blood lost. For the knee patient sample intervened after the implementation of the protocol, there was a decrease in the drop of hemoglobin levels and number of erythrocytes of 30.26% and 33% compared to the same period, respectively. In relation to the patients intervened at the hip, this decrease was 2.42% and 10% for the two analytical parameters in question. Regarding the need to perform transfusions with erythrocyte concentrate, in knee interventional patients the transfusion rate decreased from 18% to 2% after implementation of the ATX protocol, while in hip interventional patients there was no change, with a rate of 12% before and after implementation. In general, this study showed the efficacy of the protocol of prophylactic administration of ATX to patients undergoing the surgeries in question, contributing to a shorter hospitalization time and faster recovery. The second chapter concerns the activities developed by me during my internship in community pharmacy at Farmácia Moderna Tortosendense, under the guidance of Dr.ª Maria Octávia Vaz and her entire technical team, as well as the general characterization of the way the pharmacy works and the responsibilities attributed to the pharmacist in the practice of his professional activity. Chapter 3 refers to the internship held in hospital pharmacy, in the Hospital Pharmaceutical Services of the University Hospital Center of Cova da Beira, under the guidance of Dr.ª Olímpia Fonseca, and is exposed in it its mode of operation and the activities performed by me during the internship period.
Description
Keywords
Ácido Tranexâmico Artroplastia Concentrado
de Eritrócitos Farmácia Comunitária Farmácia Hospitalar Hemoderivados Hemostáticos Pta Ptj Transfusão