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Authors
Abstract(s)
O presente trabalho encontra-se dividido em três capítulos. O primeiro capítulo é
referente ao trabalho da vertente de investigação em Ciências Farmacêuticas,
desenvolvido no Centro de Investigação em Ciências da Saúde da Universidade da Beira
Interior (CICS-UBI). O segundo capítulo relata a minha experiência em farmácia
hospitalar na Unidade Local de Saúde da Guarda. Para finalizar, o terceiro capítulo
descreve a minha experiência em farmácia comunitária na farmácia São João na Covilhã.
A epilepsia é uma doença que afeta uma grande percentagem da população mundial. O
seu tratamento pode ser crónico ou agudo, sendo que o crónico é normalmente
caracterizado por antiepiléticos administrados por via oral, que o doente toma
diariamente, e o agudo por um tratamento por via intravenosa administrado em caso de
uma crise epilética. No entanto, ambas as formas de tratamento têm desvantagens
relativamente à sua via de administração. Para tentar ultrapassar essas desvantagens já
se encontram descritos na literatura tratamentos por via nasal.
O perampanel é um fármaco antiepilético muito potente, já comercializado para
administração oral. O facto de ser muito potente faz com que uma menor dose seja
necessária para que o efeito terapêutico seja atingido, o que o faz um ótimo candidato a
administração intranasal. Porém tem o problema de ter baixa solubilidade aquosa o que
o torna num desafio à formulação para administração por esta via. A equipa de
investigação já desenvolveu uma formulação para administrar este fármaco por via
intranasal com resultados promissores. Esta formulação usa a tecnologia SMEDD
(sistema automicroemulsivo, do Inglês self-microemulsifying drug delivery) que
aumenta a biodisponibilidade de fármacos, especialmente os que tem baixa solubilidade
aquosa. Considerou-se então otimizar esta formulação com o objetivo de conseguir que
a concentração do perampanel se mantivesse dentro do intervalo terapêutico por mais
tempo.
Como estratégia de promoção do direcionamento para o cérebro por via direta foi testada
a incorporação de quitosano ou albumina na fase aquosa. Os resultados obtidos foram
promissores, obtendo-se valores de tamanhos de gotículas nanométricos, sendo porém
relativamente heterogéneos. A osmolalidade das formulações também foi alta para
administração nasal, mas a viscosidade das formulações foi adequada para este sistema
de entrega. Estas formulações tiveram bons resultados em ensaios in vitro de libertação e de biodisponibilidade in vivo, prolongado o tempo em que o perampanel permaneceu
no cérebro em concentrações terapêuticas. Assim, estes resultados podem ser ponto de
partida para outros trabalhos de investigação.
No segundo capítulo é relatado o estágio no Hospital Sousa Martins, parte da unidade
Local de Saúde da Guarda que decorreu entre os dias 14 de fevereiro e 01 de abril de 2022
sob a orientação do Dr. Jorge Aperta. Apresenta o que foi apreendido ao longo das 7
semanas de estágio acerca da gestão de uma farmácia hospitalar e todo o trabalho
desenvolvido pelo farmacêutico hospitalar. Este estágio permitiu ter um primeiro
contacto com a farmácia hospitalar e ter um contacto com uma equipa multidisciplinar
que trabalha sempre em prol do doente.
O terceiro capítulo resume a experiência em farmácia comunitária na farmácia São João
na Covilhã entre os dias 04 de abril e 24 de junho de 2022 sob a orientação da Dra. Dina
Esteves. Relata o dia a dia de um farmacêutico comunitário e alguns dos desafios que
esta área apresenta como, por exemplo, a gestão de uma farmácia e a dispensa de
medicamentos e todas as responsabilidades que isso acarreta. É um estágio muito
importante para a minha formação e é uma linha condutora no mundo do trabalho.
This paper is divided into three chapters. The first chapter describes the research work in Pharmaceutical Sciences, developed at the Health Sciences Research Centre of the University of Beira Interior (CICS-UBI). The second one reports the experience in hospital pharmacy at Local Health Unit of Guarda. Finally, the third one describes my experience in Community Pharmacy at São João Pharmacy in Covilhã. Epilepsy is a disease that affects a significant percentage of the population worldwide. It’s treatment can be either chronic or acute, the chronic being usually characterized by antiepileptics administered orally, taken daily by the patient, and the acute by an intravenous administration in case of an epileptic seizure. However, both forms of treatment have disadvantages with regard to their route of administration. To solve these disadvantages intranasal administration has already been described in the literature. Perampanel is a very potent antiepileptic drug already marketed for oral administration. The fact that it is very potent means that a lower dose is necessary for the therapeutic effect to be achieved, which makes it a great candidate for intranasal administration. However, it has the problem of having low aqueous solubility which makes it a challenge to this route. The research team has already developed a formulation to deliver this drug intranasally with promising results. This formulation uses SMEDD technology (selfmicroemulsifying drug delivery system) that increases the bioavailability of drugs, especially those with low aqueous solubility. In this work was considered to optimize this formulation with the objective that the concentration of perampanel remains within the therapeutic range for a longer time. As strategy to promote direct pathway to the brain, it was tested the incorporation of chitosan or albumin in the aqueous phase was tested. The results obtained are promising, being obtained nanometric droplet size between, although relatively heterogeneous. The osmolality of the formulations is also considered high for nasal administration; however, the viscosity of the formulations is adequate for this delivery system. These formulations performed well in vitro release and in vivo bioavailability assays, prolonging the time in which perampanel remained within therapeutic concentrations in the brain. Thus, these results can be a starting point for other research works. The second chapter reports the internship at Hospital Sousa Martins, part of the Local Health Unit of Guarda, which took place between February 14th and April 1st of 2022, under the guidance of Dr. Jorge Aperta. It presents what was learned during the 7 weeks of internship about the management of a hospital pharmacy and all the work developed by the hospital pharmacist. This internship allowed me to have a first contact with hospital pharmacy and with a multidisciplinary team that works for the patient. The third chapter summarizes the experience in community pharmacy at the São João pharmacy in Covilhã between April 4th and June 24th of 2022 under the guidance of Dr. Dina Esteves. It reports the daily life of a community pharmacist and some of the challenges that this area presents. It was very important for my education ant it is a reference for future jobs.
This paper is divided into three chapters. The first chapter describes the research work in Pharmaceutical Sciences, developed at the Health Sciences Research Centre of the University of Beira Interior (CICS-UBI). The second one reports the experience in hospital pharmacy at Local Health Unit of Guarda. Finally, the third one describes my experience in Community Pharmacy at São João Pharmacy in Covilhã. Epilepsy is a disease that affects a significant percentage of the population worldwide. It’s treatment can be either chronic or acute, the chronic being usually characterized by antiepileptics administered orally, taken daily by the patient, and the acute by an intravenous administration in case of an epileptic seizure. However, both forms of treatment have disadvantages with regard to their route of administration. To solve these disadvantages intranasal administration has already been described in the literature. Perampanel is a very potent antiepileptic drug already marketed for oral administration. The fact that it is very potent means that a lower dose is necessary for the therapeutic effect to be achieved, which makes it a great candidate for intranasal administration. However, it has the problem of having low aqueous solubility which makes it a challenge to this route. The research team has already developed a formulation to deliver this drug intranasally with promising results. This formulation uses SMEDD technology (selfmicroemulsifying drug delivery system) that increases the bioavailability of drugs, especially those with low aqueous solubility. In this work was considered to optimize this formulation with the objective that the concentration of perampanel remains within the therapeutic range for a longer time. As strategy to promote direct pathway to the brain, it was tested the incorporation of chitosan or albumin in the aqueous phase was tested. The results obtained are promising, being obtained nanometric droplet size between, although relatively heterogeneous. The osmolality of the formulations is also considered high for nasal administration; however, the viscosity of the formulations is adequate for this delivery system. These formulations performed well in vitro release and in vivo bioavailability assays, prolonging the time in which perampanel remained within therapeutic concentrations in the brain. Thus, these results can be a starting point for other research works. The second chapter reports the internship at Hospital Sousa Martins, part of the Local Health Unit of Guarda, which took place between February 14th and April 1st of 2022, under the guidance of Dr. Jorge Aperta. It presents what was learned during the 7 weeks of internship about the management of a hospital pharmacy and all the work developed by the hospital pharmacist. This internship allowed me to have a first contact with hospital pharmacy and with a multidisciplinary team that works for the patient. The third chapter summarizes the experience in community pharmacy at the São João pharmacy in Covilhã between April 4th and June 24th of 2022 under the guidance of Dr. Dina Esteves. It reports the daily life of a community pharmacist and some of the challenges that this area presents. It was very important for my education ant it is a reference for future jobs.
Description
Keywords
Administração Intranasal Albumina Farmácia Comunitária Farmácia Hospitalar Perampanel