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Authors
Abstract(s)
Com a progressão da idade verifica-se um aumento da incidência da hipertensão
arterial, que afeta mais de 60% da população idosa (com =65 anos de idade). Tendo em conta
que existem vários mecanismos e sistemas fisiológicos reguladores da pressão arterial, tornase claro que várias classes farmacológicas possam ser utilizadas nesta patologia,
nomeadamente antagonistas dos recetores de angiotensina (ARA), inibidores da enzima
conversora de angiotensina (IECA), diuréticos de ansa (DIUansa), diuréticos tiazídicos
(DIUtiazida), diuréticos poupadores de potássio (DIUpp), bloqueadores dos canais de cálcio
(BCC) e antagonistas beta-adrenérgicos (ABA).
Foi realizada a análise dos dados terapêuticos dos idosos hipertensos incluídos na
EBIcohort, uma coorte criada no âmbito do projeto ICON (“Interdisciplinary Challenges On
Neurodegeneration”, Programa Operacional do Centro, Centro 2020 (CENTRO-01-0145-FEDER000013), com o intuito de estudar os fatores ou esquemas terapêuticos que podem influenciar
a qualidade de vida (QOL) dos idosos. Foram estabelecidos grupos de indivíduos com base no
número de fármacos anti-hipertensivos existentes na sua terapêutica (grupo de controlo e
grupo de idosos tratados com 1 a 5 substâncias ativas). Utilizámos o instrumento EUROHISQOL-8 para analisar os níveis de QOL nos diferentes grupos de idosos. Assim, procedeu-se à
análise dos tipos de associações terapêuticas usadas mais frequentemente, distinguindo os
diferentes tipos de classes farmacológicas, associações de fármacos, bem como o seu impacto
na QoL. Dentro das monoterapias mais frequentemente observadas estão as que contemplam
ARA (30.2%), DIUansa (26.4%) e IECA (18.9%). Nas terapêuticas duplas, a combinação DIUansaARA foi a predominante (19.1%) seguida de ARA-DIUtiazida (14.7%). Relativamente às
terapêuticas triplas, a associação ARA-DIUansa-BCC foi a mais frequente (23.3%). Nos idosos
tratados com 4 ou mais substâncias anti-hipertensivas, a associação ARA-DIUansa-BCC-ABA foi
a mais observada (25.0%). Na monoterapia, os idosos tratados com ARA parecem ter um
menor nível de QOL, enquanto os que se encontram submetidos a uma terapêutica com BCC
apresentam níveis superiores de QOL, em comparação com outras monoterapias. Nas
terapêuticas múltiplas, a associação de ARA com diuréticos tem tendência para aumentar a
QoL, comparativamente à monoterapia com ARA. Adicionalmente, a associação de um BCC
com um ARA ou DIUansa sugere um decréscimo na QOL, quando comparada à da monoterapia
com BCC.
O segundo capítulo do presente relatório de estágio refere-se ao estágio curricular
realizado no âmbito da farmácia comunitária. Este teve lugar na Farmácia Rosa (Caldas da
Rainha), de 22 de janeiro de 2019 a 1 de junho do mesmo ano, sob a orientação da Dra. Catarina Afonso. Aqui é descrito o funcionamento de uma farmácia e o seu enquadramento
legal, bem como as áreas de intervenção do farmacêutico, as quais vão sendo caracterizadas
de acordo com as tarefas que fui realizando ao longo deste período.
Hypertension increases with ageing thus affecting more than 60% of the elderly population (aged =65 years). As different blood pressure regulating systems and mechanisms coexist, different drug classes can be used to treat hypertension, namely angiotensin receptor blockers (ARB), angiotensin converting enzyme inhibitors (ACEi), loop diuretics (DIUan), thiazide diuretics (DIUtiazida), potassium-sparing diuretics (DIUpp), calcium channel blockers (CCB) and beta-adrenergic antagonists (BAA). We assessed the therapeutic data derived from hypertensive elders included in the EBIcohort, a cohort created in the scope of the ICON project (Programa Operacional do Centro, Centro 2020, CENTRO-01-0145-FEDER-000013), to study factors or therapeutic schemes that can influence the quality of life (QoL) of elders. We used the EUROHIS-QOL 8 scale to analyze the QoL levels in the different groups of elderly concerning different therapies.Groups of individuals were established taking in account the number of antihypertensive drugs in their therapy (control and elders treated with 1 to 5 drugs). We analyzed the types of drugs associations used with higher frequencies, taking in account the different pharmacologic classes, the different drug associations, as well as the impact of these drugs in QoL. The most frequently used monotherapies were ARB (30.2%), DIUan (26.4%) and ACEi (18.9%). Among dual therapies, the combination DIUan-ARB was predominant (19.1%) followed by ARB-DIUtiazida (14.7%). Concerning triple therapies the association ARB-DIUan-CCB was predominant (23.3%). In elders using four or more antihypertensive drugs, the association ARB-DIUan-CCB-BAA was predominant (25.0%). In monotherapy, elders treated with ARB seems to have lower level and CCB bigger level of QoL compared with the other monotherapies. In multi-therapy, the association of ARB with diuretics has a tendency to increase QoL comparing with ARB monotherapy. In addition, association of CCB with ARB or DIUan appears to decrease QoL when compared with CCB monotherapy. The second chapter of the present internship report refers to the curricular internship that occurred at a community pharmacy. Namely, it took place at Farmácia Rosa (in Caldas da Rainha), from January 22nd 2019 to 1st June 2019, under the guidance of Dr. Catarina Afonso. In this section, the overall functioning of a community pharmacy and its legal framework is described, as well as the pharmacist’s intervention areas, which are characterized throughout the report according to the tasks I was taught to perform along the way.
Hypertension increases with ageing thus affecting more than 60% of the elderly population (aged =65 years). As different blood pressure regulating systems and mechanisms coexist, different drug classes can be used to treat hypertension, namely angiotensin receptor blockers (ARB), angiotensin converting enzyme inhibitors (ACEi), loop diuretics (DIUan), thiazide diuretics (DIUtiazida), potassium-sparing diuretics (DIUpp), calcium channel blockers (CCB) and beta-adrenergic antagonists (BAA). We assessed the therapeutic data derived from hypertensive elders included in the EBIcohort, a cohort created in the scope of the ICON project (Programa Operacional do Centro, Centro 2020, CENTRO-01-0145-FEDER-000013), to study factors or therapeutic schemes that can influence the quality of life (QoL) of elders. We used the EUROHIS-QOL 8 scale to analyze the QoL levels in the different groups of elderly concerning different therapies.Groups of individuals were established taking in account the number of antihypertensive drugs in their therapy (control and elders treated with 1 to 5 drugs). We analyzed the types of drugs associations used with higher frequencies, taking in account the different pharmacologic classes, the different drug associations, as well as the impact of these drugs in QoL. The most frequently used monotherapies were ARB (30.2%), DIUan (26.4%) and ACEi (18.9%). Among dual therapies, the combination DIUan-ARB was predominant (19.1%) followed by ARB-DIUtiazida (14.7%). Concerning triple therapies the association ARB-DIUan-CCB was predominant (23.3%). In elders using four or more antihypertensive drugs, the association ARB-DIUan-CCB-BAA was predominant (25.0%). In monotherapy, elders treated with ARB seems to have lower level and CCB bigger level of QoL compared with the other monotherapies. In multi-therapy, the association of ARB with diuretics has a tendency to increase QoL comparing with ARB monotherapy. In addition, association of CCB with ARB or DIUan appears to decrease QoL when compared with CCB monotherapy. The second chapter of the present internship report refers to the curricular internship that occurred at a community pharmacy. Namely, it took place at Farmácia Rosa (in Caldas da Rainha), from January 22nd 2019 to 1st June 2019, under the guidance of Dr. Catarina Afonso. In this section, the overall functioning of a community pharmacy and its legal framework is described, as well as the pharmacist’s intervention areas, which are characterized throughout the report according to the tasks I was taught to perform along the way.
Description
Keywords
Hipertensão Idosos Institucionalizados Qualidade de Vida Tratamento Anti-Hipertensivo