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Authors
Advisor(s)
Abstract(s)
Este trabalho está dividido em três capítulos que descrevem a minha experiência
profissionalizante nas vertentes de investigação, farmácia hospitalar e farmácia comunitária.
O primeiro capítulo é relativo à vertente de investigação desenvolvida no âmbito de
um trabalho de revisão sobre a necrólise epidérmica tóxica (NET) induzida por fármacos. A
NET é uma reação adversa cutânea grave associada a diversos medicamentos que, embora
rara, tem um impacto significativo na saúde pública dado estar associada a uma elevada
morbilidade e mortalidade. Esta condição clínica é caracterizada por um envolvimento
mucocutâneo grave, o qual progride para uma separação da camada epidérmica da pele. O
objetivo deste trabalho foi efetuar uma análise da literatura disponível referente a fármacos
ou grupos farmacológicos mais suscetíveis de induzir NET. Efetuou-se uma pesquisa na base
de dados PubMed utilizando os termos “toxic epidermal necrolysis”, “drug-induced toxic
epidermal necrolysis”, “drug toxicity” e “cutaneous adverse drug reaction”. Diversas classes
farmacológicas estão envolvidas no desenvolvimento de NET, no entanto são os fármacos
como o alopurinol, os anticonvulsivantes, os antibióticos, os anti-inflamatórios não esteroides
do grupo dos oxicams e a sulfassalazina que estão implicados na maioria dos casos de NET. De
modo a minimizar a morbilidade e mortalidade, esta condição clínica requer um diagnóstico
precoce, com a interrupção imediata do fármaco implicado e a instituição de um tratamento
adequado.
O segundo capítulo refere-se ao relatório de estágio em farmácia hospitalar, o qual
foi realizado nos Serviços Farmacêuticos do Centro Hospitalar Cova da Beira, EPE, e
possibilitou não só a consolidação e o enriquecimento dos meus conhecimentos, mas ainda a
integração numa equipa de saúde multidisciplinar. Pretende-se assim descrever o
funcionamento e organização da farmácia hospitalar, bem como as diversas atividades
desenvolvidas nos diferentes setores deste serviço.
Por fim, o último capítulo descreve o estágio em farmácia comunitária, o qual foi
realizado na Farmácia São Cosme na Covilhã. Pretende-se descrever sumariamente as
competências adquiridas e o funcionamento de uma farmácia comunitária e todas as tarefas e
responsabilidades associadas, as quais tive oportunidade de acompanhar e de assumir um
papel ativo.
This work is divided into three chapters that describe my professional experience in research, hospital pharmacy and community pharmacy. The first chapter is focused on the research work developed as part of a review study on toxic epidermal necrolysis (TEN) induced by drugs. TEN is a severe cutaneous adverse reaction associated with several drugs which, although rare, has a significant impact on public health since it is associated with high morbidity and mortality. This clinical condition is characterized by a severe mucocutaneous involvement, which progresses to a separation of the epidermal layer of the skin. The aim of this work was to analyse the available literature concerning to drugs or pharmacological groups more susceptible to induce TEN. We conducted a search in the PubMed database using the terms “toxic epidermal necrolysis”, “drug-induced toxic epidermal necrolysis”, “drug toxicity” and “cutaneous adverse drug reaction”. Several pharmacological classes were found to be involved in the development of TEN, however drugs such as allopurinol, anticonvulsants, antibiotics, non steroidal anti-inflammatory drugs of the oxicams group and sulfasalazine are involved in the majority of cases of TEN. In order to minimize morbidity and mortality, this condition requires early diagnosis, with immediate withdrawal of the involved drug and institution of appropriate treatment. The second chapter refers to the internship report in hospital pharmacy, which was performed in the Pharmaceutical Services of the Cova da Beira Hospital Center, EPE, and enabled not only to consolidate and enrich my knowledge but also the integration in a multidisciplinary health team. Herein is described the functioning and organization of the hospital pharmacy, as well as the many activities performed in different sectors of this department. Finally, the last chapter describes the internship in community pharmacy, which was performed in Farmácia São Cosme in Covilhã. In this report is also briefly described the skills acquired and the functioning of a community pharmacy, as well as all associated tasks and responsibilities, which I followed and where I had an active role.
This work is divided into three chapters that describe my professional experience in research, hospital pharmacy and community pharmacy. The first chapter is focused on the research work developed as part of a review study on toxic epidermal necrolysis (TEN) induced by drugs. TEN is a severe cutaneous adverse reaction associated with several drugs which, although rare, has a significant impact on public health since it is associated with high morbidity and mortality. This clinical condition is characterized by a severe mucocutaneous involvement, which progresses to a separation of the epidermal layer of the skin. The aim of this work was to analyse the available literature concerning to drugs or pharmacological groups more susceptible to induce TEN. We conducted a search in the PubMed database using the terms “toxic epidermal necrolysis”, “drug-induced toxic epidermal necrolysis”, “drug toxicity” and “cutaneous adverse drug reaction”. Several pharmacological classes were found to be involved in the development of TEN, however drugs such as allopurinol, anticonvulsants, antibiotics, non steroidal anti-inflammatory drugs of the oxicams group and sulfasalazine are involved in the majority of cases of TEN. In order to minimize morbidity and mortality, this condition requires early diagnosis, with immediate withdrawal of the involved drug and institution of appropriate treatment. The second chapter refers to the internship report in hospital pharmacy, which was performed in the Pharmaceutical Services of the Cova da Beira Hospital Center, EPE, and enabled not only to consolidate and enrich my knowledge but also the integration in a multidisciplinary health team. Herein is described the functioning and organization of the hospital pharmacy, as well as the many activities performed in different sectors of this department. Finally, the last chapter describes the internship in community pharmacy, which was performed in Farmácia São Cosme in Covilhã. In this report is also briefly described the skills acquired and the functioning of a community pharmacy, as well as all associated tasks and responsibilities, which I followed and where I had an active role.
Description
Keywords
Farmácia Comunitária Farmácia Hospitalar Necrólise Epidérmica Tóxica Reação Adversa Cutânea Toxicidade Medicamentosa