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Authors
Advisor(s)
Abstract(s)
A presente dissertação encontra-se dividida em dois capítulos. O primeiro capítulo diz
respeito a um estudo retrospetivo de reações adversas aos diuréticos, em idosos com
hipertensão arterial. O segundo capítulo refere-se ao relatório de estágio curricular em
farmácia comunitária.
A hipertensão arterial é das patologias mais comuns no idoso, afetando
aproximadamente mil milhões de indivíduos. Esta patologia pode ser considerada como
parte integrante das alterações relacionadas com o envelhecimento. Os diuréticos são
agentes de 1ª linha no controlo da hipertensão arterial na população geriátrica,
reduzindo significativamente as complicações cardiovasculares.
O objetivo deste trabalho é avaliar o perfil de segurança dos diuréticos e consiste num
estudo retrospetivo das reações adversas aos diuréticos ocorridas em Portugal, enviadas
para o Sistema de Farmacovigilância Português, entre o ano de 2000 e maio de 2020,
em idosos com hipertensão arterial.
Vários parâmetros foram analisados, como o tipo de notificador, a caracterização
demográfica da população, o tipo de reação adversa a medicamentos (RAM), a
medicação concomitante, se as RAMs estão descritas ou não na literatura, a gravidade e
a evolução do quadro clínico do utente. As RAMs onde o critério de gravidade foi morte,
risco de vida e / ou hospitalização, foram analisadas em detalhe.
Os resultados obtidos permitiram concluir que, os médicos foram os profissionais de
saúde que apresentaram o maior número de notificações, a maioria das reações adversas
foi observada em indivíduos do sexo feminino e na faixa etária dos 65 aos 74 anos. O
diurético com maior número de notificações foi a furosemida e as reações adversas mais
prevalentes foram encontradas no grupo “Perturbações gerais e alterações no local de
administração” do System Organ Classes (SOC) da terminologia do Dicionário Médico
para Atividades Regulatórias (MedDRA). O critério de gravidade que mais se destacou
nas notificações recebidas foi a hospitalização. Quanto às reações em que o resultado foi
a morte, o medicamento suspeito foi na maioria dos casos a furosemida. Por fim, a maior
parte dos casos evoluíram favoravelmente até à cura e verificou-se a existência de vários
utentes polimedicados, estando a tomar mais de cinco medicamentos, aquando a
notificação da RAM. Este estudo reforça a importância da farmacovigilância na prevenção de reações adversas
e no conhecimento do perfil de segurança dos medicamentos, aumentando assim a
qualidade de vida dos idosos.
No segundo capítulo encontra-se o relatório de estágio em farmácia comunitária que
decorreu na Farmácia Crespo na Covilhã, de 8 de fevereiro a 18 de junho. Nele são
descritas todas as atividades que fazem parte do dia a dia do farmacêutico comunitário,
assim como todas as tarefas que tive oportunidade de desempenhar. Este período de
estágio foi de grande aprendizagem a vários níveis, principalmente a nível científico e
social, tendo contribuído para evoluir como profissional de saúde.
This dissertation is divided into two chapters. The first chapter concerns a retrospective study of adverse reactions to diuretics, in elderly people with arterial hypertension. The second chapter refers to the report on the traineeship in community pharmacy. Hypertension is one of the most common health problems in the elderly and affects approximately one billion individuals worldwide. This condition could be considered as part of the changes associated with aging. Diuretics are first-line agents in the control of hypertension in the geriatric population, leading to a significant reduction of cardiovascular events. The objective of this work is to evaluate the safety profile of diuretics and consists of a retrospective study of adverse reactions to diuretics that occurred in Portugal, sent to Portuguese Pharmacovigilance System, between the year 2000 and May 2020, in elderly people with arterial hypertension. Several parameters were analysed such as, type of notifier, demographic characterization of the population, type of adverse drug reaction (ADR), concomitant medication, if the ADRs are described in the literature or not, seriousness, and evolution of patient´s clinical status. ADRs with outcome, death, life-threatening and / or hospitalization, were analysed in detail. Among the results obtained, physicians were the health professionals who submitted the highest number of notifications, most adverse reactions were observed in female gender and in the age group of 65 to 74 years. The diuretic with the highest number of reports was furosemide, and the most prevalent adverse reactions were those found in the “General disorders and administration site conditions” group of the System Organ Classes (SOC) of the Medical Dictionary for Regulatory Activities (MedDRA) terminology. The most prominent severity criterion in the notifications received is hospitalization. As for the ADRs where the outcome was death, the suspected drugs were mostly furosemide. Finally, most cases evolved favorably to cure, and it was verified the existence of several polymedicated patients, taking more than five medications, when the ADR was notified. This study reinforces the importance of pharmacovigilance in preventing adverse reactions and in knowing the safety profile of drugs, thus increasing the quality of life of the elderly. The report of the traineeship in community pharmacy was included in the second chapter, which occurred in Farmácia Crespo, in Covilhã, since February 8th to June 18th. It is described all the activities that are part of everyday life of the community pharmacist, as well as all the tasks that I had the opportunity to develop. The traineeship period was one of great learning at various levels, mainly at the scientific and social level, having contributed to my evolution as a health professional.
This dissertation is divided into two chapters. The first chapter concerns a retrospective study of adverse reactions to diuretics, in elderly people with arterial hypertension. The second chapter refers to the report on the traineeship in community pharmacy. Hypertension is one of the most common health problems in the elderly and affects approximately one billion individuals worldwide. This condition could be considered as part of the changes associated with aging. Diuretics are first-line agents in the control of hypertension in the geriatric population, leading to a significant reduction of cardiovascular events. The objective of this work is to evaluate the safety profile of diuretics and consists of a retrospective study of adverse reactions to diuretics that occurred in Portugal, sent to Portuguese Pharmacovigilance System, between the year 2000 and May 2020, in elderly people with arterial hypertension. Several parameters were analysed such as, type of notifier, demographic characterization of the population, type of adverse drug reaction (ADR), concomitant medication, if the ADRs are described in the literature or not, seriousness, and evolution of patient´s clinical status. ADRs with outcome, death, life-threatening and / or hospitalization, were analysed in detail. Among the results obtained, physicians were the health professionals who submitted the highest number of notifications, most adverse reactions were observed in female gender and in the age group of 65 to 74 years. The diuretic with the highest number of reports was furosemide, and the most prevalent adverse reactions were those found in the “General disorders and administration site conditions” group of the System Organ Classes (SOC) of the Medical Dictionary for Regulatory Activities (MedDRA) terminology. The most prominent severity criterion in the notifications received is hospitalization. As for the ADRs where the outcome was death, the suspected drugs were mostly furosemide. Finally, most cases evolved favorably to cure, and it was verified the existence of several polymedicated patients, taking more than five medications, when the ADR was notified. This study reinforces the importance of pharmacovigilance in preventing adverse reactions and in knowing the safety profile of drugs, thus increasing the quality of life of the elderly. The report of the traineeship in community pharmacy was included in the second chapter, which occurred in Farmácia Crespo, in Covilhã, since February 8th to June 18th. It is described all the activities that are part of everyday life of the community pharmacist, as well as all the tasks that I had the opportunity to develop. The traineeship period was one of great learning at various levels, mainly at the scientific and social level, having contributed to my evolution as a health professional.
Description
Keywords
Diuréticos Farmácia
Comunitária Farmacovigilância Idosos Reação Adversa a Medicamentos