Navegando por Palavras-chave "Benzodiazepine"
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- ItemSomente MetadadadosAcute benzodiazepine administration induces changes in homocysteine metabolism in young healthy volunteers(Elsevier B.V., 2009-08-31) Pompeia, Sabine [UNIFESP]; Grego, Bruno H. C. [UNIFESP]; Pradella-Hallinan, Marcia [UNIFESP]; Hachul, Helena [UNIFESP]; Tufik, Sergio [UNIFESP]; D'Almeida, Vania [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: High cortisol plasma concentrations have been shown to be associated with increases in homocysteine levels. Here we studied whether decreases in cortisol concentration, induced by an acute oral dose of a benzodiazepine, could decrease homocysteine, and if changes were similar in both genders.Methods: This was a double-blind, cross-over design study of acute oral flunitrazepam (1.2 mg) and placebo in young, healthy, male and female (n = 21) volunteers. Blood samples were collected 3 h after ingestion (after peak-plasma concentration of flunitrazepam was reached). Various biochemical parameters were analysed, such as plasma homocysteine, cysteine, folate, vitamins B6, B12, and sexual hormones.Results: Flunitrazepam reduced cortisol (p = 0.0011), cysteine (p = 0.014) and homocysteine (p = 0.028) concentrations, irrespective of gender. No correlations were found between cortisol and other biochemical markers (all r's<0.03). Concentration of cysteine and homocysteine were negatively correlated with plasma flunitrazepam concentration, suggesting that changes in these amino acids might be related to the metabolism of this benzodiazepine.Conclusion: Acute administration of flunitrazepam decreases plasma homocysteine and cysteine by mechanisms that seem unrelated to changes in cortisol. Given the importance of homocysteine as a market of life-threatening disorders, the mechanisms involved in the decrease of these amino acids are potential targets for clinical application. (C) 2009 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosDiazepam effects on aversive memory retrieval and extinction: Role of anxiety levels(Pergamon-Elsevier Science Ltd, 2016) Leão, Anderson Henrique França Figueiredo; Cabral, Alicia; Izídio, Geison Souza; Ribeiro, Alessandra Mussi [UNIFESP]; Silva, Regina Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Benzodiazepines (BDZs) are anxiolytic drugs that impair memory acquisition. Previous studies using the plus maze discriminative avoidance task (PMDAT, which assesses memory and anxiety concomitantly) indicated that the effects of BDZs on anxiety and acquisition are related to each other. The possible influence of the anxiolytic action of BDZs on their effects on memory retrieval and extinction are poorly understood. This is relevant considering the relationship between aversive memories and anxiety disorders. We designed a modified protocol of PMDAT that evaluates anxiety during retrieval and extinction of the task. Male Wistar rats were trained in the PMDAT (plus-maze with two open and two enclosed arms) using a standard or a modified protocol. In the standard protocol, the aversive stimuli were presented in one of the enclosed arms during training, and the animal had free access to the whole apparatus. In the modified protocol, the open arms were blocked with glass walls. Twenty-four hours after training, the animals subjected to each of the protocols were treated with saline or 2.0 mg/kg of diazepam (DZP) 30 min before the test. There was a third session in the maze (retest) 24 h after the test. During the test, DZP impaired and improved retrieval in rats that had been trained in the standard and the modified protocol when compared to the respective saline-treated groups. In addition, treatment with DZP prior to the test induced anxiolysis, but only in the animals that were not pre-exposed to the open arms of the apparatus (modified protocol). In these animals, DZP impaired extinction, which was evaluated during retest session. The impairing effect of DZP on extinction seems to be related to its anxiolytic action during the test (extinction learning). Further, we suggest that aversive memory retrieval depends on both the treatment and the arousal elicited by exposure to the apparatus.
- ItemAcesso aberto (Open Access)Estudo da desprescrição do psicotrópico benzodiazepínico nas Unidades Básicas de Saúde do município de Diadema(Universidade Federal de São Paulo, 2022-12-20) Maia, Rafaela Silva [UNIFESP]; Fegadolli, Claudia [UNIFESP]; http://lattes.cnpq.br/6541145627909917; https://lattes.cnpq.br/6588099547407422Este estudo aborda a desprescrição do uso de benzodiazepínicos (BZD) para usuários crônicos desta classe de medicamentos. O uso de BZD por mais de quatro semanas pode ser prejudicial ao usuário, devido à sua capacidade de desenvolver tolerância e gerar dependência, além de provocar perda de memória, sedação excessiva e aumentar risco de queda, principalmente em idosos. O estudo foi conduzido pela Universidade Federal de São Paulo (UNIFESP) em parceria com a Secretaria Municipal de Saúde de Diadema, com a participação de sete farmacêuticos atuantes na atenção básica do município e das equipes de saúde. Todas as estratégias de ação foram delineadas no contexto do grupo de pesquisa interinstitucional e incluíram protocolos de acolhimento, atendimento e seguimento interprofissional, com abordagens individuais e coletivas. Os usuários foram avaliados clinicamente antes e depois do acompanhamento, através de escalas que mensuram níveis de ansiedade; sonolência diurna; qualidade do sono; dependência a benzodiazepínicos e qualidade de vida. O modelo de desprescrição tem se mostrado viável na abordagem clínica de usuários de benzodiazepínicos no tratamento da dependência e na interrupção do uso injustificável. Dentre os principais desafios enfrentados para a ampliação do alcance do programa estão a necessidade de ações de educação permanente para que os profissionais da atenção básica possam reorganizar práticas assistenciais a fim de considerarem o tratamento e prevenção da dependência a psicofármacos uma estratégia necessária e possível no contexto do trabalho interprofissional em saúde.
- ItemAcesso aberto (Open Access)Prescription of anorectic and benzodiazepine drugs through notification B prescriptions in Natal, Rio Grande do Norte, Brazil(Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, 2010-06-01) Nappo, Solange Aparecida [UNIFESP]; Carlini, Elisaldo Araujo [UNIFESP]; Araújo, Maria Dalva; Moreira, Lúcio Flávio Sousa; Universidade Federal de São Paulo (UNIFESP); Federal University of Rio Grande do Norte Department of Social Sciences Brazilian Information Center on Psychotropic DrugsA study was conducted on 22,158 special B prescriptions (notificações B) containing amphetamine-type anorectic drugs or benzodiazepines, obtained from compounding pharmacies or drugstores located in the city of Natal, RN, Brazil. The data obtained were compared with those from other Brazilian cities. Results showed that compounding pharmacies dispensed 85.4% of the prescriptions, indicating that these pharmacies filled out nearly 10 times more of these prescriptions than did the drugstores. The majority (83.5%) of B prescriptions issued for the compounding pharmacies were for women, where the female/male patient ratio ranged from 7.1/1.0 for mazindol to 10.3/1.0 for amfepramone. Similar results were obtained for the benzodiazepines with ratios of 1.9/1.0 for clonazepam to 15.6/1.0 for oxazepam. Omissions and mistakes were present in the B prescriptions, including missing information about the patient (in 49.6% of the documents) or about the pharmacies or drugstores (50.4%). There were cases where the name and/or CRM of the physician was lacking. It was noted that one medical doctor made out 1855 B prescriptions within one year. The same patient's name appeared on 138 prescriptions, and the same RG (identification card number) was present in 125 others. Comparison of Natal's data with those of several other Brazilian cities disclosed a striking similarity throughout Brazil, from Pelotas - Rio Grande do Sul State to Belem-Para State, revealing a practically identical medical/pharmaceutical behavior. This pattern of prescription/dispensation of amphetamine-type substances mostly to women for weight loss is therefore for cosmetic reasons. Consequently, there is an urgent need for an ethical review of this behavior.
- ItemSomente MetadadadosUse of fentanyl and midazolam in mechanically ventilated children-Does the method of infusion matter?(W B Saunders Co-Elsevier Inc, 2016) Lucas da Silva, Paulo Sergio; Reis, Maria Eunice; de Aguiar, Vania Euzebio; Machado Fonseca, Marcelo Cunio [UNIFESP]Background and objective: Benzodiazepines and opioids are commonly used in pediatric intensive care unit. However, there is no previous study assessing the use of administering these drugs combined (single solution) or separately. We sought to evaluate the impact of these 2 different methods of providing sedation/analgesia in pediatric intensive care unit. Methods: One hundred twelve patients mechanically ventilated for more than 48 hours were randomized to receive a protocolized sedation regimecomprising midazolamand fentanyl either separately (group 1, 57 patients) or combined as a single solution (group 2, 55 patients). Primary end point variable was the cumulated dose of midazolam and fentanyl. Results: The median cumulated doses of both fentanyl (0.19 vs 0.37 mg/kg, P < .05) and midazolam (28.8 vs 45.6 mg/kg, P < .05) required in group 2 were higher when compared with those of group 1. Moreover, group 2 patients had a significantly longer time of vasopressor drugs requirement and a higher number of patients developing tolerance. Conclusion: Patients who received a single solution of midazolam and fentanyl had a higher cumulated dose of compared with those patients who did not. The potential risk for long-term neurologic effects on developing brains associated with this finding should be considered. (C) 2015 Elsevier Inc. All rights reserved.