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- ItemSomente MetadadadosAntibiotic consumption patterns and drug leftovers in 6000 Brazilian households(Health Communications Inc, 2000-01-01) Marliere, GLL; Ferraz, M. B.; Santos, J. Q. dos; Universidade Federal de São Paulo (UNIFESP)Worldwide data indicate that antibiotics are frequently used indiscriminately. Phe present study used a questionnaire in an attempt to quantify and qualify outpatient antibiotic consumption habits, including when the drug was used, who recommended it, and to what extent treatment was completed, and to question householders on the presence of antibiotics in their homes, including leftovers from previous treatments. the questionnaire was distributed to residents of 6000 households that made up a representative sample of the Brazilian population and was completed by designated respondents from 4932 residences (82.2%) with or without field interviewer supervision. Each household reported an average of 3.7 treatments in the previous year, with amoxicillin the most frequently used antibiotic in this survey (18%), regardless of socioeconomic class. Most treatments were recommended through medical prescription, and this source of antibiotic was associated with the highest rate of completed therapy (80.4%). Azithromycin and ciprofloxacin produced the highest rates of completed treatment and the lowest rates of antibiotic leftovers. Storing antibiotics at home increases the cost of each treatment event, reduces efficacy, and may encourage the emergence of resistant organisms in the community. Educational efforts must be redoubled to promote the rational and effective use of drugs, especially antibiotics.
- ItemAcesso aberto (Open Access)Clonazepam, um campeão de vendas no Brasil. Por quê?(Universidade Federal de São Paulo (UNIFESP), 2016-06-01) Cruz, Nelma Lourenco de Matos [UNIFESP]; Carlini, Elisaldo Luiz de Araujo [UNIFESP]; http://lattes.cnpq.br/5948335656347039; http://lattes.cnpq.br/8459051263596166; Universidade Federal de São Paulo (UNIFESP)Clonazepam, a benzodiazepine, is the leading seller in Brazil and the most consumed version of Ordinance 344/98. It is used in the treatment of central nervous system disorders including epilepsy, anxiety, social phobia, insomnia, affective bipolar disorders, panic disorders and akathisia. Clonazepam has high therapeutic efficacy, low toxicity and can lead to dependence after six to eight weeks of use – withdrawal symptoms may occur if there is abrupt discontinuation of use, even in therapeutic doses. This study aims to analyse the various reasons for high sales and consumption of the drug in Brazil. Methodology: the high consumption of clonazepam is a phenomenon of unknown causes and effects; therefore, qualitative research was employed. The focus groups of nineteen patients, five doctors and four pharmacists was formed within two research sites: Funilândia (Minas Gerais) and São Paulo (São Paulo). Interviews were conducted with semi-structured scripts and content analysis with the help of NVivo software. Results – Patients: After use of Clonazepam, patients declared feeling symptoms of sleepiness, relaxation, comfort and security. The range of dosage patients self-administer can be dependent on the emotional state of the users, who do not report taking high doses of clonazepam. The period of use of the drug among patients was up to fifteen years. Information is exchanged between users, and many of them are friends or relatives. Many of them reported being able to get a prescription for clonazepam without receiving medical consultation. Many patients also tried to stop the use of the drug, but were not able to. All of them reported never having received guidance from pharmacists, and only a few received instruction from doctors. Doctors: The main stated reason for prescribing the drug to patients was “renewing a previous prescription from another doctor”. They also declared that were aware of the dosage flexibility, but that the patients do not abusive it. Doctors trust the drug and find it safe, believing that patients use Clonazepam in order to treat ‘problems’. Pharmacists: Pharmacists do not feel co-responsible for the prescription of Clonazepam. They believe that the control of sales of the drug is inefficient and easy to get around – there have been sales of the drug without the correct prescription produced. One of the pharmacists in the study declared that they sell the drug without prescription, something that was witnessed during during the interview. Pharmaceutical laboratories - were not forthcoming in their interest to be a part of the research, and they refused the invitation to participate. Conclusions: The abuse and misuse of Clonazepam is a public health problem. The results of the research indicate failure in the use, the prescription, and the control of sales of Clonazepam. It is necessary to restructure systems that monitor the production, prescription and sales of the drug. Refresher training for health professionals should be encouraged in order to promote rational and sensible use of medicines, especially in the case of psychotropic medicine. Finally, there should be further promotion of actions aimed at users of Clonazepam seeking to educate them about the benefits and risks of using such drugs, self-medication and appropriate use of medicines.