Lucchetti Giancarlo, Lucchetti Alessandra Lamas Granero, Pires Sueli Luciano, Gorzoni Milton Luiz
Geriatrics and Gerontology Sector, Santa Casa de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2011 Jan 6;129(1):17-22. doi: 10.1590/s1516-31802011000100004.
Farmácia Dose Certa is a program available in the State of São Paulo that is a national reference for providing drugs free of charge to the population. Elderly people receiving care deserve special attention regarding drugs that are appropriate for their age group. The objective was to assess the drugs in the program considered to be inappropriate for the elderly.
Descriptive study evaluating free drug distribution in the State of São Paulo, Brazil.
Following the criteria proposed by Beers and Fick (drugs or drug classes that should be avoided among elderly people, independent of the diagnosis or clinical condition, because of the high risk of side effects and because other, safer drugs are available), the drugs in the Farmácia Dose Certa program that might be inappropriate for elderly people and the levels of evidence for each drug included were assessed.
Among the available drugs, 10 (25.6%) were included within the Beers-Fick criteria. The drugs selected were: amitriptyline, cimetidine, diazepam, digoxin, fluoxetine, methyldopa, nifedipine, promethazine, thioridazine and ferrous sulfate.
The list of drugs available within the Farmácia Dose Certa program may be considered appropriate for the general population, but not completely for the elderly population. Adjusting this list to the pharmacological aspects of aging will reduce the risks of drug interactions, falls, mental confusion and excessive sedation that result from drugs that are considered inappropriate for consumption by elderly people.
“精准剂量药房”项目在圣保罗州实施,是为民众免费提供药品的全国性典范。在为老年人提供护理时,应特别关注适合其年龄段的药物。本研究旨在评估该项目中被认为不适用于老年人的药物。
描述性研究,评估巴西圣保罗州的免费药品发放情况。
依据Beers和Fick提出的标准(由于副作用风险高且有其他更安全的药物可供选择,无论诊断或临床状况如何,老年人都应避免使用的药物或药物类别),评估“精准剂量药房”项目中可能不适用于老年人的药物以及每种入选药物的证据水平。
在现有药物中,10种(25.6%)符合Beers - Fick标准。所选药物为:阿米替林、西咪替丁、地西泮、地高辛、氟西汀、甲基多巴、硝苯地平、异丙嗪、硫利达嗪和硫酸亚铁。
“精准剂量药房”项目提供的药物清单可能适用于一般人群,但不完全适用于老年人群。根据衰老的药理学特征调整该清单,将降低因被认为不适用于老年人使用的药物而导致的药物相互作用、跌倒、精神错乱和过度镇静的风险。