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Uso de produtos de saúde à base de plantas em Geriatria : falta de apetite no idoso
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O aumento da esperança média de vida a nível mundial tem trazido benefícios, mas, o envelhecimento inerente está intimamente ligado a uma maior probabilidade de aparecimento de doenças e de doentes polimedicados com menor qualidade de vida, podendo estas condições levar à falta de apetite.
Estima-se que entre 15% a 30% da população geriátrica sofra de anorexia do envelhecimento (falta de apetite associada à perda de peso), sendo escassas as opções terapêuticas disponíveis e detendo estas efeitos adversos que dificultam a sua utilização. A redução do apetite resulta de desequilíbrios nos sistemas reguladores do apetite centrais e periféricos.
A presente monografia tem como objetivo conhecer as principais plantas medicinais e produtos de saúde à base destas com utilidade terapêutica em geriatria como incrementadores do apetite. Pretende-se identificar as plantas medicinais descritas como úteis para o efeito e detentoras de monografia elaborada pela Agência Europeia do Medicamento (EMA), bem como outras plantas medicinais usadas tradicionalmente para o mesmo fim mas não objeto de monografia por parte desta. Para tal, foi realizada uma pesquisa bibliográfica na base de dados da EMA e nas bases de dados PubMed e Web of Science, segundo a metodologia PRISMA.
Foram identificadas catorze monografias da EMA para uso tradicional, treze de plantas medicinais e uma de um óleo essencial, destacando-se a planta medicinal Achillea millefolium L. pela maior evidência de segurança demonstrada com um teste adequado de genotoxicidade, podendo esta planta vir a constituir uma opção terapêutica viável e segura na abordagem da falta de apetite no idoso. No decurso da pesquisa bibliográfica foram identificadas mais nove plantas medicinais ou preparações à base destas, destacando-se a preparação Rikkunshito e a planta medicinal Astragalus membranaceus.
Apesar da heterogeneidade de ensaios e consequente dificuldade de comparação dos resultados obtidos entre estes, foi possível confirmar a eficácia terapêutica destas plantas/preparações na melhoria do apetite no idoso. Assim, estas podem vir a constituir mais uma linha de tratamento ou ser coadjuvante de certos fármacos para o fim terapêutico mencionado.
The increase in average life expectancy worldwide has brought benefits, but the inherent ageing process is closely linked to a greater likelihood of illnesses, patients with polymedication and lower quality of life, and these conditions can lead to a lack of appetite. It is estimated that between 15% and 30% of the geriatric population suffers from anorexia of ageing (lack of appetite associated with weight loss), with few therapeutic options available and adverse effects that make their use difficult. Reduced appetite results from imbalances in the central and peripheral appetite regulatory systems. The aim of this monograph is to find out about the main medicinal plants and health products based on them that have therapeutic use in geriatrics as appetite enhancers. The aim is to identify the medicinal plants described as useful for this purpose that have been monographised by the European Medicines Agency (EMA), and other medicinal plants traditionally used for the same purpose but not monographised by the EMA. To this end, a bibliographic search was carried out in the EMA database and in the PubMed and Web of Science databases, using the PRISMA methodology. Fourteen EMA monographs were identified for traditional use, thirteen of medicinal plants and one of an essential oil, with the medicinal plant Achillea millefolium L. standing out. This plant showed the greatest evidence of safety, with an adequate genotoxicity test, and could be a viable and safe therapeutic option for long-term use in the elderly for lack of appetite; during the bibliographical research, nine additional plants or preparations based on them were identified, with the Rikkunshito preparation and the Astragalus membranaceus medicinal plant standing out. Despite the heterogeneity of the trials and the consequent difficulty in comparing the results obtained between them, it was possible to confirm the therapeutic efficacy of these plants/preparations in improving appetite in the elderly. Thus, these may constitute another line of treatment or be an adjunct to certain drugs for the aforementioned therapeutic purpose.
The increase in average life expectancy worldwide has brought benefits, but the inherent ageing process is closely linked to a greater likelihood of illnesses, patients with polymedication and lower quality of life, and these conditions can lead to a lack of appetite. It is estimated that between 15% and 30% of the geriatric population suffers from anorexia of ageing (lack of appetite associated with weight loss), with few therapeutic options available and adverse effects that make their use difficult. Reduced appetite results from imbalances in the central and peripheral appetite regulatory systems. The aim of this monograph is to find out about the main medicinal plants and health products based on them that have therapeutic use in geriatrics as appetite enhancers. The aim is to identify the medicinal plants described as useful for this purpose that have been monographised by the European Medicines Agency (EMA), and other medicinal plants traditionally used for the same purpose but not monographised by the EMA. To this end, a bibliographic search was carried out in the EMA database and in the PubMed and Web of Science databases, using the PRISMA methodology. Fourteen EMA monographs were identified for traditional use, thirteen of medicinal plants and one of an essential oil, with the medicinal plant Achillea millefolium L. standing out. This plant showed the greatest evidence of safety, with an adequate genotoxicity test, and could be a viable and safe therapeutic option for long-term use in the elderly for lack of appetite; during the bibliographical research, nine additional plants or preparations based on them were identified, with the Rikkunshito preparation and the Astragalus membranaceus medicinal plant standing out. Despite the heterogeneity of the trials and the consequent difficulty in comparing the results obtained between them, it was possible to confirm the therapeutic efficacy of these plants/preparations in improving appetite in the elderly. Thus, these may constitute another line of treatment or be an adjunct to certain drugs for the aforementioned therapeutic purpose.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2023, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Achillea millefolium L. Astragalus membranaceus Falta de apetite Geriatria Rikkunshito Mestrado Integrado - 2023