A carregar...
Publicação
Farmacologia das populações especiais
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 10.85 MB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Do ponto de vista fisiológico, as populações especiais caracterizam-se por uma elevada heterogeneidade e vulnerabilidade, devido a alterações de farmacocinética, farmacodinamia e escassez de evidências de segurança/eficácia relativamente à farmacoterapia.
O processo de maturação e desenvolvimento na pediatria é dinâmico, necessitando de adaptações de terapêutica consistentes com a evolução dos formulários de farmacoterapia e guidelines de dose. Porém, doenças órfãs tornam pouco interessante o investimento da indústria, tornando necessário a utilização de medicamentos em off-label. Existem recomendações de abordagem sistemática para avaliação do seu uso, devido ao risco de terapêuticas ineficazes e efeitos adversos.
A avaliação do risco/benefício da terapêutica na gravidez é fundamental por se tratar de um estado fisiológico complexo e pela potencial toxicidade no desenvolvimento. A dose ótima pressupõe efetividade e segurança materna e fetal, porém os medicamentos não são geralmente testados para uso durante a gravidez. Os sistemas de classificação de risco apresentam limitações, tendo sido implementado recentemente um novo sistema de rotulagem dos medicamentos.
Alterações na capacidade funcional dos sistemas de órgãos, composição corporal e mecanismos homeostáticos surgem no envelhecimento. As complexas interações entre a polimedicação, co-morbilidades e alterações fisiológicas requerem terapêutica apropriada, que pode ser avaliada através de ferramentas próprias, nomeadamente, critérios de Beers e STOPP&START.
From a physiological perspective, special populations are characterized by high heterogeneity and vulnerability due to variations in pharmacokinetics and pharmacodynamics as well as scarce evidence of safety/ effectiveness in pharmacotherapy. The maturing and developing process in paediatrics is dynamic as it requires therapeutic adaptations consistent with the evolution of pharmacotherapy formularies and doses guidelines. Nonetheless, orphan diseases make it uninteresting to invest in the industry compelling the use of off-label medicines. A systemic approach is suggested to evaluate their use, due to the risk of ineffective therapeutics and adverse effects. The evaluation of risk/benefit of therapeutics in pregnancy is necessary as it is a complex physiological state and the prospective toxicity during development. The optimal dose presumes effectiveness and maternal and foetal safety, however drugs aren’t generally tested for use during pregnancy. The risk classification systems are limited as the drug labelling system has only been implemented recently. During aging, changes of functional capacity of organ systems, body composition and homeostatic mechanisms emerge. The complex interactions between polypharmacy, co-morbidity and physiological alterations demand appropriate therapeutic which can be assessed through suitable tools such as Beers criteria and STOPP&START.
From a physiological perspective, special populations are characterized by high heterogeneity and vulnerability due to variations in pharmacokinetics and pharmacodynamics as well as scarce evidence of safety/ effectiveness in pharmacotherapy. The maturing and developing process in paediatrics is dynamic as it requires therapeutic adaptations consistent with the evolution of pharmacotherapy formularies and doses guidelines. Nonetheless, orphan diseases make it uninteresting to invest in the industry compelling the use of off-label medicines. A systemic approach is suggested to evaluate their use, due to the risk of ineffective therapeutics and adverse effects. The evaluation of risk/benefit of therapeutics in pregnancy is necessary as it is a complex physiological state and the prospective toxicity during development. The optimal dose presumes effectiveness and maternal and foetal safety, however drugs aren’t generally tested for use during pregnancy. The risk classification systems are limited as the drug labelling system has only been implemented recently. During aging, changes of functional capacity of organ systems, body composition and homeostatic mechanisms emerge. The complex interactions between polypharmacy, co-morbidity and physiological alterations demand appropriate therapeutic which can be assessed through suitable tools such as Beers criteria and STOPP&START.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2013
Palavras-chave
Populações especiais Farmacoterapia Farmacocinética Farmacodinamia Doses Guidelines Mestrado Integrado - 2013