Drugs In Brazil Research Articles

Behavioral neurotoxicity in adolescent and adult mice exposed to fenproporex during pregnancy

We investigated the effects of gestational exposure to fenproporex, one of the most used anorectic drugs in Brazil, on the behavior of adolescent and adult pups (30 and 60 days of age, respectively). Pregnant Swiss mice were treated daily, by gavage, with 15 mg/kg of fenproporex chloride or water during the whole gestational period. Male pups were submitted to open-field, forced swimming test, tail suspension test and fenproporex-induced stereotyped behavior. The results demonstrated that gestational exposure to fenproporex induces antidepressant-like effect and decreases fenproporex-induced stereotyped behavior in both adolescent and adult pups. Moreover, fenproporex-exposed adolescent pups tended (P= 0.06) to be more active than control pups. Our data show, for the first time, that gestational exposure to fenproporex leads to long-lasting behavioral toxicity in male mice characteristic of altered dopaminergic transmission.

Representações sociais do medicamento genérico por farmacêuticos: determinação dos sistemas central e periférico

This article aimed to identify the central and peripheral systems in social representations of generic drugs by pharmacists, as well as their social and economic profile, thereby establishing potential mechanisms for improving policies for generic drugs in Brazil. The data collection instruments were a questionnaire and a word association test, the inductive cue of which was the term "generic drug". Data collected through the questionnaire produced a profile of pharmacists in the city of Natal, Rio Grande do Norte State, and key information related to the theme. Data analysis for the word association test used Evoc 99 software while content analysis used Bardin, thereby identifying the central system in social representations of generic drugs, consisting of the categories price, quality, and credibility, while the peripheral system consisted of the categories pharmaceutical care, social impact, novelty, accessibility, options, and interchangeability.

Prevalência do uso e aceitação de medicamentos genéricos pela população de Maringá-PR.

The establishment of a national policy for Generic Drugs was one step in order to improve Brazilian population´s life quality, giving easier access to medicines for the treatment of several pathologies. This work as its goal the analysis of the current situation on the Policy on Generic Drugs in the city of Maringa-PR, evaluating the acceptance, the use and the knowledge that population has about this kind of medicina, also bulding a profile on this Policy. For that reason, a specific data-capture questionnaire was used. The results showed that 88% of the population has already heard of Generic Drugs, and 76% affirm that know their concept. Among the questioned people, 70% have already made use of Generic Durgs and 60% have observed the desired effect of the medicines. The results showed also that there is a certain insecurity related to the replacement for generic medication done by the pharmacist, because only 33% of the population affirmed to trust this professional in the replacenment. Besides, only 28% of the interviewees said that they have been prescribed Generic Drugs by their Medical Doctors. We can conclude that, in spide of the high rate of knowledge about Generic Drugs, actions for a deep consolidation o the Policy on Generic Drugs in Brazil are needed. We also need to change their concept mainly among the health professionals, in order to provide en improvement in the population access to such medications, causing a greater impact in the population´s life quality.

Household survey on drug abuse in Brazil: Study involving the 107 major cities of the country—2001

The prevalence of the use in Brazil of illicit drugs, as well as of alcohol and tobacco, was determined. Further, illicit use of psychotropic medicines, and anabolic steroids were also surveyed. This study was carried out in 107 Brazilian cities with more than 200,000 inhabitants aged 12–65 years. The sampling design adopted was that of sampling per aggregates in three stages: first, the census sectors were selected; second, homes were selected among the sectors; finally, in each home, a respondent was selected in a manner independent of the interviewer. There were 8589 persons interviewed. The questionnaire utilized was that of the SAMHSA (Substance Abuse and Mental Health Services Administration) which was translated and adapted for Brazilian conditions. The lifetime use of alcohol in the 107 major cities of the country was 68.7%, which was close to numbers observed for Chile at 70.8% and the USA at 81.0%. Yet, tobacco lifetime use was 41.1% of the total, which is lower than the prevalence observed in the USA (70.5%). The data on the lifetime use of marijuana in Brazil (6.9%) approximated the findings for Colombia (5.4%), however, being much lower than that observed in the USA (34.2%) and the United Kingdom (25.0%). The prevalence of lifetime use of cocaine was 2.3%, well below the levels for the USA with 11.2% of the total population. The abuse of inhalants was 5.8% of the total, greater than that found in Colombia (1.4%) and about four times less than that in the United Kingdom with 20.0%. Among the medicaments, stimulants had a 1.5% prevalence of lifetime use, and that of benzodiazepines had similar percentages in Brazil (3.3%) and in the USA (5.8%). In this survey, only four individuals reported lifetime use of heroin, which was equivalent to about 0.04% of the sample and much lower than that in the USA with 1.2% and in Colombia reaching 1.5%. These findings will allow the implementation of public policies fitted to the situation with psychotropic drugs in Brazil.

Influence of the legislation on the advertisement of psychoactive medications in Brazil.

The regulations on the advertisement of medications aim to encourage and promote an improved health care and the rational use of medications. The objective of this paper is to evaluate the influence of three regulations on the advertisement of medications: the "Export act", published in the United States in 1986; the "WHO's Criteria", published in 1988, and the Resolution 102/2000 of the Collegiate Board of Directors of the ANVISA (Agência Nacional de Vigilância Sanitária- Brazilian Sanitary Surveillance Agency), on the advertisement of psychoactive medications. We collected advertisements that were published in Brazilian psychiatric journals before and after the regulations were established. The contents of the advertisements were analyzed according to a program created based on the regulation's demands. In the 118 analyzed issues there were 199 different advertisements on 85 psychotropic drugs. We observed that, regardless the studied medication, the information about restrictions of use, such as adverse drug reactions, interactions, contraindications, warnings and precautions, does not appear very often, and when it does, its print sizes were smaller than that of the information favoring the use, such as indication, presentation and dosage. After the publication of the regulations, only 38.2% of the advertisements had all the essential technical information, and 35.3% were irregular in some way. The data suggest that there was very little influence of the regulations on the advertisement of psychotropic drugs in Brazil. Consequently, other control measures are necessary in addition to the regulations.

Guidelines of the Brazilian Medical Association for the treatment of depression (complete version)

Depression is a frequent and chronic condition with high levels of functional disability. Brazilian Medical Association Guidelines project proposed guidelines for diagnosis and treatment of the most common medical disorders. The objective of this paper is to present the original document that originated the abbreviated version available at the electronic address of Brazilian Medical Association. This paper was based on guidelines developed in other countries and systematic reviews, randomized clinical trials and when absent, observational studies and recommendations from experts. Brazilian Medical Association proposed this methodology for the whole project. The following aspects are presented: prevalence, demographics, disability, diagnostics and sub-diagnosis, efficacy of pharmacological and psychotherapeutic treatment, costs and side-effects of different classes of available drugs in Brazil. Planning of different phases of treatment is22 also discussed. Guidelines are a good tool helping clinical decisions and are a reference for an attitude based on levels of evidence.

Access to antiretroviral drugs in Brazil

Since 1996, the Brazilian Ministry of Health has guaranteed free and universal access to antiretroviral treatment for people living with HIV/AIDS. Implementation of this policy has had political, financial, and logistical challenges. I have investigated the history and context of antiretroviral policy in Brazil, the logistics of the drugs' distribution, and the government's strategies for acquisition of the drugs. Many antiretrovirals used in Brazil are produced domestically; the remainder, including some of the most expensive drugs, are purchased from abroad. Although the Brazilian policy of antiretroviral distribution has had notable success, it remains threatened by the high cost of acquisition of drugs, which has led to disputes with international pharmaceutical companies over prices and patents. Whether or not the Brazilian model of guaranteeing access to antiretroviral treatment for people living with HIV/AIDS can be applied in other countries or regions, much can be learnt from the country's experience.

Moves to promote generic use of HIV/AIDS drugs in Brazil, Kenya

Moves to promote generic use of HIV/AIDS drugs in Brazil, Kenya

Use of anorectic amphetamine-like drugs by Brazilian women

The history of anorectic drug use was investigated in 2370 subjects in São Paulo and Brası́lia cities. Socio-demographic data and the number of previous treatments to lose weight were obtained. When the last treatment was drug-based, the substance(s) used, its duration, the occurrence of adverse reactions, and whether it was adequate were studied. There was a prevalence of female patients, 92.7%, in both cities and as many as 72.4% of them had already undergone from 1 to >10 previous treatments. Out of those patients, 75.37% had undergone pharmacological treatment, 79.2% of those with amphetamine-like anorectic drugs. Treatment was longer than 3 months in half of the cases, and 60% of the subjects had a Body Mass Index below 29.9. Over 50% of the subjects was given amphetamine-like drugs through compounded formulas containing four or more substances, which had been specifically tailored by the doctor for each patient. On the other hand, 86.3% of all the subjects reported adverse reactions to the amphetamine-like drugs, 37.4% of them sought medical advice, and 3.9% required hospitalization. In conclusion, the use of amphetamine-like drugs in Brazil is particularly prevalent among women and this use is strongly related to the culture of slimness as a symbol of beauty.

History, effects and mechanisms of action of ecstasy (3,4-methylenedioxyamphetamine): review of the literature

This review focuses on 3,4-methylenedioxymethamphetamine, an illegal drug known as "ecstasy." Ecstasy was introduced in Brazil in 1994. Data are lacking on the epidemiology and usage pattern of the drug in Brazil. However, there is evidence that until now the use of ecstasy has been limited to middle-class or upper-middle-class youth, so that most people, including health care professionals, are unfamiliar with the drug. However, ecstasy may be becoming more popular in Brazil, following a pattern seen in North America and Europe. Possible contributing to the drug's popularity is the fact that ecstasy is sold as a pill and is thus extremely easy to use. Ecstasy has a reputation for not being physically dangerous; however, there are many reports of adverse reactions associated with the drug. In addition, it is known that not all pills sold as ecstasy actually contain methylenedioxymethamphetamine. Since there is no quality control for the pills' contents, users never know exactly what they are taking. Thus, although users may perceive the effects of the drug as mostly positive, ecstasy is potentially dangerous. Primary and secondary interventions are needed to prevent the use of ecstasy and the occurrence of adverse reactions. To be effective, these measures must take into consideration the characteristics of the user population and the usage patterns. It is also essential to prepare health professionals for emergency medical interventions in cases of intoxication and complications resulting from the use of ecstasy.

Medicamentos de venta libre en el Brasil

In this study we examined the 100 over-the-counter drugs that were most widely sold in Brazil from June 1992 to June 1993. We excluded 23 food products that were classified as medicinal. The sample, which included 77 drugs, was representative of about 67% of all sales in monetary value, and 76.8% of all units sold of the different classes of over-the-counter drugs. The anatomical-therapeutic-chemical (ATC) system was used to classify the various drugs; each class of drugs was also graded according to a scale of its intrinsic value, taking into account effectiveness and risks. Most classes of drugs (91%) showed "little intrinsic value" (that is, were of questionable or no value, of relative value, or unacceptable), and 70% were fixed-dose combinations. Only 10 classes of drugs were included in the Ministry of Health's National Drug List, and four appeared in WHO's list of essential drugs. The therapeutic classes to which the drugs belonged were, in descending order of frequency, for the digestive tract, skin, genitourinary system, musculo-skeletal system, central nervous system, parasitic diseases, respiratory tract, and sensory system. The therapeutic subgroup that commanded the highest sales was that of the non-opiate analgesics and antipyretics. Our results confirm the hypothesis that over-the-counter drugs in Brazil are of poor therapeutic quality and that the use of many such drugs is a source of unnecessary expense for the population. Some of them should not be accessible to individuals who lack current knowledge of their side effects, since 25% of all cases of poisoning in the country are related to self-medication. Modifying the public's perception of the need for taking drugs to relieve their ailments is one approach that may improve their use of medications in the long term.

Consumption of anorexigenic amphetamine-like drugs (diethylpropion, fenproporex and mazindol) and of d,1-fenfluramine in Brazil during the years of 1988 and 1989.

Brazilian consumption of psychostimulant anorexigenic drugs--diethylpropion, fenproporex, and mazindol--and of 3,1-fenfluramine was studied, and results are presented in terms of DDDs/1000 inhabitants/day. As of 1988, consumption of these drugs in Brazil was equal to 4.59 DDDs/1000 inhabitants/day; in the following year it had risen by 43.8%. However, if only the population that can afford to buy medicines is considered, actual consumption figures are at least three times higher. Such numbers point to a very high rate of anorexigenic consumption in Brazil, in contrast with other countries where use of these drugs is smaller. It was also found that 68.6% of total consumption in 1988--and 39.4% in 1989--corresponded to prescription formulas prepared by specialized pharmacies, while the remainder was consumed in the form of ready-made medicines produced by pharmaceutical industries. The most used drugs were mazindol in 1988, and fenproporex in 1989; d,1-fenfluramine was the least used of these substances in both years. These reasons are discussed for this increased consumption in Brazil and the absence of an adequate controlling attitude on the part of public health authorities.

Consumption of anorexigenic amphetamine‐like drugs (diethylpropion, fenproporex and mazindol) and of d,1-fenfluramine in Brazil during the years of 1988 and 1989

Brazilian consumption of psychotimulant anorexigenic drugs — diethylpropion, fenproporex, and mazindol — and of 3,1-fenfluramine was studied, and results are presented in terms of DDDs/1000 inhabitants/day. As of 1988, consumption of these drugs in Brazil was equal to 4.59 DDDs/1000 inhabitants/day; in the following year it had risen by 43.8%. However, if only the population that can afford to buy medicines is considered, actual consumption figures are at least three times higher. Such numbers point to a very high rate of anorexigenic consumption in Brazil, in contrast with other countries where use of these drugs is smaller. It was also found that 68.6% of total consumption in 1988 — and 39.4% in 1989 — corresponded to prescription formulas prepared by specialized pharmacies, while the remainder was consumed in the form of ready-made medicines produced by pharmaceutical industries. The most used drugs were mazindol in 1988, and fenproporex in 1989; d,1-fenfluramine was the least used of these substances in both years. These reasons are discussed for this increased consumption in Brazil and the absence of an adequate controlling attitude on the part of public health authorities.

Preliminary note: dangerous use of anticholinergic drugs in Brazil

To better evaluate the non-medical use of anticholinergic substances in Brazil, a review of the local literature was performed. Synthetic compounds such as triexyphenidyl (Artane ®), benactizine (Asmosterona ®), dicyclomine (Bentyl ®) as well as Datura sp. tea were reported as being used by first and second grade students and by street children of several Brazilian cities. In several cases the percentage of youngsters indulging in such use was higher than the percentage found for cocaine, barbiturates, cough syrups and amphetamine-related drugs. Several cases of patients seeking treatment for dependence or for acute psychotic symptoms were also described.

Perspective for the production of antimalarial drugs in Brazil.

There appears to be no chemical manufacture of antimalarial drugs in Brazil. Technology at the laboratory process level has been developed for chloroquine, mefloquine, pyrimethamine and cycloguanil, but not perfected nor scaled-up, largely for economic reasons and market uncertainty. Development of primaquine has been contracted but it will run into the same difficulty. Manufacturing capacity for sulfadoxine was registered in the SDI by Roche. A project to produce artemisinine and its derivatives is under way at UNICAMP-CPQBA but is hampered by low content in the plant. Proguanil could be produced easily, but apparently no attempt has been made to do so. Quinine is imported on a large scale mostly for soft-drink production. Since malarial treatment falls largely within the responsibility of the Government health authorities, manufacture of drugs in Brazil will depend on an assured medium-term purchase order made to a potential local manufacturer, since competition in the world market is scarcely viable at the present moment.

Production and marketing of drugs in Brazil

Brazil is typical of many developing countries in its struggle to provide basic healthcare for its citizens in face of national economic instability. Since pharmaceuticals represent a major component of modern healthcare, their production, regulation and use become an area of concern. It appears that any change in the current production patterns will require a major commitment from governments, understanding external economic pressures. There are pros and cons in a policy directed towards pharmaceutical self-sufficiency. Aside from production, efforts directed towards extending access to essential drugs and improving the appropriateness of use, would appear to be warranted.

As Toxicomanias da Atualidade

The author analyzes world of drugs in Brazil and rejects simplistic interrpetations of situation. He states that the key to all kind of therapy is to break dependence on demand”.