Although approaches aimed at detecting inappropriate prescribing have intensified in recent years, we observed limited overlap between different PIM lists. Additionally, some PIM lists did not provide special considerations of use and alternative therapies to avoid PIMs. These facts may compromise the use of PIM lists in clinical practice. Future PIM lists should integrate information about alternative therapies and special considerations of use in order to help clinicians in the drug prescription.

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OBJECTIVE To investigate the prevalence of the adherence to the medications of the Specialized Component of Pharmaceutical Services and its association with regular access in users of these medications in the municipality of São Leopoldo, State of Rio Grande do Sul, Brazil.METHODS This is a cross-sectional study with adults aged 20 years and over, who are users of medications of the Specialized Component of Pharmaceutical Services. Sampling was carried out consecutively for users who accessed the service of the Specialized Component of Pharmaceutical Services during the period from December 2014 to March 2015. Adherence was measured by the Brief Medication Questionnaire, and adherents were defined as those who did not present barriers to adherence in the three domains. Regular access was defined as getting all medications in the last three months, regardless of how it was obtained (paying or for free). Data analysis was performed using Poisson regression with robust variance.RESULTS We interviewed 414 subjects, being them mostly women (60.9%), with mean age of 55 years (SD = 13), and using a single medication of the Specialized Component of Pharmaceutical Services (68.1%). The prevalence of adherence to the medications used in the last seven days was 28.3% and the prevalence of free regular access was 46.1%, and 25.7% did not have access to all treatment. After adjusting for the number of medications in the Specialized Component of Pharmaceutical Services and the number of medications of continuous use, users who had free regular access in the last three months were 60% more likely to show adherence. For individuals with paid regular access, no association was found between access and adherence.CONCLUSIONS The regularity in the free access to the medications of the Specialized Component of Pharmaceutical Services has an impact on the behavior of users, contributing to their commitment to treatment and self-care. The Specialized Component of Pharmaceutical Services needs programming in order to avoid irregular access, which suggests a significant limitation of the drug policies in Brazil.

O uso incorreto de medicamentos anti-inflamatórios não-esteroidais (AINEs) pode causar graves efeitos adversos como hemorragia e ulceração. O objetivo deste trabalho é relatar um caso de intoxicação por AINE em um cão atendido no Hospital Veterinário da Unijuí. O cão da raça Labrador, pelagem preta, macho, dez anos de idade deu entrada com histórico de apatia, náuseas, vômito e anorexia, principais queixas relatadas pelo tutor. O cão tem afecção articular e fez uso contínuo durante os últimos seis meses de 7,5 mg de meloxicam. Foram realizados exames como hemograma, que apresentou valores de eritrócitos, hemoglobina e hematócrito abaixo do desejável, já os valores de creatinina e ureia estavam extremamente elevados. Após tentativas de tratamento realizadas, e devido ao constante agravamento do quadro clínico do cão, foi optado por eutanásia, realizada no Hospital Veterinário com a autorização do tutor.