Beers-Fick criteria and drugs available through the Farmácia Dose Certa program

Abstract

Certa program that might be inappropriate for elderly people and the levels of evidence for each drug included were assessed. RESULTS: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. CONCLUSION: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.RESUMO CONTEXTO E OBJETIVO: Programa Dose Certa é programa estadual para disponibilizar medicamentos de forma gratuita à população do Estado de São Paulo que é referência nacional no assunto. O segmento de idosos na população assistida merece atenção especial quanto aos fármacos adequados a este segmento etário. O objetivo foi avaliar as drogas no programa que são impróprias para idosos. TIPO DE ESTUDO E LOCAL:Estudo descritivo avaliando a distribuição de medicamentos no estado de São Paulo.MÉTODOS: Seguindo-se os critérios propostos por Beers e Fick (medicamentos ou classes deles que deveriam ser evitados em idosos, independentemente do diagnóstico ou da condição clínica, devido ao alto risco de efeitos colaterais e pela existência de outros fármacos mais seguros), avaliaram-se quais medicamentos do programa Dose Certa são impróprios para idosos e os níveis de evidência para cada medicamento incluído.RESULTADOS: Dos medicamentos disponíveis, 10 (25,6%) foram incluídos nos critérios de Beers-Fick: amitriptilina, cimetidina, diazepam, digoxina, fluoxetina, metildopa, nifedipina, prometazina, tiorodazida e sulfato ferroso.conclusão: A lista de fármacos disponível no Programa Dose Certa pode ser considerada apropriada para a população em geral, mas não totalmente para idosos. Adequá-los a aspectos farmacológicos do envelhecimento reduzirá riscos de interações medicamentosas, quedas, confusão mental e sedação excessiva decorrente de medicamentos considerados impróprios para o consumo de idosos.

Comparison of four criteria for potentially inappropriate medications in Brazilian community‐dwelling older adults

“…Interestingly, all these criteria seem to be appropriate in countries worldwide. Several studies have already used and adapted Beers and STOPP for different settings, including Brazil . Furthermore, no list of PIMS for older adults has yet been developed in Brazil …”

Exposure to potentially inappropriate medications in Brazilian elderly outpatients with metabolic diseases

“…In Brazil, some of these medicines are part of the "Farmácia Dose Certa" (Right Dosage Pharmacy), a program available in the Sao Paulo State to provide some free of charge medicines in the primary care setting (Lucchetti et al, 2011). This program has significant economic and social benefit, especially for the poorest people served by the Brazilian health system.…”

“…It is considered unsuitable for elderly T2D patients due to the risk of prolonged hypoglycemia, a known ADR of sulfonylureas (Deusenberry et al, 2012). It is likely that the increase in prescription of glibenclamide is due to its availability by the "Farmácia Dose Certa" Program, in Sao Paulo State (Lucchetti et al, 2011).…”

Drugs available through the Farmácia Dose Certa program and Beers criteria: a further analysis

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We read the recently published article by Lucchetti et al 1 and we have an important comment to make on this study. The objective was to assess the drugs in the Farmácia Dose Certa ("Right Dose

Pharmacy") program that were considered to be inappropriate for the elderly.

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