Amamentação e uso de antiinflamatórios não esteróides pela nutriz: informações científicas versus conteúdo em bulas de medicamentos comercializados no Brasil

Chaves, Roberto Gomes; Lamounier, Joel Alves; César, Cibele Comini; Corradi, Mateus Alves Lima; Mello, Renata de Paula e; Gontijo, Camila Martins; Drumond, Jaqueline Matos

doi:10.1590/s1519-38292006000300002

Cited by 11 publications

(14 citation statements)

References 13 publications

(29 reference statements)

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“…However, a study that compared the information included in package inserts about the safety of using non-steroidal anti-inflammatories during lactation concluded that the information included in the inserts was in disagreement with the scientific evidence about the compatibility of these drugs with breastfeeding. 25 The association between self-medication and weaning was not confirmed in the present study, since there was no weaning due to the practice of self-medication. Such findings can be related to the fact that most drugs used by nursing mothers do not pose risk for the nursing infant or for lactation.…”

Section: Discussioncontrasting

confidence: 69%

Automedicação em nutrizes e sua influência sobre a duração do aleitamento materno

Chaves¹,

Lamounier²,

César³

2009

J. Pediatr. (Rio J.)

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Objective: To investigate the practice of self-medication by nursing mothers, the main drugs used and the influence on the duration of breastfeeding.Methods: A longitudinal cohort study involving 246 women seen at the maternity unit of Hospital Manoel Gonçalves in Itaúna, state of Minas Gerais, Brazil. A monthly follow-up of mothers and newborns was performed for the first 12 months postpartum or until weaning. The effect of the practice of self-medication on the duration of breastfeeding was evaluated by multivariate analysis using Cox's regression model with time-dependent variables.Results: Self-medication was practiced by 52.4% of the nursing mothers. The most used pharmacological classes were: analgesics/antipyretics (54.5%), non-steroidal anti-inflammatories (15%), spasmolytics (6.2%), laxatives (3.5%), benzodiazepines (3%), nasal decongestants (1.4%), and antibiotics (0.9%). The most used drugs were dipyrone (31.5%) and paracetamol (17.9%). The practice of self-medication was associated with a higher probability of the use of drugs posing the risk of adverse effects for the infant or for lactation (p = 0.000). However, the practice of self-medication was not associated with weaning (p = 0.135). Conclusions:The high rates of self-medication among nursing mothers and the use of drugs posing risks of undesirable effects for the infant and for lactation reveal the need for better education on the risks of self-medication by nursing mothers. However, self-medication was not proven to be a risk factor for weaning.J Pediatr (Rio J). 2009;85(2):129-134: Breastfeeding, lactation, weaning, self-medication, pharmaceutical preparations.

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Section: Discussioncontrasting

confidence: 69%

Automedicação em nutrizes e sua influência sobre a duração do aleitamento materno

Chaves¹,

Lamounier²,

César³

2009

J. Pediatr. (Rio J.)

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“…Moreover, ibuprofen has satisfactory anti-inflammatory mechanisms of action. These drug profiles are due to the low molecular weights of the compounds and their low liposolubility [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Oral surgical procedures and pain, postoperative after use the ibuprofen or acetaminophen

Semenoff-Segundo¹,

Matos²,

Porto³

et al. 2013

Oral Biol Dent

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Aim: The aim of this study was to compare the effects of anti-inflammatory (ibuprofen, 600 mg) and analgesic (Acetaminophen, 750 mg) drugs on postoperative pain. Material and methods: Patients with indications for surgery were selected, and a total of 57 patients, 20 male (35.1%) and 37 female (64.9%) were included in the study. Of these, 26 patients were placed in the acetaminophen group, and 31 were placed in the ibuprofen group. The average age of the patients was 30 years. The following types of surgeries were included in the evaluation: clinical crown lengthening, gingivectomy, pre-prosthetic surgery, labial frenum and frenum lingual. The surgeries were performed by students in a postgraduate training program in periodontics. Subsequent surgery, postoperative period orientations were provided by the researcher, and the medication to be prescribed was selected at random allocation. Both medications were administered for 48-h periods. A visual analogue scale with values ranging from 0 to 10, where 0 represented no pain and 10 represented maximum pain, was provided to the patients, and the patients were asked to rate their pain using this scale each time they took the medication. At the time of the follow-up visit, the patient data were given to the researcher and subsequently tabulated and applied to the statistical analysis (Mann-Whitney, p<0.05). Results:The results showed no significant difference in pain between medications (p>0.05). Conclusions: There was no difference in postoperative periodontal surgery pain after the use of anti-inflammatory or analgesic drugs.

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“…De acordo com as fontes, a maioria dos antidepressivos é compatível com a amamentação, não havendo contraindicação explícita para o uso concomitante. A verificação de informações inconsistentes entre as bulas e as evidências científicas para outras classes de medicamentos foi relatada previamente 10,11 . Entre as explicações para esses resultados, podemos considerar: (1) a existência de controvérsias na literatura, decorrente dos sistemas de classificação e das evidências utilizadas; (2) a priorização de informação conservadora nas bulas, resguardando o fabricante contra possíveis ações legais em detrimento de informação baseada nas melhores evidências.…”

Section: Tabelaunclassified

“…A informação das bulas de antidepressivos pode incentivar a interrupção da amamentação ou a não utilização de medicamentos que poderiam beneficiar a saúde e o bem-estar da nutriz 10 . Um estudo qualitativo identificou o medicamento como fator de risco para o desmame precoce 15 .…”

Section: Tabelaunclassified

Uso de medicamentos antidepressivos na amamentação: avaliação da conformidade das bulas com fontes bibliográficas baseadas em evidências científicas

et al. 2019

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O objetivo deste artigo foi avaliar a conformidade entre as recomendações de uso de medicamentos antidepressivos durante a amamentação, presentes em bulas, e as recomendações de fontes bibliográficas baseadas em evidências científicas. Foram avaliadas as bulas padrão de 23 antidepressivos com registro ativo no Brasil. A presença de contraindicação do uso do antidepressivo durante a amamentação foi comparada com as informações presentes no manual técnico do Ministério da Saúde, no livro Medications and Mothers’ Milk e nas bases de dados LactMed, Micromedex e UpToDate. Na maioria das bulas (62,5%), o antidepressivo é contraindicado na amamentação. Entre as fontes bibliográficas, esse percentual variou de 0% a 25%. O estudo aponta para baixa conformidade entre bulas e fontes bibliográficas, alertando sobre a necessidade de revisão do conteúdo e forma de apresentação das informações presentes nas bulas dos antidepressivos no Brasil.

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Amamentação e uso de antiinflamatórios não esteróides pela nutriz: informações científicas versus conteúdo em bulas de medicamentos comercializados no Brasil

Cited by 11 publications

References 13 publications

Automedicação em nutrizes e sua influência sobre a duração do aleitamento materno

Automedicação em nutrizes e sua influência sobre a duração do aleitamento materno

Oral surgical procedures and pain, postoperative after use the ibuprofen or acetaminophen

Uso de medicamentos antidepressivos na amamentação: avaliação da conformidade das bulas com fontes bibliográficas baseadas em evidências científicas

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