Availability of Analgesic and Anti-Inflammatory Medicines in Primary Health Care

Santos, Jacqueline Silva; Cruz, Alex; Castilho, Lia Silva de; Abreu, Mauro Henrique Nogueira Guimarães de

doi:10.1590/pboci.2020.045

Cited by 3 publications

(5 citation statements)

References 16 publications

(22 reference statements)

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“…28 The process of prescribing, distributing and using medicines is related to their availability in health services. 29 The presence of professionals in health services is essential to medicine prescription. In this sense, higher rates of oral health teams/1,000 residents/year have contributed for higher averages of DDD/1,000 residents/year.…”

Section: Discussionmentioning

confidence: 99%

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state

et al. 2022

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The objective of this study was to analyze possible associations between antibiotic dental prescriptions in the public health service, health service characteristics, and social characteristics of the municipalities. Using the register of dispensing in the public health service of a state in the Southeast region of Brazil, in 2017 we analyzed patterns of antibiotic prescriptions by dentists. Data were obtained from the Integrated Pharmaceutical Services Management System (SIGAF, in Portuguese). The outcome variable was the number of Daily Defined Doses (DDD) per 1,000 residents/year in each municipality. CART (Classification and Regression Tree) technique was used to determine the influence of the following variables: populational social characteristics (Human Development Index, Gini Index, the proportion of rural population and proportion of families benefiting from the Bolsa Família Program) and oral health services characteristics (access to individual dental care, number of dentists and oral health teams per 1,000 residents, and percentage of preventive and restorative individual dental procedures. Data analysis was performed using IBM SPSS Statistics 21.0. Antibiotics were the medications most prescribed by dentists in the public health service, with penicillin being the most frequently prescribed class. The average DDD/1,000 residents/year for the 421 municipalities surveyed was 96.54 (range 0.008 and 619.660). Select factors were associated with antibiotic prescriptions including access to individual dental care (Adjusted p-value ≤0.001), a number of oral health teams/1,000 inhabitants (Adjusted p-value=0.001), and Gini Index (Adjusted p-value = 0.046). Access to oral health services and inequality were associated with the use of antibiotics.

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Section: Discussionmentioning

confidence: 99%

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state

et al. 2022

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“…They are also easily available in health units throughout Brazil. 27 In Australia 6,8 and Germany, 7 ibuprofen was also the most prescribed NSAID, probably because of its efficacy in a large range of painful inflammatory conditions and its price. 28 In 2016, dental prescriptions of NSAID and analgesics in Australia reached 15.60 DDD per 1,000 inhab.…”

Section: Discussionmentioning

confidence: 99%

“…The greater availability of NSAID and analgesics was positively associated with the number of professionals prescribing them in Brazilian health units. 27 Although there is not a direct relationship, cities with higher number of prescribing professionals may present higher rates of medicines' availability and, consequently, higher rates of prescription and consumption. Taking into account the cross-sectional design of the study, the direction of the relationship is not easy to be determined, and an inverse relationship could exist, i.e.…”

Section: Discussionmentioning

confidence: 99%

Prescriptions of analgesics and anti-inflammatory drugs in municipalities from a Brazilian Southeast state

et al. 2021

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The objective of this study was to describe dental prescriptions of non-steroidal anti-inflammatory drugs (NSAID), opioids, and analgesics dispensed by the Brazilian National Health System (BNHS, SUS in Portuguese) of a Southeastern state from January to December 2017, and to analyze their association with socioeconomic and oral health care services' characteristics at municipal level. Data were collected from the Brazilian Integrated Pharmaceutical Care Management System. Medicines were grouped according to the Anatomical Therapeutic Chemical Classification System. The total number of Defined Daily Doses (DDD) and DDD per 1,000 inhabitants (inhab.) per year were presented and compared between groups of municipalities. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25.0. The total number of NSAID, opioids, and analgesics prescriptions was 70,747 and accounted for 354,221.13 DDD. The most frequently prescribed medicine was ibuprofen (n = 24,676; 34.88%). The number of dental practitioners in the BNHS per 1,000 inhab. (p < 0.001), first dental appointment coverage (p = 0.010), oral health teams per 1,000 inhab. (p=0.022), and the proportion of rural population (p = 0.014) were variables positively associated with the number of DDD of NSAID per 1,000 inhab. per year. Bolsa Família program coverage per 1,000 inhab. (p = 0.022) was negatively associated with NSAID prescription. Regarding analgesics, first dental appointment coverage (p=0.002) and Bolsa Família program coverage per 1,000 inhab. (p = 0.012) were positively associated with DDD per 1,000 inhab. per year. In conclusion, dental prescriptions of analgesics and NSAID in the BNHS were associated with socioeconomic and oral health care services' characteristics.

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“…The use of agents with analgesic action, including opioids, acetaminophen, and NSAIDs, are among the most commonly used drugs for self-medication in developed countries, apart from drugs for hypertension. 212,263,264 The differences in COVID-19 treatment protocols adopted by the various countries could also account for demographic variations in mortality rates. Furthermore, cyanide, present mainly as hydrogen cyanide in air pollution, will impede sulfide oxidation in lung EpCs.…”

Section: Demographic and Ethnic Factorsmentioning

confidence: 99%

“…The use of chronic medication and drugs that require inorganic sulfate for its metabolism, are generally much higher in developed countries 261,262 and could be one of the reasons explaining the demographic occurrence of COVID‐19. The use of agents with analgesic action, including opioids, acetaminophen, and NSAIDs, are among the most commonly used drugs for self‐medication in developed countries, apart from drugs for hypertension 212,263,264 . The differences in COVID‐19 treatment protocols adopted by the various countries could also account for demographic variations in mortality rates.…”

Section: Predisposing Factors Increasing Susceptibility To Covid‐19mentioning

confidence: 99%

Pathogenesis of COVID‐19 described through the lens of an undersulfated and degraded epithelial and endothelial glycocalyx

et al. 2021

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The glycocalyx surrounds every eukaryotic cell and is a complex mesh of proteins and carbohydrates. It consists of proteoglycans with glycosaminoglycan side chains, which are highly sulfated under normal physiological conditions. The degree of sulfation and the position of the sulfate groups mainly determine biological function. The intact highly sulfated glycocalyx of the epithelium may repel severe acute respiratory syndrome‐related coronavirus 2 (SARS‐CoV‐2) through electrostatic forces. However, if the glycocalyx is undersulfated and 3‐O‐sulfotransferase 3B (3OST‐3B) is overexpressed, as is the case during chronic inflammatory conditions, SARS‐CoV‐2 entry may be facilitated by the glycocalyx. The degree of sulfation and position of the sulfate groups will also affect functions such as immune modulation, the inflammatory response, vascular permeability and tone, coagulation, mediation of sheer stress, and protection against oxidative stress. The rate‐limiting factor to sulfation is the availability of inorganic sulfate. Various genetic and epigenetic factors will affect sulfur metabolism and inorganic sulfate availability, such as various dietary factors, and exposure to drugs, environmental toxins, and biotoxins, which will deplete inorganic sulfate. The role that undersulfation plays in the various comorbid conditions that predispose to coronavirus disease 2019 (COVID‐19), is also considered. The undersulfated glycocalyx may not only increase susceptibility to SARS‐CoV‐2 infection, but would also result in a hyperinflammatory response, vascular permeability, and shedding of the glycocalyx components, giving rise to a procoagulant and antifibrinolytic state and eventual multiple organ failure. These symptoms relate to a diagnosis of systemic septic shock seen in almost all COVID‐19 deaths. The focus of prevention and treatment protocols proposed is the preservation of epithelial and endothelial glycocalyx integrity.

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Availability of Analgesic and Anti-Inflammatory Medicines in Primary Health Care

Cited by 3 publications

References 16 publications

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state

What we know about antibiotics prescribed by dentists in a Brazilian southeastern state

Prescriptions of analgesics and anti-inflammatory drugs in municipalities from a Brazilian Southeast state

Pathogenesis of COVID‐19 described through the lens of an undersulfated and degraded epithelial and endothelial glycocalyx

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