ABSTRACT
The Cerrado is the second largest biome in Brazil and presents an immeasurable and still underexplored ecological diversity. Despite the exuberance of its endemic species, it is one of the 25 global hotspots, due to a high natural biodiversity wealth along with an expressive environment destruction. In this study, we surveyed the knowledge on medicinal use of Cerrado plants held by individuals living in a predominantly Cerrado region. A semi-structured individual questionnaire for qualitative socio-economic characterization and medicinal use of plants was applied to Public Health Service users of the city of Assis, State of Sao Paulo, Brazil. This study was approved by the Ethics Committee of the Assis Regional Hospital (Protocol 4812010). Out of 149 respondents, 90.6% reported knowledge and/or use of plants for therapeutic purposes. Among 115 mentioned plant species, only 11.4% belong to the Cerrado. We also evaluated how matching were the reported uses and the respective published data from scientific studies on the plants' medicinal properties. It was verified that for the few Cerrado plants cited, the respondents described several medicinal applications not scientifically described. More precisely, 60.5% of all medicinal applications were not found in the scientific literature. Besides that, many of the therapeutic effects described in the literature for the Cerrado species were not cited by the interviewed population. Our results indicate a relative unawareness of people on the medicinal potential of the native species of their residence region. We suggest that strengthening connection between popular and scientific knowledge, along with spreading such knowledge, could contribute for an improved valuation about the Cerrado biome and consecutive preservation of it.KEYWORDS: Popular knowledge. Scientific knowledge. Valuation about the biome. INTRODUCTION Use of medicinal plants dates back to ancient times (DUTRA et al., 2016) and, over time, accumulated empirical evidence produced from popular knowledge has enabled incorporation of phytotherapy into traditional medicine with positive results (SANTOS et al., 2011). With the advent of ethnobotany and ethnopharmacology, many of these plants began to be safely used in the production ofherbal medicines for treatment of different diseases, such as infections, tissue inflammation, and pain (EKOR, 2014). It is currently known that several secondary metabolites produced by plants not only protect themselves from herbivory and pathogens, for instance (FÜRSTENBERG-HÄGG; ZAGROBELNY; BAK, 2013; SANCHÉZ-SANCHÉZ; MORQUECHO-CONTRERAS, 2017), but also have beneficial effects on human health (TAIZ; ZEIGER, 2010). However, in many countries, including those that hold a large biodiversity, the native medicinal flora is still barely studied by scientific methods (RIBEIRO et al., 2014). The Cerrado is the second largest biome after the Amazon in Brazil. Although the extensive area of 2,036,448 km2 occupied nowadays by this biome (BARBOSA, 2017), much of the Cerrado has already been transformed into pasture, grain crops or devastated for other uses (KLINK; MACHADO, 2005). Currently, only 8,21% of its total area is fully protected (BARBOSA, 2017). As a result, it is one of the most threatened biomes in the world. According to Mittermeier et al. (2005), the Brazilian Cerrado is one of the 25 global hotspots, areas with concentration of endemic species and exceptional ongoing destruction. Many communities resident in Cerrado regions are comprised of poor people with restricted access to public health services and often dependent Received: 14/05/18 Accepted: 20/11/19
O Cerrado é o segundo maior bioma do Brasil, apresenta uma diversidade ecológica imensurável e ainda pouco explorada. Apesar da exuberância de suas espécies endêmicas, é um dos 25 hotspots globais, pois apresenta alta riqueza natural em termos de biodiversidade e destruição expressiva de seu meio ambiente. Neste estudo, pesquisamos o conhecimento sobre o uso medicinal de plantas do Cerrado entre indivíduos que vivem em uma região predominantemente do Cerrado. Um questionário individual semiestruturado com perguntas de caráter socioeconômicas qualitativas e referentes ao uso medicinal de plantas foi aplicado aos usuários do Serviço de Saúde Pública da cidade de Assis, Estado de São Paulo, Brasil. Este estudo foi aprovado pelo Comitê de Ética do Hospital Regional de Assis (Protocolo 4812010). Dos 149 entrevistados, 90,6% relataram conhecimento e / ou uso de plantas para fins terapêuticos. Entre as 115 espécies de plantas mencionadas, 11,4% pertencem ao Cerrado. Também avaliamos a correlação entre os usos relatados e os respectivos dados publicados em estudos científicos sobre as propriedades medicinais das plantas.Verificou-se que, para as poucas plantas de Cerrado citadas, os entrevistados descreveram diversas aplicações medicinais não descritas cientificamente. Mais precisamente, 60,5% do total das aplicações medicinais não foram encontrados na literatura científica. Além disso, muitos dos efeitos terapêuticos descritos na literatura para as espécies do Cerrado não foram citados pela população entrevistada. Portanto, sugerimos que o fortalecimento da conexão entre conhecimento popular e científico, aliado à disseminação desse conhecimento, poderia contribuir para uma maior valorização do bioma Cerrado e consequentemente a preservação do mesmo.
Subject(s)
Plants, Medicinal , Grassland , Brazil , Ecosystem , BiodiversityABSTRACT
A prática de associações medicamentosas é comum em pacientes hospitalizados, Esta prática é muitas vezes necessária, principalmente em pacientes psiquiátricos, uma vez que, juntamente com as doenças neuropsiquiátricas, podem ocorrer outras comorbidades, Entretanto, esta prática pode favorecer a ocorrência de interações medicamentosas com consequente potencialização de diferentes efeitos adversos, Diante deste quadro, o presente trabalho teve como objetivo avaliar a ocorrência de potenciais interações medicamentosas com os benzodiazepínicos, prescritos aos pacientes internados na Clínica Psiquiátrica do Hospital Regional de Assis ? SP, a fim de gerar informações que contribuam para a eficácia do tratamento estabelecido ao paciente, Para isso, foi realizada uma análise de 100 prescrições médicas, nas quais foram avaliadas as possibilidades de ocorrência de interações medicamentosas entre os diferentes fármacos da classe dos benzodiazepínicos administrados concomitantemente, bem como com outras classes de fármacos, Por meio deste estudo, verificou-se que das 100 prescrições médicas analisadas 93 apresentaram a possibilidade de ocorrência de interações farmacológicas entre benzodiazepínicos e com outras classes de fármacos, totalizando 356 possíveis interações, Desse total, destacam-se as associações dos benzodiazepínicos com os antipsicóticos, anti-histamínicos, antiepilépticos e antidepressivos, as quais podem potencializar a manifestação de inúmeros efeitos adversos, em destaque, a exacerbação do efeito depressor do sistema nervoso central, com repercussões que podem variar desde a manifestação clínica leve até risco de êxito letal, Neste contexto, busca-se com este trabalho contribuir para uma melhor compreensão, reconhecimento e intervenção precoce ou profilática em situações clínicas decorrentes de interações farmacológicas entre diferentes classes de fármacos com os benzodiazepínicos...
The practice of drug combinations is common in hospitalized patients. This practice is often necessary, especially in psychiatric patients, since other comorbidities may occur in parallel with neuropsychiatric disorders. However, this practice may favor the occurrence of drug interactions with consequent increase of different adverse effects. Facing this situation, the present study aimed to evaluate the occurrence of potential drug interactions with benzodiazepines prescribed to hospitalized patients at the Psychiatric Clinic of the Hospital Regional de Assis - SP, in order to generate information that contributes to the effectiveness of the treatment provided to patient. To this end, an analysis of 100 medical prescriptions was performed, in which were evaluated the possibility of drug interactions between the different medications from the class of benzodiazepines concomitantly administered, as well as other classes of drugs. By means of this study, it was verified that the 100 analyzed prescriptions 93 presented the possibility of different pharmacological interactions between benzodiazepine, and with other classes of drugs, totaling 356 possible interactions. Of this total stand out the associations of benzodiazepines with antipsychotics, antihistamines, antiepileptics and antidepressants, which can enhance the expression of numerous adverse effects, highlighted the exacerbation of depressant effect on the central nervous system, with effects that can range from mild clinical manifestation until risk of lethal outcome. In this context, it seeks in this work to contribute to a better understanding, recognition and early or prophylactic intervention in clinical situations arising from interactions between different pharmacological classes of drugs with benzodiazepines...