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1.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(4): 560-567, fev 11, 2022. tab, fig
Article in Portuguese | LILACS | ID: biblio-1359322

ABSTRACT

Introdução: depressão e ansiedade têm sido observadas entre universitários, sendo apontado como desencadeadores a sobrecarga de tarefas, cobranças pessoais e familiares entre outros fatores que podem resultar na necessidade de uso de psicofármacos. Objetivo: avaliar o uso de psicofármacos por universitários. Metodologia: estudo transversal, utilizando questionário contendo informações sociodemográficas, econômicas e sobre uso de psicofármacos. Foi realizada análise bivariada com teste qui-quadrado de Pearson para verificar associação entre as variáveis utilização de antidepressivos/ansiolíticos e sociodemográficas e econômicas. Resultados: dos 408 entrevistados, 22,3% afirmaram fazer uso de ansiolíticos/antidepressivos, tendo iniciado após o ingresso na universidade e em uso diário. A maioria relata ter alterado a dosagem sem consultar o médico, asseguraram conhecimento sobre os efeitos adversos do medicamento, sabe que a remoção do medicamento deve ser feita de maneira gradual, mas afirmam ter interrompido o tratamento sem consultar o médico. Permaneceram associadas a utilização de psicofármacos, no modelo final, ser do sexo feminino (p=0,013), idade maior que 29 anos (p=0,009) e possuir plano de saúde (p=0,020). Conclusão: verificou-se a necessidade de alertar a comunidade acadêmica e gestão sobre a necessidade de acolhimento dos universitários em sofrimento mental e propor ações que visem orientar sobre o uso racional dos psicofármacos.


Introduction: depression and anxiety have been observed among university students, with task overload, personal and family demands being pointed out as triggers, among other factors that result in the use of psychotropic drugs. Objective: to evaluate the use of psychopharmaceuticals by university students. Methodology: cross-sectional study, using a questionnaire containing sociodemographic, economic and psychotropic drug use information. A bivariate analysis was performed with Pearson's chi-square test to verify the association between the variables use of antidepressants/anxiolytics and sociodemographic and economic variables. Results: of the 408 respondents, 22.3% said they used anxiolytics/antidepressants, having started after entering university and in daily use. The majority report having changed the dosage without consulting the doctor, assured knowledge about the adverse effects of the medication, know that the removal of the medication must be done gradually, but claim to have stopped the treatment without consulting the doctor. The use of psychotropic drugs in the final model, being female (p=0.013), older than 29 years (p=0.009) and having a health plan (p=0.020) remained associated. Conclusion: there was a need to alert the academic and management community about the need to welcome university students in mental distress and propose actions that aim to guide the rational use of psychotropic drugs.


Subject(s)
Humans , Male , Female , Adult , Anxiety , Psychotropic Drugs , Students , Anti-Anxiety Agents , Mental Health , Surveys and Questionnaires , Depression , Antidepressive Agents , Laboratory and Fieldwork Analytical Methods , Epidemiology, Descriptive , Cross-Sectional Studies
2.
SMAD, Rev. eletrônica saúde mental alcool drog ; 17(1): 39-47, jan.-mar. 2021. ilus
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1280639

ABSTRACT

OBJETIVO: caracterizar os idosos atendidos em um Serviço de Urgência e Emergência Psiquiátrica quanto ao perfil sociodemográfico, diagnóstico psiquiátrico, prescrição de medicamentos e conduta médica e avaliar suas associações com o sexo. MÉTODO: estudo transversal, quantitativo, em que os dados foram obtidos a partir dos prontuários de pacientes atendidos no referido serviço, entre julho/2015 e junho/2016. A variável independente foi o sexo e as dependentes foram: idade; procedência; informante; tratamento psiquiátrico anterior; diagnóstico; medicamentos prescritos e conduta. RESULTADOS: nos 152 prontuários analisados, observam-se idade prevalente entre 60 a 69 anos, maioria de mulheres, procedência do município local e comparecimento com acompanhante. Os diagnósticos prevalentes são a esquizofrenia e os transtornos mentais e comportamentais decorrentes do uso de substâncias psicoativas. As medicações prescritas com maior frequência são da classe dos antipsicóticos e anti-histamínicos, seguidas dos ansiolíticos/sedativos. O critério de Beers considera a prescrição de medicamentos do grupo dos benzodiazepínicos, antipsicóticos e anti-histamínicos inapropriada para idosos. A principal conduta foi a alta, sem encaminhamento a outro serviço. CONCLUSÃO: embora haja incentivo do Ministério da Saúde, com a criação de novas políticas de saúde mental, muitos profissionais mantêm o modelo de atendimento baseado na queixa e conduta, dificultando a reabilitação psicossocial dos pacientes.


OBJECTIVE: characterize the elderly treated in a Psychiatric Emergency and Urgency Service regarding their sociodemographic profile, psychiatric diagnosis, prescription of medication and medical conduct and evaluate their associations with sex. METHOD: a cross-sectional, quantitative study in which data was obtained from the medical records of patients seen in the referred service, between July/2015 and June/2016. The independent variable was gender and dependents were: age; origin; informant; previous psychiatric treatment; diagnosis; prescribed drugs and conduct. RESULTS: in the 152 medical records analyzed, the prevailing age is between 60 and 69 years old, most of them women, coming from the local municipality and attending with a companion. The prevalent diagnoses are schizophrenia and mental and behavioral disorders resulting from the use of psychoactive substances. The most frequently prescribed medications are in the class of antipsychotics and antihistamines, followed by anxiolytics/sedatives. Beers' criteria consider the prescription of benzodiazepine, antipsychotic and antihistamine medications inappropriate for the elderly. The main conduct was discharge, without referral to another service. CONCLUSION: although there is encouragement from the Ministry of Health, with the creation of new mental health policies, many professionals maintain the model of care based on complaint and conduct, hindering the psychosocial rehabilitation of patients.


OBJETIVO: caracterizar a los ancianos atendidos en un servicio psiquiátrico de emergencia y urgencia en relación con el perfil sociodemográfico, el diagnóstico psiquiátrico, la prescripción de medicamentos y la conducta médica; y evaluar sus asociaciones con el sexo. MÉTODO: un estudio cuantitativo y transversal en el que se obtuvieron datos de los registros médicos de los pacientes tratados en el citado servicio, del 2015 al 2016 de julio. La variable independiente era el sexo y los dependientes eran: edad, procedencia, informante, tratamiento psiquiátrico previo, diagnóstico, medicamentos recetados y conducta. RESULTADOS: de los 152 registros médicos analizados, se observa que: la edad predominante es de 60 a 69 años, la mayoría de ellos son mujeres, desde el municipio local y atendido a la atención de un acompañante. Los diagnósticos prevalentes son la esquizofrenia y los trastornos mentales y conductuales resultantes del uso de sustancias psicoactivas. Los medicamentos recetados con mayor frecuencia son la clase antipsicótica y anti-histamina, seguida de ansiolíticos/sedantes. El criterio de Beers considera que la prescripción de fármacos del grupo de benzodiazepinas, antipsicóticos y antihistaminas, es inadecuada para los ancianos. La conducta principal era alta, sin remisión a otro servicio. CONCLUSIÓN: aunque hay aliento del Ministerio de salud con la creación de nuevas políticas de salud mental, muchos profesionales mantienen el modelo de cuidado basado en la queja y la conducta, obstaculizando la rehabilitación psicosocial de los pacientes.


Subject(s)
Humans , Male , Female , Aged , Anxiety Disorders/drug therapy , Schizophrenia/therapy , Antipsychotic Agents/therapeutic use , Anti-Anxiety Agents/therapeutic use , Mentally Ill Persons , Psychiatric Rehabilitation , Mental Disorders/therapy
3.
Int. j. med. surg. sci. (Print) ; 8(1): 1-12, mar. 2021. tab
Article in Spanish | LILACS | ID: biblio-1151620

ABSTRACT

El objetivo de este estudio fue caracterizar la prescripción de los medicamentos ansiolíticos utilizados en población de adultos mayores institucionalizados en el hogar de ancianos de Pinar del Río durante el año 2017.Se realizó un estudio descriptivo transversal, con recogida de datos retrospectiva, sobre prescripción de medicamentos ansiolíticos en la población de adultos mayores institucionalizados en el hogar de ancianos, se analizó la forma de utilización de los medicamentos, su indicación y prescripción con elementos de esquema terapéutico y factores que condicionan los hábitos de prescripción. Se trabajó con el universo (U= 98) de estudio el cual estuvo conformado por el total de pacientes institucionalizados, que estaban consumiendo ansiolíticos. Se revisaron las historias clínicas individuales y se confeccionó un modelo de recolección de datos.El medicamento más consumido por los adultos mayores fue el nitrazepam (41,8 %), siendo este a su vez el más consumido por el sexo masculino, no así para el femenino que resultó ser el clorodiazepóxido (64,6 %), el grupo de edad que más predominó fue el de 60-69 años, asimismo los viudos y el nivel educacional primario, el 79,5 % de los ancianos consume otros medicamentos que poseen interacción farmacocinética. El profesional que más indicó fue el médico de familia, la prescripción e intervalos entre dosis fue adecuada, la prescripción se consideró no racional.La prescripción de ansiolíticos en la población objeto de estudio, disminuye a medida que aumenta la edad, los más consumidores son los del sexo masculino y los institucionalizados por abandono familiar, esto apunta a la necesidad de continuar trabajando desde el nivel primario de atención dado que es de donde proceden estos ancianos.


The objective of this study was to characterize the prescription of anxiolytic medications used in the institutionalized elderly population at the Pinar del Río Nursing Home during 2017.A cross-sectional descriptive study was carried out, with retrospective data collection, on the prescription of anxiolytic medications in the population of institutionalized older adults in the Nursing Home, the form of use of the medications, their indication and prescription with elements of the therapeutic scheme was analyzed and factors that condition prescription habits. We worked with the universe (U = 98) of the study, which was made up of the total number of institutionalized patients who were consuming anxiolytics. Individual medical records were reviewed and a data collection model was created.The drug most consumed by older adults was nitrazepam (41.8%), this in turn being the most consumed by males, not so for females, which turned out to be chlorodiazepoxide (64.6%), the group The most prevalent age group was 60-69 years, likewise widowers and primary educational level, 79.5% of the elderly consume other drugs that have pharmacokinetic interaction. The professional who indicated the most was the family doctor, the prescription and intervals between doses were adequate, the prescription was considered non-rational.The prescription of anxiolytics in the population under study decreases as age increases, the most consumers are those of the male sex and those institutionalized due to family abandonment, this points to the need to continue working from the primary level of care since that is where these elders come from.


Subject(s)
Aged , Aged, 80 and over , Drug Prescriptions , Anti-Anxiety Agents/therapeutic use , Chlordiazepoxide/therapeutic use , Homes for the Aged , Nitrazepam/therapeutic use , Nursing Homes , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies , Sex Distribution , Age Distribution
4.
Article in Chinese | WPRIM | ID: wpr-879113

ABSTRACT

Based on the research literatures of Passiflora incarnata and the theory of traditional Chinese medicine, the paper discussed the traditional Chinese medicinal properties of P. incarnate, so as to provide a theoretical basis for the compatibility and application of P. incarnata. The literature databases of CNKI, Wanfang, VIP, Web of Science, PubMed and Scopus were selected, and the literatures relating to P. incarnata were reviewed to screen out the scientific research literatures with a high credibility, rational design and reliable conclusions. Foreign pharmacopoeia was consulted, and the listed products were summarized. The traditional Chinese medicine properties of P. incarnata were studied based on 32 clinical trials, 66 pharmacological researches, 64 chemical constituents researches as well as the theory of traditional Chinese medicine. It was preliminarily concluded that the medicinal properties of P. incarnata are sweet, cool, and enter heart, liver channels. The function is mainly to calm the heart and tranquilizing the mind, and calm the liver wind. It is used for hyperactivity of liver-Yang, stagnation of liver-Qi, restlessness of mind, depression, nervousness, insomnia. This paper summarized the source, characteristics of natures, tastes and channel tropism, usage and dosage, function indications of P. incarnata, and defined its clear traditional Chinese medicine property, which lays a theoretical foundation for the compatibility and clinical application of P. incarnata and Chinese medicine.


Subject(s)
Anti-Anxiety Agents , Anxiety , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Passiflora , Sleep Initiation and Maintenance Disorders/drug therapy
5.
J. Health Biol. Sci. (Online) ; 9(1): 1-7, 2021. tab, gráf
Article in English | LILACS | ID: biblio-1352382

ABSTRACT

Objetctive: Realize a systematic review on articles about cannabidiol (CBD) as an anxiolytic and antidepressant drug. Methodology: A systematic review in PubMed, Science Direct and PsycINFO databases taking into consideration articles published in English and Portuguese from 2008 to 2018 with animal experimentation. Results: Eleven articles with experimental studies on animals were included. All studies exhibited anxiolytic and antidepressant activities after CBD use. Conclusion: It was proven by several experiments the anxiolytic and antidepressant activity of CBD, however there is still a need of more preclinicals and clinicals studies to elucidate its mechanisms.


Objetivo: Realizar uma revisão sistemática de artigos sobre o canabidiol (CBD) como ansiolítico e antidepressivo. Metodos: Revisão sistemática nas bases de dados PubMed, Science Direct e PsycINFO considerando artigos publicados em inglês e português de 2008 a 2018 com experimentação animal. Resultados: Onze artigos com estudos experimentais em animais foram incluídos. Todos os estudos exibiram atividades ansiolíticas e antidepressivas após o uso de CBD. Conclusão: Foi comprovada por diversos experimentos a atividade ansiolítica e antidepressiva do CBD, porém ainda há necessidade de mais estudos pré-clínicos e clínicos para elucidar seus mecanismos.


Subject(s)
Cannabidiol , Cannabis , Anti-Anxiety Agents , Antidepressive Agents
8.
Braz. arch. biol. technol ; 63: e20200206, 2020. tab, graf
Article in English | LILACS | ID: biblio-1132262

ABSTRACT

Abstract The high prevalence of anxiety disorders associated with pharmacotherapy side effects have motivated the search for new pharmacological agents. Species from Citrus genus, such as Citrus limon (sicilian lemon), have been used in folk medicine as a potential therapy to minimize emotional disorders. In order to searching for new effective treatments with fewer side effects, the present study evaluated the anxiolytic mechanism of action and the hypnotic-sedative activity from the Citrus limon fruit's peels essential oil (CLEO). Adults male Swiss mice were submitted to barbiturate-induced sleep test; elevated plus-maze (EPM) and light-dark box (LDB) (evaluation of the mechanism of action); rotarod; and catalepsy tests. CLEO oral treatment decreased latency and increased the sleep total time; moreover it induced in animals an increased the number of entries and percentage of time spent into open arms of the EPM; an increased the number of transitions and the percentage of time into light compartment in the LDB; which were only antagonized by flumazenil pretreatment, with no injury at motor function. Thus, results suggest that CLEO treatment induced an anxiolytic behavior suggestively modulated by the benzodiazepine binding site of the GABAA receptor or by an increase of GABAergic neurotransmission, without cause impairment in the motor coordination.


Subject(s)
Animals , Male , Mice , Anxiety/drug therapy , Anti-Anxiety Agents/therapeutic use , Oils, Volatile/therapeutic use , Citrus/chemistry , GABA Modulators/pharmacology , Hypnotics and Sedatives/therapeutic use , Anti-Anxiety Agents/isolation & purification , Maze Learning/drug effects , Hypnotics and Sedatives/isolation & purification
9.
Saúde Soc ; 28(4): 137-146, out.-dez. 2019. tab
Article in Spanish | LILACS | ID: biblio-1058987

ABSTRACT

Resumen A pesar de que son ampliamente conocidos los perfiles de utilización de las benzodiazepinas (BZD) y los riesgos asociados, este conocimiento no ha conducido a visibles transformaciones que mejoren la seguridad de los tratamientos y la salud de los pacientes. Por tanto, es necesaria una mejor compresión del contexto de su utilización, con el fin de implementar acciones educativas eficaces, tomar decisiones clínicas pertinentes y perfeccionar su regulación en los servicios de salud. Este artículo se propone caracterizar el perfil de utilización de benzodiazepinas en un área de salud de Santiago de Cuba y analizar el contexto de consumo a partir de los sentidos construidos por usuarios crónicos. Se realiza un estudio de caso, que describe el perfil de consumo a partir de las recetas dispensadas en la Farmacia Principal Municipal, y se realizan entrevistas a profundidad a los usuarios crónicos. El contenido de las entrevistas fue realizado temáticamente. Los resultados revelan los siguientes temas: poca concientización sobre el beneficio-riesgo del tratamiento, sufrimiento con la dependencia y tolerancia, autonomía en el tratamiento y limitada credibilidad en las terapias alternativas. La proporción de adultos mayores que reciben las BZD es mayor que la identificada en otros estudios. Se concluye que los usuarios perciben aspectos negativos del uso, pero están presos en la dependencia. Se evidencia la importancia de estudiar estrategias para el tratamiento del insomnio y la ansiedad en la atención primaria de salud, así como valorizar las políticas de implementación de terapias naturales y otros abordajes para contribuir al uso racional de las BZD.


Abstract The profiles for the use of benzodiazepines and associated risks are well known. However, this knowledge has not led to visible transformations that improve the safety of treatments and the health of patients. It is therefore necessary to better understand the context of use of these medications in order to implement effective educational actions, make relevant clinical decisions and improve their regulation in health services, especially in primary care. To characterize the profile of use of benzodiazepines in a health area of Santiago de Cuba and to analyze the context of consumption from the senses built by chronic users. Methods: A case study was carried out on the consumption patterns and interviews with chronic users was performed. The content of the interviews was thematically analyzed. The themes revealed were: little awareness of the benefit-risk of treatment; suffering with dependence and tolerance; autonomy in treatment; and limited credibility in alternative therapies. The proportion of older adults receiving benzodiazepines is greater than that identified in other studies. The users perceive negative aspects of use, but they are tied to the dependence. It is evident the importance of studying strategies for the treatment of insomnia and anxiety in primary health care, as well as valuing the policies of implementation of natural therapies and other approaches to contribute to the rational use of benzodiazepines.


Subject(s)
Humans , Male , Female , Pharmaceutical Services , Anti-Anxiety Agents , Benzodiazepines , Substance-Related Disorders
10.
Rev. bras. cir. cardiovasc ; 34(3): 311-317, Jun. 2019. tab, graf
Article in English | LILACS | ID: biblio-1013477

ABSTRACT

Abstract Objective: To investigate the effects of preoperative anxiety relieving on electrophysiological changes in patients undergoing off-pump coronary artery bypass surgery. Methods: A total of 61 patients at ASA III risk group in the age range of 18-65 years were enrolled in the present study. Patients were randomly divided into two groups. Group S (Sedation group) was administered 0.04 mg/kg lorazepam per os (PO) twice before the operation. Group C (control group) was not administered with any anxiolytic premedication. State Trait Anxiety Inventory (STAI-I) and Beck Anxiety Inventory (BAI) were used to evaluate the level of anxiety. Electrocardiography (ECG), pulse oximeter and standard monitoring were performed for each patient. QT and P dispersions in each derivation of all ECGs were calculated. Results: Preoperative STAI-I scores were significantly lower in sedation group compared to the controls. Mean values of QT dispersion measured before induction, at the 1st minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.024; P=0.027; P=0.001; P=0.033, respectively). The mean values of P dispersion measured before induction, at the 3rd minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.001; P=0.020; P=0.023; P=0.005, respectively). Conclusion: Elevated anxiety levels in patients undergoing coronary bypass surgery have a negative effect through prolonged QT and P-wave dispersion times. Anxiolytic treatment before surgery may be useful to prevent ventricular and atrial arrhythmias and associated complications through decreasing the QT and P-wave dispersion duration.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Anxiety/physiopathology , Anxiety/drug therapy , Anti-Anxiety Agents/therapeutic use , Preoperative Care/methods , Coronary Artery Bypass, Off-Pump/psychology , Electrocardiography/psychology , Lorazepam/therapeutic use , Arrhythmias, Cardiac/physiopathology , Arrhythmias, Cardiac/psychology , Reference Values , Time Factors , Reproducibility of Results , Risk Factors , Treatment Outcome , Statistics, Nonparametric , Coronary Artery Bypass, Off-Pump/methods
12.
Rev. bras. psiquiatr ; 41(2): 168-178, Mar.-Apr. 2019. tab
Article in English | LILACS | ID: biblio-990820

ABSTRACT

Objective: Anxiety disorders are highly prevalent and the efficacy of the available anxiolytic drugs is less than desired. Adverse effects also compromise patient quality of life and adherence to treatment. Accumulating evidence shows that the pathophysiology of anxiety and related disorders is multifactorial, involving oxidative stress, neuroinflammation, and glutamatergic dysfunction. The aim of this review was to evaluate data from animal studies and clinical trials showing the anxiolytic effects of agents whose mechanisms of action target these multiple domains. Methods: The PubMed database was searched for multitarget agents that had been evaluated in animal models of anxiety, as well as randomized double-blind placebo-controlled clinical trials of anxiety and/or anxiety related disorders. Results: The main multitarget agents that have shown consistent anxiolytic effects in various animal models of anxiety, as well in clinical trials, are agomelatine, N-acetylcysteine (NAC), and omega-3 fatty acids. Data from clinical trials are preliminary at best, but reveal good safety profiles and tolerance to adverse effects. Conclusion: Agomelatine, NAC and omega-3 fatty acids show beneficial effects in clinical conditions where mainstream treatments are ineffective. These three multitarget agents are considered promising candidates for innovative, effective, and better-tolerated anxiolytics.


Subject(s)
Humans , Animals , Anxiety Disorders/drug therapy , Acetylcysteine/pharmacology , Anti-Anxiety Agents/pharmacology , Fatty Acids, Omega-3/pharmacology , Hypnotics and Sedatives/pharmacology , Acetamides/pharmacology , Neuroimmunomodulation/drug effects , Oxidative Stress/drug effects , Disease Models, Animal , Glutamine/drug effects
13.
Rev. bras. psiquiatr ; 41(1): 9-14, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-985360

ABSTRACT

Objective: Cannabidiol (CBD), one of the non-psychotomimetic compounds of Cannabis sativa, causes anxiolytic-like effects in animals, with typical bell-shaped dose-response curves. No study, however, has investigated whether increasing doses of this drug would also cause similar curves in humans. The objective of this study was to compare the acute effects of different doses of CBD and placebo in healthy volunteers performing a simulated public speaking test (SPST), a well-tested anxiety-inducing method. Method: A total of 57 healthy male subjects were allocated to receive oral CBD at doses of 150 mg (n=15), 300 mg (n=15), 600 mg (n=12) or placebo (n=15) in a double-blind procedure. During the SPST, subjective ratings on the Visual Analogue Mood Scale (VAMS) and physiological measures (systolic and diastolic blood pressure, heart rate) were obtained at six different time points. Results: Compared to placebo, pretreatment with 300 mg of CBD significantly reduced anxiety during the speech. No significant differences in VAMS scores were observed between groups receiving CBD 150 mg, 600 mg and placebo. Conclusion: Our findings confirm the anxiolytic-like properties of CBD and are consonant with results of animal studies describing bell-shaped dose-response curves. Optimal therapeutic doses of CBD should be rigorously determined so that research findings can be adequately translated into clinical practice.


Subject(s)
Humans , Male , Anxiety/drug therapy , Speech/drug effects , Anti-Anxiety Agents/administration & dosage , Cannabidiol/administration & dosage , Socioeconomic Factors , Double-Blind Method , Dose-Response Relationship, Drug
14.
Saúde Soc ; 28(1): 107-120, jan.-mar. 2019. graf
Article in Portuguese | LILACS | ID: biblio-991680

ABSTRACT

Resumo Este estudo objetiva analisar o fenômeno do abuso de benzodiazepínicos, considerando o modo como essa substância comparece nos discursos constituídos na abordagem do mal-estar na contemporaneidade. Trata-se de uma pesquisa descritiva, de natureza qualitativa; foram ouvidos 18 médicos e enfermeiros atuantes na rede de saúde de Fortaleza, além de nove mulheres usuárias dos serviços. A população entre usuários limitou-se ao sexo feminino, devido ao fato de a literatura apontar prevalência do abuso de benzodiazepínicos nesse público. No exame dos dados, usou-se a análise do discurso de corrente francesa, a qual permitiu entrever como o medicamento comparece no laço social, apresentando diferentes significações, a depender do lugar ocupado nos discursos. Nos resultados encontrados destaca-se que o benzodiazepínico entra em uma espécie de curto-circuito no qual o tráfico de drogas comparece tanto na porta de entrada (como argumento para o consumo da substância em decorrência da violência cotidiana experimentada por essas mulheres) como na outra ponta (como substância desviada dos serviços de saúde e comercializada nos pontos de venda de drogas). Essa medicação constitui-se, assim, num gadget - objeto de consumo revestido pelo brilho de supostamente recobrir a falta. Diante desse cenário, urge pensar políticas públicas que possam ir além do modelo medicalizante.


Abstract This study aims to analyze the phenomenon of benzodiazepine abuse, considering the way this substance appears in discourses constituted in approaching the lack of well-being in the contemporary world. This is a descriptive research of qualitative nature. Eighteen physicians and nurses working in the health network of Fortaleza were heard, in addition to nine female users of these services. The user population was restricted to females due to the literature underlining a prevalence of benzodiazepine abuse in this public. Data analysis using French discourse analysis showed how the drug affects the social bond, presenting different meanings depending on the place occupied in the discourse. It is worth noting that in the findings the benzodiazepine user sort of short-circuits, in which drug trafficking appears both on one side (as an argument for substance consumption due to the daily violence experienced by these women) and on the other (as it is a substance deviated from health services and marketed at drug outlets). This medication thus constitutes a gadget object - an object of consumption coated with the gloss of supposedly satisfying its lack. Given this scenario, it is crucial to ponder new public policies capable of surpassing the medicalization model.


Subject(s)
Humans , Male , Female , Psychoanalysis , Anti-Anxiety Agents , Public Health , Substance-Related Disorders , Medicalization , Language Arts
15.
Experimental Neurobiology ; : 593-601, 2019.
Article in English | WPRIM | ID: wpr-763787

ABSTRACT

3-Carene, a bicyclic monoterpene, is one of the major components of the pine tree essential oils. It has been reported that, in addition to its known properties as a phytoncide, 3-carene has anti-inflammatory, antimicrobial, and anxiolytic effects. We have previously demonstrated that α-pinene, the major component of pine tree, has a hypnotic effect through GABA(A)-benzodiazepine (BZD) receptors. However, a hypnotic effect of 3-carene has not been studied yet. Here, we report that oral administration of 3-carene increases the sleep duration and reduces sleep latency in pentobarbital-induced sleep test. 3-Carene potentiates the GABA(A) receptor-mediated synaptic responses by prolonging the decay time constant of inhibitory synaptic responses. These enhancing effects of 3-carene are reproduced by zolpidem, a modulator for GABA(A)-BZD receptor, and fully inhibited by flumazenil, an antagonist for GABA(A)-BZD receptor. The molecular docking of 3-carene to the BZD site of GABA(A) protein structure, suggests that 3-carene binds to the BZD site of α1 and ϒ2 subunits of GABA(A)-BZD receptor. These results indicate that, similar to α-pinene, 3-carene shows a sleep-enhancing effect by acting as a positive modulator for GABA(A)-BZD receptor.


Subject(s)
Administration, Oral , Anti-Anxiety Agents , Flumazenil , Hypnotics and Sedatives , Oils, Volatile , Pinus
16.
Asian Nursing Research ; : 295-305, 2019.
Article in English | WPRIM | ID: wpr-816610

ABSTRACT

PURPOSE: Although lavender is purported to possess anxiolytic and sedative properties and is often recommended for relieving anxiety, the efficacy of lavender has not been well established. Thus, this review aimed to evaluate the anxiolytic effects of lavender aromatherapy.METHODS: Ten data bases were searched for studies published between 2000 and 2018. Randomized controlled trials investigating the anxiolytic effects of lavender aromatherapy with any type of application for persons with or without clinical anxiety were included. The outcome variables included self-rated anxiety, vital signs, and salivary cortisol and chromogranin A (CgA) levels. In the meta-analysis, standardized mean difference and 95% confidence interval were calculated as effect measures by applying the random effect model and inverse variance method.RESULTS: Twenty-two trials met our inclusion criteria. Lavender aromatherapy was found to have favorable effects in relieving anxiety (Hedges' ĝ = −0.65; 95% CI, −0.84 to −0.46) and decreasing systolic blood pressure (ĝ = −0.22; 95% CI, −0.43 to −0.02), heart rate (ĝ = −0.53; 95% CI, −0.74 to −0.32), and salivary cortisol (ĝ = −1.29; 95% CI, −2.23 to −0.35) and CgA (ĝ = −2.29; 95% CI, −3.24 to −1.34) levels. However, the meta-analysis did not reveal any significant effects of lavender on diastolic blood pressure (effect size: −0.17; 95% CI, −0.37e0.04).CONCLUSION: Aromatherapy using lavender oil might have favorable effects on anxiety and its physiological manifestations. Future studies are recommended with an emphasis on methodological quality. In nursing practice, it is suggested that lavender aromatherapy be included in programs intended to manage anxiety in patients across diverse healthcare settings.


Subject(s)
Anti-Anxiety Agents , Anxiety , Aromatherapy , Blood Pressure , Chromogranin A , Delivery of Health Care , Heart Rate , Humans , Hydrocortisone , Lavandula , Methods , Nursing , Vital Signs
17.
Rev. bras. epidemiol ; 22: e190021, 2019. tab
Article in Portuguese | LILACS | ID: biblio-990733

ABSTRACT

RESUMO: Introdução: O uso de ansiolíticos é uma opção no tratamento de sintomas psíquicos. Contudo, ainda que o uso seja controlado há riscos de dependência, intoxicação e alterações cognitivas. O uso não controlado entre trabalhadores agrava tais problemas. Objetivos: Identificar a prevalência do uso de ansiolíticos e conhecer os fatores associados ao consumo em bombeiros militares. Método: Pesquisa transversal de base censitária investigou 711 bombeiros de Belo Horizonte, Minas Gerais, por meio de autorrelato. Regressão logística multinomial foi utilizada para verificar associação entre características sociodemográficas, condições de vida, trabalho e saúde e consumo de ansiolíticos de modo controlado ou não. Resultados: A prevalência do uso de ansiolíticos foi 9,9%. Para 7,5% dos bombeiros o consumo ocorreu sem indicação e/ou controle terapêutico especializado. O uso controlado foi associado ao relato compatível com Transtorno Mental Comum (OR = 23,6; IC95% 6,54 - 85,11). O uso não controlado foi associado ao tempo de serviço (OR = 2,57; IC95% 1,03 - 6,40), ao tabagismo (OR = 3,22; IC95% 1,50 - 6,91) e ao Transtorno Mental Comum (OR = 4,02; IC95% 2,17 - 7,45). Conclusão: A alta prevalência de consumo indica alerta para as ações dos programas de saúde ocupacional.


ABSTRACT: Introduction: Use of anxiolytic drugs is an option for treating psychological symptoms. However, even if their use is controlled, there are risks of dependence, intoxication and cognitive alterations. Uncontrolled use among workers worsens these problems. Objectives: Identify the prevalence of anxiolytic use and to know the factors associated with consumption in military firefighters. Method: Cross-sectional survey of 711 firefighters from Belo Horizonte, Minas Gerais, Brazil, was conducted through self-reporting. Multinomial logistic regression was used to investigate associations between sociodemographic characteristics, living, working and health conditions and anxiolytic consumption in a controlled or uncontrolled manner. Results: Prevalence of anxiolytic use was 9.9%. For 7.5% of firefighters the consumption occurred without indication and/or specialized therapeutic control. Controlled use was only associated with symptoms compatible with Common Mental Disorder (OR = 23.6; 95%CI 6.54 - 85.11). Uncontrolled use was associated with length of service (OR = 2.57; 95%CI 1.03 - 6.40), smoking (OR = 3.22; 95%CI 1.50 - 6.91) and symptomatology compatible with Common Mental Disorder (OR = 4.02; 95%CI 2.17 - 7.45). Conclusion: The high prevalence of consumption indicates alert to occupational health programs.


Subject(s)
Humans , Male , Anti-Anxiety Agents/therapeutic use , Firefighters/psychology , Mental Disorders/drug therapy , Military Personnel/psychology , Occupational Diseases/drug therapy , Socioeconomic Factors , Brazil/epidemiology , Epidemiologic Methods , Occupational Health , Mental Disorders/epidemiology , Occupational Diseases/epidemiology
18.
Physis (Rio J.) ; 29(4): e290407, 2019. tab
Article in Portuguese | LILACS | ID: biblio-1056962

ABSTRACT

Resumo A alocação de recursos com a aquisição de medicamentos é um dos maiores desafios para a efetivação da assistência farmacêutica no SUS. No entanto, poucos estudos avaliam a evolução desses gastos no nível estadual, especialmente com as classes dos antidepressivos, ansiolíticos e hipnótico-sedativos. O objetivo do estudo foi analisar e identificar os determinantes dos gastos com essas classes terapêuticas em Minas Gerais. Foram utilizados dados de compras públicas do Sistema Integrado de Administração de Materiais e Serviços (SIAD-MG) entre 2010 e 2015. Estimaram-se os gastos e volumes totais, além dos gastos com medicamentos não constantes nas listas de medicamentos essenciais. As análises de "Top 10" e de "Drug Cost 90%" identificaram os medicamentos responsáveis pelo maior gasto, e a análise de decomposição estabeleceu os determinantes da variação das despesas. Os gastos com as três classes totalizaram R$ 81 milhões e aumentaram 2,5 vezes entre 2010 e 2015, passando de R$ 7,5 milhões para R$ 18,7 milhões. Os antidepressivos representaram 89% dos gastos e 71% do volume adquirido. O preço foi o principal fator determinante do aumento das despesas, especialmente na classe dos antidepressivos. Os aumentos dos gastos ressaltam a necessidade de aprimoramento dos procedimentos de compra adotados pelo estado.


Abstract The allocation of financial resources on medicines procurement is one of the greatest challenges to the effectiveness of the Pharmaceutical Services in the Brazilian National Health System. However, there are few studies evaluating this expenditure trends at state level, especially with antidepressants, anxiolytics, hypnotics and sedatives. The study evaluated public expenditure trends and drivers for these therapeutic classes in Minas Gerais state, Brazil, by using data from SIAD database [Sistema Integrado de Administração de Materiais e Serviços] from 2010 to 2015. Total expenditure, volume and also expenditures with medicines not included in the essential lists were estimated. The top 10 medicines in terms of expenditure and drugs accounting for 90% of the total cost were identified. Decomposition analysis was conducted to assess the drivers of expenditure. Expenditure in the period totaled R$ 81 million and increased 2.5 times from 2010 to 2015. Antidepressants accounted for 89% of expenses and 71% of volume. Price contributed positively to the expenditure variation during the period, especially in antidepressants. The results highlight the need of improvement of public procurement procedures adopted by Minas Gerais state.


Subject(s)
Pharmaceutical Services , Anti-Anxiety Agents , Drug Costs , Health Expenditures , Resource Allocation , Hypnotics and Sedatives , Antidepressive Agents , State Government , Unified Health System , Brazil , Health Management
19.
Braz. j. med. biol. res ; 52(11): e8899, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039258

ABSTRACT

Few behavioral tests allow measuring several characteristics and most require training, complex analyses, and/or are time-consuming. We present an apparatus based on rat exploratory behavior. Composed of three different environments, it allows the assessment of more than one behavioral characteristic in a short 3-min session. Factorial analyses have defined three behavioral dimensions, which we named Exploration, Impulsivity, and Self-protection. Behaviors composing the Exploration factor were increased by chlordiazepoxide and apomorphine and decreased by pentylenetetrazole. Behaviors composing the Impulsivity factor were increased by chlordiazepoxide, apomorphine, and both acute and chronic imipramine treatments. Behaviors composing the Self-protection factor were decreased by apomorphine. We submitted Wistar rats to the open-field test, the elevated-plus maze, and to the apparatus we are proposing. Measures related to exploratory behavior in all three tests were correlated. Measures composing the factors Impulsivity and Self-protection did not correlate with any measures from the two standard tests. Also, compared with existing impulsivity tests, the one we proposed did not require previous learning, training, or sophisticated analysis. Exploration measures from our test are as easy to obtain as the ones from other standard tests. Thus, we have proposed an apparatus that measured three different behavioral characteristics, was simple and fast, did not require subjects to be submitted to previous learning or training, was sensitive to drug treatments, and did not require sophisticated data analyses.


Subject(s)
Animals , Male , Anxiety/psychology , Behavior, Animal/physiology , Behavioral Research/instrumentation , Exploratory Behavior/physiology , Fear/physiology , Impulsive Behavior/physiology , Time Factors , Anti-Anxiety Agents/pharmacology , Behavior, Animal/drug effects , Apomorphine/pharmacology , Chlordiazepoxide/pharmacology , Rats, Wistar , Maze Learning/drug effects , GABA Antagonists/pharmacology , Dopamine Agonists/pharmacology , Exploratory Behavior/drug effects , Fear/drug effects , Impulsive Behavior/drug effects , Antidepressive Agents, Tricyclic/pharmacology
20.
Article in English | WPRIM | ID: wpr-765963

ABSTRACT

BACKGROUND/AIMS: Gastrointestinal (GI) symptoms may develop when we fail to adapt to various stressors of our daily life. Central oxytocin (OXT) can counteract the biological actions of corticotropin-releasing factor (CRF), and in turn attenuates stress responses. Administration (intracerebroventricular) of OXT significantly antagonized the inhibitory effects of chronic complicated stress (CCS) on GI dysmotility in rats. However, intracerebroventricular administration is an invasive pathway. Intranasal administration can rapidly deliver peptides to the brain avoiding stress response. The effects of intranasal OXT on hypothalamus-pituitary-adrenal axis and GI motility in CCS conditions have not been investigated. METHODS: A CCS rat model was set up, OXT 5, 10, or 20 μg were intranasal administered, 30 minutes prior to stress loading. Central CRF and OXT expression levels were analyzed, serum corticosterone and OXT concentrations were measured, and gastric and colonic motor functions were evaluated by gastric emptying, fecal pellet output, and motility recording system. RESULTS: Rats in CCS condition showed significantly increased CRF expression and corticosterone concentration, which resulted in delayed gastric emptying and increased fecal pellet output, attenuated gastric motility and enhanced colonic motility were also recorded. OXT 10 μg or 20 μg significantly reduced CRF mRNA expression and the corticosterone concentration, OXT 20 μg also helped to restore GI motor dysfunction induced by CCS. CONCLUSION: Intranasal administration of OXT has an anxiolytic effect and attenuates the hypothalamus-pituitary-adrenal axis in response to CCS, and gave effects which helped to restore GI dysmotility, and might be a new approach for the treatment of stress-induced GI motility disorders.


Subject(s)
Administration, Intranasal , Animals , Anti-Anxiety Agents , Brain , Colon , Corticosterone , Corticotropin-Releasing Hormone , Gastric Emptying , Gastrointestinal Motility , Models, Animal , Oxytocin , Peptides , Rats , RNA, Messenger
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