Off-label drug use in an adult intensive care unit of a Brazilian hospital

Abstract The objective of this study was to determine the prevalence and describe the factors associated with off-label drug use in an adult intensive care unit (ICU) of a Brazilian hospital. An analytical, cross-sectional, prospective study was conducted in the adult ICU population from March 2018 to May 2018. Off-label use of medication was classified by indication, dosage, route of administration, type and volume of diluent, and duration of administration. Most patients were female (57.89%), non-elderly (56.14%), and had a mean age of 54.44 ± 17.15 years. The prevalence of off-label drug use was 70.31%, but was not associated with the clinical severity of the patients. A statistically significant association was observed between label use of drugs and prescribing potentially inappropriate medicines (PIM). The most common reasons for off-label drug use were therapeutic indication (19.58%) and volume of diluent (23.30%). Drug administration by enteral tubes accounted for the largest number of off-label uses due to route of administration (90.85%). There was a higher prevalence of off-label use of systemic antimicrobials (14.44%) and norepinephrine (9.28%). Our study provided a broad characterization of off-label drug use in an adult ICU and showed why it is important for health professionals to evaluate the specific risks and benefits of this practice

Investigação farmacológica dos mecanismos de ação gastroenteroprotetors do ácido centipédico, um diterpeno de Egletes viscosa Less., em modelos experimentais [manuscrito] / Pharmacological investigation of the mechanisms of action of gastroenteroprotetors centipédico acid, a diterpene Egletes viscous Less., in experimental models [manuscript]

Ácido Centipédico (AC), um diterpeno isolado Egletes viscosa Less. (Asteraceae) foi avaliado em modelos experimentais de lesão gástrica aguda e crônica, e, em modelo de lesão intestinal. AC (50 e 100 mg/kg, v.o.) atenuou significativamente as lesões gástricas induzidas por etanol (53 e 79% de inibição). Na dose de 50 mg/kg mostrou envolvimento do óxido nítrico, prostaglandinas, canais de potássio ATP-dependente, mas de receptores TRPV1. O diterpeno diminuiu significativamente a depleção dos grupos sulfidrilas não-proteicos e SOD e diminuiu a formação de MDA, associados à administração de etanol. AC aumentou ainda os níveis de muco gástrico. No modelo de etanol acidificado AC (50 e 100 mg/kg, v.o.) e lansoprazol (30 mg/kg, v.o.) atenuaram significativamente as lesões gástricas...