Interações medicamentosas de prescrições médicas em pacientes acometidos pelo coronavírus da síndrome respiratória aguda grave / Possible drug interactions in drug prescriptions of patients affected by sars-cov-2 / Posibles interacciones farmacológicas en la prescripción de medicamentos de pacientes afectados por sars-cov-2

Objetivo: Identificar as potenciais interações medicamentosas em prescrições médicas em pacientes acometidos por coronavírus da síndrome respiratória aguda grave. Método: Trata-se de um estudo descritivo, do tipo documental e retrospectivo realizado no período de abril a junho de 2020. Os dados foram coletados por meio de instrumento semi-estruturado, que abordou os medicamentos utilizados, dados sociodemográficos, e condições clínicas associadas. A análise dos dados efetivou-se numa abordagem quantitativa por estatística descritiva. Resultados: Verificou-se que os fármacos mais utilizados foram azitromicina, ondasetrona, enoxaparina e omeprazol. Ao avaliar as possíveis interações medicamentosas, constatou-se a média de 2,98 por cliente, sendo as de maior gravidade a ondasetrona e azitromicina; cloridrato de ondansetrona di-hidratado e fentanil, assim como midazolam e fentanil. Conclusão: Enfatiza-se a necessidade em avaliar os fármacos prescritos, bem como seus aprazamentos de forma que a assistência ao paciente seja realizada com o mínimo de danos. (AU)

Objective: To identify potential drug interactions of medical prescriptions in patients affected by severe acute respiratory syndrome coronavirus. Methods: This is a descriptive, documentary and retrospective study carried out from April to June 2020. Data were collected using a semi structured instrument, which addressed the drugs used, sociodemographic data, and associated clinical conditions. Data analysis was carried out using a quantitative approach using descriptive statistics. Results: It was found that the most used drugs were azithromycin, wavesetron, enoxaparin and omeprazole. When evaluating the possible drug interactions, an average of 2.98 per client was found, with the most severe being wavesetron and azithromycin; ondansetron hydrochloride dihydrate and fentanyl, as well as midazolam and fentanyl. Conclusion: The need to evaluate the prescribed drugs, as well as their schedules, is emphasized so that patient care is carried out with minimal damage. (AU)

Objetivo: Identificar posibles interacciones medicamentosas de prescripciones médicas en pacientes afectados por coronavírus síndrome respiratório agudo severo. Métodos: Se trata de un estudio descriptivo, documental y retrospectivo realizado de abril a junio de 2020. Los datos fueron recolectados mediante un instrumento semiestructurado, que abordó los fármacos utilizados, datos sociodemográficos y condiciones clínicas asociadas. El análisis de los datos se realizó mediante un enfoque cuantitativo utilizando estadística descriptiva. Resultados: Se encontró que los fármacos maus utilizados fueron azitromicina, wavesetron, enoxaparina y omeprazol. Al evaluar las posibles interacciones medicamentosas, se encontró un promedio de 2,98 por cliente, siendo los más graves el wavesetron y la azitromicina; hidrocloruro de ondansetrón dihidrato y fentanilo, así como midazolam y fentanilo. Conclusión: Se enfatiza la necesidad de evaluar los fármacos prescritos, así como sus horarios, para que la atención al paciente se lleve a cabo con el mínimo daño. (AU)

Clinical Predictors of Excessive Daytime Sleepiness in Patients with Parkinson's Disease

BACKGROUND AND PURPOSE: Excessive daytime sleepiness (EDS) is a common complaint among patients with Parkinson's disease (PD). Several factors have been associated with EDS in PD, especially neuropsychiatric symptoms. This study aimed to determine the relationships between neuropsychiatric symptoms, sociodemographic and clinical parameters, and EDS in PD. METHODS: This cross-sectional study analyzed 85 patients with PD. All patients underwent socioeconomic and clinical data evaluations followed by a psychiatric interview and a neurological examination, including the assessment of sleep features. Patients were divided into two groups according to the presence or absence of EDS, which was defined as a score higher than 10 on the Epworth Sleepiness Scale. Binary logistic regression was performed in order to describe the predictors of EDS. RESULTS: We found that EDS affects 40% of PD patients and is associated with older age, restless legs syndrome, depressive and anxious symptoms, and worse sleep quality. In the multivariate analysis, older age, levodopa use, and worse sleep quality remained as significant predictors of EDS in PD. CONCLUSIONS: Nighttime sleep problems, older age, and levodopa use are significantly associated with EDS in PD. A careful assessment and the management of sleep problems in PD patients might help to improve their quality of life.

Plasma Levels of Tumor Necrosis Factor Superfamily Molecules Are Increased in Bipolar Disorder

OBJECTIVE: Patients with bipolar disorder (BD) exhibit peripheral low-grade inflammation. The aim of the current study was to investigate the involvement of hitherto unexplored components of the tumor necrosis factor (TNF) superfamily in BD. METHODS: Eighty patients with type I BD and 50 healthy controls matched for age and gender were enrolled in this study. All subjects were assessed with the Mini-Plus to evaluate psychiatric comorbidities; the Young Mania Rating Scale and the Hamilton Depression Rating Scale to evaluate manic and depressive symptoms severity, respectively. TNF superfamily molecules (TNF, TNF-related weak inducer of apoptosis [TWEAK], TNF-related apoptosis-inducing ligand [TRAIL], soluble TNF receptor type 1 [sTNFR1], and soluble TNF receptor type 2 [sTNFR2]) levels were measured by ELISA. RESULTS: Patients with BD, regardless of mood state, presented increased plasma levels of sTNFR1 and TWEAK in comparison with controls. CONCLUSION: These findings corroborate the view that TNF superfamily may play a role in BD pathophysiology.