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O papel do farmacêutico nos primeiros socorros em intoxicações
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| PPG_37640 | 2.37 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
As intoxicações humanas representam uma importante causa de morbidade e mortalidade
a nível nacional e internacional. A prevenção é a melhor estratégia, mas o reconhecimento
da sintomatologia e a prestação adequada e atempada de primeiros socorros em casos de
intoxicação pode minorar as suas consequências. O Farmacêutico Comunitário, sendo o
profissional de saúde mais acessível à população, tem um papel chave na educação para
a prevenção de situações de risco relacionadas com medicamentos, como os ansiolíticos
e antidepressivos, e outras substâncias não farmacêuticas potencialmente tóxicas, como a
lixívia, bebidas alcoólicas, pesticidas, entre outros. A prevenção assume particular
relevância sobretudo nas crianças e idosos, que são grupos populacionais mais suscetíveis
a intoxicações acidentais. Além disso, é frequentemente confrontado com situações de
emergência médica, devendo proceder em cada situação de acordo com as melhores
práticas e de modo harmonizado com o Sistema Integrado de Emergência Médica
(SIEM).
Neste trabalho pretendeu-se efetuar primeiramente uma revisão da literatura sobre a
etiologia das intoxicações humanas, as vias de contacto com o tóxico e medidas gerais de
socorro em caso de contacto com os olhos, contaminação da pele, inalação ou ingestão,
os grupos de agentes envolvidos em intoxicações humanas, as principais síndromes
tóxicas e o respetivo tratamento. Outro objetivo deste trabalho foi o de caracterizar o
panorama das intoxicações em Portugal e identificar as principais classes de agentes
tóxicos envolvidos, a evolução e as circunstâncias das ocorrências. Para tal, foi realizado
um levantamento na base de dados do Centro de Informação Antivenenos (CIAV) das
consultas realizadas a este centro relativas a intoxicações entre 2017 e 2019.
Os dados apresentados neste estudo revelam que, nos últimos três anos, o CIAV recebeu
uma média de 82 chamadas por dia, das quais mais de 80% são referentes a intoxicações
agudas ou crónicas. Os consultantes são principalmente o familiar do intoxicado, o
operador do Centro de Orientação de Doentes Urgentes (CODU) do Instituto Nacional de
Emergência Médica (INEM), e o médico, ou a própria pessoa que sofreu intoxicação.
Entre os meses de maio e agosto os contactos são ligeiramente superiores aos restantes
meses do ano, e são, sobretudo, provenientes de áreas de maior densidade populacional,
Lisboa, seguida do Porto. No que respeita às vítimas de intoxicação, mais de 65% são adultos e 30% são crianças, sendo as circunstâncias das intoxicações sobretudo
intencionais e acidentais, respetivamente. A via de exposição predominante tanto em
adultos como em crianças é a digestiva, com mais de 80% dos casos. Nos adultos, a faixa
etária mais afetada compreendeu-se entre os 40 e os 49 anos, sendo as intoxicações mais
prevalentes no sexo feminino. Em crianças, as intoxicações são mais comuns na faixa
etária entre 1 a 4 anos, em que é mais prevalente no sexo masculino, verificando-se o
oposto na faixa dos 10 aos 15 anos.
Os principais agentes de intoxicações em crianças são sobretudo medicamentos, produtos
domésticos, e cosméticos/higiene. Quanto aos adultos são os medicamentos, produtos
domésticos e substâncias de abuso. Os motivos do contacto efetuado para o CIAV por
parte dos farmacêuticos foram maioritariamente relacionados com intoxicações por
medicamentos e produtos domésticos, sendo concordante com as principais categorias de
agentes envolvidos em intoxicações.
Os principais grupos terapêuticos envolvidos em intoxicações medicamentosas são, por
ordem decrescente, as benzodiazepinas, os inibidores seletivos da recaptação de
serotonina (ISRSs), outros antipsicóticos e os anti-inflamatórios não esteroides (AINEs).
Por fim, é dado enfoque ao papel do farmacêutico na prestação/esclarecimento das
medidas de socorro em casos de intoxicação, bem como na educação da população de
forma a prevenir situações de risco, especialmente nas crianças e nos idosos.
Human intoxications represent an important cause of morbidity and mortality at national and international levels. Prevention is the best strategy, but the recognition of symptoms and the adequate and timely first aid in cases of intoxication can lessen the consequences. The Community Pharmacist, being the most accessible health professional to the population, has a key role in education for the prevention of risks related to medications, such as anxiolytics and antidepressant drugs, and other potentially non-pharmaceutical toxic substances, such as bleach, alcoholic beverages, pesticides, among others. Prevention is particularly important especially in children and the elderly, which are population groups more susceptible to accidental poisoning. In addition, these health professionals are often faced with medical emergency situations, and must proceed in each situation according to best practices and in harmony with the Integrated Medical Emergency System (SIEM). The aim of this work was to first carry out a review of the literature on the etiology of human intoxications, such as routes of contact with the toxic agent and general first aid measures in case of contact with the eyes, skin contamination, inhalation or ingestion, groups of agents responsible for human intoxications, as well as the main toxic syndromes and the respective treatment. Another objective of this work was to characterize the panorama of intoxications in Portugal and to identify the main classes of toxic agents involved, the evolution and the occurrences. To this end, a survey was carried out in the database of the Centro de Informações Antiveneno (CIAV) of the consultations made to this center regarding poisonings between 2017 and 2019. The data in this study reveal that CIAV in the last 3 years has an average of 82 calls per day, of which more than 80% refer to acute or chronic intoxications. The consultants are mainly a relative of the intoxicated person, the operator of the Centro de Orientação de Doentes Urgentes (CODU), the doctor, or the intoxicated person himself. Between the months of May and August, contacts are secondary to the rest of the year, and refer mostly to areas of greater population density, Lisbon, followed by Porto. Regarding the victims of intoxication, there are over 65% adults and 30% of children, being the entity of mainly intentional and accidental intoxications, respectively. The predominant route of exposure in both adults and children is digestive, with more than 80% of cases. In adults, the most affected age group was between 40 and 49 years old, with the most prevalent intoxications in females. In children, intoxications are more common in the age group between 1 and 4 years, in which it is more prevalent in males, with the opposite occurring in the range of 10 to 15 years. The main agents of poisoning in children are mainly medicines, household products, and cosmetics / hygiene. As for adults, they are drugs, products and chemicals of abuse. The contact made for the CIAV by the pharmacists, were about medicines and products, being in agreement with the main categories of agents that cause poisoning. The main therapeutic groups involved in drug intoxications were, in decreasing order, such as benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), other antipsychotics and non-steroidal anti-inflammatory drugs (NSAIDs). Finally, focus is given to the role of the pharmacist in providing/clarifying relief measures in cases of intoxication, as well as educating the population in order to prevent risky situations, especially in children and the elderly.
Human intoxications represent an important cause of morbidity and mortality at national and international levels. Prevention is the best strategy, but the recognition of symptoms and the adequate and timely first aid in cases of intoxication can lessen the consequences. The Community Pharmacist, being the most accessible health professional to the population, has a key role in education for the prevention of risks related to medications, such as anxiolytics and antidepressant drugs, and other potentially non-pharmaceutical toxic substances, such as bleach, alcoholic beverages, pesticides, among others. Prevention is particularly important especially in children and the elderly, which are population groups more susceptible to accidental poisoning. In addition, these health professionals are often faced with medical emergency situations, and must proceed in each situation according to best practices and in harmony with the Integrated Medical Emergency System (SIEM). The aim of this work was to first carry out a review of the literature on the etiology of human intoxications, such as routes of contact with the toxic agent and general first aid measures in case of contact with the eyes, skin contamination, inhalation or ingestion, groups of agents responsible for human intoxications, as well as the main toxic syndromes and the respective treatment. Another objective of this work was to characterize the panorama of intoxications in Portugal and to identify the main classes of toxic agents involved, the evolution and the occurrences. To this end, a survey was carried out in the database of the Centro de Informações Antiveneno (CIAV) of the consultations made to this center regarding poisonings between 2017 and 2019. The data in this study reveal that CIAV in the last 3 years has an average of 82 calls per day, of which more than 80% refer to acute or chronic intoxications. The consultants are mainly a relative of the intoxicated person, the operator of the Centro de Orientação de Doentes Urgentes (CODU), the doctor, or the intoxicated person himself. Between the months of May and August, contacts are secondary to the rest of the year, and refer mostly to areas of greater population density, Lisbon, followed by Porto. Regarding the victims of intoxication, there are over 65% adults and 30% of children, being the entity of mainly intentional and accidental intoxications, respectively. The predominant route of exposure in both adults and children is digestive, with more than 80% of cases. In adults, the most affected age group was between 40 and 49 years old, with the most prevalent intoxications in females. In children, intoxications are more common in the age group between 1 and 4 years, in which it is more prevalent in males, with the opposite occurring in the range of 10 to 15 years. The main agents of poisoning in children are mainly medicines, household products, and cosmetics / hygiene. As for adults, they are drugs, products and chemicals of abuse. The contact made for the CIAV by the pharmacists, were about medicines and products, being in agreement with the main categories of agents that cause poisoning. The main therapeutic groups involved in drug intoxications were, in decreasing order, such as benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), other antipsychotics and non-steroidal anti-inflammatory drugs (NSAIDs). Finally, focus is given to the role of the pharmacist in providing/clarifying relief measures in cases of intoxication, as well as educating the population in order to prevent risky situations, especially in children and the elderly.
Description
Keywords
Intoxicações Portugal Primeiros socorros Farmacêutico comunitário CIAV Poisoning Portugal First aid Community pharmacist