terça-feira, 12 de julho de 2016

ESTUDO DIRIGIDO: IBUPROFENO

USO

O Ibuprofeno é um medicamento da classe dos antiinflamatórios não esteróides (AINES), NÃO SELETIVO, com ações antitérmicas (contra febre), analgésicas (contra dor) e antiinflamatórias. O ibuprofeno é indicado para uma série de condições, principalmente para casos de dor de origem inflamatória, como artrites, dores traumáticas, inflamações dentárias, cólicas menstruais, entre outros..
O início de ação ocorre de 15 a 30 minutos após sua administração oral e permanece por 4 a 6 horas.

O ibuprofeno já é vendido como medicação genérica, sendo muito fácil encontrá-lo nas farmácias. Em relação aos nomes comerciais disponíveis no mercado, os principias são: Advil, Alivium, Buscofen, Dalsy, Motrin, Spidufen, sob a forma de gotas, comprimidos ou como suspensão oral. 


Não se deve utilizar o ibuprofeno concomitante com bebidas alcoólicas e o Ibuprofeno é contraindicado a pacientes com úlcera gastroduodenal ou sangramento gastrintestinal e para menores de 6 meses de idade.

MECANISMO DE AÇÃO

Ibuprofeno é um derivado do ácido fenilpropiônico, inibidor da síntese das prostaglandinas, tendo propriedades analgésicas e antipiréticas. Os analgésicos antiinflamatórios não-esteróides inibem a enzima ciclooxigenase, diminuindo a formação de precursores das prostaglandinas e dos tromboxanos a partir do ácido araquidônico, diminuindo a ação destes mediadores no termostato hipotalâmico e nos receptores de dor (nociceptores).


Observação: Nota-se que a COX 1 tem um papel fisiológico no nosso organismo, uma vez que uma de suas funções é a produção do muco protetor do trato gastrointestinal. 
Como foi visto acima, o ibuprofeno é um medicamento que possui ação NÃO seletiva para COX, ou seja, ele não era inibir apenas a COX 2 que está envolvida no processo da inflamação, mas também a COX 1, que é fisiológica. 
Portanto,  nesse contexto, não é recomendado o uso desse medicamento por pacientes que possuem problemas estomacais, porque poderá ser prejudicial para o paciente. 

Propriedades farmacocinéticas – O ibuprofeno apresenta boa absorção oral, com aproximadamente 80% da dose absorvida no trato gastrintestinal, havendo diferença quando a administração é feita em jejum ou após refeição, pois a presença de alimentos diminui a absorção.


INTERAÇÕES MEDICAMENTOSA

- Interações medicamento-medicamento

O uso de ibuprofeno e de outros analgésicos e antipiréticos junto com os seguintes fármacos, deve ser evitado, especialmente nos casos de administração continua: ácido acetilsalicílico, paracetamol, colchicina, iodetos, medicamentos fotossensibilizantes, outros antiinflamatórios não esteroides, corticosteroides, antidiabéticos orais ou insulina, anti-hipertensivos e diuréticos, lítio, agentes anticoagulantes ou trombolíticos, inibidores de agregação plaquetária, digoxina, metotrexato e hormônios tireoidianos.

- Interações medicamento-exame laboratorial

Durante o uso de ibuprofeno, os exames de sangue poderão indicar anemia. Se houver sangramento no aparelho digestivo devido ao uso do ibuprofeno, o exame de fezes para pesquisa de sangue oculto poderá ter resultado positivo. O valor da taxa de açúcar no sangue (glicemia) poderá vir mais baixo durante o uso de ibuprofeno. Não existe interferência conhecida com outros exames.

REAÇÕES ADVERSAS

As reações adversas mais comuns incluem reações de hipersensibilidade, náusea, vômito, dor epigástrica, azia, tontura e rash cutâneo. 
As reações adversas raras incluem sangramento gastrintestinal ou perfuração, nefrotoxicidade, hepatite, meningite asséptica, tontura, vertigem, síndrome de Stevens-Johnson, eritema multiforme e dermatoses.

POSOLOGIA

O ibuprofeno é habitualmente vendido nas doses de 200 mg, 400 mg e 600 mg. A dose para tratar dores de origem inflamatórias é de 400 a 800 mg de até 6 em 6 horas. Nos casos de febre a dose recomendada é de 200 mg a cada 4 horas. 
A dose diária total máxima é de 3200mg (3.2 gramas), mas o recomendado é não ultrapassar as 2400 mg por dia sem autorização médica, devido ao maior riscos de efeitos colaterais. 
O uso prolongado, por mais de 1 semana, também deve ser evitado a não que sejam ordens médicas. 
Em geral, a posologia de 400 a 600 mg, 2 a 3 vezes por dia é suficiente para controlar a maioria das dores de leve a moderada intensidade.

NOTIFICAÇÃO
Você sabia que quando você toma um medicamento e tem uma reação adversa (uma resposta indesejada do seu corpo ao medicamento) você deve notificar, ou seja, comunicar a ANVISA ou a um Centro de Farmacovigilância?
Essa atitude é muito importante, pois a indústria que produz o remédio vai passar a ter conhecimento do que este está causando no paciente, e se irá retirar o medicamento do mercado ou não, caso o número de reações estejam aumentando (o que mostra que ele está causando mal a nós e não resolvendo nosso problema de saúde).
O mesmo deve ser feito quando você compra, por exemplo, uma caixinha de medicamentos e um deles vem quebrado ou com uma cor diferente.
Conheça o CEFAL (Centro de Farmacovigilância da Universidade Federal de Alfenas) e um pouco mais sobre a notificação.
Notifique!




Referências

DRUGS.COM. Ibuprofen. Disponível em: <http://www.drugs.com/ibuprofen.html>. Acesso em: 12/07/2016.

BRASIL. Agência Nacional de Vigilância Sanitária- ANVISA. Ibuprofeno. Disponível em <http://www.anvisa.gov.br/datavisa/fila_bula/frmVisualizarBula.asp?pNuTransacao=2813342015&pIdAnexo=2545759>. Acesso em: 12/07/2016.

13 comentários:

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  2. Muito boa sua matéria e explicações sobre o remédio.
    Me ajudou a tirar umas boas dúvidas junto com esta outra pagina.
    E antes de tomar qualquer remédio é importante falar com seu médico.

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