Uso de f?rmacos e consumo de nutrientes por idosos

• Main Author: Venturini, Carina Duarte
• Other Authors: Carli, Geraldo Att?lio de
• Format: Others
• Language: Portuguese
• Published: Pontif?cia Universidade Cat?lica do Rio Grande do Sul 2015
• Subjects: MEDICINA; GERONTOLOGIA; GERIATRIA; IDOSOS; ENVELHECIMENTO; INTERA??ES DE MEDICAMENTOS; IDOSOS - NUTRI??O; CNPQ::CIENCIAS DA SAUDE::MEDICINA
• Online Access: http://tede2.pucrs.br/tede2/handle/tede/2689

Made available in DSpace on 2015-04-14T13:53:53Z (GMT). No. of bitstreams: 1 445300.pdf: 610047 bytes, checksum: b17944cdf4b2eeba31164303e8b9746a (MD5) Previous issue date: 2012-10-29 === Background : Physiological changes related to aging leads to nutritional deficiencies that may be aggravated by inadequate intake of nutrients in the diet and polypharmacy. Objectives : The paper 1 had the objective of analyzing the potential pharmacological interactions among drugs taken by elderly patients. The paper 2 aimed to determine the profile of nutrients consumption and the paper 3 proposed to associate the inadequate intake with nutrient depletion caused by drugs. Methods : A cross-sectional observational population based study was performed by the Institute of Geriatrics and Gerontology (IGG), PUCRS. We retrospectively analyzed the database provided by IGG composed of 512 elderly persons and epidemiologic indicators. In paper 1, drugs were classified using the Anatomical Therapeutic and Chemical Classification System (ATC). Drug-durg interactions and their severity were assessed using the software Micromedex? Healthcare Series. In the paper 2 dietary intake was assessed by the 24-hour food recall Survey and the Research Dietetic History. Nutritional composition of daily diet was calculated using the Nutwin software. In the paper 3 the amount of nutrients intake in daily diet was compared to Dietary Reference Intake (DRIs) for inadequate consumption analyses and it was considered inadequate values below the EAR (Estimated Average Requirement) and above the UL (tolerable Upper Intake Level). Drugs used were associated with inadequate intake nutrients depleted by such drugs. Results : Paper 1 showed a high prevalence of use of drugs by elderly with significant statistical difference between genders. Age group between 70 and 79 years old use more drugs than others. Paper 2 showed that men consumed more calories, protein, fiber, minerals and vitamins. Carbohydrate and calcium intake increase with advancing age, as well decreases zinc intake. Physical exercise has increased intake of calorie, magnesium, potassium and phosphorus. The higher education and family income increased intake of vitamins B complex. Paper 3 pointed that acetylsalicylic acid, hydrochlorothiazide and proton pump inhibitors are responsible for the most number of nutrients depletion. Furthermore, 97% of users of hypolipidemic enzyme inhibitor hydroxymethyl-glutaryl coenzyme A reductase have inadequate intake of vitamin E, 90% of potassium-sparing diuretic users have inadequate intake of magnesium, 83.3% of digoxin users have inadequate consumption of magnesium and 58.3% of inadequate for calcium and potassium; People that has used anti-ulcers H2 antagonists have 83.3% of inadequate of folate consumption. The analyses of hidroclorothiazide, acetylsalicylic acid and furosemide pointed 83.2%, 82.1% and 80% of respectively inadequate intake of potassium. Conclusions : The number of drugs used by elderly increases with age. Women are the largest users of drugs, as well as pointed higher number of nutrient deficiencies in daily diet. Drugs most commonly used are also involved in drug interactions and responsible for depletion of several micronutrients that showed a high prevalence of inadequate intake by elderly === Introdu??o : Altera??es fisiol?gicas decorrentes do envelhecimento levam o idoso a defici?ncias nutricionais que podem ser agravadas pelo consumo inadequado de nutrientes na dieta e pela polifarm?cia. Objetivos : O artigo 1 prop?s analisar as potenciais intera??es farmacol?gicas entre os f?rmacos utilizados por idosos. O artigo 2 objetivou tra?ar o perfil de consumo de nutrientes nesses indiv?duos e o artigo 3 prop?s associar a inadequa??o de consumo de nutrientes da dieta com a deple??o de nutrientes causada pelo uso de f?rmacos. M?todos : Foi realizado um estudo observacional transversal, de base populacional pelo Instituto de Geriatria e Gerontologia (IGG), PUCRS. Foi realizada uma an?lise retrospectiva da base de dados do IGG, composta por 512 idosos e diversos indicadores epidemiol?gicos. No artigo 1 foi utilizado o sistema de classifica??o de f?rmacos denominado Anatomical Therapeutic and Chemical Classification System (ATC). As intera??es farmacol?gicas foram analisadas atrav?s do programa Micromedex? Healthcare Series. No artigo 2, foi avaliado o consumo alimentar, utilizando-se o Inqu?rito Recordat?rio de 24 Horas e Investiga??o da Hist?ria Diet?tica. Foi calculada a composi??o nutricional da dieta com o aux?lio do software Nutwin. No artigo 3 a quantidade de nutrientes na dieta habitual foi comparada com as Dietary Reference Intake (DRIs) para avalia??o da inadequa??o de consumo. Foi considerado inadequado o consumo abaixo da EAR (Estimated Average Requirement) e acima da UL (Tolerable Upper Intake Level). Os principais f?rmacos utilizados foram associados ? inadequa??o de consumo dos nutrientes depletados pelos f?rmacos. Resultados : O artigo 1 mostrou alta preval?ncia de uso de medicamentos por idosos, sendo a diferen?a estatisticamente significativa entre os sexos. Os idosos entre 70 e 79 anos utilizam mais medicamentos do que as demais faixas et?rias. O artigo 2 mostrou que os homens consomem mais prote?nas, fibras, minerais e vitaminas. O consumo de carboidrato e c?lcio aumentou e o consumo de zinco diminuiu conforme o avan?o da idade. A pr?tica de exerc?cio f?sico elevou o consumo de calorias, magn?sio, pot?ssio e f?sforo. Maior escolaridade e renda familiar elevaram o consumo de vitaminas do complexo B. O artigo 3 mostrou que AAS, hidroclorotiazida e inibidores das bombas de pr?tons s?o os f?rmacos que depletam maior n?mero de nutrientes. Al?m disso, 97% dos usu?rios de Inibidores da HMG-CoA redutase possuem inadequa??o de consumo de vitamina E; dos usu?rios de diur?ticos poupadores de pot?ssio, 90,0% possui inadequa??o de consumo de magn?sio; dos usu?rios de digoxina, 83,3% possui inadequa??o para o magn?sio e 58,3% para c?lcio e pot?ssio. Entre os usu?rios de antiulcerosos antagonistas H2, 83,3% deles possui inadequa??o de consumo de folato. A an?lise da hidroclorotiazida, AAS e furosemida apontou respectivamente 83,2%, 82,1% e 80,0% de inadequa??o de consumo de pot?ssio. Conclus?es : O uso de medicamentos por idosos aumenta com a idade, sendo as mulheres s?o as maiores usu?rias e entre elas h? maior defici?ncia de nutrientes na alimenta??o di?ria. Os f?rmacos mais utilizados s?o tamb?m os mais envolvidos em intera??es farmacol?gicas e respons?veis pela deple??o de micronutrientes que mostraram alta preval?ncia de inadequa??o de consumo por idosos