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PANORAMA DA PRESCRIÇÃO DE MEDICAMENTOS FITOTERÁPICOS NA CIDADE DO RIO DE JANEIRO
Alternative title
Overview of the prescription of herbal medicines in the city of Rio de JaneiroAuthor
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Abstract in Portuguese
Os fitoterápicos constituem uma classe de medicamentos amplamente utilizada no Brasil que vem se fortalecendo no cenário farmacêutico, configurando um mercado em potencial expansão. Contudo, no Brasil, são raras as pesquisas que avaliam o grau de utilização dos derivados vegetais como medicamentos e sua inserção em prática moderna de medicina. Uma vez que a prescrição é o ato que define o medicamento a ser consumido pelo paciente e que induz ao seu uso racional, a avaliação da forma e frequência com que os medicamentos fitoterápicos são prescritos caracteriza-se como um dos aspectos fundamentais em uma avaliação da fitoterapia no país. Considerando a abrangência e complexidade do tema, o presente trabalho busca traçar um panorama da prescrição de medicamentos fitoterápicos na cidade do Rio de Janeiro. A análise de 156 questionários, preenchidos por médicos, odontologistas e médicos-veterinários, permitiu verificar que 47% dos profissionais participantes da pesquisa prescrevem medicamentos fitoterápicos. As espécies vegetais com maior número de derivados prescritos foram Passiflora incarnata (11%) e Valeriana officinalis (7%), de um total de 65 plantas citadas, configurando uma alta taxa de indicação para ações ansiolíticas simples. Medicamentos a base destas espécies foram mencionados pelas três áreas da Saúde. Quanto ao conhecimento da área, 33% dos profissionais alegaram não ter conhecimento sobre fitoterapia e medicamentos fitoterápicos. Para os prescritores desses medicamentos, 51% os prescrevem principalmente pela menor ocorrência de reações adversas e 66% indicam o tratamento com medicamentos fitoterápicos industrializados.
Abstract
Herbal medicines are widely used in Brazil and have been gaining ground in
the pharmaceutical market. However, in Brazil, there are few studies to assess the
use of herbal medicines in modern medicine. Prescription is the act that defines
the product to be consumed by the patient and that places the use of medicines
on a rational basis, so that assessing how and how often herbal medicines are
prescribed is a fundamental piece of information in the assessment of their use in
Brazil. The analysis of 156 questionnaires answered by physicians, dentists and
veterinarians demonstrated the prevalence of herbal medicines in 47% of
prescriptions. The plant species with the highest number of prescriptions were
Passiflora incarnata (11%) and Valeriana officinalis (7%) out of a total of sixty-five
plants cited, indicating high rates of prescription of anxiolytics. Medicinal products
based on these species were mentioned in the three health areas investigated.
With regard to knowledge of phytotherapy and herbal medicines by the participant
professions, 33% of these professionals alleged lack of knowledge in the area.
One factor favouring prescription is the lower incidence of adverse reactions (51%)
compared to conventional medications. Also 66% indicate treatment with
industrialized herbal medicines rather than privately formulated preparations. With
regard to the difficulties related to the prescription of these drugs, the participants
(55%), prescribing or not prescribing, reported that lack of instruction in the area
during the undergraduate program and the absence of efficacy and safety data for
herbal medicines configure the greatest limitations. Thus although Brazil is the
country with the greatest plant diversity of the planet, creating a scene favourable
to herbal medicine, advance is limited by the poor training for prescribers of these
drugs, a result of little or no teaching of herbal medicine in undergraduate courses.
Another anachronic feature is the huge preponderance in the use of exotic plants
in detriment to native species, in spite of the majority of traditional herbs having
been scientifically studied for their potential medicinal use, but the absence of
adequate toxicological and clinical trials are the greatest limitations for prescription.
The promotion of toxicological and clinical studies to ensure efficacy and safety as
well as the institution of teaching related to the herbal medicines in undergraduate
courses are necessary to form little by little a new mentality towards the renewed
use of the native flora in public health.
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