Self-medication is one of the main public health problems that has been growing in Brazil and in the world in recent years. Thus, the present study aims to verify and evaluate self-medication in public health in Brazil, its risk factors and the role of the pharmacist in the multidisciplinary team as an advisor in the rational use of medications. A bibliographic review was carried out using SciELO and Google Scholar databases with the intention of collecting data on the numbers of registered cases and deaths. According to the reviewed literature, self-medication in Brazil is linked to several factors. Among them, it can be highlighted the excessive advertising and easy access to medications in pharmacies. Moreover, the analysis pointed out that 77% of the population adhere to this practice; males represent about 40% of the cases. The indiscriminate use of these drugs and their associations can cause several adverse effects and intoxications that can lead the patient to death. According to the National Toxic-Pharmacological Information System (SINITOX) (SINITOX-Sistema Nacional de Informações Tóxico-Farmacológicas), only in 2017, about 27.11% of the registered intoxications were caused by medications, with 20,637 cases e 50 deaths. One way of controlling self-medication is the humanization of health services, especially in the public network. Therefore, The Federal Pharmacy Council (Conselho Federal de Farmácia-CFF) implemented the Resolution 586 on August 29 th , 2013, a guideline about the prescription of overthe-counter medications. In this context, the pharmacist has great relevance as an advisor and health agent. This professional collaborates for the rational use of medicines and the reduction of selfmedication cases. Finally, pharmaceutical assistance projects intended to guide the correct use of medicines would be of paramount importance to the population, thus reducing public health problems, mainly related to self-medication.

Introdução A resistência bacteriana impacta a saúde mundial. O tratamento de Klebsiella pneumoniae produtora de carbapenemase (CB-Kp) é uma dificuldade principalmente em pacientes com SARS-CoV-2. Objetivo Avaliar o tratamento da infecção secundária por CB-Kp e as taxas de sucesso terapêutico em pacientes com COVID-19 internados na (UTI-COVID). Método Foram incluídos, pacientes com COVID-19 que tiveram quadro infeccioso por CB-Kp da UTI-COVID entre setembro/2020 e abril/2021. Todos os isolados de CB-Kp foram identificados pelo sistema BD-PhoenixTM, e a pesquisa de carbapenemase pelo método NG-Test CARBA 5 (Biotech Next Generation) para detecção de KPC, OXA-48, VIM, IMP e NDM. A tipagem molecular por ERIC-PCR. Dados do tratamento foram obtidos de prontuários eletrônicos. Resultados Um total de 44 pacientes da UTI-COVID apresentaram cultura positiva para CB-Kp, 25 isolados de cultura de vigilância e 19 de quadros infecciosos. Todos os isolados foram agrupados num mesmo cluster (similaridade de 100%). Dos 19 pacientes com infecção, 9 tiveram pneumonia associada a ventilação mecânica (PAV), 5 bacteremia, 4 PAV seguida de bacteremia e 1 infecção urinária. A avaliação do tratamento não pode ser realizada para 9/19 pacientes, pois foram a óbito antes da emissão do laudo microbiológico. Para 9 dos 10 pacientes a combinação de antibacterianos foi utilizada com 5/9 (56%) de sucesso terapêutico. Para 3 pacientes utilizou-se polimixina B 1000000UI 12/12h (PB 2x) + meropenem 1 g 8/8h (MEM 3x), 2/3 tiveram alta hospitalar (AH) e 1 foi à óbito. O uso de PB2x + MEM 3x seguido de outras combinações (MEM3x e levofloxacino 500 mg/dia ou amicacina 1 g/dia) resultaram em 2 AH, assim como o uso de MEM 3x e Levofloxacino 500 mg 24/24h -1 AH. Associação dupla de MEM 3x com linezolida 600 mg 12/12h ou com vancomicina 1 g 8/8h resultaram em 2 óbitos, da mesma forma a associação tripla de PB2x mais MEM 3x mais vancomicina 1 g 8/8h (2 óbitos); e a monoterapia com MEM 3x (1 óbito). Dos 5 pacientes com AH, 4 tiveram PAV e 1 bacteremia destes 4 isolados de CB-Kp eram produtores KPC e 1 de NDM. Entre os 5 óbitos, 3 tiveram PAV e 2 bacteremias sendo 5 produtores de KPC. Conclusão A dificuldade terapêutica é evidenciada pelo alto número de óbitos, a combinação de PB 2x e MEM 3x teve maior taxa de sucesso terapêutico para isolados produtores de KPC ou NDM. Mais estudos devem ser realizados para que nesta dificuldade terapêutica das co-infecções em COVID-19 possamos ainda conseguir algum êxito.

Hyperthermia is a febrile condition that is usually present in hospitalized patients with a conclusive diagnosis of neurological lesions of diverse origins. The increase in body temperature may negatively impact the recovery of the tissue damage that was affected. The treatment of hyperthermia is usually performed at the hospital level with the introduction of established doses of antipyretic drugs or through physical interventions. However, the patient may be resistant to pharmacological treatment, aggravating the clinical condition and with this, leading to definitive sequelae or even death. Early and correct diagnosis would be the crucial factor for the choice of drug in the control of hyperthermia of noninfectious origin, favoring the recovery of the patient successfully and preventing the unnecessary use of some drug classes that could generate some type of harm to the patient as well favoring the reduction of the permanence and costs in the hospitalization unit. Therefore, the objective of this work was to carry out a bibliographic review on the use of antipyretic drugs in the treatment of noninfectious febrile state of hospitalized patients diagnosed with neurological lesions of different origins.

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Opuntia ficus-indica Haw (Cactaceae) is a xerophilous plant, developing in arid and semi-arid climates popularly known as prickly pear, fig tree or nopal. This study aimed to determine the beneficial effects of phytochemicals present in Opuntia ficus-indica. To this end, a literature review was carried out in the Google Scholar® and PubMed databases using the health descriptors: Opuntia ficus-indica, prickly pear and nopal, until 2020. As an inclusion criterion, the articles were analyzed based on the quality of the hypothesis / objective description; quality of the description of the outcome to be studied; characterization of the included sample; quality of the description and discussion of the main photochemical compounds found in Opuntia ficus-indica related to the benefits for human health; quality of the description of the study's main findings. Cladodes are the most used part of the plant, where most of the important beneficial properties that are used for human health and disease prevention are concentrated. In view of what is available in the literature, it is concluded that it is a plant that has not been explored much, therefore, more studies are needed for new discoveries to be made about the biological activities of the plant under study.