It is a qualitative study aimed to discuss how the practice of prescription, dispensation and use of benzodiazepines in the Family Health Strategy occurs in the municipality of the state of Bahia, Brazil. It was used as a technique for data collection semi-structured interview applied to three groups of subjects (users, prescribers and dispensers of pharmacies). The results showed that there are no institutional protocols relating to prescribing and dispensing in the Family Health Units, with divergence in the use of benzodiazepines related practices. Access to therapeutic alternative to the use of benzodiazepines, and training of health workers were identified as a need of the service. The dispensation differs from existing laws, this function being performed by nursing staff and in the absence of pharmacists. These aspects have contributed to the lack of information and education users as well as the indiscriminate and excessive use of these drugs. Changes in the practice of workers and their relation with the health needs of the users can be decisive for bringing about change that reality.Key Words: Psychotropic drugs. Primary health care. Drug utilization. RESUMO:Trata-se de estudo de abordagem qualitativa que teve como objetivo discutir como ocorre a prática da prescrição, dispensação e o uso de benzodiazepínicos na Estratégia de Saúde da Família, em um município do estado da Bahia, Brasil. Foi utilizada, como técnica de coleta de dados, a entrevista semiestruturada aplicada a três grupos de sujeitos (usuários, prescritores e dispensadores das farmácias). Os resultados mostraram que não existem protocolos institucionais relacionados à prescrição e dispensação nas Unidades de Saúde da Família, havendo divergência nas práticas relacionadas ao uso de benzodiazepínicos. O acesso à terapêutica alternativa ao uso de benzodiazepínicos e a capacitação dos trabalhadores de saúde foram apontados como uma necessidade do serviço. A dispensação diverge dos dispositivos legais vigentes, sendo esta função realizada por técnicos de enfermagem e na ausência de farmacêuticos. Mudanças na prática dos trabalhadores e na sua relação com as necessidades de saúde dos usuários podem ser determinantes para provocar transformações nessa realidade.Palavras-Chave: Psicotrópicos. Atenção primária à saúde. Uso de medicamentos.
The dual inhibition of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) is considered as an important strategy for the treatment of Alzheimer's disease. In this study, we applied the bioguided fractionations of Ocotea daphinifolia ethyl acetate active extract to furnish a fraction with high inhibitory activity for AChE and BuChE (82% and 92%, respectively). High‐performance liquid chromatography semipreparative purification of this fraction provided two new natural products: 1‐β‐D‐galactopyranosyl‐glycerol‐2,3‐heptanedionate, (1) whose complete chemical structural elucidation was made with spectrometric analysis (MS, 1D, and 2D NMR) and its minor derivative 1‐β‐D‐gulopyranosyl‐glycerol‐2,3‐heptanedionate; (2) which could be characterized by 2D 1H‐13C heteronuclear single‐quantum correlation spectra analysis. Investigation of the intermolecular interactions with cholinesterases was carried out by molecular docking studies, and results suggested that both compounds are capable to interact with the catalytic site of both enzymes. Compounds 1 and 2 interact with residues of catalytic domains and the peripheral anionic binding site of AChE and BuChE. The results are comparable to those achieved with rivastigmine and galantamine. Thus, this study provides evidence for consideration of the glycosylglycerol from O. daphnifolia as new valuable dual cholinesterases inhibitor.
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