Muscle adverse events among users of simvastatin in primary health care: collaborative drug therapy management

  • Marcos Francisco Pereira Lobrigatte Biosciences to Pharmacy, Department of Clinical Analysis and Biomedicine, State University of Maringa, Brazil.
  • Glauco de Mello Nogueira Basic Health Unit, Department of Health, Peabiru
  • Vinícius João Navarini Biosciences to Pharmacy, Department of Clinical Analysis and Biomedicine, State University of Maringa, Brazil.
  • Márcia Terezinha Lonardoni Crozatti Department of Biological Sciences, Federal University of Sao Paulo, Diadema-SP.
  • Jorge Juarez Vieira Teixeira Biosciences to Pharmacy, Department of Clinical Analysis and Biomedicine, State University of Maringa, Brazil.

Resumo

Collaborative drug therapy management in primary health care involves communication among the physician, pharmacist and user of simvastatin and can result in safer results regarding patient wellbeing. The aim of the study was to investigate muscle adverse events and risk factors related to simvastatin. For patients who developed muscle adverse events, collaborative drug therapy management was performed in an attempt to resolve the symptoms. A non-randomized case study was conducted at the single basic health unit in the city of Peabiru, Parana, Brazil, for a period of one year. Patients were interviewed using a structured form. To confirm muscle adverse events, the patient was referred to a physician and submitted to the suspension and return to treatment. Thyroid-stimulating hormone, creatine kinase and alanine aminotransferase exams were performed. A sample of 148 users of simvastatin was selected. Eleven patients had some type of simvastatin-associated muscle adverse event (myopathy), among whom seven had muscle symptoms (myalgia) and four had elevated creatine kinase, but were asymptomatic (asymptomatic myopathy). Collaborative drug therapy management focused on simvastatin for five patients with myalgia led to improvements in the quality of life of two patients. EVENTOS ADVERSOS MUSCULARES ENTRE USUÁRIOS DE SINVASTATINA NA ATENÇÃO PRIMÁRIA EM SAÚDE: MANEJO COLABORATIVO DE TERAPIA MEDICAMENTOSA Resumo: O manejo colaborativo de tratamento medicamentoso em atenção primária envolve a comunicação entre o médico, farmacêutico e o usuário de sinvastatina e pode levar a resultados mais seguros, favorecendo o bem-estar do paciente. O objetivo do estudo foi investigar eventos adversos musculares e fatores de risco para tais eventos, relacionados à sinvastatina. Para os pacientes que desenvolveram eventos adversos musculares, o manejo colaborativo foi realizada de forma a resolver os sintomas. Um estudo de caso não randomizado foi realizado na única unidade básica de saúde na cidade de Peabiru, Paraná, Brasil, por um período de um ano. Os pacientes foram entrevistados por meio de um formulário estruturado. Para confirmar os eventos adversos musculares, o paciente era encaminhado ao médico, sendo submetido à suspensão e retorno da sinvastatina. Foram realizadas dosagens do hormônio tireoestimulante, creatina quinase e alanina aminotransferase. Uma amostra de 148 usuários de simvastatina foi selecionada. Do grupo estudado, 11 pacientes tiveram algum tipo de evento adverso muscular (miopatia) associada à sinvastatina, entre os quais sete tiveram sintomas musculares (mialgia) e quatro apresentaram elevação da creatina quinase, mas eram assintomáticos (miopatia assintomática). O manejo colaborativo de terapia medicamentosa focada na sinvastatina para cinco pacientes com mialgia levou a melhoria na qualidade de vida de dois pacientes. Palavras-chave: Evento adverso; Manejo da terapia medicamentosa; Doença muscular; Atenção primária em saúde; Sinvastatina.

Biografia do Autor

Marcos Francisco Pereira Lobrigatte, Biosciences to Pharmacy, Department of Clinical Analysis and Biomedicine, State University of Maringa, Brazil.
Master's degree in Applied Biosciences to Pharmacy.
Glauco de Mello Nogueira, Basic Health Unit, Department of Health, Peabiru
Family and Community Physician
Vinícius João Navarini, Biosciences to Pharmacy, Department of Clinical Analysis and Biomedicine, State University of Maringa, Brazil.
Master's degree in Applied Biosciences to Pharmacy.
Márcia Terezinha Lonardoni Crozatti, Department of Biological Sciences, Federal University of Sao Paulo, Diadema-SP.
Doctor in Public Health from the University of São Paulo. Professor at the Federal University of São Paulo, for pharmacy
Jorge Juarez Vieira Teixeira, Biosciences to Pharmacy, Department of Clinical Analysis and Biomedicine, State University of Maringa, Brazil.
PhD in Public Health from the University of São Paulo Professor of the State University of Maringá, for pharmacy, biomedicine and master's degree

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Publicado
2018-05-02
Seção
Artigos Originas - Promoção da Saúde