Print version ISSN 1516-3180
Sao Paulo Med. J. vol.130 no.4 São Paulo 2012
LETTER TO THE EDITOR
RESPONSE TO LETTER TO THE EDITOR
Programa "Farmácia Dose Certa" e critérios de Beers-Fick: análise geral versus específica
Giancarlo LucchettiI; Alessandra Lamas Granero LucchettiII; Sueli Luciano PiresIII; Milton Luiz GorzoniIV
IMD. Geriatrics Specialist, Geriatrics and Gerontology Sector, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
IIMD. Geriatrics Specialist, Interdisciplinary Center for Aging Research and Care, Belo Horizonte, Minas Gerais, Brazil
IIIMD, MSc. Professor of Geriatrics and Director of Hospital Dom Pedro II, Geriatrics and Gerontology Sector, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
IVMD, PhD. Professor and Head of Geriatrics and Gerontology Sector, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
First, we would like to thank the authors of the letter: "Drugs available through the Farmácia Dose Certa program and Beers criteria: a further analysis" for their comments. Our group has been working on polypharmacy, the Beers-Fick criteria and adverse drug effects among the geriatric population for many years.1-3 In fact, our article4 had the main purpose of alerting health professionals who deal with older individuals to the risks involved in the drugs available through the Dose Certa program in general, and not for those with specific medical conditions.
Due to space restrictions, we decided to consider only the first Beers-Fick criterion "drugs or drug classes that should generally be avoided for people over 65 years of age, because they are ineffective or have a high risk of unnecessary adverse effects when a safer alternative is available". The second criterion, which should be considered according to specific known conditions, would be very complex for this paper, because for each medical condition, there is a full range of drugs that must be avoided. For instance, those with stress incontinence may not use the following drugs: alpha-blockers (doxazosin, prazosin and terazosin), anticholinergics, tricyclic antidepressants (imipramine hydrochloride, doxepin hydrochloride and amitriptyline hydrochloride) and long-acting benzodiazepines.
In order to ease the interpretation of our article, we decided to include only the first Beers-Fick criterion. Nevertheless, a further article dealing with the second criterion could be also helpful.
We believe that our paper has fostered discussion about whether geriatric patients should be treated more carefully than the general population, in public healthcare programs.
1. Lucchetti G, Granero AL, Pires SL, Gorzoni ML. Fatores associados à polifarmácia em idosos institucionalizados [Factors associated to polypharmacy in institutionalized elderly]. Rev Bras Geriatr Gerontol. 2010;13(1):51-8. [ Links ]
2. Lucchetti G, Granero AL, Pires SL, Gorzoni ML, Tamai S. Fatores associados ao uso de psicofármacos em idosos asilados [Factors associated with the use of psychoactive drugs in institutionalized elderly]. Rev Psiquiatr Rio Gd Sul. 2010;32(2):38-43. [ Links ]
3. Gorzoni ML, Fabbri RMA, Pires SL. Critérios de Beers-Fick e medicamentos genéricos no Brasil [Beer-Fick criteria and generic drugs in Brazil]. Rev Assoc Med Bras (1992). 2008;54(4):353-6. [ Links ]
4. Lucchetti G, Lucchetti ALG, Pires SL, Gorzoni ML. Critérios de Beers-Fick e medicamentos disponíveis no Programa Farmácia Dose Certa [Beers-Fick criteria and drugs available through the Farmácia Dose Certa program]. Sao Paulo Med J. 2011;129(1):17-22. [ Links ]