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During the post-marketing period, when medicines are used by large population contingents and for longer periods, unexpected adverse events (AE) can occur, potentially altering the drug's risk-benefit ratio enough to demand regulatory action. AE are health problems that can occur during treatment with a pharmaceutical product, which in the drug's post-marketing period can require a significant increase in health care and result in unnecessary and often fatal harm to patients. Therefore, a key objective for the health system is to identify AE as soon as possible in the post-marketing period. Some countries have pharmacovigilance systems responsible for collecting voluntary reports of post-marketing AE, but studies have shown that social networks can be used to obtain more and faster reports. The current project's main objective is to build a totally automated system using Twitter as a source to detect both new and previously known AE and conduct the statistical analysis of the resulting data. A system was thus built to collect, process, analyze, and assess tweets in search of AE, comparing them to U.S. Food and Drug Administration (FDA) data and the reference standard. The results allowed detecting new and existing AE related to the drug doxycycline, showing that Twitter can be useful in pharmacovigilance when employed jointly with other data sources.

The study aimed to estimate the prevalence of self-reported chronic respiratory diseases and the indication, access to, and use of medicines, as well as their sources, in the Brazilian adult population. Data were analyzed on adults 20 years and older from the National Survey on Access, Utilization, and Promotion of Rational Use of Medicines in Brazil (PNAUM), conducted from September 2013 to February 2014. Prevalence of chronic respiratory diseases was 3% (95%CI: 2.7-3.3). Of these individuals, 58.1% (95%CI: 51.8-64.0) had an indication for pharmacological treatment. Of those with indication for treatment, 77.1% (95%CI: 71.0-82.8) were using at least one of the prescribed drugs. Total access to therapy was 91.4% (95%CI: 79.9-96.6), and more than half of individuals with chronic respiratory diseases purchased at least one of the drugs in retail pharmacies (57.3%). The most frequently reported drug class was the association of a corticosteroid plus a long-acting beta-2 agonist in inhalation form, the most common example of which was the association budesonide/formoterol (20.3%; 95%CI: 16.0-25.4). According to our study, prevalence of self-reported chronic respiratory diseases was lower than in previous studies published on the Brazilian population. Nearly half of the population reporting chronic respiratory diseases did not have an indication for pharmacological treatment. Among those with such indication, approximately one-fourth were not using medications during the study period, and for those who were on medication, although access was high, they had to pay for their medicines.

The National Commission for incorporation of Health Technologies (CONITEC), established in 2011, advises the Ministry of Health in decisions related to the incorporation, exclusion or change of medicines, products and procedures in the Unified Health System (SUS).The study investigated the decision-making process, profile of demands and incorporation of new medicines in the SUS from January/2012 to June/2016, based on data available on the CONITEC website. All submissions were evaluated and characterized by technology and applicant type. The incorporations were analyzed according to the Anatomical-Therapeutic-Chemical classification, International Classification of Disease of the clinical indication and active record in the National Health Surveillance Agency. In the period, 485 submissions were received, 92.2% concerning requests for incorporation and 62.1% for medicines, of which 93 (30.1%) received a favorable recommendation for incorporation. Domestic demands were more successful than externally originated ones. Six unregistered drugs were incorporated. Infectious and parasitic diseases and musculoskeletal diseases constituted the main clinical indications. The recommendation of incorporation occurred mainly based on the additional clinical benefits and low budget impact.

This study aimed to characterize the clinical trials with medicines enrolling Brazilian children and adolescents, registered in the databases of Clinical Trials and the Brazilian Clinical Trials Network (ReBEC) from 1994 to 2014. Only 462 clinical trials enrolled Brazilian children and adolescents. There was an increase in registrations beginning in 2003, with an important drop in 2011. Among these trials, 35.5% were hosted in Brazil. The international clinical trials were mostly conducted by North American companies. In both cases, multinational industry was the principal source of funding. The clinical trials were predominantly phase III with injectable and solid oral pharmaceutical forms of antiviral drugs. Domestic clinical trials showed wider variation in the pharmaceutical forms and higher percentage of liquid formulations, when compared to the international trials. In addition to heavy external dependence for conducting clinical trials, the study emphasized the challenge for pediatric care in Brazil, which presents epidemiological peculiarities in an environment prone to the use of unlicensed medicines for children.

One strategy to implement the rational use of medicines is the adoption of an 'essential medicines list'. The objective of this study was to analyze the list of medicines contained in the Brazilian National Relation of Essential Medicines (Rename, 2013) in terms of essentiality and rationality. Essentiality was determined by comparing this list to the 18th Essential Medicines List (EML) published by the World Health Organization (WHO). Drugs which were part of the Brazilian National Relation of Essential Medicines but not included in the EML were assessed using the classification described in La revue Prescrire to detect medications without added therapeutic value. It was discovered that the Brazilian National Relation of Essential Medicines contains 190 medications not included in the EML, of which 63 have no added therapeutic value. In addition, discrepancies were identified between the recommendations of the WHO and the drugs included in the Brazilian National Relation of Essential Medicines. It is concluded that drugs that are non-essential and provide no added therapeutic value should not be included in a list of essential medicines funded by the three Brazilian federal entities.

It is about a quantitative, descriptive and exploratory study with the objective of investigating the difficulties faced by the elderly regarding therapeutic medicaments. The sampling unit: elderly of both sexes, integrated into the area of the Health Unit totaling 45 subjects. The results have demonstrated that the most utilized medicaments were the antihypertensive ones. The reasons that interfere with adhesion to the treatment: the use of several medications concomitantly by 15 elderly; 5 out of them have not understood the medical prescription. The drawn conclusion is that the elderly consume several medications and present understanding difficulties, resulting in nonagreement with the imposed treatment and possible damages to their health.

The concept of drug class effect is profoundly rooted in clinical practice. The use of drugs seen as similar in their clinical effects--and therefore interchangeable--is very frequent: two examples of this are the use of beta-blockers in arterial hypertension and angiotensin-converting enzyme (ACE) inhibitors in congestive heart failure. The definition of drug class effect is based on three concepts: a similar chemical structure (for example, the dihydropyridine ring of some calcium channel blockers), a similar mechanism of action (beta-blockers block adrenoreceptors), or similar pharmacological effects (antihypertensives, antianginals, etc.). In this article, we will describe the type of evidence that a cardiologist can use in order to select a specific drug (from within a class). It constitutes a clinical approach, different from the one that might be used by a third party payer (more interested in cost-effectiveness issues) or the pharmaceutical industry (more interested in promoting sales). As usual, the recommendations are based on the strength of scientific evidence.