Desafios ao controle da qualidade de medicamentos no Brasil

Overview of Analytical Methods for Evaluating Tinidazole

BACKGROUND

Tinidazole (TIN) has amoebicidal, giardicidal, antifungal, and antimicrobial activities. It is marketed in the form of tablets. Analytical methods to assess the quality of TIN-based products are essential for correct pharmacotherapy.

OBJECTIVE

The objective of this review is to show an overview of the existing analytical methods for evaluating TIN, according to the quality control (QC) analysis routine and green analytical chemistry (GAC).

RESULTS

Official compendia show a method for evaluating TIN in tablets by nonaqueous titration, which has limitations (materials on the mg scale using solvents considered not recommended and harmful). The literature shows some analytical methods for evaluating TIN, both physicochemical and microbiological. The most used physicochemical method is UV (41%), and second is HPLC (28%). Among the microbiological methods, agar diffusion and turbidimetric methods are equally divided. The most studied matrix is TIN tablets (73%), and the most used solvent is methanol.

CONCLUSIONS

The literature shows space for the development of analytical methods according to GAC for evaluating TIN, optimizing time, resources, and materials, reducing waste generation, and opting for less aggressive reagents, solvents, and diluents.

HIGHLIGHTS

This review shows the status of analytical methods, both physicochemical and microbiological, for the analysis of TIN in pharmaceutical matrix, in the context of routine analysis of the chemical-pharmaceutical industries and of GAC.

[Interchangeability of biological products in the Brazilian Unified National Health System (SUS): the main regulatory challenges]

Biological products have sparked a worldwide therapeutic revolution. However, the high cost of these products threatens health systems' sustainability. The development of copies is considered an economic alternative, but due to the products' complexity, many concepts used in generic drugs do not apply. Interchangeability between biologicals poses a regulatory challenge. This essay discusses the main regulatory challenges for establishing criteria for interchangeability between new biologicals and their copies in the scope of the Brazilian Unified National Health System (SUS), considering the guidelines adopted by the world's main drug regulatory agencies concerning interchangeability and the prevailing Brazilian regulatory framework on this issue. Concerns related to the interchangeability of biologicals include automatic substitution, nomenclature, pharmacovigilance, immunogenicity, and extrapolation of therapeutic indications and clinical data from new biologicals to their copies. While the clinical success and economic benefits of switching from new biologicals to their biosimilars have already been observed, the heterogeneity between countries in the regulatory barriers to the approval of copies of biologicals should be taken into consideration during the regulation of interchangeability of biologicals in Brazil.

Qualidade do cuidado: Avaliação da disponibilidade de insumos, imunobiológicos e medicamentos na Atenção Básica em município de Minas Gerais, Brasil

Objetivo: Avaliar a Atenção Básica quanto aos insumos, imunobiológicos e medicamentos disponibilizados nos serviços de saúde da família de município de Minas Gerais, Brasil. Métodos: Trata-se de pesquisa transversal, analítica, conduzida em 2014, a partir de instrumento ministerial intitulado Autoavaliação para Melhoria do Acesso e da Qualidade da Atenção Básica, de equipes de saúde da família. Oito itens foram considerados, com valores entre zero a 10 pontos, da total inadequação à total adequação da Unidade Básica de Saúde (UBS), ao item avaliado. Classificaram-se as unidades em padrões de qualidade “muito insatisfatório” a “muito satisfatório” e analisou-se conforme localização rural e urbana, nível de significância p<0,05. Resultados: Participaram 75 equipes, que apresentaram expressiva inadequação nos itens: UBS dispor todas as vacinas exigidas no calendário básico, 5,95 (±4,003); possuir insumos e medicamentos para abordagem inicial de urgência/emergência, 2,33 (±2,500); apresentar os medicamentos básicos com regularidade, 3,68 (±3,146). A classificação foi regular para 45,3% das unidades e insatisfatória para 29,3%, sem diferenças quanto à localização urbana ou rural (p=0,479). Conclusão: Evidenciou-se avaliação insatisfatória, com inadequações relativas às vacinas, à abordagem inicial nas situações de urgência e emergência e à disponibilidade dos medicamentos. Tal situação prejudica o elenco de ações e a resolutividade dos serviços, afetando a capacidade da equipe para atender, efetivamente, as demandas de saúde da população