Buscar

polimedicacao idosos

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 3, do total de 7 páginas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes
Você viu 6, do total de 7 páginas

Faça como milhares de estudantes: teste grátis o Passei Direto

Esse e outros conteúdos desbloqueados

16 milhões de materiais de várias disciplinas

Impressão de materiais

Agora você pode testar o

Passei Direto grátis

Você também pode ser Premium ajudando estudantes

Prévia do material em texto

Interciência 
 & Sociedade72
POLIMEDICAÇÃO EM IDOSOS
RESUMO: 2�DXPHQWR�GD�SRSXODomR� LGRVD� �HQYHOKHFLPHQWR��p�XP� IDWRU�TXH�DEUDQJH� WRGRV�RV�SDt�
VHV� VHP� GLVFULPLQDomR�� WHQGR� RFRUULGR�� KLVWRULFDPHQWH�� HP� SDtVHV� GHVHQYROYLGRV� H�� QD� VHTXrQFLD��
HP�HPHUJHQWHV��$�H[SOLFDomR�SDUD�HVWH�IDWR�VH�EDVHLD�QD�PHOKRULD�GDV�FRQGLo}HV�GH�YLGD�GDV�SRSX�
ODo}HV��DYDQoRV�QD�PHGLFLQD��PHOKRULD�QR�VDQHDPHQWR�EiVLFR�H�� FXLGDGRV�FRP�D�VD~GH� LQGLYLGXDO��
8PD�REVHUYDom¤R�LPSRUWDQWH�TXH�SRGH�VHU�IHLWD�QHVWD�SDUFHOD�GD�SRSXODomR�PXQGLDO�p�R�XVR�GH�YiULRV�
PHGLFDPHQWRV�� DXWRPHGLFDomR�� UHDo}HV� DGYHUVDV� DRV�PHGLFDPHQWRV�� LQWHUDo}HV�PHGLFDPHQWRVDV��
SUREOHPDV�TXDQWR�D�QmR�DGHVmR�DR�WUDWDPHQWR�H�GLPLQXLomR�GD�TXDOLGDGH�GH�YLGD�GR�LGRVR�
PALAVRAS-CHAVE: ,GRVRV��0HGLFDPHQWRV��6D~GH
ABSTRACT: The increase in the aging of the population is a factor that covers all countries without 
GLVFULPLQDWLRQ��KDYH�RFFXUUHG�KLVWRULFDOO\��¿UVW��LQ�GHYHORSHG�FRXQWULHV�DQG�WKHQ�LQ�HPHUJLQJ�FRXQWULHV��
The explanation for this fact is based on improving the living conditions of populations, advances in 
medicine, improved sanitation and individual health care. An important observation that can be made 
in this portion of the world population is the use of various medications, self-medication, adverse drug 
reactions, drug interactions, problems as non-adherence to treatment and decreased quality of life of 
the elderly.
KEYWORDS: Elderly, Drugs, Health.
ROSA, Gabriela Rotello
JDELURWHOOR#KRWPDLO�FRP
&HQWUR�5HJLRQDO�8QLYHUVLWiULR�GH�(VStULWR�6DQWR�GR�3LQKDO��81,3,1+$/�
CAMARGO, Eliana Anunciato Franco
HDIFDPDUJR#\DKRR�FRP�EU
8QLYHUVLGDGH�(VWDGXDO�GH�&DPSLQDV��81,&$03�
&HQWUR�5HJLRQDO�8QLYHUVLWiULR�GH�(VStULWR�6DQWR�GR�3LQKDO��81,3,1+$/�
1 - INTRODUÇÃO
6HJXQGR�D�2UJDQL]DomR�3DQ�$PH�
ULFDQD�GH�6D~GH��23$6���
HQYHOKHFLPHQWR� p� XP� SURFHVVR�
VHTXHQFLDO�� LQGLYLGXDO�� FXPXODWLYR�� LUUHYHU�
VtYHO�� QmR� SDWROyJLFR�� GH� GHWHULRUDomR� GH�
XP�RUJDQLVPR�PDGXUR�H�SUySULR�D�WRGRV�RV�
PHPEURV�GH�XPD�HVSpFLH��GH�PDQHLUD�TXH�
R� WHPSR�WRUQH�RV�PHQRV�FDSD]HV�GH�ID]HU�
IUHQWH�DR�HVWUHVVH�GR�PHLR�DPELHQWH�H��SRU�
WDQWR��DXPHQWH�VXD�SRVVLELOLGDGH�GH�PRUWH�
�%5,&2/$�HW�DO���������
6HQGR� R� HQYHOKHFLPHQWR� XP� SUR�
FHVVR� ELROyJLFR� TXH� RFRUUH� QDWXUDOPHQWH��
FRP� HOH�� RV� yUJmRV� H� VXDV� IXQo}HV� ¿FDP�
SUHMXGLFDGRV��WHQGR�FRPR�XPD�GDV�PXGDQ�
oDV� j� DOWHUDomR� GDV� DWLYLGDGHV� UHDOL]DGDV�
SHORV�PHGLFDPHQWRV�QR�RUJDQLVPR��&RPR�R�
RUJDQLVPR�Mi�QmR�UHVSRQGH�FRPR�DQWHV��DX�
PHQWDP�VH�DV�SDWRORJLDV�FU{QLFDV�H�VXUJH�D�
SROLPHGLFDomR�TXH�p�XP�SUREOHPD�GH�VD~GH�
S~EOLFD��GHYLGR�DR�DXPHQWR�GRV�FXVWRV�FRP�
VHUYLoRV� GH� VD~GH� H� PHGLFDPHQWRV�� VHP�
que isso se traduza em aumento da qua�
OLGDGH�GH�YLGD�GHVWD�SDUFHOD�GD�SRSXODomR�
�628=$�HW�DO���������6$17,6��������
$� SROLPHGLFDomR�� WDPEpP� FRQKH�
FLGD�FRPR�SROLIDUPiFLD�RX�SROLIDUPDFRWHUD�
SLD��VLQ{QLPRV�GH�XVR�VLPXOWkQHR�H�GH�IRUPD�
FU{QLFD�GH�IiUPDFRV�SDUD�GRHQoDV�H�VLQWR�
PDV�GLVWLQWRV�SHOR�PHVPR�LQGLYLGXR��SUiWLFD�
FDGD�YH]�PDLV�IUHTXHQWH�HP�LGRVRV��DXPHQ�
WD�D�SUREDELOLGDGH�GH�UHDo}HV�DGYHUVDV�DR�
PHGLFDPHQWR��LQWHUDo}HV�PHGLFDPHQWRVDV��
GLPLQXLomR�GD�DGHVmR�DR�WUDWDPHQWR�H�WR[L�
cidade, entre outros fatores. Diante disso, 
FDEH�DRV�SUR¿VVLRQDLV�GD�VD~GH�DGRWDUHP�
HVWUDWpJLDV� SDUD� PHOKRUDU� D� GLQkPLFD� GR�
XVR�GH�PHGLFDPHQWRV�SHORV� LGRVRV�� IUHQWH�
jV�SHFXOLDULGDGHV�GHVWH�JUXSR�GH�SHVVRDV�
$� SROLPHGLFDomR� p� FRQVLGHUDGD�
XP�SUREOHPD�GH� VD~GH� S~EOLFD�� TXH� UHÀH�
WH� FRQGLo}HV� VRFLRHFRQ{PLFDV� GHVIDYRUi�
Interciência 
 & Sociedade73
,QWHUFLrQFLD�	�6RFLHGDGH��,661���������������9RO�����1���������
YHLV� WDQWR�SDUD�R�(VWDGR� �UHVSRQViYHO� SRU�
GLVSRQLELOL]DU� PHGLFDomR� QHFHVViULD� QDV�
XQLGDGHV�EiVLFDV�GH�VD~GH�H�VROXFLRQDU�D�
GHPDQGD�SRU�PpGLFRV�HVSHFLDOLVWDV��TXDQ�
WR�SDUD�D�SRSXODomR�LGRVD�TXH�HQFRQWUD�LQ~�
PHUDV�GL¿FXOGDGHV�HP�UHODomR�j�XWLOL]DomR�
GH�PHGLFDPHQWRV�� D� VDEHU�� GL¿FXOGDGH� GH�
ORFRPRomR�SDUD� EXVFD� �DTXLVLomR�� H�� SULQ�
FLSDOPHQWH��GL¿FXOGDGH�GH�HQWHQGLPHQWR�GD�
SUHVFULomR�� LQFOXLQGR�R�PRGR�GH�XWLOL]DomR��
7DLV�GL¿FXOGDGHV�UHVXOWDP�QD�GLPLQXLomR�GD�
DGHVmR�DR�WUDWDPHQWR�H�QD�EDL[D�TXDOLGDGH�
GH�YLGD�REVHUYDGD�QHVWHV�SDFLHQWHV�
2. EPIDEMIOLOGIA DO ENVELHECIMEN-
TO
$� ORQJHYLGDGH� p� VHP� G~YLGD� XP� WULXQIR��
1R�HQWDQWR��DV�FRQGLo}HV�GH�YLGD�REVHUYD�
GDV�HP�SHVVRDV�LGRVDV�YDULD�JUDQGHPHQWH�
TXDQGR�VH�FRQVLGHUD�SDtVHV�GHVHQYROYLGRV�
H�SDtVHV�HP�GHVHQYROYLPHQWR��1RV�GHVHQ�
YROYLGRV��R�HQYHOKHFLPHQWR�RFRUUH�DVVRFLD�
GR�jV�PHOKRULDV�QDV�FRQGLo}HV�GH�YLGD��SR�
UpP�� QRV� SDtVHV� HP� GHVHQYROYLPHQWR�� HP�
FRQWUDSDUWLGD�� HVVH� SURFHVVR� DFRQWHFH� GH�
IRUPD�UiSLGD��QmR�SHUPLWLQGR�DR�LQGLYtGXR�H�
DR�SRGHU�S~EOLFR��WHPSR�SDUD�XPD�UHRUJDQL�
zação social e consequente reestruturação 
GD�iUHD�GH�VD~GH��GH�PRGR�TXH�HVWD�VHMD�
DGHTXDGD� SDUD� DWHQGHU� DV� QRYDV� GHPDQ�
GDV� HPHUJHQWHV�� 2� HQYHOKHFLPHQWR� DQWHV�
YLVWR�FRPR�IHQ{PHQR��KRMH�ID]�SDUWH�GD�UHD�
OLGDGH�GDV�VRFLHGDGHV��%5$6,/��������
(VSHFL¿FDPHQWH� VREUH� R�%UDVLO�� D�
SDUFHOD� GH� LGRVRV� QD� SRSXODomR� YHP� DX�
PHQWDQGR� QDV� ~OWLPDV� GpFDGDV�� (QWUH� R�
SHUtRGR�GH������H�������KRXYH�XP�FRQVL�
GHUiYHO� DXPHQWR� GD� H[SHFWDWLYD� GH� YLGD�
GD� SRSXODomR�� GHYLGR�� DV� Do}HV� GH� VD~GH�
S~EOLFD�� YDFLQDomR�� VDQHDPHQWR� EiVLFR� H�
DRV�DYDQoRV�PpGLFR�WHFQROyJLFRV��(P�WRGR�
PXQGR� D� SURSRUomR� GH� SHVVRDV� FRP� ���
DQRV�RX�PDLV�HVWi�FUHVFHQGR�UDSLGDPHQWH��
WUDWD�VH�GH�XPD�UHVSRVWD�jV�PXGDQoDV�GH�
DOJXQV�LQGLFDGRUHV�GH�VD~GH��HVSHFLDOPHQ�
te a queda da mortalidade e aumento da 
HVSHUDQoD�GH�YLGD��8P�IDWRU�QHJDWLYR�SUR�
YHQLHQWH�GR�HQYHOKHFLPHQWR��p�TXH�R�PHV�
PR�VRIUH�LQÀXrQFLDV�GRV�SURFHVVRV�GH�GLV�
FULPLQDomR��H[FOXVmR�DVVRFLDGR�DR�JrQHUR��
HWQLD�� UDFLVPR��FRQGLo}HV�VRFLDLV�H�HFRQ{�
PLFDV��UHJLmR�GHPRJUi¿FD�H�ORFDOL]DomR�GH�
PRUDGLD�� �%5,&2/$� HW� DO��� ������ %5$6,/��
������
6HJXQGR�DV�SURMHo}HV�HVWDWtVWLFDV�
GD�2UJDQL]DomR�0XQGLDO�GD�6D~GH��206���
HVWLPD�VH� TXH� HQWUH� RV� DQRV� GH� ����� H�
������D�SRSXODomR�GH�LGRVRV�QR�SDtV�FUHV�
FHUi����YH]HV�FRQWUD���YH]HV�GD�SRSXODomR�
total, o que nos colocará em termos absolu�
WRV�FRPR�SRUWDGRUHV�GD�VH[WD�PDLRU�SRSX�
ODomR�GH� LGRVRV�GR�PXQGR�� LVWR�p��FRP����
PLOK}HV�GH�SHVVRDV�FRP����DQRV�RX�PDLV�
�%5,&2/$�HW�DO���������
3. DOENÇAS PREVALENTES NOS IDO-
SOS
2�HQYHOKHFLPHQWR� QRUPDO� �VHQHVFrQFLD�� p�
TXDQGR� RFRUUHP� DOWHUDo}HV� LQHYLWiYHLV� QR�
funcionamento do organismo relacionadas 
FRP�D�LGDGH��FRPR�DSDUHFLPHQWR�GH�UXJDV�
QD�SHOH��PXGDQoD�QD�FRORUDomR�GRV�FDEHORV�
H�PHQRU�UHVLVWrQFLD�ItVLFD��3RUpP�GHYH�VHU�
GLIHUHQFLDGR�GR�HQYHOKHFLPHQWR�SDWROyJLFR�
�VHQLOLGDGH��� TXH� VH� WUDWD� GDV� FRQVHTXrQ�
FLDV�GH�FHUWDV�GRHQoDV��FRPR��RVWHRSRURVH��
FDWDUDWD��$O]KHLPHU��3(/(*5,12��������
7DPEpP� SRGH� VHU� FRPSUHHQGLGR�
FRPR�XP�SURFHVVR�QDWXUDO�� FRQWtQXR�� LQGL�
YLGXDO�H�LUUHYHUVtYHO��GH�GLPLQXLomR�SURJUHV�
VLYD�GD�UHVHUYD�IXQFLRQDO�GRV�LQGLYtGXRV��R�
TXH� HP� FRQGLo}HV� QRUPDLV� QmR� FRVWXPD�
SURYRFDU� JUDQGHV� SUREOHPDV�� (P� FRQGL�
o}HV�GH�VREUHFDUJD��R�HQYHOKHFLPHQWR�SD�
WROyJLFR��QDV�GRHQoDV��HVWUHVVH�HPRFLRQDO��
DFLGHQWHV��� SRGH� RFDVLRQDU� XPD� FRQGLomR�
SDWROyJLFD�TXH�H[LMD�DVVLVWrQFLD��VDOLHQWDQ�
GR� TXH� FHUWDV� DOWHUDo}HV� SRGHP� WHU� VHXV�
HIHLWRV�GLPLQXtGRV�SHOD�DVVLPLODomR�GH�XP�
HVWLOR� GH� YLGD� PDLV� DWLYR� �%5$6,/�� ������
3(/(*5,12��������
$� 7DEHOD� �� DSUHVHQWD� XP� HVWXGR�
realizado no Rio Grande do Sul com idosos 
e as UHVSHFWLYDV� SRUFHQWDJHQV� GDV� GRHQoDV�
PDLV�FRPXQV�HQFRQWUDGDV�QDTXHOD�UHJLmR�SDUD�
R�DQR�GH������
Interciência 
 & Sociedade74
,QWHUFLrQFLD�	�6RFLHGDGH��,661���������������9RO�����1���������
Doenças Percentual (%)
'RHQoDV�FDUGLRYDVFXODUHV ����
'RHQoDV�HQGyFULQDV�QXWULFLRQDLV�H�PHWDEyOLFDV ����
'RHQoDV�GR�VLVWHPD�RVWHRPXVFXODU�H�WHFLGR�FRQMXQWLYR ����
7UDQVWRUQRV�PHQWDLV�H�GH�FRPSRUWDPHQWR ����
'RHQoDV�GRV�ROKRV�H�DQH[RV ���
'RHQoDV�GRV�DSDUHOKR�JHQLWXULQiULR���
'RHQoDV�UHVSLWDUyULDV ���
'RHQoDV�GR�VLVWHPD�QHUYRVR ���
Outros ���
Tabela 1 ±�'RHQoDV�SUHYDOHQWHV�REVHUYDGDV�HP�XP�HVWXGR�UHDOL]DGR�QR�(VWDGR�GR�5LR�*UDQGH�GR�
6XO�������
)RQWH��*$87e5,2�HW�DO�������
4. MUDANÇAS FISIOLÓGICAS NO META-
BOLISMO DO IDOSO
$V� PXGDQoDV� ¿VLROyJLFDV� GHFRU�
rentes da idade alteram a absorção, dis�
WULEXLomR�� R� PHWDEROLVPR� H� H[FUHomR� GH�
IiUPDFRV��SRLV�PRGL¿FDP�D�DomR�GHVWHV�H�
DIHWDP�VXD�FRQFHQWUDomR�QR�VLWLR�UHFHSWRU��
(VVDV� DOWHUDo}HV� VmR� FRPXQV� D� WRGDV� DV�
SHVVRDV�TXH�HQYHOKHFHP��SRUpP��VHX�LQLFLR�
H�LQWHQVLGDGH�YDULDP�GH�LQGLYLGXR�SDUD�LQGL�
YLGXR��3(/(*5,12��������
'HQWUH� DV� PXGDQoDV� ¿VLROyJLFDV�
GHVWDFDP�VH�DOWHUDo}HV�QD�FRPSRVLomR�GD�
PDVVD�FRUSRUDO��HVWDWXUD��IXQo}HV�FDUGtDFD��
SXOPRQDU��UHQDO�H�GLJHVWLYD��VLVWHPDV�QHUYR�
VR�H�HQGyFULQR��3(/(*5,12��������
As mudanças decorrentes da com�
SRVLomR� FRUSRUDO�� PHWDEROLVPR� EDVDO�� ÀX�
[R� VDQJXtQHR� KHSiWLFR� H� WD[D� GH� ¿OWUDomR�
JORPHUXODU� SRGHP� SUHMXGLFDU� D� DEVRUomR��
GLVWULEXLomR�� PHWDEROL]DomR� H� H[FUHomR� GD�
maioria dos fármacos. Por isso, os idosos 
WHQGHP� D� DSUHVHQWDU� UHDo}HV� DGYHUVDV� D�
PHGLFDPHQWRV�HP�WD[DV�PDLV�HOHYDGDV�TXH�
D�SRSXODomR�GH�PHQRV�LGDGH��%5,&2/$�HW�
DO���������
�����$OWHUDo}HV�)DUPDFRFLQpWLFDV
$V� DOWHUDo}HV� GR� WLSR� IDUPDFRFL�
QpWLFDV� HQYROYHP� SURFHVVRV� GHVGH� D� DG�
PLQLVWUDomR�� DEVRUomR� DWp� D� H[FUHomR� GRV�
IiUPDFRV�GR�RUJDQLVPR��(VFROKHU�D�YLD�GH�
DGPLQLVWUDomR� GH� XP� DJHQWH� WHUDSrXWLFR�
SRVVXL�YDQWDJHQV�H�GHVYDQWDJHQV�TXH�GH�
SHQGHP�GDV�SURSULHGDGHV�GR�IiUPDFR��IRU�
PD�IDUPDFrXWLFD��ORFDLV�GH�DEVRUomR��DOpP�
GH�FDUDFWHUtVWLFDV�GR�SDFLHQWH�H�TXDGUR�SD�
WROyJLFR��6,/9$��������
Em idosos, a administração de 
IRUPDV�IDUPDFrXWLFDV�RUDLV�SRGH�VHU�SUHMX�
GLFDGD� GHYLGR� DR� ³DIURX[DPHQWR´� GD�PXV�
FXODWXUD� RURIDUtQJHD�H� GLPLQXLomR�GR� ÀX[R�
VDOLYDU��WRUQDQGR�D�ERFD�VHFD��RFDVLRQDQGR�
GHVWD� IRUPD�� SUREOHPDV�GH�GHJOXWLomR�GRV�
PHGLFDPHQWRV�QHVWHV�LQGLYtGXRV��%5,&2/$�
HW�DO���������
2XWUD�REVHUYDomR�D�VHU�IHLWD�p�UH�
ODWLYD� j� DEVRUomR� GR� IiUPDFR��3DUD� TXH� R�
PHVPR�DWLQMD� VHX� ORFDO� GH�DomR�p� SUHFLVR�
TXH� DWUDYHVVH� EDUUHLUDV� ELROyJLFDV� DWp� R�
VDQJXH��$OpP� GLVVR�� D� DEVRUomR� SRGH� VHU�
LQÀXHQFLDGD�SRU� IDWRUHV�FRPR� OLSRVVROXELOL�
GDGH��KLGURVVROXELOLGDGH��HVWDELOLGDGH��SHVR�
PROHFXODU�� FDUJD� HOpWULFD�� IRUPD� IDUPDFrX�
tica, concentração no local de absorção e 
YHORFLGDGH�GH�GLVVROXomR�GR�IiUPDFR��6,/�
9$��������
2�SURFHVVR�GH�HQYHOKHFLPHQWR�DO�
WHUD�IXQo}HV�JDVWURLQWHVWLQDLV�TXH�DJHP�VR�
EUH� D� DEVRUomR�GHVWHV� FRPSRVWRV��2EVHU�
YD�VH�XP�DXPHQWR�GR�S+�JiVWULFR�� GHYLGR�
D� UHGXomR�QD�SURGXomR�GH�iFLGR�FORUtGULFR�
�+&/�� H� VHFUHomR� JiVWULFD�� RFRUUH� DWUDVR�
QR�HVYD]LDPHQWR�JiVWULFR�SRU�XPD�PRWLOLGD�
GH�GLPLQXtGD�H�UHGX]LGD�iUHD�GH�DEVRUomR��
alterando a ionização e solubilidade dos 
fármacos e/ou aumentando a degradação 
VHFXQGiULD� j� DomR� GR� iFLGR� FORUtGULFR� QRV�
Interciência 
 & Sociedade75
,QWHUFLrQFLD�	�6RFLHGDGH��,661���������������9RO�����1���������
PHGLFDPHQWRV��%5,&2/$�HW�DO���������0$�
7,$6���������
2FRUUH�XPD�UHGXomR�GR�ÀX[R�VDQ�
JXtQHR� KHSiWLFR�� UHWDUGDQGR� D� DEVRUomR��
7DPEpP� RFRUUH� GLPLQXLomR� GR� HIHLWR� GH�
SULPHLUD� SDVVDJHP� KHSiWLFD� DXPHQWDQGR�
D�GLVSRQLELOLGDGH�GDV�GURJDV�QD�FLUFXODomR�
VLVWrPLFD��%5,&2/$�HW�DO���������
�����$OWHUDo}HV�)DUPDFRGLQkPLFDV
'XUDQWH�R�HQYHOKHFLPHQWR�RFRUUHP�
DOWHUDo}HV� D� QtYHLV� PROHFXODUHV�� FHOXODU��
WHFLGXDO� H� RUJkQLFR�� TXH� FRQWULEXHP� SDUD�
D� GLPLQXLomR� SURJUHVVLYD� GD� FDSDFLGDGH�
IXQFLRQDO��$�FDSDFLGDGH�GH�PDQXWHQomR�GD�
KRPHRVWDVH��PDQXWHQomR�GR�HTXLOtEULR��p�R�
SULQFLSDO�IDWRU�TXH�GLIHUHQFLD�R�LGRVR�GR�MR�
YHP���3(/(*5,12��������
$V� DOWHUDo}HV� GRV� PHFDQLVPRV�
homeostáticos em idosos está relaciona�
GR� j� DSDUHQWH� DOWHUDomR� GD� VHQVLELOLGDGH�
D� GLYHUVRV� IiUPDFRV�� GHFRUUHQWHV� GD� GL�
PLQXLomR� GH� YiULDV� IXQo}HV� RUJkQLFDV� WDLV�
FRPR��UHGXomR�QD�DomR�GR�VLVWHPD�QHUYRVR�
DXW{QRPR�� FRP� R� DXPHQWR� GD� KLSRWHQVmR�
RUWRVWiWLFD�H�GLVIXQo}HV�UHQDLV�H�LQWHVWLQDLV��
PHQRU�FRQWUROH�SRVWXUDO��GL¿FXOGDGH�GD�WHU�
PRUUHJXODomR�� GLPLQXLomR� GD� FDSDFLGDGH�
FRJQLWLYD��DOWHUDo}HV�PHWDEyOLFDV��DXPHQWR�
GD�LQWROHUkQFLD�D�JOLFRVH�H�UHVSRVWD�LPXQR�
OyJLFD�GLPLQXtGD��SDUWLFXODUPHQWH�D�FHOXODU��
�6,/9$�HW�DO���������%5,&2/$�HW�DO���������
3RGHP� RFRUUHU� PRGL¿FDo}HV� QRV�
UHFHSWRUHV�H�VtWLRV�GH�DomR�FRP�YiULRV�SRQ�
WRV�HQWUH�D� LQWHUDomR� IiUPDFR�UHFHSWRU�H�R�
HIHLWR�IDUPDFROyJLFR�¿QDO��(VVDV�DOWHUDo}HV�
IUHTXHQWHPHQWH�VH�LQLFLDP�SRU�YROWD�GRV����
DQRV� GH� LGDGH�� H� VH� UHODFLRQDP� HVSHFLDO�
PHQWH�D�UHFHSWRUHV�HVSHFt¿FRV��EHWD�DGUH�
QpUJLFRV��DOID�DGUHQpUJLFRV��FROLQpUJLFRV���H�
aumento da sensibilidade aos benzodiaze�
StQLFRV�UHODFLRQDGRV�FRP�UHFHSWRUHV�*$%$�
�%5,&2/$�HW�DO���������6,/9$�HW�DO���������
5. USO RACIONAL DE MEDICAMENTOS 
PELA POPULAÇÃO IDOSA
'H¿QH�VH� FRPR� ³XVR� UDFLRQDO� GH�
PHGLFDPHQWRV´� TXDQGR� RV� SDFLHQWHV� UH�
FHEHP�R�PHGLFDPHQWR� DGHTXDGR� jV� VXDV�
QHFHVVLGDGHV� FOtQLFDV�� QDV� GRVHV� FRUUHV�
SRQGHQWHV�DV�QHFHVVLGDGHV�LQGLYLGXDLV��GX�
UDQWH�XP�SHUtRGR�GH�WHPSR�DGHTXDGR�H�DR�
PHQRU�FXVWR�SDUD�D�FRPXQLGDGH��%5,&2/$�
HW�DO���������
2�JUDQGH�GHVD¿R�GRV�SUR¿VVLRQDLV�
GD�iUHD�GD�VD~GH�p�FRQWULEXLU�QD�SURPRomR�
GR� XVR� UDFLRQDO� GRV� PHGLFDPHQWRV�� YLVWR�
TXH�RV�LGRVRV�XWLOL]DP�XP�Q~PHUR�HOHYDGR�
GH� HVSHFLDOLGDGHV� IDUPDFrXWLFDV� GLVWLQWDV��
FRQWULEXLQGR�PXLWDV�YH]HV�SDUD�R�XVR� LUUD�
cional desses medicamentos, que se traduz 
QR� FRQVXPR� H[FHVVLYR� GH� PHGLFDomR� VX�
SpUÀXD��RFDVLRQDQGR�IDWRUHV�QHJDWLYRV�TXH�
SUHMXGLFDP�D�VXD�TXDOLGDGH�GH�YLGD��%25�
72/21�HW�DO����������$VVLP��FDEH�DRV�SUR�
¿VVLRQDLV�GD�iUHD�GD�VD~GH�FRQVFLHQWL]DU�H�
RULHQWDU�D�SRSXODomR�LGRVD�H�VHXV�FXLGDGR�
UHV�VREUH�R�TXH�GHYH�VHU�HYLWDGR��%5,&2/$�
HW�DO���������
$OJXPDV�PHGLGDV�VmR�LPSRUWDQWHV��
são elas: 
‡� 1mR� ID]HU�XVR�GH�DXWRPHGL�
cação, ou seja, ingestão de medica�
PHQWRV�SRU�FRQWD�SUySULD��VHP�SUHV�
FULomR��QHP�RULHQWDomR�PpGLFD�
‡� 1mR�VXEVWLWXLU�RX� LQFOXLU�PH�
GLFDPHQWRV� VHP� FRQKHFLPHQWR�Pp�
GLFR�
‡� ,QIRUPDU� RV� SUR¿VVLRQDLV� GH�
VD~GH�TXDLV�PHGLFDPHQWRV�HVWi� ID�
]HQGR�XVR��SDUD�HYLWDU�R�XVR�VLPXO�
WkQHR�GH�GURJDV�TXH�SRGHP�SURYR�
FDU� LQWHUDo}HV� PHGLFDPHQWRVDV� RX�
DJUDYRV�DGYLQGRV�GD�SROLPHGLFDomR�
‡� )D]HU�R�XVR�FRUUHWR�GRV�PH�
GLFDPHQWRV��DGHVmR�DR�WUDWDPHQWR���
DWHQWDQGR�VH�D�KRUiULRV��GRVHV��GLDV�
GH� LQJHVWmR�� DWHQGHU� R� WHPSR�PtQL�
PR�RX�Pi[LPR�GR�XVR�GH�DOJXQV�PH�
GLFDPHQWRV� FRPR�� SRU� H[HPSOR�� RV�
DQWLGHSUHVVLYRV�� TXH� UHTXHUHP� XP�
WHPSR�PtQLPR�GH�XVR� �%5,&2/$�HW�
DO���������
6. POLIMEDICAÇÃO
$� GH¿QLomR� GH� SROLPHGLFDomR� p�
FRQWURYHUVD��RQGH�SRGH�VHU�GH¿QLGD�FRPR�
R� XVR� GH� XP�PHGLFDPHQWR� SDUD� FRUULJLU� R�
HIHLWR�DGYHUVR�GH�RXWUR�RX�GR�DXPHQWR�GR�
Q~PHUR� GH� PHGLFDPHQWRV� FRQVLGHUDQGR�
FLQFR�RX�PDLV�DVVRFLDo}HV�SRGHQGR�DLQGD�
RFDVLRQDU��QmR�DGHVmR�� UHDo}HV�DGYHUVDV��
Interciência 
 & Sociedade76
,QWHUFLrQFLD�	�6RFLHGDGH��,661���������������9RO�����1���������
erros de medicação, aumento do risco de 
KRVSLWDOL]DomR� H� GRV� FXVWRV� FRP� D� VD~GH�
�%5,&2/$�HW�DO���������
$LQGD�VHJXQGR�RXWUR�DXWRU��D�GH¿�
QLomR�VH�EDVHLD�QR�XVR�GH�YiULRV�PHGLFD�
PHQWRV�DR�PHVPR�WHPSR��H[FHVVR�GR�XVR�
de medicamentos não necessários ou o uso 
GH�FLQFR�RX�PDLV�IiUPDFRV��6$17,6��������
2�WHUPR�SROLPHGLFDomR�DLQGD�SRGH�
DSUHVHQWDU� GH¿QLomR� TXDOLWDWLYD� H� TXDQWL�
WDWLYD��$�TXDOLWDWLYD� VH� UHIHUH�j�SUHVFULomR��
DGPLQLVWUDomR�RX�XVR�GH�PDLV�WLSRV�GH�PH�
GLFDPHQWRV�TXH�QmR�SUHVFULWRV��VHQGR�PDLV�
XWLOL]DGD�QRV�(VWDGRV�8QLGRV��-i�D�GH¿QLomR�
TXDQWLWDWLYD�VH�UHIHUH�DR�Q~PHUR�GH�PHGLFD�
PHQWRV�FRQVXPLGRV��SRGHQGR�VHU�VXEGLYLGL�
GD�HP�SROLPHGLFDomR�PHQRU�TXH�p�R�XVR�GH�
��D���PHGLFDPHQWRV��H�SROLPHGLFDomR�PDLRU�
TXDQGR�R�XVR�p�GH���RX�PDLV�PHGLFDPHQWRV�
�&$59$/+2��������
3DUD� GLDJQRVWLFDU� H� WUDWDU� D� SROL�
PHGLFDomR�p�QHFHVViULR� LGHQWL¿FDU�RV�PH�
GLFDPHQWRV�XVDGRV�� VXD� LQGLFDomR� FOtQLFD�
H� D� UHVSRVWD� LQGLYLGXDO� DR� WUDWDPHQWR��9H�
PRV�TXH�D�SDUWLU� GH�TXDWUR�PHGLFDPHQWRV�
DXPHQWD�VH�WUrV�YH]HV�R�ULVFR�GH�XPD�UHD�
omR�DGYHUVD�DR�PHGLFDPHQWR�H�HVVD�FKDQ�
FH�FUHVFH�FRP�R�Q~PHUR�GH�PHGLFDPHQWRV��
GRLV�PHGLFDPHQWRV������GH�FKDQFH�GH�5HD�
omR�$GYHUVD�DR�0HGLFDPHQWR��5$0���FLQFR�
PHGLFDPHQWRV� �� ����GH� FKDQFH� GH�5$0��
RLWR�PHGLFDPHQWRV�±������FKDQFH�GH�5$0��
'H¿QLPRV�5HDomR�$GYHUVD�DR�0HGLFDPHQ�
WR��5$0���FRPR�XP�HYHQWR�QRFLYR��QmR�LQ�
tencional, que ocorre em doses comumente 
XVDGDV�SDUD�SUR¿OD[LD��GLDJQyVWLFR�RX�WUDWD�
PHQWR��%5,&2/$�HW�DO���������6,/9$�HW�DO���
������
$� SROLPHGLFDomR� SRGH� RFDVLRQDU�
GLYHUVDV� FRQVHTXrQFLDV�� HQWUH� HODV� R� DX�
PHQWR�GD�FRPSOH[LGDGH�GR�WUDWDPHQWR�IDU�
PDFROyJLFR��FRQIRUPH�R�PpGLFR�PRGL¿FD�R�
WUDWDPHQWR�� WRUQDQGR�R�PDLV� FRPSOH[R�H[�
tenso, aumentam os fatores associados a 
QmR�DGHVmR�DR�WUDWDPHQWR��UHDo}HV�DGYHU�
VDV�� LQWHUDo}HV�PHGLFDPHQWRVDV�� ULVFR� GH�
KRVSLWDOL]Do}HV�H�FXVWRV�FRP�D�PHGLFDomR�
�&$59$/+2��������
7. PADRÃO DE CONSUMO
6DEH�VH� TXH� R� %UDVLO� p� R� TXDUWR�
mercado mundial de consumo dos medi�
camentos, sendo o mercado farmacêutico 
brasileiro um dos cinco maiores do mundo, 
DWLQJLQGR�YHQGDV�GH�����ELOK}HV�GH�GyODUHV�
DQR��&$59$/+2��������
2� XVR� GRV� PHGLFDPHQWRV� YDULD�
FRQIRUPH�D�LGDGH��VH[R��FRQGLo}HV�GH�VD~�
GH�H�IDWRUHV�VRFLDLV��HFRQ{PLFRV�RX�GHPR�
JUi¿FRV��2�FRQVXPR�DOWHUD�VH�DR�ORQJR�GR�
WHPSR� H� GD� JHRJUD¿D��$� LGDGH� p� XP� IDWRU�
SUHGLWLYR� GR� XVR� GRV� PHGLFDPHQWRV�� H� D�
FKDQFH�GH�XWLOL]i�ORV�DXPHQWD�D�SDUWLU� GRV�
���DQRV��1R�%UDVLO�� HVWXGRV�SRSXODFLRQDLV�
mostram um uso crescente de medicamen�
tos com o aumentar da idade, tanto no inte�
ULRU�FRPR�QRV�JUDQGHV�FHQWURV��$FUHGLWD�VH��
que o maior consumo está entre as mulhe�
UHV��TXH�DSUHVHQWDP�SLRU�HVWDGR�IXQFLRQDO��
VLQWRPDV� GHSUHVVLYRV� H� PDLRU� Q~PHUR� GH�
KRVSLWDOL]Do}HV��52=(1)(/'��������
2� XVR� GRV� PHGLFDPHQWRV� SHORV�
LGRVRV� VH� WRUQD� FDGD� YH]� PDLV� IUHTXHQWH�
H�WHP�FRPR�SURSyVLWR�UHVWDXUDU��FRUULJLU�RX�
PRGL¿FDU� DV� IXQo}HV�GR�RUJDQLVPR��R�XVR�
GRV� PHGLFDPHQWRV� p� FRQVLGHUDGR� LQDGH�
TXDGR�TXDQGR�RV� ULVFRV�GR�VHX�XVR�VXSH�
UDP� VHXV� EHQHItFLRV�� 2� XVR� UDFLRQDO� GRV�
PHGLFDPHQWRV�UHTXHU�TXH�R�SDFLHQWH�UHFH�
ED�D�PHGLFDomR�DSURSULDGD�D�VXD�QHFHVVL�
GDGH�FOLQLFD��HP�GRVHV�DGHTXDGDV��SRU�XP�
SHUtRGR� DGHTXDGR� H� DR�PHQRU� FXVWR� SDUD�
R�LQGLYLGXR�H�VXD�FRPXQLGDGH��&RQIHUrQFLD�
0XQGLDO� 6REUH� 8VR� 5DFLRQDO� GH� 0HGLFD�
PHQWRV��1DLUREL���������0$7,$6��������
&RP�D�LGDGH�DYDQoDGD��RV�LGRVRV�
DSUHVHQWDP� PDLRUHV� VLQWRPDV� H� P~OWLSODV�
GRHQoDV��ID]HQGR�FRP�TXH�SURFXUHP�PDLV�
HVSHFLDOLGDGHV� PpGLFDV� GLIHUHQWHV� DFDUUH�
WDQGR�GXSOLFLGDGH�GH�SUHVFULomR�H�DXPHQWR�
GRV�FXVWRV�FRP�PHGLFDPHQWRV��,GRVRV�JDV�
WDP�HP�PpGLD�����GR�VDOiULR�PtQLPR�FRP�
medicamentos de uso regular, ou seja, du�
UDQWH����GLDV��HVVH�SUREOHPD�p�DLQGD�PDLRU�
TXDQGR� D� SUHVFULomR� QmR� FRUUHVSRQGH� DR�
SDGUmR� GH� PHGLFDPHQWRV� HVVHQFLDLV� �3(�
/(*5,12���������
8. DESAFIOS PARA A ATENÇÃO À SAÚ-
DE DOS IDOSOS
$OpP� GDV� DOWHUDo}HV� ¿VLROyJLFDV��
FRP�R�HQYHOKHFLPHQWR�DXPHQWDP�DV�GRHQ�
oDV�FU{QLFDV�H�D�GHSHQGrQFLD��6HJXQGR�D�
206��FHUFD�GH�����GRV�LGRVRV�DSUHVHQWDP�
Interciência 
 & Sociedade77
,QWHUFLrQFLD�	�6RFLHGDGH��,661���������������9RO�����1���������
DOJXPD� OLPLWDomR� SDUD� DWLYLGDGHV� FRWLGLD�
QDV��FXMDV�SULQFLSDLV�FDXVDV�VmR�SUREOHPDV�
RVWHRDUWLFXODUHV� H� Gp¿FLWV� YLVXDLV� H� DXGLWL�
YRV�� 2� GLDJQyVWLFR� H� LQWHUYHQomR� SUHFRFH�
GD� SHUGD� DXGLWLYD� DVVRFLDGD� j� LGDGH� VmR�
IXQGDPHQWDLV�SDUD�D�ERD�TXDOLGDGH�GH�YLGD�
GRV�LGRVRV��8P�IDWRU�GH�JUDQGH�LPSRUWkQFLD�
DLQGD� p� D� FRPXQLFDomR� TXH� R� SUR¿VVLRQDO�
GHYH� HVWDEHOHFHU� FRP� R� LGRVR�� YLVWR� TXH�
PXLWDV�YH]HV��HOH�DSUHVHQWD�DOpP�GH�GLPL�
QXLomR�DXGLWLYD�H�YLVXDO��SUREOHPDV�GH�PH�
PyULD�H�GL¿FXOGDGH�GH�HQWHQGLPHQWR��R�TXH�
DFDED�OHYDQGR�DR�LVRODPHQWR�VRFLDO��SUHMX�
GLFDQGR�DLQGD�PDLV�VXD�TXDOLGDGH�GH�YLGD��
DVVLP� D� FRPXQLFDomR� HIHWLYD� H� DGHTXDGD�
FRP�R� LQGLYLGXR� LGRVR�p� IXQGDPHQWDO� SDUD�
TXH�HOH�VH�VLQWD�H�SHUPDQHoD�SVLFRORJLFD�
PHQWH�LQWHJUR��3(/(*5,12���������
9. CONCLUSÕES
6HQGR� R� HQYHOKHFLPHQWR� XP� SUR�
FHVVR� QDWXUDO� FRQVHTXHQWH� GDV� DWLYLGDGHV�
GR� RUJDQLVPR�� WHPRV� FRP� HOH� SUREOHPDV�
decorrentes do uso de medicamentos como 
D�SROLPHGLFDomR�
$� SROLPHGLFDomR� p� FDUDFWHUL]DGD�
SHOR�XVR�GH�YiULRV� WLSRV�GH�PHGLFDPHQWRV�
SHOR�PHVPR�LQGLYLGXR�D�¿P�GH�FRQWUROH�PD�
QXWHQomR�GH�SDWRORJLDV��VHQGR�R�XVR�DOJXQV�
DWp�PHVPR�GHVQHFHVViULRV�
7UDWD�VH�GH�XP�SUREOHPD�RQGH�QmR�
WHPRV�XPD� VROXomR�SDUD� HUUDGLFDomR� WRWDO�
GR� SUREOHPD� �SROLPHGLFDomR��� R� TXH� SRGH�
VHU� OHYDGR�HP�FRQVLGHUDomR�p�R� WLSR�HVWLOR�
GH�YLGD�TXH�R�LQGLYLGXR�VHJXH�DR�ORQJR�GD�
YLGD�FRPR�ERQV�KiELWRV�DOLPHQWDUHV��SUiWLFD�
UHJXODU�GH�H[HUFtFLRV� ItVLFRV�� FXLGDGRV�Ei�
VLFRV� FRP�D� VD~GH�� VRPHQWH�DVVLP�p�TXH�
SRGHPRV� DOFDQoDU� XPD� PHOKRU� TXDOLGDGH�
GH�YLGD�FRP�EHP�HVWDU�QD�YHOKLFH�� ,GRVRV�
VDXGiYHLV� WHQGHP� D� SUDWLFDU� H[HUFtFLRV� It�
VLFRV�� YLYHP� PDLV� H� PHOKRU�� DXPHQWDP� D�
FDSDFLGDGH� FRJQLWLYD�� SRVVXHP� PDLRU� LQ�
GHSHQGrQFLD� �ItVLFD��PHQWDO�H�VRFLDO���SRV�
VXHP�FRQVHTXHQWHPHQWH�PHQRV�SDWRORJLDV�
assim necessitando de menos medicamen�
WRV��FRQVHTXrQFLD�GLPLQXLomR�GD�SROLPHGL�
cação.
10. REFERÊNCIAS BIBLIOGRÁFICAS
%5$6,/��0LQLVWpULR�GD�6D~GH��6HFUHWDULD�GH�$WHQomR�
j� 6D~GH�� 'HSDUWDPHQWR� GH�$WHQomR� %iVLFD�� (QYH�
OKHFLPHQWR� H�6D~GH�GD�3HVVRD� ,GRVD��Caderno de 
Atenção Básica,� %UDVtOLD� �� ')�� HG�� ��� Q�� ���� ������
'LVSRQtYHO� HP�� KWWS���EYVPV�VDXGH�JRY�EU�EYV�SXEOL�
FDFRHV�HQYHOKHFLPHQWRBVDXGHBSHVVRDBLGRVD�SGI��
$FHVVR�HP�����PDL���������
%2572/21��&��3��.$51,.296.,��2��*��0��$66,6��
0��$XWRPHGLFDomR�9HUVXV�,QGLFDomR�)DUPDFrXWLFD��R�
SUR¿VVLRQDO�GH�IDUPiFLD�QD�DWHQomR�SULPDULD�j�VD~GH�
do idoso. Revista APS��Y������Q�����S������D������MXO��
GH]��������
%5,&2/$��&��3��$��6��628=$��5��&��)��0217$*1,1,��
.��0285$'��$��(QYHOKHFLPHQWR� GD�3RSXODomR� H� D�
Polifarmácia. Revista Eletrônica da Sociedade Bra-
sileira de Clínica Médica – Regional São Paulo,�Y��
���Q�����-XOKR������
&$59$/+2��&��)��0��A Polifarmácia em Idosos no 
Município de São Paulo – Estudo SABE – Saúde, 
Bem-estar e Envelhecimento. 'LVVHUWDomR� DSUH�
VHQWDGD�DR�3URJUDPD�GH�3yV�*UDGXDomR�HP�6D~GH�
3~EOLFD��8QLYHUVLGDGH�GH�6mR�3DXOR�±�)DFXOGDGH�GH�
6D~GH�3~EOLFD�������
*$87e5,2��3��'��6$1726��&��6��6��3(/=(5��7��0��
%$5526�� -�� (�� %$80*$57(1�� /�� &DUDFWHUL]DomR�
dos idosos usuários de medicação residentes em 
LQVWLWXLomR�GH�ORQJD�SHUPDQrQFLD��Revista da Escola 
de Enfermagem da USP��6mR�3DXOR��Y������Q����'H]��
�����
0$7,$6��0��)��$��3HU¿O�7HUDSrXWLFR�H�5LVFR�GH�,Q-
teracção Medicamentosa no Idoso. Dissertação 
DSUHVHQWDGD�j�SDUD�REWHQomR�GR�JUDX�HP�PHVWUH�HP�
*HURQWRORJLD��6HFomR�$XW{QRPD�GH�&LrQFLDV�GD�6D~�
GH��3RUWXJDO��������
3(/(*5,12��6��3��3HUVSHFWLYD�ELRSVLFROyJLFD�GR�HQ�
YHOKHFLPHQWR�� 6HFUHWDULD� (VWDGXDO� GH�$VVLVWrQFLD� H�
'HVHQYROYLPHQWR�6RFLDO��Fundação Padre Anchieta, 
6mR�3DXOR�������
52=(1)(/'�� 6�� 3UHYDOrQFLD�� IDWRUHV� DVVRFLDGRV� H�
PDX�XVR�GH�PHGLFDPHQWRV�HQWUH�RV�LGRVRV��XPD�UHYL�
são. Cadernos de Saúde Pública��5LR�GH�-DQHLUR��S��
���������PDL��-XQ��������
6$17,6��6��/��3��7��Polimedicação e Medicação Po-
tencialmente Inapropriada no Idoso: estudo des-
critivo de base populacional em cuidados de saú-
de primários. Dissertação de Mestrado em Geriatria, 
)DFXOGDGH� GH� 0HGLFLQD�� 8QLYHUVLGDGH� GH� &RLPEUD��
3RUWXJDO��������
6,/9$��$��7��$QWRQLR��Apostila de Farmacologia Far-
mácia/UniPinhal,�������$EVRUomR��'LVWULEXLomR��0H�
WDOL]DomR�H�([FUHomR�GRV�IiUPDFRV��S�����±�����
6,/9$��5��6&+0,'7��)��2��6,/9$��6��3ROLIDUPiFLD�HP�
geriatria. Revista da AMRIGS, 3RUWR�$OHJUH��S������
�����DEUL��MXQ�������
628=$��0��3��6$1726��/��/��6,/9(,5$��1��$��&��)iU�
Interciência 
 & Sociedade78
,QWHUFLrQFLD�	�6RFLHGDGH��,661���������������9RO�����1���������PDFRV�HP�,GRVRV��Secretaria de Ciência, Tecnolo-
gia e Insumos Estratégicos/MS – FTN,�������'LV�
SRQtYHO�HP��KWWS���SRUWDO�VDXGH�JRY�EU�SRUWDO�DUTXLYRV�
PXOWLPHGLD�SDJLQDFDUWLOKD�GRFV�IDUPDFRVL�SGI�� $FHV�
VR�HP�����PDL�������

Continue navegando