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Master's Dissertation
DOI
10.11606/D.25.2003.tde-14122004-084243
Document
Author
Full name
Andrea Anzai
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2003
Supervisor
Committee
Silva, Salete Moura Bonifacio da (President)
Buzalaf, Marilia Afonso Rabelo
Cintra, Pedro Angelo
Title in Portuguese
Concentração de flúor em medicamentos pediátricos e risco de fluorose dentária
Keywords in Portuguese
fluorose dentária
odontopediatria
Abstract in Portuguese
As crianças com problemas de saúde crônicos fazem uso rotineiro de medicamentos e, com o aumento na incidência da fluorose dentária, todas as possíveis fontes de flúor consumidas por crianças na faixa etária de risco devem ser avaliadas. Os objetivos deste estudo foram analisar a presença de flúor total (FT) em 114 medicamentos pediátricos líquidos, através do método da difusão facilitada por HMDS-HCl, de Taves; avaliar a concentração de flúor solúvel em HCl 0,01 M (FS), após hidrólise ácida, daqueles que apresentaram FT superior à faixa de ingestão “segura” de 0,05 a 0,07 mg F/kg massa corporal/dia, para uma criança de 12 kg, como uma simulação do flúor que estaria biodisponível para absorção no estômago; e destacar os medicamentos que poderiam ser considerados como fatores de risco à fluorose dentária, adotando para comparação a mesma faixa de ingestão de flúor. A partir destas condições experimentais, pôde-se constatar que 99,12% dos medicamentos apresentaram FT na sua composição, com variações entre 0,0 e 97,8 ppm F. Destes, os medicamentos que revelaram FT igual ou superior à faixa de ingestão para uma criança de 12 kg após considerar o volume de medicamento consumido diariamente foram: Kalyamon B-12 (97,80 ppm F; 0,244 mg F/kg/dia), Epelin (57,89 ppm F; 0,072 mg F/kg/dia), Calcigenol Irradiado (51,83 ppm F; 0,086 mg F/kg/dia) e Calcigenol Composto B12 (25,62 ppm F; 0,064 mg F/kg/dia). Eles também apresentaram valores de FS de 1,88 ppm F; 37,15 ppm F; 5,98 ppm F; e 3,58 ppm F, respectivamente, todos inferiores em comparação aos de FT. Nenhum medicamento apresentou teor de FS igual ou superior à faixa correspondente à dose “segura” de flúor. Porém, o Epelin (0,046 mg F/kg/dia) aproximou-se estreitamente dessa faixa. Constatou-se que o flúor estava presente sem uma finalidade clara na maioria dos medicamentos. Os três medicamentos polivitamínicos mostraram redução mais acentuada da biodisponibilidade do flúor no estômago, por serem enriquecidos com sais minerais. Considerando-se somente a absorção gástrica, o Epelin poderia representar risco à fluorose quando associado a outras fontes de flúor. Porém, recomenda-se cautela com relação aos demais polivitamínicos, pois desconhece-se a taxa de absorção intestinal, além de não ser possível controlar as associações com as demais fontes de flúor, que normalmente ocorrem.
Title in English
Fluoride concentration in pediatric medicines and the risk of dental fluorosis
Abstract in English
Owing to the increasing incidence of dental fluorosis, all possible fluoride sources consumed by children in the risk age group should be evaluated. Children with chronic health problems make routine use of medicines. This study aimed at analyzing the presence of total fluoride (TF) in 114 liquid pediatric medicines, through Taves´ HMDS-HCl facilitated diffusion method; evaluating the concentration of soluble fluoride in HCl 0.01 M (SF), after acid hydrolisis, of those which presented TF superior to the “safe” intake rate from 0.05 to 0.07 mg F/kg body mass/day, for a 12-kg child, as a simulation of the fluoride that would be bioavailable for absorption in the stomach; and researching the medicines that could be considered as risk factors to dental fluorosis, adopting for comparison, the same fluoride intake rate. Starting from these experimental conditions, it could be verified that 99.12% of the medicines presented TF in their composition, with variations between 0.0 and 97.8 ppm F. Amongst these, the medicines which revealed TF equal or superior to the intake rate for a 12-kg child after, considering the medicine volume consumed daily were: Kalyamon B-12 (97.80 ppm F; 0.244 mg F/kg/day), Epelin (57.89 ppm F; 0.072 mg F/kg/day), Irradiated Calcigenol (51.83 ppm F; 0.086 mg F/kg/day) and Combined Calcigenol B12 (25.62 ppm F; 0.064 mg F/kg/day). They also presented values of SF of 1.88 ppm F; 37.15 ppm F; 5.98 ppm F; and 3.58 ppm F, respectively, all inferior when compared to those of TF. No medicine presented a SF content equal or superior to that of the corresponding fluoride “safe” dose. Nevertheless, Epelin (0.046 mg F/kg/day) was close to that rate. It was concluded that fluoride was present without a clear purpose in most medicines. The three polivitaminic medicines showed a marked reduction of fluoride bioavailability in the stomach, for being enriched with mineral salts. Taking into account the gastric absorption, alone, Epelin could pose a risk to fluorosis when associated to other fluoride sources. However, caution is recommended regarding the other polivitaminics, for the rate of intestinal absorption is ignored, besides that it is not possible to control the associations with the other fluoride sources, which usually take place.
 
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Publishing Date
2004-12-20
 
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