A seleção de medicamentos essenciais orienta a utilização eficaz, segura e racional de medicamentos. O texto descreve e discute o processo e os resultados alcançados pelo trabalho da Comissão de Farmácia e Terapêutica do Instituto Fernandes Figueira no momento de revisão de sua lista de medicamentos, ressaltando as implicações para a gestão, para a clínica e para a formação médica e da equipe multidisciplinar. Os dados trabalhados foram resgatados de documentos produzidos pelo grupo entre abril de 2005 e março de 2008. Foram trabalhados três grupos de medicamentos. Os achados apontam diminuição mínima de 44% no quantitativo de itens. O processo envolveu grande número de profissionais de diferentes categorias e setores do hospital. Embora demorada e complexa, estima-se que a revisão da lista de medicamentos tenha despertado todos para a necessidade de repensar a utilização do arsenal terapêutico, contribuindo para uma formação mais centrada no paradigma da evidência científica e favorecendo a adesão aos produtos finais.

Essential drug selection guides the efficacious, safe, and rational use of medicines. This article describes and discusses the process and results achieved in the work of the Pharmacy and Therapeutics Committee of the Fernandes Figueira Institute in Rio de Janeiro, Brazil, in the revision of its drug list, highlighting the implications for management, clinical practice, and medical and multidisciplinary team training. The data were retrieved from documents produced by the group from April 2005 to March 2008. Three drug groups were analyzed. The findings point to a decrease of at least 44% in the amount of items. The process involved a large number of staff members from different professions and departments in the hospital. Although long and complex, it is estimated that the revision of the drug list awakened the entire staff to the need for rethinking the use of the therapeutic armamentarium, contributing to training based on the scientific evidence paradigm and favoring adherence to the drugs on the final list.

The X-ray repair cross-complementing Group1 (XRCC1) gene has been defined as essential in the base excision repair (BER) and single-strand break repair processes. This gene is highly polymorphic, and the most extensively studied genetic changes are in exon 6 (Arg194Trp) and in exon 10 (Arg399Gln). These changes, in conserved protein sites, may alter the base excision repair capacity, increasing the susceptibility to adverse health conditions, including cancer. In the present study, we estimated the frequencies of the XRCC1 gene polymorphisms Arg194Trp and Arg399Gln in healthy individuals and also in women at risk of breast cancer due to family history from Rio de Janeiro. The common genotypes in both positions (194 and 399) were the most frequent in this Brazilian sample. Although the 194Trp variant was overrepresented in women reporting familial cases of breast cancer, no statistically significant differences concerning genotype distribution or intragenic interactions were found between this group and the controls. Thus, in the population analyzed by us, variants Arg194Trp and Arg399Gln did not appear to have any impact on breast cancer susceptibility.