Os fitoterápicos constituem uma modalidade de terapia complementar ou alternativa diante das necessidades de saúde e seu uso tem sido crescente na população idosa de diversos países. Entretanto, apresentam interações medicamentosas e reações adversas importantes e sua utilização não deve ser indiscriminada. Este estudo objetivou caracterizar o perfil de utilização de fitoterápicos por aposentados e pensionistas do INSS, com 60 anos e mais, residentes em Belo Horizonte, MG. A partir do cadastro do INSS, selecionou-se uma amostra aleatória de 881 idosos para entrevista. Investigou-se a prevalência de uso de fitoterápicos e interações medicamentosas potenciais. Um total de 667 (80,3%) dos selecionados foi entrevistado. Setenta e um participantes (10,6%) utilizaram fitoterápicos nos últimos 15 dias, principalmente aqueles preparados a partir de extratos de ginkgo (41,8%), aesculus (12,3%) e isoflavonas de soja (8,2%). Mais de 60% dos fitoterápicos foram adquiridos em farmácias de manipulação. Aproximadamente 45% dos usuários de fitoterápicos estavam expostos a pelo menos uma interação medicamentosa potencial entre eles e medicamentos sintéticos, tais como entre ginkgo e diuréticos tiazídicos (14) e antiagregante plaquetário/anticoagulantes (8). São necessárias estratégias de orientação para o uso racional de fitoterápicos entre idosos, mais vulneráveis aos prejuízos decorrentes da utilização inadequada desses.

The herbal drugs constitute an alternative or complementary therapy for the health needs and its use has been growing in the aged population of many countries. However, herbal drugs present important adverse effects and drug interactions and should not be indiscriminately used. The aim of this study was to investigate the profile of herbal drug use by elderly and pensioner residents of Belo Horizonte, Brazil. Eight hundred and eighty-one retirees were randomly selected from the Instituto Nacional do Seguro Social (INSS) database for in-home interview. The prevalence of herbal drugs use, and possible drug interactions were investigated. Results showed that 667 (80.3%) of selected individuals were interviewed. Seventy-one subjects (10.6%) used herbal drugs in the past 15 days, mainly those prepared from ginkgo (41.8%), horse chestnut (12.3%), and soya extract (8.2%). More than 60% of the herbal drugs were acquired in compounding pharmacies. Almost 45% of the herbal drug users were exposed to at least one potential herb-drug interaction, such as between ginkgo and thiazide diuretics (14) and antithrombotic/anticoagulants (8). Strategies to provide orientation for the rational use of these products in elderly people are necessary, since they are the population most exposed to polypharmacy and in consequence, most vulnerable to inappropriate uses of medications.

In this review we discuss the ongoing situation of human malaria in the Brazilian Amazon, where it is endemic causing over 610,000 new acute cases yearly, a number which is on the increase. This is partly a result of drug resistant parasites and new antimalarial drugs are urgently needed. The approaches we have used in the search of new drugs during decades are now reviewed and include ethnopharmocology, plants randomly selected, extracts or isolated substances from plants shown to be active against the blood stage parasites in our previous studies. Emphasis is given on the medicinal plant Bidens pilosa, proven to be active against the parasite blood stages in tests using freshly prepared plant extracts. The anti-sporozoite activity of one plant used in the Brazilian endemic area to prevent malaria is also described, the so called "Indian beer" (Ampelozizyphus amazonicus, Rhamnaceae). Freshly prepared extracts from the roots of this plant were totally inactive against blood stage parasites, but active against sporozoites of Plasmodium gallinaceum or the primary exoerythrocytic stages reducing tissue parasitism in inoculated chickens. This result will be of practical importance if confirmed in mammalian malaria. Problems and perspectives in the search for antimalarial drugs are discussed as well as the toxicological and clinical trials to validate some of the active plants for public health use in Brazil.