Interações medicamentosas potenciais em pacientes de unidade de terapia intensiva de um hospital universitário do Ceará / Potential drug interactions in patients hospitalized in Intensive Care Units of the teaching hospital in Ceará-Brazil

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

In clinical practice, it is common to associate several drugs for the treatment of chronic pathologies. However, some associations may cause undesirable conditions that may result in inefficacy of drug therapies and serious adverse events. Drugs interaction is a kind of adverse event, whose occurrence has relation with factors involving characteristics of patients, drugs, and prescriptions. With respect to patients, some populations are more vulnerable to drugs interaction, such as that ones including aged people, people submitted to surgery procedures, people hospitalized in intensive care units. Thus, this investigation has analysed potential drugs interactions in an intensive care unit of the teaching hospital in Ceará-Brazil. The analysis of the prescription sheets have been made between July and August 2007, including all patients that stayed hospitalized for more than six days between June 2006 and July 2007. 102 patients have been selected after to apply the inclusion criteria. Among them, 74 (72,5%) have been exposed to potential drugs interactions. With respect to sociodemographic and clinical characteristics of the patients, most of the drugs interaction has occurred with female 47 (64%), with age between 63 and 72 years old 17 (23%), with a hospitalized period in the range of six to ten days 42 (56,7%), and with patients with heart and circulatory failures 115 (25,2%). The patients exposed to potential drugs interaction have received twice more drugs than the other patients. The most frequent class of drugs in drugs interaction are those related to the digestive system and metabolism. However, drugs interactions have been more frequent between drugs for the Nervous System 124 (40%), such as midazolam 65 (20,8%) and fentanil 21 (6,7%). Among the 1845 evaluated drugs, 1140 (61,8%) have been scheduled to be applied administration. Among them, 844 (74%) have presented potential drugs interaction. Most of them have been scheduled to 6am. The intravenous way has been the most frequent form of administration of drugs in the study 1151 (62,3%). The most frequent associations have been midazolam with fentanil 45 (14,5%) and midazolam with omeprazol 19 (6,1%). With respect to classification of drugs interaction, 150 (48,2%) present farmacokinetic profile; 173 (55,4%) present delayed beginning; 170 (54,7%) present moderate severity; 189 (60,6%) have presented good scientific documentation. The most frequent clinical handling has been to observe signals and symptoms, with 221 (47,9%) recommendations. It is important to emphasize that 80% of preventive procedures to avoid undesirable effects of drugs interactions can be performed by nursing staff. For that, nurses must have knowledge about pharmacological mechanisms of drugs interactions, as well as their causes.

ASSUNTO(S)

efeitos adversos interação de medicamentos drug interactions adverse effects unidades de cuidados intensivos intensive care units

ACESSO AO ARTIGO

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