Prescrição e preparo de medicamentos sem formulação adequada para crianças: um estudo de base hospitalar

Abstract

This work aimed to identify medicines whose form or pharmaceutical formula presents a problem to pediatrics (Problem Medication - PM), the strategies employed by doctors to use them in children, and the potential risks involved. Descriptive study: based on a survey with pediatricians from a SUS (Public Health System) reference hospital in Fortaleza-CE (Northeastern Brazil), in order to identify PMs, from July to August 2004; an analysis of prescriptions containing modification of medicines in the solid forms; and a follow-up of medicinal preparations, developed in December 2004 and January 2005, respectively. The medications were grouped by an anatomic, therapeutic and chemical classification and by means of a calculation of variables frequency. The pediatricians (N=48, 98% of the total) identified as PMs: 16 products without an injectable form; 32 in an injectable form that should be presented in lesser concentrations; and 30 without a liquid formula for oral use. Eighty two (82) prescriptions containing modifications of solid forms, involving 111 medicinal items were analyzed, all of which contained inadequacies; the main one being the partition of pills. In 33.6% of the cases, the prescribed doses were in accordance with that generally recommended. The modifications were carried out in inadequate places, by nonqualified professionals and without the use of best practices. The lack of appropriate formulae for pediatric use has an impact on medical practices. It is aggravated by the lack of appropriate conditions for medicines manipulation by pharmacists, in Brazilian hospitals, and this impact involves risks to patients.