Drug interactions and adverse events in elderly heart disease patients
DOI:
https://doi.org/10.1590/s2175-979020200004181011Keywords:
Drug interactions. Elderly. Heart diseases.Abstract
Chronic and multiple diseases are more prevalent in elderly individuals and, epidemiological highlight can be given to cardiovascular conditions requiring multi-drug therapies, which favor the occurrence of drug interactions. This study aims to analyze potential drug interactions and correlate them with adverse events in elderly heart-disease patients in a hospital setting. This is a prospective description of the analysis of medical prescriptions and records of 80 patients, with data collection performed by using validated instruments during a seven-month period. The drug interactions found were indicated by scientifically recognized databases and subsequently treated statistically with adequate software. 1841 potential interactions between drugs were detected, of which 74.1% did not show any therapeutic benefits, with antithrombotic and analgesic drugs accounting for the worst results. The
number of potential interactions was proportional to the occurrence of adverse events, classified at 87.3% as moderate to severe. It is concluded from such results that there is a proportionality between the occurrence of potential drug interactions and the detection of adverse events, with therapeutic management being of great importance for safety, quality and affordability of the treatment.
Downloads
References
Alvim MM, Silva LA, Leite ICG, Silvério MS. Eventos Adversos por interações medicamentosas potenciais em unidade de terapia intensiva de um hospital de ensino. Rev Bras Ter Intensiva. 2015;27(4):353-59.
Brasil. Ministério da Saúde. Investigação de Eventos Adversos em Serviços de Saúde. Brasília (DF): Ministério da Saúde, 2013.
Brasil. Ministério da Saúde . Manual para notificação de eventos adversos e monitoramento de segurança em ensaios clínicos. Brasília (DF): Ministério da Saúde , 2016.
Brasil. Ministério da Saúde. Prêmio InovaSUS 2015: valorização de boas práticas e inovação na Gestão do Trabalho na Saúde. Brasília (DF): Ministério da Saúde , 2017.
Brunton LL, Parker KL, Blumenthal DK, Buxton ILO. Goodman & Gilman manual de farmacologia e terapêutica. Porto Alegre: AMGH; 2010.
Bussab WO, Morettin PA. Estatística Básica. 5th ed . São Paulo: Saraiva; 2006.
Frizon F, Santos AH, Caldeira LF, Menolli PVS. Reconciliação de medicamentos em hospital universitário. Rev Enferm UERJ. 2014;22(4):454-60.
Hussar DA. Drug Interactions. In: Gennaro AR. Remington: the science and practice of pharmacy. 20th ed. Baltimore: Lippincott Williams & Wilkins; 2000. p. 1746- 61.
Iyer SV, Harpaz R, Lependu P, Bauer-Mehren A, Shah NH. Mining clinical text for signals of adverse drug-drug interactions. J Am Med Inform Assoc. 2014;21(2):353-62.
Jha AK, Larizgoitia I, Audera-Lopes C, Prasopa-Plaizier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Qual Saf. 2013;22(10):809-15.
Karch FE, Lasagna L. Adverse drug Reaction. A critical review. JAMA Netw Open. 1975;234:1236-41.
Lexicomp® Online. Lexi-Interact™. Hudson, Ohio: Lexi-comp Inc. (1978-2015). Available from: https://online.lexi.com/lco/action/
» https://online.lexi.com/lco/action/
Lima REF. Interações medicamentosas potenciais em pacientes de Unidade de Terapia Intensiva de um Hospital Universitário do Ceará [Master´s dissertation]. Ribeirão Preto: Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto; 2007.
Lisboa SML. Interações e Incompatibilidades Medicamentosas. In: Gomes MJVM, Reis AMM, organizadores. Ciências Farmacêuticas: uma abordagem em farmácia hospitalar. São Paulo: Atheneu; 2000. p. 147-63.
Medscape® LLC. Multi-Drug Interaction Checker. New York: Medscape, 2017. Available from: http://reference.medscape.com/drug-interactionchecker
» http://reference.medscape.com/drug-interactionchecker
Micromedex® (electronic version). Truven Health Analytics, Greenwood Village, Colorado, USA, 2017. Available from: http://www.micromedexsolutions.com/
» http://www.micromedexsolutions.com/
Neter J, Kutner MH, Nachtsheim CJ, Wasserman W. Applied linear statistical models. 4th ed. Boston: Irwin; 1996.
Passarelli MCG. Reações adversas a medicamentos em uma população idosa hospitalizada Doctoral thesis. São Paulo: Universidade de São Paulo, Faculdade de Medicina; 2005.
R Code Team. ® R: A language and environment for statistical computing, version 3.3.2. Computer program. Viena: R Foundation for Statistical Computing, 2016. Available from: http://www.R-project.org/
Reis AMM. Fatores associados às interações medicamentosas potenciais e aos eventos adversos a medicamentos em uma unidade de terapia intensiva Doctoral thesis. Ribeirão Preto: Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto , 2009.
Rodrigues MCS, Oliveira C. Interações medicamentosas e reações adversas a medicamentos em polifarmácia em idosos: uma revisão integrativa. Rev Lat Am Enfermagem. 2016; 24.
Secoli SR. Polifarmácia: interações e reações adversas no uso de medicamentos por idosos. Rev Bras Enferm. 2010;63(1):136-40.
Siegel S. Estatística não paramétrica para ciências do comportamento. 2nd ed. Porto Alegre: Artmed; 2006.
Steinman MA, Beizer JL, Dubeau CE, Laird RD, Lundebjerg NE, Mulhausen P. Beers Criteria-A Guide for Patients, Clinicians, Health Systems, and Payors. New York: American Geriatrics Society; 2015.
Strom BL. Pharmacoepidemiology. 3rd ed. Chinchester: John Wiley & Sons; 2000. p.874.
Tatro DS. Drug Interaction Facts. St Louis: Facts and Comparisons; 1999.
Vira T, Colquhoun M, Etchells E. Reconcilable differences: correcting medication errors at hospital admission and discharge. Qual Saf Health Care. 2006; 15:122-26.
Published
Issue
Section
License
Copyright (c) 2022 Brazilian Journal of Pharmaceutical Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content of the journal, except where identified, is licensed under a Creative Commons attribution-type BY.
The on-line journal has open and free access.