Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r) program, and frequencies were calculated. Results: 786 errors were observed, 63.9% (502) in Phase 2, and 36.1% (284) in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. Conclusion: guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes.
knowing the risk factors associated with medication may help prevent and reduce falls, especially when therapeutic regimens cannot be modified.
Farmacodermias são definidas como qualquer mudança indesejada na estrutura ou função da pele, seus apêndices e membranas mucosas, e incluem todos os eventos adversos relacionados a erupções promovidas por medicamentos. Embora frequentes, a manifestação de forma muito parecida a outras doenças cutâneas comuns leva a dificuldades de direcionamento da avaliação. Caso o paciente esteja sob tratamento de diversos medicamentos, a determinação do medicamento causador da farmacodermia se torna complexa. É necessário ao profissional atuante em Farmacovigilância conhecimento científico atual e adequado para investigação. Embora as bases de dados e literatura forneçam informações com alto nível de evidência científica, por vezes a falta de dados atualizados e compilados compromete o processo de investigação de farmacodermias em curso. Durante a execução da Farmacovigilância, a consulta de documentos institucionais que norteiem a investigação - com embasamento científico e atualizado - favorece seu decurso. Nortear a identificação e manejo de graves reações adversas cutâneas a medicamentos foi o objetivo desta revisão narrativa realizada nas bases de dados científicas National Library of Medicine, Washington, DC (MEDLINE: Pubmed) e Scientific Electronic Library Online (SciELO). Foram recuperados 615 artigos científicos, que após seleção resultaram em 36 artigos relacionados à descrição e manejo de farmacodermias, escolhidos para elaboração desta revisão de literatura. Quadros informativos de consulta rápida foram elaborados para cada farmacodermia abordada, contendo informações essenciais para identificação, avaliação e sugestões de manejo. A existência de materiais de fácil consulta com embasamento científico adequado para execução da Farmacovigilância favorece a tomada de decisões e manejo de farmacodermias. Palavras-chave: Farmacovigilância. Exantema, Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos. AbstractCutaneous adverse drug reactions (ADR) are defined as any undesired change in the structure or function of the skin, its appendages and mucous membranes, and include all adverse events related to drug-induced eruptions. Cutaneous manifestations of ADR, although frequent, are very similar to other common skin diseases, leading to difficulties in the process of their evaluation. If the patient is under a multidrug therapy, the determination of the drug causing the cutaneous ADR becomes complex. It is necessary for the professional working in Pharmacovigilance current scientific knowledge for adequate investigation of the case. There are databases and literature information with high level of scientific evidence, however sometimes the lack of updated and compiled data about this theme compromises the research process of in course cutaneous ADR. During Pharmacovigilance execution, consult of institutional documents that guide the investigation - with scientific and updated data - favor its course. The aim of this narrative review was to guide identification and management of adverse drug reactions, conducted in some scientific databases: National Library of Medicine, Washington, DC (MEDLINE: Pubmed) and Scientific Electronic Library Online (SciELO). Of the 615 scientific articles, 36 articles related to the description and management of cutaneous ADR were selected to elaborate this literature review. Quick reference information tables were prepared for each cutaneous ADR approached, containing essential information for identification, evaluation and suggestions for their management. Scientific and easy-to-read available materials for the Pharmacovigilance activity improves decision-making process and the management of cutaneous ADR. Keywords: Pharmacovigilance. Exanthema. Drug-Related Side Effects and Adverse Reactions.
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