Análise clínica e epidemiológica das internações hospitalares de idosos decorrentes de intoxicações e efeitos adversos de medicamentos, Brasil, de 2004 a 2008

Abstract

The elderly are more susceptible to adverse drugs effects due to a variety of factors, such as excessive and concomitant use of several drugs, administration errors, physiological changes in the body that alter the pharmacodynamics and pharmacokinetics. In order to determine the main therapeutic classes involved in hospital admissions of elderly people due to intoxication and adverse drug effects, as well as major health problems related to these events, 9,793 hospitalizations of people aged 60 or over registered in the Hospital Information System of the Unified Health System (SIH-SUS) in the period of 2004 to 2008 were analyzed. Unspecified drugs, systemic antibiotics, psychotropics, psychoactives, antiepileptics, sedatives, hypnotics and antiparkinsonians accounted for 57% of the total of admissions analyzed. Injuries and falls were the main health problems related to intoxication and adverse drug effects. Hospitalizations due to injuries were associated with analgesic, antipyretic and antirheumatic non-opioid. Falls were associated with systemic antibiotics, contradicting studies which point out psychotropic drugs as the main drug involved in these events. The results reflect the growing trend of problems associated with drug use by elderly people. It was verified that the consumption profile alone is not sufficient to explain the concentration of cases of the major therapeutic classes. We suggest the adoption of more effective programs of pharmacovigilance, capable of intervening at different stages of drug use: prescribing, dispensing, marketing, administration and compliance.

Prevalence of self-medication in Brazil and associated factors

“…In this context, considering the small number of published studies that have a national representation, the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), developed by the Brazilian Ministry of Health, makes it possible to evaluate the self-medication situation in Brazil as a relevant theme, given the inherent risks to its practice (medicinal poisoning and adverse reactions) and the possible increase in health care spending 13 , 18 , 19 .…”

Incidência de internações por eventos adversos a medicamentos em Minas Gerais

“…Paula et al [10], ao analisarem a população brasileira idosa e as internações decorrentes do uso de medicamentos, concluíram que os EAM representam uma causa importante de internações hospitalares nessa faixa etária e vem aumentando no decorrer do tempo, chegando a quase 14% de aumento em quatro anos. Os idosos consomem mais medicamentos devido ao acúmulo das comorbidades e aumento da frequência das doenças crônicas, que muitas vezes necessitam de medicação contínua [11,12].…”

Caracterização das internações por intoxicação medicamentosa, São Paulo, 2004 a 2006

“…Os casos selecionados para o presente estudo podem estar sujeitos a maior influência dos efeitos da automedicação devido a não estarem sujeitos a apresentação e cópia de prescrição. Novos estudos devem ser realizados para avaliar o impacto dessa legislação nas intoxicações e eventos adversos 23 . Foi verificado que há diferença entre os agentes envolvidos nas internações com relação ao tempo de internação.…”