Factors associated to potential drug interactions in one Intensive Care Unit: a cross-sectional study

Abstract

Objective: to identify the factors associated to Potential Drug Interactions with High Alert Medications in the Intensive Care Unit of a Sentinel Hospital. Methods: a cross-sectional, retrospective study using a quantitative approach carried out at a Sentinel Hospital in Rio de Janeiro. The research was based on the analysis of the prescriptions of patients hospitalized in the Intensive Care Unit of the Hospital, in a period of one year, in order to identify the drug interactions related to high alert medications in these prescriptions. Results: Of the 60 prescriptions analyzed, 244 were selected. In these prescriptions, 846 potential drug interactions related to high alert medications and 33 high alert medications were identified. Of the 112 types of potential drug interactions identified, some were more recurrent: tramadol e ondansetron, midazolam and omeprazole, regular insulin and hydrocortisone, fentanyl and midazolam, and regular insulin and noradrenaline. The variables polypharmacy, length of hospital stay, and some specific medications were associated with drug interactions with high alert medications. Conclusion and Implications for practice: It is important to strengthen strategies to reduce adverse drug events. Therefore, the relevance of studies that investigate the origin of these events is highlighted. Drug interactions can represent medication errors. It’s indispensable to work with strategies to better manage the medication system.

Análise das incompatibilidades medicamentosas em uma unidade cardiointensiva: estudo transversal

“…Se sabe que, en la práctica, el paciente es expuesto al riesgo de incompatibilidades medicamentosas cuando posee una cantidad de medicamentos prescritos elevada y superior a la capacidad de administración exclusiva. Se destaca que el uso de más de seis medicamentos por día aumenta 9.8 veces el riesgo de interacciones medicamentosas y la prevalencia de incompatibilidades es fuertemente asociada al número de medicamentos prescritos (14)(15)(16) .…”

“…Sin embargo, esas incompatibilidades no fueron clasificadas conforme las gravedades por el Micromedex®. Todos los medicamentos son de suma importancia y gran uso en unidades cardio-intensivas, lo que ratifica la atención que el enfermero debe tener en el proceso de la marcación y administración de las mismas (15,16) .…”

“…La insulina fue destacada en otros estudios también: de 840 pares de medicamentos identificados, 14 se relacionaban a la insulina, siendo la frecuencia de interacción envolviendo este medicamento de 6,67% (15) .…”

“…Un estudio que aborda el conocimiento de los profesionales de enfermería sobre interacciones medicamentosas mostró que el equipo presentaba conocimientos insuficientes sobre interacción medicamentosa (18) . Es fundamental que el enfermero tenga conocimiento sobre farmacología para discutir con el equipo multidisciplinar la posibilidad de sustitución de medicamentos por una alternativa terapéutica compatible o sobre la indicación de un catéter venoso que ofrezca mayor número de vías (15,18) . Al administrar dos o más medicamentos simultáneos, el enfermero debe verificar si los mismos son físicamente compatibles, una vez que las reacciones químicas requieren más tiempo de contacto para que ocurra una reducción significativa en la concentración del fármaco (16,18,19) Esas acciones del enfermero reflejan un cuidado seguro y cualificado.…”

Drug Therapy Scheduling by Nurses and Resulting Potential Drug Interactions in the Hospital Care Of Adolescents: A Cross-Sectional Study

“…Although the scheduling and administration of drug therapy are incorporated into the work routine of the nursing team, scheduling requires nurses to have knowledge of pharmacology knowledge, including the interactions and reactions associated with drugs, which sometimes go unnoticed among nurses' numerous routines. Among the many responsibilities of the nursing team, particularly in the context of hospital care, drug therapy administration is one that requires continuous, ongoing professional training that should be implemented at the drug preparation, administration, monitoring and scheduling stages with technical and scientific rigor to promote patient recovery (Cortes & Silvino, 2019).…”