Einstein (São Paulo) (Dec 2007)
Prevalence and classification of drug-drug interactions in intensive care patients
Abstract
Objective: To identify, quantify and classify drug-drug interactionsamong the medications most frequently dispensed in the adult ICU of alarge private tertiary care hospital over a period of 30 days. Methods:Collection of data from an electronic database on consumptionand drug-drug interactions of the 50 most frequently dispensedmedications. Results: During the period studied, 395 commercialbrands were dispensed, representing 258 active ingredients, classifiedinto ten large groups and 36 subgroups according to AnatomicalTherapeutic Chemical criteria. Four hundred and nine drug-druginteractions were identified - 174 were severe and 235 moderate.The drug-drug interactions were classified as pharmacokinetic (30%),neurologic (22%), and cardiologic (18%), and together accounted for70% of drug-drug interactions tracked with the Micromedex HealthcareSeries® electronic database. The other interactions were classifiedas hematologic, renal, endocrine/metabolic, respiratory, muscular,gastrointestinal, hepatic, and others, comprising the remaining 30%.Conclusion: Drug-drug interactions are very common in ICU patients.They may potentially produce a significant economic and clinicalimpact. The use of electronic computerized systems allows a betterapproach for medical prescriptions making it possible to prevent andintervene in cases of harmful interactions and adverse events evenbefore medications are dosed.
