Prevalência de interações medicamentosas potenciais em prescrições de pacientes psiquiátricos internados em hospital geral

Abstract

Drug interactions refer to the interference of one drug in the action of another or a of food or nutrient in the action of medications. Although their results may be both positive (increased efficacy) and negative (decreased efficacy, toxicity or idiosyncrasy), they are generally unanticipated and undesirable in pharmacotherapy. The present study aimed to identify and classify the main drug interactions of the medical prescriptions of psychiatric patients attended at the University Hospital Onofre Lopes. Thirty-eight (38) hospitalized patients were followed from July to December 2017 , employing the evidence-based me-dical information database MICROMEDEX. The drug interactions per patient research was carried out. Analysis of the prescriptions of these patients showed 71 sorts of drug-drug interactions. Of the drug-drug interactions, the most prevalent were: a) Haloperidol x Promethazine, which concomitant use increases the risk of prolonging the QT interval (12,6 %); b) Lithium Carbonate x Haloperidol, which the concomitant use increases the risk of dyskinesia, extrapyramidal symptoms and encephalopathy (6,6%); c) Lithium Car-bonate x Promethazine, in which the concomitant use increases the risk of dyskinesia, extrapyramidal symptoms and encephalopathy (5,6%); d) Metoclopramide x Haloperidol, in which the concomitant use increases the risk of extrapyramidal reactions and neurolep-tic malignant syndrome (50%) and e) Lithium Carbonate x Olanzapine, in which the con-current use increases the risk of dyskinesia, extrapyramidal symptoms and encephalopa-thy (3,55%). The prescriptions analysis by the clinical pharmacist provided some gains for the process, such as the possibility of monitoring the interaction in question through exa-minations, scheduling, therapeutic response of the drug and sometimes even allowing the suggestion of therapeutic change, thus minimizing the occurrence of adverse events.