Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança

Abstract

Cardiovascular disease presents itself among the leading causes of death in Brazil and in the Western world. At this scope, acute coronary syndrome (ACS) occupies a prominent place. Drug therapy administered mostly demand polypharmacy, that is, use of five or more drugs and different classes. Such an event predisposes the occurrence of potential drug drug interactions (PDDI), reducing the safety and efficacy of the therapeutic process. From the nursing perspective on patient safety, associated with the complex process of use of medicines, the present study has as objective the analysis of PDDI in patients with ACS. We conducted a retrospective descriptive cross-sectional study, with data collected from medical charts from january to december 2015, in cardiac intensive care unit of a university hospital in the city of Rio de Janeiro. Socio-demographic and clinical characteristics of the population was carried out, the pharmacological profile analysis and classification of PDDI in severity, mechanism, start time, level of documentation and risk index. For that, we used the database Micromedex® and scientific literature. Was used descriptive data analysis of qualitative and quantitative variables. For bivariate analysis, was applied the X2 test (chi-square) Pearson, T test and Mann-Whitney. The data were analyzed by the software Microsoft Excel® and Stata 11.0.® software. 390 prescriptions were analyzed where the average age was 58.8 ± 9.6 years, the main risk factors were: hypertension (95.4%), smoking (46.2%) and dyslipidemia (40,0%). The average number of drugs per prescription was 7,15±1,48. 2062 PIM were identified, with the average number of prescription 5,2±2,2, there was prevalence of the most severe level of 1,505 (73.0%), quick start time 740 (35.9%), pharmacodynamic mechanism 910 (44.1%), level of documentation good 1.025 (49.7%) and risk index C 1,166 (56.4%). About associations, the SCA CSSST group had a higher average number of PDDI compared to SCA SSSST group (p = 0.022). It was concluded that the study population presented a high level of vulnerability to PDDI, whose main consequence was the risk of bleeding, so it is of great importance to the implementation of clinical and managerial nursing interventions for monitoring and prevention of possible adverse events from drug therapy.