No abstract

A critical patient is one who is seriously ill and needs a multi-professional team dedicated to their intensive care. Because ample prescription medication is involved, such patients are more susceptible to pharmacotherapeutic problems. The purpose of the study was to evaluate the profile of pharmacotherapeutic problems (PP) and pharmaceutical interventions (PI) performed by residents of a Multi-professional Residency Program in Critical Patient Care. This was a descriptive and quantitative study carried out by evaluating pharmaceutical care records completed by residents caring for critical patients who were hospitalized at a teaching hospital in Campo Grande, MS, from March to August 2016. The study was approved by the Ethics Committee of the Federal University of Mato Grosso do Sul, opinion No. 1,371,325. The drug prescriptions of 60 patients with an average age of 60.2 (± 16.6) years were evaluated. A total of 218 PP were identified, with an average of 3.6 (± 1.4) PP per participant. Twenty-six patients (43.3%) had 4 or more PP. The most frequent were: medication not available due to lack of stock (n=48; 22%), existence of a more adequate/available therapeutic alternative (n=37; 17%), and need for laboratory monitoring (n=22; 10.1%). A total of 154 PI, 2.56 (± 0.7) per participant, were performed. The most frequent were: indication of a more adequate/available therapeutic alternative (n=37; 24%), orientation on drug-drug incompatibility (n=16, 10.4%), and orientation on drugdrug interaction (n=12; 7.8%). Most PI (n=133; 86.4%) were directed to physicians and were accepted without change (n=96; 62%). The results showed a high incidence of PP and PI in critical patients.

We developed and validated a stability-indicating assay method for the simultaneous determination of enrofloxacin and piroxicam in combination and in the presence of degradation products. Reversephase high-performance liquid chromatography analyses were carried out on a Vertisep C18 column and acetonitrile-water (48:52 v/v, pH 3.0) mobile phase with a 1.00 mL min −1 flow rate. The efficient chromatographic separation of these drugs and their forced degradation products was achieved in less than 5 min with a peak purity match factor higher than 950. The method used showed linearity in the concentration ranges of 0.25 to 16.0 μg mL −1 for enrofloxacin (r = 0.9997) and 0.125 to 8.0 μg mL −1 for piroxicam (r = 0.9999) as well as precision (relative standard deviation lower than 2%), accuracy (mean recovery 100 ± 2%), and robustness, according to ICH (International Conference on Harmonization) and AOAC (Association of Official Analytical Chemists) guidelines. This method can simultaneously determine the combination of these drugs in a veterinary formulation and separate the drug peaks from their forced degradation products. Additionally, its optimized chromatographic conditions can contribute to the quality control of this formulation in pharmaceutical manufacturing plants and minimize waste from the organic solvent.