Drug interactions in maternal intensive care: prevalence, risk factors, and potential risk medications

Pessoa, Thiago de Lima; Clemente, Washington Sales; Costa, Tatiana Xavier da; Bezerra, Priscilla Karilline do Vale; Martins, Rand Randall

doi:10.31744/einstein_journal/2019ao4521

Cited by 7 publications

(8 citation statements)

References 35 publications

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“…According to a study by Pessoa et al published in 2019, nearly one-third of pregnant women experienced at least one severe pDDI and were subjected to more than two-thirds of the hospital stay. A significant number of pharmaceuticals provided during the hospitalization period and past medication usage before admission were shown to be risk factors for severe pDDIs, which were present in around 33.9% of patients [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Potential Drug-Drug Interactions Among Hypertensive Pregnant Women Admitted to a Tertiary Care Hospital

Ragam¹,

R²

2023

Cureus

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Aims and objectives: The aim is to determine the frequency of potential drug-drug interactions (pDDIs) and to analyze the clinically relevant drug interactions among hypertensive pregnant women.Materials and methods: This was an observational, cross-sectional study conducted at a tertiary care hospital. The prescriptions of the hypertensive pregnant women admitted to the hospital from June 2021 to December 2021 were analyzed for potential drug-drug interactions using the database from Lexicomp ® Solutions android mobile application version 7.5.4 (Wolters Kluwer, The Netherlands).Results: A total of 127 patients were evaluated during the study period of 6 months, of which 70 (55.12%) had pDDIs. The total number of pDDIs was 85, of which 70 (82.35 %) were clinically relevant interactions with the majority of them having moderate severity (81.17%) followed by minor severity (17.65%) and major severity (1.18%). The most frequently interacting pDDIs were between Labetalol and Lornoxicam (42.35%), followed by Labetalol and Diclofenac (22.35%).Conclusion: This study highlights the high prevalence of potential drug interactions among hypertensive pregnant women and the need for rational drug use and strict vigilance in their monitoring.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Potential Drug-Drug Interactions Among Hypertensive Pregnant Women Admitted to a Tertiary Care Hospital

Ragam¹,

R²

2023

Cureus

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“…Moreover, differences in medication regimen in the outpatient compared to the inpatient setting might further explain discrepancies in PIMCs. According to a meta-analysis and systematic review, 33% of all hospitalized general patients received at least one PIMC, [ 32 ] whereby PIMC prevalence ranged from 16.3% [ 33 ] to 71.1% [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Potentially inappropriate medications and medication combinations before, during and after hospitalizations: an analysis of pathways and determinants in the Swiss healthcare setting

Migliazza

Bähler

Liedtke

et al. 2021

BMC Health Serv Res

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Background A hospitalization phase represents a challenge to medication safety especially for multimorbid patients as acute medical needs might interact with pre-existing medications or evoke adverse drug effects. This project aimed to examine the prevalence and risk factors of potentially inappropriate medications (PIMs) and medication combinations (PIMCs) in the context of hospitalizations. Methods Analyses are based on claims data of patients (≥65 years) with basic mandatory health insurance at the Helsana Group, and on data from the Hirslanden Swiss Hospital Group. We assessed PIMs and PIMCs of patients who were hospitalized in 2013 at three different time points (quarter prior, during, after hospitalization). PIMs were identified using the PRISCUS list, whereas PIMCs were derived from compendium.ch. Zero-inflated Poisson regression models were applied to determine risk factors of PIMs and PIMCs. Results Throughout the observation period, more than 80% of patients had at least one PIM, ranging from 49.7% in the pre-hospitalization, 53.6% in the hospitalization to 48.2% in the post-hospitalization period. PIMCs were found in 46.6% of patients prior to hospitalization, in 21.3% during hospitalization, and in 25.0% of patients after discharge. Additional medication prescriptions compared to the preceding period and increasing age were the main risk factors, whereas managed care was associated with a decrease in PIMs and PIMCs. Conclusion We conclude that a patient’s hospitalization offers the possibility to increase medication safety. Nevertheless, the prevalence of PIMs and PIMCs is relatively high in the study population. Therefore, our results indicate a need for interventions to increase medication safety in the Swiss healthcare setting.

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“…Comparando a estudos prévios que investigaram a ocorrência de IMp em UTI, a prevalência encontrada neste estudo foi similar a de estudos prévios que variou de 58 a 96% [6][7][8][9][10] . O perfil medicamentoso relacionado às IMp deste estudo corrobora com achados de recente revisão sistemática com metanálise 6 e de outros estudos observacionais [11][12][13][14][15][16] que objetivaram avaliar IMp em UTI.…”

Section: Discussionunclassified

“…A prevalência de IMp em UTI tem sido elevada, variando de 58 a 96% [6][7][8][9][10] . Estudos 6,11 têm reportado que os principais fatores de risco e associados a estas taxas envolvem ser do sexo masculino, idade maior de 60 anos, uso de polifarmácia incluindo algumas classes de medicamentos específicas (antiagregantes plaquetários, antidiabéticos, antiarrítmicos, diuréticos, inibidores de bomba de prótons, hipnóticos/sedativos e antiepilépticos) e maior tempo de internação 6,11 .…”

Section: Introductionunclassified

“…Diversos estudos observacionais [7][8][9][10][11][12][13][14][15][16] caracterizaram as IMp bem como sua frequência e fatores associados em UTI. No entanto, não foram encontradas estimativas consistentes da prevalência de IMp consideradas clinicamente significantes (com potencial de acarretar riscos fatais) por pacientes bem como dos medicamentos, fatores associados e potencias impactos clínicos em pacientes hospitalizados em UTI adulto.…”

Section: Introductionunclassified

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Fatores associados para potenciais interações medicamentosas clinicamente significantes em terapia intensiva adulto

Moraes

Maia

Trindade

et al. 2020

Medicina (Ribeirão Preto)

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Modelo do estudo: Estudo transversal. Objetivo: caracterizar as interações medicamentosas potenciais (IMp) maiores e contraindicadas em terapia intensiva adulto e determinar sua prevalência, medicamentos e fatores associados à exposição dessas interações. Métodos: a amostra foi composta por 309 pacientes internados em uma unidade de terapia intensiva adulto de um hospital da Região Centro-Oeste de Minas Gerais, Brasil. Os dados demográficos-clínicos e perfil medicamentoso foram coletados, prospectivamente. As IMp foram caracterizadas pela base Micromedex 2.0 quanto à gravidade, prevalência e implicação clínica. Realizaram-se análises descritivas para as variáveis qualitativas e contínuas. Modelos Lineares Generalizados com distribuição Gama e Poisson foram utilizados para avaliar a relação entre um conjunto de variáveis independentes e a prevalência de IMp maiores e contraindicadas (p<0.05). Resultados: Um total de 81,8% (n=251) foi exposto a, no mínimo, uma IMp maior ou contraindicada. Mais de um terço (37,4%) destes participantes foram expostos a seis ou mais IMp. Medicamentos com ação no sistema nervoso colaboraram para maior probabilidade de IMp maiores e/ou contraindicadas. Pessoas idosas (p=0,006), do sexo masculino (p=0,028) e polimedicadas (<0,001) tiveram maior probabilidade de serem expostas ao menos a uma IMp maior ou contraindicada. Conclusão: Interações medicamentosas potenciais maiores e contraindicadas apresentaram alta frequência. Pessoas idosas, do sexo masculino e polimedicadas foram mais expostas às IMp maiores e/ou contraindicadas. É importante que profissionais da saúde conheçam os riscos e potenciais eventos adversos relacionados às IMp maiores e contraindicadas, para que sejam implementadas medidas para promoção da segurança do paciente.

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Drug interactions in maternal intensive care: prevalence, risk factors, and potential risk medications

Cited by 7 publications

References 35 publications

Prevalence of Potential Drug-Drug Interactions Among Hypertensive Pregnant Women Admitted to a Tertiary Care Hospital

Prevalence of Potential Drug-Drug Interactions Among Hypertensive Pregnant Women Admitted to a Tertiary Care Hospital

Potentially inappropriate medications and medication combinations before, during and after hospitalizations: an analysis of pathways and determinants in the Swiss healthcare setting

Fatores associados para potenciais interações medicamentosas clinicamente significantes em terapia intensiva adulto

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