Keywords
Diabetes Mellitus
Hypertension
Adverse Drug Reactions
Public Health
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Abstract
Objective: To estimate potential drug interactions based on medical prescriptions for individuals over 18 years of age, diagnosed with systemic arterial hypertension and/or diabetes mellitus, in an emergency care unit. Methods: Quantitative, documentary, descriptive and retrospective study, carried out with the help of DrugBank's Drug Interaction Checker to evaluate and stratify potential drug interactions. Results: 58.2% of patients treated were aged 60 or over, with a higher prevalence of systemic arterial hypertension. 434 potential drug interactions were found, which were classified, according to severity, as high (2.8%), moderate (51.6%) and low (45.6%). Of these, 43.3% had an additive effect between the drugs involved in the potential drug interaction, 40.3% would have the therapeutic effect of one of the drugs reduced by the other, and in 15.9% there would be increased exposure to a given drug. Conclusion: The knowledge of possible pharmacological interactions in the elderly population with systemic arterial hypertension and/or diabetes mellitus is essential for the success of a pharmacological protocol, as these patients have a greater risk of suffering adverse events.
References
AL-MUSAWE L. et al. The association between polypharmacy and adverse health consequences in elderly type 2 diabetes mellitus patients; a systematic review and meta-analysis. Diabetes Research and Clinical Practice, 2019; 155: 107804.
BOMBELLI, A. et al. Two Years of Active Pharmacovigilance Surveillance and Therapeutic Reconciliation in Frail Populations: The MEAP 3.0 Study. Journal of Clinical Medicine, 2023; 12(23): 7447.
BUDREVICIUTE A. et al. Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors. Frontiers in Public Health, 2020; 8: 574111.
CASSETTARI SSR, MELLO ALSF. Demand and type of care provided in emergency services in the city of Florianópolis, Brazil. Texto & contexto enfermagem, 2017; 26(1): e3400015.
DAVIES LE, et al. Adverse Outcomes of Polypharmacy in Older People: Systematic Review of Reviews. Journal of the American Medical Directors Association, 2020; 21(2): 181–187.
DEODHAR M, et al. Mechanisms of CYP450 Inhibition: Understanding Drug-Drug Interactions Due to Mechanism-Based Inhibition in Clinical Practice. Pharmaceutics, 2020; 12(9): 846.
ESTEVES M, et al. Qualidade de vida de idosos hipertensos e diabéticos em um serviço ambulatorial. Medicina (Ribeirão Preto), 2017; 50(1): 18–28.
FELICIANO SCC, et al. Association between Mortality from Chronic Noncommunicable Diseases and Human Development Index in Brazil between 1980 and 2019. Arquivos brasileiros de cardiologia, 2023; 120(4): e20211009.
FLAHERTY JH, et al. Polypharmacy and hospitalization among older home care patients. The journals of gerontology: medical sciences, 2000; 55(10): m554-m559.
FLOR LS, CAMPOS MR. Prevalência de diabetes mellitus e fatores associados na população adulta brasileira: evidências de um inquérito de base populacional. Revista Brasileira de Epidemiologia, 2017; 20(1): 16-29.
FLORES LM, MENGUE SS. Uso de medicamentos por idosos em região do sul do Brasil. Revista de Saúde Pública, 2005; 39(6): 924–929.
GIMENES C, et al. Profile of Hiperdia patients in the municipality of Barra Bonita, Sao Paulo state. Fisioterapia em Movimento, 2016; 29(4): 731–739.
GUIMARÃES RM, ANDRADE FCD. Expectativa de vida com e sem multimorbidade entre idosos brasileiros: Pesquisa Nacional de Saúde 2013. Revista Brasileira de Estudos de População, 2020; 37: 1-15.
HAUBEN M. Artificial Intelligence and Data Mining for the Pharmacovigilance of Drug–Drug Interactions. Clinical Therapeutics, 2023; 45(2): 117–133.
HODKINSON A, et al. Preventable medication harm across health care settings: a systematic review and meta-analysis. BMC Medicine, 2020; 18: 313.
LATHAM LP, ACKROYD-STOLARZ S. Emergency department utilization by older adults: a descriptive study. Canadian geriatrics journal, 2014; 17(4): 118–125.
LEÃO DFL, et al. Avaliação de interações medicamentosas potenciais em prescrições da atenção primária de Vitória da Conquista (BA), Brasil. Ciência & Saúde Coletiva, 2014; 19(1): 311–318.
LEVINE DM, et al. Estatística - Teoria e Aplicações usando Microsoft® Excel em Português. Rio de Janeiro: LTC, 2000.
LEVORATO CD, et al. Fatores associados à procura por serviços de saúde numa perspectiva relacional de gênero. Ciência & Saúde Coletiva, 2014; 19(4): 1263–1274.
LIMA TAM, et al. Análise de potenciais interações medicamentosas e reações adversas a anti-inflamatórios não esteroides em idosos. Revista Brasileira de Geriatria e Gerontologia, 2016; 19(3): 533–544.
MALLET L, et al. The challenge of managing drug interactions in elderly people. Lancet, 2007; 370(9582): 185–191.
MARIN MJS, et al. Use of medicines by the elderly in a Family Health Program unit in Brazil. Cadernos de saúde pública, 2008 ;24(7): 1545–1555.
MAZZOLA PG, et al. Perfil e manejo de interações medicamentosas potenciais teóricas em prescrições de UTI. Revista Brasileira de Farmácia Hospitalar e Serviços de Saúde, 2011; 2(2): 15–19.
MCQUEENIE R, et al. Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort. PLOS ONE, 2020; 15(8): e0251613.
MOURA CS, et al. Interação medicamentosa associada à reinternação hospitalar: estudo retrospectivo em um hospital geral. Revista de Saúde Pública, 2012; 46(6): 1082–1089.
NIU J, et al. Pharmacodynamic Drug–Drug Interactions. Clinical Pharmacology & Therapeutics, 2019; 105(6): 1395–1406.
OLIVEIRA MBM, et al. Interações medicamentosas potenciais em prescrições de pacientes internados em unidade de terapia intensiva. Brazilian Journal of Development, 2023; 9(1): 4912–4929.
OLIVEIRA SN, et al. Emergency Care Units (UPA) 24h: the nurses’ perception. Texto & contexto enfermagem, 2015; 24(1): 238–244.
PINTO NBF, et al. Interações medicamentosas em prescrições de idosos hipertensos: prevalência e significância clínica. Revista Enfermagem UERJ, 2014; 22(6): 735-741.
SECOLI SR. Polifarmácia: interações e reações adversas no uso de medicamentos por idosos. Revista Brasileira de Enfermagem, 2010; 63(1): 136–140.
SIMÕES TC, et al. Prevalências de doenças crônicas e acesso aos serviços de saúde no Brasil: evidências de três inquéritos domiciliares. Ciência & Saúde Coletiva, 2021; 26(9): 3991–4006.
SIROIS C, et al. Exploring the associations between polypharmacy and COVID-19-related hospitalisations and deaths: a population-based cohort study among older adults in Quebec, Canada. BMJ Open, 2022; 12(3) :e060295.
SOEIRO VMS, et al. Perfil dos pacientes acompanhados pelo SIS-HiperDia em um estado do nordeste brasileiro. Archives of Health Sciences, 2019; 26(1): 28-31.
TEIXEIRA JJM, et al. Perfil de internação de idosos. Revista da Sociedade Brasileira de Clínica Médica, 2017: 15(1): 15–20.
WHO. Medication Without HarmWorld Health Organization. 2023. Disponível em: https://www.who.int/publications/i/item/WHO-HIS-SDS-2017.6. Acessado em:28 de agosto de 2023.
WISHART DS, et al. DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic acids research, 2018: 46(D1): D1074–D1082.
XING XX, et al. Associations Between Potentially Inappropriate Medications and Adverse Health Outcomes in the Elderly: A Systematic Review and Meta-analysis. Annals of Pharmacotherapy, 2019: 53(10): 1005–1019.
ZHANG, Y. et al. Application of Artificial Intelligence in Drug–Drug Interactions Prediction: A Review. Journal of Chemical Information and Modeling, 2023.