Abstract
Objective: To analyze clinical pharmacists' interventions regarding the use of the proton pump inhibitor omeprazole 40mg injectable in intensive care units (ICUs). Methods: This is a retrospective, descriptive, observational, and quantitative cross-sectional study involving 123 pharmaceutical interventions performed between January 2024 and June 2024 in ICUs 1, 4, 5, 8, and 9 of a tertiary hospital in the state of Pernambuco involving omeprazole. The sample size was calculated using the OpenEpi web application version 3.01, and the data were processed in Microsoft Office Excel®. The study was approved by the Research Ethics Committee under CAAE: 83196624.3.0000.5201. Results: ICU 4 performed 29.3% of interventions, and ICU 5 had the highest acceptance rate of pharmaceutical interventions (31%). Regarding the type of intervention performed, 51.2% involved discontinuation of injectable omeprazole 40mg. Regarding medication errors, 54.5% involved the wrong medication due to inappropriate prescription. Conclusion: The clinical pharmacist's role is essential to direct patient care, ensuring greater safety in the use of injectable omeprazole 40mg. The acceptance of this professional's role has been gaining significant ground within the multidisciplinary team.
References
ANDRE M, et al. Mental confusion from interaction of a proton-pump inhibitor with benzodiazepines: 3 cases. Therapie, 2000; 55(2):319-20.
ALGABBANI AM, ALANGARI AS. Proton pump inhibitor prescribing patterns andutilization: A retrospective chart review analysis. Saudi Pharm J, 2023; 31(12): 101841.
ALI T, HARTY RF. Stress-Induced Ulcer Bleeding in Critically Ill Patients. Gastroenterology Clinics, 2009; 38(2): 245-265.
ALJBOURI TM, et al. Impact of clinical pharmacist on cost of drug therapy in the ICU. Saudi Pharm J, 2013; 21(4): 371–4.
ALSAYED HAH, et al. Clinical pharmacist interventions in an intensive care unit reduces ICU mortality at a tertiary hospital in Dubai, United Arab Emirates. Explor Res Clin Soc Pharm, 2024; 14: 100431.
AMORIM GKD, SILVA GSN. Nutricionistas e cuidados paliativos no fim de vida: revisão integrativa. Revista Bioética, 2021; 29(3): 547-57.
ARAUJO EO, et al. Intervenções Farmacêuticas em uma Unidade de Terapia Intensiva de um Hospital Universitário. Revista Brasileira e Farmácia Hospitalar e Serviços de Saúde, 2017; 8(3): 25-30.
ARAÚJO ES, et al. Intervenção farmacêutica no uso racional de omeprazol intravenoso. Einstein, 2020; 18: 1-6.
BEN-ELTRIKI M, et al. Inappropriate Use of Proton Pump Inhibitor Among Elderly Patients inBritish Columbia: What are the Long-term Adverse Events? Current Drug Safety, 2024; 19: 244-247.
BISCHOFF LM, et al. Inappropriate usage of intravenous proton pump inhibitors and associated factors in a high complexity hospital in Brazil. Arquivos de Gastroenterologia, 2021; 58(1): 32–38.
BRASIL. Metas Internacionais de Segurança do Paciente. 2024. Disponível em:https://www.gov.br/ebserh/pt-br/hospitais-universitarios/regiao-sudeste/hc-ufmg/saude/metas-internacionais-de-seguranca-do-paciente/metas-internacionais-de-seguranca-do-paciente. Acessado em: 18 de agosto de 2025.
BUENDGENS L, et al. Prevention of stress-related ulcer bleeding at the intensive care unit: Risks and benefits of stress ulcer prophylaxis. World JCrit Care Med, 2016; 5:57–64.
CALAFIORI ALS, et al. Efeitos adversos do uso contínuo e irracional dos Inibidores de Bomba de Prótons em idosos. BrazilianJournalof Health Review, 2022; 5(5): 17964-17976.
CARVALHO CM, et al. Avaliação das intervenções farmacêuticas em uma unidade de terapia intensiva de um hospital de ensino da Paraíba e desenvolvimento de um instrumento de classificação. Revista Eletrônica Acervo Saúde, 2024; 24(6): 1-12.
CASCONE AE, et al. Pharmacist-Initiated De-Prescribing Efforts Reduce Inappropriate Continuation of Acid-Suppression Therapy Initiated in the ICU. Am J Med, 2023; 136(2): 186–92.
CAVALCANTE MG, et al. A importância da integração do farmacêutico clínico em uma unidade de terapia intensiva (uti): uma revisão integrativa. Revista Expressão Católica Saúde, 2022; 7(1): 37–46.
CLARKE K, et al. Indications for the Use of Proton Pump Inhibitors for Stress Ulcer Prophylaxis and Peptic Ulcer Bleeding in Hospitalized Patients. Am J Med, 2022; 135(3): 313–7.
DEZENA RCAB, et al. Erros de medicação e implicações na assistência de enfermagem. CuidEnferm, 2021; 15(2):274-280.
FARRELL B, et al. Deprescribing proton pump inhibitors Evidence-based clinical practice guideline. Can Fam Physician, 2017;63:354-64 (Eng), e253-65 (Fr).
FORGERINI M, et al. Safety assessment of omeprazole use: a review. Sao Paulo Med J, 2018;136(6):557-70.
ISMP. Prevenção de erros de medicação. 2021. Disponível em: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.ismp-brasil.org/site/wp-content/uploads/2021/03/Boletim-ISMP-Prevencao-Erros-Prescricao.pdf. Acessado em: 02 de julho de 2025.
JALIL BA, EL-KERSH K. Enteral nutrition better than protonpump inhibitors?Curr Opin Crit Care, 2019; 25(4): 334-339.
LÓPEZ MJO, et al. ActualizacióndelacalssificacióndeerroresdemedicacióndelgrupoRuiz-Jarabo2000.Farm. Hosp, 2008;32(1):38-52.
LÓPEZ MJO. Nuevas inciativas para mejorarlaseguridad de lautilización de losmedicamentos enloshospitales. RevEsp Salud Pública, 2004; 78: 323-39.
MACHADO AS, et al. Profilaxia para Úlcera de Estresse nas Unidades de Terapia Intensiva: Estudo Observacional Multicêntrico. Revista Brasileira de Terapia Intensiva, 2006; 18(3): 229-233.
MACLAREN R. A review of stress ulcer prophylaxis. Journal of Pharmacy Practice, 2002; 15(2): 147-157.
MARKER S, et al. What’s new with stress ulcer prophylaxis in the ICU? Intensive Care Medicine, 2017; 43(8): 1132–1134.
MATOSO AGB, et al. Proton pump inhibitor indications in a Brazilian tertiary hospital. Rev Assoc Med Bras, 2020; 66(7): 913–7.
MILANI AC, et al. Pharmacotherapeutic problems and pharmaceutical interventions in critical hospitalized patients. O Mundo da Saúde, 2018; 42(2):369-392.
MÖSCHWITZER J, et al. Development of an intravenously injectable chemically stable aqueous omeprazole formulation using nanosuspension technology. European Journal of Pharmaceutics and Biopharmaceutics, 2004; 58(3): 615–619.
OLIVEIRA BS, et al. Farmácia clínica hospitalar: desafios para implantação em um município de médio porte do Sudoeste da Bahia. JAFF, 2019; 4(1): 67.
OLIVEIRA RCC, et al. Prescrições em unidade de terapia intensiva devem adequar-se aos fatores de risco na prevenção de sangramento por úlcera de estresse. ABCD ArqBrasCir Dig, 2021; 34(3): e1587.
OLIVEIRA SMM. Avaliação farmacotécnica da estabilidade de preparações orais líquidas de Omeprazol: uma revisão integrativa. BrazilianJournalof Health Review, 2024; 7(2): 01-20.
PILAU R, et al. Atuação do farmacêutico clínico em unidade de terapia intensiva adulto: uma revisão da literatura. Ver. Bras. Farm. Hosp. Serv. Saúde, 2014; 5(1): 19-24.
PIMENTA SF, et al. Erros relacionados à medicação nas Unidades de Terapia Intensiva: revisão integrativa. REAS/EJCH, 2019; 27: e931.
QUENOT JP, et al. Criteria deemed important by the relatives for designating a reference person for patients hospitalized in ICU. J Crit Care, 2020; 57: 191–6.
SANTOS HC, et al. Possíveis interações medicamentosas com psicotrópicos encontradas em pacientes da Zona Leste de São Paulo. RevCiêncFarm Básica Apl., 2009;30(3):285-289.
SANTOS PS, TAKASHI MH. Atuação do farmacêutico clínico na unidade de terapia intensiva. REVISA, 2021; 10(2): 833-8.
TAM VC, et al. Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review. Canadian Medical Association Journal, 2005; 173(5): 510-515.
WENSEL TM. Administration of proton pump inhibitors in patients requiring enteral nutrition. Pharmacy and Therapeutics, 2009; 34(3): 143-160.
