Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal

Introduction: Drug Related Problem (DRP) is any event related to pharmacotherapy that actually or potentially interferes with the desirable clinical outcome. DRPs are very common in intensive care, however, little is known about DRPs in Neonatal Intensive Care Units (NICU). Objective: To analyze the...

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Autor principal: Leopoldino, Ramon Weyler Duarte
Outros Autores: Oliveira, Márcio Galvão Guimarães de
Formato: Dissertação
Idioma:por
Publicado em: Brasil
Assuntos:
Farmacoterapia
Problema relacionado a medicamentos
Neonato
Unidade de terapia intensiva
CNPQ::CIENCIAS DA SAUDE::FARMACIA
Endereço do item:https://repositorio.ufrn.br/jspui/handle/123456789/25128
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id ri-123456789-25128
record_format dspace
institution Repositório Institucional
collection RI - UFRN
language por
topic Farmacoterapia
Problema relacionado a medicamentos
Neonato
Unidade de terapia intensiva
CNPQ::CIENCIAS DA SAUDE::FARMACIA
spellingShingle Farmacoterapia
Problema relacionado a medicamentos
Neonato
Unidade de terapia intensiva
CNPQ::CIENCIAS DA SAUDE::FARMACIA
Leopoldino, Ramon Weyler Duarte
Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal
description Introduction: Drug Related Problem (DRP) is any event related to pharmacotherapy that actually or potentially interferes with the desirable clinical outcome. DRPs are very common in intensive care, however, little is known about DRPs in Neonatal Intensive Care Units (NICU). Objective: To analyze the DRPs in the NICU according to frequency, type, cause and corresponding pharmaceutical conducts. Methods: A prospective observational study was conducted in the NICU of a teaching hospital in Brazil from January 2014 to November 2016, based on the records of the clinical pharmacy service, excluding neonates with length of stay< 24 hours and with no prescribed drugs. DRPs were classified according to the Pharmaceutical Care Network Europe system and assessed for safety-relevance. Logistic regression analysis was applied to identify factors and drugs associated with DRPs. Results: Six hundred neonates were included in the study with mean gestational age of 31.9±4.1 weeks and birth weight of 1,779.4±885,3 g. The incidence of DRPs was 6.8 cases/1,00 patient-days (95%CI 6.2 – 7.3). Sub-optimal effect (52.8%) and dose selection (39.7%) were the most common problem and cause, respectively. Most of the pharmaceutical interventions were performed at the prescription level, with over 90% being accepted by the NICU team. Number of medications (OR 1.19; 95%CI 1.09 – 1.30), number of clinical problems (OR 1.17; 95%CI 1.01 – 1.37), length of stay (OR 1.05; 95%CI 1.02 – 1.07) and vaginal delivery (OR 1.61; IC95% 1.04-2.50) were associated with DRPs. Medicines with increased risk for DRP were alprostadil, amikacin, aminophylline, amphotericin B, ciprofloxacin, fluconazole, gentamicin, meropenem, phenobarbital and vancomycin. These drugs represent only one-third of all prescribed drugs. Conclusions: DRPs are very common in NICU, predominating problems of sub-optimal treatment, mainly due to inappropriate dose choice.
author2 Oliveira, Márcio Galvão Guimarães de
author_facet Oliveira, Márcio Galvão Guimarães de
Leopoldino, Ramon Weyler Duarte
format masterThesis
author Leopoldino, Ramon Weyler Duarte
author_sort Leopoldino, Ramon Weyler Duarte
title Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal
title_short Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal
title_full Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal
title_fullStr Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal
title_full_unstemmed Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal
title_sort análise dos problemas relacionados a medicamentos em terapia intensiva neonatal
publisher Brasil
publishDate 2018
url https://repositorio.ufrn.br/jspui/handle/123456789/25128
work_keys_str_mv AT leopoldinoramonweylerduarte analisedosproblemasrelacionadosamedicamentosemterapiaintensivaneonatal
AT leopoldinoramonweylerduarte analysisofdrugrelatedproblemsinneonatalintensivetherapy
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spelling ri-123456789-251282019-05-26T05:49:24Z Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal Analysis of drug related problems in neonatal intensive therapy Leopoldino, Ramon Weyler Duarte Oliveira, Márcio Galvão Guimarães de Souza, Nilba Lima de Diniz, Rodrigo dos Santos Farmacoterapia Problema relacionado a medicamentos Neonato Unidade de terapia intensiva CNPQ::CIENCIAS DA SAUDE::FARMACIA Introduction: Drug Related Problem (DRP) is any event related to pharmacotherapy that actually or potentially interferes with the desirable clinical outcome. DRPs are very common in intensive care, however, little is known about DRPs in Neonatal Intensive Care Units (NICU). Objective: To analyze the DRPs in the NICU according to frequency, type, cause and corresponding pharmaceutical conducts. Methods: A prospective observational study was conducted in the NICU of a teaching hospital in Brazil from January 2014 to November 2016, based on the records of the clinical pharmacy service, excluding neonates with length of stay< 24 hours and with no prescribed drugs. DRPs were classified according to the Pharmaceutical Care Network Europe system and assessed for safety-relevance. Logistic regression analysis was applied to identify factors and drugs associated with DRPs. Results: Six hundred neonates were included in the study with mean gestational age of 31.9±4.1 weeks and birth weight of 1,779.4±885,3 g. The incidence of DRPs was 6.8 cases/1,00 patient-days (95%CI 6.2 – 7.3). Sub-optimal effect (52.8%) and dose selection (39.7%) were the most common problem and cause, respectively. Most of the pharmaceutical interventions were performed at the prescription level, with over 90% being accepted by the NICU team. Number of medications (OR 1.19; 95%CI 1.09 – 1.30), number of clinical problems (OR 1.17; 95%CI 1.01 – 1.37), length of stay (OR 1.05; 95%CI 1.02 – 1.07) and vaginal delivery (OR 1.61; IC95% 1.04-2.50) were associated with DRPs. Medicines with increased risk for DRP were alprostadil, amikacin, aminophylline, amphotericin B, ciprofloxacin, fluconazole, gentamicin, meropenem, phenobarbital and vancomycin. These drugs represent only one-third of all prescribed drugs. Conclusions: DRPs are very common in NICU, predominating problems of sub-optimal treatment, mainly due to inappropriate dose choice. Introdução: Problema Relacionado a Medicamento (PRM) é qualquer evento relacionado a farmacoterapia que interfere real ou potencialmente nos desfechos clínicos desejáveis. Os PRMs são muito comuns em terapia intensiva, porém, são pouco conhecidos em Unidade de Terapia Intensiva Neonatal (UTIN). Objetivo: Analisar os PRMs em UTIN segundo frequência, tipo, causa e condutas farmacêuticas correspondentes. Métodos: Estudo prospectivo observacional na UTIN de um hospital de ensino no Brasil conduzido de janeiro de 2014 a novembro de 2016, baseado nas fichas do serviço de farmácia clínica, sendo excluídos neonatos com tempo de internação< 24 horas e sem medicamentos prescritos. Os PRMs foram classificados segundo o sistema Pharmaceutical Care Network Europe e avaliados quanto a relevância-segurança. Aplicou-se uma análise de regressão logística para identificar fatores e medicamentos associados a PRMs. Resultados: Seiscentos neonatos foram incluídos no estudo com média de idade gestacional de 31,9±4,1 semanas e peso ao nascer de 1.779,4±885.3 g. A incidência de PRM foi de 6,8 casos/1.00 paciente-dias (IC95% 6,2 – 7,3). Efeito subótimo (52,8%) e seleção da dose (39,7%) foram, respectivamente, o problema e a causa mais comuns. A maioria das intervenções farmacêuticas foram realizadas em nível de prescrição, sendo mais de 90% aceitas pela equipe da UTIN. Número de medicamentos (OR 1,19; IC95% 1,09 – 1,30), número de condições clínicas (OR 1,17; IC95% 1,01 – 1,37), tempo de internação (OR 1,05; IC95% 1,02 – 1,07) e parto vaginal (OR 1,61; IC95% 1,04-2,50) foram os fatores associados a PRMs. Os medicamentos de alto risco para PRMs foram alprostadil, amicacina, aminofilina, anfotericina B, ciprofloxacino, fluconazol, gentamicina, meropenem, fenobarbital e vancomicina. Conclusões: PRMs são muito comuns em UTIN, predominando problemas de tratamento subótimo decorrentes, principalmente da escolha inapropriada da dose. 2018-05-08T22:37:21Z 2018-05-08T22:37:21Z 2018-02-20 masterThesis LEOPOLDINO, Ramon Weyler Duarte. Análise dos problemas relacionados a medicamentos em Terapia Intensiva Neonatal. 2018. 83f. Dissertação (Mestrado em Ciências Farmacêuticas) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2018. https://repositorio.ufrn.br/jspui/handle/123456789/25128 por Acesso Aberto application/pdf Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS FARMACÊUTICAS

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