Interações medicamentosas clinicamente manifestadas em pacientes hospitalizados com doenças cardiovasculares - uma revisão sistemática

Abstract

Cardiovascular diseases are the main causes of morbidity and mortality worldwide, with hypertension as the main risk factor, being controlled in an expressive number of patients by pharmacological combinations. The concomitant combination of drugs is a common practice, seeking to improve therapeutic efficacy, reducing adverse effects. However, this combination may produce an undesirable effect, resulting in changes in drug efficacy or toxicity, leading to drug-drug interaction, affecting patient safety, especially the elderly, and consequently increasing costs for hospital admissions. The objective of the present study was to determine the prevalence of MMI manifested in hospitalized patients with cardiovascular diseases (CVD). A systematic review was performed by means of a search of the scientific bases of PUBMED and COCHRANE between April and September 2017. They were included by studies that identified the clinical interactions manifested clinically in patients hospitalized with CVD. Eight studies published between 1996 and 2016 met the inclusion criteria. Among the two studies were retrospective and six were prospective. The sample sizes ranged from 101 to 1000 patients, totaling 3,737 individuals, which were evaluated between two months and two years. The Micromedex database was the most used to identify the drug interactions. Four studies were published in pharmaceutical journals and four were published in medical journals. 45.6% of the patients were exposed to at least one potential drug interaction. 13.4% of the potential interactions manifested, causing damage to the patient during hospitalization. Considering the high prevalence of clinically manifest drug interactions, and since approximately half of hospitalized patients with cardiovascular disease are exposed to at least one potential interaction, a greater number of ducts, studies and procedures for identifying and managing clinically manifested interactions is necessary to reduce the potential damage resulting from this pharmacotherapeutic problem