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Estudo das interações medicamentosas em indivíduos internados por hipertensão arterial no Serviço de Medicina Interna do Hospital Geral de Luanda
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Introdução: A Hipertensão arterial (HTA) é uma elevação crónica da pressão arterial
sistólica (PAS) e diastólica (PAD), sendo uma das doenças crónicas mais frequentes
nos dias de hoje. Atualmente é considerada como um dos maiores problemas de
saúde pública, devido à sua importância como fator de risco cardiovascular. Os
doentes hipertensos necessitam de atenção especial, uma vez que muitos utilizam
associações de medicamentos, aumentando assim o risco de interações
medicamentosas (IMs). Cerca de 80% dos doentes com idade superior a 65 anos
apresentam multipatologias o que revela a importância que a polimedicação e as
potenciais IMs e suas possíveis consequências assumem neste grupo de doentes.
Objetivo: Identificar e caracterizar as potenciais e principais IMs na terapêutica
antihipertensores nos indivíduos hipertensos internados no serviço de medicina interna
do Hospital Geral de Luanda (HGL).
Métodos: Foi realizado um estudo descritivo transversal, numa amostra de doentes
internados no serviço de medicina interna do HGL. A recolha de dados foi obtida
através de processo clínico de doentes internados com diagnóstico de HTA. Foram
incluídos no estudo, os processos clínicos de doentes com idade superior a 18 anos,
no mínimo dois medicamentos antihipertensores. Foram excluídos do estudo, os
processos clínicos não legíveis, e os processos clínicos dos doentes com apenas um
medicamento. As IMs foram analisadas e classificadas em desejáveis (reduzem os
efeitos colaterais ou melhoram a eficácia terapêutica dos agentes combinados) e as
indesejáveis (prejudiciais à terapêutica, podendo aumentar as RAMs e causar
ineficácia terapêutica). Esta análise foi feita recorrendo à literatura especializada Drug
Interactions Facts.
Resultados: A população estudada foi predominantemente do sexo feminino (69%).
Foram identificadas 14 episódios diferentes de IMs, onde 9 (64%) caracterizaram-se
por interações desejáveis. As potenciais IMs desejáveis foram as mais frequentes,
ocorrendo em 64% (n=50) dos doentes. Os fármacos mais frequentemente envolvidos
em interações desejáveis foram captopril mais hidroclorotiazida.
Conclusões: Embora as interações desejáveis tenham sido frequentes, observou-se
uma elevada prevalência de interações indesejáveis, que sugere a presença do
profissional farmacêutico na validação das prescrições, visando maior segurança dos
doentes.
Introduction: Arterial hypertension (AH) is a chronic elevation of systolic (SBP) and diastolic (DBP) pressure, being one of the most frequent chronic diseases today. It is currently considered one of the major public health problems due to its importance as a cardiovascular risk factor. Hypertensive patients require special attention as many of them often use drug combinations, thus increasing the risk of drug-drug interactions (DDIs). Approximately 80% of patients aged 65 years or older have several comorbidities, which highlights the importance of polymedication and the potential DDIs with the possible consequences on this group of patients. Objective: To identify and characterize the potential and main DDIs in the therapy of hypertensive individuals admitted to the internal medicine service of the General Hospital of Luanda (HGL). Methods: A descriptive cross-sectional study was conducted in a sample of patients admitted to the HGL internal medicine service. The data collection was obtained through medical charts of inpatients diagnosed with AH. Patients were included in this study if they fulfilled the following inclusion criteria: aged 18 years or older, with AH diagnosis and under an antihypertensive therapy of at least 2 drugs. Patients with non legible medical charts, under one antihypertensive drug, were excluded from the study. DDIs were analyzed and classified as desirable (those that reduce the side effects or improve the therapeutic efficacy of the combined drugs) and undesirable (classified with an increased risk of adverse drug reactions and therapeutic ineffectiveness). This analysis was conducted using the specialized Drug Interactions Facts. Results: Study population was predominantly female (69%). Fourteen different DDIs episodes were identified, where 9 (64%) were characterized as desirable interactions. The desirable potential DDIs were the most frequent, occurring in 64% (n= 50) patients. The drugs most frequently involved in desirable interactions were captopril in combination with hydrochlorothiazide. Conclusions: Although the desirable DDIs were frequent, a high prevalence of undesirable DDIs was observed, suggesting the presence of the pharmacist in the validation of prescriptions, with the main goal of increasing patient safety.
Introduction: Arterial hypertension (AH) is a chronic elevation of systolic (SBP) and diastolic (DBP) pressure, being one of the most frequent chronic diseases today. It is currently considered one of the major public health problems due to its importance as a cardiovascular risk factor. Hypertensive patients require special attention as many of them often use drug combinations, thus increasing the risk of drug-drug interactions (DDIs). Approximately 80% of patients aged 65 years or older have several comorbidities, which highlights the importance of polymedication and the potential DDIs with the possible consequences on this group of patients. Objective: To identify and characterize the potential and main DDIs in the therapy of hypertensive individuals admitted to the internal medicine service of the General Hospital of Luanda (HGL). Methods: A descriptive cross-sectional study was conducted in a sample of patients admitted to the HGL internal medicine service. The data collection was obtained through medical charts of inpatients diagnosed with AH. Patients were included in this study if they fulfilled the following inclusion criteria: aged 18 years or older, with AH diagnosis and under an antihypertensive therapy of at least 2 drugs. Patients with non legible medical charts, under one antihypertensive drug, were excluded from the study. DDIs were analyzed and classified as desirable (those that reduce the side effects or improve the therapeutic efficacy of the combined drugs) and undesirable (classified with an increased risk of adverse drug reactions and therapeutic ineffectiveness). This analysis was conducted using the specialized Drug Interactions Facts. Results: Study population was predominantly female (69%). Fourteen different DDIs episodes were identified, where 9 (64%) were characterized as desirable interactions. The desirable potential DDIs were the most frequent, occurring in 64% (n= 50) patients. The drugs most frequently involved in desirable interactions were captopril in combination with hydrochlorothiazide. Conclusions: Although the desirable DDIs were frequent, a high prevalence of undesirable DDIs was observed, suggesting the presence of the pharmacist in the validation of prescriptions, with the main goal of increasing patient safety.
Descrição
Tese de mestrado, Regulação e Avaliação do Medicamento e Produtos de Saúde, 2019, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Cuidados farmacêuticos Tratamento hipertensão Interações medicamentosas Teses de mestrado - 2019