Laboratory alterations caused by drugs acting on the nervous system which are part of the List of essential drugs of a northeastern Brazilian municipality




Objective: To conduct a survey on the interference of drugs in laboratory tests that are included in the Anatomical Therapeutic Chemical (ATC) N classification (drugs that act on the nervous system), present in the Municipal List of Essential Drugs (REMUME) of the city of Fortaleza, in the state of Ceará. Methods: This is exploratory research. We used as search descriptors the names of the drugs present in the 3rd edition REMUME 2022, the Electronic Bulletin of the National Health Surveillance Agency and UpToDate® databases. Next, the laboratory interferences identified were classified into in vitro and in vivo. Furthermore, in vivo changes were grouped according to the frequency of adverse reactions, based on what is recommended by the Medical Dictionary for Regulatory Activities. Data were compiled and analyzed using Microsoft Office Excel® 2013 software. Results: Of the 50 drugs analyzed, it was observed that only 16% showed no interference in vitro and/or in vivo. The following therapeutic classes exhibited the most in vitro laboratory alterations; anticonvulsants (12%, n=6), followed by antidepressants (6%, n=3). With regard to in vivo alterations, anticonvulsants also were responsible for most of the changes in laboratory testing (22%, n=11), followed by antidepressants (18%, n=9). Biperidene, clobazam, hydroxyzine, nicotine, pramipexole, pyridostigmine, rivastigmine, and rasagiline did not show alterations in vitro or in vivo, according to the literature consulted. The main organic alterations that affects laboratory results observed in this study, involved the hematological system, with reactions of unknown frequency. Conclusion: We found REMUME drugs from the city of Fortaleza-CE, used in clinical situations involving the central nervous system, can cause laboratory changes. Altered laboratory results caused by the drugs and not by the pathology itself may compromise patient’s therapy, generating erroneous medical conducts and consequently iatrogenesis, culminating in long hospital stays and increasing health care costs.


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GOMES LS, PEREIRA BR, DIAS LM, MESQUITA JL, PASSOS BV, SOUSA MH. Laboratory alterations caused by drugs acting on the nervous system which are part of the List of essential drugs of a northeastern Brazilian municipality. Rev Bras Farm Hosp Serv Saude [Internet]. 2024Mar.23 [cited 2024Jul.20];15(1):1020. Available from: