Severe drug interactions in paracetamol poisoning in Brazil: a cross-sectional study based on the Notifiable Diseases Information System
Objective: To describe paracetamol poisoning associated with other drugs and to analyze factors associated with severe drug interactions. Methods: Cases of poisoning involving paracetamol available in the 2017 Notifiable Diseases Information System were analyzed. Records containing association with pesticides, food, alcohol and drugs of abuse were excluded. Drugs related to poisoning were identified, coded and grouped according to the Anatomical Therapeutic Chemical classification. The intensity of the interaction was analyzed to determine the severity according to Micromedex®. To investigate the factors associated with severe drug interactions, we estimated the prevalence ratios (PR) by Poisson regression, which considered the following variables: region, age group, gender, ethinicity, month of occurrence, day of the week, association with analgesics, anti-inflammatories and suicide attempts. Results: In 2017, 763 notifications of poisoning by paracetamol with other drugs were identified. There were 5.6 cases of suicide attempt for each unintentional case. Multivariate analysis indicated that severe drug interactions were more frequent in those aged over 37 years (PR=2.73; 95% CI 1.35 to 5.54), analgesic users (PR=2.56; 95% CI 1.52 to 4.30) and anti-inflammatory drug users (PR=4.04; 95% CI 2.41 to 6.78) . Conclusion: Serious drug interactions in cases of paracetamol poisoning have been associated with analgesics, anti-inflammatory drugs, adults and suicide attempts.
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