Potential drug-drug interactions in prescriptions of hospitalized patients with respiratory diseases in a university hospital during the Amazonian winter

Abstract

Objective: To identify and demonstrate the prevalence Potential drug-drug interactions (DDI) in hospitalized patients with respiratory diseases during the Amazonian winter, also seeking to classify DDI according to risk and clinical management. Methods: A descriptive, cross-sectional, retrospective study with a quantitative approach of patients admitted to the university hospital in Amazonian winter. 40 patients were selected and 120 prescriptions were answered, collecting data such as patient identification, diagnostic hypothesis, and medications used. The investigation of DDI occurred in the period of 24 hours, 7 and 14 days. The identification and classification of DDI risks are carried out by the LexicomP® support platform via the UpToDate® software. Descriptive statistics were performed on the data, which were compiled in a Microsoft Excel® spreadsheet. Results: 55% of patients were men, the mean age was 46 ± 22 years old, the mean length of stay was 41 ± 30 days, most patients had Pulmonary Tuberculosis, Unspecified Pneumonia and Pleural Effusion. In this population, the analysis of the risk classification DDI showed a total of 989, with approximately 8 DDI/prescription. A DDI prevalence of low risk (classes C and B). Among the drugs involved, omeprazole x dipyrone, dipyrone x captopril, these being risk B and C, respectively. Despite the majority of DDI being low risk, there were also high risk ones, not recommended (Class X), totaling 51 DDI, the most prevalent was omeprazole and rifampicin, which can induce gastrointestinal discomfort, and its management consists of replacing make omeprazole for pantoprazole. In addition, the second most frequent X-risk interaction was scopolamine plus ipratropium bromide, which could induce anticholinergic effects in patients. And a DDI was also detected between Promethazine x Bromopride with a risk of neuroleptic malignant syndrome or extrapyramidal reactions, these should be managed individually. Conclusion: A high occurrence of DDI was identified in the prescriptions of patients with respiratory diseases during the putative Amazonian winter period. Despite being mostly low risk, DDI classified as X were present and consequently demanding clinical management. On the other hand, for evaluate its clinical repercussions, more methodologically different studies are needed. Still, knowledge of DDI can help establish appropriate therapeutic strategies in this population.