Avaliação da prescrição de medicamentos para idosos internados emServiço de Clínica Médica do Sistema Único de Saúde em um hospitalpúblico universitário brasileiro
| Ano de defesa: | 2009 |
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| Autor(a) principal: | |
| Orientador(a): | |
| Banca de defesa: | |
| Tipo de documento: | Dissertação |
| Tipo de acesso: | Acesso aberto |
| Idioma: | por |
| Instituição de defesa: |
Universidade Federal de Minas Gerais
UFMG |
| Programa de Pós-Graduação: |
Não Informado pela instituição
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| Departamento: |
Não Informado pela instituição
|
| País: |
Não Informado pela instituição
|
| Palavras-chave em Português: | |
| Link de acesso: | http://hdl.handle.net/1843/ECJS-7YYHUA |
Resumo: | The elderly population represents an adverse effect prone group. This iscaused primarily by the use of multiple drugs, during hospitalization. The medication profile used by an elderly group admitted to a public brazilian hospital was determined. This study was undertaken during a twelve month period in 2006. A group of 149 patients was studied during 157 hospital stays, no longer than 14 days. Some of the few parameters studied were: drug profile, drug interaction and number of times the drug prescription was modified, either in dosage or time of administration. The mean age of the patients in this study was 72.6 +/ 8.6 year-old and the mean number of prescribed drugs for each patient was 10 +/- 3.4. The most frequent clinical pathologies were upper respiratory diseases (38.9%), neoplasias (28.0%) and congestive heart failure (26.8%). The most prevalent comorbidities were high blood pressure (54.1%), congestive heart failure (26.8%) and diabetes mellitus (24.1%). The lack of comorbidities was noted for 15 patients, which represented 10%of the population studied. The frequency of inappropriate medication used was 38.9%, and included: Diazepam, Dexchlorpheniramine and Amiodarone. The total number of patients with renal failure was 66. Potentially nephrotoxic antibiotics, that demanded change in posology (concentration or time of administration) was 41 patients (62.1%). The most frequent antibiotics used were: Ceftriaxone (12.6%), Vancomycin (10.5%) and Cefepime (9.5%). The posology change was done for 34patients (82.9%) with renal failure, based on its creatinine clearance time. The mean number of antibiotics prescribed for patients with renal failure was 2.2 +/- 1.4 , with a minimum of 1 and a maximum of 6 antibiotics. A total number of 599 potential drug interactions was verified. The most frequent drug associations was Dypirone (Metamizole sodium)/ Captopril (10.0%), Dypirone/ Furosemide (8.6%) and Digoxin/ Metoclopramide (4.5%). Therefore, a significant association between inappropriate orpotentially nephrotoxic medication, and adverse effects caused by drug interaction was perceived, and the risk factor was the number of drugs prescribed in a day. After reviewing the potential drug effects, it was verified that there was a significant prevalence of drugs that would demand change in posology. |