porPrevalence and classification of drug-drug interactions in intensive care patients

Objective: To identify, quantify and classify drug-drug interactions among the medications most frequently dispensed in the adult ICU of a large private tertiary care hospital over a period of 30 days. Methods: Collection of data from an electronic database on consumption and drug-drug interactions of the 50 most frequently dispensed medications. Results: During the period studied, 395 commercial brands were dispensed, representing 258 active ingredients, classified into ten large groups and 36 subgroups according to Anatomical Therapeutic Chemical criteria. Four hundred and nine drug-drug interactions were identified - 174 were severe and 235 moderate. The drug-drug interactions were classified as pharmacokinetic (30%), neurologic (22%), and cardiologic (18%), and together accounted for 70% of drug-drug interactions tracked with the Micromedex Healthcare Series (R) electronic database. The other interactions were classified as hematologic, renal, endocrine/metabolic, respiratory, muscular, gastrointestinal, hepatic, and others, comprising the remaining 30%. Conclusion: Drug-drug interactions are very common in ICU patients. They may potentially produce a significant economic and clinical impact. The use of electronic computerized systems allows a better approach for medical prescriptions making it possible to prevent and intervene in cases of harmful interactions and adverse events even before medications are dosed.