Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança

Detalhes bibliográficos
Autor(a) principal: Sousa, Daniel Gomes de
Data de Publicação: 2017
Outros Autores: danidg.sousa@gmail.com
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
Texto Completo: http://www.bdtd.uerj.br/handle/1/18320
Resumo: Cardiovascular disease presents itself among the leading causes of death in Brazil and in the Western world. At this scope, acute coronary syndrome (ACS) occupies a prominent place. Drug therapy administered mostly demand polypharmacy, that is, use of five or more drugs and different classes. Such an event predisposes the occurrence of potential drug drug interactions (PDDI), reducing the safety and efficacy of the therapeutic process. From the nursing perspective on patient safety, associated with the complex process of use of medicines, the present study has as objective the analysis of PDDI in patients with ACS. We conducted a retrospective descriptive cross-sectional study, with data collected from medical charts from january to december 2015, in cardiac intensive care unit of a university hospital in the city of Rio de Janeiro. Socio-demographic and clinical characteristics of the population was carried out, the pharmacological profile analysis and classification of PDDI in severity, mechanism, start time, level of documentation and risk index. For that, we used the database Micromedex® and scientific literature. Was used descriptive data analysis of qualitative and quantitative variables. For bivariate analysis, was applied the X2 test (chi-square) Pearson, T test and Mann-Whitney. The data were analyzed by the software Microsoft Excel® and Stata 11.0.® software. 390 prescriptions were analyzed where the average age was 58.8 ± 9.6 years, the main risk factors were: hypertension (95.4%), smoking (46.2%) and dyslipidemia (40,0%). The average number of drugs per prescription was 7,15±1,48. 2062 PIM were identified, with the average number of prescription 5,2±2,2, there was prevalence of the most severe level of 1,505 (73.0%), quick start time 740 (35.9%), pharmacodynamic mechanism 910 (44.1%), level of documentation good 1.025 (49.7%) and risk index C 1,166 (56.4%). About associations, the SCA CSSST group had a higher average number of PDDI compared to SCA SSSST group (p = 0.022). It was concluded that the study population presented a high level of vulnerability to PDDI, whose main consequence was the risk of bleeding, so it is of great importance to the implementation of clinical and managerial nursing interventions for monitoring and prevention of possible adverse events from drug therapy.
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spelling Albuquerque, Denilson Campos dehttp://lattes.cnpq.br/5219627521398631Andrade, Karla Biancha Silva ehttp://lattes.cnpq.br/8981588528468134Silvino, Zenith Rosahttp://lattes.cnpq.br/7539582782188269http://lattes.cnpq.br/9660042636471778Sousa, Daniel Gomes dedanidg.sousa@gmail.com2022-09-02T17:19:53Z2017-02-02SOUSA, Daniel Gomes de. Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança. 2017. 98 f. Dissertação (Mestrado em Enfermagem). Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017.http://www.bdtd.uerj.br/handle/1/18320Cardiovascular disease presents itself among the leading causes of death in Brazil and in the Western world. At this scope, acute coronary syndrome (ACS) occupies a prominent place. Drug therapy administered mostly demand polypharmacy, that is, use of five or more drugs and different classes. Such an event predisposes the occurrence of potential drug drug interactions (PDDI), reducing the safety and efficacy of the therapeutic process. From the nursing perspective on patient safety, associated with the complex process of use of medicines, the present study has as objective the analysis of PDDI in patients with ACS. We conducted a retrospective descriptive cross-sectional study, with data collected from medical charts from january to december 2015, in cardiac intensive care unit of a university hospital in the city of Rio de Janeiro. Socio-demographic and clinical characteristics of the population was carried out, the pharmacological profile analysis and classification of PDDI in severity, mechanism, start time, level of documentation and risk index. For that, we used the database Micromedex® and scientific literature. Was used descriptive data analysis of qualitative and quantitative variables. For bivariate analysis, was applied the X2 test (chi-square) Pearson, T test and Mann-Whitney. The data were analyzed by the software Microsoft Excel® and Stata 11.0.® software. 390 prescriptions were analyzed where the average age was 58.8 ± 9.6 years, the main risk factors were: hypertension (95.4%), smoking (46.2%) and dyslipidemia (40,0%). The average number of drugs per prescription was 7,15±1,48. 2062 PIM were identified, with the average number of prescription 5,2±2,2, there was prevalence of the most severe level of 1,505 (73.0%), quick start time 740 (35.9%), pharmacodynamic mechanism 910 (44.1%), level of documentation good 1.025 (49.7%) and risk index C 1,166 (56.4%). About associations, the SCA CSSST group had a higher average number of PDDI compared to SCA SSSST group (p = 0.022). It was concluded that the study population presented a high level of vulnerability to PDDI, whose main consequence was the risk of bleeding, so it is of great importance to the implementation of clinical and managerial nursing interventions for monitoring and prevention of possible adverse events from drug therapy.A doença cardiovascular apresenta-se entre as principais causas de morte no Brasil e no mundo ocidental. Neste escopo, a síndrome coronariana aguda (SCA) ocupa lugar de destaque. A terapia medicamentosa instituída em sua maioria demanda a polifarmácia, ou seja, o uso de cinco ou mais medicamentos concomitantes e em diferentes classes. Tal evento predispõe a ocorrência de potenciais interações medicamentosas (PIM), podendo resultar na redução da segurança e eficácia do processo terapêutico. Partindo da perspectiva do enfermeiro na segurança do paciente, associada ao complexo processo de utilização dos medicamentos, o presente estudo apresenta como objetivo, a análise das PIM em pacientes com SCA. Realizou-se uma pesquisa do tipo descritiva retrospectiva de corte transversal, com coleta de dados em prontuários de janeiro a dezembro de 2015, na unidade cardiointensiva de um hospital universitário no município do Rio de Janeiro. Foi realizada caracterização sociodemográfica e clínica da população, análise do perfil farmacológico e classificação das PIM quanto à gravidade, mecanismo, tempo de início, nível de documentação e índice de risco. Para tal utilizou-se a base de dados Micromedex® e literatura específica. Empregou-se análise descritiva para variáveis qualitativas e quantitativas. Para análise bivariada foi aplicado o Teste X2 (Qui-Quadrado) de Pearson, Teste T e U de Mann-Whitney. Os dados foram analisados pelos softwares Microsoft Excel® e Stata 11.0.®. Foram analisadas 390 prescrições onde a média de idade foi de 58,8 ± 9,6 anos. Os principais fatores de risco encontrados foram: hipertensão arterial sistêmica (95,4%), tabagismo (46,2%) e dislipidemia (40,0%). O número médio de fármacos por prescrição foi 7,151,48. Foram identificadas 2062 PIM, com número médio por prescrição de 5,22,2, houve prevalência do nível de gravidade maior 1.505 (73,0%), tempo de inicio rápido 740 (35,9%), mecanismo farmacodinâmico 910 (44,1%), nível de documentação bom 1.025 (49,7%), e 1.166 (56,4%) demandam monitoramento da terapia (índice de risco C). Quanto às associações, o grupo SCA CSSST apresentou número médio maior de PIM quando comparado ao grupo SCA SSSST (p=0,022). Conclui-se que a população do estudo apresentou alto grau de vulnerabilidade as PIM, cuja principal consequência identificada foi o risco de sangramento, desta forma, é de suma importância a implementação de intervenções clínicas e gerenciais de enfermagem para monitoramento e prevenção de possíveis eventos adversos advindos da terapia medicamentosa.Submitted by Diana CB/B (dianaamadosantos@gmail.com) on 2022-09-02T17:19:53Z No. of bitstreams: 1 Dissertação - Daniel Gomes de Sousa - 2017 - Completa.pdf: 1129985 bytes, checksum: f07e70bd5dc10718efa732ac754286f6 (MD5)Made available in DSpace on 2022-09-02T17:19:53Z (GMT). No. of bitstreams: 1 Dissertação - Daniel Gomes de Sousa - 2017 - Completa.pdf: 1129985 bytes, checksum: f07e70bd5dc10718efa732ac754286f6 (MD5) Previous issue date: 2017-02-02application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em EnfermagemUERJBrasilCentro Biomédico::Faculdade de EnfermagemDrug InteractionsAcute coronary syndromePatient safetySíndrome coronariana aguda - EnfermagemInterações MedicamentosasSegurança do pacienteCIENCIAS DA SAUDE::ENFERMAGEMInterações medicamentosas na síndrome coronariana aguda: gerenciamento de segurançaDrug drug interactions in acute coronary syndrome: safety managementinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALDissertação - Daniel Gomes de Sousa - 2017 - Completa.pdfDissertação - Daniel Gomes de Sousa - 2017 - Completa.pdfapplication/pdf1129985http://www.bdtd.uerj.br/bitstream/1/18320/2/Disserta%C3%A7%C3%A3o+-+Daniel+Gomes+de+Sousa+-+2017+-+Completa.pdff07e70bd5dc10718efa732ac754286f6MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/18320/1/license.txte5502652da718045d7fcd832b79fca29MD511/183202024-02-26 16:23:05.986oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T19:23:05Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false
dc.title.por.fl_str_mv Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança
dc.title.alternative.eng.fl_str_mv Drug drug interactions in acute coronary syndrome: safety management
title Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança
spellingShingle Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança
Sousa, Daniel Gomes de
Drug Interactions
Acute coronary syndrome
Patient safety
Síndrome coronariana aguda - Enfermagem
Interações Medicamentosas
Segurança do paciente
CIENCIAS DA SAUDE::ENFERMAGEM
title_short Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança
title_full Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança
title_fullStr Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança
title_full_unstemmed Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança
title_sort Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança
author Sousa, Daniel Gomes de
author_facet Sousa, Daniel Gomes de
danidg.sousa@gmail.com
author_role author
author2 danidg.sousa@gmail.com
author2_role author
dc.contributor.advisor1.fl_str_mv Albuquerque, Denilson Campos de
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/5219627521398631
dc.contributor.referee1.fl_str_mv Andrade, Karla Biancha Silva e
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/8981588528468134
dc.contributor.referee2.fl_str_mv Silvino, Zenith Rosa
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/7539582782188269
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/9660042636471778
dc.contributor.author.fl_str_mv Sousa, Daniel Gomes de
danidg.sousa@gmail.com
contributor_str_mv Albuquerque, Denilson Campos de
Andrade, Karla Biancha Silva e
Silvino, Zenith Rosa
dc.subject.eng.fl_str_mv Drug Interactions
Acute coronary syndrome
Patient safety
topic Drug Interactions
Acute coronary syndrome
Patient safety
Síndrome coronariana aguda - Enfermagem
Interações Medicamentosas
Segurança do paciente
CIENCIAS DA SAUDE::ENFERMAGEM
dc.subject.por.fl_str_mv Síndrome coronariana aguda - Enfermagem
Interações Medicamentosas
Segurança do paciente
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::ENFERMAGEM
description Cardiovascular disease presents itself among the leading causes of death in Brazil and in the Western world. At this scope, acute coronary syndrome (ACS) occupies a prominent place. Drug therapy administered mostly demand polypharmacy, that is, use of five or more drugs and different classes. Such an event predisposes the occurrence of potential drug drug interactions (PDDI), reducing the safety and efficacy of the therapeutic process. From the nursing perspective on patient safety, associated with the complex process of use of medicines, the present study has as objective the analysis of PDDI in patients with ACS. We conducted a retrospective descriptive cross-sectional study, with data collected from medical charts from january to december 2015, in cardiac intensive care unit of a university hospital in the city of Rio de Janeiro. Socio-demographic and clinical characteristics of the population was carried out, the pharmacological profile analysis and classification of PDDI in severity, mechanism, start time, level of documentation and risk index. For that, we used the database Micromedex® and scientific literature. Was used descriptive data analysis of qualitative and quantitative variables. For bivariate analysis, was applied the X2 test (chi-square) Pearson, T test and Mann-Whitney. The data were analyzed by the software Microsoft Excel® and Stata 11.0.® software. 390 prescriptions were analyzed where the average age was 58.8 ± 9.6 years, the main risk factors were: hypertension (95.4%), smoking (46.2%) and dyslipidemia (40,0%). The average number of drugs per prescription was 7,15±1,48. 2062 PIM were identified, with the average number of prescription 5,2±2,2, there was prevalence of the most severe level of 1,505 (73.0%), quick start time 740 (35.9%), pharmacodynamic mechanism 910 (44.1%), level of documentation good 1.025 (49.7%) and risk index C 1,166 (56.4%). About associations, the SCA CSSST group had a higher average number of PDDI compared to SCA SSSST group (p = 0.022). It was concluded that the study population presented a high level of vulnerability to PDDI, whose main consequence was the risk of bleeding, so it is of great importance to the implementation of clinical and managerial nursing interventions for monitoring and prevention of possible adverse events from drug therapy.
publishDate 2017
dc.date.issued.fl_str_mv 2017-02-02
dc.date.accessioned.fl_str_mv 2022-09-02T17:19:53Z
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dc.identifier.citation.fl_str_mv SOUSA, Daniel Gomes de. Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança. 2017. 98 f. Dissertação (Mestrado em Enfermagem). Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017.
dc.identifier.uri.fl_str_mv http://www.bdtd.uerj.br/handle/1/18320
identifier_str_mv SOUSA, Daniel Gomes de. Interações medicamentosas na síndrome coronariana aguda: gerenciamento de segurança. 2017. 98 f. Dissertação (Mestrado em Enfermagem). Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2017.
url http://www.bdtd.uerj.br/handle/1/18320
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dc.publisher.department.fl_str_mv Centro Biomédico::Faculdade de Enfermagem
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