Evaluación de las interacciones medicamentosas en el Área de Cuidados Intensivos Neonatales del Hospital Gineco Obstétrico Isidro Ayora.

Abstract

The objective of this study was to evaluate drug interactions (DI) in the Neonatal Intensive Care Unit (NICU) of the Isidro Ayora Gynecological -obstetric Hospital (IAGOH), over a period of 3 months, by accessing to medical records, and the use of databases such as Drugs 2.9, I Doctus 2.3.101 and Micromedex. Pharmacotherapeutic follow up (FU) through the review of daily medical prescriptions and laboratory parameters, allowed the identification of DI and their main adverse effects associated (AEA), subsequently the DI were classified according to their mechanism of action, therapeutic group and clinical relevance. A total of 50 patients were studied, presenting an incidence rate of 4.17 per 12 neonates / day of stay in the ICU, with an absolute rate of 10 DI / day and a median of 6 DI / day. The statistical analysis was carried out using SPSS 25, applying the Chi square test, relative risk (RR) and multivariate logistic regression (to obtain odds ratio). 835 IEF and 77 EA were registered; the most frequent associations were Fluconazole-Fentanyl (14%), Furosemide-Hydrocortisone (10%) and Fentanyl-Furosemide (4%) for serious, mild and moderate interactions respectively. With a 95% confidence interval the interactions Amikacina-Furosemide (OR = 6.6), Fentanyl-Morphine (OR = 6.8), Moxifloxacin-Furosemide (OR = 18.5), Hydrocortisone- Spironolactone- Enalapril (OR=24.4) and Furosemide-Amphotericin-Hydrocortisone-Salbutamol (OR = 49.3), were associated with potential ADR. The Intensive Care Unit (ICU) is the hospital area with the highest incidence of drug interactions in health institutions of 2nd and 3rd level of care, being the polymedication the main cause of this drug-related problems (DRPs) For this reason, it is considered that the assistance intervention of the Chemist or Pharmaceutical Biochemist through FU systems, as well as active Pharmacovigilance, would significantly reduce the number of potential DI, contributing to improve the quality of health care provided by the staff and reduce the risk of complications and / or prolongation of hospital stay.