RESUMO
Background Drug-drug interactions in patients taking warfarin may contribute to a higher risk of adverse events. Objective To identify and evaluate the prevalence and characteristics of potential DDIs with warfarin. Methods A cross-sectional study was performed in a Brazilian tertiary hospital. The electronic prescriptions of the patients receiving warfarin between January 2004 and December 2010 were analyzed. Socio-demographic, clinical, and therapeutic variables were collected. Warfarin drug-drug interactions were classified as either risk A, B, C, D, or X according to the Lexi-Interact™ Online database. Results A total of 3048 patients were identified who were prescribed warfarin. Of the 154,161 total drug prescriptions issued, 42,120 (27.3 %) were for warfarin. Evaluation of the prescriptions showed that 63.1 and 0.1 % of patients received concomitant drugs classified as having class D or X risk. It was found that 20,539 (48.7 %) prescriptions had at least one drug with a D or X risk. Patients were prescribed an average of 1.4 (±0.4) concomitant medications with a class D or X warfarin-DDI risk, the most frequent being acetylsalicylic acid and amiodarone. Conclusion The results demonstrate a high prevalence of concomitant drug prescriptions with the potential for clinically relevant DDIs with warfarin, the most frequent being acetylsalicylic acid and amiodarone.
Assuntos
Anticoagulantes/metabolismo , Interações Medicamentosas/fisiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/metabolismo , Hospitalização , Varfarina/metabolismo , Adulto , Idoso , Amiodarona/efeitos adversos , Amiodarona/metabolismo , Anticoagulantes/efeitos adversos , Aspirina/efeitos adversos , Aspirina/metabolismo , Brasil/epidemiologia , Estudos Transversais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Feminino , Hospitalização/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Centros de Atenção Terciária/tendências , Varfarina/efeitos adversosRESUMO
Objective: to identify the available evidence in the literature on the effect of multidisciplinary/interdisciplinary actions on health or in the treatment of the elderly with Alzheimers disease. Methods: an integrative revision made in databases, without accrual period of publication of articles, using controlled and non controlled descriptors. Results: the initial search resulted in a total of 508 studies, six of which were considered eligible for analysis. The results showed that the multidisciplinary/interdisciplinary actions used were effective in the care of the elderly with Alzheimers disease. The main effects observed were improved behavioral problems and cognitive function and the decrease use of psychotropic drugs. Conclusion: multidisciplinary/interdisciplinary actions can provide more effective care for the elderly with Alzheimers disease, maximizing their cognitive and functional levels, with improvement in the quality of life for both the patient and for the family/caregivers.
Objetivo: identificar as evidências disponíveis na literatura sobre o efeito das ações multidisciplinares/interdisciplinares na saúde ou no tratamento do idoso com Doença de Alzheimer. Métodos: revisão integrativarealizada em bases de dados, sem delimitação de período de publicação dos artigos, utilizando-se descritorescontrolados e não controlados. Resultados: a busca inicial resultou em um total de 508 estudos, dos quaisseis foram considerados elegíveis para análise. Os resultados mostraram que as ações multidisciplinares/interdisciplinares utilizadas foram efetivas no cuidado ao idoso com Doença de Alzheimer. Os principais efeitosobservados foram a melhoria dos problemas comportamentais e da função cognitiva e a diminuição do uso dedrogas psicotrópicas. Conclusão: as ações multidisciplinares/interdisciplinares podem oferecer cuidados maisefetivos para os idosos com Doença de Alzheimer, maximizando seu nível cognitivo e funcional, com melhoria daqualidade de vida tanto para o paciente, quanto para os familiares/cuidadores.