title: Prevalence of potential drug interactions in patients in an intensive care unit of a university hospital in Brazil.
abstract: OBJECTIVE
  To investigate the prevalence of potential drug interactions at the intensive care unit of a university hospital in Brazil and to analyze their clinical significance.
  
  
  METHODS
  This cross-sectional retrospective study included 299 patients who had been hospitalized in the intensive care unit of the hospital. The drugs administered during the first 24 hours of hospitalization, in the 50th length-ofstay percentile and at the time of discharge were analyzed to identify potential drug-drug and drug-enteral nutrition interactions using DRUG-REAXH software. The drugs were classified according to the anatomical therapeutic chemical classification.
  
  
  RESULTS
  The median number of medications per patient was smaller at the time of discharge than in the 50th length-of-stay percentile and in the first 24 hours of hospitalization. There was a 70% prevalence of potential drug interactions at the intensive care unit at the studied time points of hospitalization. Most of the drug interactions were either severe or moderate, and the scientific evidence for the interactions was, in general, either good or excellent. Pharmacodynamic interactions presented a subtle predominance in relation to pharmacokinetic interactions. The occurrence of potential drug interactions was associated with the number of medications administered and the length of stay. Medications that induced cytochrome P450, drugs that prolong the QT interval and cardiovascular drugs were pharmacotherapy factors associated with potential drug interactions.
  
  
  CONCLUSIONS
  The study showed that potential drug interactions were prevalent in the intensive care unit due to the complexity of the pharmacotherapies administered. The interactions were associated with the number of drugs, the length of stay and the characteristics of the administered medications.
authors: Faculty of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil. amreis@farmacia.ufmg.br
authors: Adriano Max Moreira
authors: AM
authors: Reis
authors: Silvia Helena De Bortoli
authors: SH
authors: Cassiani
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D016903:Drug Monitoring / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017891:Pharmacoepidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors