title: Clinical relevancy and risks of potential drug-drug interactions in intensive therapy.
abstract: OBJECTIVE
  Evaluate the potential Drug-Drug Interactions (pDDI) found in prescription orders of adult Intensive Care Unit (ICU) of a Brazilian public health system hospital; quantify and qualify the pDDI regarding their severity and risks to the critical patient, using the database from Micromedex®.
  
  
  METHODS
  Prospective study (January-December of 2011) collecting and evaluating 369 prescription orders (convenient sampling), one per patient.
  
  
  RESULTS
  During the study 1844 pDDIs were identified and distributed in 405 pairs (medication A × medication B combination). There was an average of 5.00 ± 5.06 pDDIs per prescription order, the most prevalent being moderate and important interactions, present in 74% and 67% of prescription orders, respectively. In total, there were 9 contraindicated, 129 important and 204 moderate pDDIs. Among them 52 had as management recommendation to "avoid concomitant use" or "suspension of medication", while 306 had as recommendation "continuous and adequate monitoring".
  
  
  CONCLUSIONS
  The high number of pDDIs found in the study combined with the evaluation of the clinical relevancy of the most frequent pDDIs in the ICU shows that moderate and important interactions are highly incident. As the majority of them demand monitoring and adequate management, being aware of these interactions is major information for the safe and individualized risk management.
authors.affiliation: Department of Clinical Pathology, Faculty of Medical Sciences (FCM), State University of Campinas (UNICAMP), Alexander Fleming, 105, 13083-881 Campinas, SP, Brazil.
authors.forename: Aline Teotonio
authors.initials: AT
authors.lastname: Rodrigues
authors.affiliation: Department of Clinical Pathology, Faculty of Medical Sciences (FCM), State University of Campinas (UNICAMP), Alexander Fleming, 105, 13083-881 Campinas, SP, Brazil.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Stahlschmidt
authors.affiliation: Pharmacy Service, Hospital of Clinics of State University of Campinas (HC/UNICAMP), Vital Brasil, 251, 13083-888 Campinas, SP, Brazil.
authors.forename: Silvia
authors.initials: S
authors.lastname: Granja
authors.affiliation: Department of Surgery, Intensive Care Unit, Faculty of Medical Sciences, University of Campinas (FCM-UNICAMP), Campinas, SP, Brazil.
authors.forename: Antonio Luis Eiras
authors.initials: AL
authors.lastname: Falcão
authors.affiliation: Department of Clinical Pathology, Faculty of Medical Sciences (FCM), State University of Campinas (UNICAMP), Alexander Fleming, 105, 13083-881 Campinas, SP, Brazil; Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Sérgio Buarque de Holanda, 250, Piso II, E06, 13083-859 Campinas, SP, Brazil.
authors.forename: Patricia
authors.initials: P
authors.lastname: Moriel
authors.affiliation: Department of Clinical Pathology, Faculty of Medical Sciences (FCM), State University of Campinas (UNICAMP), Alexander Fleming, 105, 13083-881 Campinas, SP, Brazil; Faculty of Pharmaceutical Sciences, University of Campinas (UNICAMP), Sérgio Buarque de Holanda, 250, Piso II, E06, 13083-859 Campinas, SP, Brazil.
authors.forename: Priscila Gava
authors.initials: PG
authors.lastname: Mazzola
keywords: ATC, Anatomical Therapeutic Chemical; CYP, Cytochrome P; ICU, Intensive Care Unit; Intensive Care Unit; Potential drug–drug interactions; Prescription orders; pDDI, Potential Drug–Drug Interaction