title: Drug incompatibilities in the adult intensive care unit of a university hospital.
abstract: OBJECTIVE
  This study sought to identify the physical and chemical incompatibilities among the drugs administered intravenously to patients admitted to an adult intensive care unit. We also aimed to establish pharmaceutical guidelines for administering incompatible drugs.
  
  
  METHODS
  This cross-sectional, prospective, and quantitative study was conducted from July to September 2015. Drug incompatibilities were identified based on an analysis of the patient prescriptions available in the hospital online management system. A pharmaceutical intervention was performed using the guidelines on the preparation and administration of incompatible drugs. Adherence to those guidelines was subsequently assessed among the nursing staff.
  
  
  RESULTS
  A total of 100 prescriptions were analyzed; 68 were incompatible with the intravenous drugs prescribed. A total of 271 drug incompatibilities were found, averaging 4.0 ± 3.3 incompatibilities per prescription. The most commonly found drug incompatibilities were between midazolam and hydrocortisone (8.9%), between cefepime and midazolam (5.2%), and between hydrocortisone and vancomycin (5.2%). The drugs most commonly involved in incompatibilities were midazolam, hydrocortisone, and vancomycin. The most common incompatibilities occurred when a drug was administered via continuous infusion and another was administered intermittently (50%). Of the 68 prescriptions that led to pharmaceutical guidelines, 45 (66.2%) were fully adhered to by the nursing staff.
  
  
  CONCLUSIONS
  Patients under intensive care were subjected to a high rate of incompatibilities. Drug incompatibilities can be identified and eliminated by the pharmacist on the multidisciplinary team, thereby reducing undesirable effects among patients.
authors.affiliation: Programa de Residência Integrada Multiprofissional em Saúde, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Naiane Roveda
authors.initials: NR
authors.lastname: Marsilio
authors.affiliation: Unidade de Assistência Farmacêutica, Serviço de Farmácia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Daiandy da
authors.initials: Dd
authors.lastname: Silva
authors.affiliation: Programa de Pós-Graduação em Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Denise
authors.initials: D
authors.lastname: Bueno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004344:Drug Incompatibility; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control; D005260:Female; D019983:Guideline Adherence; D006785:Hospitals, University; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000737:chemistry; D010595:Pharmacists / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D024382:Professional Role; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations