Dahiliye Yoğun Bakım Hastalarında Potansiyel İlaç Etkileşimlerinin, Farklı Veri Tabanları Kullanılarak Karşılaştırmalı Olarak İncelenmesi

Öz

İlaç etkileşimleri, yoğun bakım ünitelerinde sıkça karşılaşılan önemli bir sağlık sorunudur. Çalışmamızın amacı, daha güncel veriler elde etmek ve ilaç etkileşimleri konusunda farkındalığı artırmaktır. 2019 yılında yoğun bakım ünitesine yatışı yapılan 163 hastanın verileri retrospektif olarak analiz edildi. Hastaların ilaç listeleri günlük bazda değerlendirildi ve üç farklı çevrimiçi veri tabanı kullanılarak ilaç bilgileri analiz edildi. Toplam 1.834 ilaç reçetesi incelendi. En sık yatış tanıları pnömoni, akut böbrek yetmezliği ve gastrointestinal kanama idi. Eşlik eden hastalık sayısı ve ilaç sayısı arttıkça etkileşim sayısı anlamlı şekilde arttı. Bu ilişki özellikle kardiyovasküler hastalıklar için belirgindi. Etkileşim sayısı erkeklerde daha yüksekti. Etkileşimler Micromedex’te reçetelerin %82,9’unda, Lexicomp’ta %92,5’inde ve Drugs.com’da %95,5’inde tespit edildi. En sık kontrendike etkileşim linezolid ile tramadol arasında, en sık majör etkileşim ise aspirin ile enoksaparin arasında görüldü. İlaç etkileşimlerinin değerlendirilmesi, hasta sonuçlarının iyileştirilmesine ve gereksiz ekonomik yükün önlenmesine yol açabilir. Klinik hekimler bu değerlendirmeleri yaparken birden fazla kaynaktan yararlanmalıdır. Veri tabanları arasında önemli farklılıklar mevcuttur.

Anahtar Kelimeler

• İlaç etkileşimleri
• yoğun bakım
• polifarmasi
• veri tabanları

Comparative Evaluation of Potential Drug Interactions in Internal Medicine Intensive Care Unit Patients Using Different Databases

Öz

Drug interactions are a significant healthcare concern frequently encountered in intensive care units. Our study aims to acquire more up-to-date data and raise awareness of drug interactions. A retrospective analysis was performed on the data of 163 patients admitted to the intensive care unit in 2019. The patients' medication lists were evaluated on a daily basis, and drug information was analyzed using three different online databases, and1,834 medication orders were analyzed. The most common admission diagnoses were pneumonia, acute renal failure, and gastrointestinal bleeding. The number of interactions increased significantly with increasing comorbidities and number of drugs. This association was particularly evident for cardiovascular diseases. The number of interactions was higher in men. Interactions were identified in 82.9% of orders in Micromedex, 92.5% in Lexicomp, and 95.5% in Drugs.com. The most common contraindicated interaction was between linezolid and tramadol, while the most common major interaction was between aspirin and enoxaparin. Assessment of drug interactions can lead to improved patient outcomes and avoidance of unnecessary economic burden. Clinicians should use several sources when performing such assessments. There are significant differences between the databases.

Anahtar Kelimeler

• Drug Interactions
• Intensive Care
• Polypharmacy
• Databases

Kaynakça

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