Caracterización de las reacciones adversas a medicamentos como causa de ingreso a una unidad de cuidado intermedio en un hospital de tercer nivel de atención


Autoria(s): Rojas, Camilo; Vallejos, Alvaro; Calderón, Carlos
Contribuinte(s)

Calderon-Ospina, Carlos-Alberto

Vallejos, Alvaro

Data(s)

21/10/2014

31/12/1969

Resumo

Objetivo: Determinar la ocurrencia de reacciones adversas a medicamentos (RAM) como causa de ingreso a una unidad de cuidado intermedio de un hospital universitario. Materiales y Métodos: Se revisaron las historias clínicas de los pacientes admitidos a la Sala de Emergencias – Cuidado Intermedio (SALEM) entre septiembre y diciembre de 2012 que cumplieron los criterios de inclusión y se detectaron los casos sospechosos de reacción adversa a medicamento (RAM) que posteriormente fueron evaluados por cuatro investigadores respecto a la causalidad a través del Algoritmo de Naranjo, prevenibilidad usando los criterios de Shumock y Thornton y la clasificación clínica mediante el empleo del sistema DoTS. Resultados: Se encontraron 96 pacientes que presentaron 108 casos de RAM. Las RAM más frecuentes fueron las arritmias y la hemorragia de vías digestivas altas (12.04%), 20.3% de los casos correspondieron a fallos terapéuticos, y, los medicamentos mayormente asociados fueron el ácido acetil salicílico (15.74%) y el losartán (10.19%). 46 casos fueron catalogados como posibles y uno solo como definitivo. Usando la clasificación DoTS se estableció que en el 82.4% de los casos la dosis era colateral (dentro del rango de dosis terapéutica), 89.8% fueron independientes del tiempo, y entre los factores mayormente asociados a susceptibilidad a la RAM estuvieron las comorbilidades (41.7%) y la edad (49%). 44% de las RAM fueron prevenibles. Conclusión: Las RAM son una causa de ingreso no despreciable en una unidad de cuidado intermedio para las cuales existen diferentes sistemas de evaluación, y una cantidad significativa de ellas es prevenible. Se requieren más estudios a nivel nacional para evaluar la incidencia de estas y establecer estándares de clasificación y medidas para mitigar su efecto.

Objective: To determine the occurrence of adverse drug reactions (ADR) as a cause for admittance to an intermediate care unit in a university hospital. Materials and Methods: Clinical histories were reviewed for patients admitted to the Emergency Room – Intermediate Care Unit (ER) between September and December 2012 who met the inclusion criteria. Suspected cases of adverse drug reactions (ADR) were detected. Four researchers later evaluated causality using the Naranjo Algorithm, preventability using Shumock and Thornton criteria and clinical classifications based on the DoTS system. Results: A total of 96 patients presented 108 cases of ADR. The most frequent ADR were arrhythmias and hemorrhage of the upper digestive tract (12.04%). Therapeutic failure accounted for 20.3% of the cases. The most commonly associated medications were salicylic acetic acid (15.74%) and Losartan (10.19%). Forty-six cases were categorized as possible and only one as definitive. Using the DoTS classification, it was determined that in 82.4% of the cases the dosage was collateral (within the therapeutic range), 89.8% were independent of time, and the factors most associated with susceptibility to ADR included comorbilities (41.7%) and age (49%), among others. Forty-four percent of the ADR were preventable. Conclusion: ADR is a significant cause of admittance to an intermediate care unit, for which different evaluation systems exist and a significant amount of ADR is preventable. More national studies are needed to evaluate the incidence of ADR and establish classification standards and measures to mitigate their effects.

Formato

application/pdf

Identificador

http://repository.urosario.edu.co/handle/10336/9072

Idioma(s)

spa

Publicador

Facultad de Medicina

Direitos

info:eu-repo/semantics/embargoedAccess

Fonte

instname:Universidad del Rosario

reponame:Repositorio Institucional EdocUR

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TEME

Palavras-Chave #615.9 #Toxicología clínica #Administración de drogas #Medicina #Adverse drug reaction; intermediate care unit; pharmacovigilance; cause for hospital admittance; preventability; therapeutic failure.
Tipo

info:eu-repo/semantics/bachelorThesis

info:eu-repo/semantics/acceptedVersion