Uso de medicamentos rastreadores na identificação e notificação de reações adversas em um hospital universitário

Abstract

Medications are widely used in medical practice; however, it is crucial to consider the risks associated with their use. Pharmacovigilance is an area dedicated to studying medication-related issues, including adverse drug reactions (ADRs). The aim of this study was to identify and report ADRs using trigger medications in prescriptions of hospitalized patients at a University Hospital in João Pessoa – PB. This was a descriptive, cross-sectional, retrospective, and documentary study conducted using the Trigger Tool method, supported by the list of trigger medications conceived by the Institute of Healthcare Improvement from August to December 2022. A list of seven trigger medications was compiled. Prescriptions of all hospitalized patients during this period were evaluated, and patients prescribed at least one trigger medication were included in the analysis. The indication for medication use was then verified with the pharmacovigilance team to assess the occurrence of adverse reactions. Out of 5,200 prescriptions analyzed, 754 contained trigger medications. Among them, 20 were analyzed for suspected adverse reactions, and 20 cases presented confirmed adverse reactions. The average age of patients with suspected ADRs was 46.5 years, ranging from 20 to 83, with the majority being female (55%). The trigger medications responsible for detecting ADRs were ondansetron 4 mg (55%), dexchlorpheniramine 2mg (35%), promethazine 25mg/mL (5%), and protamine 1% - 5mL (5%). The most common ADRs were nausea and vomiting (60%) and pruritus (35%). Vancomycin (25%), tramadol (20%), and morphine (20%) were the standout suspected medications causing ADRs. All reactions were "probable" according to the Naranjo algorithm, with the majority being "Mild" severity (90%), and 10% being "Moderate." The use of the Trigger Tool methodology by pharmacists to actively identify adverse drug reactions proved to be effective in monitoring events in hospitalized patients in the units analyzed in this study.