Interações medicamentosas graves em gestantes de alto risco: uma análise de rede

Abstract

Introduction: High-risk gestation presents a high therapeutic complexity and this framework favors the occurrence of Potential Serious Drug Interactions (PDIs). Objective: This study aims to characterize the occurrence of Potential Drug Interactions (PDIs) in hospitalized pregnant women, main drugs involved and possible clinical outcomes via network analysis. Methods: Cohort trial with 297 high-risk pregnant women seen at the Januário Cicco Maternity School between August 2019 and August 2021. All patients with hospitalization time longer than 24h and having at least one prescribed medicine were included. This trial received approval from the institutional Research and Ethics Committee. Daily follow-up assessment via interviews and electronic medical chart analysis. PDIs were categorized using the Uptodate databank into minor, moderate and major, network analysis was made using the Gephi software applying the centrality criterion. Results: In total 297 patients were admitted it was possible to observe a predominance of both hypertension (32%) and gestational diabetes (35.7%), a prevalence of 85.3% and incidence of 146.3 PDIs per 1000 patients (95% CI 121.5 - 198.6) were observed. As for severe PDIs, the network analysis emphasized three drugs: levomepromazine associated with depressants and anticholinergics, dipyrone associated with NSAIDs, and ferrous sulfate combined with drugs with potential for chelation. Conclusions: The prevailing of IMPs in high-risk pregnant women is high and clinically they have been associated with impaired blood pressure control, anemia, anti muscarinic effects, and CNS depression.