Drug interactions with greater toxic potential in patients admitted to Intensive Care Units

a literature review

Abstract

The prescription of medications under conditions of hospitalization in the Intensive Care Unit (ICU) is twice as high as in the ward, favoring more frequent drug interactions and increasing the risk of adverse events associated with medications. The objective of the present study was to review the scientific literature in order to understand the profile of Drug Interactions (DI) and characterize the most prevalent and potentially toxic pharmacological interactions in ICU patients. To this end, a bibliographical search was conducted in the MEDLINE, LILACS and EMBASE databases. After selecting studies published between 2017 and 2023, 24 articles were included in the present review. The results of the studies analyzed indicate that the majority of interactions are due to pharmacodynamic mechanisms, with cardiovascular drugs being the main responsible for DI. Combinations of clopidogrel and aspirin, clopidogrel and pantoprazole, followed by the combination of azithromycin and salbutamol, were the combinations most commonly related to DIs. Understanding the main DIs helps healthcare professionals optimize therapy and obtain better results for patients, preventing the occurrence of a potentially fatal error at some point during their ICU stay. The assistance of appropriate software and the participation of the clinical pharmacist as responsible for monitoring DIs and notifying the doctor about possible problems arising from prescriptions can reduce the incidence of adverse effects related to DIs under ICU admission conditions.