Banca de DEFESA: DANIEL PAIVA MARQUES

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : DANIEL PAIVA MARQUES
DATE: 22/01/2025
TIME: 10:00
LOCAL: Faculdade de Farmácia
TITLE:

Profile of drug interactions in a Neonatal Intensive Care Unit and their associated clinical outcomes

KEY WORDS:

Profile of drug interactions in a Neonatal Intensive Care Unit and their associated clinical outcomes

PAGES: 43
BIG AREA: Ciências da Saúde
AREA: Farmácia
SUBÁREA: Farmácia clínica, assistência e atenção farmacêuticas
SUMMARY:

Introduction: Neonates in intensive care are susceptible to adverse events due to physiological immaturity, severity of cases, and the administration of multiple medications, increasing the risk of drug-drug interactions (DDIs). Unlike adult ICUs, DDIs in neonatology are not well characterized, especially concerning clinical relevance and outcomes. Many of these interactions are, in fact, unavoidable, and the lack of data complicates the assessment of their risk-benefit ratio. Objective: The aim of this study is to investigate the influence of potential DDIs on clinical outcomes in neonates under intensive care. Methodology: A prospective cohort study will be conducted in the Neonatal Intensive Care Unit (NICU) at the Maternidade Escola Januario Cicco (MEJC), where neonates will be evaluated daily for the occurrence of DDIs. Clinical-laboratory and pharmacotherapeutic parameters will be assessed daily. The influence of DDIs on neonates will be correlated with key clinical outcomes (death, treatment duration, and weight variation) through univariate and multivariate modeling (logistic and linear mixed-effects). Results: About 69.9% (255 patients) experienced one or more interactions during hospitalization, particularly involving antimicrobials (58.6%), potential arrhythmogenic interactions (27.4%), nephrotoxic interactions (18.3%), and those that may cause central nervous system depression (16.8%). The incidence of arrhythmia-related and CNS depression-related interactions tends to decrease over the days (β = -0.106; p < 0.01 and β = -0.088; p < 0.01, respectively). Conversely, interactions associated with nephrotoxicity increase during hospitalization (β = 0.097; p < 0.01). Potentially arrhythmogenic interactions raised heart rate by 5.9% (p < 0.001), those associated with nephrotoxicity decreased glomerular filtration values by 44% (p < 0.001), and those associated with CNS depression reduced heart rate by 6% (p < 0.001). Conclusion: DDIs were significantly associated with arrhythmias, nephrotoxicity, and central nervous system depression, negatively impacting critical clinical parameters. Although the risk of arrhythmias and CNS depression decreases over the course of hospitalization, the risk of nephrotoxicity increases. These findings emphasize the importance of careful monitoring and management of DDIs to improve clinical outcomes in neonates.

COMMITTEE MEMBERS:
Interna - 3315645 - FRANCISCA SUELI MONTE MOREIRA
Presidente - 2432313 - RAND RANDALL MARTINS
Externa à Instituição - YONARA MONIQUE DA COSTA OLIVEIRA - UFCG