Potenciais interações medicamentosas no tratamento da leucemia linfóide aguda

Abstract

Leukemia is the most frequent type of cancer in children, being considered the second most common cause of child mortality in Brazil. Acute Lymphocytic Leukemia (ALL) represents 75% of all types of acute leukemia in children. Its treatment is long and complex, being polypharmacy a very common characteristic, what contributes to the occurrence of possible drug interactions. The aim of this study was to carry out an inventory regarding the potential drug interactions that result from the combination of the different pharmacological agents used in the beginning of ALL treatment. It is as descriptive study with quantitative data analysis, and were included all patients admitted to the Pediatric Haemato-Oncology service at Hospital Universitário de Santa Maria, in Santa Maria, Rio Grande do Sul, Brazil, between April 2012 and April 2014, for the treatment of ALL. The daily prescriptions of all participating patients were assessed and all the co-administered medication was included for the analysis of potential drug interactions by using the Micromedexelectronic database. The sample corresponded to 869 prescriptions and 4481 prescribed drugs. Sixty-six distinct drugs were identified and the presence of potential drug interactions was verified in 100% of the samples, in a total of 758 potentially interactive combinations, during the first hospitalization. 60,8% of these combinations were classified as of major severity. Most drugs used belong to the class of anti-infectives, and Sulfamethoxazole/Trimethoprim was the most used drug. It was possible to observe that the entire sample was exposed to polypharmacy and to potentially interactive combinations during the first stage of the treatment, thus evidencing the relationship between polypharmacy and the risk of drug interactions. The confirmation of a significant number of potentially interactive combinations, most of them of major severity, reaffirms the need for the multiprofessional team to improve their practice in the sense of expanding their knowledge regarding this subject, aiming at improving the quality of the service offered and reducing the harm for patients.