Pharmacy Service, National Cancer Institute José Alencar Gomes da Silva - Cancer Hospital II, Rio de Janeiro, RJ, Brazil.
J Oncol Pharm Pract. 2023 Jul;29(5):1103-1111. doi: 10.1177/10781552221091298. Epub 2022 Apr 11.
The aim of this study was to identify the main therapeutic classes prescribed to ovarian cancer patients and the potential drug interactions (PDI) during hospitalization. This descriptive retrospective work was carried out in a referral gynecological cancer hospital from the Brazilian public health system. The first 24 h inpatients' prescriptions were evaluated to obtain the pharmacological profile data. Clinical and epidemiological characteristics were collected through the analysis of electronic medical records. A total of 236 patients were included in the study, of which 154 (65.25%) had PDI, with a mean of 1.43 ± 1.76 interactions per patient. The main therapeutic classes prescribed were analgesics and antiemetics (35%), compatible with the oncologic supportive care. All PDI identified (n = 331) were categorized by severity, using the Micromedex database, resulting in: 1.51% contraindicated, 67.67% major, 24.77% moderate, and 6.04% minor. The more prevalent PDI were ondansetron/tramadol (22.05%) and metoclopramide/tramadol (7.25%), both major. An association between PDI and polypharmacy was observed, which did not occur between age or length of stay. Ongoing prescription review by the pharmaceutical team is necessary to identify, monitor, and manage PDI-related adverse events and carry out required interventions with patients, physicians, and nurses. Taken together the data showed that even in a specialized hospital, the complexity of the pharmacotherapy can cause harm to the ovarian cancer patient. The clinical pharmacist acting in a multidisciplinary team is important for improving patient safety in oncology services.
本研究旨在确定卵巢癌患者住院期间主要的治疗类别和潜在的药物相互作用（PDI）。这是一项描述性的回顾性工作，在巴西公共卫生系统的一家转诊妇科癌症医院进行。评估了前 24 小时住院患者的处方，以获取药物治疗概况数据。通过电子病历分析收集了临床和流行病学特征。共有 236 名患者纳入研究，其中 154 名（65.25%）有 PDI，平均每名患者有 1.43±1.76 种相互作用。开的主要治疗类别是镇痛药和止吐药（35%），符合肿瘤支持性护理。使用 Micromedex 数据库对所有确定的 PDI（n=331）按严重程度进行分类，结果为：1.51%禁忌，67.67%主要，24.77%中度，6.04%轻微。更常见的 PDI 是昂丹司琼/曲马多（22.05%）和甲氧氯普胺/曲马多（7.25%），均为主要 PDI。观察到 PDI 与多药治疗之间存在关联，而与年龄或住院时间无关。药物治疗团队需要持续审查处方，以识别、监测和管理与 PDI 相关的不良事件，并与患者、医生和护士一起进行必要的干预。综上所述，数据表明，即使在专科医院，药物治疗的复杂性也可能对卵巢癌患者造成伤害。在多学科团队中发挥作用的临床药师对于提高肿瘤服务患者的安全性非常重要。
