Abordagem do tratamento das intoxicações por medicamentos, em hospital de referência

• Ano de defesa: 2026
• Autor(a) principal: Vieira, Maria Luisa de Sá
• Orientador(a): Fook, Sayonara Maria Lia
• Banca de defesa: Olinda, Ricardo Alves de , Mariz, Saulo Rios
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual da Paraíba; 24004014009P4
• Departamento: Centro de Ciências Biológicas e da Saúde - CCBS
• País: BR
• Palavras-chave em Português: Intoxicação; Toxicologia clínica; Suicídio
• Área do conhecimento CNPq: CIENCIAS BIOLOGICAS
• Link de acesso: https://repositorio.uepb.edu.br/handle/123456789/76897

Drug poisonings constitute a significant public health problem, associated with high morbidity and mortality and frequent demand for emergency services. Clinically, they present with varied manifestations and require treatment following protocols that include clinical support, use of antidotes, decontamination measures, and advanced elimination techniques. This study aimed to investigate the management of drug poisonings in a tertiary healthcare unit of the Brazilian Unified Health System (SUS). This is a cross sectional, retrospective, and descriptive study, based on the analysis of data referring to the 2023–2024 biennium, registered in CIATox-CG and collected in DATATOX/SINAN. 437 cases of poisoning by isolated medications were included, selected from the five most prevalent pharmacological classes. Sociodemographic variables, circumstances, clinical manifestations, severity, treatment, and outcome were analyzed. Treatment was compared to NPIS and UpToDate guidelines. Data were analyzed using descriptive statistics and Fisher’s exact test. Poisonings by the medications clonazepam (71.4%), risperidone (12.4%), sertraline (9.8%), phenobarbital (3.9%), and dipyrone (2.5%) were analyzed. There was a predominance of females (72.5%), with a significant association between sex and age group (p < 0.001). The age group with the highest prevalence was 10 to 39 years (72.8%). Regarding race, the majority were mixed race (54%), and the predominant level of education was complete secondary education (25.8%). Suicide attempt was the most prevalent circumstance (79.2%). Regarding the severity of the cases, the initial classification of mild predominated (69.8%). Phenobarbital presented a higher proportion of moderate cases and the only recorded death. The analysis between medication and outcome also showed a significant association (p = 0.0106), with most cases evolving to cure (87.3%). Regarding the toxic dose, there was great variation among the medications, with a high proportion of subtoxic exposures for clonazepam. Concerning the time elapsed between exposure and treatment, most cases involving clonazepam, sertraline, and dipyrone occurred within the first 6 hours. Clinically, neurological symptoms predominated. Management was based primarily on clinical support measures, considered effective in most cases. However, significant discrepancies were identified in relation to current guidelines, especially regarding the frequent and inappropriate use of gastric lavage (20.8%) and flumazenil.