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GRP-071 Evaluation of the Prescription of Intravenous Non-Steroidal Anti-Inflammatory Drugs Compared to the Recommendations of the Summary of Product Characteristics
  1. C Salazar Saldebenito,
  2. MJ De Dios Garcia,
  3. M Alcalde Rodrigo,
  4. C Gonzalez-Guerrero,
  5. JB Montoro Ronsano,
  6. M Munné Garcia,
  7. I Cardona Pascual
  1. Hospital Universitari Vall d’Hebron, Pharmacy, Barcelona, Spain

Abstract

Background Acute renal failure is a side effect of NSAIDs.

Purpose To assess the appropriateness of the intravenous prescription of dexketoprofen according to the dosage specifications depending on renal function following the recommendations of the Summary of Product Characteristics.

Materials and Methods An observational, retrospective study that analysed dexketoprofen prescriptions in surgical patients admitted to a tertiary hospital from January-September 2011. The estimated glomerular filtration rate (eGF) was calculated by the CKD-EPI formula, of reference in the hospital.

The Summary of Product Characteristics advises using the following posology for dexketoprofen:

  • 150 mg maximum daily dose for a maximum duration of 48 hours.

  • In patients with renal impairment:

    • GF < 50 mL/min: administration contraindicated

    • GF 50–80 mL/min: 25 mg/12 h. Maximum: 50 mg daily.

    • GF > 80 mL/min: No dosage adjustment required.

Results Prescriptions from 1946 patients were analysed. Of the patients, 54.3% were male and 45.7% female, with a mean age of 59.8 years (17–103). The mean serum creatinine levels were 0.84 mg/dL ± 0.43 and the mean eGF from the CKD-EPI calculation was 83.05 ± 26.17 mL/min/1.73m2.

In 58% of the admissions the drug was not prescribed correctly. Of these:

  1. 270 patients were prescribed dexketoprofen when the eFG was less than 50 mL/min/1.73m2;

  2. 550 of them had an unadjusted prescription with an eFG 50–80 mL/min/1.73m2.

  3. 370 patients with an eGF > 80 mL/min/1.73 m2 were prescribed NSAIDs for longer than 48 h.

Conclusions 58% of the intravenous NSAID prescriptions did not conform to the SPC recommendations. Due to this fact and in order to prevent renal toxicity it is recommended:

  1. To establish protocols for pain management during hospitalisation to limit the duration of these drugs to 48 hours and adjust the dose to the patient’s renal function.

  2. To enhance the proactive role of the pharmacist in individualised patient monitoring.

No conflict of interest.

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