PHARMACIST INTERVENTION ON IDENTIFICATION OF DRUG INTERACTIONS IN TERTIARY CARE HOSPITALS
DOI:
https://doi.org/10.22159/ijpps.2018v10i10.28399Keywords:
Cardiac, pDDIs, Neurology, Aspirin and clopidogrel, Carbamazepine-seizuresAbstract
Objective: The aim of this study was to assess the potential drug interactions (pDIs) among hospitalized patients in cardiac and neurology wards in 3 tertiary care hospitals.
Methods: A prospective, observational study was carried out for a period of 12 mo. A sample of 1330 patients was assessed for pDDIs using Micromedex®-2.7and drugs.com and www.dugs.com.
Results: A total of 1330 patients were analyzed and it was found that 685 were cardiac and 645 were neurology patients. The study identified 524 (76.49%) cardiac patients and 425 (65.89%) neurology patients, with potential drug-drug interactions (pDDIs) higher in male cardiac [298 (56.87%)] and male neurology [235 (55.29%)] patients, compared to females. Incidences of pDDIs were found to be higher in the age group of 60-70 y in cardiac [193 (36.83%)] and neurology [165 (38.84%)] patients and incidences of interactions based on duration of (4-6 d) hospital stays in cardiac were 380 (72.53%) and 275 (64.70%) in neurology patients respectively. Moreover, 51.90% cardiac patients and 57.41% neurology patients were found to be prescribed with more number of drugs in cardiac and neurology (7 drugs) patients, were found to have developed higher incidences of pDDIs. The most common drug interacting pair was between aspirin and clopidogrel combination, observed in 245 cardiac and 316 in neurology patients. Drug-food interactions (DFIs) were found with between atorvastatin-citrus fruits in cardiac and phenytoin-protein rich foods in neurology patients. The most common drug-disease interaction (D-DIs) was found to between isosorbide dinitrate–myocardial infarction in cardiac and carbamazepine-seizuresin neurology respectively.
Conclusion: It is recommended that physicians should be aware of the interactions among those drugs while prescribing, and careful monitoring is also required.
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References
Peterson JF, Bates DW. Preventable medication errors; identifying and eliminating serious drug interactions. J Am Pharm Assoc 2001;41:159-60.
Hamilton RA, Briceland LL, Andritz MH. Frequency of hospitalization after exposure to known drug-drug interactions in a medical population. Ann Pharmacother 1988;18:112-20.
Juurlink DN, Mamdani M, Kopp A, Laupacis A, Redelmeier DA. Drug-drug interactions among elderly patients hospitalized for drug toxicity. J Am Med Inform Assoc 2003;289:1652–8.
Astrand E, Astrand B, Antonov K, Petersson G. Potential drug interactions during a three-decade study period: a cross-sectional study of a prescription register. ‎Eur J Clin Pharmacol 2007;63:851–9.
Akram A, Muhammad UK, Irfanul H. Evaluation of potential drug-drug interactions in general medicine ward of teaching hospital in Southern India. J Clin Diagn Res 2015;9:10-3.
Becker ML, Kallewaard M, Caspers PW, Visser LE, Stricker BH. Hospitalisations and emergency department visits due to the drug-drug interactions-a literaturereview. Adv Pharmacoepidemiol Drug Saf 2007;16:641-51.
Delafuente JC. Understanding and preventing drug interactions in elderly patients. Crit Rev Oncol Hematol 2003;48:133-43.
Namazi S, Pourhatami S, Borhani-Haghighi A, Roosta S. Incidence of potential drug-drug interaction and related factors in hospitalized neurological patients in two Iranian teaching hospitals. Iran J Med Sci 2014;39:515-21.
Gourie Devi M. Epidemiology of neurological disorders in India: review of background, prevalence and incidence of epilepsy, stroke, Parkinson's disease and tremors. Neurol India 2014;62:588-98.
Shahabudin S, Bharti C, Faizal P. Surveillance of the potential drug-drug interactions in the medicine department of a tertiary care hospital. J Clin Diagn Res 2012;6:1258-61.
Kashyap M, D’Cruz S, Sachdev A, Tiwari P. Drug-drug interactions and their predictors: results from Indian elderly inpatients. Pharm Pract 2013;11:191-5.
Bose D, Sushma M. Pattern and predictors of drug-drug interactions among the patients admitted in neurology at a tertiary care hospital-a cross-sectional study. Int J Pharm Sci Res 2016;7:3458-64.
Hines LE, Murphy JE. Potentially harmful drug-drug interactions in the elderly: a review. Am J Geriatr Pharmacother 2011;9:364-77.
Sharma S, Chhetri HP, Alam K. A study of potential drug-drug interactions among hospitalized cardiac patients in a teaching hospital in Western Nepal. Indian J Pharmacol 2014;46:152-6.
Murtaza G, Ghani Khan MY, Azhar S, Ali Khan S, Khan TM. Assessment of potential drug-drug interactions and its associated factors in the hospitalized cardiac patients. Saudi Pharm J 2015;43:281-67.
Chelkebaa L, Alemsegedc F, Bedadaa W. Assessment of potential drug-drug interactions among outpatients receiving cardiovascular medications at Jimma University specialized hospital, South West Ethiopia. Int J Basic Clin Pharmacol 2013;2:144-52.
Fita R, Nurrochmah H, Wasilah R, Syed A. Potentiality of drug-drug interactions in hospitalized geriatric patients in a private hospital, Yogyakarta, Indonesia. Asian J Pharm Clin Res 2010;3:191-4.
Lubinga SJ, Uwiduhaye E. Potential drug-drug interactions on in-patient medication prescriptions at Mbarara Regional Referral Hospital (MRRH) in western Uganda: prevalence, clinical importance, and associated factors. Afr Health Sci 2011;11:499–507.
de Andrade TNG, Silvestre CC, Cunha LC. Pharmaceutical intervention assessment in the identification and management of drug interactions in an intensive care unit. J Appl Pharm Sci 2015;5:13-8.
Dumbreck S, Angela F, Nairn M, Wilson M, Treweek S, Mercer SW. Drug-disease and drug-drug interactions: a systematic examination of recommendations in 12 UK national clinical guidelines. Br Med J 2015;350:949.
Mannesse CK, Derkx FH, de Ridder MA, Man in ‘t Veld AJ, van der Cammen TJ. Contribution of adverse drug reactions to hospital admission of older patients. Age Ageing 2000;29:35-9.
Doan J, Zakrzewski-Jakubiak H, Roy J, Turgeon J. Prevalence and risk of potential cytochrome P450-mediated drug-drug interactions in older hospitalized patients with polypharmacy. Ann Pharmacother 2013;47:324–32.
Murtaza G, Ghani Khan MY, Azhar S, Ali Khan S, Khan TM. Assessment of potential drug-drug interactions and its associated factors in the hospitalized cardiac patients. Saudi Pharm J 2015;43:281-67.
Patel VK, Acharya LD, Rajakannan T, Surulivelrajan M, Guddattu V, Padmakumar R. Potential drug interactions in patients admitted to cardiology wards of a south Indian teaching hospital. Australas Med J 2011;4:9-14.
Jennifer Diedler, Niaz Ahmed, Marek Sykora. Safety of intravenous thrombolysis for acute ischemic stroke in patients receiving antiplatelet therapy at stroke onset. Stroke 2010;41:288-94.
Ismail M, Iqbal Z, Khattak MB, Javaid A, Khan TM. Prevalence, types, and predictors of potential drug-drug interactions in pulmonology ward of a tertiary care hospital. Afr J Pharm Pharmacol 2011;5:1303-9.
Aghajani MH, Sistanizad M, Abbasinazari M. Potential drug-drug interactions in post-CCU of a teaching hospital. Iran J Pharm Res 2013;12:243-8.
Fokter N, Mozina M, Brvar M. Potential drug-drug interactions and admissions due to drug-drug interactions in patients treated in medical departments. Wien Klin Wochenschr 2010;122:81-8.
Chavda N, Solanky P, Baria H, Naik R, Bharti K. Study of potential drug-drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region. Natl J Physiol Pharm Pharmacol 2015;5:236-42.
Avoid food and drug interaction. Available from: www.fda.gov/downloads/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/generaluseofmedicine/ucm229033.pdf. [Last accessed on 10 Jun 2010].
Anila KN, Emmanuel J. Clinical pharmacist governed anticoagulation service stroke unit of a tertiary care teaching hospital. Int J Pharm Res Bio-sci 2013;6:149-52.
Dimitriadis G, Tegos C, Golfinopoulou L, Roboti C, Raptis S. Furosemide-induced hyperglycaemia: the implication of glycolytic kinases. Horm Metab Res 1993;25:557-9.
Kameswaran Ramalingam, Shanmuga Sundaram Rajagopal, Krishnaveni Kandasamy, Karthikeyan Krishnan. Assessment of potential drug interactions among hospitalized patients at the cardiac and pulmonary departments in tertiary care hospitals. Asian J Pharm Clin Res 2018;11:443-9.
Athira Jith, Chaithanya T Kumar, Joffey Sara Joy, Kavitha Samy P, Sambath Kumar R. A prospective study of drug–drug interactions and adverse drug reactions among stroke patients in a tertiary care hospital. Asian J Pharm Clin Res 2016;9:100-4.
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