Abstract
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.
Highlights
Drug-drug interactions are defined as two or more drugs interacting in such a manner that the effectiveness or toxicity of one or more drugs is altered [1, 2]
Out of 685 cardiac patients, 524 (76.49%) had found to be potential drug-drug interactions (pDDIs). 856 pDDIs were found in 524 cardiac patients. 795 pDDIs were found in 645 neurology patients
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. 51.90% patients and 57.41%, cardiac and neurology patients prescribed with more than 7 drugs in cardiac and neurology patients were found to have developed higher incidences of pDDIs
Summary
Drug-drug interactions are defined as two or more drugs interacting in such a manner that the effectiveness or toxicity of one or more drugs is altered [1, 2]. Polypharmacy, geriatric and patients with co-morbidities are considered as one of the major risk factors in the precipitation of Drug-Drug interactions (DDIs) [5]. The issue of drug interactions is a global concern, a study of the US reported that 30.3% patients aware at risk of DDIs [7]. It was estimated that about 46.3% drug interactions were seen in neurological patients in a cross-sectional study conducted in Karnataka and majority of the DDIs were moderate in severity and required therapeutic monitoring [12]. An exhaustive literature search did not reveal as many published reports on DDIs in neurological disorders in Indian population or other countries, similar studies in other hospital wards has been done
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