Abstract
BackgroundClinically relevant potential drug-drug interactions are considered preventable adverse drug reactions.ObjectiveThe aim of this study was to ascertain the frequency of potential drug-drug interactions in acute ischemic stroke patients and to explore factors associated with occurrence of potentially contraindicated drug-drug interactions.MethodsThis observational retrospective cohort and nested case-control study was carried out among patients treated for acute ischemic stroke at the Neurological Intensive Care Unit in the Clinical Centre Kragujevac, Serbia. The potentially drug-drug interactions for each day of hospitalization were identifi ed using Micromedex® soft ware. Based on the existence or absence of potentially contraindicated drug-drug interactions, the participants were divided into a group of cases (n=111) and the control group (n=444).ResultsA total of 696 patients were analysed. All patients had a minimum of one potential drug-drug interaction during hospitalization. The most common drugs involved in potential drug-drug interactions were aspirin (8.02%), diclofenac (7.49%) and warfarin (7.14%). The number of medications prescribed for simultaneous use during hospitalisation and the use of antipsychotics in therapy signifi cantly increased the likelihood of potentially contraindicated drug-drug interactions aft er adjustment by means of logistic regression for 1.2 and 3 times, respectively.ConclusionsThis study suggests that patients with acute ischemic stroke are frequently exposed to potential drug-drug interactions. It is essential to identify potentially drug-drug interactions in these patients as early as possible in order to prevent adverse drug reactions and ensure safe recovery. Besides, full attention should be paid when adding each new medication in therapy, particularly when a neurologist decides to prescribe antipsychotics, such as risperidone.
Highlights
Potential drug-drug interactions occur when the effects of one drug may be altered by the effects of another drug(s) during their concomitant use
This study suggests that patients with acute ischemic stroke are frequently exposed to potential drugdrug interactions
Six hundred and forty (43, 48%) medical records were excluded from the study: 456 (30%) patients due to stay in the Neurological Intensive Care Unit (NICU) for less than 7 days, 141 (9.58%) patients because the diagnosis of stroke could not be confirmed at admission to hospital and 43 (2.92%) patients who met both exclusion criteria
Summary
Potential drug-drug interactions (pDDIs) occur when the effects of one drug may be altered by the effects of another drug(s) during their concomitant use. In a small percentage of cases, drug-drug interactions have a clinical relevance and can lead to serious harm; if recognized in time, they could be avoided by therapy modifications, and that is why they are considered to be preventable adverse drug reactions (ADRs) [1]. There are several online checkers varying in regard to sensitivity and specificity to detect pDDIs in routine practice, like Micromedex®, Drug Interaction Facts®, Lexi-Interact®, Pharmavista®, EpocratesRx®, etc [3]. These pieces of software are very practical and applicable in everyday. Relevant potential drugdrug interactions are considered preventable adverse drug reactions
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