Frequency Of Drug Interactions Research Articles

Drug interactions and drug-food interactions in patients receiving diabetes mellitus treatment

Drug interaction is the change of a drug's effects by the preceding and/or concurrent administration of a different substance (precipitant drug). Drug interactions may either intensify or weaken the effects that one or both medications are supposed to have. Any drug's therapeutic, preventative, or diagnostic capabilities may change as a result. A major contributing factor to the prevalence and occurrence of adverse medication responses and adverse drug events might be drug interactions. Patients receiving drug combinations or polypharmacy or suffering from co-morbid diseases like diabetes, hypertension, peptic ulcer, fungal infections, and neurodegenerative disorders have a much higher rate of occurrence and incidence of drug interactions. As these patients receive prolonged and multiple treatments, the risk of drug interactions rises. Conclusion: Drug interactions are more likely to occur in diabetes patients who are also getting a mix of medications for diabetic complications. As a result, the frequency of drug interactions is fast increasing. Because of its increasing incidence and the corresponding rise in morbidity and mortality, diabetes mellitus has been regarded as a major public health concern globally. The major goal of this review study is to highlight the different medication interactions that may occur between drugs and foods, as well as to record any unfavorable side effects of other treatments used in conjunction with antidiabetic drugs in diabetic patients.

Potential Drug-Drug Interactions in Patients Using Warfarin, Heparin, and Enoxaparin

Background: Drug-drug interactions can often lead to preventable adverse drug events and hospitalization. However, the clinical outcome of a potential drug-drug interaction that may range from minor alterations to major toxicity or loss of effect is often unknown. Drugs with narrow therapeutic index are more susceptible to the outcomes of interactions. Anticoagulants are one of the drug groups prone to drug-drug interactions and have important side effects. in this retrospective study, the frequency of drug-drug interactions involving warfarin, heparin and enoxaparin was investigated. Methods: Overall, 300 patients (including 55% males with an average age of 50.75 years) participated in this study, and for each anticoagulant, 100 patient orders were randomly selected from the hospital system. Drug-drug interactions were evaluated using the Micromedex drug interaction checker. Results: A total of 1691 drug-drug interactions (306 major, 253 moderate, and 89 minor interactions) were recorded of which only 648 (average 2.16) involved warfarin, heparin, or enoxaparin. Most interactions were recorded in patients admitted to the cardiovascular surgery (n=312) and cardiology (n=119) wards. There was a significant relationship between the number of drugs and the frequency of interaction. warfarin had the highest number of interactions (n=388). Conclusion: The frequency of drug interactions is high in patients on anticoagulant therapy. The efficacy and safety of these drugs can be affected by drug interactions. Accordingly, these interactions should always be considered, especially in patients with multiple drug use. Efficient monitoring strategies should be employed to optimize treatment while reducing adverse effects.

Comparative Assessment of Drug Drug Interactions Among Public and Private Sector Hospitals

Background: Drug drug interactions (DDIs), being one of the most preventable drug related hazards having serious life threatening adverse consequences or at least results in therapeutic failure . Aim : T o confirm the drug drug interactions among medical patients at private and public sector hospitals of Jhelum and Kharian . Study d esign: Comparative study. Methodology: The collected data was analyzed for drug interactions. P atients who were being prescribed less than two drugs along with topical drugs (ointments, creams, ear drops and eye drops) were excluded. Information on prescriptions was retrieved from the hospital prescription. SPSS for windows version 20.0 was used to analyze the data. Results were presented as frequency and percen tage. Results: The results showed that the public sector showed 1640 drug interactions, that is 75%; on the other hand, the private sector showed 260 drug interactions, that is 41%. Conclusions: We concluded that frequency of drug interactions were more in public sector hospitals. Hence, a possible reason for such a result could be the greater patient load on public sector hospitals and less number of appointed doctors in such facilities. Keywords: Adverse Drug I nte raction, Drug Related Problems and Drug Drug Interaction.

Comparative assessment of drug interactions in pediatrics at private and public sector hospitals of Sargodha and Faisalabad

The present study was performed in the cities of Faisalabad and Sargodha, and pediatric in-patient prescriptions were collected from four private and D.H.Q hospitals of these two cities. The collected data of 1420 prescriptions was analyzed for drug interactions by using the software developed by the Medical Letter. The drug interactions found were divided into severe, moderate and mild depending on the type of effect produced. The results showed that the public sector showed 820 drug interactions, that is 74.55%; on the other hand, the private sector showed 130 drug interactions, that is 40.63%. The private sector hospital of Faisalabad showed only 40 drug interactions, that is 20%; while 90 drug interactions, that is 75% were found in private sector hospital of Sargodha. The public sector hospital of Sargodha showed 390 drug interactions, 92.86% and 430 drug interactions, that is 63.24% were found in public sector hospital of Faisalabad. The results showed that the frequency of drug interactions was much less in private hospitals as compared to the public sector hospitals. The possible reason was the presence of clinical pharmacists in more numbers in the private hospitals as compared to the public sector hospitals. It is therefore required that the role of pharmacist should be increased in the hospitals.

Frequency of potential interactions between drugs in medical prescriptions in a city in southern Brazil

Drug interactions form part of current clinical practice and they affect between 3 and 5% of polypharmacy patients. The aim of this study was to identify the frequency of potential drug-drug interactions in prescriptions for adult and elderly patients. TYPE OF STUDY AND SETTING: Cross-sectional pharmacoepidemiological survey in the Parque Verde housing project, municipality of Cascavel, Paraná, Brazil, between December 2006 and February 2007. Stratified cluster sampling, proportional to the total number of homes in the housing project, was used. The sample consisted of 95 homes and 96 male or female patients aged 19 or over, with medical prescriptions for at least two pharmaceutical drugs. Interactions were identified using DrugDigest, Medscape and Micromedex softwares. Most of the patients were female (69.8%), married (59.4%) and in the age group of 60 years or over (56.3%), with an income less than or equal to three minimum monthly salaries (81.3%) and less than eight years of schooling (69.8%); 90.6% of the patients were living with another person. The total number of pharmaceutical drugs was 406 (average of 4.2 medications per patient). The drugs most prescribed were antihypertensives (47.5%). The frequency of drug interactions was 66.6%. Among the 154 potential drug interactions, 4.6% were classified as major, 65.6% as moderate and 20.1% as minor. The high frequency of drug prescriptions with a potential for differentiated interactions indicates a situation that has so far been little explored, albeit a reality in household surveys.

Pitavastatin in the Management of Hypercholesterolemia

Pitavastatin is an HMG-CoA reductase inhibitor that significantly reduces the plasma levels of total cholesterol, LDL-C and triglycerides, while also causing modest elevation of the plasma high-density cholesterol (HDL-C) level. This statin is minimally metabolized by the cytochrome P-450 (CYP) isozymes; it is glucuronized and converted to the inactive lactone form, which is also minimally metabolized by human hepatic microsomes; therefore, it is associated with a low frequency of drug interactions. Pitavastatin has also been shown to have various pleiotropic effects on platelets, monocytes/macrophages and endothelial cells. In addition, a new effect of pitavastatin of increasing the serum for adiponectin level has been reported recently. Pitavastatin has been reported to be associated with a lower frequency of adverse drug effects such as hepatic dysfunction and rhabdomyolysis, therefore, it may be judged as one of the safer among the strong statins. Several clinical trials of pitavastatin have been conducted. At present, its evaluation in actual clinical use by clinicians around the world is underway. Pitavastatin is an effective and safe drug for patients with hypercholesterolemia.

Tegaserod-Related Possible Drug Interactions

TO THE EDITOR: I read with great interest the article by Muller-Lissner et al. regarding safety, tolerability, and efficacy of tegaserod in patients with chronic constipation (1). A number of studies have addressed safety issues regarding tegaserod in several indications. However, for any drug, another important measure of safety is the frequency of drug interactions, for which the present study, like the previous ones, also gives no information. The data in hand regarding tegaserod-related drug interactions are limited and restricted to animal studies and individual cases. The authors state in the article that, at baseline, current medications were used as exclusion criteria only when related to intestinal motility, which means that some of the participants were already under medications for other reasons.

眼科病棟における薬物療法の安全性向上への薬剤師の介入―薬物療法上の問題症例の解析結果に基づく情報提供による眼科医の処方の変化―

Cases of intervention in pharmacotherapy by pharmacists in the ophthalmology ward were collected and analyzed and the drug information obtained by doing this was provided to ophthalmologists and nurses at a study meeting. This significantly changed the writing of prescriptions by ophthalmologists and helped avoid medication problems.For each case of intervention by pharmacists in pharmacotherapy, we prepared a “PREAVOID report” and submitted 39 of them to the Japanese Society of Hospital Pharmacists. They were classified according to “pharmaceutical management” and “medicines involved in medication errors”. As for the former, 16 cases (41.0%) came under the heading of drug interactions and duplicate medications and for the latter, 13 cases (33.3%) came under “pre-admission medications”, 15 cases (38.5%) under “medications prescribed by ophthalmologist” and 11 cases (28.2%) under “concomitant use of preadmission medications and those prescribed on-admission”. Thus 24 cases (61.5%) concerned “pre-admission medications”. The study meeting held by pharmacists for ophthalmologists and nurses focused on these medication errors, and was held twice. Afterwards, the frequency of errors significantly decreased-from 13.7×10-4 (cases/patient/month) before the meetings to 6.8×10-4 after the meetings (p<0.05).There was a particularly great improvement as regards the frequency of drug interactions between the antibiotic cefdinir prescribed by ophthalmologists and metal cation medicines included in “pre-admission medications”. The reason for this was discovered by examining the prescribing tendency for metal cation medicines and that of cefdinir for both before and after the meetings. While there was no significant change for metal cation medicines between before and after the meetings (p=0.443), there was a significant decrease in cefdinir prescriptions (p<0.05).

Cardiac transplantation: a review for the intensivists.

Cardiac transplantation has now become accepted therapy for the treatment of end-stage heart disease in both children and adults, and literally thousands of patients are bearers of cardiac grafts. Because of these patients' susceptibility to infections, rejection, coronary disease, and malignancy, as well as to serious illnesses unrelated to their transplantation, they will often be encountered at hospital centers both close to their homes and distant from the site of their surgery. The intensive care unit physician's role will be a demanding one when caring for these patients because of the broad differential diagnosis of infections, frequency of drug interactions and altered immunosuppression, and continuous uncertainty regarding the possibility of rejection, particularly during the first year after transplantation.

Detecting Drug Interactions: A Review of the Literature

This article provides a historic overview of drug interaction screening and reviews 19 studies that have sought to measure the frequency of drug interactions. Differences in study designs, methodologies, and definitions contribute to considerable variation in the reported incidence rates, which ranged from 2.2 to 70.3 percent for all potential drug interactions. The percentage of patients actually experiencing symptoms that could be attributed to a drug interaction, however, ranged from 0 to 11.1 percent. The relative importance of drug interactions as a clinical problem remains unclear. Screening programs that do more than simply identify large numbers of patients who receive potentially interacting drug combinations without indicating which subpopulations of these individuals are likely to be harmed by the drugs have not yet been developed.