Specialist pharmacist in general practice coordinating HIV patient care to manage a complicated drug–drug interaction: case report

2019 ◽  
Vol 49 (3) ◽  
pp. 291-295 ◽  
Author(s):  
Kathryn F. Mackie ◽  
Alison J. Duncan ◽  
Daniel Fineberg ◽  
Olga Vujovic
Keyword(s):  
General Practice ◽  
Drug Interaction ◽  
Case Report ◽  
Patient Care ◽  
Drug Drug Interaction ◽  
Specialist Pharmacist

Potential Drug Interactions— Fact or Fallacy?

1975 ◽  
Vol 9 (11) ◽  
pp. 586-590 ◽  
Author(s):  
Curtis D. Black ◽  
Nicholas G. Popovich
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Patient Care ◽  
Clinical Studies ◽  
Literature Search ◽  
Potential Drug ◽  
Careful Evaluation ◽  
Current Drug ◽  
Drug Drug Interaction

At present, the pharmacist is faced with a perplexing number of potential drug interactions as they relate to patient care. The purpose of the investigation was to evaluate current drug-drug interaction literature, specifically gastrointestinal drug interactions. Literature search and review evaluated the authoritative basis on which conclusions were made. From this, a review was written to illustrate fallacies and misconceptions that could be derived from the literature with the intent it would serve as a guide in interpreting and evaluating drug-drug interactions. The overall study illustrates the vast need for careful evaluation of drug interaction literature before erroneous recommendations are made on conceivably inconclusive clinical studies.

scholarly journals A Comparison of Tertiary Drug Resources’ Consistency Regarding Drug-Drug Interactions of Adjunctive Analgesics

2020 ◽  
pp. 875512252095133
Author(s):  
Andrew Lang ◽  
Michael A. Veronin ◽  
Justin P. Reinert
Keyword(s):  
Health Care ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Patient Care ◽  
Health Care Providers ◽  
Drug Information ◽  
Interaction Analysis ◽  
Information Resources ◽  
Care Providers ◽  
Drug Drug Interaction

Background: Health care providers routinely rely on tertiary drug information resources to affirm knowledge or proactively verify the safety and efficacy of medications. Though all patient care areas are affected, the reliability of these resources is perhaps nowhere as poignant as it is in high-acuity settings, including the emergency department and the intensive care unit. As providers seek to identify adjunctive analgesics for acute pain in these areas, they must be able to rely on the integrity to whichever resource their institution has granted access. Objective: To determine the congruency of drug-drug interaction information found on 3 tertiary drug resources. Methods: A drug-drug interaction analysis was conducted on Micromedex, Lexicomp, and Medscape. Adjunctive analgesics included dexmedetomidine and ketamine, which were compared with the intravenous opioid products morphine, fentanyl, and hydromorphone. Results: Significant discrepancies were appreciated with regard to the severity of drug-drug interactions. In addition, the heterogeneity in which reaction severity and likelihood are described by each respective resource makes direct comparisons difficult. Interaction warnings for dexmedetomidine and fentanyl included a “major interaction” from Micromedex, whereas Lexicomp did not identify a risk and Medscape only recommended increased monitoring on the grounds of respiratory and central nervous system depression. Conclusions: Health care providers must remain vigilant when reviewing tertiary drug information resources. Pharmacists possess the training and skills necessary to assist interdisciplinary medical teams in providing optimal patient care through evaluating and applying the information gleaned from these resources.

scholarly journals Toxicological Findings in a Possible Drug-drug Interaction Death: A Case Report

2021 ◽  
Vol 3 (1) ◽  
pp. 128-133
Author(s):  
Mohammed Y. Albeishy ◽  
Magbool E. Oraiby ◽  
Ahmad M. Alamir ◽  
Ibrahim A. Khardali ◽  
Farid M. Abualsail ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Solid Phase ◽  
Synergistic Effects ◽  
Post Mortem ◽  
Migraine Headaches ◽  
History Of ◽  
Drug Drug Interaction ◽  
Serotonergic Drugs ◽  
Identification And Quantification

Synergistic effects are the most encountered types of drug-drug interaction in post-mortem toxicology. Concomitant use of fentanyl, tramadol and carbamazepine may increase the risk of severe serotonin toxicity. The decedent was a 32-year-old black man, with a history of severe migraine headaches. He died after being administered several drugs to treat the migraine. For fentanyl identification and quantification, samples were extracted using solid phase extraction and analyzed by GC-MS. For carbamazepine and tramadol identification and quantification, samples were extracted by liquid-liquid extraction and analyzed by LC-QTOF. Toxicology showed post-mortem concentrations of fentanyl 0.033, 0.025, 0.005, 0.0127, and 0.005 mg/L; tramadol 0.143, 0.093, 0.043, 0.09, and 0.08 mg/L; carbamazepine 1.6, 1.04, 0.3, 0.83, and 0.18 mg/L in the blood, brain, liver, kidney and stomach, respectively. In this case report, the combination of serotonergic drugs can contribute to synergistic serotonergic effects. Therefore, drug-drug interaction is expected, and the cause of death may be attributed to toxic synergistic drug-drug interaction including fentanyl, tramadol and carbamazepine.

Phenelzine and Morphine Drug-Drug Interaction? A Literature Review

2020 ◽  
pp. 089719002097075
Author(s):  
Ryan J. Beechinor ◽  
Rachel Tyson ◽  
Mary E. Roth
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Single Case ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Human Studies ◽  
Close Monitoring ◽  
Review Articles ◽  
Drug Drug Interaction

The objectives of this manuscript are to describe a case report of a patient whose phenelzine maintenance therapy was discontinued due to concern for a phenelzine-morphine drug interaction, to review the available literature regarding the potential for this drug-drug interaction, and provide recommendations for this clinical scenario. A PubMed/MEDLINE literature search was conducted and all publications determined to be relevant to this case report were included. Literature describing in vitro data, case reports/human studies, and review articles concerning the interaction between morphine and monoamine oxidase inhibitors (MAOIs) were included. A total of 14 publications pertinent to the potential phenelzine-morphine interaction were included in this review including 5 in vitro studies, 4 human studies, and 6 review articles detailing the drug interaction profile between opioids and antidepressants. Of these publications, only a single case report of a potential drug interaction between morphine and phenelzine was identified. The literature suggesting a drug interaction between morphine and phenelzine is limited. The combination of phenelzine and morphine, with close monitoring for signs and symptoms of serotonin syndrome, is reasonable for patients with appropriate indications for both agents.

Life-threatening digoxin toxicity due to drug–drug interactions in an HIV-positive man

2016 ◽  
Vol 28 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Kathir Yoganathan ◽  
Beth Roberts ◽  
Martyn K Heatley
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Drug Interactions ◽  
Digoxin Toxicity ◽  
Hiv Positive ◽  
Hiv Patients ◽  
First Case ◽  
Life Threatening ◽  
Drug Drug Interaction ◽  
Positive Population

Drug–drug interactions with corticosteroids, causing Cushing’s syndrome with secondary adrenal suppression, are well known in HIV patients. Corticosteroids are widely prescribed in the HIV-positive population. However, digoxin is rarely used in HIV patients; hence, digoxin toxicity due to drug–drug interaction is not widely recognised. Nevertheless, this practice might change in the future as HIV cohorts of patients are ageing, due to the successful treatment of HIV infection with combination antiretroviral therapy. We report a case of digoxin toxicity in an HIV-positive 51-year-old man, due to a combination of drug–drug interaction and renal impairment. The first case report of digoxin toxicity due to drug–drug interaction with ritonavir in an HIV-positive woman was published in 2003. To the best of our knowledge, no similar case report has since been published in the literature. This case alerts the profession to the importance of drug–drug interaction and highlights the clinical features of digoxin toxicity.

scholarly journals Digoxin Toxicity presented with Right Bundle Branch Block: A Case report of Drug- Drug Interaction

2017 ◽  
Vol 5 (10) ◽  
pp. 921-924
Author(s):  
Dr. Shreya R Patel ◽  
◽  
Dr. Harsha D Makwana ◽  
Dr. Kamlesh P Patel ◽  
Dr. Supriya D Malhotra ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Right Bundle Branch Block ◽  
Digoxin Toxicity ◽  
Bundle Branch Block ◽  
Drug Drug Interaction
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