scholarly journals Reducing harms: Focus on drug-drug interactions and adverse drug events

2017 ◽  
Vol 71 (10) ◽  
pp. e13036
Author(s):  
Leslie Citrome
Keyword(s):  
Drug Interactions ◽  
Adverse Drug Events

Analysis of effectiveness and drug related problems of pain reliever for knee osteoarthritis: weighing clinical risk and benefit

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Junaidi Khotib ◽  
Henny Utami Setiawan ◽  
Ahmad Dzulfikri Nurhan ◽  
Erreza Rahadiansyah ◽  
Chrismawan Ardianto ◽  
...  
Keyword(s):  
Side Effects ◽  
Drug Interactions ◽  
Adverse Drug Events ◽  
Laboratory Data ◽  
Age Distribution ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Drug Related Problems ◽  
Pain Reliever ◽  
Pain Medications

AbstractBackgroundOsteoarthritis (OA) is a chronic degenerative joint disease, characterized by physiological disorders, such as cartilage degradation, bone remodeling, osteophyte formation, and joint inflammation, which results in pain. Several studies have reported problems with the use of pain medications in OA, such as the use of a combination of many drugs and their long-term use. Therefore, this study was designed to evaluate the use of pain medications in OA patients. The study focused on the analysis of effectiveness and drug related problems (DRPs) with the category of drug interactions and adverse drug events (ADEs) in knee OA patients in Orthopedic and Traumatology Clinic, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia.MethodsThe study used a retrospective approach through tracking and recording of the medical data from the period of 1st January to 30th June, 2018. The potential of drug interactions was determined by analyzing data based on literature. The actual side effects of the drug were identified based on the patient’s medical record through clinical data, laboratory data, and therapeutic data received by the patient. The study involved 143 subjects who met the inclusion criteria of 871 visits to the hospital.ResultsThe results showed that women as much as 80.42% with an age distribution of at most 46–65 years are the most affected by OA cases. The predominant history of illness and comorbidities in OA patients was hypertension in 58.74% of patients. The use of analgesic meloxicam had a percentage of 26.06%, sodium diclofenac 20.21%, mefenamic acid 4.36% and paracetamol 4.25%. The effectiveness of the use of pain reliever was characterized by a decrease in VAS in each patient at the beginning and at the end of the study, where a decrease in pain intensity occurred in 79.72% of patients who received pain medications. Based on drug interactions, we were able to identify pharmacodynamic interactions of 43 events (4.94%) and onine events of pharmacokinetic interactions (1.03%), with a minor severity of 7 events (0.80%),44 moderate events (5.05%), and one major event (0.11%). Mostly identified side effects of the drugs were those due to the use of non-steroid anti inflammatory drugs, which occurred in 42 events (4.82%).ConclusionsIt can be concluded that OA therapy with a number of pain relievers shows an adequate therapeutic response with some side effects and interactions both pharmacokinetically and pharmacodynamically.

scholarly journals Potential Adverse Drug Events and Drug–Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use

2019 ◽  
Vol 8 (7) ◽  
pp. 989 ◽  
Author(s):  
Joshua Brown ◽  
Almut Winterstein
Keyword(s):  
Drug Interactions ◽  
Sleep Disturbances ◽  
Adverse Drug Events ◽  
Alternative Therapy ◽  
Consumer Products ◽  
Medical Cannabis ◽  
Biological Targets ◽  
Safety Issues ◽  
Treatment Regimens ◽  
Potential Safety

Cannabidiol (CBD) is ubiquitous in state-based medical cannabis programs and consumer products for complementary health or recreational use. CBD has intrinsic pharmacologic effects and associated adverse drug events (ADEs) along with the potential for pharmacokinetic and pharmacodynamic drug–drug interactions (DDIs). Given CBD use among patients with complex conditions and treatment regimens, as well as its expanded consumer use, awareness of potential safety issues with CBD is needed. Prescribing information for federally approved products containing CBD were reviewed. Data on ADEs and DDIs were extracted and summarized. Nearly one-half of CBD users experienced ADEs, which displayed a general dose-response relationship. Common ADEs include transaminase elevations, sedation, sleep disturbances, infection, and anemia. Given CBD effects on common biological targets implicated in drug metabolism (e.g., CYP3A4/2C19) and excretion (e.g., P-glycoprotein), the potential for DDIs with commonly used medication is high. General clinical recommendations of reducing substrate doses, monitoring for ADEs, and finding alternative therapy should be considered, especially in medically complex patients. CBD is implicated as both a victim and perpetrator of DDIs and has its own ADE profile. These effects should be considered in the risk-benefit assessment of CBD therapy and patients and consumers made aware of potential safety issues with CBD use.

Adverse drug reactions and drug interactions

2012 ◽  
Author(s):  
Philip Wiffen ◽  
Marc Mitchell ◽  
Melanie Snelling ◽  
Nicola Stoner
Keyword(s):  
Quality Of Life ◽  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Adverse Reactions ◽  
Adverse Drug Events ◽  
Hospital Environment ◽  
Drug Reactions ◽  
Significant Cost

Introduction to ADRs 14Classification of ADRs 15Adverse reactions: drug or disease? 16Helping patients understand the risk of ADRs 17Reporting ADRs 18Drug interactions 20Managing drug interactions 23Adverse drug reactions (ADRs), also known as ‘side effects’, ‘adverse drug events’, or ‘drug misadventures’, are a frequent cause of morbidity in hospital and the community. They have a significant cost both financially and in terms of quality of life. Few studies of ADRs have been carried out in the community so the effect on primary care is harder to assess, but studies in the hospital environment have shown the following. ...

Adverse Drug Events, Medication Errors, and Drug Interactions

2019 ◽  
pp. 227-245
Author(s):  
Vincent W.L. Tsui ◽  
Dixon Thomas ◽  
Shuhui Tian ◽  
Allen J. Vaida
Keyword(s):  
Drug Interactions ◽  
Medication Errors ◽  
Adverse Drug Events

scholarly journals Potential Adverse Drug Events with Tetrahydrocannabinol (THC) Due to Drug–Drug Interactions

2020 ◽  
Vol 9 (4) ◽  
pp. 919 ◽  
Author(s):  
Joshua D. Brown
Keyword(s):  
Drug Interactions ◽  
Adverse Drug Events ◽  
Alternative Therapy ◽  
Medical Marijuana ◽  
Racial Groups ◽  
Metabolizing Enzymes ◽  
Potential Risks ◽  
Neurological Effects ◽  
Medical Marijuana Use ◽  
Future Work

Tetrahydrocannabinol (THC) is the primary psychoactive ingredient in cannabis. While the safety of THC and cannabis has been extrapolated from millennia of recreational use, medical marijuana programs have increased exposure among medically complex individuals with comorbid conditions and many co-prescribed medications. Thus, THC should be recognized as a pharmacologically complex compound with potential for drug–drug interactions and adverse drug events. This review summarizes potential adverse drug events related to THC when combined with other medications. Metabolic drug–drug interactions are primarily due to THC conversion by CYP3A4 and CYP2C9, which can be impacted by several common medications. Further, CYP2C9 polymorphisms are highly prevalent in certain racial groups (up to 35% in Caucasians) and increase the bioavailability of THC. THC also has broad interactions with drug-metabolizing enzymes and can enhance adverse effects of other medications. Pharmacodynamic interactions include neurological effects, impact on the cardiovascular system, and risk of infection. General clinical recommendations for THC use include starting with low doses and titrating to desired effects. However, many interactions may be unavoidable, dose-limiting, or a barrier to THC-based therapy. Future work and research must establish sufficient data resources to capture medical marijuana use for such studies. Meanwhile, clinicians should balance the potential risks of THC and cannabis and the lack of strong evidence of efficacy in many conditions with patient desires for alternative therapy.

INITIALLY BUILDING AND APPLYING A LIST OF DRUG INTERACTIONS AT VINH LONG GENERAL HOSPITAL, IN 2020

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Pham Phuong Lien ◽  
Tran Hoang Anh ◽  
Bui Thi My Anh
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
General Hospital ◽  
Medical Staff ◽  
Adverse Drug Events ◽  
Drug List ◽  
Level 1 ◽  
Outpatient Prescriptions ◽  
Outpatient Drug

Background: Drug interactions are the main causes of adverse drug events. In order to promptly detect, and handle drug interactions, medical staff often have to look up information in different databases. However, in practice this is still difficult. Stemming from practical needs, we conducted the study "Initially building and applying a list of drug interactions at Vinh Long General Hospital, in 2020". Methods: The study built a list of drug interactions appearing in the list of outpatient drugs at Vinh Long General Hospital. Then, the above list was used to examine the drug interaction on 260 outpatient prescriptions at the hospital.             Results: The main findings show that 23 pairs of interactions appearing in the outpatient drug list applied at Vinh Long General Hospital; The rate of prescriptions with interactions is still quite high (44.2%). Among prescriptions with interactions: the rate of prescriptions with 1 interaction was 58.2%; 13% of prescriptions have 3 types of interactions and 4.5% of prescriptions have more than 3 types of interactions. The proportion of prescriptions with interactions at level 1 – "need to be monitored"  accounted for 72.2%. The rate of prescriptions with serious interactions requiring replacement of other drugs was 11.3% and contraindications was 2.6%.

scholarly journals Deep learning improves prediction of drug–drug and drug–food interactions

2018 ◽  
Vol 115 (18) ◽  
pp. E4304-E4311 ◽  
Author(s):  
Jae Yong Ryu ◽  
Hyun Uk Kim ◽  
Sang Yup Lee
Keyword(s):  
Drug Interactions ◽  
Adverse Drug Events ◽  
Structural Information ◽  
Drug Prescription ◽  
Pharmacological Effects ◽  
Drug Candidates ◽  
Causal Mechanisms ◽  
Alternative Drug ◽  
Food Constituent ◽  
Approved Drugs

Drug interactions, including drug–drug interactions (DDIs) and drug–food constituent interactions (DFIs), can trigger unexpected pharmacological effects, including adverse drug events (ADEs), with causal mechanisms often unknown. Several computational methods have been developed to better understand drug interactions, especially for DDIs. However, these methods do not provide sufficient details beyond the chance of DDI occurrence, or require detailed drug information often unavailable for DDI prediction. Here, we report development of a computational framework DeepDDI that uses names of drug–drug or drug–food constituent pairs and their structural information as inputs to accurately generate 86 important DDI types as outputs of human-readable sentences. DeepDDI uses deep neural network with its optimized prediction performance and predicts 86 DDI types with a mean accuracy of 92.4% using the DrugBank gold standard DDI dataset covering 192,284 DDIs contributed by 191,878 drug pairs. DeepDDI is used to suggest potential causal mechanisms for the reported ADEs of 9,284 drug pairs, and also predict alternative drug candidates for 62,707 drug pairs having negative health effects. Furthermore, DeepDDI is applied to 3,288,157 drug–food constituent pairs (2,159 approved drugs and 1,523 well-characterized food constituents) to predict DFIs. The effects of 256 food constituents on pharmacological effects of interacting drugs and bioactivities of 149 food constituents are predicted. These results suggest that DeepDDI can provide important information on drug prescription and even dietary suggestions while taking certain drugs and also guidelines during drug development.

Sign in / Sign up

Export Citation Format

Share Document