ASSESSMENT OF DRUG INTERACTIONS IN OUTPATIENT PRESCRIPTIONS IN HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
Vol 8 (5) ◽  
pp. 26-36
Author(s):  
Phuong Vo Thi Hong ◽  
Hien Nguyen Thi
Keyword(s):  
Drug Interaction ◽  
Proton Pump Inhibitor ◽  
Drug Interactions ◽  
Descriptive Study ◽  
Management Guideline ◽  
Cross Sectional ◽  
Significant Drug Interaction ◽  
Clinically Significant ◽  
Multiple Symptoms ◽  
Outpatient Prescriptions

Background: The combination of drugs in treatment is inevitable, especially in multiple diseases and multiple symptoms. This is the leading cause of occurrence of drug - drug interactions. Objectives: (1) To identify clinically significant drug interactions in outpatient prescriptions in Hue University of Medicine and Pharmacy Hospital, (2) To build a management guideline of clinically significant drug interactions in Hue University of Medicine and Pharmacy Hospital. Materials and methods: 5338 outpatient prescriptions were collected from Pharmacy Faculty – Hue University of Medicine and Pharmacy Hospital from 1st to 31st October 2017, using cross-sectional descriptive study method. Results and Conclusion: The list of 20 clinically significant drug interaction pairs was identified and a management guideline for each interacting pair was built. The prevalence of prescriptions with drug interactions was 6.7%. The most commonly identified drug interaction pair was clopidogrel and proton pump inhibitor (1.59%). The occurrence of drug interactions increased with increase in the age of patients and the number of drugs prescribed (p < 0.05). Key words: combination of drugs, drug interaction, clinically significant, prescription, outpatient

Inhibition of Hepatic Microsomal Drug Metabolism by the Hydrazines Ro 4-4602, MK 486, and Procarbazine Hydrochloride

1972 ◽  
Vol 50 (7) ◽  
pp. 721-724 ◽  
Author(s):  
Norman R. Bade ◽  
Stuart M. MacLeod ◽  
Kenneth W. Renton
Keyword(s):  
Drug Interaction ◽  
Drug Metabolism ◽  
Sleeping Time ◽  
Hydrazine Derivatives ◽  
Significant Drug Interaction ◽  
Microsomal Drug Metabolism ◽  
Clinically Significant ◽  
Hepatic Biotransformation

Preliminary experiments were undertaken to examine the effect of three hydrazine derivatives, viz. Ro 4-4602, MK 486, and procarbazine hydrochloride, on hepatic microsomal drug metabolism in rats. All three compounds when given as pretreatment significantly prolonged pentobarbital sleeping time. In vitro, the hepatic microsomal N-demethylation of aminopyrine was inhibited. It is concluded that all three drugs are possible sources of clinically significant drug interaction when administered in combination with other agents which undergo hepatic biotransformation.

The prevalence of potentially beneficial and harmful drug-drug interactions in intensive care units

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Hossein Ali Mehralian ◽  
Jafar Moghaddasi ◽  
Hossein Rafiei
Keyword(s):  
Intensive Care ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Intensive Care Units ◽  
Medical Records ◽  
Potential Ddis ◽  
Cross Sectional ◽  
Text Book ◽  
The Mean ◽  
Potential Interactions

Abstract Background The present study was conducted with the aim of investigating the prevalence of potentially beneficial and harmful drug-drug interactions (DDIs) in intensive care units (ICUs). Methods The present cross-sectional prospective study was conducted in two ICUs in Shahr-e Kord city, Iran. The study sample was consisted of 300 patients. The Drug Interaction Facts reference text book [Tatro DS. Drug interaction facts. St Louis, MO: Walters Kluwer Health, 2010.] was used to determine the type and the frequency of the DDIs. Results The participants consisted of 189 patients men and 111 women. The mean age of patients was 44.2 ± 24.6 years. Totally, 60.5% of patients had at least one drug-drug interaction in their profile. The total number of DDIs found was 663 (the mean of the total number of drug-drug interactions was 2.4 interactions per patient). Of all the 663 interactions, 574 were harmful and others were beneficial. In terms of starting time, 98 of the potential interactions were rapid and 565 of them were delayed. In terms of severity, 511 of the potential interactions were moderate. Some of the drugs in the patients’ medical records including phenytoin, dopamine, ranitidine, corticosteroid, dopamine, heparin, midazolam, aspirin, magnesium, calcium gluconate, and antibiotics, the type of ventilation, the type of nutrition and the duration of hospital stay were among the factors that were associated with high risk of potential DDIs (p < 0.05). Conclusions The prevalence of potentially beneficial and harmful DDIs, especially harmful drug-drug interactions, is high in ICUs and it is necessary to reduce these interactions by implementing appropriate programs and interventions.

scholarly journals Lack of a clinically significant drug-drug interaction in healthy volunteers between the HCV protease inhibitor boceprevir and the proton pump inhibitor omeprazole

2013 ◽  
Vol 68 (6) ◽  
pp. 1415-1422 ◽  
Author(s):  
C. T. M. M. de Kanter ◽  
A. P. H. Colbers ◽  
M. I. Blonk ◽  
C. P. W. G. M. Verweij-van Wissen ◽  
B. J. J. W. Schouwenberg ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Proton Pump Inhibitor ◽  
Protease Inhibitor ◽  
Healthy Volunteers ◽  
Proton Pump ◽  
Hcv Protease ◽  
Drug Drug Interaction ◽  
Clinically Significant

scholarly journals Clinically Relevant Drug-Drug Interactions and Management Strategies: A Hospital based Study

2020 ◽  
Vol 2 (2) ◽  
pp. 109-114
Author(s):  
Arun Sharma ◽  
Sitaram Khadka ◽  
Bimal Kunwar ◽  
Kapil Amgain ◽  
Rinku Joshi ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Management Strategies ◽  
Clinical Importance ◽  
Cross Sectional Study ◽  
Automated System ◽  
Clinical Settings ◽  
Evaluation Tool ◽  
Cross Sectional ◽  
Medication Therapy ◽  
Clinically Significant

Background: Drug-drug interactions (DDIs) are one of the significant drug related problems encountered in clinical settings. Better understanding of the mechanisms, severity, and likely consequences of clinically significant DDIs are essential for proper medication therapy management (MTM). This study is conducted with the aim to aware clinical practitioners about clinically significant DDIs that occur in clinical settings and to help them manage such events with the accurate knowledge and technique. Methods: A descriptive cross-sectional study was conducted in Shree Birendra Hospital, Kathmandu on the prescription of medical out-patient department from June to November 2020. Total 483 prescriptions were selected randomly. A panel of physicians, pharmacologists and clinical pharmacists under the supervision of a consultant physician using MICROMEDEX DRUG-REAX, Evaluation of Drug Interactions, Drug Interaction Facts, Drug Interactions: Analysis and Management was conducted. Main outcome measure was obtained by the supervisor’s endorsement on panelists' opinion about clinical importance of DDIs. Results: A total of 2006 medicines were prescribed in 483 prescription samples. The number of drugs per prescription was in a range from 2 to 11 with 4.15 on average. DDIs were found in 21.53% prescriptions (n=104). 168 DDIs were identified with major, moderate, and minor types in 32 (19%), 85 (51%), and 51 (30%) respectively. As per occurrence, the panel determined that 13 interactions were clinically important. Conclusion: The drug interactions identified by a panel of expert using standard evaluation tool are considered to be clinically important and likely to occur in the clinical settings. Clinically significant DDIs can be preventable and can also be used for the beneficial effects in MTM. Adequate knowledge regarding nature of DDIs, inclusion of automated system in prescribing and dispensing area, and inter-professional collaboration of a clinical team is liable to prevent and manage such events and help in rational drug therapy.

scholarly journals Evaluation of drug information resources for interactions between therapeutic drugs and drugs of abuse

2020 ◽  
Vol 108 (4) ◽  
Author(s):  
Robert D. Beckett ◽  
Jennifer R. Martin ◽  
Curtis D. Stump ◽  
Megan A. Dyer
Keyword(s):  
Clinical Pharmacology ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Subject Matter ◽  
Drugs Of Abuse ◽  
Point Of Care ◽  
Clinical Effects ◽  
Subject Matter Experts ◽  
Cross Sectional ◽  
Therapeutic Drugs

Objective: The research evaluated point-of-care resources for scope, completeness, and consistency of information describing interactions between therapeutic drugs and drugs of abuse (DoA).Methods: A cross-sectional evaluation study was conducted focusing on seven resources: Clinical Pharmacology, Facts & Comparisons eAnswers, Lexicomp Online, Micromedex, Drug Interactions Analysis and Management, Drug Interaction Facts, and Stockley’s Drug Interactions. A sample of clinically relevant interactions was developed through review of tertiary literature and resources, and input was solicited from subject matter experts. Entries from each resource for each interaction were evaluated for scope (i.e., whether there was an entry for the interaction); completeness (i.e., whether there was information addressing mechanism; clinical effects, severity, course of action, and level of certainty, described as a median rating on a 5-point scale); and consistency (i.e., whether the information in the resource was similar to the majority) among resources with an entry.Results: Following review by subject matter experts, the final sample contained 159 interactions. Scope scores ranged from 0.6% (Drug Interactions Analysis and Management) to 43.4% (Lexicomp Online). Completeness scores ranged from 2 (interquartile range [IQR] 0 to 3, Stockley’s Drug Interactions) to 5 (IQR 5 to 5, Drug Interaction Facts, Micromedex, Facts & Comparisons eAnswers). Consistency scores ranged from 30.8% (Stockley’s Drug Interactions) to 87.1% (Clinical Pharmacology) for severity and from 15.4% (Facts & Comparisons eAnswers) to 71.4% (Drug Interaction Facts) for course of action.Conclusions: Although coverage of drug-DoA interactions was low and content was often inconsistent among resources, the provided information was generally complete.

scholarly journals Evaluation of resources for analyzing drug interactions

2017 ◽  
Vol 104 (4) ◽  
Author(s):  
Risha I. Patel, PharmD ◽  
Robert D. Beckett, PharmD, BCPS
Keyword(s):  
Clinical Pharmacology ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Dietary Supplement ◽  
Drug Information ◽  
Cross Sectional Study ◽  
Information Resources ◽  
Ease Of Use ◽  
Sectional Study ◽  
Cross Sectional

Objective: The research sought to evaluate seven drug information resources, specifically designed for analyzing drug interactions for scope, completeness, and ease of use, and determine the consistency of content among the seven resources.Methods: A cross-sectional study was conducted where 100 drug-drug and drug-dietary supplement interactions were analyzed using 7 drug information resources: Lexicomp Interactions module, Micromedex Drug Interactions, Clinical Pharmacology Drug Interaction Report, Facts & Comparisons eAnswers, Stockley’s Drug Interactions (10th edition), Drug Interactions Analysis and Management (2014), and Drug Interaction Facts (2015). The interaction sample was developed based on published resources and peer input. Two independent reviewers gathered data for each interaction from each of the 7 resources using a common form.Results: Eighty-two drug-drug and 18 drug-dietary supplement interactions were analyzed. Scope scores were higher for Lexicomp Interactions (97.0%), Clinical Pharmacology Drug Interaction Report (97.0%), and Micromedex Drug Interactions (93.0%) compared to all other resources (p<0.05 for each comparison). Overall completeness scores were higher for Micromedex Drug Interactions (median 5, interquartile range [IQR] 4 to 5) compared to all other resources (p<0.01 for each comparison) and were higher for Lexicomp Interactions (median 4, IQR 4 to 5), Facts & Comparisons eAnswers (median 4, IQR 4 to 5), and Drug Interaction Facts (4, IQR 4 to 5) compared to all other resources, except Micromedex (p<0.05 for each comparison). Ease of use, in terms of time to locate information and time to gather information, was similar among resources. Consistency score was higher for Micromedex (69.9%) compared to all other resources (p<0.05 for each comparison).Conclusions: Clinical Pharmacology Drug Interaction Report, Lexicomp Interactions, and Micromedex Drug Interactions scored highest in scope. Micromedex Drug Interactions and Lexicomp Interactions scored highest in completeness. Consistency scores were overall low, but Micromedex Drug Interactions was the highest.

scholarly journals Clinically Significant Drug Interaction between Tipranavir-Ritonavir and Phenobarbital in an HIV-Infected Subject

2007 ◽  
Vol 45 (12) ◽  
pp. 1654-1655 ◽  
Author(s):  
S. Bonora ◽  
A. Calcagno ◽  
S. Fontana ◽  
A. D'Avolio ◽  
M. Siccardi ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Infected Subject ◽  
Significant Drug Interaction ◽  
Clinically Significant

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%.

Clinically Significant Drug−Drug Interaction Between Tacrolimus and Phenobarbital

2010 ◽  
Vol 23 (6) ◽  
pp. 585-589 ◽  
Author(s):  
Nida Siddiqi ◽  
Kwaku Marfo
Keyword(s):  
Drug Interaction ◽  
Renal Transplant ◽  
Drug Interactions ◽  
Transplant Rejection ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Patient Identification ◽  
Clinically Significant ◽  
Trough Levels ◽  
Renal Transplant Rejection

Purpose: The case of a 57-year-old male who experienced acute renal transplant rejection due to subtherapeutic tacrolimus levels as a result of drug interaction with phenobarbital. Summary: Drug interactions with tacrolimus due to its metabolism through the CYP 450 3A4 enzymatic pathway have led to several reports of altered tacrolimus levels, which can lead to acute rejection in renal transplant recipients. We describe the case of a 57-year-old male initiated on immunosuppressive therapy with tacrolimus in addition to his anticonvulsant medications. Conclusion: Upon tacrolimus dose increases, discontinuation of carbamazepine, and minimization of phenobarbital dose, effective tacrolimus trough levels were achieved in our patient. Identification and elimination of such drug−drug interactions is necessary to assure adequate immunosuppression in renal transplant recipients.

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