Drug interactions between the anti-inflammatory drugs and with other agents

1987 ◽  
pp. 179-193 ◽  
Author(s):  
P. F. D’Arcy ◽  
J. C. McElnay
Keyword(s):  
Drug Interactions ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Non-Steroidal Anti-Inflammatory Drugs: Usage and Co-prescription with Other Potentially Interacting Drugs in Elderly: a Cross-sectional Study

2019 ◽  
Author(s):  
Nuru Abdu ◽  
Samuel Teweldemedhin ◽  
Asmerom Mosazghi ◽  
Luwam Asfaha ◽  
Makda Teshale ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Protective Agents ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Introduction: Globally, non-steroidal anti-inflammatory drugs (NSAIDs) usage in the elderly with chronic pain has been reported as frequent. Though it is fundamental in maintaining their quality of life, the risk of polypharmacy, drug interactions and adverse effects is of paramount importance as the elderly usually require multiple medications for their co-morbidities. If prescriptions are not appropriately monitored and managed, they are likely to expose patients to serious drug interactions and potentially fatal adverse effects. Thus, the objective of the study was to assess the appropriateness of NSAIDs use and incidence of NSAIDs related potential interactions in elderly. Methods: A descriptive cross-sectional study was conducted among elderly out-patients (aged 60 and above) who visited three hospitals in Asmara between August 22 and September 29, 2018. The sampling design was two-stage random sampling and data was collected using a questionnaire, exit interview and by abstracting information from patients’ clinical cards. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS. Results: A total of 285 elderly respondents were enrolled in the study with similar male to female ratio. One in four of all respondents were chronic NSAIDs users, of which 74.6% were not prescribed prophylactic gastro-protective agents (GPAs). About 20% of the elderly were involved in polypharmacy and nearly all of the encountered potential NSAIDs related interactions (n=322) with prescribed drugs were moderate. Diabetes and hypertension were significantly associated with chronic NSAIDs use (OR=3, 95% CI: 1.54, 5.84; OR=9.99, 95% CI: 4.46, 22.38) and incidence of drug interactions (OR=3.95, 95%CI: 1.92, 8.13; OR=3.12, 95%CI: 1.81, 5.33) while diabetes and cardiac problem were significantly associated with incidence of polypharmacy (OR=4.33, 95% CI: 2.36, 7.96; OR=3.56, 95% CI: 1.05, 12.11). Conclusion: Though the overall reflection of prescription pattern of NSAIDs during the study period was almost satisfactory, gastro-protective agents were poorly prescribed as a prophylaxis.

Drug-drug interactions of non-steroidal anti-inflammatory drugs with other drugs in patients with rheumatic diseases

2005 ◽  
Vol 1 (2) ◽  
pp. 116-120 ◽  
Author(s):  
I. Peláez-Ballestasa ◽  
C. Meléndez-Mercado ◽  
A. Hernández-Garduño ◽  
J.L. Viramontes-Madrid ◽  
R. Burgos-Vargas
Keyword(s):  
Drug Interactions ◽  
Rheumatic Diseases ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Drug-Drug Interactions Between Lithium and Cardiovascular as Well as Anti-Inflammatory Drugs

2020 ◽  
Vol 53 (05) ◽  
pp. 229-234
Author(s):  
Maike Scherf-Clavel ◽  
Susanne Treiber ◽  
Jürgen Deckert ◽  
Stefan Unterecker ◽  
Leif Hommers
Keyword(s):  
Blood Flow ◽  
Renal Function ◽  
Serum Concentration ◽  
Drug Interactions ◽  
Renal Blood Flow ◽  
Serum Levels ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
And Function ◽  
Bipolar Affective Disorders

Abstract Introduction Lithium is the gold standard in treating bipolar affective disorders. As patients become increasingly older, drug-drug interactions leading to decreased excretion of lithium represent a key issue in lithium safety. As no study considered the effect of comedications on lithium serum concentration in combination, we aimed to quantify the impact of drugs affecting renal blood flow and function and thus potentially interacting drugs (diuretics, ACE inhibitors, AT1 antagonists, and non-steroidal anti-inflammatory drugs) on lithium serum levels in addition to age, sex, and sodium and potassium serum levels as well as renal function. Methods Retrospective data of lithium serum levels were analyzed in 501 psychiatric inpatients (2008–2015) by means of linear regression modelling. Results The number of potentially interacting drugs was significantly associated with increasing serum levels of lithium in addition to the established factors of age, renal function, and sodium concentration. Additionally, absolute lithium levels were dependent on sex, with higher values in females. However, only NSAIDs were identified to increase lithium levels independently. Discussion Routine clinical practice needs to focus on drugs affecting renal blood flow and function, especially on NSAIDs as over-the-counter medication that may lead to an increase in lithium serum concentration. To prevent intoxications, clinicians should carefully monitor the comedications, and they should inform patients about possible intoxications due to NSAIDs.

Shared Decision Making for Drug Interactions: Design and Usability of an Application for Warfarin and Non-steroidal Anti-inflammatory Drugs (Preprint)

2021 ◽  
Author(s):  
Thomas Reese ◽  
Guilherme Del Fiol ◽  
Keaton Morgan ◽  
Jason T. Hurwitz ◽  
Kensaku Kawamoto ◽  
...  
Keyword(s):  
Decision Making ◽  
Drug Interactions ◽  
Shared Decision Making ◽  
Critical Role ◽  
Patient Specific ◽  
Shared Decision ◽  
System Usability Scale ◽  
Life Threatening ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

BACKGROUND Exposure to life-threatening drug-drug interactions (DDIs) occurs despite the widespread use of clinical decision support. The DDI between warfarin and non-steroidal anti-inflammatory drugs is common and potentially life-threatening. Patients can play a critical role in preventing harm from DDIs; however, the current model for DDI decision-making is clinician-centric. OBJECTIVE To design and study the usability of DDInteract, a tool to support shared decision making (SDM) between a patient and provider for the DDI between warfarin and non-steroidal anti-inflammatory drugs. METHODS We used an SDM framework and user-centered design methods to guide the design and usability of DDInteract – an SDM electronic health record (EHR) app to prevent harm from clinically significant DDIs. The design involved iterative prototypes, qualitative feedback from stakeholders, and a heuristic evaluation. The usability evaluation included patients and clinicians. Patients participated in a simulated SDM discussion using clinical vignettes. Clinicians were asked to complete eight tasks using DDInteract and to assess the tool using a survey adapted from the System Usability Scale. RESULTS The designed DDInteract prototype includes the following features: a patient-specific risk profile, dynamic risk icon array, patient education section, and treatment decision tree. Four patients and eleven clinicians participated in the usability study. After an SDM session where patients and clinicians review the tool concurrently, patients generally favored pain treatments with less risk of gastrointestinal bleeding. Clinicians successfully completed the tasks with a mean (standard deviation) of 144 (74) seconds and rated the usability of DDInteract as 4.32 (0.52) out of 5. CONCLUSIONS This study expands the use of SDM to DDIs. The next steps are to determine if DDInteract can improve shared decision-making quality and to implement it across health systems using interoperable technology.

Drug Interactions between Non-Steroidal Anti-Inflammatory Drugs and Cardiovascular Treatments (Except Anti-Agregant Therapy)

2013 ◽  
Vol 12 (1) ◽  
pp. 36-46 ◽  
Author(s):  
Benoit Lattuca ◽  
Ziad Khoueiry ◽  
Guilhem Malcles ◽  
Jean-Marc Davy ◽  
Florence Leclercq
Keyword(s):  
Drug Interactions ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Evaluation of para-Aminosalicylic Acid as a Substrate of Multiple Solute Carrier Uptake Transporters and Possible Drug Interactions with Nonsteroidal Anti-inflammatory Drugs In Vitro

2017 ◽  
Vol 61 (5) ◽  
Author(s):  
M. Masud Parvez ◽  
Ho Jung Shin ◽  
Jin Ah Jung ◽  
Jae-Gook Shin
Keyword(s):  
Drug Interactions ◽  
Organic Anion ◽  
Multidrug Resistant ◽  
Aminosalicylic Acid ◽  
Anion Transporters ◽  
Net Uptake ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

ABSTRACT para-Aminosalicylic acid (PAS) is a second-line antituberculosis drug that has been used to treat multidrug-resistant and extensively drug-resistant tuberculosis for more than 60 years. Renal secretion and glomerular filtration are the major pathways for the elimination of PAS. We comprehensively studied PAS transport by using cell lines that overexpressed various transporters and found that PAS acts as a novel substrate of an organic anionic polypeptide (OATP1B1), organic cationic transporters (OCT1 and OCT2), and organic anion transporters (OAT1 and OAT3) but is not a substrate of any ATP-binding cassette (ABC) transporters. Net PAS uptake was measured, and the transport affinities (Km values) for OATP1B1, OCT1, OCT2, OAT1, and OAT3 were found to be 50.0, 20.3, 28.7, 78.1, and 100.1 μM, respectively. The net uptake rates suggested that renal OAT1 and OAT3 play relatively major roles in PAS elimination. The representative inhibitors rifampin for OATP1B1, probenecid for OAT1 and OAT3, and verapamil for OCT1 and OCT2 greatly inhibited PAS uptake, suggesting that PAS is dependent on multiple transporters for uptake. We also evaluated nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), and metformin for the inhibition of PAS uptake via these transporters. Half-maximal (50%) inhibitory concentrations (IC50s) were kinetically determined and used to predict the drug-drug interactions (DDIs) affecting these transporters' activity toward PAS. We found that rifampin, probenecid, ibuprofen, naproxen, cimetidine, and quinidine each exhibited a significant potential for in vivo DDIs with PAS. In this study, PAS was found to be a novel substrate of several transporters, and drugs that inhibit these transporters can reduce PAS elimination.

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