scholarly journals Comparison between two databases regarding the classification of Drug Interactions and their mechanism of action

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
D Fernandes ◽  
A Jesus

Abstract Introduction Many drug-related problems are caused by drug interactions (DIs) that result from the pharmacological influence of one drug on another when taken together. DIs may have beneficial and predictable effects, but may also cause undesirable results, such as treatment ineffectiveness or serious adverse effects. There are a number of available databases with information about DIs. Although the information they provide is not always consensual, it is a useful tool in analysing the occurrence of potential drug interactions (PDIs) and in preventing unwanted or even fatal consequences for patients. Objectives To compare the convergence of two databases (Micromedex/Drugs.com) regarding the classification of DIs and their mechanism of action. Methodology A cross-sectional, descriptive and exploratory observational study was carried out using prescriptions from users with diabetes, dyslipidaemia or both pathologies from pharmacies in two districts, Porto and Braga. Information from each sample group was further analysed using two databases, Micromedex/Drugs.com. Results Of the 57 pairs whose interaction potential was analysed, 64.3% converged on the classifications in both databases. Micromedex assigns moderate potential interaction to 36 drug pairs, and of these, 28 get the same rating on Drugs.com. Regarding the major PDIs, the degree of agreement was 40%. There are 4 drug pairs with potential for major interaction at Micromedex to which Drugs.com assigns moderate PDI. Minor PDIs were found on Drugs.com in 4 drug pairs, which Micromedex rated as major or moderate. For the remaining twelve divergent rating pairs, Drugs.com does not assign them potential for interaction while Micromedex gives them potential for major or moderate PDIs. Regarding the consequences of the occurrence of PDIs, there is agreement between Micromedex and Drugs.com, except for pair AAS/Loop Diuretics. Conclusion Micromedex identifies a higher number of PDIs and assigns higher severity to a higher number.

Author(s):  
Erna Yanti ◽  
Erna - Kristin ◽  
Alfi Yasmina

Objective: Patients with hypertension often suffer from other comorbidities, resulting in prescriptions of multiple drugs to treat the conditions. Multiple drug treatment is potentially associated with drug interactions. This aim of the study was to assess potential drug interactions in hypertensive patients in Liwa District Hospital.Methods: The design of the study was cross-sectional. The prescriptions for in-patients with essential hypertension in the Internal Medicine Unit in Liwa District Hospital during April-December 2012 were collected. Potential drug interactions were analyzed with the Drug Interaction Facts version 4.0, and classified into minor, significant, and serious.Results: A total of 60 hypertensive patients were included. They were prescribed 265 prescriptions, with a median total of 6 (range 1-21) drugs prescribed per prescription. There were 1616 potential drug interactions, with 6 (1-31) potential interactions per prescription. Most interactions (75.6%) were classified as significant. Serious potential interactions were most common in the combinations of diltiazem-amlodipine and spironolactone-potassium chloride, while significant potential interaction may occur most often with the combinations of calcium chloride-amlodipine and bisoprolol-amlodipine.Conclusion: Numerous potential drug interactions might occur in hypertensive patients, and most interactions were significant in severity. The largest proportion of the interactions occurred between antihypertensive agents and other drugs. 


2020 ◽  
Vol 54 (4) ◽  
pp. 218-224
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.


2021 ◽  
Vol 15 (10) ◽  
pp. 3072-3075
Author(s):  
Hammad Ahmed Butt ◽  
Muhammad Zeeshan Anwar ◽  
Akram Shahzad ◽  
Farah Iqbal ◽  
Zafra Seemab ◽  
...  

Drug-drug interactions (DDIs), are preventable medical related hazards having grave life menacing and unfavorable consequences Purpose: To find the clinical adverse effects and interaction frequency witnessed in prescriptions of a medical OPD Study Design: Comparative study Methodology: A sample of 546 patients who were being prescribed at least two drugs simultaneously was assessed using a drug interaction program Statistical analysis: SPSS v.20.0 was used to analyze the data to present results as proportions Results: The 546 patients (72.8% male having mean age of 58.3±14.7 years. Out of these 186 (4.7%), 2595 (65.6%) and 773 (19.5%) were severe, moderate and mild interactions respectively Conclusions: We concluded that large percentage of patients were detected having one or more potential drug-drug interactions Keywords: Adverse Drug Interaction, Drug-Related Problems, Drug-Drug Interaction and Pharmaco-epidemiology.


2020 ◽  
Vol 54 (4) ◽  
pp. 237-243
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.


2014 ◽  
Vol 83 (3) ◽  
pp. 238-243
Author(s):  
Karolina Kilińska ◽  
Magdalena Cerbin-Koczorowska ◽  
Arleta Matschay ◽  
Michał Mierzwicki ◽  
Karolina Chmaj-Wierzchowska

Aim. The aim of the pilot study was to assess the effectiveness of the tool designed for detecting potential drug-drug interactions of combined oral contraceptives (COCs) with particular emphasis on those which can affect their contraceptive action. A proper study protocol design seems to be essential for further analysis of more data and for establishing correlations between observed interactions and demographic variables.Material and methods. The cross-sectional descriptive, retrospective study was carried out on Polish females from March to May 2013. Gathered data, including products used concomitantly with contraceptive drugs, were derived electronically by patients and underwent thematic analysis.Results. Out of 49 respondents who agreed to participate in the study and fit the inclusion criteria only 15 derived qualitative data about other medicinal products they used. However, some of them sent their monthly report more than once, which gave the total of 158 drugs listed in 25 forms gathered during the whole pilot study. Fifty-three potential drug interactions were found, including 13 (24.53%) which could have decreased the effectiveness of contraceptive drugs.Conclusions. Continuation of the study in accordance with the study protocol will result in identification of common potential drug-related problems, which may enable development of an educational solution for gynecologists, pharmacists and patients increasing their awareness of the potential risk of contraceptive failures and unintended pregnancies.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Yuan ◽  
Chunying Shen ◽  
Chengnan Wang ◽  
Gang Shen ◽  
Bing Han

Background: Drug interactions are the most common preventable cause of adverse drug reaction, which may result in drug toxicity or undesired therapeutic effect with harmful outcomes to patients. Given the rising use of combination therapies, the main objectives of this study were to estimate the degree to which physicians can identify potential drug-drug interactions (PDDIs) correctly and to describe the common source of information used by physicians when they need to check PDDIs.Methods: A cross-sectional survey utilizing a self-administered online questionnaire was conducted among physicians in China. Participants were asked to classify 20 drug pairs as “no interaction,” “may be used together with monitoring,” “contraindication,” and “not sure.” We also collected data on the physician's source of information and altitude toward the PDDIs. An ordinary least square regression model was performed to investigate the potential predictors of PDDI knowledge.Results: Eligible questionnaires were obtained from 618 physicians. The respondents classified correctly 6.7 out of 20 drug pairs, or 33.4% of the drug interactions investigated. The number of drug pairs recognized by respondents was ranged from 0 to 16. The percentage of physicians who recognized specific drug pairs ranged from 8.3% for no interactions between conjugated estrogens and raloxifene, to 64.0% for the interaction between dopamine and phenytoin. When the respondents want to check PDDI information, the most commonly used source of information was package inserts (n = 572, 92.6%), followed by the Internet or mobile Apps (n = 424, 68.6%), consultation with clinical pharmacists (n = 384, 62.1%), medical textbooks (n = 374, 60.5%), knowledge base in Chinese (n = 283, 45.8%), and other physicians (n = 366, 59.2%). In the multiple regression analysis, the significant predictors of a higher number of recognized drug pairs were years of practice and altitudes toward PDDIs.Conclusion: In this online survey accessing physician's ability to detect PDDIs, less than half of the drug pairs were recognized, indicating unsatisfactory level of knowledge about the clinically significant drug interactions. Continuing education and accessible electronic database can help physicians detecting PDDIs and improve drug safety.


Author(s):  
DURGA PRASAD THAMMISETTY ◽  
DIVITI RANGANAYAKULU ◽  
DEVANNA NAYAKANTI

Objective: The objective of the study was to assess the drug-related problems (DRPs) and the World Health Organization (WHO) core prescribing indicators among stroke patients. Methods: A prospective observational study was conducted among stroke inpatients of Acute Medical Care and General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data about demographics, clinical characteristics, WHO prescribing indicators, and DRPs. Descriptive statistics were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Chi-square test was employed to test the significant association between the demographics and the occurrence of DRPs. Results: Among 174 patients included in the study, 89 had one or more DRPs. A total of 122 DRPs were identified in the study population. Drug interactions (48.4%) and adverse drug reactions (ADRs) (17.2%) were commonly observed DRPs. A significant direct association was observed between the occurrence of DRPs and number of comorbidities (p<0.001), polypharmacy (p<0.001), and hospital stay (p<0.05). The average number of drugs per prescription was 7.2. Of drugs prescribed, 67.6% were in their generic names. The percentage of encounters in which an antibiotic, injection was prescribed was 65.5% and 89.6% respectively. The percentage of drugs prescribed from an essential drug list was 91.2%. Conclusion: The rate of drug interactions and ADRs was high in treatment of stroke patients. Patients suffering from comorbidities, polypharmacy, and long hospital stay were positively associated with occurrence of DRPs in stroke. Regular monitoring and screening for drug interactions and ADRs were advised to reduce the burden DRPs in stroke patients admitted in a critical care unit.


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