Sensitivity and specificity of drug interaction databases to detect interactions with recently approved oral antineoplastics

2021 ◽  
pp. 107815522098424
Author(s):  
John B Bossaer ◽  
Danielle Eskens ◽  
Austin Gardner
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Potential Drug ◽  
Considerable Variability ◽  
Potential Ddis ◽  
Chi Square ◽  
Small Pilot Study ◽  
Significant Variability ◽  
Chi Square Test ◽  
Prescribing Information

Rationale: Drug-drug interactions (DDIs) with oral antineoplastics (OAs) are of increasing concern given the rapid increase in OA approvals and use in cancer patients. A small pilot study of 20 DDIs with OAs showed significant variability in commonly used DDI screening databases in sensitivity of detecting potentially clinically relevant DDIs. This study builds upon that work by expanding the number of potential DDIs analyzed and including a specificity analysis. Methods Newly approved OAs from 2016 to May 2019 (n = 22) were included in this analysis. Prescribing information for each drug was reviewed. A list of explicit and theoretical drug interactions was created for each OA by the two investigators. A board-certified oncology pharmacist adjudicated all DDI pairs for potential clinical significance. In total, 229 DDI pairs were used to analyze sensitivity of 5 DDI databases (Lexicomp®, Micromedex®, Medscape, Eporactes®, & Drugs.com). Additionally, 64 “dummy” or false DDI pairs were created to analyze specificity. Sensitivity and specific were analyzed using Cochran’s Qtest, while accuracy was analyzed using chi-square test. Results There was significant variability among the databases with regards to sensitivity (p < 0.0001), specificity (p < 0.0001), and accuracy (p < 0.0001). In terms of accuracy (max score = 400), Lexicomp®(355), Epocrates® (344), and Drugs.com (352) scored higher than MicroMedex® (270) and Medscape (280). Conclusions Considerable variability exists among DDI screening databases with regards to OAs and potential drug interactions. Clinicians should be vigilant in both screening for DDIs with OAs and describing DDIs encountered in clinical practice.

scholarly journals ANALYSIS OF POTENTIAL DRUGS INTERACTION ON ANTIHYPERTENSION DRUGS PRESCRIPTION IN COMMUNITY HEALTH CENTER OF SUKMAJAYA DISTRICT IN PERIOD OF JUNE-NOVEMBER 2015

2017 ◽  
Vol 10 (17) ◽  
pp. 61
Author(s):  
Atika Wahyu Puspitasari ◽  
Azizahwati Azizahwati ◽  
Ayu Rahmawati Hidayat
Keyword(s):  
Drug Interactions ◽  
Community Health ◽  
Health Center ◽  
Community Health Center ◽  
Interaction Mechanism ◽  
Potential Interaction ◽  
Common Disease ◽  
Potential Drug ◽  
Chi Square ◽  
Chi Square Test

Objectives: Hypertension is a common disease around the world. Depending on the severity or the presence of other diseases, whether related or unrelated, additional drug therapy may be required to optimize treatment and to reduce the side effects of drugs. The use of drugs in large amounts may increase the risk of drug interactions. The purpose of this research was to evaluate the characteristics of hypertension patients, prescriptions, and potential drug interactions in hypertensive patients in the Sukmajaya Community Health Center from June to November 2015.Methods: This research used a descriptive analytic method and the data were retrospectively obtained.Results: The results were based on the analysis of 350 prescriptions of female (67.43%) and male (32.57%) patients, with the highest prevalence of hypertension occurring at the age of ≥55 years. Potential drug interactions were analyzed using Micromedex. The most frequent potential interaction resulted from the combined use of captopril and non-steroidal anti-inflammatory drugs. The most frequent mechanism of drug interaction was pharmacokinetics (51.06%). The chi-square test results showed a significant relationship between the number of prescribed drugs and potential interactions at a probability value of 0.0001 and an odds ratio of 5.940 (15.588-2.263).Conclusions: With respect to interaction mechanism, pharmacokinetic (51.06%) was the most frequent and 61.70% of potential cases involved a moderate interaction risk.

scholarly journals Potential Drug-Drug Interactionsamong Adult Patients Admitted to MedicalWards at a Tertiary Teaching Hospital inEthiopia

2018 ◽  
Vol 8 (5-s) ◽  
pp. 348-354 ◽  
Author(s):  
Samson Kibrom ◽  
Zelalem Tilahun ◽  
Solomon Assefa Huluka
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Teaching Hospital ◽  
Adult Patients ◽  
Potential Drug ◽  
Potential Ddis ◽  
Pharmacodynamic Interaction ◽  
Cross Sectional ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

  Abstract Introduction: A Drug-drug interaction (DDI) is a decrease or increase in the pharmacological or clinical response to the administration of two or more drugs that are different from the anticipated response they initiate when individually administered. Objectives: To assess the prevalence and factors associated with potential DDIs among adult inpatients admitted to the medical wards of a tertiary teaching Hospital in Ethiopia. Methods: A retrospective cross-sectional study design was employed on adult patients who were admitted to the medical ward in one year period. A total of 384patients’ medical records were checked for a possible DDI using Micromedex DrugReax® drug interaction database and analyzed consecutively using SPSS version 20.0. Results: Among 384 adult patients enrolled in the study, 209 (54.4%) of them had medications with at least one potential DDI in their prescriptions. Of the 209 potential DDI, 26.3% were with a minimum of one major potential DDI. The median number of potential DDI per patient was 2.2. Overall, 296 potential DDI were identified in the current study. Among 296 identified potential drug-drug interactions, most of the interaction (49.7%) had good documentation. The number of medication prescribed per patient showed a significant (p< 0.001) association with the occurrence of potential DDIs. Conclusion: More than half of the patients’ prescription contains potentially interacting medications. This study, additionally, revealed that there is a significant association between potential DDIs and number of medications prescribed per patient. Key words: Drug-drug interactions, pharmacokinetic interaction, pharmacodynamic interaction, internal medicine

scholarly journals Review of Impact and Handling of Potential Antihypertensive Drug Interactions in Chronic Kidney Disease Patients

2021 ◽  
Vol 7 (1) ◽  
pp. 39-53
Author(s):  
Ni Made Susilawati ◽  
Eli Halimah ◽  
Siti Saidah
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Heart Function ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Potential Drug ◽  
Analysis Program ◽  
Drug Related Problems ◽  
Related Effect ◽  
Complete Knowledge

Drug interaction is a type of Drug-Related Problems (DRPs) that caneventually increase morbidity and mortality rates. CKD patients have asignificant risk of developing polypharmacy due to comorbid diseases andpharmacokinetics' alteration. The literature review was conducted byexploring all of the articles related to the drug interaction using druginteraction analysis program in CKD patients, which obtained from threedatabases, namely Google Scholar, PubMed, and Science Direct, usingseveral keywords combination. Based on the comprehensive reviewsconducted, it is known that the most common effects of antihypertensivedrug interactions in CKD patients are decreasing effects of antihypertensivedrugs, hypotension, and hyperkalemia. Handling management used for theemergence of potential drug interactions is based on the severity of the druginteractions and complete knowledge of the patients' clinical condition. Themanagement of drug interaction by monitoring blood pressure, diuresis, andpotassium levels; Monitor the related effect symptoms; Monitor the fluidand body weight; Monitor the kidney and heart function. On the conditionwhere the handling management of potential drug interactions is not carriedout, elevated morbidity and mortality rates are the risks of complicationsarising from the drug interactions.

scholarly journals Emerging and experimental treatments for COVID-19 and drug interactions with psychotropic agents

2020 ◽  
Vol 10 ◽  
pp. 204512532093530 ◽  
Author(s):  
Delia Bishara ◽  
Chris Kalafatis ◽  
David Taylor
Keyword(s):  
Drug Interaction ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Clinical Trial Data ◽  
Potential Drug ◽  
Qtc Prolongation ◽  
Experimental Drugs ◽  
Psychotropic Agents ◽  
The Common ◽  
Experimental Treatments

As yet, no agents have been approved for the treatment of COVID-19, although several experimental drugs are being used off licence. These may have serious adverse effects and potential drug interactions with psychotropic agents. We reviewed the common agents being used across the world for the treatment of COVID-19 and investigated their drug interaction potential with psychotropic agents using several drug interaction databases and resources. A preliminary search identified the following drugs as being used to treat COVID-19 symptoms: atazanavir (ATV), azithromycin (AZI), chloroquine (CLQ)/hydroxychloroquine (HCLQ), dipyridamole, famotidine (FAM), favipiravir, lopinavir/ritonavir (LPV/r), nitazoxanide, remdesivir, ribavirin and tocilizumab. Many serious adverse effects and potential drug interactions with psychotropic agents were identified. The most problematic agents were found to be ATV, AZI, CLQ, HCLQ, FAM and LPV/r in terms of both pharmacokinetic as well as serious pharmacodynamic drug interactions, including QTc prolongation and neutropenia. Significant caution should be exercised if using any of the medications being trialled for the treatment of COVID-19 until robust clinical trial data are available. An even higher threshold of vigilance should be maintained for patients with pre-existing conditions and older adults due to added toxicity and drug interactions, especially with psychotropic agents.

scholarly journals ASSESSMENT OF POTENTIAL DRUG INTERACTIONS AMONG HOSPITALIZED PATIENTS IN NEUROLOGY DEPARTMENT IN TERTIARY CARE HOSPITALS

2019 ◽  
pp. 173-176
Author(s):  
DIJO DAIS ◽  
RANJEET AVIS CHERUVATHOOR ◽  
KAMESWARAN R ◽  
SHANMUGA SUNDARAM RAJAGOPAL
Keyword(s):  
Risk Factors ◽  
Drug Interactions ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Daily Basis ◽  
Potential Drug ◽  
Potential Ddis ◽  
Patient History ◽  
Therapeutic Advantage ◽  
Tertiary Care Hospitals

Objective: This research was instigated to determine and assess the prevalence, severity, type, and the total number of potential drug interactions in the neurology department of two hospitals in India. Methods: The data were collected from the prescriptions and by patient history interview on a daily basis. The drug-drug interactions (DDIs) were identified using Micromedex® database-2.7 and drugs.com. Results: The drug interactions were influenced by a plethora of risk factors: Gender, age, comorbidities, length of hospital stay, and the neurological condition. The study was comprised 320 patients, among 196 patients were identified with potential DDIs (PDDIs), and a total of 450 PDDIs were observed. The prevalence of PDDIs according to the severity was major (42.6%), moderate (45.11%), and minor (12.22%). Conclusion: To lessen PDDIs, the range of medications for the patients must be properly managed, and it is encouraged to remove all medicines without therapeutic advantage, intention, and an indication.

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.

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 Improved Label Propagation Model to Predict Drug - drug Interactions

2018 ◽  
Vol 173 ◽  
pp. 02007
Author(s):  
Zhice Yan ◽  
Lasheng Zhao ◽  
Xiaopeng Wei ◽  
Qiang Zhang
Keyword(s):  
Drug Interactions ◽  
Characteristic Curve ◽  
Clinical Stage ◽  
Real Life ◽  
Propagation Model ◽  
Label Propagation ◽  
Chi Square ◽  
Propagation Algorithm ◽  
Proposed Model ◽  
Chi Square Test

Drug-drug interactions (DDIs) is one of the most concerned issues in drug design. Accurate prediction of potential DDIs in clinical trials can reduce the occurrence of side effects in real life of drugs. Therefore, we propose a model to predict DDIs. The model integrates several methods that can improve label propagation algorithm. Firstly, the chi-square test (CHI) method is adopted to filter or select the features that contain a large amount of information. Secondly, the sample similarity calculation method is reconstructed by label similarity and feature similarity. Then the label initialization information of unlabeled samples is constructed. Finally, we use label propagation algorithm to estimate the labels of the unlabeled drugs. The results show that the proposed model can obtain higher the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPR), which provides a favorable guarantee for the discovery of DDIs in the clinical stage.

scholarly journals A Minimal Information Model for Potential Drug-Drug Interactions

2021 ◽  
Vol 11 ◽  
Author(s):  
Harry Hochheiser ◽  
Xia Jing ◽  
Elizabeth A. Garcia ◽  
Serkan Ayvaz ◽  
Ratnesh Sahay ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Best Practice ◽  
Task Force ◽  
Information Model ◽  
Potential Drug ◽  
Community Group ◽  
Drug Drug Interaction ◽  
Potential Interactions ◽  
Minimal Information

Despite the significant health impacts of adverse events associated with drug-drug interactions, no standard models exist for managing and sharing evidence describing potential interactions between medications. Minimal information models have been used in other communities to establish community consensus around simple models capable of communicating useful information. This paper reports on a new minimal information model for describing potential drug-drug interactions. A task force of the Semantic Web in Health Care and Life Sciences Community Group of the World-Wide Web consortium engaged informaticians and drug-drug interaction experts in in-depth examination of recent literature and specific potential interactions. A consensus set of information items was identified, along with example descriptions of selected potential drug-drug interactions (PDDIs). User profiles and use cases were developed to demonstrate the applicability of the model. Ten core information items were identified: drugs involved, clinical consequences, seriousness, operational classification statement, recommended action, mechanism of interaction, contextual information/modifying factors, evidence about a suspected drug-drug interaction, frequency of exposure, and frequency of harm to exposed persons. Eight best practice recommendations suggest how PDDI knowledge artifact creators can best use the 10 information items when synthesizing drug interaction evidence into artifacts intended to aid clinicians. This model has been included in a proposed implementation guide developed by the HL7 Clinical Decision Support Workgroup and in PDDIs published in the CDS Connect repository. The complete description of the model can be found at https://w3id.org/hclscg/pddi.

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