scholarly journals Pharmacological Studies on Drug Interaction. II. Drug Interactions of Nonsteroidal Anti-inflammatory Drugs on the Hypothermic Action, the Antipyretic Action and the Acute Toxidty

1976 ◽  
Vol 96 (1) ◽  
pp. 91-98
Author(s):  
HIKARU OZAWA ◽  
MAKOTO IKEDA ◽  
YOSHIO TOYOGUCHI
2019 ◽  
Author(s):  
Nuru Abdu ◽  
Samuel Teweldemedhin ◽  
Asmerom Mosazghi ◽  
Luwam Asfaha ◽  
Makda Teshale ◽  
...  

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.


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

2020 ◽  
Vol 53 (05) ◽  
pp. 229-234
Author(s):  
Maike Scherf-Clavel ◽  
Susanne Treiber ◽  
Jürgen Deckert ◽  
Stefan Unterecker ◽  
Leif Hommers

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.


1998 ◽  
Vol 54 (5) ◽  
pp. 399-404 ◽  
Author(s):  
T. Andersson ◽  
E. Bredberg ◽  
P.-O. Lagerström ◽  
J. Naesdal ◽  
I. Wilson

2021 ◽  
Author(s):  
Thomas Reese ◽  
Guilherme Del Fiol ◽  
Keaton Morgan ◽  
Jason T. Hurwitz ◽  
Kensaku Kawamoto ◽  
...  

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.


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