scholarly journals Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Maria Cristina Soares Rodrigues ◽  
Cesar de Oliveira
Keyword(s):  
Older Adults ◽  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Inappropriate Prescribing ◽  
Integrative Review ◽  
Geriatric Nursing ◽  
Drug Reactions ◽  
Exclusion Criteria ◽  
Drug Classes ◽  
Negative Health Outcomes

ABSTRACT Objective: to identify and summarize studies examining both drug-drug interactions (DDI) and adverse drug reactions (ADR) in older adults polymedicated. Methods: an integrative review of studies published from January 2008 to December 2013, according to inclusion and exclusion criteria, in MEDLINE and EMBASE electronic databases were performed. Results: forty-seven full-text studies including 14,624,492 older adults (≥ 60 years) were analyzed: 24 (51.1%) concerning ADR, 14 (29.8%) DDI, and 9 studies (19.1%) investigating both DDI and ADR. We found a variety of methodological designs. The reviewed studies reinforced that polypharmacy is a multifactorial process, and predictors and inappropriate prescribing are associated with negative health outcomes, as increasing the frequency and types of ADRs and DDIs involving different drug classes, moreover, some studies show the most successful interventions to optimize prescribing. Conclusions: DDI and ADR among older adults continue to be a significant issue in the worldwide. The findings from the studies included in this integrative review, added to the previous reviews, can contribute to the improvement of advanced practices in geriatric nursing, to promote the safety of older patients in polypharmacy. However, more research is needed to elucidate gaps.

Understanding adverse drug reactions in older adults through drug–drug interactions

2014 ◽  
Vol 25 (9) ◽  
pp. 843-846 ◽  
Author(s):  
A. Marengoni ◽  
L. Pasina ◽  
C. Concoreggi ◽  
G. Martini ◽  
F. Brognoli ◽  
...  
Keyword(s):  
Older Adults ◽  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Drug Reactions

scholarly journals Off-label antipsychotics prescription to adolescents with acute psychotic episodes does not cause adverse drug reactions

2021 ◽  
Vol 13 (3) ◽  
pp. 19-26
Author(s):  
D. V. Ivashchenko ◽  
N. I. Buromskaya ◽  
A. D. Malakhova ◽  
N. A. Tsarkova ◽  
L. M. Savchenko ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Psychotic Episode ◽  
Age Group ◽  
Off Label Use ◽  
Drug Reactions ◽  
Off Label ◽  
Drug Classes ◽  
Increased Risk ◽  
Label Use

Antipsychotics are often used to treat children and adolescents. Because of their age, there are a lot of off-label prescribed antipsychotics in that population. However, the off-label use of medications is considered to be potentially unsafe.Objective: to evaluate whether the off-label prescription of antipsychotics outside of the approved age group increased the risk of adverse drug reactions in adolescents experiencing an acute psychotic episode.Patients and methods. We analyzed 450 charts of adolescents hospitalized due to an acute psychotic episode (only completed cases). In addition, we evaluated adverse drug reactions adjusted by off-label antipsychotics prescription outside the approved age group using the Global Trigger Tool (GTT). We also registered prescriptions with duplicates drug classes and potentially dangerous drug interactions.Results and discussion. Off-label antipsychotics prescription outside the approved age group was less frequently associated with adverse drug reactions (3.2% vs. 10.5%; p=0.013). The logistic regression analysis did not show any significant associations between the off-label antipsychotic use and increased risk of adverse drug reactions (Odds ratio=0.994 (95% confidence interval 0.572-1.726), p=0.982). Although, patients with off-label use of antipsychotics were more likely to have potentially dangerous drug interactions (35.2% vs. 16.15%; p=0.0001) and prescriptions with duplicates drug classes (39.6% vs. 15.43%; p=0.0001).Conclusion. Off-label antipsychotic prescription outside the approved age group in adolescents with acute psychotic episode does not increase the risk of adverse drug reactions. However, an increase in potentially dangerous drug interactions and prescriptions with duplicates drug classes frequency could be considered red flags. Therefore, we have concluded that the concerns about off-label antipsychotics prescription outside of approved age groups in adolescents with acute psychotic episodes were overrated.

scholarly journals In-hospital adverse drug reactions in older adults; prevalence, presentation and associated drugs—a systematic review and meta-analysis

2020 ◽  
Vol 49 (6) ◽  
pp. 948-958 ◽  
Author(s):  
Emma L M Jennings ◽  
Kevin D Murphy ◽  
Paul Gallagher ◽  
Denis O’Mahony
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Adverse Drug Reactions ◽  
Older Patients ◽  
Final Analysis ◽  
Cochrane Library ◽  
Drug Reactions ◽  
Drug Classes ◽  
Clinical Presentations ◽  
Hospitalised Patients

Abstract Background the prevalence of adverse drug reactions (ADRs) in hospitalised older patients, their clinical presentations, causative drugs, severity, preventability and measurable outcomes are unclear, ADRs being an increasing challenge to older patient safety. Methods we systematically searched PubMed, Embase, EBSCO-CINAHL, the Cochrane Library, ‘rey’ literature and relevant systematic review bibliographies, published from database inception to March 2020. We included any study reporting occurrence of in-hospital ADRs as primary or secondary outcomes in hospitalised older adults (mean age ≥ 65 years). Two authors independently extracted relevant information and appraised studies for bias. Study characteristics, ADR clinical presentations, causative drugs, severity, preventability and clinical outcomes were analysed. Study estimates were pooled using random-effects meta-analytic models. Results from 2,399 abstracts, we undertook full-text screening in 286, identifying 27 studies (29 papers). Final analysis yielded a pooled ADR prevalence of 16% (95%CI 12–22%, I2 98%,τ2 0.8585), in a population of 20,153 hospitalised patients aged ≥65 years of whom 2,479 patients experienced ≥ one ADR. ADR ascertainment was highly heterogeneous. Almost 48.3% of all ADRs involved five presentations: fluid/electrolyte disturbances (17.3%), gastrointestinal motility/defaecation disorders (13.3%), renal disorders (8.2%), hypotension/blood pressure dysregulation disorders/shock (5.5%) and delirium (4.1%). Four drug classes accounted for 57.8% of causative medications i.e. diuretics (19.8%), anti-bacterials (14.8%), antithrombotic agents (12.2%) and analgesics (10.9%). Pooled analysis of severity was not feasible. Four studies reported the majority of ADRs as preventable (55–95%). Conclusions on average, 16% of hospitalised older patients experience significant ADRs, varying in severity and mostly preventable, with commonly prescribed drug classes accounting for most ADRs.

Biology of Heme: Drug Interactions and Adverse Drug Reactions with CYP450

2019 ◽  
Vol 18 (23) ◽  
pp. 2042-2055 ◽  
Author(s):  
Neeraj Kumar ◽  
Heerak Chugh ◽  
Damini Sood ◽  
Snigdha Singh ◽  
Aarushi Singh ◽  
...  
Keyword(s):  
Cytochrome P450 ◽  
Drug Metabolism ◽  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Genetic Defects ◽  
Drug Reactions ◽  
Detailed Structure ◽  
Synthesis And Degradation ◽  
Porphyrin Rings

Heme is central to functions of many biologically important enzymes (hemoproteins). It is an assembly of four porphyrin rings joined through methylene bridges with a central Fe (II). Heme is present in all cells, and its synthesis and degradation balance its amount in the cell. The deregulations of heme networks and incorporation in hemoproteins lead to pathogenic state. This article addresses the detailed structure, biosynthesis, degradation, and transportation associated afflictions to heme. The article is followed by its roles in various diseased conditions where it is produced mainly as the cause of increased hemolysis. It manifests the symptoms in diseases as it is a pro-oxidant, pro-inflammatory and pro-hemolytic agent. We have also discussed the genetic defects that tampered with the biosynthesis, degradation, and transportation of heme. In addition, a brief about the largest hemoprotein group of enzymes- Cytochrome P450 (CYP450) has been discussed with its roles in drug metabolism.

Adverse drug reactions & drug interactions in MDR-TB patients

2020 ◽  
Vol 67 (4) ◽  
pp. S69-S78
Author(s):  
Amitesh Gupta ◽  
Vikas Kumar ◽  
Sekar Natarajan ◽  
Rupak Singla
Keyword(s):  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Drug Reactions ◽  
Mdr Tb

Importance of cytochrome P450 (CYP450) in adverse drug reactions due to drug–drug interactions: a PharmacoVigilance study in France

2012 ◽  
Vol 69 (4) ◽  
pp. 885-888 ◽  
Author(s):  
Anne Charlotte Danton ◽  
François Montastruc ◽  
Agnès Sommet ◽  
Geneviève Durrieu ◽  
Haleh Bagheri ◽  
...  
Keyword(s):  
Cytochrome P450 ◽  
Drug Interactions ◽  
Adverse Drug Reactions ◽  
Drug Reactions

scholarly journals 24In-Hospital Adverse Drug Reactions in Hospitalised Older Adults - A Systematic Review

2018 ◽  
Vol 47 (suppl_5) ◽  
pp. v13-v60 ◽  
Author(s):  
Emma Jennings ◽  
Kevin Murphy ◽  
Paul Gallagher ◽  
Denis O’Mahony
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Adverse Drug Reactions ◽  
Drug Reactions
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