scholarly journals Occurrence of possible drug related interactions in medical patients in out-patient departments of Pakistan

2020 ◽  
Vol 9 (10) ◽  
pp. 1503
Author(s):  
Hammad A. Butt ◽  
Ammara Khan ◽  
Naveed Suleman
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Related Problem ◽  
Potential Drug ◽  
Medical Patients ◽  
Interaction Detection ◽  
Drug Related Problem ◽  
Detection Program ◽  
Background Data ◽  
Potential Interactions

Background: Data regarding occurrence of drug-drug interactions in Pakistan is rare. In the current study, we have tried to find out the clinical adversity and frequency witnessed in prescriptions of a medical outpatient department.Methods: Patient prescriptions were analyzed for potential drug-drug interactions.  A sample of 364 patients, visited outpatient department who were being prescribed at least two drugs simultaneously using a drug interaction program website.Results: The 364 patients (72.8% male, mean age 57.9±15.2 years) were prescribed a median of six drugs (range 2-13) at OPD visit. Three hundred forty nine patients (95.8%) had at least one potentially interacting drug combination. 2636 potential interactions were seen in the visiting patients. Out of these 124 (4.7%) were of major severity, 1730 (65.6%) moderate and 515 (19.5%). Out of 124 patients with a potential DDI with major severity, no patient was re-hospitalized within 2 months after discharge due to a probable drug-related problem associated with the potential DDI.Conclusions: A large percentage of patients were detected having one or more potential drug-drug interactions, using drug interaction detection program. However, the percentage of patients having clinically adverse consequences due to drug-drug interactions appears to be very low.

scholarly journals Analisis Hubungan Polifarmasi Dan Interaksi Obat Pada Pasien Rawat Jalan Yang Mendapat Obat Hipertensi Di Rsp. Dr. Ario Wirawan Periode Januari-Maret 2019

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Lamtiar Parulian Parulian ◽  
Ening Listyanti ◽  
Anita Kumala Hati ◽  
Istianatus Sunnah
Keyword(s):  
Drug Interaction ◽  
Drug Therapy ◽  
Drug Interactions ◽  
Related Problem ◽  
Current Treatment ◽  
Antihypertensive Drug Therapy ◽  
Drug Related Problems ◽  
Inclusion Criteria ◽  
Drug Related Problem ◽  
Spearman Test

Hipertensi merupakan masalah kesehatan masyarakat yang umum di negara berkembang. Riskesdas tahun 2013 menyatakan bahwa prevalensi hipertensi secara  umum diindonesia sebesar 26,5% dengan proporsi  serbesar berada di Jawa Tengah yaitu 57,89%. Polifarmasi secara signifikan bisa meningkatkan resiko interaksi obat dimana interaksi obat merupakan salah satu faktor penting dalam drug related problem yang dapat mempengaruhi outcome terapi pasien. Interaksi obat merupakan satu dari delapan kategori masalah terkait obat (drug-related problem) yang dapat mempengaruhi outcome klinis pasien, dengan meningkatnya kompleksitas obat-obat yang digunakan dalam pengobatan saat ini dan kecenderungan terjadinya praktik polifarmasi, maka kemungkinan terjadinya interaksi obat semakin besar. Tujuan dari penelitian ini adalah untuk mengetahui hubungan interaksi obat dalam resep polifarmasi pada pasien yang mendapat terapi obat antihipertensi di instalasi farmasi RSP dr. Ario Wirawan Salatiga. Penelitian ini dilakukan secara retrospektif dengan menggunakan  resep pasien hipertensi rawat jalan di Rumah Sakit Paru Ario Wirawan Salatiga periode Januari-Maret 2019  sebanyak 72 sampel yang termasuk ke dalam kriteria inklusi. Data dianalisis secara deskriptif menggunakan Drug Interaction Facts dan di analisis dengan Spearman test. Diperoleh data bahwa jumlah interaksi obat-obat yang terjadi (51,39%). Pola mekanisme yang terbanyak adalah farmakokinetik (53,97%) dengan tingkat keparahan yang terbanyak adalah minor (42,86%). Hasil menunjukkan adanya korelasi antara jumlah obat dengan kejadian interaksi (r=0,986, p=000) adanya hubungan yang sangat signifikan.Kata kunci : Interaksi Obat, polifarmasi, terapi obat hipertensi.Hypertension is a common problem in developing countries. Based on the basic health research  in 2013, the prevalence of hypertension in Indonesia was 26.5% with a large proportion in Central Java at 57.89%. Polypharmacy can significantly increase the risk of drug interactions where drug interactions are an important factor in drug related problems that can affect the outcome of patient therapy. Drug interaction is one of eight categories of drug-related problems that can affect a patient's clinical outcome. Increasing complexity of the drugs used in current treatment will raise the tendency for polypharmacy to occur, resulting higher chance for the drug interaction possibility.This study is aimed to find relationship of drug interactions with polypharmacy prescriptions by patients receiving antihypertensive drug therapy in Dr. Ario Wirawan Hospital. This study was conducted retrospectively using the outpatient prescription that entered the inclusion criteria at Dr. Ario Wirawan Hospital Salatiga. A total of 72 samples that included in the inclusion criteria. Data were analyzed descriptively using Drug Interaction Facts and analyzed by Spearman test. Result showed that the number of drug interactions that occurred (51,39%). The most mechanism pattern of the drug interaction was pharmacokinetics (53,97%) with the highest severity level being minor (42,86%). This study showed that there is a a very significant correlation between the number of drugs and interactions (r = 0.986, p = 000).Keywords : Drug interactions, polypharmacy, hypertension drug therapy  

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.

Presence of Affirmable Drug Affiliated Interactions in Medical Patients in Medical OPD of Pakistani Hospital

2021 ◽  
Vol 15 (10) ◽  
pp. 3072-3075
Author(s):  
Hammad Ahmed Butt ◽  
Muhammad Zeeshan Anwar ◽  
Akram Shahzad ◽  
Farah Iqbal ◽  
Zafra Seemab ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Statistical Analysis ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Interaction Frequency ◽  
Potential Drug ◽  
Medical Patients ◽  
Drug Related Problems ◽  
Adverse Drug Interaction ◽  
Study Methodology

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.

IDENTIFIKASI DRUG RELATED PROBLEMS PADA PASIEN AUTIS DI RUMAH SAKIT X KOTA YOGYAKARTA

2019 ◽  
pp. 30-40
Author(s):  
Ruri Renggani Sandra ◽  
Della Midi Wardhani ◽  
Woro Supadmi
Keyword(s):  
Autism Spectrum Disorders ◽  
Drug Interaction ◽  
Related Problem ◽  
Drug Information ◽  
Autism Spectrum ◽  
Drug Related Problems ◽  
Drug Reactions ◽  
Drug Related Problem ◽  
Spectrum Disorders ◽  
Drugs Interaction

   Autism spectrum disorders (ASD) adalah gangguan perkembangan saraf dengan penyebab yang kompleks dari banyak fakor Penggunaan obat pada pasien autis harus dimonitoring untuk mencegah terjadinya drug related problems. Intervensi farmasis dengan mengidentifikasi kejadian drug related problem adalah kegiatan pelayanan asuhan kefarmasian untuk meningkatkan keberhasilan terapi. Penelitian ini adalah observasional dengan pengumpulan data secara retrospektif berdasarkan data rekam medik. Evaluasi kejadian drug related problems meliputi indikasi yang tidak diterapi, terapi tanpa indikasi, pemilihan obat yang tidak tepat, overdosis, under dosis, adverse drug reactions dan interaksi obat. Literatur yang digunakan sebagai acuan adalah Drug Information Handbook, 18thed, Stockley Drug Interaction, Drugs Interaction Facts 2001, dan Pharmacotherapy A Pathophysiologic Approach 2005 dan jurnal yang relevan.   Hasil penelitian diperoleh pasien dengan jenis kelamin laki-laki 20 pasien (77%), perempuan 6 pasien (23%). Usia antara 6-11 tahun yaitu 15 pasien (58%), 1-5 tahun terdapat 9 pasien (34%), usia <1 tahun dan 12-17 tahun masing-masing sebanyak 1 pasien (4%). Penyakit penyerta ISPA merupakan kasus yang paling banyak terjadi, terbanyak kedua adalah epilepsi dan gastroenteritis akut (GEA). Kejadian DRPs Indikasi tidak diterapi 9%, Terapi tanpa indikasi 9%, Pemilihan obat tidak tepat 9%, Over dosis 31%, Under dosis 33% dan interaksi obat 9%.   Terdapat 24 pasien ( 92,3%) yang mengalami DRPs potensial dan 2 pasien (7,7%) yang tidak mengalami. Kriteria DRPs dengan persentase tertinggi adalah under dosis sebanyak 33% dan over dosis sebanyak 31%.

scholarly journals POTENTIAL DRUG INTERACTIONS IN HYPERTENSIVE PATIENTS IN LIWA DISTRICT HOSPITAL, LAMPUNG BARAT, INDONESIA

2017 ◽  
Vol 9 (6) ◽  
pp. 134
Author(s):  
Erna Yanti ◽  
Erna - Kristin ◽  
Alfi Yasmina
Keyword(s):  
Drug Interactions ◽  
District Hospital ◽  
Antihypertensive Agents ◽  
Potential Interaction ◽  
Multiple Drug ◽  
Potential Drug ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Multiple Drugs ◽  
Potential Interactions

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. 

scholarly journals IDENTIFIKASI DRPs (DRUG RELATED PROBLEMs) PENDERITA ISPA PASIEN PEDIATRIK DI INSTALASI FARMASI RUMAH SAKIT

WARTA FARMASI ◽  
2017 ◽  
Vol 6 (1) ◽  
pp. 37-49
Author(s):  
Musdalipah Musdalipah ◽  
Eny Nurhikma ◽  
Sartika Sartika
Keyword(s):  
Drug Interaction ◽  
Respiratory Infection ◽  
Acute Respiratory Infection ◽  
Related Problem ◽  
Dose Interval ◽  
Drug Related Problems ◽  
Cross Sectional ◽  
Drug Related Problem ◽  
Descriptive Method ◽  
Random Method

ABSTRAK Drug Related Problem (DRP) atau masalah terkait obat adalah bagian dari asuhan kefarmasian (parmaceutical care) yang menggambarkan suatu keadaan, dimana profesional kesehatan (apoteker) menilai adanya ketidaksesuaian pengobatan dalam mencapai terapi yang sesungguhnya. Tujuan penelitian adalah untuk mengidentifikasi DRPs penderita ISPA (Infeksi Saluran Pernafasan Akut) di Instalasi Farmasi Rumah Sakit kota Kendari dengan kategori polifarmasi, interaksi obat dan interval dosis. Penelitian ini menggunakan metode deskriptif dengan pendekatan Cross Sectional, sampel dalam penelitian ini adalah resep pasien pediatrik yang menderita ISPA. Pengambilan sampel menggunakan metode acak sederhana. Data diolah secara deskriptif dan di jabarkan dalam bentuk narasi. Hasil penelitian ini menunjukkan identifikasi DRPs (Drug Related Problems) dari 30 pasien penderita ISPA di temukan 11 (36,66%) pasien (43,33%) mengalami DRPs kategori polifarmasi, dan 4 pasien (13,33%) mengalami DRPs kategori interval dosis dan tidak di temukan DPRs kategori interaksi obat. Kata Kunci     : DRPs, Peresepan, ISPA, Pediatrik   ABSTRACT Drug Related Problem (DRP) is a part of pharmaceutical care that describes a situation in which the health professional (pharmacist) assesses a treatment discrepancy in achieving actual therapy. The purpose of this research was identification patient of ISPA (Acute Respiratory Infection) at Pharmacy Installation of Kendari Hospital with Polifarmacy category, drug interaction and dose interval. This research uses descriptive method with Cross Sectional approach, the sample in this research is recipe of pediatric patient suffering from ARI. Sampling using simple random method. Data is processed descriptively and described in the form of narration. The results of this study indicate that based on the identification of DRPs (Drug Related Problems) it can be concluded that from 30 patients with respiratory infection found 11 patients (36.66%) experienced DRPs polifarmation category, and 4 patients (13.33%) experienced DRPs category interval Dose and not found DPRs drug interaction category. Keywords : DRPs, Prescribing, ISPA, Child

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.

Comparison of eight screening tools to detect interactions between herbal supplements and oncology agents

2020 ◽  
Vol 26 (8) ◽  
pp. 1843-1849
Author(s):  
Faisal Shakeel ◽  
Fang Fang ◽  
Kelley M Kidwell ◽  
Lauren A Marcath ◽  
Daniel L Hertz
Keyword(s):  
Drug Interaction ◽  
Positive Predictive Value ◽  
Drug Interactions ◽  
Predictive Value ◽  
Screening Tools ◽  
Herbal Supplements ◽  
Interaction Detection ◽  
Natural Medicine ◽  
Interaction Screening ◽  
Drug Drug Interaction

Introduction Patients with cancer are increasingly using herbal supplements, unaware that supplements can interact with oncology treatment. Herb–drug interaction management is critical to ensure optimal treatment outcomes. Several screening tools exist to detect drug–drug interactions, but their performance to detect herb–drug interactions is not known. This study compared the performance of eight drug–drug interaction screening tools to detect herb–drug interaction with anti-cancer agents. Methods The herb–drug interaction detection performance of four subscription (Micromedex, Lexicomp, PEPID, Facts & Comparisons) and free (Drugs.com, Medscape, WebMD, RxList) drug–drug interaction tools was assessed. Clinical relevance of each herb–drug interaction was determined using Natural Medicine and each drug–drug interaction tool. Descriptive statistics were used to calculate sensitivity, specificity, positive predictive value, and negative predictive value. Linear regression was used to compare performance between subscription and free tools. Results All tools had poor sensitivity (<0.20) for detecting herb–drug interaction. Lexicomp had the highest positive predictive value (0.98) and best overall performance score (0.54), while Medscape was the best performing free tool (0.52). The worst subscription tools were as good as or better than the best free tools, and as a group subscription tools outperformed free tools on all metrics. Using an average subscription tool would detect one additional herb–drug interaction for every 10 herb–drug interactions screened by a free tool. Conclusion Lexicomp is the best available tool for screening herb–drug interaction, and Medscape is the best free alternative; however, the sensitivity and performance for detecting herb–drug interaction was far lower than for drug–drug interactions, and overall quite poor. Further research is needed to improve herb–drug interaction screening performance.

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.

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