scholarly journals Evaluation of drug information resources for interactions between therapeutic drugs and drugs of abuse

2020 ◽  
Vol 108 (4) ◽  
Author(s):  
Robert D. Beckett ◽  
Jennifer R. Martin ◽  
Curtis D. Stump ◽  
Megan A. Dyer
Keyword(s):  
Clinical Pharmacology ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Subject Matter ◽  
Drugs Of Abuse ◽  
Point Of Care ◽  
Clinical Effects ◽  
Subject Matter Experts ◽  
Cross Sectional ◽  
Therapeutic Drugs

Objective: The research evaluated point-of-care resources for scope, completeness, and consistency of information describing interactions between therapeutic drugs and drugs of abuse (DoA).Methods: A cross-sectional evaluation study was conducted focusing on seven resources: Clinical Pharmacology, Facts & Comparisons eAnswers, Lexicomp Online, Micromedex, Drug Interactions Analysis and Management, Drug Interaction Facts, and Stockley’s Drug Interactions. A sample of clinically relevant interactions was developed through review of tertiary literature and resources, and input was solicited from subject matter experts. Entries from each resource for each interaction were evaluated for scope (i.e., whether there was an entry for the interaction); completeness (i.e., whether there was information addressing mechanism; clinical effects, severity, course of action, and level of certainty, described as a median rating on a 5-point scale); and consistency (i.e., whether the information in the resource was similar to the majority) among resources with an entry.Results: Following review by subject matter experts, the final sample contained 159 interactions. Scope scores ranged from 0.6% (Drug Interactions Analysis and Management) to 43.4% (Lexicomp Online). Completeness scores ranged from 2 (interquartile range [IQR] 0 to 3, Stockley’s Drug Interactions) to 5 (IQR 5 to 5, Drug Interaction Facts, Micromedex, Facts & Comparisons eAnswers). Consistency scores ranged from 30.8% (Stockley’s Drug Interactions) to 87.1% (Clinical Pharmacology) for severity and from 15.4% (Facts & Comparisons eAnswers) to 71.4% (Drug Interaction Facts) for course of action.Conclusions: Although coverage of drug-DoA interactions was low and content was often inconsistent among resources, the provided information was generally complete.

scholarly journals Evaluation of drug information resources for drug-ethanol and drug-tobacco interactions

2019 ◽  
Vol 107 (1) ◽  
Author(s):  
Robert D. Beckett ◽  
Curtis D. Stump ◽  
Megan A. Dyer
Keyword(s):  
Clinical Pharmacology ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Drug Information ◽  
Point Of Care ◽  
Information Resources ◽  
Clinical Effects ◽  
Cross Sectional ◽  
Course Of Action ◽  
Sectional Analysis

Objective: The research evaluated point-of-care drug interaction resources for scope, completeness, and consistency in drug-ethanol and drug-tobacco content.Methods: In a cross-sectional analysis, 2 independent reviewers extracted data for 108 clinically relevant interactions using 7 drug information resources (Clinical Pharmacology Drug Interaction Report, Facts & Comparisons eAnswers, Lexicomp Interactions, Micromedex Drug Interactions, Drug Interactions Analysis and Management, Drug Interaction Facts, and Stockley’s Drug Interactions). Scope (presence of an entry), completeness (content describing mechanism, clinical effects, severity, level of certainty, and course of action for each present interaction; up to 1 point per assessed item for a total possible score of 5 points), and consistency (similarity among resources) were evaluated.Results: Fifty-three drug-ethanol and 55 drug-tobacco interactions were analyzed. Drug-ethanol interaction entries were most commonly present in Lexicomp (84.9%), Clinical Pharmacology (83.0%), and Stockley’s Drug Interactions (73.6%), compared to other resources (p<0.05). Drug-tobacco interactions were more often covered in Micromedex (56.4%), Stockley’s Drug Interactions (56.4%), Drug Interaction Facts (43.6%), and Clinical Pharmacology (41.8%) (p<0.001). Overall completeness scores were higher for Lexicomp, Micromedex, Drug Interaction Facts, and Facts & Comparisons (median 5/5 points, interquartile range [IQR] 5 to 5, p<0.001) for drug-ethanol and for Micromedex (median 5/5 points, IQR 5 to 5, p<0.05) for drug-tobacco, compared to other resources. Drug Interaction Facts and Micromedex were among the highest scoring resources for both drug-ethanol (73.7%, 68.6%) and drug-tobacco (75.0%, 32.3%) consistency.Conclusions: Scope and completeness were high for drug-ethanol interactions, but low for drug-tobacco interactions. Consistency was highly variable across both interaction types.

scholarly journals Evaluation of resources for analyzing drug interactions

2017 ◽  
Vol 104 (4) ◽  
Author(s):  
Risha I. Patel, PharmD ◽  
Robert D. Beckett, PharmD, BCPS
Keyword(s):  
Clinical Pharmacology ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Dietary Supplement ◽  
Drug Information ◽  
Cross Sectional Study ◽  
Information Resources ◽  
Ease Of Use ◽  
Sectional Study ◽  
Cross Sectional

Objective: The research sought to evaluate seven drug information resources, specifically designed for analyzing drug interactions for scope, completeness, and ease of use, and determine the consistency of content among the seven resources.Methods: A cross-sectional study was conducted where 100 drug-drug and drug-dietary supplement interactions were analyzed using 7 drug information resources: Lexicomp Interactions module, Micromedex Drug Interactions, Clinical Pharmacology Drug Interaction Report, Facts & Comparisons eAnswers, Stockley’s Drug Interactions (10th edition), Drug Interactions Analysis and Management (2014), and Drug Interaction Facts (2015). The interaction sample was developed based on published resources and peer input. Two independent reviewers gathered data for each interaction from each of the 7 resources using a common form.Results: Eighty-two drug-drug and 18 drug-dietary supplement interactions were analyzed. Scope scores were higher for Lexicomp Interactions (97.0%), Clinical Pharmacology Drug Interaction Report (97.0%), and Micromedex Drug Interactions (93.0%) compared to all other resources (p<0.05 for each comparison). Overall completeness scores were higher for Micromedex Drug Interactions (median 5, interquartile range [IQR] 4 to 5) compared to all other resources (p<0.01 for each comparison) and were higher for Lexicomp Interactions (median 4, IQR 4 to 5), Facts & Comparisons eAnswers (median 4, IQR 4 to 5), and Drug Interaction Facts (4, IQR 4 to 5) compared to all other resources, except Micromedex (p<0.05 for each comparison). Ease of use, in terms of time to locate information and time to gather information, was similar among resources. Consistency score was higher for Micromedex (69.9%) compared to all other resources (p<0.05 for each comparison).Conclusions: Clinical Pharmacology Drug Interaction Report, Lexicomp Interactions, and Micromedex Drug Interactions scored highest in scope. Micromedex Drug Interactions and Lexicomp Interactions scored highest in completeness. Consistency scores were overall low, but Micromedex Drug Interactions was the highest.

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.

scholarly journals THE PREDICTORS OF POTENTIAL DRUG-DRUG INTERACTIONS AMONG DIABETIC HYPERTENSIVE ADULT OUTPATIENTS IN A KENYAN REFERRAL HOSPITAL

2020 ◽  
pp. 63-67
Author(s):  
MAKITE SIMON LATI ◽  
NYAMU GITONGA DAVID ◽  
ROSALINE NJERI KINUTHIA
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Cross Sectional Study ◽  
Potential Drug ◽  
National Hospital ◽  
Cross Sectional ◽  
Kenyatta National Hospital ◽  
Stage 4 ◽  
Drug Drug Interaction ◽  
Study Participants

Objective: To characterize the predictors of potential drug-drug interactions among adult diabetic hypertensive outpatients at Kenyatta National Hospital. Methods: This cross-sectional study collected and analyzed data on potential drug interactions from 104 diabetic hypertensive outpatients (aged ≥18 y) at the Department of Endocrinology Outpatient Clinic of Kenyatta National Hospital from 1st May 2019 to 31st August 2019. The main outcome measure was the prevalence of potential drug-drug interactions and their predictors among the study population. Results: There was a female preponderance (70.2%). The mean age of the study participants was 61.6 y (SD±10.8). The prevalence of potential drug interactions was high at 57.7%. The average number of drug interactions was one interacting pair per patient, with a majority of the prescriptions (81.0%) having moderate drug-drug interactions. Patients receiving>2 drugs were almost three times more likely to have drug-drug interaction compared to those prescribed ≤ 2 drugs (AOR=2.79; 95% CI: 1.11-7.28); p=0.029). Participants who were at stage 4 of hypertension were 2.5 times more likely to have a drug-drug interaction compared to the other stages of hypertension (AOR=2.52; 95% CI 1.31-4.89; p=0.007). Conclusion: Polypharmacy and stage 4 hypertension are independently associated with drug-drug interactions among patients with both diabetes and hypertension. Future studies should characterize the specific type of drug interactions and possible targets of minimization of drug-drug interactions.

Assessment of Drug Interactions with Online Electronic Checkers in Multi-Pathological Patients

Pharmacology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Bernardino Roca ◽  
Manuel Roca
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medicine Department ◽  
Interaction Detection ◽  
Drug Substances ◽  
Positive Correlations ◽  
Hospital General

<b><i>Introduction:</i></b> Multi-pathological patients are at high risk of drug interactions and side effects. We aimed to assess the usefulness of 3 online drug interaction checkers. <b><i>Methods:</i></b> In a cross-sectional study, carried out in the Medicine Department of Hospital General of Castellon, Spain, in February 2020, we assessed drug interaction detection with 3 online electronic checkers, Drugs.com, Lexicomp®, and Medscape, and compared results obtained with the 3 tools. From every hospitalized patient, we obtained the list of drugs he or she had been taking until admission. Bivariable tests were used for analysis. <i>p</i> values &#x3c;0.05 were considered significant. <b><i>Results:</i></b> We included data from 134 patients; 68 (51%) were male; median (and interquartile range) of their age was 82 (76–88) years. A total of 1,082 substance drugs were entered in the checkers. The number of highest grade interactions found with every program was Drugs.com 85, Lexicomp® 33, and Medscape 67. Positive correlations were found between age and number of drug substances prescribed (<i>p</i> = 0.009) and between number of drug substances prescribed and interactions found with any of the 3 checkers (<i>p</i> &#x3c; 0.001 in all 3 cases). Regarding highest grade interactions, agreement among all 3 checkers was poor. <b><i>Conclusions:</i></b> The 3 online checkers we assessed found a large number of interactions. The 3 programs gave very discrepant results. <b><i>Impact on Practice Statements:</i></b> The analyzed programs, Drugs.com, Lexicomp®, and Medscape Interactions, found a large number of drug interactions in the studied patients. The 3 programs gave very discrepant results among them.

ASSESSMENT OF DRUG INTERACTIONS IN OUTPATIENT PRESCRIPTIONS IN HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
Vol 8 (5) ◽  
pp. 26-36
Author(s):  
Phuong Vo Thi Hong ◽  
Hien Nguyen Thi
Keyword(s):  
Drug Interaction ◽  
Proton Pump Inhibitor ◽  
Drug Interactions ◽  
Descriptive Study ◽  
Management Guideline ◽  
Cross Sectional ◽  
Significant Drug Interaction ◽  
Clinically Significant ◽  
Multiple Symptoms ◽  
Outpatient Prescriptions

Background: The combination of drugs in treatment is inevitable, especially in multiple diseases and multiple symptoms. This is the leading cause of occurrence of drug - drug interactions. Objectives: (1) To identify clinically significant drug interactions in outpatient prescriptions in Hue University of Medicine and Pharmacy Hospital, (2) To build a management guideline of clinically significant drug interactions in Hue University of Medicine and Pharmacy Hospital. Materials and methods: 5338 outpatient prescriptions were collected from Pharmacy Faculty – Hue University of Medicine and Pharmacy Hospital from 1st to 31st October 2017, using cross-sectional descriptive study method. Results and Conclusion: The list of 20 clinically significant drug interaction pairs was identified and a management guideline for each interacting pair was built. The prevalence of prescriptions with drug interactions was 6.7%. The most commonly identified drug interaction pair was clopidogrel and proton pump inhibitor (1.59%). The occurrence of drug interactions increased with increase in the age of patients and the number of drugs prescribed (p < 0.05). Key words: combination of drugs, drug interaction, clinically significant, prescription, outpatient

scholarly journals Studying the Prevalence of Medical Interventions in the Recipes

2019 ◽  
Vol 7 (11) ◽  
pp. 1879-1883
Author(s):  
Amin Alinezhad ◽  
Molouk Haji Babaei ◽  
Kheirollah Gholami ◽  
Seyed Hamid Khoei
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Drug Prescription ◽  
Age Groups ◽  
P Value ◽  
Potential Drug ◽  
Cross Sectional ◽  
Medical Interventions ◽  
Male Patients ◽  
Public Drug

BACKGROUND: Drug interaction is a term used to refer to unfavourable side effects caused by mixing or taking two or more drugs simultaneously. Although it is not possible to identify all drug interactions, awareness of therapeutic team of potential drug interactions, risk factors that enhance the possibility of these interactions and familiarity with mechanisms of drug interactions can help reduce real drug interactions. AIM: The present research seeks to study the frequency and intensity of possible interactions among various age groups and their correlation with doctor’s speciality, time of drug prescription, patient’s gender, etc.MATERIAL AND METHOD: This is observational, cross-sectional research conducted in spring and winter to study the prevalence of drug interactions among 6000 recipes belonging to 2 private and 2 public drug stores. The information associated with recipes was recorded, and drug interactions were studied based upon quick index of interactions using Up to Date software. Quick index of medical interactions is a response to data dealing with how drugs interact with one another. The risk factor is divided into groups A, B, C, D, and X according to this index with each one having its own definition. The data analysis was studied in terms of prevalence type of drug interactions and the possible correlation with other parameters. SPSS v.16 was used for statistical analysis. RESULTS: The average age of the patients was 42.07 ± 21.56 years. The frequency of male patients was 41.7%. An average number of 4.82 ± 1.91 drugs were prescribed for each patient and an average number of 1.95 ± 2.40 drugs had interaction with one another with levels C, D, and X having the following drug interaction levels: 1.60 ± 2.05, 0.275 ± 0.69, and 0.072 ± 0.31. No such interactions were observed in 31.1% (1846 cases) of recipes. The presence of drug interaction was statistically significant in terms of age, season, drug store and speciality of doctor (P-value < 0.05). The average number of interactions in the recipes issued by psychologists, cardiologists, rheumatologist, neurologists, and general practitioners was more, and this result was statistically significant (P-value < 0.05). CONCLUSION: Considering the results achieved in this research, we may conclude that the drug interactions in recipes exhibit a noticeable frequency with the highest frequency observed in level C influenced by factors such as age, season, class of drugs, and expertise of the doctor.

scholarly journals Prevalence of Side Effects, Drug Interaction among Patients Taking Statin in Turaif, Saudi Arabia

2020 ◽  
pp. 86-97
Author(s):  
Maria Abdul Ghafoor Raja ◽  
Gharam Hamdan Alrawili ◽  
Nawaf Al-Otaibi ◽  
Muhammad Wahab Amjad
Keyword(s):  
Saudi Arabia ◽  
Drug Interaction ◽  
Side Effects ◽  
Drug Interactions ◽  
Statin Therapy ◽  
Health Impact ◽  
Arabic Language ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Saudi Patients

Background: Statins perceived to have favorable safety profile. Although many people on statin therapy do well but no drug is without potential for side effects. Awareness about risks as well as benefits of drugs is needed particularly drugs which are used on wide scale like statins because even uncommon side effects can have significant health impact.  Objectives of the Study: To determine side effects occurrence among Saudi patients taking statins and to evaluate drug-drug interactions in Saudi patients taking statins. Methodology: Self administered cross sectional study conducted during a period of four months from October 2018 to January 2019 in Turaif general hospital, Saudi Arabia on random sample of 500 Saudi patients out of which 330 participants were included in the study which were taking different types of statins medication using self-administered questionnaire in Arabic language specially designed for the research purpose after obtaining verbal consent and the data analyzed by SPSS program. Results: A total of 330 patients; 128 (39%) females and 202 (61%) males—participated in the study. The majority 165 (50%) were in the age-group of 50 – 59 years. Simvastatin was the most commonly used statin among study participants 136 (41%) followed by rosuvastatin 114 (35%). Among the participants, there were some patients who take drugs which have drug interactions with statins; there were 64 (19%) take Amlodipine with simvastatin, 13 (4%) and 6 (2%) take esomeprazole and ompeprazole respectively with statins. Only 9 (3%) reported that they were advised by pharmacist to avoid grape fruit. Majority of participants 309 (94%) reported neck pain, difficulty in walking, frequently fatigue after starting on statin. Also majority of participants 320 (97%) suffer from muscle pain after starting statins medications. Conclusion: The percentage of statin related side effects in this study population is high especially myopathy. Also some patients in this study taking medications that have drug interaction with statins, Counseling to patient regarding statin therapy appear to be insufficient. So, this study indicate that there's a need for more efforts from the physicians and pharmacist to avoid prescribing or dispensing medication that have drug-drug interaction with statins and provide counseling to patients regarding their statin therapy.

scholarly journals Potential drug interactions analysis of COVID-19 patients at a hospital in West Java

2021 ◽  
Vol 17 (2) ◽  
pp. 182-197
Author(s):  
Larasati Arrum Kusumawardani ◽  
Nisa Maria ◽  
Yumna Nabila Fanani
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Treatment Guidelines ◽  
Cross Sectional Study ◽  
Potential Drug ◽  
Cross Sectional ◽  
Medication Schedule ◽  
Route Changing ◽  
Correlated Factors ◽  
Therapy Modification

Background: Treatment guidelines of COVID-19 are changing continuously by involving many off-label and various symptomatic or supportive drugs. The use of these various drugs might increase the patient’s risk of developing drug interactions. Objective: The study aimed to analyze potential drug-drug interactions in COVID-19 inpatients and the correlated factors. Method: A cross-sectional study was conducted in a hospital by using inpatients admitted from August-December 2020. Potential drug-drug interaction was analyzed by using Lex-Interact® software. Results: From 107 patients, the majority of them are in moderate severity-degree (98.1%), having comorbidities (93.5%), and polypharmacy (98.1%). The average of potential drug interactions was 8.47±8,04, with most of the interaction in risk rating C-monitor therapy. Major potential drug interactions found were prolongation of QT interval and disturbance of drug absorption in the gastrointestinal tract. A positive correlation occurred between drug interactions found and comorbidity (r=0.436), number of drugs per prescription (r=0.674), and length of stay (r=0.222) Conclusions: COVID-19 patient is at risk for developing potential drug interactions that can affect the patient's physiological condition and reduce drug effect. It is necessary to manage the medication schedule, therapy modification, administration route changing, dosage adjustment, and monitoring of effects that might occur because of the drug interactions. Keywords: drug interaction, COVID-19, inpatient, correlated factor

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