scholarly journals Incidence of Drug-drug Interactions in Prescriptions of General Practitioners and Specialists in Bangladesh

2021 ◽  
pp. 60-66
Author(s):  
Kazi Al Mamun ◽  
. Soleyman ◽  
Md. Ariful Islam ◽  
Tahmida Sharmin ◽  
Kushal Biswas
Keyword(s):  
Drug Interaction ◽  
Side Effects ◽  
Drug Interactions ◽  
Clinical Significance ◽  
General Practitioners ◽  
Drug Efficacy ◽  
Concomitant Administration ◽  
Medical Institutions ◽  
General Surgeons ◽  
Different Levels

Aim: Drug-drug interactions (DDI) can cause unexpected side effects, changes in drug efficacy, metabolism or overall action of any particular drug and DDI is one of the major prescription errors. DDI can be caused by using concomitant administration of a second drug. This study aims to find DDI in prescriptions of 10 different medical specializations of Bangladesh.  Study Design and Methodology: This study is based on the evaluation of prescription, type, and clinical significance of drug-drug interaction. For this study, 21088 prescriptions were evaluated from 45 different medical institutions and 10 different specializations including general practitioners, cardiologists, medicine specialists, general surgeons, gynecologists, ENT specialists, neurologists, urologists, pediatricians, and ophthalmologists. After the collection of prescriptions, all prescribed medications were checked by using several sources to point out the probable interactions. Results: Among all the prescriptions most DDI was found from cardiologists (6.17%) and the least DDI was found from pediatricians (3.29%). Clopidogrel and warfarin were the most common medications causing drug interaction while drug interaction with cardiovascular drugs and antibiotics generic were most common among all. Polypharmacy, absence or shortage of pharmacists, workload, miscommunications and lack of knowledge were found as the leading causes of DDI. Conclusion: Active participation of the pharmacist in crosschecking the prescribed medication, proper communication of the physician and patients, relevant workshops regarding DDI and distribution of the workload of the physicians in different levels can play a role in minimizing DDI.

scholarly journals HCIP: An Online database for prediction CYP450 Enzyme Inhibition potential of bioactive compounds

2021 ◽  
Vol 11 (2) ◽  
pp. 253-255
Author(s):  
Sabarathinam Sarvesh ◽  
Preethi L ◽  
Haripritha Meganathan ◽  
M Arjun Gokulan ◽  
Dhivya Dhanasekaran ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Enzyme Inhibition ◽  
Bioactive Compounds ◽  
Bioactive Compound ◽  
Concomitant Administration ◽  
Cyp3a4 Inhibitor ◽  
Online Database ◽  
Computer Aided ◽  
Cyp450 Enzyme

Background: Concomitant administration of herbal medicine and conventional may lead to severe metabolism-oriented herb-drug interactions. However, detecting herb-drug interaction is expensive and higher time-consuming. Several computer-aided techniques have been proposed in recent years to predict drug interactions. However, most of the methods cannot predict herb-drug interactions effectively. Methods: Canonical SMILES of bioactive compounds was gathered from the PubChem online database, and its inhibition details were gathered PKCSM from the webserver. Results: By searching the bioactive compound name in the search bar of “The Herb-CYP450 Enzyme Inhibition Predictor online database” (HCIP- http://hcip.in/), it will provide the liver enzyme inhibition profile of the selected bioactive compound. For example; Guggulsterone:  CYP3A4 inhibitor.  Conclusion: The Herb-CYP450 Enzyme Inhibition Predictor online database is very peculiar and easy to determine the inhibition profile of the targeted bioactive compound. Keywords: CYP450; Enzyme inhibition; Bioactive Compounds; Online database; Herb-Drug Interaction

Herbal Drug Interactions

2017 ◽  
pp. 201-231 ◽  
Author(s):  
Mymoona Akhter
Keyword(s):  
Drug Interaction ◽  
Side Effects ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Herbal Drugs ◽  
Herbal Drug ◽  
Herbal Therapy ◽  
Alternative Medicines ◽  
Regulatory Bodies

Use of complementary and alternative medicines (CAM) for preventive and therapeutic purposes has increased tremendously in the last two decades internationally. The manufacturers of these products are not required to submit proof of safety or efficacy to the Food and Drug Administration. As a result, the adverse effects and drug interactions associated with them are largely unknown. In this chapter, the author presents interactions of herbal medicines with other medicines (herbal or non-herbal). A large number of herbal drugs, including from single drug to a variety of mixtures have been used to treat kidney disorders. Herb-herb or herb drug interaction has been reported intensively during last decade, therefore it becomes important to keep an eye on the use of combination herbal therapy in order to avoid serious results because of interactions with each other. Due to the growing awareness about the interactions and side effects of herbal drugs/supplements over the past few years, regulatory bodies are working on these issues and pharmacopoeias are being developed for reference.

Herbal Drug Interactions

2022 ◽  
pp. 120-141
Author(s):  
Mymoona Akhter
Keyword(s):  
Drug Interaction ◽  
Side Effects ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Herbal Drugs ◽  
Herbal Drug ◽  
Herbal Therapy ◽  
Alternative Medicines ◽  
Regulatory Bodies

Use of complementary and alternative medicines (CAM) for preventive and therapeutic purposes has increased tremendously in the last two decades internationally. The manufacturers of these products are not required to submit proof of safety or efficacy to the Food and Drug Administration. As a result, the adverse effects and drug interactions associated with them are largely unknown. In this chapter, the author presents interactions of herbal medicines with other medicines (herbal or non-herbal). A large number of herbal drugs, including from single drug to a variety of mixtures have been used to treat kidney disorders. Herb-herb or herb drug interaction has been reported intensively during last decade, therefore it becomes important to keep an eye on the use of combination herbal therapy in order to avoid serious results because of interactions with each other. Due to the growing awareness about the interactions and side effects of herbal drugs/supplements over the past few years, regulatory bodies are working on these issues and pharmacopoeias are being developed for reference.

Antidepressant Drug Interactions

2001 ◽  
Vol 14 (6) ◽  
pp. 467-477 ◽  
Author(s):  
Sheila R. Botts ◽  
Cara Alfaro
Keyword(s):  
Cytochrome P450 ◽  
Drug Interaction ◽  
Side Effects ◽  
Drug Interactions ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Drug ◽  
Pharmacodynamic Interactions ◽  
Toxicological Profile ◽  
Pharmacokinetic Drug ◽  
Isozyme System

Second-generation antidepressants are more selective in their pharmacological mechanisms and offer fewer side effects and a safer toxicological profile than cyclic antidepressants and monoamine oxidase inhibitors. While the risk for pharmacodynamic interactions is more limited than with older agents with broader receptor effects, the risks for pharmacokinetic interactions is greater. The capacity of selective serotonin reuptake inhibitors to inhibit the metabolic activity of cytochrome P450 isozyme system has spurred over a decade of intense psychopharmacological and pharmacogenetics research to better the understanding of the significance of these interactions. Clinicians have had to increase their knowledge and understanding of drug interaction potential to better manage patients receiving these newer antidepressants. The following is a review of both pharmacodynamic and pharmacokinetic drug-drug interactions with antidepressants.

scholarly journals THE CLINICAL SIGNIFICANCE OF POTENTIAL DRUG-DRUG INTERACTIONS AND THEIR TARGETS FOR MINIMIZATION AMONG HYPERTENSIVE DIABETIC OUTPATIENTS AT A KENYAN REFERRAL HOSPITAL

2020 ◽  
pp. 6-11
Author(s):  
MAKITE SIMON LATI ◽  
NYAMU GITONGA DAVID ◽  
ROSALINE NJOKI KINUTHIA
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Clinical Significance ◽  
Blood Pressure Monitoring ◽  
Adverse Outcomes ◽  
Potential Drug ◽  
National Hospital ◽  
Hypertensive Patients ◽  
Kenyatta National Hospital ◽  
Arterial Blood

Objective: To characterize the clinical significance of potential drug interactions and identify the targets for their minimization among adult diabetic hypertensive outpatients at Kenyatta National Hospital. Methods: This cross-sectional study collected and analyzed data 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 clinical significance of potential drug interactions and the targets for minimization. Participants’ sociodemographic data, drugs prescribed and targets for prevention of potential drug-drug interactions were extracted from patient medical records into predesigned data collection forms. Potential drug interactions were identified using the Micromedex® drug interaction checker. Data was exported to STATA® software version 13 for analysis. Results: The study comprised predominantly females (70.2%) and the mean age was 61.6 (±10.8) years. Over 80% of patients were receiving renin inhibitors or metformin and the commonest potential drug interaction (25.0%) was antidiabetics-beta blockers. The most common potential clinical outcome of the drug-drug interaction was hyperkalemic lactic acidosis (14.4%), induced by combining enalapril with metformin, and hypoglycemia (9.6%) on concomitant use of antidiabetic and beta-blocker. Adverse clinical outcomes were mainly minimized through regular blood sugar checks (100%), blood pressure monitoring (98.1%), and minimal HbA1c (30.8%) checks as well as serum urea and electrolytes (17.3%) measurements. Conclusion: There are potential adverse outcomes of combination pharmacologic therapies among diabetic hypertensive patients in Kenyatta National Hospital. Apart from the clinical monitoring, clinicians should be aware that diabetic hypertensive patients are likely to have serious adverse effects of drug interactions and, therefore, institute or intensify other measures such as arterial blood gases and serum electrolyte tests.

Drug-Drug Interactions and HIV Therapy: What Should Pharmacists Know?

2005 ◽  
Vol 18 (4) ◽  
pp. 278-294 ◽  
Author(s):  
Susan A. Krikorian ◽  
Dorothea C. Rudorf
Keyword(s):  
Drug Interaction ◽  
Clinical Practice ◽  
Antiretroviral Therapy ◽  
Side Effects ◽  
Clinical Outcome ◽  
Drug Interactions ◽  
Highly Active Antiretroviral Therapy ◽  
Hiv Therapy ◽  
Highly Active ◽  
Complex Patients

Drug-interaction issues continue to present a major dilemma for the clinician caring for complex patients such as those infected with HIV. The inherent possibility of a drug interaction is magnified by the multitude of drugs being administered in highly-active antiretroviral therapy (HAART). In addition, other classes of medications are used to alleviate side effects, reduce toxicities associated with HAART, or treat concomitant diseases. The modification of one drug by another substance or drug-drug interaction is the main focus of this article. Drug-drug interactions may result in toxicity, treatment failure, or loss of effectiveness and can significantly affect a patient’s clinical outcome. An understanding of the fundamental mechanisms of HIV drug-drug interactions may allow for the early detection or avoidance of troublesome regimens and prudent management if they develop. Although HIV drug interactions are usually thought of as detrimental, resulting in a loss of therapeutic effect or toxicity, some drug interactions such as ritonavir boosted protease inhibitor–based antiretroviral treatments are beneficial and are commonly used in clinical practice. Therefore, pharmacists need to understand drug interaction mechanisms, remember key drug interactions, and vigilantly monitor patients for potential complications.

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 Tamoxifen and antidepressant’s co-prescription: general practitioners and pharmacist’s alert

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A C Chaslerie ◽  
C Vigneau Victorri ◽  
F Grude ◽  
A Thomasset ◽  
A Even ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Drug Interaction ◽  
Health Insurance ◽  
Drug Interactions ◽  
General Practitioners ◽  
Moderate Level ◽  
Concomitant Treatment ◽  
Risk Of Death ◽  
Drug Drug Interaction ◽  
High Level

Abstract Issue Well known drug-drug interaction with some antidepressants, especially selective serotonin reuptake inhibitors which reduce tamoxifen’s effectiveness and associated with an increased risk of death from breast cancer. Description of the problem To identify and characterize the exposure to antidepressants in women with breast cancer treated with tamofixen in a west french area. Retrospective population based cohort study; claims from the French Health insurance database. Women living in Pays de la Loire area, aged 20 years or older treated with tamoxifen for breast cancer in 2018 who had concomitant treatment with antidepressants. Call phone to general practitioner’s and meeting with pharmacist when a high or moderate level drug-drug interaction’s was identified. Results Of 4138 women treated with tamoxifen, 497 (12%) received an antidepressant treatment in 2018, corresponding to 571 co-prescriptions. Of them, 74 (13%) was moderate level drug-drug interaction, 66 (11.6%) high level and 307 (53.8%) weak level.70% of high level drug-drug interaction were due to paroxetine and 43% of moderate level due to duloxetine. For these co-prescriptions, concomitant patient’s exposure was for more than four months in 22% cases. 127 different general practitioners and 152 pharmacists (339 different dispensation’s date) were concerned by these drug-drug interactions. Lessons French health insurance medical department has contacted general practitioners or pharmacists concerned by these drug-drug interactions. We informed general practitioners to be aware about women treated with tamoxifen when co-prescription with an antidepressant is necessary, preference should be given to one of them that show little or no inhibition of cytochrome P450 2D6. Key messages Mediation medication and detection of drug-drug interaction by pharmacist. Preferential choice of antidepressant by general practitioner or women treat with co-prescription (tamoxifen and antidepressant).

Medication therapy management (MTM) in a multidisciplinary supportive oncology clinic.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 30-30
Author(s):  
Robert Mancini ◽  
Kathleen Clifford ◽  
Michele Brown ◽  
Lori Watts ◽  
Dan Sayam Zuckerman ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Side Effects ◽  
Drug Interactions ◽  
Cancer Patients ◽  
Social Worker ◽  
Nurse Practitioner ◽  
Interaction Analysis ◽  
Medication Therapy ◽  
Supportive Oncology

30 Background: Patients with advanced cancer experience significant symptom burden and psychosocial distress from the onset of their diagnosis and throughout treatment shifting the paradigm of supportive care. In addition, most cancer patients have multiple co-morbidities and are at high risk of poly-pharmacy. One in three ambulatory cancer patients are at risk of drug-drug interactions. Methods: In June 2010, a multidisciplinary supportive oncology clinic, modeled after the Massachusetts General Hospital article by Temel et al., was started and staffed by a pharmacist, a nurse, a social worker and a dietitian and lead by a nurse practitioner. A chart audit was conducted for all patients seen in the clinic between June 2010 and March 2012. Pharmacy assessment entries were evaluated for diagnosis, medication issues and total time spent with patients. Duplicate therapy was defined as an unnecessary duplication in therapy for a single symptom and/or two medications in the same class. Drug-Interactions were assessed utilizing Micromedex 2.0 Drug-Interaction Checker and Lexicomp Lexi-Interact Online drug-interaction analysis program. All major kinetic interactions were recorded and pharmacodynamic interactions were recorded if they required intervention. Results: From June 2010 to May 2012, 153 patients were seen in the clinic. The most common diagnoses were pancreatic, lung, breast and head and neck. Use of a standardized pharmacy assessment identified duplicate therapies in 45.1% of patients, drug-drug interactions in 35.3%, side-effects in 83%, lack of efficacy in 88.9% and untreated conditions 68.6%. The pharmacists spent an average of 44.1 minutes (range 15-90 min) with patients. Conclusions: Pharmacist-initiated MTM identifies a higher rate of poly-pharmacy, drug-drug interactions and side effects than found in literature. Identification allows for referral to other disciplines within the clinic for work-up. Gastrointestinal related issues were referred to a dietitian, psychosocial issues including adherence issues to a social worker and medication related issues to the nurse practitioner for follow-up. Initial identification of these issues has allowed for more long-term follow-up in these patients.

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