Interacciones farmacológicas en una unidad de cuidados paliativos

Madero, Alfonso Díaz; Ramos-Hernández, Cristina; Pollo, Daniel Ramos; González, María Martín; Martínez, Nathalie Tamayo; Arruz, Ana Bermejo

doi:10.1016/j.medipa.2010.11.009

Cited by 6 publications

(8 citation statements)

References 25 publications

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“…The potential therapeutic cascades identified in this pattern were: a) antifungal drugs for the treatment of candidiasis secondary to antibiotics [8] and corticoids inhalers [14]; b) electrolytes for the treatment of gastroenteritis dehydration after use of antibiotics [14]; and c) anxiolytics, supposedly prescribed for the symptomatic treatment of the potential side effects of adrenergic inhalants (e.g., tachycardia, hyperactivity, and insomnia) dispensed for the symptomatic treatment of acute respiratory infection [14]. As potential drug-drug interactions (DDIs) we observed the combined use of NSAIDs and corticoids [15].…”

Section: Resultsmentioning

confidence: 99%

“…Factor 2 clustered a wide range of medications used for the treatment of chronic pain, such as opioids, corticosteroids, analgesics, antipyretics, and anti-inflammatories. This pattern was unexpectedly associated with: a) antithrombotic agents comprising both heparins and acetylsalicylic acid, typically used for the prevention of thromboembolism after surgery and/or long-term stays (which can be caused by musculoskeletal pain); b) drugs for peptic ulcers, probably prescribed to treat the gastrointestinal side effects of antithrombotics, analgesics, and corticosteroids [15,18,20]; and c) macrolides, penicillin antibiotics, and drugs for peptic ulcers. The potential DDIs identified in this pattern were: a) the interaction of fentanyl with macrolides, which increases the effect of the opioid and the risk of respiratory depression [14]; b) acetylsalicylic acid with diclofenac [21]; c) omeprazole with warfarin [18]; and d) omeprazole and esomeprazole with clopidogrel [15].…”

Section: Resultsmentioning

confidence: 99%

“…However, substance use was no longer present. Several DDIs were identified in this pattern: a) the use of carbamazepine as antiepileptic drug and omeprazole [18]; b) the dispensation of antidepressants and drugs for neuropathic pain [16]; and c) the combined use of benzodiazepines with PPIs and opioids, which could increase sedation [15].…”

Section: Resultsmentioning

confidence: 99%

“…Factor 2 clustered acute respiratory infection, allergic-rhinitis and asthma with medications such as corticoids, inhaled beta-adrenergic agonists, antipyretics, antihistamines, NSAIDS, quinolones, macrolides, and other beta-lactam antibacterials. The DDIs identified were: a) the use of inhaled beta-adrenergic agonists and corticosteroids, which decrease potassium levels, thus increasing the risk of arrhythmia [15]; and b) the combined use of macrolides and inhaled beta-adrenergic and antihistamines, producing a QT prolongation and thus increasing the risk of arrhythmia [14].…”

Section: Resultsmentioning

confidence: 99%

“…First, changes that occur in the connective tissue with ageing, have been linked to a low grade of inflammation. Second, side effects are related to the pharmacological treatment of the diseases included in the musculoskeletal pattern [20], such as the treatment of gastrointestinal disease caused by NSAIDs, corticosteroids, and antithrombotic agents [15,18,20] It is noteworthy that the pattern also comprised macrolides, penicillin antibiotics, and drugs for peptic ulcers, all of which are usually used for the eradication of Helicobacter pylori ( H . pylori ).…”

Section: Discussionmentioning

confidence: 99%

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Patterns of multimorbidity and polypharmacy in young and adult population: Systematic associations among chronic diseases and drugs using factor analysis

et al. 2019

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ObjectivesThe objective was to identify the systematic associations among chronic diseases and drugs in the form of patterns and to describe and clinically interpret the constituted patterns with a focus on exploring the existence of potential drug-drug and drug-disease interactions and prescribing cascades.MethodsThis observational, cross-sectional study used the demographic and clinical information from electronic medical databases and the pharmacy billing records of all users of the public health system of the Spanish region of Aragon in 2015. An exploratory factor analysis was conducted based on the tetra-choric correlations among the diagnoses of chronic diseases and the dispensed drugs in 887,572 patients aged ≤65 years. The analysis was stratified by age and sex. To name the constituted patterns, assess their clinical nature, and identify potential interactions among diseases and drugs, the associations found in each pattern were independently reviewed by two pharmacists and two doctors and tested against the literature and the information reported in the technical medicinal forms.ResultsSix multimorbidity-polypharmacy patterns were found in this large-scale population study, named as respiratory, mental health, cardiometabolic, endocrinological, osteometabolic, and mechanical-pain. The nature of the patterns in terms of diseases and drugs differed by sex and age and became more complex as age advanced.ConclusionsThe six clinically sound multimorbidity-polypharmacy patterns described in this non-elderly population confirmed the existence of systematic associations among chronic diseases and medications, and revealed some unexpected associations suggesting the prescribing cascade phenomenon as a potential underlying factor. These findings may help to broaden the focus and orient the early identification of potential interactions when caring for multimorbid patients at high risk of adverse health outcomes due to polypharmacy.

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Section: Resultsmentioning

confidence: 99%