Pilot study: Evaluation of potential drug–drug interactions in hospitalized pediatric patients

Medina-Barajas, Fabiola; Vázquez-Méndez, Estefanía; Pérez-Guerrero, Edsaúl Emilio; Sánchez-López, Virginia Aleyda; Hernandez-Cañaveral, Iván; A, Real-Ornelas Gabriel; Huerta-Olvera, Selene G.

doi:10.1016/j.pedneo.2019.11.006

Cited by 13 publications

(31 citation statements)

References 21 publications

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“…As expected, the result of logistic regression analysis showed that polypharmacy (more than 3 medications per prescription) was a risk factor for the occurrence of pDDIs, which was in agreement with the pilot study of hospitalized pediatric patients conducted by Fabiola Medina-Barajas et al [ 4 ]. Several studies had drawn a consistent conclusion that the increasing amount of medications was a risk factor for presenting drug interactions [ 24 – 26 ].…”

Section: Discussionsupporting

confidence: 91%

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Prevalence of potential drug–drug interactions in outpatients of a general hospital in China: a retrospective investigation

et al. 2020

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Background Potential drug-drug interactions are important factors resulting in adverse drug reactions or therapeutic failure. Therefore, potential drug-drug interactions need to be identified to prevent the related risk and improve drug safety. Objective This study was designed to determine the prevalence of potential drug-drug interactions and investigate the association of potential drug-drug interactions with characteristics in outpatient prescriptions. Setting A large-scale general university hospital in Jinshan District of Shanghai, China. Method The retrospective study was conducted on data obtained from prescriptions containing two or more drugs, written for outpatients older than 18 years. They were screened for potential drug-drug interactions using Lexi-Interact in UpToDate, Stockley's Drug Interactions and Medicine Specification in the order of priority. Main outcome measure Drug-drug interactions with C, D, X risk rating and clinical parameters recorded at the prescriptions. Results 16,120 prescriptions were screened for the presence of potential drug-drug interactions and 4882 (30.29%) prescriptions containing 6667 potential drug-drug interactions were identified. Among 6667 potential drug-drug interactions, 90.81% (6054/6667), 8.49% (566/6667), 0.70% (47/6667) potential drug-drug interactions belonged to the risk category of C, D and X, respectively. Male, old age and polypharmacy increased the likelihood of potential drug-drug interactions. The most frequently prescribed drugs responsible for potential drug-drug interactions included pioglitazone, dihydrocodeine, thalidomide, sotalol, amiodarone and amlodipine. The predominant potential adverse outcome of potential drug-drug interactions was the increased central nervous system suppression function with the mechanism of reinforced pharmacological effects. Conclusion This study showed that potentially significant drug-drug interactions in outpatients were prevalent in real-world practice. Considering the risk of potential clinical consequences related to potential drug-drug interactions, it is necessary to implement the computerized surveillance and warning systems with drug-drug interactions databases as well as develop the clinical guidelines regarding the widespread potential drug-drug interactions.

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Section: Discussionsupporting

confidence: 91%

“…Several factors contribute to the occurrence of DDIs in populations, such as age, comorbidities, polypharmacy, nutritional status, and genetic constitution of an individual [3,4]. Therefore, DDIs are of concern especially in elderly patients with comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of potential drug–drug interactions in outpatients of a general hospital in China: a retrospective investigation

et al. 2020

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“…Profile of children in intensive care unit included in this study (mean age, subtle male predominance, respiratory diseases as the principal cause of hospitalization) confirmed the findings of other national and international researches (Corullón, 2007;Vonbach et al, 2008;Ferreira et al, 2012;Lanetzki et al, 2012;Alves et al, 2014;Medina-Barajas et al, 2020). However, the mean length of hospital stays of children in the ICU (11.3 days) was longer than that observed in other Brazilian hospitals, which ranged from 5.5 to 10.6 days (Corullón, 2007;Molina et al, 2008;Lima and Cassiani, 2009;Ferreira et al, 2012;Alves et al, 2014).…”

Section: Discussionsupporting

confidence: 88%

“…The incidence observed in this study (70%) was similar to findings in PICU of United States children hospitals (75%) and another Brazilian PICU (72%) (Lima and Cassiani, 2009;Dai et al, 2016). Other studies found lower frequencies in Indian (63%), Pakistani (59.4%), Mexican (42%), Chilean (41%) PICUs (Santibáñez et al, 2014;Ismail et al, 2017;Rao et al, 2019;Medina-Barajas et al, 2020). An investigation at a Brazilian neonatal intensive care unit found a pDDI prevalence equal to 51% (Queiroz et al, 2014).…”

Section: Discussionsupporting

confidence: 84%

Severe Potential Drug-Drug Interactions and the Increased Length of Stay of Children in Intensive Care Unit

Lima

Camarinha²,

Bezerra

et al. 2020

Front. Pharmacol.

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Children are exposed to drug-drug interactions (DDI) risks due to their organism’s complexity and the need for several medicines prescriptions in pediatric intensive care units (PICU). This study aimed to assess the prevalence of potential DDIs in a Brazilian PICU. We carried out a cross-sectional study at a pediatric teaching hospital from Rio de Janeiro (Brazil) over one year. Potential DDIs (pDDIs) between prescribed medicines for hospitalized children in PICU (n = 143) were analyzed according to severity using Micromedex®. Sex, age group, number of drugs prescribed, vasoactive amines use (a proxy of clinical complexity), and the PICU length of stay were summarized using descriptive statistics. Association between the PICU length stay, and variables sex, age, clinical condition complexity, number of drugs prescribed, and severity of pDDI were examined by univariate and multiple linear regression. Seventy percent of patients aged three days to 14 years old were exposed at least one potential DDIs during PICU stay. Two hundred eighty-four different types of pDDIs were identified, occurring 1,123 times. Nervous system drugs were implicated in 55% of the interactions, and fentanyl (10%) was most involving in pDDIs. Most pDDIs were classified as higher severity (56.2%), with reasonable documentation (64.6%) and unspecified onset time (63.8%). Worse clinical condition, ten or more drugs prescribed, and most severe pDDIs were associated with a longer PICU length of stay. Multiple linear regression analysis showed an increase of 9.83 days (95% confidence interval: 3.61–16.05; p = 0.002) in the PICU length of stay in children with major or contraindicated pDDIs. The results of this research may support the monitoring and prevention of pDDIs related to adverse events in children in intensive care and the design and conduction of new studies.

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“…Ahmed et al also reported that out of 800 prescriptions, 290 have at least one drugdrug interaction (36.25%) [21]. Medina-Barajas et al reported that most of the interactions in their study were minor [22]. They also stated that about 42% of the patients presented some degree of potential drug-drug interactions [22].…”

Section: Resultsmentioning

confidence: 98%

Pilot Study: Assessment of Drug-Food and Drug-Drug Interactions in the Outpatient Settings

Ahmed

Alkhawaja

Khan

2020

JPRI

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Background: A drug-drug interaction arises when the pharmacologic effect of a medication is changed by the action of other medication causing unexpected clinical effects. Drug-drug interactions are widely known but the identification of the consequences of food and drug interactions has been growing slowly. Aim: The present study aims to describe the occurrence of drug –food and drug-drug interactions in the outpatient settings in Riyadh city. Methodology: A retrospective study was piloted in Riyadh city. The prescriptions were reviewed to identify potential drug - food and drug–drug interactions using Drug Interactions Checker. Results: About 16.16% of the prescriptions included a drug - drug interaction. The most frequent interaction was the interaction between ciprofloxacin and metronidazole (25.00%) that is a minor interaction. Regarding drug – food interactions there were 40 interactions, the majority of these interactions were moderate. The most common drug - food interactions were metronidazole with food (20.00%) that is a major interaction. Conclusion: Drug interactions with other drugs or with foods are common. These interactions could have a beneficial or a harmful effect. Physicians and pharmacists should use programs that detects the drug interactions.

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Pilot study: Evaluation of potential drug–drug interactions in hospitalized pediatric patients

Cited by 13 publications

References 21 publications

Prevalence of potential drug–drug interactions in outpatients of a general hospital in China: a retrospective investigation

Prevalence of potential drug–drug interactions in outpatients of a general hospital in China: a retrospective investigation

Severe Potential Drug-Drug Interactions and the Increased Length of Stay of Children in Intensive Care Unit

Pilot Study: Assessment of Drug-Food and Drug-Drug Interactions in the Outpatient Settings

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