Significant Drug Interactions Among Intensive Care Unit Patients

Hamidy, Muhammad Yulis; Fauzia, Dina

doi:10.22159/ajpcr.2017.v10s2.19482

Cited by 7 publications

(8 citation statements)

References 15 publications

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“…Our study showed a high prevalence of pDDI (81.2%) along with the presence of polypharmacy and the majority of pDDI were clinically relevant (75.08%) which was almost similar to the studies done by Hamidy et al 14 Valizade et al 15 Gupta et al 16 in critically ill patients stressing to the need for increased awareness about the pDDI in health care providers. The reason may be due to the increased number of drugs prescribed per patients with the average number being 7.95±3.07.…”

Section: Discussionsupporting

confidence: 89%

“…This finding was similar to the other studies by Gupta et al Bista et al Bleich et al [16][17][18] Cardiovascular drugs were mainly responsible for clinically relevant drug interaction. Antiplatelet drugs were most commonly involved drugs, mainly Clopidogrel with Aspirin and Clopidogrel with Pantoprazole followed by anti-infective drug Azithromycin with Salbutamol this was in similar to the findings of Baniasadi et al 24 but this was in contrast to the Valizade et al 14 were most commonly involved drugs were Ranitidine followed by Cephalosporin. Variations in patient's presentation, diagnosis, practices and use of medications between ICU settings may lead to different pDDIs patterns.…”

Section: Discussionsupporting

confidence: 81%

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Prevalence of Potential Drug-Drug Interactions in the Intensive Care Unit of a Tertiary Care Hospital: A Cross-Sectional Study

Acharya¹,

Ragam²,

Holla³

et al. 2019

JYP

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Objective: To analyze the various Potential Drug-Drug Interactions in ICU patients with the ultimate goal of raising awareness among clinicians on safe medication usage. Materials and Methods: This was a Cross-sectional study conducted at a tertiary care hospital. The medical records of the patients admitted to the ICU of the hospital from January 2017 to June 2017 formed material for the study, were analyzed using the database from Lexicomp ® Solutions android mobile application for Potential Drug-Drug Interactions. Results: Among the 176 patients,81.39% had Potential Drug-Drug Interactions, with cardiovascular drugs (22.6%) being the majority group followed by respiratory drugs (17. 97%). Among these 73.2% of the interactions were clinically relevant with the majority being moderate (72.26%) in severity with fair (72.6%) documentation and belonging to Category C (61.080%) in risk rating. The pharmacodynamics type of interactions was more (59.31%) than pharmacokinetic type (36.13%). Conclusion: The high prevalence of Potential Drug-Drug in the ICU setting emphasizes the need for effective medication management and pharmacological consultation to reduce the adverse effect and improve the therapeutic outcome in these patients.This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 81%

Prevalence of Potential Drug-Drug Interactions in the Intensive Care Unit of a Tertiary Care Hospital: A Cross-Sectional Study

Acharya¹,

Ragam²,

Holla³

et al. 2019

JYP

View full text Add to dashboard Cite

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“…In our study out of a total of 151 cases collected, 71.5% of cases had the potency of drug-drug interactions. Similarly, other studies reviewed reported a 70% prevalence of potential drug interactions in the ICU patients [8,9]. However, a much higher frequency of drug interactions (91.43%) [10].…”

Section: Discussionmentioning

confidence: 79%

“…In this study it was found that most of the potential drug-drug interactions were of moderate severity (65.9%). Various studies also confirm that most drug interactions identified were of moderate severity [9][10][11].…”

Section: Discussionmentioning

confidence: 79%

Prevalence of Drug-Drug Interactions in Intensive Care Unit of a Multispecialty Hospital at Hyderabad, South India

Hassan¹

2019

IInt J Gen Med Surg

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Background: A drug interaction occurs when the effect of a drug is altered by other drugs; it may affect the drug's pharmacokinetics or pharmacodynamics. In pharmacokinetic type of drug interactions, a drug alters the absorption of another drug or the, distribution, metabolism, or elimination of another drug; in pharmacodynamics type of interactions, the action of a drug is altered by other drugs. This study was conducted to investigate the prevalence of potential drug-drug interaction, to examine the number of drugs used and prevalence of polypharmacy, to determine the frequency, severity and the drug combinations involved in DDIs occurring in ICU. Materials and Methods: This is an observational study carried out at an ICU of a multi-specialty hospital. Patient of age group between 18-80 years of both the gender admitted for more than 24 hours and prescribed at least more than 2 drugs are included in the study. All the relevant and necessary details of the patients including the demographic data, laboratory parameters and drug therapy details were collected from the patient case notes. The patient drug therapy were reviewed every day and assessed for any drug-drug interactions. Results: A total of 151 prescriptions were assessed out of which 82 were male and 69 were female. In the study group the average age was 54.6 and association was found between the DI and increased age. There were around 1,709 drugs prescribed and average drugs per prescription was 11.2. From a total of 276 drug interactions found, 46 drug interactions were of major severity, 184 drug interactions of moderate severity and 46 drug interactions of minor severity. Mechanism of DDI was identified of which 85(30.7%) DDI showed pharmacokinetic mechanism, 135(48.9%) DDI showed pharmacodynamic mechanism and 57(20.6%) DDI showed unknown mechanism. The prevalence of drug-drug interaction was seen more in age group of 41-60 years. Conclusion: Prevalence of potential DDIs is high in intensive care units and is predisposed by factors such as a number of drugs received by patients, comorbid conditions; complex pharmacotherapies administered and geriatrics. Health professionals who provide care to these patients should be aware to identify and prevent possible drug events. Also, the pharmacist's involvement might have allowed greater familiarity of physicians regarding clinically relevant drug-drug interactions, optimizing the quality of the prescriptions, especially in critical care units. Therefore,

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“…Among 108 significant drug interactions, dobutamine [55(50.92%)] shows high in frequency due to the complexity of pharmacotherapies administered and ultimately led to adverse effects shown in the study done by Yulis Hamidy. M et al 9 Most of the potential drug interactions were significant (major and moderate) than serious and contraindicated. 10 and Brad E. Cooper.…”

Section: Discussionmentioning

confidence: 99%

Role of Clinical Pharmacist in Medication Management of Inotropes and Vasopressors in Intensive Care Unit

Sebastian¹,

Justin²,

Ps³

et al. 2020

IJOPP

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Background: Medication management of inotropes and vasopressors are essential in critically ill patients, as it is considered as important life-saving medications. The present study was carried out to understand the effect of these drugs on unstable patient and identifying drug-related problems like significant interactions, adverse effects, incompatibility and its factors. Methods: A prospective observational study was carried out in the medical, surgical Intensive Care Unit for a period of 6 months. All the interventions and drug related problems were categorized based on the Pharmaceutical Care Network Europe. Results: Out of 150 study population male patients were more and the majority of patients were from the age group of 60-80 years (56.66%). Most of the admissions were due to septic shock (50%). Noradrenaline (64%) were mostly prescribed. This study illustrates that there is an increased effect of drugs on hemodynamic instability based on mean arterial pressure and heart rate. By comparing before and after administration there was a significant (P<0.0001) increased effect in unstable patients. Among 108 significant drug interactions, dobutamine (50.92%) shows high in frequency. Tachycardia (18.66%) is the most common adverse drug reactions. Among 11 incompatible combinations, Dobutamine+pantoprazole (30.18%) shows the highest and the factors affecting the incompatibility of drugs such as diluents used, rate and duration of infusion, pH of drug solution. Out of 126 recommendations given by clinical pharmacist, 70 problems were solved. Conclusion: Interventions made by a clinical pharmacist improves medication safety in critically ill patients by the safe and effective use of inotropes and vasopressors.

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Significant Drug Interactions Among Intensive Care Unit Patients

Cited by 7 publications

References 15 publications

Prevalence of Potential Drug-Drug Interactions in the Intensive Care Unit of a Tertiary Care Hospital: A Cross-Sectional Study

Prevalence of Potential Drug-Drug Interactions in the Intensive Care Unit of a Tertiary Care Hospital: A Cross-Sectional Study

Prevalence of Drug-Drug Interactions in Intensive Care Unit of a Multispecialty Hospital at Hyderabad, South India

Role of Clinical Pharmacist in Medication Management of Inotropes and Vasopressors in Intensive Care Unit

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