A Prospective Analysis of Drug Interactions in Patients of Intensive Cardiac Care Unit
- PMID: 28511403
- PMCID: PMC5427329
- DOI: 10.7860/JCDR/2017/23638.9403
A Prospective Analysis of Drug Interactions in Patients of Intensive Cardiac Care Unit
Abstract
Introduction: Drug-Drug Interaction (DDI) is a serious concern in cardiac patients due to polypharmacy.
Aim: The present study was aimed to identify the potential DDI among hospitalized cardiac patients and evaluate the mechanism and severity of such interactions.
Materials and methods: A prospective observational study was conducted in intensive cardiac care unit of a tertiary care hospital for six months. Patients aged 18 years and above and taking two or more drugs were included in the study. Medscape drug interaction checker was used to identify and analyze the pattern of potential DDI.
Results: Out of 500 patients, most of the patients were male (78.4%) in the age group of 50-60 years (31%). The most common diagnosis was acute coronary syndrome (57.2%). Out of total 2849 DDI, 2194 (77.01%) were pharmacodynamic, 586 (20.57%) were pharmacokinetic in nature while 69 (2.42%) drug pairs interacted by unknown mechanism. Majority of drug interactions were significant {2031 (71.29%)} in nature followed by minor {725(25.45%)} while serious drug interactions were observed in only 93 (3.26%) drug pairs. A positive correlation was observed between patient's age and number of drugs prescribed (r=0.178, p<0.001), number of drugs prescribed and potential Drug-Drug Interaction (pDDI) (r= 0.788, p<0.001) and between patient's age and pDDI (r=0.338, p<0.001).
Conclusion: The risk of pDDI was more commonly observed in elderly male patients particularly with antiplatelet drugs like low dose aspirin and clopidogrel.
Keywords: Drug-drug interactions; Medscape; Polypharmacy; Severity.
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References
-
- Kane-Gill S, Weber RJ. Principles and practices of medication safety in the ICU. Crit Care Clin. 2006;22:273–90. - PubMed
-
- May FE, Stewart RB, Cluff LE. Drug interactions and multiple drug administration. Clin Pharmacol Ther. 1977;22:322–28. - PubMed
-
- Zarowitz BJ. Textbook of critical care. 3rd ed. Philadelphia: WB. Saunders; 1995. Pharmacologic principles. In: Ayres SM, Grenvik A, Holbrook PR, hoemaker WC, editors; pp. 1141–50.
-
- Zagli G, Tarantini F, Bonizzoli M, Di Filippo A, Peris A, De Gaudio AR, et al. Altered pharmacology in the intensive care unit patient. Fundam Clin Pharmacol. 2008;22:493–501. - PubMed
-
- Gholami K, Ziaie S, Shalviri G. Adverse drug reactions induced by cardiovascular drugs in outpatients. [Last cited on 2016 Sep 20] Pharm Pract. 2008;6:51–5. Available from: http://www.pharmacypractice.org/journal/index.php/pp/article/view/234. - PMC - PubMed
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