Surveillance of the potential drug-drug interactions in the medicine department of a tertiary care hospital

S. Soherwardi, B. Chogtu, P. Faizal

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: Drug-Drug Interactions (DDIs) account for 6-30% of the adverse drug events, pose a significant risk to the patient's health outcome and they put an economic burden on the health care system. Polypharmacy significantly contributes to these interactions. This study was aimed at assessing the drug-drug interactions in the in-patients in the medicine department in a tertiary care hospital. Materials and Methods: The case records of 250 patients who were admitted in the medicine ward were analyzed regarding the demography of the patient, the prescription and the interaction details like the object drug, severity, management and the outcome. Results: The patients received drugs which ranged from 5 to 18. 66% of the patients had DDIs, with a majority being moderate in severity and occurring in the patients who received cardiovascular drugs. Age and gender did not have a significant effect on the drug- drug interactions. Conclusion: Most of the DDIs are preventable. The frequently occurring DDIs are seen between fluoroquinolones and oral anti-diabetics, iron and pantoprazole, aspirin and clopidogrel.
Original languageEnglish
Pages (from-to)1258-1261
Number of pages4
JournalJournal of Clinical and Diagnostic Research
Volume6
Issue number7 SUPPL.
Publication statusPublished - 2012

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Drug interactions
Bioelectric potentials
Tertiary Healthcare
Drug Interactions
Tertiary Care Centers
Medicine
Pharmaceutical Preparations
clopidogrel
Cardiovascular Agents
Polypharmacy
Fluoroquinolones
Drug-Related Side Effects and Adverse Reactions
Aspirin
Prescriptions
Health care
Iron
Economics
Demography
Delivery of Health Care
Health

Cite this

@article{5f81b2ee8a8642d692ac895f3d874785,
title = "Surveillance of the potential drug-drug interactions in the medicine department of a tertiary care hospital",
abstract = "Introduction: Drug-Drug Interactions (DDIs) account for 6-30{\%} of the adverse drug events, pose a significant risk to the patient's health outcome and they put an economic burden on the health care system. Polypharmacy significantly contributes to these interactions. This study was aimed at assessing the drug-drug interactions in the in-patients in the medicine department in a tertiary care hospital. Materials and Methods: The case records of 250 patients who were admitted in the medicine ward were analyzed regarding the demography of the patient, the prescription and the interaction details like the object drug, severity, management and the outcome. Results: The patients received drugs which ranged from 5 to 18. 66{\%} of the patients had DDIs, with a majority being moderate in severity and occurring in the patients who received cardiovascular drugs. Age and gender did not have a significant effect on the drug- drug interactions. Conclusion: Most of the DDIs are preventable. The frequently occurring DDIs are seen between fluoroquinolones and oral anti-diabetics, iron and pantoprazole, aspirin and clopidogrel.",
author = "S. Soherwardi and B. Chogtu and P. Faizal",
note = "Cited By :4 Export Date: 28 November 2017 Correspondence Address: Chogtu, B.; Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, India; email: bhartimagazine@gmail.com Chemicals/CAS: acetylsalicylic acid, 493-53-8, 50-78-2, 53663-74-4, 53664-49-6, 63781-77-1; atorvastatin, 134523-00-5, 134523-03-8; ciprofloxacin, 85721-33-1; clopidogrel, 113665-84-2, 120202-66-6, 90055-48-4, 94188-84-8; cotrimoxazole, 8064-90-2; digoxin, 20830-75-5, 57285-89-9; furosemide, 54-31-9; gentamicin, 1392-48-9, 1403-66-3, 1405-41-0; insulin, 9004-10-8; iron, 14093-02-8, 53858-86-9, 7439-89-6; lamivudine, 134678-17-4, 134680-32-3; nicotinic acid, 54-86-4, 59-67-6; pantoprazole, 102625-70-7; ramipril, 87333-19-5; spironolactone, 52-01-7; terbutaline, 23031-25-6; theophylline, 58-55-9, 5967-84-0, 8055-07-0, 8061-56-1, 99007-19-9; zinc, 7440-66-6, 14378-32-6 References: Costa, A.J., Potential drug interactions in an ambulatory geriatric population (1991) Fam Pract, 8, pp. 234-236; Mahmood, M., Malone, D.C., Skrepnek, G.H., Abarka, J., Armstrong, E.P., Murphy, J.E., Potential drug drug interactions within the veteran affairs medical centers (2007) Am J Health-Syst Pharm, 64, pp. 1500-1505; (2007), https://www.thomsonhc.com/hcs/librarian, Micromedex{\circledR} Healthcare Series. Greenwood Village (CO): Thomson Reuters (Healthcare) Inc, Available from, URL, [Accessed 2011 Jul 5]; Almeida, S.M., Gama, C.S., Akamine, N., The prevalence and the classification of drug drug interactions in intensive care patients (2007) Einstein, 5 (4), pp. 347-351; Doucet, J., Chassagne, P., Trivalle, C., Landrin, I., Pauty, M.D., Kadri, N., Drug-Drug interactions which are related to hospital admissions in older adults: A prospective study on 1000 patients J Am Geriatr Soc, pp. 944-948; Seymour, R.M., Routledge, P.A., Important drug-drug interactions in the elderly (1998) Drugs Aging, 12, pp. 485-494; Johnson, J.A., Bootman, J.L., Drug related morbidity and mortality. A cost-of-illness model (1995) Arch Intern Med, 155, pp. 1949-1956; Mallet, L., Spinewine, A., Huang, A., The challenge of managing the drug interactions in elderly people (2007) Lancet, 370, pp. 185-191; White, J.R., Campbell, R.K., Dangerous and common drug interactions in patients with diabetes mellitus (2000) Endocrinology and Metabolism Clinics, 29, pp. 789-801; Yusuf, S., Zhao, F., Mehta, S.R., Chrolavicius, S., Tognoni, G., Fox, K.K., The effect of Clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation (2001) N Engl J Med, 345, pp. 494-502; Diener, H.C., Bogousslavsky, J., Brass, L.M., Cimminiello, C., Csiba, L., Kaste, M., The aspirin and clopidogrel combination which was compared with clopidogrel alone after a recent ischemic stroke or a transient ischemic attack in high risk patients (MATCH): A randomized, double blind, placebo controlled trial (2004) Lancet, 364, pp. 331-337; Brunton, L.L., Chabner, B.A., Knollman, B.C., (2011) The Pharmacological Basis of Therapeutics, p. 1312. , Eds., Goodman and Gilman's, 12th ed., McGraw Hill, New York, USA; Ghaly, H., Kriet, C., Sahin, S., Pfloger, A., Holzgrabe, U., Zunkler, B.J., The insulinotropic effects of the fluoroquinolones (2009) Biochemical Pharmacology, 77, pp. 1040-1052; Gajjar, D.A., Lacretab, F.P., Kollia, G.D., Stolz, R.R., Berger, S., Smith, W.B., The effect of multidose gatifloxacin or ciprofloxacin in patients with non-insulin dependent diabetes mellitus which was maintained with diet and exercise (2000) Pharmacotherapy, 20, pp. 76S-86S; Pitt, B., Zannad, F., Remme, W.J., Cody, R., Castargne, A., Perez, A., The effect of spironolactone on the morbidity and the mortality in patients with severe heart failure (1999) N Eng J Med, 341, pp. 709-717; Fenester, P.E., Hager, W.D., Goodman, M.M., The Digoxin-quinidine-spironolactone interaction (1984) Clin Pharmacol Ther, 36, pp. 70-73; Johnston, R.T., de Bono, D.P., Nyman, C.R., Preventable sudden death in patients who received angiotensin converting enzyme inhibitors and loop/potassium sparing diuretic combinations (1992) Int J Cardiol, 34, pp. 213-215; Wregner, E., Muller, R., Moesenthin, M., Welte, T., Frolich, J.C., Neumann, K.H., Interaction of spironolactone with the ACE inhibitors or an angiotensin receptor blocker: An analysis of 44 cases (2003) BMJ, 327, pp. 147-149; Schepkens, H., Vanholder, R., Billiouw, J.M., Lamiere, N., Life-threatening hyperkalemia during a combined therapy with angiotensin-converting enzyme inhibitors and spironolactone: An analysis of 25 cases (2001) The American Journal of Medicine, 110, pp. 438-441; Gagne, J.J., Maio, V., Rabinowitz, C., The prevalence and the predictors of the potential drug- drug interactions in Regione Emilia-Romagna, Italy (2008) J Clin Pharm Ther, 33, pp. 141-151; Magro, L., Conforti, A., Del Zotti, F., Leone, R., Iorio, M.L., Meneghelli, I., Identification of the severe potential DDIs by using an Italian general-practitioner database (2008) Eur J Clin Pharmacol, 64, pp. 303-309",
year = "2012",
language = "English",
volume = "6",
pages = "1258--1261",
journal = "Journal of Clinical and Diagnostic Research",
issn = "2249-782X",
publisher = "Journal of Clinical and Diagnostic Research",
number = "7 SUPPL.",

}

Surveillance of the potential drug-drug interactions in the medicine department of a tertiary care hospital. / Soherwardi, S.; Chogtu, B.; Faizal, P.

In: Journal of Clinical and Diagnostic Research, Vol. 6, No. 7 SUPPL., 2012, p. 1258-1261.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Surveillance of the potential drug-drug interactions in the medicine department of a tertiary care hospital

AU - Soherwardi, S.

AU - Chogtu, B.

AU - Faizal, P.

N1 - Cited By :4 Export Date: 28 November 2017 Correspondence Address: Chogtu, B.; Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, India; email: bhartimagazine@gmail.com Chemicals/CAS: acetylsalicylic acid, 493-53-8, 50-78-2, 53663-74-4, 53664-49-6, 63781-77-1; atorvastatin, 134523-00-5, 134523-03-8; ciprofloxacin, 85721-33-1; clopidogrel, 113665-84-2, 120202-66-6, 90055-48-4, 94188-84-8; cotrimoxazole, 8064-90-2; digoxin, 20830-75-5, 57285-89-9; furosemide, 54-31-9; gentamicin, 1392-48-9, 1403-66-3, 1405-41-0; insulin, 9004-10-8; iron, 14093-02-8, 53858-86-9, 7439-89-6; lamivudine, 134678-17-4, 134680-32-3; nicotinic acid, 54-86-4, 59-67-6; pantoprazole, 102625-70-7; ramipril, 87333-19-5; spironolactone, 52-01-7; terbutaline, 23031-25-6; theophylline, 58-55-9, 5967-84-0, 8055-07-0, 8061-56-1, 99007-19-9; zinc, 7440-66-6, 14378-32-6 References: Costa, A.J., Potential drug interactions in an ambulatory geriatric population (1991) Fam Pract, 8, pp. 234-236; Mahmood, M., Malone, D.C., Skrepnek, G.H., Abarka, J., Armstrong, E.P., Murphy, J.E., Potential drug drug interactions within the veteran affairs medical centers (2007) Am J Health-Syst Pharm, 64, pp. 1500-1505; (2007), https://www.thomsonhc.com/hcs/librarian, Micromedex® Healthcare Series. Greenwood Village (CO): Thomson Reuters (Healthcare) Inc, Available from, URL, [Accessed 2011 Jul 5]; Almeida, S.M., Gama, C.S., Akamine, N., The prevalence and the classification of drug drug interactions in intensive care patients (2007) Einstein, 5 (4), pp. 347-351; Doucet, J., Chassagne, P., Trivalle, C., Landrin, I., Pauty, M.D., Kadri, N., Drug-Drug interactions which are related to hospital admissions in older adults: A prospective study on 1000 patients J Am Geriatr Soc, pp. 944-948; Seymour, R.M., Routledge, P.A., Important drug-drug interactions in the elderly (1998) Drugs Aging, 12, pp. 485-494; Johnson, J.A., Bootman, J.L., Drug related morbidity and mortality. A cost-of-illness model (1995) Arch Intern Med, 155, pp. 1949-1956; Mallet, L., Spinewine, A., Huang, A., The challenge of managing the drug interactions in elderly people (2007) Lancet, 370, pp. 185-191; White, J.R., Campbell, R.K., Dangerous and common drug interactions in patients with diabetes mellitus (2000) Endocrinology and Metabolism Clinics, 29, pp. 789-801; Yusuf, S., Zhao, F., Mehta, S.R., Chrolavicius, S., Tognoni, G., Fox, K.K., The effect of Clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation (2001) N Engl J Med, 345, pp. 494-502; Diener, H.C., Bogousslavsky, J., Brass, L.M., Cimminiello, C., Csiba, L., Kaste, M., The aspirin and clopidogrel combination which was compared with clopidogrel alone after a recent ischemic stroke or a transient ischemic attack in high risk patients (MATCH): A randomized, double blind, placebo controlled trial (2004) Lancet, 364, pp. 331-337; Brunton, L.L., Chabner, B.A., Knollman, B.C., (2011) The Pharmacological Basis of Therapeutics, p. 1312. , Eds., Goodman and Gilman's, 12th ed., McGraw Hill, New York, USA; Ghaly, H., Kriet, C., Sahin, S., Pfloger, A., Holzgrabe, U., Zunkler, B.J., The insulinotropic effects of the fluoroquinolones (2009) Biochemical Pharmacology, 77, pp. 1040-1052; Gajjar, D.A., Lacretab, F.P., Kollia, G.D., Stolz, R.R., Berger, S., Smith, W.B., The effect of multidose gatifloxacin or ciprofloxacin in patients with non-insulin dependent diabetes mellitus which was maintained with diet and exercise (2000) Pharmacotherapy, 20, pp. 76S-86S; Pitt, B., Zannad, F., Remme, W.J., Cody, R., Castargne, A., Perez, A., The effect of spironolactone on the morbidity and the mortality in patients with severe heart failure (1999) N Eng J Med, 341, pp. 709-717; Fenester, P.E., Hager, W.D., Goodman, M.M., The Digoxin-quinidine-spironolactone interaction (1984) Clin Pharmacol Ther, 36, pp. 70-73; Johnston, R.T., de Bono, D.P., Nyman, C.R., Preventable sudden death in patients who received angiotensin converting enzyme inhibitors and loop/potassium sparing diuretic combinations (1992) Int J Cardiol, 34, pp. 213-215; Wregner, E., Muller, R., Moesenthin, M., Welte, T., Frolich, J.C., Neumann, K.H., Interaction of spironolactone with the ACE inhibitors or an angiotensin receptor blocker: An analysis of 44 cases (2003) BMJ, 327, pp. 147-149; Schepkens, H., Vanholder, R., Billiouw, J.M., Lamiere, N., Life-threatening hyperkalemia during a combined therapy with angiotensin-converting enzyme inhibitors and spironolactone: An analysis of 25 cases (2001) The American Journal of Medicine, 110, pp. 438-441; Gagne, J.J., Maio, V., Rabinowitz, C., The prevalence and the predictors of the potential drug- drug interactions in Regione Emilia-Romagna, Italy (2008) J Clin Pharm Ther, 33, pp. 141-151; Magro, L., Conforti, A., Del Zotti, F., Leone, R., Iorio, M.L., Meneghelli, I., Identification of the severe potential DDIs by using an Italian general-practitioner database (2008) Eur J Clin Pharmacol, 64, pp. 303-309

PY - 2012

Y1 - 2012

N2 - Introduction: Drug-Drug Interactions (DDIs) account for 6-30% of the adverse drug events, pose a significant risk to the patient's health outcome and they put an economic burden on the health care system. Polypharmacy significantly contributes to these interactions. This study was aimed at assessing the drug-drug interactions in the in-patients in the medicine department in a tertiary care hospital. Materials and Methods: The case records of 250 patients who were admitted in the medicine ward were analyzed regarding the demography of the patient, the prescription and the interaction details like the object drug, severity, management and the outcome. Results: The patients received drugs which ranged from 5 to 18. 66% of the patients had DDIs, with a majority being moderate in severity and occurring in the patients who received cardiovascular drugs. Age and gender did not have a significant effect on the drug- drug interactions. Conclusion: Most of the DDIs are preventable. The frequently occurring DDIs are seen between fluoroquinolones and oral anti-diabetics, iron and pantoprazole, aspirin and clopidogrel.

AB - Introduction: Drug-Drug Interactions (DDIs) account for 6-30% of the adverse drug events, pose a significant risk to the patient's health outcome and they put an economic burden on the health care system. Polypharmacy significantly contributes to these interactions. This study was aimed at assessing the drug-drug interactions in the in-patients in the medicine department in a tertiary care hospital. Materials and Methods: The case records of 250 patients who were admitted in the medicine ward were analyzed regarding the demography of the patient, the prescription and the interaction details like the object drug, severity, management and the outcome. Results: The patients received drugs which ranged from 5 to 18. 66% of the patients had DDIs, with a majority being moderate in severity and occurring in the patients who received cardiovascular drugs. Age and gender did not have a significant effect on the drug- drug interactions. Conclusion: Most of the DDIs are preventable. The frequently occurring DDIs are seen between fluoroquinolones and oral anti-diabetics, iron and pantoprazole, aspirin and clopidogrel.

M3 - Article

VL - 6

SP - 1258

EP - 1261

JO - Journal of Clinical and Diagnostic Research

JF - Journal of Clinical and Diagnostic Research

SN - 2249-782X

IS - 7 SUPPL.

ER -