Adverse drug reactions impact on patient health, effectiveness of pharmacological therapy and increased health care costs. This investigation intended to detect the most critical drug-drug interactions in hospitalized elderly patients, weighting clinical risk. We conducted a cross-sectional study between January and April 2014; all patients 70 years or older, hospitalized for >24 hr and prescribed at least one medication were included in the study. Drug-drug interactions were estimated by combining Stockley's, Hansten and Tatro drug interactions. Drug-drug interactions were weighted using a risk-analysis method based on failure modes, effects and criticality analysis. We calculated a criticality index for each drug involved in the drug-drug interactions based on the severity of the interaction mechanism, the frequency the drug was involved in drug-drug interactions and the risk of drug-drug interactions in patients with impaired renal function. The average number of drugs consumed in the hospital was 6 AE 2.69, involving 160 active ingredients. The most frequent were as follows: Furosemide, followed by Enalapril. Of drug-drug interactions, 2% were classified as contraindicated, 14% advised against and 83% advised caution during the hospital stay. Thirty-four drug-drug interactions were assessed, of which 23 were pharmacodynamic drug-drug interactions and 12 were pharmacokinetic drug-drug interactions (1 was both). The clinical risk calculated for each drug-drug interaction included heparins + non-steroidal anti-inflammatory drugs (NSAIDs) or Digoxin + Calcium Gluconate, cases which are pharmacodynamic drug-drug interactions with agonist effect and clinical risk of bleeding, one of the most common clinical risks in the hospital. An index of clinical risk for drug-drug interactions can be calculated based on severity by the interaction mechanism, the frequency that the drug is involved in drug-drug interactions and the risk of drug-drug interactions in an elderly patient with impaired renal function.Drug-related problems (DRP) are a very important public health concern that cause adverse drug reactions (ADR), which impact on patient health, effectiveness of pharmacological therapy and increased healthcare costs [1]. Drug-drug interactions have been reported to account for 5.6% to 63% of medication-related problems (MRPs), particularly in elderly patients, where the prevalence of at least one drug-drug interaction is about 46% [2]. The conditions of elderly patients, such as a decline in the functional capacity of most organs and systems, comorbidity and, in turn, polypharmacy (more than five drugs), make this population more susceptible to drug-drug interactions, resulting in a long hospital stay or death [3,4].There are many studies that report the prevalence of drugdrug interactions, while focusing on identifying the implicated drugs and the type of clinical effect on the patient [5,6]. Currently, research has focused on knowing the DDI action mechanisms, which allows assessment of their relevance and ...
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