BackgroundDrug interactions in oncology are of particular importance due to the narrow therapeutic range and inherent toxicity. The incidence of interactions increases when patients are polymedicated, which is very common in cancer patients as they often have other co-morbidities.PurposeTo identify potential drug–drug interactions in patients with colorectal cancer treated with fluoropyrimidines-based regimens and concomitant treatment.Material and methodsRetrospective study to evaluate drug interactions in patients with colorectal cancer who started chemotherapy between January and March 2014, in a central hospital, and who were also prescribed other drugs. Interactions were screened using the Lexi-Interact database between chemotherapy regimens including FOLFOX4, mFOLFOX6, FOLFIRI, capecitabine and fluorouracil continuous infusion, supportive treatment for prevention of emesis (dexamethasone, ondansetron) and other prescribed treatment.ResultsOf the patients who started fluoropyrimidines-based chemotherapy, 29 were also prescribed other drugs, the majority cardiovascular and Central Nervous System drugs. Of the 108 drugs prescribed, 20 interacted with the chemotherapeutic regimen, and accounted for 34 interactions, with an average of 1.2 interactions per prescription. According to the Lexi-Interact database 10 had risk rating C and required monitoring of side effects; 23 had risk rating D and were recommended for treatment modification or aggressive monitoring; 1 had risk rating X which required avoidance of the combination. The drugs included in the chemotherapy regimens with the highest number of interactions were dexamethasone (n = 20) and fluorouracil (n = 8).ConclusionThe screening of drugs for the treatment of co-morbidities was based on electronic medical records hence OTC drugs and dietary supplements were not included in this study. The identification of these drug interactions enables their inclusion in the prescription program, allowing alerts to be issued at the time of prescription.ReferenceCrul M, Yap KD, Terpstra WE. Frequent interactions between chemotherapy and community-dispensed drugs in a continuous screening programme. Eur J Hosp Pharm 2012;19:171No conflict of interest.
BackgroundPolymedication increases the risk of developing drug interactions, and this risk is higher as the number of drugs used increases. At the hospital, medication review is performed for patients receiving treatment with drugs subject to additional monitoring.PurposeCharacterise the profile of drug interactions in oncological/haematological patients proposed for treatment with drugs subject to justification.Material and methodsDescriptive, observational, retrospective study conducted between January and December 2016 in a central general hospital. Oncological/haematological patients with drug prescription subject to justification were included. Information was collected through consultation of the clinical process and other hospital records. Drug interactions were manually screened and classified using Lexi-interact database risk rating. Data were recorded and processed in Microsoft Excel 2010.ResultsA total of 174 patients that had drugs subject to justification were included. We identified 57 drug interactions between the drug for other comorbidities and the proposed therapy, corresponding to 32.7% of the patients. The majority of patients in this group were on five or more drugs. Drug-drug interactions identified had the following risk classification: 48 with risk C, five with risk D and four with risk X. The groups with the highest number of interactions were the cardiovascular system, CNS and drugs used to treat endocrine diseases. Everolimus (three drug interactions/two requests) followed by bortezomib (28 drug interactions/23 requests) had the highest number of drug interactions/number of requests. A management plan for patients’ therapy that included monitoring (risk C interactions), suggestions to change therapy (risk D interactions) and therapy modification (risk X interactions) was established with the oncologist.ConclusionThe present study allowed the identification of the need for pharmaceutical intervention in the pharmacotherapy review. Knowledge of potential drug interactions can lead to the development of institutional strategies to minimise it and to prevent significant changes in therapy goal. Thus, it is important to identify thecriteria for selecting patients who can benefit most from this type of evaluation.References and/or Acknowledgements1. Riechelmann RP, Girardi D. Drug interactions in cancer patients: a hidden risk? J Res Pharm Pract2016Apr–Jun;5(2):77–78.2. Blenkinsopp A, Bond C, Raynor DK. Medication reviews. Br J Clin Pharmacol2012Oct;74(4):573–580.No conflict of interest
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