Background: Both polypharmacy and potential drug-drug interactions (pDDIs), especially those at the pharmacokinetic level, are common in hospitalized patients and are associated with adverse effects and failure of therapy; Objective: The aim of the present study is to investigate retrospectively the prevalence of polypharmacy and the risk of potential pharmacokinetic drug-drug interaction among hospitalized patients; Methods: The medical documentation of hospitalized patients in the unit of internal diseases at the hospital “St Marina” in Varna, Bulgaria for a period of six months (January–July 2016) was retrospectively reviewed. Lexicomp® Drug Interaction software was used for the detection of pDDI. Descriptive statistic and logistic regression were used for data analysis; Results: In this study, 294 patients out of 510 (57%) were selected with polypharmacy. The number of detected potential pharmacokinetic DDIs (pPKDDIs) was only 216 (or 12,4%), but almost 40% of patients with polypharmacy were exposed to at least one pPKDDIs. The most common pPKDDIs occur at the biotransformation level – 78 (36,1%), and the most common enzyme form that is involved in these interactions is cytochrome 3A4 (44 or 20,4%). The number of prescribed medications (>7) was found to increase the possibility of having pDDIs (OR 25.535, 95% CI 12.529 to 52.042; p = <0.001) and pPKDDIs (OR 5.165, 95% CI 3.430 to 7.779; p = <0.001) as well; Conclusion and Relevance: Caution should be taken in patients taking more than seven drugs and careful assessment of the pPKDDIs should be made. When such interactions are detected, they need to be properly evaluated and managed.
Purpose: The present study aimed to evaluate the frequency of pDDIs in male patients admitted to a university-based intensive psychiatric unit over a twelve-month period and to assess patients' exposure to pDDIs as inpatients and potential outpatients. Material/Methods: Charts of 425 consecutive hospitalized patients with psychiatric disorders were reviewed. Potential DDIs were assessed and categorized using Lexicomp® drug interaction software. Statistical analyses were performed with IBM SPSS Statistics for Windows, Version 20.0. Results: A total of 1404 pDDIs (3.3 per patient) were identified for the hospitalization period. Categorized in risk rating categories X and D, considered most relevant for the safety of the patients were 346 (24.64%) of them. Among the pharmacodynamic pDDIs, most frequent were pDDIs associated with central nervous system depression, followed by QT‐interval prolongation. Hospital discharge prescriptions included 631 pDDIs (1.48 per patient). Out of them, 144 (22.82%) were identified in risk rating categories X and D. Among the pharmacodynamic pDDIs first in frequency were pDDIs related to QT-interval prolongation, followed by pDDIs associated with central nervous system depression. Potential DDIs that could lead to serotonin syndrome or extrapyramidal side effects were relatively infrequent during hospitalization and at discharge. No pharmacokinetic pDDIs were categorized in groups X and D. Conclusions: The study showed a higher frequency of pDDIs during the hospitalization period compared to hospital discharge with no change of the nature of the potential risks for the safety of the patients. Caution is warranted to limit the exposure of the patients to pDDIs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.