Citation: Kirilochev OO, Dorfman IP, Umerova AR, Bataeva SE (2019) Potential drug-drug interactions in the psychiatric hospital: Frequency analysis. Research Results in Pharmacology 5(4): 1-6. https://doi. AbstractIntroduction: Drug-drug interactions are an important clinical problem in pharmacotherapy. This study is focused on different types of drugs used in a psychiatric hospital. Materials and methods:The pharmacoepidemiological study included the analysis of medical records of 500 psychiatric inpatients. The patients were divided into 2 groups: under 65 and over 65 years of age. All the drug prescriptions were analyzed to identify the combinations of drugs that can induce drug-drug interactions and determine their clinical significance.Results and discussion: Over 77% of hospitalized patients were administered drug combinations that could induce drug-drug interactions, most of which were of moderate clinical significance. A reliable association was found between the patient's age, the clinical significance of drug-drug interactions, and the pharmacotherapy structure. The most common irrational drug combinations were identified.Conclusion: Timely analysis of drug prescriptions for potential drug-drug interactions can enhance the safety of pharmacotherapy and decrease the risk of adverse drug reactions in the psychiatric inpatient setting. Keywordsadverse drug reactions, drug-drug interactions, pharmacotherapy safety. Copyright Kirilochev OO et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Research Results in Pharmacology 5(4): 1-6 UDC: 615.065
The results substantiate the need to continue drug safety monitoring in the Astrakhan region. We plan to further improve the software for ADR analysis.
Проблема безопасности комбинированной фармако-терапии актуальна во всех сферах медицины, поскольку практикующий врач любой специальности сталкивается с назначением нескольких препаратов одному больному. Однако клиническое мышление врача, как правило, в большей степени направлено на выбор наиболее эффек-тивной комбинации лекарственных средств для усиления терапевтического эффекта или воздействия сразу на не-сколько клинических проявлений, нежели оценку без-опасности такой комбинации. Во многих случаях комби-нированная фармакотерапия приводит к возникновению лекарственного взаимодействия, которое способно вы-звать неблагоприятные лекарственные реакции.Межлекарственное взаимодействие -это изменение эффективности и безопасности одного лекарственного средства при одновременном или последовательном при-менении с другим лекарственным средством [1]. Проведен анализ 132 лекарственных препаратов, используемых в условиях психиатрического стационара, на предмет возможности развития их взаимодействия. Установлено, что каждая пятая потенциальная комбинация вступает в лекарственное взаимодействие, среди которых преобладают клинически значимые сочетания препаратов. Психотропные лекарственные препараты занимают лидирующие позиции по количеству таких взаимодействий. Учет приведенных в статье данных способен повысить безопасность комбинированной фармакотерапии путем выбора альтернативного лекарственного препарата, коррекции дозового режима или активного мониторирования клинического состояния пациента, включая лабораторные и инструментальные данные. An analysis of 132 drugs used in a psychiatric hospital for the estimation of the possibility of drug-drug interactions has been carried out. It has been established that one in five potential combination has a drug-drug interaction with clinically significant interactions being more frequent. Psychotropic drugs occupy a leading position in the number of such interactions. This analysis is able to improve the safety of the combined pharmacotherapies by choosing an alternative drug, correction of dose or active monitoring of the clinical condition of the patient, including laboratory and instrumental data. Keywords: combined pharmacotherapies, drug-drug interactions, adverse drug reactions.К видам взаимодействия лекарственных средств от-носят: а) фармацевтическое -обусловлено физическими и химическими свойствами лекарств, происходит до по-ступления лекарственных препаратов (ЛП) в организм че-ловека (например, смешивание препаратов в одной инфу-зионной системе); б) фармакокинетическое -происхо-дит на уровнях всасывания, распределения, метаболизма и выведения ЛП и приводит к изменению концентрации ЛП в плазме крови, а следовательно, изменению воздей-ствия на молекулы-мишени; в) фармакодинамическое -связано с изменением фармакологического эффекта од-ного ЛП под действием другого, как правило, происходит на уровне механизма действия препарата. Наибольшее клиническое значение имеют последние два типа взаимо-действия, которые могут привести как к изменению тера-певтического ответа, так и увели...
Relevance. If we reduce the treatment exclusively to the eradication of Helicobacter pylori (Hp), the question of monitoring the results of anti-Hp therapy is controversial, given the widely known data on the detection of Hp, including virulent strains of Hp, in most healthy individuals.The aim of the study: to track the dynamics of stomach colonization with various Hp strains in patients with gastric ulcer and duodenal ulcer (PUD) immediately after the use of standard three-component anti-Hp therapy (AHT) and 1.5–2 months after AHT.Methods. Genotyping of Hp strains was carried out by the VNTR method together with the determination of the cagA gene.Results. Assessment of the results of AHT in the form of «eradication of Hp — re-detection of Hp» (i. e., without taking the determination of Hp strains into account) showed less reliability in the differences than the «eradication — preservation of the strain or change of the strain» score in patients with PUD; in addition, the differences between the initial bacteriological picture and that observed immediately after AHT were on the verge of reliability, while the differences between the initial bacteriological picture and that observed after 1.5–2 months had a high degree of reliability. The number of eradications increased (eradication achieved immediately after AHT was not preserved, except for one) and the number of cagA-containing strains decreased (due to new eradication detected at late follow-up periods and due to a change in strains) in long-term follow-up in patients with PUD.Conclusion. Since all patients with PUD achieved clinical remission, which lasted for the next 1.5–2 months, the success of AHT should not be unambiguously associated with the eradication of Hp; the restoration of the organism's colonization resistance to Hp after a course of therapy is more likely.
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