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.

The aim. To evaluate the economic efficiency and the choice of the vaccination strategy in the respiratory pneumococcal infection risk groups among the adult population of the Astrakhan region.Materials and methods. The data for the period of 2015 - 2018 were analyzed on the number of registered diseases in the patients living in the service area of the medical organizations (Form No. 12, Federal State Statistics Service Orders No. 591, dated 27 November, 2015; No. 679, dated 22 November, 2019). The following working directives were studied: the base medical examination documentation submitted by medical institutions (Form No. 030/y “Dispensary Monitoring Checklist”; lists of the persons subjected to medical observation in the reporting year; Orders of the Ministry of Health of the Russian Federation: No. 1344, dated 12 December, 2012; No. 173n, dated 29 March, 2019). Statistical materials of the territorial fund for compulsory medical insurance of the Astrakhan region on the payment of medical care to 12,970 patients who had had pneumonia in 2015-2018, were analyzed. The financial support of vaccination based on the results of tenders for the procurement of pneumococcal vaccines organized by the regional Ministry of Health, was considered. The calculations were carried out in accordance with the guidelines of “Cost-effectiveness of vaccine prophylaxis” (Methodological guidelines 3.3.1878-04, dated 04.03.2004).Results. The prospective calculation of the vaccination cost showed that the benefits of vaccination with pneumococcal conjugate vaccine Prevenar13 (PCV13) and pneumococcal polyvalent vaccine Pneumovax 23 (PPV23) with a 95% vaccination coverage, are recorded after 2 years. The economic benefit of vaccination by reducing the possible number of pneumonias at the end of 2028 will be 968.2 million rubles.Conclusion. The economic feasibility of vaccine prophylaxis of the adult contingent with an increased risk of developing pneumococcal infection has been established. The sequential strategy of PCV13 and PPV23 application provides the most effective localization of pneumococcal infection. The research results should be widely introduced into the long-term plans for vaccination and healthcare practice in the Astrakhan region.

The choice of drugs used to treat patients with chronic obstructive pulmonary disease (COPD) (inhaled β-agonists, M-anticholinergic drugs, inhaled corticosteroids (ICS)) in view of their interchangeability is reviewed in this article. This aspect is especially important for clinicians when choosing an effective and safe treatment for COPD and for increasing patient adherence to treatment.The aim of this study was to assess the ratio of the number of reference (original), interchangeable, and generic drugs used in COPD.Methods. In accordance with the Russian clinical guidelines 2018 and GOLD 2019, modern drugs for the treatment of COPD with bronchodilator and anti-inflammatory activity were selected. All trade names of the corresponding drugs for each international non-proprietary name (INN) In the State Register of Medicines website were considered. The information on the availability of reference (original) drugs and the corresponding interchangeable products, as well as their presence in the List of vital and essential drugs was analyzed.Results. A large number of generic prodcuts are registered in the State Register of Medicines, and only a few of them are interchangeable with the corresponding reference (original) drug.Conclusion. The analysis will help widen the doctors’ choice of interchangeable drugs in treatment of COPD with an equivalent effect and safety of reference drugs, as well as to increase the patients’ adherence to treatment.

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...

аспекты безопасности фармако тера пии пожилых пациентов с психическими заболеваниями. Клин фармакол тер 2020;29(1):80-84 [Kirilochev OO, Umerova AR, Dorfman IP, Bataeva SE. Safety of pharmacotherapy in the elderly patients with psychiatric diseases. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Ther 2020;29(1). (In Russ.)].

The aim of the study was to estimate the economic damage by COPD, including direct medical and non-medical costs and indirect costs associated with premature deaths of working-age individuals.Materials and methods. First, estimation of the economic COPD burden in Astrakhan region (AR) was carried out using the clinical and economic analysis of the "cost of illness" (COI). Direct medical costs of inpatient, outpatient, ambulance and emergency medical care, as well as direct non-medical costs associated with the disability benefits payments, were taken into account. Indirect costs were defined as economic losses from undelivered products due to premature deaths of working-age individuals.Results. From 2015 to 2019, the economic COPD burden in AR amounted to 757.11 million rubles in total, which is equivalent to 0.03% of the gross regional product covering a five-year period of the study. Direct medical and non-medical costs totaled 178.02 million rubles. In the structure of direct medical expenses, expenses for inpatient, as well as ambulance and emergency medical care during the study period, increased by 92.5% and 45.5%, respectively. While the costs for the outpatient care decreased by 31.9%, the increase in direct non-medical costs associated with the disability benefits payments, increased by 5.1% (2019). Indirect losses amounted to 579.09 million rubles.Conclusion. The structure of the main damage is dominated by indirect losses in the economy associated with premature deaths of working-age individuals. In the structure of direct medical costs, inpatient care costs prevailed. These studies indicate the need to continue an advanced analysis of the economic burden of COPD, as well as to optimize the treatment and prevention of the exacerbations development of this disease.

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