Risk of drug interaction: combination of antidepressants and other drugs

Miyasaka, Lincoln Sakiara; Atallah, Álvaro Nagib

doi:10.1590/s0034-89102003000200008

Cited by 16 publications

(13 citation statements)

References 8 publications

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“…This prevalence was higher than others found in similar Brazilian studies. 9,13,14 Miyasaka and Atallah 9 found that in prescriptions for psychiatric patients, 22% had DDI; Meiners and Bergsten-Mendes 13 found that in pediatric prescriptions, 32% had DDI. This discrepancy could have occurred because of the different designs of the studies.…”

Section: Discussionmentioning

confidence: 99%

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A Pharmacoepidemiologic Study of Drug Interactions in a Brazilian Teaching Hospital

Cruciol¹,

Thomson²

2006

Clinics

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Cruciol-Souza JM, Thomson JC. A pharmacoepidemiologic study of drug interactions in a brazilian teaching hospital. Clinics. 2006;61(6):515-20. PURPOSE:Although drug-drug interactions constitute only a small proportion of adverse drug reactions, they are often predictable and therefore avoidable or manageable. There are few studies on drug-drug interactions from Brazil. This study aimed to assess the frequency of drug-drug interactions in prescriptions and their potential clinical significance in patients of a Brazilian teaching hospital. METHODS: From January to April 2004, a sample of 1785 drug prescriptions was drawn from a total of 11,250. Drug-drug interactions were identified by using Micromedex ® DrugReax ® System. Patients´ records with major drug-drug interactions were reviewed by a pharmacist and a medical doctor looking for signs, symptoms, and lab tests that could indicate adverse drug reactions due to such interactions. RESULTS: From the 1785 prescriptions examined, 1089 (61%) were from the male adult ward. Patients' average age was 52.7 years (SD = 18.9; range, 12-98). The median number of drugs in each prescription was 7 (range, 2-26). At least 1 drug-drug interactions was present in 887 (49.7%) prescriptions. Regarding the severity of the clinical result, the interactions were classified as minor (20; 2.3%), moderate (184; 20.7%), major (30; 3.4%), and undetermined because of an incidence of more than 1 interaction in a single patient (653; 73.6%). From the 30 patients with major interactions, 17 (56.7%) presented adverse drug reactions induced by exposure to a major drug-drug interaction. CONCLUSIONS: Patients did suffer adverse drug reactions from major drug-drug interactions. Many physicians may be unaware of drug-drug interactions. Education, computerized prescribing systems and drug information, collaborative drug selection, and pharmaceutical care are strongly encouraged for physicians and pharmacists.

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Section: Discussionmentioning

confidence: 99%

“…5,6 At least 15% of the patients admitted to hospitals have 1 DDI at admission. 1,[7][8][9] The risk of DDI can increase in the hospital because new drugs are often added to an existing drug therapy. 10 Drug-drug interactions are often predictable and, therefore, avoidable or manageable, but the reactions caused by them are mostly unknown.…”

Section: Introductionmentioning

confidence: 99%

A Pharmacoepidemiologic Study of Drug Interactions in a Brazilian Teaching Hospital

Cruciol¹,

Thomson²

2006

Clinics

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“…The steps required comprise careful monitoring of patients, changes to the doses of one or both drugs, or exchanging of one or both drugs to lessen the possible interactions. 8 Vonbach et al 9 reported that to reduce the number and improve the management of drug-drug interactions (DDIs), physicians primarily have to be aware of the presence of a DDI. Cruciol-Souza and Thomson 10 reported that education for healthcare professionals, computerized systems for prescriptions and drug information, along with collaborative drug selection and pharmaceutical care are some of the possible solutions for the problem.…”

Section: Introductionmentioning

confidence: 99%

Frequency of potential interactions between drugs in medical prescriptions in a city in southern Brazil

Bleich¹,

Bleich

Chiamulera

et al. 2009

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Drug interactions form part of current clinical practice and they affect between 3 and 5% of polypharmacy patients. The aim of this study was to identify the frequency of potential drug-drug interactions in prescriptions for adult and elderly patients. METHODS: Stratified cluster sampling, proportional to the total number of homes in the housing project, was used. The sample consisted of 95 homes and 96 male or female patients aged 19 or over, with medical prescriptions for at least two pharmaceutical drugs. Interactions were identified using DrugDigest, Medscape and Micromedex softwares. TYPE OF STUDY AND SETTING: RESULTS:Most of the patients were female (69.8%), married (59.4%) and in the age group of 60 years or over (56.3%), with an income less than or equal to three minimum monthly salaries (81.3%) and less than eight years of schooling (69.8%); 90.6% of the patients were living with another person.The total number of pharmaceutical drugs was 406 (average of 4.2 medications per patient). The drugs most prescribed were antihypertensives (47.5%).The frequency of drug interactions was 66.6%. Among the 154 potential drug interactions, 4.6% were classified as major, 65.6% as moderate and 20.1% as minor. CONCLUSION:The high frequency of drug prescriptions with a potential for differentiated interactions indicates a situation that has so far been little explored, albeit a reality in household surveys.RESUMO CONTEXTO E OBJETIVO: As interações medicamentosas fazem parte da prática corrente na clínica médica e a sua incidência oscila entre 3% e 5% nos pacientes fazendo uso da polifarmácia. O objetivo do estudo foi identificar a frequência de interações droga-droga potenciais em prescrições de pacientes adultos e idosos. MÉTODO: A amostra foi por conglomerado e estratificada, proporcional ao total de residências no conjunto habitacional, constituída de 95 residências, com 96 pacientes de 19 anos ou mais, sexo feminino e masculino, com prescrição de no mínimo duas especialidades farmacêuticas. As interações foram identificadas de acordo com os softwares DrugDigest, Medscape, Micromedex. TIPO DE ESTUDO E LOCAL: RESULTADOS:A maioria dos pacientes pertencia ao gênero feminino (69,8%), em situação conjugal casada (59,4%), com renda menor ou igual a três salários mínimos (81,3%), faixa etária 60 anos ou mais (56,3%) e 8 anos ou menos de estudo (69,8%) com 90,6% dos pacientes moravam com mais outra pessoa. O total de especialidades farmacêuticas foi de 406, correspondendo a uma média de 4,2 medicamentos por paciente. Os fármacos mais prescritos foram os anti-hipertensivos (47,5%). A frequência de interações medicamentosas foi de 66,6%. Dentre as 154 interações medicamentosas potenciais, 4,6% foram classificadas como maior e 65,6% como moderada e 20,1% como menor.CONCLUSÃO: A alta frequência de prescrições de drogas com potencial de interações diferenciado indica uma situação ainda pouco explorada, mas real em pesquisa domiciliar.

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“…Prescribing multiple medications requires the review of medications in use and extensive knowledge of them, in order to minimize substances used, monitoring and taking into account side effects and toxic effects (14) .…”

Section: Discussionmentioning

confidence: 99%

Antidepressants: knowledge and use among nursing students

Istilli

Miasso

Padovan

et al. 2010

Rev. Latino-Am. Enfermagem

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This study examined the knowledge of nursing students in regard to using antidepressant medication and proposes actions such that nurses contribute to a safe and effective antidepressant therapy. This cross-sectional and descriptive study was conducted in a public nursing school in the state of São Paulo, Brazil, between March and November 2008. Fifty-two (19%) out of the 273 participants were using or had used antidepressants.Instruction concerning the use of antidepressants was provided by physicians. Even after receiving instruction concerning the antidepressant treatment before its administration, Incluso, con la orientación previa a la administración de antidepresivos, la mayoría de los estudiantes (χ 2 1 = 0,07, p> 0,05) tiene dudas sobre el uso de antidepresivos. La fluoxetina es el fármaco más utilizado. Acciones para generar mayor conocimiento sobre el uso y efectos terapéuticos de los antidepresivos por parte de las enfermeras, parecen necesarias y apropiadas.

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Risk of drug interaction: combination of antidepressants and other drugs

Cited by 16 publications

References 8 publications

A Pharmacoepidemiologic Study of Drug Interactions in a Brazilian Teaching Hospital

A Pharmacoepidemiologic Study of Drug Interactions in a Brazilian Teaching Hospital

Frequency of potential interactions between drugs in medical prescriptions in a city in southern Brazil

Antidepressants: knowledge and use among nursing students

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