Drug-drug interactions in cancer chemotherapy: an observational study in a tertiary health care centre

Singh, Harminder; Singh, Baltej

doi:10.1515/dmpt-2017-0002

Cited by 4 publications

(14 citation statements)

References 16 publications

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“…Notoriously, elderly patients are more exposed to polypharmacy 21,42,43 and consequently have greater susceptibility to drug interactions. 21,27 However, the results found do not show any difference between elderly and nonelderly participants. This divergence may be due to the fact that the investigation was restricted to patients, who were undergoing outpatient treatment, excluding hospitalized patients who are presumably more seriously ill patients.…”

Section: Discussionmentioning

confidence: 67%

“…This result corroborates with previous research that estimated between 14% and 75% the prevalence of DDI involving antineoplastic drugs. 13,20,27 Most of the interactions found were classified as pharmacodynamic and previous studies show divergent results in relation to this variable. 14,20,21 Those data are of concern because, although pharmacodynamic interactions have greater potential to be harmful due to the toxic or antagonistic effects, pharmacokinetic interactions can also result in relevant clinical consequences.…”

Section: Discussionmentioning

confidence: 99%

“…This result corroborates with previous research that estimated between 14% and 75% the prevalence of DDI involving antineoplastic drugs. 13,20,27…”

Section: Discussionmentioning

confidence: 99%

“…20,21 Similarly, data from studies conducted in other countries show DDI rates ranging from 27% to 58% of the patients assessed. 14,22,24 The presence of comorbidities increases the tendency to use a greater number of medications, [25][26][27] increasing their susceptibility to drug interactions, 20,26,27 notably among antineoplastic and psychotropic drugs. 24,[28][29][30] An expressive DDI between chemotherapeutic and psychotropic drugs has been observed in patients undergoing cancer treatment, 14,31 and the psychotropics most commonly cited in these interactions are antiepileptics, antipsychotics, barbiturates, and benzodiazepines, 24,28,31 more specifically carbamazepine, phenobarbital, primidone, 31 haloperidol, alprazolam, 28 sodium valproate, 28,31 and phenytoin.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Potential Drug Interactions Between Psychotropics and Intravenous Chemotherapeutics Used by Patients With Cancer

Turossi-Amorim

Camargo

Nascimento³

et al. 2022

Journal of Pharmacy Technology

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Introduction: Patients undergoing cancer treatment usually have comorbidities, and psychiatric disorders are commonly seen in these patients. For the treatment of these psychiatric disorders, the use of psychotropic drugs is common, turning these patients susceptible to untoward drug interactions. Therefore, the aim of this study was to estimate the prevalence of clinically relevant drug–drug interactions (DDI) between chemotherapeutic and psychotropic agents in patients with cancer treated at an oncology service in southern Brazil. Methods: An observational epidemiological study with a cross-sectional census-type design was carried out between October and December 2020. The drug-drug interactions were identified through consultation and analysis of the Medscape Drug Interaction Check and Micromedex databases. The interactions were classified as major, when the interaction can be fatal and/or require medical intervention to avoid or minimize serious adverse effects and moderate, when the interaction can exacerbate the patient’s condition and/or requires changes in therapy. Results: A total of 74 patients was included in the study among the 194 patients seen in the oncology service during the period studied. A total of 24 (32.4%) DDIs were found, 21 (87.5%) of which were classified as being of major risk and 3 (12.5%) as moderate risk. According to the mechanism of action, 19 (79.1%) were classified as pharmacodynamic interactions and 5 (20.9%) as pharmacokinetic interactions. Conclusion: It was shown that a considerable percentage of patients undergoing intravenous chemotherapy are at risk of pharmacological interaction with psychotropic drugs. Thus, it is essential that the oncologist considers all psychotropic drugs and other drugs used by patients in order to avoid drug-drug interactions.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

“…This result corroborates with previous research that estimated between 14% and 75% the prevalence of DDI involving antineoplastic drugs. 13,20,27…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Potential Drug Interactions Between Psychotropics and Intravenous Chemotherapeutics Used by Patients With Cancer

Turossi-Amorim

Camargo

Nascimento³

et al. 2022

Journal of Pharmacy Technology

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Potential drug–drug interaction and its determinants among patients with cancer receiving chemotherapy in oncology centres of Northwest Ethiopia: an institutional-based cross-sectional study

Wondm,

Tamene,

Gubae

et al. 2023

BMJ Open

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ObjectiveThe study was conducted to assess potential drug–drug interactions (PDDIs) and its determinants among patients with cancer receiving chemotherapy.Design and settingAn institutional-based cross-sectional study was used. This study was conducted from 1 June 2021 to 15 December 2021, in Northwest Ethiopia oncology centres.ParticipantsAll eligible patients with cancer received a combination of chemotherapy.OutcomesThe prevalence and severity of PDDIs were evaluated using three drug interaction databases. Characteristics of participants were presented, arranged and summarised using descriptive statistics. The predictors and outcome variables were examined using logistic regression. The cut-off point was a p value of 0.05.ResultsOf 422 patients included in the study, 304 patients were exposed to at least one PDDI with a prevalence of 72.1% (95 % CI: 68% to 76%) using three drug interaction databases. There were varied reports of the severity of PDDI among databases, but the test agreement using the kappa index was 0.57 (95% CI: 0.52 to 0.62, p=0.0001) which is interpreted as a moderate agreement among three databases. Patients aged ≥50 years old had the risk to be exposed to PDDI by odds of 3.1 times (adjusted OR (AOR)=3.1, 95% CI (1.8 to 5.3); p=0.001) as compared with patients <50 years old. Similarly, patients with polypharmacy and comorbidity were more likely to be exposed to PDDI than their counterparts (AOR=2.4, 95% CI (1.4 to 4.1); p=0.002 and AOR=1.9, 95% CI (1.1 to 3.4); p=0.02, respectively).ConclusionThe main finding of this study is the high prevalence of PDDI, signifying the need for strict patient monitoring for PDDIs among patients with cancer receiving chemotherapy. We suggest the use of at least three drug databases for quality screening. Patients with an age ≥50 years old, polypharmacy and comorbidity were significantly associated with PDDIs. The establishment of oncology clinical pharmacists and computerised reminder mechanisms for PDDIs through drug utilisation review is suggested.

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Prevalence of Potential Pharmacological Interactions in Patients Undergoing Systemic Chemotherapy in a Tertiary Hospital

2022

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Introduction: Pharmacological interactions are frequently observed in patients with chronic diseases, and their occurrence is proportional to the amount of medication used daily. Patients undergoing chemotherapy treatment commonly have comorbidities, which favor a greater prevalence of polypharmacy, increasing the risk of drug interactions. Therefore, the aim of this study was to estimate the prevalence of drug interactions in patients undergoing intravenous chemotherapy treated at a hospital oncology service in southern Brazil. Methods: This was an observational study with a cross-sectional design that was carried out with the analysis of secondary data obtained through the review of medical records. The population assessed consisted of all cancer patients who received intravenous chemotherapy from October to December 2020. Results: Out of the 297 patients included in the study, 231 (77.8%) had at least 1 potential pharmacological interaction. In total, 1044 drug interactions were found that were classified according to severity, resulting in 18 (1.7%) contraindicated drug-drug interactions (DDI), 699 (67%) severe, 281 (26.9%) moderate, and 46 (4.4%) minor interactions. There was an association between polypharmacy and the prevalence of drug interactions. Conclusion: The results demonstrate that a large percentage of patients undergoing chemotherapy are susceptible to drug interactions. Thus, it is necessary that prescribers consider all drugs used by patients and, when possible, prescribe alternative drugs that have less potential for interaction in order to prevent drug interactions adverse effects and provide a better prognosis for patients.

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Drug-drug interactions in cancer chemotherapy: an observational study in a tertiary health care centre

Cited by 4 publications

References 16 publications

Potential Drug Interactions Between Psychotropics and Intravenous Chemotherapeutics Used by Patients With Cancer

Potential Drug Interactions Between Psychotropics and Intravenous Chemotherapeutics Used by Patients With Cancer

Potential drug–drug interaction and its determinants among patients with cancer receiving chemotherapy in oncology centres of Northwest Ethiopia: an institutional-based cross-sectional study

Prevalence of Potential Pharmacological Interactions in Patients Undergoing Systemic Chemotherapy in a Tertiary Hospital

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