Drug interactions with oral antineoplastic drugs: The role of the pharmacist

Abstract

The main objective of the study is to determine the pharmacist detection of drug‐drug and drug‐food interactions in patients receiving oral antineoplastic drugs (OADs). Descriptive, prospective study in a tertiary‐care teaching hospital. The study population included patients who received OADs from the Outpatient Pharmacy of the hospital. The study population was attended by a pharmacist who checked potential interactions. The severity of interactions was evaluated using the summary of product characteristics of each drug and three different databases. We included 219 patients with a total of 736 concomitant medications. A total of 34 drug‐drug or food‐drug interactions were recorded. The most common interaction detected was between erlotinib and ranitidine (major interaction). In 19 of the 34 interactions detected in the experimental group, the pharmacist prevented them from reaching the patient. Interactions were resolved by drug suspensions, drug changes, or changes in schedules always according to the attending physician or the patient. In the remaining 15 interactions, the doctor was not contacted because the interactions were considered to be of little relevance or because they only required surveillance. Hospital pharmacist can improve the patient's safety and the efficiency of oral cytostatic treatment by detecting and preventing drug‐drug and drug‐food interactions.

Medication Errors During Treatment with New Oral Anticancer Agents: Consequences for Clinical Practice Based on the AMBORA Study

“…A systematic review on drug‐drug interactions between oral antineoplastic agents and the comedication emphasized the high risk of drug‐drug interactions and stated that published data from clinical practice is rare 33 . The prevalence and types of our results are difficult to compare with previous analyses due to different methodology (e.g., only single oral antitumor agents investigated, 34 lack of investigation of drug‐drug interactions within the co‐medication, 32,35 lack of investigation of drug‐food interactions, 15 or diverging setting 36 ). Clinical decision support systems (CDSS) focusing on drug‐drug interactions only cover a limited number of all medication errors.…”

Potential drug-drug interactions in drug therapy for older adults with chronic coronary syndrome at hospital discharge: A real-world study

“…In certain instances, a multidisciplinary team with a physician, a pharmacist and a nurse was required especially in complex drug regimens ( Silva et al, 2015 ; Aghili and Kasturirangan, 2021 ). Clinical pharmacists should also make attempts at patient education and counseling to reduce the incidence of serious or fatal DDIs ( Riu-Viladoms et al, 2019 ).…”

Estudio piloto: Impacto del farmacéutico en la identificación y evaluación de interacciones potenciales fármaco-fármaco en prescripciones de pacientes hospitalizados de Medicina Interna

“…De los estudios más recientes en la literatura, se muestra que uno realizado en pacientes oncológicos, en donde se evaluaron 736 medicamentos concomitantes, se identificaron 34 interacciones fármaco-fármaco, de las cuales el 56 % fueron prevenidas, sin alcanzar al paciente, mediante la detección oportuna por el farmacéutico. De éstas, el 44% fueron descartadas mediante el análisis del farmacéutico al no ser consideradas clínicamente importantes (12). En nuestro estudio, la capacidad de reducción identificada mediante el análisis del farmacéutico fue del 88.7 % [tabla 4], esta mayor reducción podría estar relacionada con el tipo de paciente evaluado, ya que los pacientes oncológicos pueden tener características muy distintas a los pacientes hospitalizados en el área de Medicina Interna.…”

“…La mayoría de los fallos de la farmacoterapia se pueden atribuir a una mala utilización de los medicamentos por parte de los pacientes. Diversos estudios han mostrado, que el incorporar al farmacéutico clínico como parte del equipo de salud, en donde éste evalúe de manera previa a la administración de medicamentos, la farmacoterapia del paciente, disminuye de manera considerable las interacciones que puedan causar daño al paciente (12).…”