Drug interactions

Kennedy, Cormac; Brewer, Linda; Williams, David

doi:10.1016/j.mpmed.2020.04.001

Cited by 8 publications

(35 citation statements)

References 5 publications

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“…25 According to the classification of the DI in terms of their monitorability, it was possible to verify that most DI were classified as monitorable (90.9%), but few were associated with a detectable clinical consequence (27%), very similar to that found by Dumbreck et al 24 These results reveal that the pharmacist could and should easily use clinical parameters to determine the existence of a DI whenever possible, since the identification of a potential DI in the pharmacotherapy does not necessarily reflect a clinical alteration. 2,26 That is, when it comes to a monitorable DI, continuous attention to the parameters of effectiveness and safety of each medication can go a longer way than the identification of all DI and their communication to the health team.…”

Section: Discussionmentioning

confidence: 99%

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Drug interactions in the pharmacotherapy of patients included in primary care comprehensive medication management services

Silva¹,

Oliveira²,

Martins³

et al. 2021

Rev Bras Farm Hosp Serv Saude

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Objective: A drug interaction (DI) is the clinical event in which the effect or action of one drug is modified by the presence of another. Because of potential harms and low consistency of available information, it is critical to assess the clinical relevance of DI. This study aimed to identify and evaluate the clinical consequences of DI in the pharmacotherapy of patients followed in a primary care Comprehensive Medication Management (CMM) services. Methods: This observational cross-sectional study was based on the analysis of the CMM records all the patients that used at least two medications and attended to at least three CMM consultations from August 2015 to March 2016 (n=88). Potential DI were identified among the medications used in the initial consultation of CMM using Micromedex® Drug-Reax® software. The DI were classified as “monitorable” (when its clinical consequences could be monitored by effectiveness or safety paremeters) or non-monitorable, and their clinical consequences were evaluated by analysis of CMM records. Results: Among the studied population 95.5% of the patients had at least one potential DI in their pharmacotherapy, totaling 493 potential DI. Of all the potential DIs identified, 90.9% were monitorable, and the majority of these monitorable DI presented no clinical consequences (62.7%). For 63.9% of the DI with clinical impact, the pharmacist adopted direct or indirect measures that would favor the resolution or reduction of the clinical impact of DIs. Conclusion: The CMM service facilitates the management of DIs since its decision-making method calls for monitoring of the effectiveness and safety parameters, individualizing the management of DIs according to the patient’s needs and their clinical consequences.

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Section: Discussionmentioning

confidence: 99%

“…Medications used by a patient may act independently or interact with each other. 1,2 These interactions can be beneficial, harmful or without any consequence to the health of individuals. The outcome resulting from a DI will depend not only on the drugs involved, but also on the characteristics of individuals and their clinical state.…”

mentioning

confidence: 99%

Drug interactions in the pharmacotherapy of patients included in primary care comprehensive medication management services

Silva¹,

Oliveira²,

Martins³

et al. 2021

Rev Bras Farm Hosp Serv Saude

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“…Although pharmacodynamic interactions are relatively common in clinical practice, adverse outcomes usually can be avoided or minimized if clinicians take this into consideration. 6–8…”

Section: Pharmacodynamic Interactionsmentioning

confidence: 99%

Cardio-Oncology Drug Interactions: A Scientific Statement From the American Heart Association

Beavers¹,

Rodgers²,

Bagnola³

et al. 2022

Circulation

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In the cardio-oncology population, drug interactions are of particular importance given the complex pharmacological profile, narrow therapeutic index, and inherent risk of therapies used to manage cardiovascular disease and cancer. Drug interactions may be beneficial or detrimental to the desired therapeutic effect. Clinicians in both cardiology and oncology should be cognizant of these potential drug-drug interactions that may reduce the efficacy or safety of either cardiovascular or cancer therapies. These risks can be mitigated through increased recognition of potential drug-drug interaction, use of alternative medications when possible, and careful monitoring. This scientific statement provides clinicians with an overview of pharmacodynamic and pharmacokinetic drug-drug interactions in patients with cancer exposed to common cardiovascular and cancer medications.

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“…Drug–drug interactions (DDIs) occur when one drug (the perpetrator drug) affects how the body acts on a victim drug (pharmacokinetic effects) and/or how the victim drug acts on the body (pharmacodynamic effects). 4 , 18 There is a third mechanism by which drugs can interact (pharmaceutical DDIs, caused by inappropriate mixing of drugs before administration eg, precipitation of phenytoin solution for injection when mixed with a glucose solution) 18 but these are not common and are therefore not discussed further.…”

Section: Drug–drug Interactionsmentioning

confidence: 99%

Drug–Drug–Gene Interactions in Cardiovascular Medicine

Asiimwe¹,

Pirmohamed²

2022

PGPM

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Cardiovascular disease remains a leading cause of both morbidity and mortality worldwide. It is widely accepted that both concomitant medications (drug–drug interactions, DDIs) and genomic factors (drug–gene interactions, DGIs) can influence cardiovascular drug-related efficacy and safety outcomes. Although thousands of DDI and DGI (aka pharmacogenomic) studies have been published to date, the literature on drug–drug–gene interactions (DDGIs, cumulative effects of DDIs and DGIs) remains scarce. Moreover, multimorbidity is common in cardiovascular disease patients and is often associated with polypharmacy, which increases the likelihood of clinically relevant drug-related interactions. These, in turn, can lead to reduced drug efficacy, medication-related harm (adverse drug reactions, longer hospitalizations, mortality) and increased healthcare costs. To examine the extent to which DDGIs and other interactions influence efficacy and safety outcomes in the field of cardiovascular medicine, we review current evidence in the field. We describe the different categories of DDIs and DGIs before illustrating how these two interact to produce DDGIs and other complex interactions. We provide examples of studies that have reported the prevalence of clinically relevant interactions and the most implicated cardiovascular medicines before outlining the challenges associated with dealing with these interactions in clinical practice. Finally, we provide recommendations on how to manage the challenges including but not limited to expanding the scope of drug information compendia, interaction databases and clinical implementation guidelines (to include clinically relevant DDGIs and other complex interactions) and work towards their harmonization; better use of electronic decision support tools; using big data and novel computational techniques; using clinically relevant endpoints, preemptive genotyping; ensuring ethnic diversity; and upskilling of clinicians in pharmacogenomics and personalized medicine.

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Drug interactions

Cited by 8 publications

References 5 publications

Drug interactions in the pharmacotherapy of patients included in primary care comprehensive medication management services

Drug interactions in the pharmacotherapy of patients included in primary care comprehensive medication management services

Cardio-Oncology Drug Interactions: A Scientific Statement From the American Heart Association

Drug–Drug–Gene Interactions in Cardiovascular Medicine

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