Possibility of Drug-Drug Interaction in Prescription Dispensed by Community and Hospital Pharmacy

Abstract

Objective: To analyze the use of all subsidized prescription drugs including their use of drug combination generally accepted as carrying a risk of severe interactions. Methodology: In a cross sectional study, we analyzed all prescriptions (n = 1014) involving two or more drugs dispensed to the population (age range 4-85 years) from all pharmacies, clinics and hospitals. Data were stratified by age and sex, and frequency of common interacting drugs. Potential drug interactions were classified according to clinical relevance as significance of severity (types A: major, B: moderate, and C: minor) and documented evidence (types 1, 2, 3, and 4). Result and Discussion: The growing use of pharmacological agents means that drug interactions are of increasing interest for public health. Monitoring of potential drug interactions may improve the quality of drug prescribing and dispensing, and it might form a basis for education focused on appropriate prescribing. To make the manifestation of adverse interaction subside, management strategies must be exercised if two interacting drugs have to be taken with each other, involving: adjusting the dose of the object drug; spacing dosing times to avoid the interaction. The pharmacist, along with the prescriber has a duty to ensure that patients are aware of the risk of side effects and a suitable course of action they should take. Conclusion: It is unrealistic to expect clinicians to memorize the thousands of drug-drug interactions and their clinical significance, especially considering the rate of introduction of novel drugs and the escalating appreciation of the importance of pharmacogenomics. Reliable regularly updated decision support systems and information technology are necessary to help avert dangerous drug combinations.

Drug interaction and its implication in clinical practice and personalized medicine

“…Patients with hypertension, diabetes, and other chronic diseases are more likely to experience polypharmacy. [1,9,10] Polypharmacy may cause ADRs owing to the drug additive effect, synergism, duplication, DIs, discontinuation of treatment, and physiological antagonism. It was reported that patients aged above 65 years use an average of two to six prescribed drugs and 1 to 3.4 nonprescribed drugs.…”

“…The incidence of DIs is 40% in patients taking five drugs and perhaps up to 80% in patients taking seven drugs. [1,7,10] The female gender was established to be more prone to DIs owing to their frequent hospital visits. [1,7,10] In a developed country such as Switzerland, the incidence of DIs was 23%.…”

“…[1,7,10] The female gender was established to be more prone to DIs owing to their frequent hospital visits. [1,7,10] In a developed country such as Switzerland, the incidence of DIs was 23%. [7] A Dutch study among pharmacies showed that 28% of the prescriptions revealed DIs.…”

“…[13] ||DRUG-DRUGINTERACTION Introduction DDIs take place when two or more drugs administered concurrently, produce an effect that is not consistent with the principal pharmacological action. [4,[8][9][10] DIs between potassium supplement and potassium sparing diuretic may cause lifethreatening hyperkalemia. [10,14] Similarly, patients treated with sulfonylureas while taking sulfonamide antibiotic are at risk of developing hypoglycemia.…”

Possible interactions between garlic and conventional drugs: a review

“…This population also having a higher prevalence of chronic disease because of lower immunity as well as thy use typical drug therapy for several health related issues. 9,10 Possibility of manifestation of interaction was very difficult to identify due to 11  A large number of an herbal product was easily available in the market.  Herbs consist of multiple constituents of various pharmacological activities.…”