Potential drug-drug interactions in pediatric patients admitted to intensive care unit of Khyber Teaching Hospital, Peshawar, Pakistan: A cross-sectional study

Ismail, Mohammad; Aziz, Sana; Noor, Sidra; Haider, Iqbal; Shams, Faryal; Haq, Inamul; Khadim, Faiza; Khan, Qudrat; Khan, Fahadullah; Asif, Muhammad

doi:10.1016/j.jcrc.2017.04.028

Cited by 24 publications

(38 citation statements)

References 26 publications

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“…The findings of this study support that provision of multiple therapy has been positively associated with pDDIs prevalence [16,[37][38][39]. Moreover, the statistically significant association of pDDIs with prolong hospitalization reported by the current study is in accordance with the published reports [21,40].…”

Section: Discussionsupporting

confidence: 91%

Potential drug–drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria

Noor

Ismail

Khadim

2020

Malar J

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Background: Hospitalized patients with malaria often present with comorbidities or associated complications for which a variety of drugs are prescribed. Multiple drug therapy often leads to drug-drug interactions (DDIs). Therefore, the current study investigated the prevalence, levels, risk factors, clinical relevance, and monitoring parameters/management guidelines of potential DDIs (pDDIs) among inpatients with malaria. Methods: A retrospective cohort study was carried out at two tertiary care hospitals. A total of 398 patients' profiles were evaluated for pDDIs using the Micromedex Drug-Reax ®. Odds ratios were calculated to identify the strength of association between presence of DDIs and potential risk factors via logistic regression analysis. Further, the clinical relevance of frequent pDDIs was investigated. Results: Of 398 patients, pDDIs were observed in 37.2% patients, while major-pDDIs in 19.3% patients. A total of 325 interactions were found, of which 45.5% were of major-and 34.5% moderate-severity. Patients with the most common pDDIs were found with signs/symptoms and abnormalities in laboratory findings representing nephrotoxicity, hepatotoxicity, QT interval prolongation, and reduced therapeutic efficacy. The following drug pairs reported the highest frequency of adverse events associated with the interactions; calcium containing products-ceftriaxone, isoniazid-rifampin, pyrazinamide-rifampin, isoniazid-acetaminophen, and ciprofloxacin-metronidazole. The adverse events were more common in patients prescribed with the higher doses of interacting drugs. Multivariate regression analysis showed statistically significant association of pDDIs with 5-6 prescribed medicines (p = 0.01), > 6 prescribed medicines (p < 0.001), > 5 days of hospital stay (p = 0.03), and diabetes mellitus (p = 0.04). Conclusions: PDDIs are commonly observed in patients with malaria. Healthcare professional's knowledge about the most common pDDIs could help in preventing pDDIs and their associated negative effects. Pertinent clinical parameters, such as laboratory findings and signs/symptoms need to be checked, particularly in patients with polypharmacy, longer hospital stay, and diabetes mellitus.

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Section: Discussionsupporting

confidence: 91%

Potential drug–drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria

Noor

Ismail

Khadim

2020

Malar J

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“…Hospitalized patients with malaria receive a variety of medications for the management of underlying disease, related complications, and/or comorbid illnesses [4][5][6]. Our findings support that provision of multiple therapy has been positively associated with pDDIs prevalence [15,[32][33][34]. Moreover, the statistically significant association of pDDIs with prolong hospitalization reported by our study is in accordance with the published reports [20,35].…”

Section: Discussionsupporting

confidence: 91%

“…The reason is that, in patients with DM, such drugs are prescribed, having higher risk of DDIs [36]. [27,31,34].…”

Section: Discussionmentioning

confidence: 99%

“…The median (IQR) age, prescribed drugs and hospital stay was 30 years (22-50), 7 drugs (5-9), and 4 days (3-6), respectively. Hypertension (n = 52), DM (45), urinary tract infections (34), hepatitis (23), and ischemic heart diseases (IHD) (15) were the most prevalent comorbidities of the studied patients. Moreover, exposure to pDDIs stratified against the patient's characteristics are also shown in Table 1.…”

Section: General Characteristics Of Study Patientsmentioning

confidence: 99%

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Drug-drug interactions in patients with malaria: a multicenter retrospective study

Noor

Ismail

2020

Preprint

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Background: Hospitalized patients with malaria often present with comorbidities or associated complications for which a variety of drugs are prescribed. Multiple drug therapy often leads to drug-drug interactions (DDIs). Therefore, we investigated the prevalence, levels, risk factors, clinical relevance, and monitoring parameters/management guidelines of potential DDIs (pDDIs) among inpatients with malaria. Methods: A retrospective cohort study was carried out at multiple hospital settings. A total of 398 patients’ profiles were evaluated for pDDIs using the Micromedex Drug-Reax ®. Odds ratios were calculated to identify the strength of association between presence of DDIs and potential risk factors via logistic regression analysis. Further, the clinical relevance of frequent pDDIs was investigated. Results: Of 398 patients, pDDIs were observed in 37.2% patients, while major-pDDIs in 19.3% patients. Total 325 interaction were found, of which 45.5% were of major- and 34.5% moderate-severity. Patients with the most common pDDIs were found with signs/symptoms and abnormalities in laboratory findings representing nephrotoxicity, hepatotoxicity, QT interval prolongation, and reduced therapeutic efficacy . The adverse events were more common in patients prescribed with the higher doses of interacting drugs. Multivariate regression analysis showed statistically significant association of pDDIs with 5-6 prescribed medicines (p=0.01), >6 prescribed medicines (p<0.001), >5 days of hospital stay (p=0.03), and diabetes mellitus (p=0.04). Conclusions: PDDIs are commonly observed in patients with malaria. Healthcare professional’s knowledge about the most common pDDIs could help in preventing pDDIs and their associated negative effects. Pertinent clinical parameters, such as laboratory findings and signs/symptoms need to be checked, particularly in patients with polypharmacy, longer hospital stay, and diabetes mellitus.

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“…These findings are consistent with previously conducted studies. 6,14,15 Also, it has been evident from the study, the longer the duration of stay of patient in the hospital the more the risk of developing pDDI. This indirectly correlates to the number of medicines prescribed.…”

Section: Increase In Anti-hypertensive Effectmentioning

confidence: 89%

Potential drug-drug interactions among elderly in-patients with cardiac illness at a tertiary care centre

Mathur

Jain

Sharma

et al. 2020

Int J Basic Clin Pharmacol

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Background: Drug interactions are major cause of concern in hospitalized patients with cardiac illness especially in elderly population. Therefore, the study was conducted to determine the prevalence and pattern of potential drug-drug interactions (pDDI) and risk factors, if any.Methods: It was a prospective observational study involving 75 elderly in-patients with cardiac diseases. IHEC approval was taken before commencement of study and written informed consent was taken from all the study participants. Data was collected using structured data collection tool. pDDI were analyzed using MEDSCAPE databse. Data was analyzed using SPSS 20.0 in terms of descriptive statistics. Pearson correlation coefficient was used to find the association between the risk factors and potential DDIs. P value of ≤0.05 was considered statistically significant.Results: The prevalence of pDDI was found to be 100%. Total 593 pDDI and 33 interacting drug pairs were observed in the study. The common drug interacting pairs were aspirin and furosemide 140 (23.61%), followed by aspirin+ enalapril 98 (16.53%) and heparin and clopidogrel 56 (9.44%). Majority of pDDI 480 (81%) were found to be of moderate severity. A significant association was documented between length of hospital stay (p=0.041) and occurrence of pDDI. A statistically significant correlation (r =0.621; p<0.01) was noted between number of drugs prescribed and total number of pDDIs.Conclusions: A high prevalence of pDDI was observed. The prevalence rate is directly related to number of drugs prescribed and length of hospital stay. Therefore, close monitoring of hospitalized patients is recommended.

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Potential drug-drug interactions in pediatric patients admitted to intensive care unit of Khyber Teaching Hospital, Peshawar, Pakistan: A cross-sectional study

Cited by 24 publications

References 26 publications

Potential drug–drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria

Potential drug–drug interactions associated with adverse clinical outcomes and abnormal laboratory findings in patients with malaria

Drug-drug interactions in patients with malaria: a multicenter retrospective study

Potential drug-drug interactions among elderly in-patients with cardiac illness at a tertiary care centre

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