Potential drug-drug interactions of immunosuppressants in kidney transplant recipients: comparison of drug interaction resources

Pehlivanlı, Aysel; Eren-Sadioglu, Rezzan; Aktar, Merve; Eyupoglu, Sahin; Şengül, Şule; Keven, Kenan; Ertürk, Şehsuvar; Başgut, Bilgen; Özçeli̇kay, A.Tanju

doi:10.1007/s11096-022-01385-9

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…Nevertheless, for safety reasons, it is advisable and necessary to extrapolate the results regarding incompatibility, regardless of whether the incompatibility was demonstrated for preparations intended for adults or children. It is also advisable to check the compatibility data not only in the available literature but also in electronic databases, e.g., Micromedex, Lexicomp, Medscape, or Drugs.com [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

Y-Site Compatibility Studies of Parenteral Nutrition and Other Intravenous Medications in Neonatal and Pediatric Patients: A Review of the Literature Evidence

Gostyńska,

Przybylski,

Ogrodowczyk

2024

Pharmaceutics

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Background: Polytherapy in neonatal and pediatric patients requiring parenteral nutrition (PN) administration is a challenging task. Due to limited intravenous access, the Y-site administration of medication with PN admixtures is sometimes inevitable. Aim: This review aims to summarize the evidence on the compatibility of the Y-site of intravenous medications and PN admixtures in neonatal and pediatric settings. Methods: A literature review of the PubMed database was conducted. Articles published between January 1995 and November 2023 concerning the compatibility of intravenous medications in pediatric-dose PN admixtures or with intravenous lipid emulsions only were included. Studies concerning the compatibility/stability of the ingredients of PN admixtures and those concerning unapproved medications were excluded. Based on the methodology used, the quality of the research was assessed. Results: A total of fifteen studies were explored. Among fifty-five different drug substances assessed in the research reviewed, 56% (31/55) were found to be compatible, 13% (7/55) were assigned as incompatible, and for 31% (17/55), the data were ambiguous. None of the studies demonstrated an “A” grade (very high quality), and the grades “B”, “C”, and “D” were assigned to four, six, and five studies, respectively. The compatibility data are presented in two tables, the first concerning the simultaneous administration of medications with 2-in-1 PN formulations (without lipids) and the second, with 3-in-1 formulations (with lipids) and lipid emulsions. Conclusions: This review presents data on compatibilities between intravenously administered medications and PN mixtures intended for neonates and pediatric patients found in the PubMed database. It should be highlighted, however, that this work has some limitations. The clinical decisions on the simultaneous administration of intravenous medication with PN admixtures should be based not only on this review (including assessment of the quality of evidence) but also on manufacturer data, available electronic databases, and incompatibility data for PN admixtures dedicated to adult patients.

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Section: Resultsmentioning

confidence: 99%

Y-Site Compatibility Studies of Parenteral Nutrition and Other Intravenous Medications in Neonatal and Pediatric Patients: A Review of the Literature Evidence

Gostyńska,

Przybylski,

Ogrodowczyk

2024

Pharmaceutics

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“…This variability has been demonstrated in multiple studies with other drug classes, outside of ARVs and with a variety of online DDI databases. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 Databases were selected to represent resources at varying levels of access, including subscription and open access. Additionally, of the selected databases, some were general resources while others were HIV‐specific.…”

Section: Discussionmentioning

confidence: 99%

“…A similar study was performed by Pehlivanli et al comparing potential DDIs of immunosuppressants in kidney transplant recipients in four different online data bases. 11 Potential DDIs identified were compared to a gold standard reference to determine sensitivity and specificity of each database. Such a gold standard does not exist for ARVs, making it difficult to determine a single, most‐reliable online database.…”

Section: Discussionmentioning

confidence: 99%

“…Each of the six DDI databases identified a different number of actual or potential DDIs between the ARVs and concomitant medications. This variability has been demonstrated in multiple studies with other drug classes, outside of ARVs and with a variety of online DDI databases [11][12][13][14][15][16][17][18]. Databases were selected to represent resources at varying levels of access, including subscription and open access.…”

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confidence: 99%

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Antiretroviral drug–drug interactions: A comparison of online drug interaction databases

Drwiega

Badowski

Michienzi

2022

Clinical Pharmacy Therapeu

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What is known and objective Antiretrovirals have a high drug interaction potential, which can lead to increased toxicity and/or decreased efficacy. Multiple databases are available to assess drug–drug interactions. The aim of our study was to compare interaction identification for commonly used ARVs and concomitant medications between six different online drug–drug interaction databases. Comment This was a cross‐sectional review using each of the following six databases: LexiComp®, Clinical Pharmacology®, Micromedex®, Epocrates®, University of Liverpool, and University of Toronto. Sixteen antiretroviral drugs and 100 of the DrugStats Database “Top 200 of 2019” list of medications were included. Each of the six databases identified a different number of actual or potential interactions. The number of interactions ranged from 211 to 283. What is new and conclusions A variety of databases exist with inconsistent identification of actual or potential drug–drug interactions amongst them. It may be beneficial to cross‐reference multiple databases prior to making decisions regarding patient care.

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“…A straightforward method to evaluate the agreement between EDICs and their databases is the percentage comparison of DDIs classified on different levels of severity [ 12 , 23 , 24 , 25 , 26 , 27 , 29 , 30 ]. A more elaborated method is calculating kappa and weighted kappa Fleiss’ coefficients as quantitative measures of agreement between online drug interaction checkers [ 11 , 22 , 28 , 31 , 32 ]. Some studies have combined the two methods [ 9 , 10 , 33 ], and others have used the Jaccard similarity coefficient to assess global agreement between drug databases [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Categorical Analysis of Database Consistency in Reporting Drug–Drug Interactions for Cardiovascular Diseases

Suciu,

Ardelean,

Udrescu

et al. 2024

Pharmaceutics

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Drug–drug interactions (DDIs) can either enhance or diminish the positive or negative effects of the associated drugs. Multiple drug combinations create difficulties in identifying clinically relevant drug interactions; this is why electronic drug interaction checkers frequently report DDI results inconsistently. Our paper aims to analyze drug interactions in cardiovascular diseases by selecting drugs from pharmacotherapeutic subcategories of interest according to Level 2 of the Anatomical Therapeutic Chemical (ATC) classification system. We checked DDIs between 9316 pairs of cardiovascular drugs and 25,893 pairs of cardiovascular and other drugs. We then evaluated the overall agreement on DDI severity results between two electronic drug interaction checkers. Thus, we obtained a fair agreement for the DDIs between drugs in the cardiovascular category, as well as for the DDIs between drugs in the cardiovascular and other (i.e., non-cardiovascular) categories, as reflected by the Fleiss’ kappa coefficients of κ=0.3363 and κ=0.3572, respectively. The categorical analysis of agreement between ATC-defined subcategories reveals Fleiss’ kappa coefficients that indicate levels of agreement varying from poor agreement (κ<0) to perfect agreement (κ=1). The main drawback of the overall agreement assessment is that it includes DDIs between drugs in the same subcategory, a situation of therapeutic duplication seldom encountered in clinical practice. Our main conclusion is that the categorical analysis of the agreement on DDI is more insightful than the overall approach, as it allows a more thorough investigation of the disparities between DDI databases and better exposes the factors that influence the different responses of electronic drug interaction checkers. Using categorical analysis avoids potential inaccuracies caused by particularizing the results of an overall statistical analysis in a heterogeneous dataset.

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Potential drug-drug interactions of immunosuppressants in kidney transplant recipients: comparison of drug interaction resources

Cited by 4 publications

References 23 publications

Y-Site Compatibility Studies of Parenteral Nutrition and Other Intravenous Medications in Neonatal and Pediatric Patients: A Review of the Literature Evidence

Y-Site Compatibility Studies of Parenteral Nutrition and Other Intravenous Medications in Neonatal and Pediatric Patients: A Review of the Literature Evidence

Antiretroviral drug–drug interactions: A comparison of online drug interaction databases

Categorical Analysis of Database Consistency in Reporting Drug–Drug Interactions for Cardiovascular Diseases

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