Potentially Serious Drug-Drug Interactions in Older Patients Hospitalized for Acute Ischemic and Hemorrhagic Stroke

Abstract

Background: Polypharmacy is very common in older persons and it is associated with inappropriate prescribing and potential drug-drug interactions (DDIs). Aims of this study were to identify prevalence of DDIs in older persons with acute stroke and to evaluate the association between stroke and DDIs. Methods: One hundred forty-six patients admitted with diagnosis of acute stroke were enrolled. The therapeutic regimen of patients was analyzed at admission to identify the number of DDIs, prevalence and sorts of serious DDIs according to subtype of acute stroke (ischemic or hemorrhagic) and to its recurrence. Results: Five hundred eighty-two DDIs were identified: 18 mild, 415 moderate and 149 serious. Sixty-one percent of patients were exposed to at least one serious DDI. A higher percentage of patients were exposed to at least one serious DDI among those with a recurring ischemic event compared to those with a first event (74 vs. 50%; p < 0.01, respectively). Serious DDIs potentially associated with an increased risk of a cerebral event were identified in 19 (17%) patients with ischemic stroke, and in 7 (19%) patients with hemorrhagic stroke. Conclusions: The prevalence of serious DDIs was high in aging patients with acute stroke but different according to subtype and recurrence of the cerebrovascular event.

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

“…Furthermore, in current study, prevalence of major-pDDIs is higher (19.3%) as compared to that reported among patients with cancer (16%) [16]. Whereas, it is lower in comparison to that reported among patients with liver cirrhosis (21.4%) [12], hepatitis C (30-44%) [20], and stroke (61%) [17]. Similarly, the prevalence of contraindicated-pDDIs in patients with malaria is also lower (14.3%) in comparison to the prevalence reported among patients with hepatitis C (16.7%) [30].…”

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

“…Furthermore in current study, prevalence of major-pDDIs is higher (19.3%) as compared to that reported among patients with cancer (16%) [15]. Whereas, it is lower in comparison to that reported among patients with liver cirrhosis (21.4%) [11], hepatitis C (30-44%) [19], and stroke (61%) [16]. Similarly, the prevalence of contraindicated-pDDIs in patients with malaria is also lower (14.3%) in comparison to the prevalence reported among patients with hepatitis C (16.7%) [25].…”

“…Potential DDIs (pDDIs) issue has been addressed generally in hospitalized patients [7] as well as in specific diseases such as liver cirrhosis [11], hypertension [12], diabetes mellitus (DM) [13], bone marrow transplant [14], cancer [15], stroke [16], pneumonia [17], urinary tract infections [18], and hepatitis C [19]. Despite, being the most prevalent causes of hospitalization [20], DDIs particularly among inpatients with malaria remains unaddressed.…”

Characterisation of Drug-Related Problems and Associated Factors at a Clinical Pharmacist Service-Naïve Hospital in Northern Sweden

“…This is of concern because the sensitivity to side effects of drugs also increases with age, as a result of decreased renal function, cognitive function and body composition [2]. In addition, polypharmacy increases the risk of adverse drug events (ADEs), drug–drug interactions and medication errors in the elderly [3, 4]. Previous studies have shown that drug-related problems (DRPs) are common.…”