Study of Potential Drug Interactions Among Eight Major Departments-General Medicine, Orthopedics, Gynecology, Pulmonology, General Surgery, Psychiatry, Otolaryngology and Dermatology of a Tertiary Care Teaching Hospital in Southern India

Abstract

Objective: To identify frequency, type, severity and predictors of potential drug-drug interactions(pDDIs), potential drug-food interactions(pDFIs), potential drug-alcohol interactions(pDAIs) and potential drug-tobacco interactions(pDTIs) and most frequently interacting drug combination pairs in hospitalized patients from departments(depts) of General Medicine(GM), Orthopedic(Ortho), Gynecology(OBG), Pulmonology(Pulmo), General Surgery (GS), Psychiatry (Psych), Otolaryngology(ENT) and Dermatology (Derm) of study population.
 Methods: A Prospective Observational Study was conducted in eight major dept's of a tertiary care teaching hospital for a period of 6 mo. A sample size of 650 prescriptions reflecting admission no's for each department were used.
 Results: A total of 650 patients were included in the study. Among them, 282(43.4%) were males and 368(56.6%) were females. The mean age of the study population was 39.67±15.23. A total of 487 pDDIs, 734 pDFIs, 586 pDAIs and 159 pDTIs were found out of 650 hospitalized episodes. OBG showed the highest pDDIs and pDAIs. Highest pDFIs and pDTIs were seen in Pulmo. The majority of DDIs were minor, DFIs and DAIs were moderate and DTIs were of major in severity. Pharmacokinetic types of interactions were seen in the majority of the depts. Logistic regression analysis showed that Polypharmacy was associated with the occurrence of DIs. Most of the DIs repeated several times in particular depts and a list of these combinations was prepared.
 Conclusion: With the high occurrence of overall DIs and characteristic patterns of DIs combination pairs among different departments of the hospital, the presence of clinical pharmacists in hospitals can play a great role, especially in developing nations like India where their role in hospitalized settings is always controversial.

Evaluation of the potential drug-drug interactions at orthopedics and traumatology outpatient clinics of a tertiary care hospital

“…The most common DDIs in this study were between systemic NSAIDs and topical NSAIDs which combination increases the risk of gastrointestinal adverse effects. Similar to our results, a study evaluating the potential DDIs among eight major departments reported that DDIs between NSAIDs were among the most commonly seen DDIs in orthopedic deparment 26 . According to the current evidence, using a topical NSAID and systemic NSAID concomitantly has no advantage over using these agents alone, on the contrary this combination enhances the number of adverse reactions 27 .…”