Abstract
Background Patients admitted to intensive care unit (ICU) present with severe and life-threatening illnesses. Most of them suffer from various comorbidities. They usually receive complex pharmacotherapy with large number of medicines which increase the risk of drug–drug interactions (DDIs). Objective The present report aimed to investigate prevalence and levels of potential DDIs (pDDIs) in medical ICU. Methods Medications profiles of 416 patients were checked for pDDIs using Micromedex Drug-Reax®. Prevalence, levels of severity and levels of documentation were reported. Results Of total 416 patients, 310 were exposed to pDDIs (overall prevalence = 74.5 %). Likewise, a prevalence rate of 13.9 % was recorded for contraindicated pDDIs, 52.2 % for major pDDI and 58.4 % for moderate pDDI. This study reported 740 interacting drug pairs that were presented in total 1686 pDDIs. Of 1686 pDDIs, 4.3 % were of contraindicated severity, 33.8 % of major severity and 49.6 % of moderate severity, whereas 45.5 % were of fair scientific evidence and 41.4 % of good scientific evidence. Conclusion In this study, pDDIs were found highly prevalent in ICU patients at a rate of 74.5 %. Most of the pDDIs had moderate severity; however, substantial number of interactions (38.1 %) had major and contraindicated severity.
References
Uijtendaal EV, van Harssel LL, Hugenholtz GW, Kuck EM, Zwart-van Rijkom JE, Cremer OL, et al. Analysis of potential drug–drug interactions in medical intensive care unit patients. Pharmacotherapy. 2014;34:213–9.
Reis AM, Cassiani SH. Prevalence of potential drug interactions in patients in an intensive care unit of a university hospital in Brazil. Clinics (Sao Paulo). 2011;66:9–15.
Rodrigues AT, Stahlschmidt R, Granja S, Falcão ALE, Moriel P, Mazzola PG. Clinical relevancy and risks of potential drug–drug interactions in intensive therapy. Saudi Pharm J. 2015;23:366–70.
Abideen S, Vivekanandan K, Mishra P. Assessment of prevalence of potential drug–drug interactions in medical intensive care unit of a tertiary care hospital in India. Asian J Pharm Clin Res. 2015;8:125–30.
Ismail M, Iqbal Z, Khattak MB, Khan MI, Arsalan H, Javaid A, et al. Potential drug–drug interactions in internal medicine wards in hospital setting in Pakistan. Int J Clin Pharm. 2013;35:455–62.
Micromedex Drug-Reax®. Greenwood Village, CO: Truven Health Analytics, USA. http://www.micromedexsolutions.com/home/dispatch. Accessed 17 Feb 2016.
Egger SS, Drewe J, Schlienger RG. Potential drug–drug interactions in the medication of medical patients at hospital discharge. Eur J Clin Pharmacol. 2003;58:773–8.
van Leeuwen RWF, Swart EL, Boven E, Boom FA, Schuitenmaker MG, Hugtenburg JG. Potential drug interactions in cancer therapy: a prevalence study using an advanced screening method. Ann Oncol. 2011;22:2334–41.
Ismail M, Iqbal Z, Khattak MB, Javaid A, Khan MI, Khan TM, et al. Potential drug–drug interactions in psychiatric ward of a tertiary care hospital: prevalence, levels and association with risk factors. Trop J Pharm Res. 2012;11:289–96.
Ismail M, Iqbal Z, Khan MI, Javaid A, Arsalan H, Farhadullah, et al. Frequency, levels and predictors of potential drug–drug interactions in a pediatrics ward of a teaching hospital in Pakistan. Trop J Pharm Res. 2013;12:401–6.
Roblek T, Vaupotic T, Mrhar A, Lainscak M. Drug–drug interaction software in clinical practice: a systematic review. Eur J Clin Pharmacol. 2015;71:131–42.
Acknowledgments
The authors are very thankful to the staff and administration of the hospital for their support during this work; and Dr. Muhammad Imran Khan, Medical-C Unit, Postgraduate Govt. Lady Reading Hospital (LRH), Peshawar, for his help during data interpretation and analysis.
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Ismail, M., Khan, F., Noor, S. et al. Potential drug–drug interactions in medical intensive care unit of a tertiary care hospital in Pakistan. Int J Clin Pharm 38, 1052–1056 (2016). https://doi.org/10.1007/s11096-016-0340-3
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DOI: https://doi.org/10.1007/s11096-016-0340-3