SIGNIFICANT DRUG INTERACTIONS AMONG INTENSIVE CARE UNIT PATIENTS

  • M Yulis Hamidy Department of Pharmacology, Faculty of Medicine, University of Riau, Indonesia.
  • Dina Fauzia Department of Pharmacology, Faculty of Medicine, University of Riau, Indonesia.

Abstract

Objective:Drug interaction is one factor that contributes to drug-related problems. The hospitalized patients in intensive care units (ICU) have a higher risk for developing drug interactions. The purpose of this study was to evaluate the potency of significantdrug interactions in ICU patients.

Methods:Drug-drug interactions from patient's medical records from ICU of Arifin Achmad General Hospital in Pekanbaru, Province of Riau, Indonesia at period July to December 2015 wereassessed. Drug Interaction Checker (Medscape) software was used to identify potential drug interactions.

Results: This study included 28 ICU patients (mean age, 48 years) who had potency to drug interactions based on the software. Of these, 29% were male and 71% were female patients. The number of drugs that were given to patients was 3 to 13 drugs (average 7 drugs per patient). There were 122 potential drug-drug interactions found in this study, consisting of 43% potency of minor or non-significant, 52% potency of significant, 3% potency of serious, and 2% potency of contraindicated drug interactions. A total of 67% were pharmacodynamics and 33% were pharmacokinetics interactions. Dexamethasone, ketoprofen, ketorolac, furosemide, nifedipine, and enoxaparin were among drugs with highest frequency of potential drug interactions.

 Conclusion:Significant drug-drug interactions were prevalent in the ICU patients. This may be due to the complexity of the pharmacotherapies administered. The health professionals who provide care to these patients must be aware in order to identify and prevent possible drug events.

  

Keywords: Significant drug interactions, Intensive care unit, Potency, Drug-related problems.

References

1. Smithburger PL, Kane-Gill SL, Seybert AL. Drug-drug interactions in the medical intensive care unit: an assessment of frequency, severity, and the medication involved. Int J Pharm Pract 2012;20 Suppl 6:402-8.
2. Spriet I, Meersseman W, de Hoon J, von Winckelmann S, Wilmer A, Willems L. Clinically relevant CYP450-mediated drug interactions in the ICU. Intensive Care Med 2009;35 Suppl 4:603-12.
3. Osterhoudt K, Penning TM. Drug toxicity and poisoning. In: Brunton LL, Chabner BA, Knollman BC, editors. Goodman & Gilman’s the pharmacological basis of therapeutics. 12th edition. New York: The McGraw-Hill Companies; 2011. p. 73-87.
4. Palleria C, Di Paolo A, Giofrè C, Caglioti C, Leuzzi G, Siniscalchi A, et al. Pharmacokinetic drug-drug interaction and their implication in clinical management. J Res Med Sci 2013;18 Suppl 7:601–10.
5. Lima RE, De Bortoli, Cassiani SH. Potential drug interactions in intensive care patients at a teaching hospital. Rev Latinoam Enferm 2009;17 Suppl 2:222-7.
6. Hammes JA, Pfuetzenreiter F, Silveira F, Koenig A, Westphal GA. Potential drug interactions prevalence in intensive care units. Rev Bras Ter Intensiva 2008;20 Suppl 4:349-54.
7. Reis AMM, Cassiani SHDB. Prevalence of potential drug interactions in patients in an intensive care unit of a university hospital in Brazil. Clinics2011;66 Suppl 1:9-15.
8. Carvalho REFL, Reis AMM, de Faria LMP, Zago KSA, Cassiani SHDB. Prevalence of drug interactions in intensive care units in Brazil. Acta Paul Enferm 2013;26 Suppl 2:150-7.
9. Annisa N, Abdullah R. Potency of drugs interaction among geriatric patients prescribing: retrospective study in pharmacies in Bandung. Indones J Clin Pharm2012;1 Suppl 3:96-101.
10. Bosch ME, Ramos BS, Navarro MVG, Rubio MDS, Gil RM, Linaza PV. Prevalence of drug interactions in hospital healthcare. Int J Clin Pharm 2012; 34 Suppl 6:807–17.
11. 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 Suppl 11:773-8.
12. Becker ML, Visser LE, van Gelder T, Hofman A, Stricker BH. Increasing exposure to drug-drug interactions between 1992 and 2005 in people aged > or = 55 years. Drugs Aging 2008;25 Suppl 2:145–52.
13. Bregnhoj L, Thirstrup S, Kristensen MB, Bjerrum L, Sonne J. Prevalence of inappropriate prescribing in primary care. Pharm World Sci 2007;29 Suppl 3:109–15.
14. Mouly S, Meune C, Bergmann JF. Uncertainty and inaccuracy of predicting CYP-mediated in vivo drug interactions in the ICU from in vitro models: focus on CYP3A4. Intensive Care Med 2009;35 Suppl 3:417–29.
15. Spriet I, Meersseman W, de Hoon J, et al. Clinically relevant CYP450-mediated drug interactions in the ICU. Intensive Care Med 2009;35 Suppl 4:603–12.
16. Williams NT. Medication administration through enteral feeding tubes. Am J Health Syst Pharm 2008;65 Suppl 24:2347-57.
17. Horn JR, Hansten PD. Prediction of potential drug-drug interactions. [Accessed on: October 26,2016]. Available at: http://www.pharmacytimes.com/publication/issue.
18. Carvalho LAE, Marques MPM, Tomkinson J. Drug-excipient interactions in ketoprofen: a vibrational spectroscopy study. Biopolymers 2006;82 Suppl 4:420-4.
19. Ulugol A, Ozyigit F, Yesilyurt O, Dogrul A. The additive antinociceptive interaction between WIN 55,212-2, a cannabinoid agonist, and ketorolac. AnesthAnalg2006;102 Suppl 2:443–7
20. Bates D, Beaumont SJ, Baylis BW. Ototoxicity induced by gentamicin and furosemide. Annals of Pharmacotherapy 2002;36 Suppl 3:446-51.
21. Opie LH. Drug interactions of antihypertensive agents. S Afr Fam Pract 2012;54 Suppl 2:523-5
22. Kubitza D, Becka M, Schwers S, Voith B. Investigation of pharmacodynamics and pharmacokinetic interactions between rivaroxaban and enoxaparin in healthy male subject. Clinical Pharmacology in Drug Development 2013;2 Suppl 3: 270-7.
Statistics
437 Views | 653 Downloads
Citatons
How to Cite
Hamidy, M. Y., and D. Fauzia. “SIGNIFICANT DRUG INTERACTIONS AMONG INTENSIVE CARE UNIT PATIENTS”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, no. 14, May 2017, pp. 35-38, doi:10.22159/ajpcr.2017.v10s2.19482.
Section
Original Article(s)