TO ESTIMATE THE INCIDENCE OF POTENTIAL DRUG-DRUG INTERACTION IN STROKE PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL, TELANGANA

  • SIDRAH FIRDOUS Department of Pharmacology, Sultan-Ul-Uloom College of Pharmacy, Road No. 3, Banjara Hills, Hyderabad 500034, Telangana, India
  • SAFA AMREEN SALIM AWAD Department of Pharmacology, Sultan-Ul-Uloom College of Pharmacy, Road No. 3, Banjara Hills, Hyderabad 500034, Telangana, India
  • AFIFA FATIMA Department of Pharmacology, Sultan-Ul-Uloom College of Pharmacy, Road No. 3, Banjara Hills, Hyderabad 500034, Telangana, India
  • MOHAMMAD FARHAN AHMED Department of Pharmacology, Sultan-Ul-Uloom College of Pharmacy, Road No. 3, Banjara Hills, Hyderabad 500034, Telangana, India
  • N. ANITHA Department of Pharmacology, Sultan-Ul-Uloom College of Pharmacy, Road No. 3, Banjara Hills, Hyderabad 500034, Telangana, India
  • NILOUFER ALI Department of Cardiology, Aster Prime Hospitals, Hyderabad, Telangana, India

Abstract

Objective: To determine the frequency and pattern of potential drug-drug interactions in hospitalized stroke patients.


Methods: A retrospective study was carried out among patients treated for ischemic and haemorrhagic stroke at a tertiary care hospital, Hyderabad for a period of 1 y. A total of 177 prescriptions were analyzed during the study period. The potential drug-drug interactions were identified using Clinirex software.


Results: Among the 177 prescriptions, 63.8% were male and 36.2% were female. Out of 177, 79 % of prescriptions had shown potential drug-drug interactions. The patients prescribed with more than 5 drugs developed higher incidence of drug-drug interactions. Based on severity scale we observed 12% major, 71% moderate and 17% minor drug-drug interactions. The incidence of pharmacodynamic interactions was 68% and the pharmacokinetic interactions were 32%.


Conclusion: This study suggests that patients with stroke are frequently exposed to potential drug-drug interactions. The incidence of potential drug-drug interactions was higher in patients above 40 y. Most of the prescriptions contained polypharmacy which may lead to increased risk of hospitalization and higher health care cost. It is essential to identify potential drug-drug interactions especially in elderly patients as early as possible in order to prevent adverse drug reactions and ensure patient’s safety. 

Keywords: Stroke, Drug-drug interactions, Pharmacodynamic interactions, Pharmacokinetic Interaction, Clinirex software

References

1. 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;8:125-313.
2. Seymour RM, Routledge PA. Important drug-drug interactions in the elderly. Drugs Aging 1998;12:485–94.
3. Strong K, Mathers C. The global burden of stroke. In: Mohr JP, Grotta JC, Wolf PA, Moskowitz MA, Mayberg MR, Von Kummer R. editors. Stroke: Pathophysiology, Diagnosis and Management. 5th ed. Philadelphia, PA: Elsevier; 2011. p. 279–89.
4. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2016 update: a report from the American heart association. Circulation 2016;133:38–360.
5. Murray C, Lopez A. Global health statistics: A compendium of incidence, prevalence and mortality estimates for over 200 conditions. Cambridge MA: Harvard University Press; 1996.
6. Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol 2007;6:182–7.
7. Mahmood M, Malone DC, Skrepnek GH, Abarka J, Armstrong EP, Murphy JE, et al. Potential drug-drug interactions within veterans affairs medical centers. Am J Health Syst Pharm 2007;64:1500–5.
8. Hansten PD. Drug interaction management. Pharm World Sci 2003;25:94–7.
9. Merlo J, Liedholm H, Lindblad U, Bjorck Linne A, Falt J, Lindberg G, et al. Prescriptions with potential drug interaction dispensed at swedish pharmacies in January 1999: cross sectional study. Br Med J 2001;323:427–8.
10. Dechanont S, Maphanta S, Butthum B, Kongkaew C. Hospital admissions/visits associated with drug-drug interactions: a systematic review and meta-analysis, Pharmacoepidem Drug Saf 2014;23:489–97.
11. Sameer D, Milind P. Assessment of a drug interaction of antidepressants with other prescribed drugs. Asian J Pharm Clin Res 2011;4:102-4.
12. Jeyaraj DP, Sudhan P. Stroke epidemiology and stroke care services in India. J Stroke 2013;15:128-34.
13. Eric R, Bates DM, Wei CL. Drug–drug interactions involving antiplatelet agents. Eur Heart J 2003;24:1707–9.
14. Mendes Nett RS, Silva CQ, Oliveira Filbo AD, Rocha CE, Lyra Junior DP. Assessment of drug interactions in elderly patients of a family healthcare unit in Aracaju (Brazil): a pilot study, Afr J Pharm Pharmacol 2011;5:812–8.
15. Maher RL, Hanlon JT, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf 2014;13:57–65.
16. Vijayakumar S, Ravikanth S, Ayesha S, Dheeraj Kumar G. Drug-drug interaction is occurring during hospital stay among stroke patients. Afr J Pharm Pharmacol 2012;6:2670-4.
17. Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS, et al. Incidence, types, risk factors and outcome of stroke in a developing country: the trivandrum stroke registry. Stroke 2009;40:1212-8.
18. Mateti UV, Rajakannan T, Nekkanti H, Rajesh V, Mallaysamy SR, Ramachandran P. Drug-drug interactions in hospitalized cardiac patients. J Young Pharm 2011;3:329–33.
19. Venkateswaramurthy N, Krishnaveni K, Mercy FR, Sambath KR. Assessment of potential drug–drug interaction in stroke patients. Int J Pharm Pharm Sci 2016;8:221-4.
20. Indira KN, Veera RB. Risk factor assessment of stroke and its awareness among stroke survivors: a retrospective study. Int J Res Health Sci 2015;3:140-5.
21. Phillips WS, Smith J, Greaves M, Preston FE, Channer KS. An evaluation and improvement program for inpatient anticoagulant control. Thromb Haemost 1997;77:283-307.
22. Gouya G, Reichardt B, Ohrenberger G, Wolzt M. Survival of patients discharged after acute myocardial infarction and evidence-based drug therapy. Eur J Epidemiol 2007;22:145-9.
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FIRDOUS, S., S. A. S. AWAD, A. FATIMA, M. F. AHMED, N. ANITHA, and N. ALI. “TO ESTIMATE THE INCIDENCE OF POTENTIAL DRUG-DRUG INTERACTION IN STROKE PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL, TELANGANA”. International Journal of Current Pharmaceutical Research, Vol. 12, no. 2, Mar. 2020, pp. 48-52, doi:10.22159/ijcpr.2020v12i2.37487.
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