Abstract

ASSESSMENT OF PREVALENCE AND SEVERITY OF POSSIBLE DRUG-DRUG INTERACTIONS IN A TERTIARY CARE HOSPITAL

Jeffin Joseph*, Dr. Abel Abraham Thomas and Jeffy Abraham

ABSTRACT

BackGround: Drug related problems such as adverse drug reactions, drug–drug interactions, idiosyncratic reactions, and hypersensitivity reactions remained a major challenge in clinical practice. Potential drug–drugs interactions (pDDIs) are observed to be one of the most frequently appearing challenge that may alter the pharmacokinetic and pharmacodynamics of the drugs thus alter the overall therapeutic response. Methods: A prospective observational cross sectional study was conducted in a tertiary care hospital. Relevant information was collected according to the approved pre-designed drug interaction collection form including patient demographics, medical history, drug interactions, type of interaction, its severity, management. Data was then statistically analyzed. Result: Among 568 subjects enrolled, 60% belong to the age group of 60-100 years (old adults), 27% belong to 40-59 years (middle age adults), 11% belong to 3-39 years (young adults) followed by less than 1% infants (0-2 years). It was also observed that interactions mostly occurred in males (56.33%) and about 43% interactions were seen in females. From 568 drug interactions, 67.6% were moderate interactions, 26.4% major interactions and 5.9% minor interactions. Most commonly observed effect was risk of hemorrhage (6.1%), followed by hypoglycemia (5.6%), theophylline toxicity (5.4%), CVS effects (3.1%), rhabdomyolysis (2.9%), serotonin syndrome (2.4%) and postural hypotension (2.1%). Among 150 major interactions, risk of hemorrhage was the most commonly seen effect and the management provided was to monitor INR/PT. Among 384 moderate interactions most commonly seen effect was theophylline toxicity and was monitored for the symptoms of theophylline toxicity. Conclusion: Polypharmacy is unavoidable as elderly patients usually suffer from many chronic diseases which demand use of multiple drugs resulting in complex regimen. The use of computer assisted drug interaction software before prescribing drugs can serve as an important tool in identifying these potential drug-drug interactions which can help us to detect and prevent drug interactions. To enable monitoring the interactions in a systematic way, patients should be encouraged to disclose all of their medications to the pharmacist and physician. By doing so, many drug interactions can be avoided or managed safely. Hence pharmacist participation can improve the treatment to hospitalized patients and promote drug safety.

Keywords: Drug-drug interaction, severity, prevalence, pharmacokinetic, pharmacodynamics.