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An update on drug-drug interactions for care of the acutely ill in the era of COVID-19
PURPOSE: To provide key pharmacological concepts underlying drug-drug interactions (DDIs), a decision-making framework, and a list of DDIs that should be considered in the context of contemporary acutely ill patients with COVID-19. SUMMARY: DDIs are frequently encountered in the acutely ill. The imp...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516707/ https://www.ncbi.nlm.nih.gov/pubmed/37368815 http://dx.doi.org/10.1093/ajhp/zxad152 |
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author | Patanwala, Asad E Jager, Nynke G L Radosevich, John J Brüggemann, Roger |
author_facet | Patanwala, Asad E Jager, Nynke G L Radosevich, John J Brüggemann, Roger |
author_sort | Patanwala, Asad E |
collection | PubMed |
description | PURPOSE: To provide key pharmacological concepts underlying drug-drug interactions (DDIs), a decision-making framework, and a list of DDIs that should be considered in the context of contemporary acutely ill patients with COVID-19. SUMMARY: DDIs are frequently encountered in the acutely ill. The implications of DDIs include either increased risk of drug toxicity or decreased effectiveness, which may have severe consequences in the acutely ill due to lower physiological and neurocognitive reserves in these patients. In addition, an array of additional therapies and drug classes have been used for COVID-19 that were not typically used in the acute care setting. In this update on DDIs in the acutely ill, we provide key pharmacological concepts underlying DDIs, including a discussion of the gastric environment, the cytochrome P-450 (CYP) isozyme system, transporters, and pharmacodynamics in relation to DDIs. We also provide a decision-making framework that elucidates the identification of DDIs, risk assessment, selection of alternative therapies, and monitoring. Finally, important DDIs pertaining to contemporary acute care clinical practice related to COVID-19 are discussed. CONCLUSION: Interpreting and managing DDIs should follow a pharmacologically based approach and a systematic decision-making process to optimize patient outcomes. |
format | Online Article Text |
id | pubmed-10516707 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-105167072023-09-23 An update on drug-drug interactions for care of the acutely ill in the era of COVID-19 Patanwala, Asad E Jager, Nynke G L Radosevich, John J Brüggemann, Roger Am J Health Syst Pharm Clinical Consultation PURPOSE: To provide key pharmacological concepts underlying drug-drug interactions (DDIs), a decision-making framework, and a list of DDIs that should be considered in the context of contemporary acutely ill patients with COVID-19. SUMMARY: DDIs are frequently encountered in the acutely ill. The implications of DDIs include either increased risk of drug toxicity or decreased effectiveness, which may have severe consequences in the acutely ill due to lower physiological and neurocognitive reserves in these patients. In addition, an array of additional therapies and drug classes have been used for COVID-19 that were not typically used in the acute care setting. In this update on DDIs in the acutely ill, we provide key pharmacological concepts underlying DDIs, including a discussion of the gastric environment, the cytochrome P-450 (CYP) isozyme system, transporters, and pharmacodynamics in relation to DDIs. We also provide a decision-making framework that elucidates the identification of DDIs, risk assessment, selection of alternative therapies, and monitoring. Finally, important DDIs pertaining to contemporary acute care clinical practice related to COVID-19 are discussed. CONCLUSION: Interpreting and managing DDIs should follow a pharmacologically based approach and a systematic decision-making process to optimize patient outcomes. Oxford University Press 2023-06-27 /pmc/articles/PMC10516707/ /pubmed/37368815 http://dx.doi.org/10.1093/ajhp/zxad152 Text en © American Society of Health-System Pharmacists 2023. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Consultation Patanwala, Asad E Jager, Nynke G L Radosevich, John J Brüggemann, Roger An update on drug-drug interactions for care of the acutely ill in the era of COVID-19 |
title | An update on drug-drug interactions for care of the acutely ill in the era of COVID-19 |
title_full | An update on drug-drug interactions for care of the acutely ill in the era of COVID-19 |
title_fullStr | An update on drug-drug interactions for care of the acutely ill in the era of COVID-19 |
title_full_unstemmed | An update on drug-drug interactions for care of the acutely ill in the era of COVID-19 |
title_short | An update on drug-drug interactions for care of the acutely ill in the era of COVID-19 |
title_sort | update on drug-drug interactions for care of the acutely ill in the era of covid-19 |
topic | Clinical Consultation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516707/ https://www.ncbi.nlm.nih.gov/pubmed/37368815 http://dx.doi.org/10.1093/ajhp/zxad152 |
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