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Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study

BACKGROUND: Potential drug–drug interactions (pDDIs) are one of the preventable drug related problems having the risk of serious adverse events or therapeutic failure. In developing countries like Pakistan, this issue remains poorly addressed. The objective of this study was to explore prevalence of...

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Autores principales: Ismail, Mohammad, Noor, Sidra, Harram, Umme, Haq, Inamul, Haider, Iqbal, Khadim, Faiza, Khan, Qasim, Ali, Zahid, Muhammad, Tahir, Asif, Muhammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186060/
https://www.ncbi.nlm.nih.gov/pubmed/30314487
http://dx.doi.org/10.1186/s12913-018-3579-7
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author Ismail, Mohammad
Noor, Sidra
Harram, Umme
Haq, Inamul
Haider, Iqbal
Khadim, Faiza
Khan, Qasim
Ali, Zahid
Muhammad, Tahir
Asif, Muhammad
author_facet Ismail, Mohammad
Noor, Sidra
Harram, Umme
Haq, Inamul
Haider, Iqbal
Khadim, Faiza
Khan, Qasim
Ali, Zahid
Muhammad, Tahir
Asif, Muhammad
author_sort Ismail, Mohammad
collection PubMed
description BACKGROUND: Potential drug–drug interactions (pDDIs) are one of the preventable drug related problems having the risk of serious adverse events or therapeutic failure. In developing countries like Pakistan, this issue remains poorly addressed. The objective of this study was to explore prevalence of pDDIs in the Outpatient Department (OPD) of a tertiary care hospital in Pakistan. The secondary aim was to describe the levels of reported pDDIs and develop a list of widespread clinically relevant interactions. METHODS: Prescriptions of 2400 OPD patients were analyzed for pDDIs through Micromedex Drug-Reax®. Prevalence, severity- and documentation-levels and widespread clinically relevant interactions were reported. RESULTS: Of total 2400 prescriptions, pDDIs were present in 22.3%. Whereas, moderate- and major-pDDIs were found in 377 (15.7%) and 225 (9.4%), respectively. PDDIs were more prevalent in Medicine (9.2%) and Cardiology (2.6%) as compared with other OPD specialties. Total 942 pDDIs were identified, of which, the majority were either moderate- (61.9%) or major-pDDIs (32.1%). Some of the most common interactions were ibuprofen + levofloxacin (n = 50), ciprofloxacin + diclofenac (32), aspirin + atenolol (24), and diclofenac + levofloxacin (19). The potential adverse outcomes of widespread interactions were seizures, bleeding, QT-interval prolongation, arrhythmias, tendon rupture, hypoglycemia/hyperglycemia, serotonin syndrome, drug toxicity, and decreased therapeutic response. CONCLUSIONS: OPD patients were at risk to pDDIs, particularly to major- and moderate-pDDIs. Screening of prescriptions for pDDIs and monitoring of pharmacotherapy in terms of response and associated adverse drug events will contribute to patient safety. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3579-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-61860602018-10-19 Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study Ismail, Mohammad Noor, Sidra Harram, Umme Haq, Inamul Haider, Iqbal Khadim, Faiza Khan, Qasim Ali, Zahid Muhammad, Tahir Asif, Muhammad BMC Health Serv Res Research Article BACKGROUND: Potential drug–drug interactions (pDDIs) are one of the preventable drug related problems having the risk of serious adverse events or therapeutic failure. In developing countries like Pakistan, this issue remains poorly addressed. The objective of this study was to explore prevalence of pDDIs in the Outpatient Department (OPD) of a tertiary care hospital in Pakistan. The secondary aim was to describe the levels of reported pDDIs and develop a list of widespread clinically relevant interactions. METHODS: Prescriptions of 2400 OPD patients were analyzed for pDDIs through Micromedex Drug-Reax®. Prevalence, severity- and documentation-levels and widespread clinically relevant interactions were reported. RESULTS: Of total 2400 prescriptions, pDDIs were present in 22.3%. Whereas, moderate- and major-pDDIs were found in 377 (15.7%) and 225 (9.4%), respectively. PDDIs were more prevalent in Medicine (9.2%) and Cardiology (2.6%) as compared with other OPD specialties. Total 942 pDDIs were identified, of which, the majority were either moderate- (61.9%) or major-pDDIs (32.1%). Some of the most common interactions were ibuprofen + levofloxacin (n = 50), ciprofloxacin + diclofenac (32), aspirin + atenolol (24), and diclofenac + levofloxacin (19). The potential adverse outcomes of widespread interactions were seizures, bleeding, QT-interval prolongation, arrhythmias, tendon rupture, hypoglycemia/hyperglycemia, serotonin syndrome, drug toxicity, and decreased therapeutic response. CONCLUSIONS: OPD patients were at risk to pDDIs, particularly to major- and moderate-pDDIs. Screening of prescriptions for pDDIs and monitoring of pharmacotherapy in terms of response and associated adverse drug events will contribute to patient safety. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3579-7) contains supplementary material, which is available to authorized users. BioMed Central 2018-10-10 /pmc/articles/PMC6186060/ /pubmed/30314487 http://dx.doi.org/10.1186/s12913-018-3579-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ismail, Mohammad
Noor, Sidra
Harram, Umme
Haq, Inamul
Haider, Iqbal
Khadim, Faiza
Khan, Qasim
Ali, Zahid
Muhammad, Tahir
Asif, Muhammad
Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study
title Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study
title_full Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study
title_fullStr Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study
title_full_unstemmed Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study
title_short Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study
title_sort potential drug-drug interactions in outpatient department of a tertiary care hospital in pakistan: a cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186060/
https://www.ncbi.nlm.nih.gov/pubmed/30314487
http://dx.doi.org/10.1186/s12913-018-3579-7
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