Pharmacoepidemiological study of potential drug interactions in heart and neurological outpatients
Keywords:Drug-drug interaction, Polypharmacy, Cardiac patient, Neurological patients
Background: Drug-drug interaction (DDI) is a potential cause of adverse drug reactions. This study estimates the rate and factors associated with potential DDI in cardiac and neurological prescriptions from the out-patient department of various hospitals.
Methods: A cross-sectional study was conducted from February to April, 2014 in various outpatients department of different hospitals in Indore. Total 60 prescriptions of cardiac and 60 prescriptions of neuro patients were collected from different hospitals. All the prescriptions were analyzes by various pharmaceutical and medical books, drug interaction checker software, and journals, etc.
Results: Prescriptions having moderate drug interactions are more than that of severe and minor interactions and severity of the interaction found moderate in both type of prescriptions. Among cardiac patients 75% are male and 25% are females including all age groups, and in neuro patients, 58.33% are male, and 41.66% are females including all age groups. Types of drug interaction found in prescriptions are as follow, severe interaction (13% in cardiac, 8% in neuro), and moderate interaction (45% in cardiac, 37% in neuro), minor interaction (17% in cardiac, 25% in neuro), interaction not found (25% in cardiac, 30% in neuro patients).
Conclusion: The hazards of prescribing many drugs, including side-effects, DDI and difficulties of compliance have long been recognized as particular problems when prescribing. Proper emphasis should be given to drug information center and training of clinical pharmacy across the country, which can play an important role in minimizing DDIs.
Shaktibala D, Mirza AB. Role of pharmaco-epidemiology in psychopharmacology: a study in psychiatric out-patient department of a tertiary care teaching hospital at Dehradun, Uttarakhand. Int J Basic Clin Pharmacol. 2014;3(4):637 43.
Jigar K, Dhaval T, Chetna D. A study of potential drug-drug interactions in indoor patients of medicine department at a tertiary care hospital. J Appl Pharm Sci. 2013;3(10):089-96.
Viorel CN, Popescu F. Pharmacodynamic and pharmacokinetic interactions of class III antiarrhythmic drugs. Curr Health Sci J. 2011;37(1):38-43.
Bista D, Palaian S, Shankar PR, Prabhu MM, Paudel R, Mishra P. Understanding the essentials of drug interactions: a potential need for safe and effective use of drugs. Kathmandu Univ Med J (KUMJ). 2007;5(3):421-30.
Chelkeba L. Assessment of potential drug-drug interactions among outpatients receiving cardiovascular medications at Jimma University specialized hospital, South West Ethiopia. Int J Basic Clin Pharmacol. 2013;2(2):144-52.
Banerjee S. Common drug interactions in cardiology prescription. Med Update. 2012;22:223-8.
Cruciol-Souza JM, Thomson JC. Prevalence of potential drug-drug interactions and its associated factors in a Brazilian teaching hospital. J Pharm Pharm Sci. 2006;9(3):427-33.
Masters KP, Carr BM. Survey of pharmacists and physicians on drug interactions between combined oral contraceptives and broad-spectrum antibiotics. Pharm Pract (Granada). 2009;7(3):139-44.
Tammy JB. Drug interactions involving warfarin: practice tool and practical management tips. CPJ. 2011;144(1):21 34.
Sharma S, Chhetri HP, Alam K. A study of potential drug-drug interactions among hospitalized cardiac patients in a teaching hospital in Western Nepal. Indian J Pharmacol. 2014;46(2):152 6.
Singh N. Concept of drug interaction. Int Res J Pharm. 2012;3(7):120-2.
Bryant L, Fishman T. Clinically important drug-drug interactions and how to manage them. J Prim Health Care. 2009;1(2):150-1.
Lau WC, Gurbel PA. The drug-drug interaction between proton pump inhibitors and clopidogrel. CMAJ. 2009;180(7):699-700.