E-ISSN 2231-3206 | ISSN 2320-4672
 

Original Research 


Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik, Komal Bharti.

Cited by (5)

Abstract
Background: Drug–drug interactions (DDIs) are very common and responsible for 6%–30% of the adverse drug events that will increase healthcare cost and patient outcome. Polypharmacy significantly contributes to DDIs.

Aims and Objective: To assess the DDIs in the outpatients in the medicine department in a tertiary-care hospital.

Materials and Methods: The prescription of patients attending OPD of medicine department were analyzed for demography of patients and potential drug–drug interaction (pDDI). pDDI were checked by freely available drug interaction checker on Internet. pDDI were classified major, moderate, and minor according to severity and, by its mechanism, as pharmacokinetic, pharmacodynamic, or pharmacokinetic + pharmacodynamic. Statistical analysis was done using appropriate statistical software (MS Excel, Epi info, etc.).

Results: Of the 300 patients who attended the medicine OPD during the study period, 253 patients were included in our study. From these, 128 (50.59%) were men and 125 (49.41%) women. Among these 253 patients, 147 (58.27%) patients had at least one pDDI and 106 (41.9%) patients had no pDDIs. The incidence of pDDI per patient was 1.68 ± 2.68 in our study. Average number of drugs prescribed per patient was 4.4 ± 1.48 in our study. A direct correlation was observed between the age of the patients and the number of pDDIs (r = 0.35, P < 0.01), between the age of the patients and the number of the drugs prescribed (r = 0.18, P < 0.01), and between the number of drugs prescribed and the number of pDDIs (r = 0.69, P < 0.01). Among 423 pDDIs, 215 (50.83%) were pharmacodynamic drug interactions, 163 (38.53%) pharmacokinetic, and 45 (10.64%) showed both kinds of mechanisms. Interactions with major severity accounted for seven (1.65%) of the total pDDIs, while those with moderate and minor severity accounted for 321 (75.87%) and 95 (22.46%), respectively.

Conclusions: In our study, we found that most common pDDIs were pharmacodynamic in nature and of moderate severity. The number of pDDI increased with increase in the age of patients and the number of drugs prescribed.

Key words: Potential Drug–Drug Interaction (pDDI); Pharmacokinetic Drug Interaction; Pharmacodynamic Drug Interaction; Severity of Drug Interaction


 
ARTICLE TOOLS
Abstract
PDF Fulltext
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Nilesh B Chavda
Articles by Priti P Solanky
Articles by Hinal Baria
Articles by Ruchi Naik
Articles by Komal Bharti
on Google
on Google Scholar


REFERENCES
1. Johnson JA, Bootman JL. Drug-related morbidity and mortality. A cost-of-illness model. Arch Intern Med. 1995;155:1949-56. [DOI via Crossref]    [Pubmed]   
2. Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, et al. The nature of adverse events in hospitalized patients: results of the Harvard Medical Practice Study II. N Engl J Med. 1991;324:377-84. [DOI via Crossref]    [Pubmed]   
3. Mahmood M, Malone DC, Skrepnek GH, Abarka J, Armstrong EP, Murphy JE, et al. Potential drug-drug interactions within the veteran affairs medical centers. Am J Health Syst Pharm. 2007;64:1500-5. [DOI via Crossref]    [Pubmed]   
4. Costa AJ. Potential drug interactions in an ambulatory geriatric population. Fam Pract. 1991;8:234-36. [DOI via Crossref]    [Pubmed]   
5. http://www.drugs.com/drug_interactions.php (last accessed on January 15, 2014).
6. Aparasu R, Baer R, Aparasu A. Clinically important potential drugdrug interactions in outpatient settings. Res Soc Adm Pharm. 2007;3:426-37. [DOI via Crossref]    [Pubmed]   
7. Doucet J, Chassagne P, Trivalle C, Landrin I, Pauty MD, Kadri N, et al. Drug-drug interactions which are related to hospital admissions in older adults: a prospective study on 1000 patients. J Am Geriatr Soc. 1996;44:944-8. [DOI via Crossref]    [Pubmed]   
8. Seymour RM, Routledge PA. Important drug-drug interactions in the elderly. Drugs Aging. 1998;12:485-94. [DOI via Crossref]   
9. Soherwardi S, Chogtu B, Faizal P. Surveillance of the potential drugdrug interactions in the medicine department of a tertiary care hospital. J Clin Diagn Res. 2012;6(7):1258-61.
10. Nag KA, Umesh M, Churi S. Assessment of drug-drug interactions in hospitalised patients in India. Asian J Pharm Clin Res 2011; 4(Suppl 1) 62-5.
11. Bergendal L, Friberg A, Scheffrath AM. Potential drug-drug interactions in 5125 mostly elderly out-patients in Gothenberg, Sweden. Pharm World Sci. 1995;17:152-7. [DOI via Crossref]    [Pubmed]   
12. Kristina J, Inga K. The relationship between number of drugs and potential drug-drug interactions in the elderly. Drug Saf. 2007; 30(10):911-8. [DOI via Crossref]   
13. Goldberg RM, Mabee J, Chan L, Wong S. Drug-drug and drugdisease interactions in the elderly. Analysis of a high-risk population. Am J Emerg Med. 1996;14:44-7. [DOI via Crossref]   
14. Matthijs LB, Visser LE, Teun VG, Albert H, Burno HS. Increasing exposure to drug-drug interactions between 1992 and 2005 in people aged 455 years. Drugs Aging. 2008;25(2):145-52. [DOI via Crossref]   
15. van Dijk KN, de Vries CS, van Den Berg PB, Brouwers JRBJ, de JongVan Den Berg LTW. Occurrence of potential drug-drug interactions in nursing home residents. Int J Pharm Pract. 2001;3:45-51. [DOI via Crossref]   
16. Vonbach P, Dubied A, Krahenbuhl S, Beer JH. Prevalence of drugdrug interactions at hospital entry and during hospital stay of patients in internal medicine. Eur J Int Med. 2008;19:413-20. [DOI via Crossref]    [Pubmed]   
17. Henry M, Kay MM, Viccellio P. Cardiogenic shock associated with calcium-channel and beta blockers: reversal with intravenous calcium chloride. Am J Emerg Med. 1985;3:334-6. [DOI via Crossref]   
18. Pouleur H, Etienne J, Van Mechelen H, Van Eyll C, Charlier AA, Brasseur LA, et al. Effects of nicardipine or nifedipine added to propranolol in patients with coronary artery disease. Postgrad Med J. 1984;60:23-8. [Pubmed]   
19. Caraco Y, Tateishi T, Wood AJJ. Interethnic difference in omeprazole’s inhibition of diazepam metabolism. Clin Pharmacol Ther. 1995;58:62-72. [DOI via Crossref]   
20. Andersson T, Andren K, Cederberg C, Edvardsson G, Heggelund A, Lundborg P. Effect of omeprazole and cimetidine on plasma diazepam levels. Eur J Clin Pharmacol. 1990;39:51-4. [DOI via Crossref]    [Pubmed]   
21. Sharma VR, Brannon MA, Carloss EA. Effect of omeprazole on oral iron replacement in patients with iron deficiency anemia. South Med J. 2004;97:887-9. [DOI via Crossref]    [Pubmed]   
22. Lombardi TP, Bertino JS, Goldberg A, Middleton E, Slaughter RL. The effects of a beta-2 selective adrenergic agonist and a beta-nonselective antagonist on theophylline clearance. J Clin Pharmacol. 1987;27:523-9. [DOI via Crossref]    [Pubmed]   
23. Gardiner JS, Blough D, Drinkard CR, Shatin D, Anderson G, Graham D, et al. Tramadol and seizures: a surveillance study in a managed care population. Pharmacotherapy. 2000;20:1423-31. [DOI via Crossref]   
24. Pisani F, Spina E, Oteri G. Antidepressant drugs and seizure susceptibility: from in vitro data to clinical practice. Epilepsia 1999;40(Suppl 10) S48-56. [DOI via Crossref]    [Pubmed]   
25. Wrenger E, Muller R, Moesenthin M, Welte T, Frolich JC, Neumann KH. Interaction of spironolactone with ACE inhibitors or angiotensin receptor blockers: analysis of 44 cases. BMJ. 2003;327: 147-9. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
26. Svensson M, Gustafsson F, Galatius S, Hildebrandt PR, Atar D. Hyperkalaemia and impaired renal function in patients taking spironolactone for congestive heart failure: retrospective study. BMJ. 2003;327:1141-2. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
27. Troger U, Stotzel B, Martens-Lobenhoffer J, Gollnick H, Meyer FP. Drug points: severe myalgia from an interaction between treatments with pantoprazole and methotrexate. BMJ. 2002;324(7352):1497. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
28. Beorlegui B, Aldaz A, Ortega A, Aquerreta I, Sierrasesumega L, Giraldez J. Potential interaction between methotrexate and omeprazole. Ann Pharmacother. 2000;34:1024-7. [DOI via Crossref]    [Pubmed]   
29. Byakika-Kibwika P, Lamorde M, Mayanja-Kizza H, Khoo S, Merry C, Van Geertruyden J-P. Artemether-lumefantrine combination therapy for treatment of uncomplicated malaria: the potential for complex interactions with antiretroviral drugs in HIV-infected individuals. Malaria Res Treat. 2011;2011:703730. [DOI via Crossref]   
30. Mega JL, Close SL, Wiviott SD, Shen L, Hockett RD, Brandt JT, et al. Cytochrome p-450 polymorphisms and response to clopidogrel. N Engl J Med. 2009;360:354-62. [DOI via Crossref]    [Pubmed]   
31. Pezalla E, Day D, Pulliadath I. Initial assessment of clinical impact of a drug interaction between clopidogrel and proton pump inhibitors. J Am Coll Cardiol. 2008;52:1038-9. [DOI via Crossref]    [Pubmed]   
32. Moayyedi P, Sadowski DC. Proton pump inhibitors and clopidogrel—hazardous drug interaction or hazardous interpretation of data? Can J Gastroenterol. 2009;23:251-2. [Pubmed]    [PMC Free Fulltext]   
33. Kapadia J, Thakor D, Desai C, Dikshit RK. A study of potential drug-drug interactions in indoor patients of medicine department at a tertiary care hospital. J Appl Pharmaceut Sci. 2013;3(10):89-96.

This Article Cited By the following articles

Assessment of Potential Drug–Drug Interactions and Their Predictors in Chronic Outpatient Department of Dessie Referral Hospital, Dessie, Northeast Ethiopia
DHPS 2021; Volume 13(): 29.

1
 
Assessment of Clinically Relevant Drug Interactions by Online Programs in Renal Transplant Recipients
JMCP 2020; 26(10): 1291.

2
 
Evaluation of Potential Drug-drug Interactions in the Prescriptions in Outpatient Settings
2020; (): .

3
 
Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study
BMC Health Serv Res 2018; 18(1): .

4
 
Evaluation of Potential Drug-Drug Interactions with Medications Prescribed to Geriatric Patients in a Tertiary Care Hospital
Journal of Aging Research 2018; 2018(): 1.

5
 
How to Cite this Article
Pubmed Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti. Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region. Natl J Physiol Pharm Pharmacol. 2015; 5(3): 236-242. doi:10.5455/njppp.2015.5.0508201428


Web Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti. Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region. https://www.njppp.com/?mno=165251 [Access: June 01, 2022]. doi:10.5455/njppp.2015.5.0508201428


AMA (American Medical Association) Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti. Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region. Natl J Physiol Pharm Pharmacol. 2015; 5(3): 236-242. doi:10.5455/njppp.2015.5.0508201428



Vancouver/ICMJE Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti. Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region. Natl J Physiol Pharm Pharmacol. (2015), [cited June 01, 2022]; 5(3): 236-242. doi:10.5455/njppp.2015.5.0508201428



Harvard Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti (2015) Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region. Natl J Physiol Pharm Pharmacol, 5 (3), 236-242. doi:10.5455/njppp.2015.5.0508201428



Turabian Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti. 2015. Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region. National Journal of Physiology, Pharmacy and Pharmacology, 5 (3), 236-242. doi:10.5455/njppp.2015.5.0508201428



Chicago Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti. "Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region." National Journal of Physiology, Pharmacy and Pharmacology 5 (2015), 236-242. doi:10.5455/njppp.2015.5.0508201428



MLA (The Modern Language Association) Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti. "Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region." National Journal of Physiology, Pharmacy and Pharmacology 5.3 (2015), 236-242. Print. doi:10.5455/njppp.2015.5.0508201428



APA (American Psychological Association) Style

Nilesh B Chavda, Priti P Solanky, Hinal Baria, Ruchi Naik , Komal Bharti (2015) Study of potential drug–drug interaction between prescribed drugs in patients attending outpatient department of medicine at tertiary-care hospital in south Gujarat region. National Journal of Physiology, Pharmacy and Pharmacology, 5 (3), 236-242. doi:10.5455/njppp.2015.5.0508201428