Potential Drug-Drug Interaction And Measurement Of Their Prevention In Medicine Inpatients At K.L.E.

By - 08/22/2007

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Hemendra gautam

Hemendra Gautam

A drug- drug interaction can be defined as the phenomenon that occurs when the effect of pharmacokinectics of the drugs are altered by prior administration or co administration of second drug.

Or in other words the term Drug interaction is used when the effect of drug in the presence of other drug, food, beverages or environmental and chemical factor alters^.The frequency of adverse drug reactions increases disproportionately with an increase in the number of drugs given to patients.Drug interactions-more specifically pharmacological interactions-are those, which may occur in the organism when two or more drugs are present simultaneously.

Adverse drug-related events (ADEs) present a challenging and expensive public health problem. Drug-drug interactions are a particularly important type of adverse drug event because they are often predictable based on previous reports, clinical studies, and an understanding of pharmacological principles. Some drug-related problems develop unexpectedly and cannot be predicted, many are related to known pharmacological actions of the drugs and reasonably can be anticipitated.

Objectives Of The Study:

1.Prospective survey of potential Drug-Drug interactions.

2.To estimate the risk associated with drug interaction in medicine inpatients.

3.To identify the drug most commonly implanted in Drug-Drug interactions.

Methodology

Study Period: 6 months

Study Site: Medicine Department, K.L.E.S.’s Hospital and Medical Research Centre, Belgaum.

Ethical Clearance: Ethical clearance was obtained from the Institutional Ethical Committee on Human Subjects Research.

Study Design: This was a prospective pharmacist based study.

Study Procedure:

Potential drug-drug interactions detected during the ward rounds were notified in patient daily progress record.

The patient’s demographic data, current medications, laboratory investigation, past medical and medication history was collected from the patient’s progress record, treatment chart, laboratory reports and patient history record.

Each of the potential drug-drug interaction was categorized according to their level of significance. The level of significance relates to the magnitude of the effect, to the likelihood of occurrence, and subsequently to the necessity of monitoring the patients or altering therapy to avoid potentially adverse consequences. The primary factors that define level of clinical significance include significance rating, the time of onset of the interactions, and the documentation that an interaction occurs clinically. The following discussion defines the guidelines used to designate these factors.

Data Collection: 1. in patient progress records, 2. Treatment charts, 3. Laboratory data reports, 4. Patients history record, 5. ADR notification forms.

Inclusion criteria:

Patients on multiple drug therapy; with minimum of three drugs.
Patients admitted for a minimum of 48 hours in the wards of medicine units.
All patients above the age of 18 years.
Patients of both sexes.

Exclusion criteria:

·Patients on herbal medications.

·Pregnant and lactating women.

·Patients on non-prescription drugs or self-medication.

·Pharmaceutical incompatibilities.

·Drug-Alcohol interactions.

·Patient under critical conditions and requiring critical stay.

· Patients treated on outpatient basis