Lapi F, Vietri M, Moschini M, Cecchi E, Pugi A, Lucenteforte E, Banchelli G, Di Pirro M, Gallo E, Mugelli A, Vannacci A
Tuscan Regional Centre of Pharmacovigilance, Department of Pharmacology, University of Florence, Viale G. Pieraccini No. 6, 50139, Florence, Italy.
Pharm World Sci. 2010 Apr;32(2):200-5. doi: 10.1007/s11096-010-9370-4. Epub 2010 Feb 5.
To evaluate the type, frequency, severity and predictors of potential Drug-Drug Interactions (DDIs) in a cohort of patients undergoing radiodiagnostic procedures.
Eight Radiology wards located in Tuscany (Italy).
All participants exposed to at least two medications were included in the analysis. DDIs were grouped according to their severity as 'minor', 'moderate' or 'major'. A logistic model was used to estimate Odds Ratios and 95% Confidence Intervals for all predictors of potential DDI.
Type and predictors of potential DDI in a cohort of patients undergoing radiodiagnostic procedures.
One-thousand-and-two subjects (57.6% females; mean age: 67.3 +/- 12.2) entered the analysis, and 46.1% of them incurred in a potential DDI (78.9% 'moderate' in severity). The combination of allopurinol and ACE-inhibitors was the most frequent (21/153) among major potential DDIs, while steroids were involved in all cases of potential DDI due to premedication. Co-morbidity, number of co-medications, advanced age and premedication use increased the risk of potential DDI; a protective role was found for positive history of allergy. When the analysis was restricted to subjects with premedication (n = 93), only 12.9% of them reported a potential DDI directly attributable to premedication drugs.
Among patients undergoing radiological examination, types and predictors of potential DDIs appeared in agreement with other kind of in-hospital populations. Premedication revealed to be a proxy predictor for potential DDIs. Considering the poor capability of the prescriber in recognizing interactions, their systematic evaluation (using an informatics tool) in patients undergoing radiological examination might be helpful in preventing the occurrence of clinically relevant DDIs.
评估接受放射诊断检查的患者队列中潜在药物相互作用（DDIs）的类型、频率、严重程度及预测因素。
位于意大利托斯卡纳的八个放射科病房。
所有至少使用两种药物的参与者纳入分析。DDIs根据严重程度分为“轻微”“中度”或“重度”。采用逻辑模型估计潜在DDI所有预测因素的比值比及95%置信区间。
接受放射诊断检查的患者队列中潜在DDI的类型及预测因素。
1002名受试者（57.6%为女性；平均年龄：67.3±12.2岁）纳入分析，其中46.1%发生了潜在DDI（78.9%为“中度”严重程度）。在主要潜在DDIs中，别嘌醇与血管紧张素转换酶抑制剂的联合使用最为常见（21/153），而由于预防性用药，类固醇参与了所有潜在DDI病例。合并症、联合用药数量、高龄及预防性用药增加了潜在DDI的风险；发现过敏阳性史具有保护作用。当分析仅限于接受预防性用药的受试者（n = 93）时，其中只有12.9%报告了直接归因于预防性用药的潜在DDI。
在接受放射检查的患者中，潜在DDIs的类型及预测因素与其他住院人群一致。预防性用药被证明是潜在DDIs的替代预测因素。考虑到开处方者识别相互作用的能力较差，对接受放射检查的患者进行系统评估（使用信息学工具）可能有助于预防临床相关DDIs的发生。
