Allscripts, Malvern, PA, USA.
J Clin Pharmacol. 2013 Nov;53(11):1212-9. doi: 10.1002/jcph.151. Epub 2013 Aug 13.
Electronic Medical Records (EMRs) are wealthy storehouses of patient information, to which data mining techniques can be prudently applied to reveal clinically significant patterns. Detecting patterns in drug-drug interactions, leading to adverse drug reactions is a powerful application of EMR data mining. Adverse effects of drug treatments can be investigated by mining clinical laboratory tests data which are reliable indicators of abnormal physiological functions. We report here the co-medication effects of pravastatin (HMG-CoA reductase inhibitor) and paroxetine (selective serotonin reuptake inhibitor (SSRI) anti-depressant) on significant clinical parameters, identified through a data mining analysis conducted on the Allscripts data warehouse. We found that the concomitant drug treatments of pravastatin and paroxetine increased the mean values of glucose serum from 113.2 to 132.1 mg/dL and international normalized ratio (INR) from 2.18 to 2.52, respectively. It also decreased the mean values of estimated glomerular filtration rate (eGFR) from 43 to 37 mL/min/1.73 m(3) and blood CO2 levels from 24.8 to 23.9 mEq/L respectively. Our findings indicate that co-medication of pravastatin and paroxetine might have significant impact on blood anti-coagulation, kidney function, and glucose homeostasis. Our methodology can be applied to any EMR data set to reveal co-medication effects of any drug pairs.
电子病历(EMR)是患者信息的丰富宝库,可以谨慎地应用数据挖掘技术从中揭示具有临床意义的模式。检测药物-药物相互作用导致药物不良反应的模式是 EMR 数据挖掘的一个强大应用。通过挖掘临床实验室测试数据可以研究药物治疗的不良反应,这些数据是异常生理功能的可靠指标。我们在此报告普伐他汀(HMG-CoA 还原酶抑制剂)和帕罗西汀(选择性 5-羟色胺再摄取抑制剂(SSRI)抗抑郁药)联合用药对重要临床参数的共同用药效果,这些效果是通过对 Allscripts 数据仓库进行数据挖掘分析确定的。我们发现,普伐他汀和帕罗西汀的联合药物治疗使血清葡萄糖的平均值从 113.2 增加到 132.1mg/dL,国际标准化比值(INR)从 2.18 增加到 2.52。它还分别使估算肾小球滤过率(eGFR)的平均值从 43 降低到 37mL/min/1.73m(3),使血液 CO2 水平从 24.8 降低到 23.9mEq/L。我们的研究结果表明,普伐他汀和帕罗西汀的联合用药可能对血液抗凝、肾功能和葡萄糖稳态产生重大影响。我们的方法可以应用于任何 EMR 数据集,以揭示任何药物对的共同用药效果。