Sherin Reena, Udaykumar Padmaja
Department of Pharmacology, Father Muller Medical College, Kankanady, Mangalore, 575002, India.
Rev Recent Clin Trials. 2016;11(2):128-34. doi: 10.2174/1574887111666160201122532.
Associated co-morbidities with psoriasis are treated with concomitant medications apart from the antipsoriatic therapy and the resulting Drug-Drug Interactions (DDI) may affect therapeutic outcome.
To assess the DDI in psoriatic patients with co-morbidities.
In this prospective observational analysis, 150 prescriptions of psoriatic patients, receiving two or more drugs were analysed using drug interaction checker software. DDI was classified into minor, moderate, major and pharmacokinetic & pharmacodynamic.
Of 150 patients, 77.3% (n=116) had cardiovascular comorbities; diabetes mellitus (49.3%), psoriatic arthritis (20.7%), hyperlipidemia (46%), infections (28.7%), neurologic conditions (24.7%) and dermatologic conditions (37.3%) were other reported comorbidities. Of these, 138 (92%) patients had 612 DDI (4.49 interactions/patient). More number of interactions were seen in 45-60 yrs (n=311, 50.8%). Moderate DDI (79.9%) were higher; 306 (50%) were pharmacokinetic interactions. Frequent interactions were due to non-steroidal anti-inflammatory drugs (n=229, 37.4%) and antibiotics (n=176, 28.8%). Monitoring of the signs & symptoms was the advised intervention in 67.2% of patients. Mean DDI per patient was more in those who received >10 drugs (9.67). There was an increased number of DDI with an increase in the number of medications which was statistically significant (p<0.01), with greater number of (n=458, 74.8%) interactions seen in those who received 5-10 drugs.
There was an increased number of DDI in those who received more number of drugs. Careful monitoring with appropriate timely laboratory investigations, and a rational drug prescription for the comorbid conditions can prevent the occurrence of harmful DDIs.
银屑病相关的合并症除接受抗银屑病治疗外，还需使用其他伴随药物治疗，由此产生的药物相互作用（DDI）可能会影响治疗效果。
评估合并有其他疾病的银屑病患者中的药物相互作用情况。
在这项前瞻性观察分析中，使用药物相互作用检查软件对150例接受两种或更多药物治疗的银屑病患者的处方进行了分析。药物相互作用被分为轻微、中度、重度以及药代动力学和药效学相互作用。
150例患者中，77.3%（n = 116）患有心血管合并症；其他报告的合并症包括糖尿病（49.3%）、银屑病关节炎（20.7%）、高脂血症（46%）、感染（28.7%）、神经系统疾病（24.7%）和皮肤病（37.3%）。其中，138例（92%）患者存在612次药物相互作用（每位患者4.49次相互作用）。45至60岁的患者中出现的相互作用数量更多（n = 311，50.8%）。中度药物相互作用（79.9%）更为常见；306次（50%）为药代动力学相互作用。常见的相互作用是由非甾体抗炎药（n = 229，37.4%）和抗生素（n = 176，28.8%）引起的。67.2%的患者建议采取监测体征和症状的干预措施。接受超过10种药物治疗的患者中，每位患者的平均药物相互作用次数更多（9.67次）。药物相互作用的数量随着药物数量的增加而增加，具有统计学意义（p < 0.01），接受5至10种药物治疗的患者中出现的相互作用数量更多（n = 458，74.8%）。
接受药物数量较多的患者中药物相互作用的数量增加。通过适当及时的实验室检查进行仔细监测，以及针对合并症合理开药，可以预防有害药物相互作用的发生。
