Jain Shipra, Jain Pushpawati, Sharma Kopal, Saraswat Pushpendra
Assistant Professor, Department of Pharmacology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
Professor and Head, Department of Pharmacology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
J Clin Diagn Res. 2017 Mar;11(3):FC01-FC04. doi: 10.7860/JCDR/2017/23638.9403. Epub 2017 Mar 1.
Drug-Drug Interaction (DDI) is a serious concern in cardiac patients due to polypharmacy.
The present study was aimed to identify the potential DDI among hospitalized cardiac patients and evaluate the mechanism and severity of such interactions.
A prospective observational study was conducted in intensive cardiac care unit of a tertiary care hospital for six months. Patients aged 18 years and above and taking two or more drugs were included in the study. Medscape drug interaction checker was used to identify and analyze the pattern of potential DDI.
Out of 500 patients, most of the patients were male (78.4%) in the age group of 50-60 years (31%). The most common diagnosis was acute coronary syndrome (57.2%). Out of total 2849 DDI, 2194 (77.01%) were pharmacodynamic, 586 (20.57%) were pharmacokinetic in nature while 69 (2.42%) drug pairs interacted by unknown mechanism. Majority of drug interactions were significant {2031 (71.29%)} in nature followed by minor {725(25.45%)} while serious drug interactions were observed in only 93 (3.26%) drug pairs. A positive correlation was observed between patient's age and number of drugs prescribed (r=0.178, p<0.001), number of drugs prescribed and potential Drug-Drug Interaction (pDDI) (r= 0.788, p<0.001) and between patient's age and pDDI (r=0.338, p<0.001).
The risk of pDDI was more commonly observed in elderly male patients particularly with antiplatelet drugs like low dose aspirin and clopidogrel.
由于联合用药，药物相互作用（DDI）是心脏病患者的一个严重问题。
本研究旨在确定住院心脏病患者中潜在的药物相互作用，并评估此类相互作用的机制和严重程度。
在一家三级医院的心脏重症监护病房进行了为期六个月的前瞻性观察研究。纳入年龄在18岁及以上且服用两种或更多药物的患者。使用Medscape药物相互作用检查器来识别和分析潜在药物相互作用的模式。
在500名患者中，大多数患者为男性（78.4%），年龄在50 - 60岁之间（31%）。最常见的诊断是急性冠状动脉综合征（57.2%）。在总共2849例药物相互作用中，2194例（77.01%）是药效学相互作用，586例（20.57%）本质上是药代动力学相互作用，而69对（2.42%）药物通过未知机制相互作用。大多数药物相互作用本质上是显著的{2031例（71.29%）}，其次是轻微的{725例（25.45%）}，而仅在93对（3.26%）药物中观察到严重的药物相互作用。观察到患者年龄与处方药物数量之间存在正相关（r = 0.178，p < 0.001），处方药物数量与潜在药物相互作用（pDDI）之间存在正相关（r = 0.788，p < 0.001），以及患者年龄与pDDI之间存在正相关（r = 0.338，p < 0.001）。
在老年男性患者中，尤其是使用低剂量阿司匹林和氯吡格雷等抗血小板药物时，更常观察到潜在药物相互作用的风险。
