Das Saibal, Behera Sapan Kumar, Xavier Alphienes Stanley, Dharanipragada Subrahmanyam, Selvarajan Sandhiya
Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Perspect Clin Res. 2019 Apr-Jun;10(2):62-66. doi: 10.4103/picr.PICR_55_18.
Although drug-drug interactions (DDIs) cause major adverse drug reactions (ADRs) in patients under polypharmacy, the risk of some specific DDIs may be overrated in literature and different software. This study was conducted to determine the frequency and type of potential and clinically significant DDIs among inpatients admitted in a tertiary care hospital in South India.
This longitudinal study was conducted for 30 days. Preformatted forms were used to collect data on the second day of admission. "Medscape Drug Interaction Checker" was used to evaluate and grade the DDIs. All the potential serious DDIs were intimated to the treating physicians and their responses in the prescriptions were noted. The same patients were followed up to evaluate the occurrence of any clinically significant DDIs.
A total of 763 drugs with 125 discrete types were prescribed in 155 patients with an average of 4.9 drugs per patient. One hundred and eight minor, 169 significant, and 24 serious potential DDIs were identified. Patient's age did not correlate, but number of drugs prescribed strongly correlated ( < 0.001) with the incidence of different types of DDIs. The prescription was modified in only 6 (25%) cases where potential serious DDIs were reported. Interestingly, no ADRs or impaired efficacy was observed due to the potential serious DDIs.
There was a disparity between the potential and clinically relevant DDIs. Hence, clinical prudency is required before changing prescription due to potential DDIs reported by different software.
尽管药物相互作用（DDIs）在接受多种药物治疗的患者中会引发严重的药物不良反应（ADRs），但在文献和不同软件中，某些特定药物相互作用的风险可能被高估。本研究旨在确定印度南部一家三级护理医院住院患者中潜在的及具有临床意义的药物相互作用的频率和类型。
本纵向研究为期30天。入院第二天使用预先格式化的表格收集数据。使用“Medscape药物相互作用检查器”评估药物相互作用并进行分级。所有潜在的严重药物相互作用均告知主治医生，并记录他们在处方中的应对措施。对同一批患者进行随访，以评估是否发生任何具有临床意义的药物相互作用。
155名患者共开具了763种药物，有125种不同类型，平均每位患者4.9种药物。共识别出108种轻度、169种中度和24种严重的潜在药物相互作用。患者年龄与药物相互作用的发生率无相关性，但开具的药物数量与不同类型药物相互作用的发生率密切相关（<0.001）。在报告有潜在严重药物相互作用的病例中，仅6例（25%）修改了处方。有趣的是，未观察到因潜在严重药物相互作用导致的药物不良反应或疗效受损。
潜在的药物相互作用与具有临床相关性的药物相互作用之间存在差异。因此，在因不同软件报告的潜在药物相互作用而更改处方之前，需要临床审慎判断。
