Dipartimento di Scienza e Tecnologia del Farmaco, Universita degli Studi di Torino, Torino, Italy
Dipartimento di Scienza e Tecnologia del Farmaco, Universita degli Studi di Torino, Torino, Italy.
Eur J Hosp Pharm. 2020 Nov;27(6):341-345. doi: 10.1136/ejhpharm-2018-001697. Epub 2019 Mar 16.
Prescription of proton pump inhibitors (PPIs) may be a source of potentially clinically relevant drug-drug interactions (DDIs) and related complications for elderly patients with complex polytherapy at discharge from hospital. The aim of the study was to identify, through the analysis of hospital discharge records, the co-administrations (PPIs + one or more drugs potentially generating DDIs) hypothetically leading to severe consequences according to the literature and online databases. Subsequently, alternatives to PPIs were evaluated for the treatment of gastric acidity and ulcers.
The medical records of 1288 patients, discharged from a geriatric ward at the Città della Salute e della Scienza Hospital in Turin from January 2012 to December 2013, were collected in an Excel database for analysis of DDIs using the literature and online sources such as Micromedex. RESULTS : Six hundred and sixty-three of the 1288 clinical folders had a PPI prescription. A list of 18 drugs considered potentially hazardous and able to trigger a DDI when co-administrated with PPIs was drafted; the frequencies of the co-prescriptions of each PPI with one of the listed drugs were esomeprazole 65.38%, lansoprazole 52.87%, omeprazole 48.19% and pantoprazole 37.11%. An analysis of these co-prescriptions, according to Micromedex classification, gave a percentage of major interactions of 11.01% over 663 clinical folders including a PPI.
This study provides a collection of potentially hazardous drug associations and helpful suggestions to improve the quality of prescriptions for elderly patients and strengthens the case for synergic work between doctors and pharmacists in the wards.
质子泵抑制剂 (PPI) 的处方可能是医院出院后接受复杂多药物治疗的老年患者潜在临床相关药物-药物相互作用 (DDI) 和相关并发症的来源。本研究的目的是通过分析医院出院记录，根据文献和在线数据库，确定假设会导致严重后果的联合用药（PPI + 一种或多种可能产生 DDI 的药物）。随后，评估了 PPI 的替代品用于治疗胃酸和溃疡。
从 2012 年 1 月至 2013 年 12 月，在都灵的 Città della Salute e della Scienza 医院老年病房出院的 1288 名患者的病历被收集到 Excel 数据库中，使用文献和在线资源（如 Micromedex）分析 DDI。
1288 份临床文件夹中有 663 份有 PPI 处方。制定了一份潜在危险药物清单，当与 PPI 联合使用时，这些药物可能会引发 DDI；列出了每种 PPI 与列出药物之一的联合处方频率，艾司奥美拉唑为 65.38%、兰索拉唑为 52.87%、奥美拉唑为 48.19%、泮托拉唑为 37.11%。根据 Micromedex 分类，对这些联合处方进行分析，在包括 PPI 的 663 份临床文件夹中，主要相互作用的百分比为 11.01%。
本研究提供了一组潜在危险的药物组合，并提出了有助于改善老年患者处方质量的建议，并加强了医生和药剂师在病房协同工作的理由。
