Department of Medical Pharmacology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey.
Department of Medical Pharmacology, Medical Faculty, Halic University, Istanbul 34098, Turkey.
Medicina (Kaunas). 2022 Jan 26;58(2):183. doi: 10.3390/medicina58020183.
Chronic kidney disease (CKD) is usually linked with polypharmacy and patients are invariably at risk of complex medication regimens. The present study was designed to estimate the potential drug-drug interactions (pDDIs) through the prescription patterns provided to patients of the Nephrology Transplant Unit of Cerrahpasa Medical Faculty patients. 96 patients were included in the study. pDDIs among every combination of the prescribed drug were analyzed using the Thomson Reuters Micromedex. We found 149 pDDIs making 2.16 interactions per prescription with incidence rates of 69.7%. Approximately 4.1% of interactions were of significant severity, 75.1% moderate severity, and 20.8% were classified as minor pDDIs. The most frequent interactions were found between iron and aluminum, calcium or magnesium-containing products (21.37%), calcium channel blockers and beta-blockers (8.96%); and aspirin and aluminum, calcium, or magnesium-containing products (7.58%). We identified 42 drug pairs with probability of clinical significance. The most commonly reported clinical outcomes of the pDDIs were hypo- or hypertension (39.24%), decreased drug efficacy (24.05%), and arrhythmia (9.49%). Aluminum, calcium, or magnesium-containing drug products (33.10%) constituted the primary class of drugs involved in interactions. This study showed pharmacodynamics (49%), pharmacokinetics (42.94%) interactions, polypharmacy and gender as determinant of pDDIs. A comprehensive multicenter research is required to decrease the morbidity and ease the state burden.
慢性肾脏病(CKD)通常与多种药物治疗相关,患者始终存在复杂药物治疗方案的风险。本研究旨在通过 Cerrahpasa 医学系肾脏病移植科患者的处方模式来估计潜在的药物-药物相互作用(pDDI)。 96 名患者纳入研究。使用 Thomson Reuters Micromedex 分析了每种处方药物组合之间的 pDDI。 我们发现了 149 种 pDDI,每处方有 2.16 种相互作用,发生率为 69.7%。大约 4.1%的相互作用具有显著严重程度,75.1%为中度严重程度,20.8%为轻度 pDDI。最常见的相互作用发生在铁和铝、钙或镁制剂(21.37%)、钙通道阻滞剂和β受体阻滞剂(8.96%)之间;以及阿司匹林和铝、钙或镁制剂(7.58%)之间。我们确定了 42 对具有临床意义概率的药物对。pDDI 最常见的临床后果是低血压或高血压(39.24%)、药物疗效降低(24.05%)和心律失常(9.49%)。含铝、钙或镁的药物制剂(33.10%)构成了相互作用中主要的药物类别。 本研究表明,药效学(49%)、药代动力学(42.94%)相互作用、多种药物治疗和性别是 pDDI 的决定因素。需要进行全面的多中心研究,以降低发病率并减轻国家负担。