Abdelkawy Khaled, Kharouba Maged, Shendy Khloud, Abdelmagged Omar, Galal Naira, Tarek Mai, Abdelgaied Mohamed, Zakaria Amr Y, Mahmoud Sherif Hanafy
Faculty of Pharmacy, Kafrelsheikh University, Kafrelsheikh 33516, Egypt.
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB T6G 2E1, Canada.
Pharmacy (Basel). 2023 Jun 18;11(3):106. doi: 10.3390/pharmacy11030106.
In clinical practice, drug-drug interactions (DDIs) pose significant risks to a large number of patients. Consequently, healthcare providers are required to diligently identify, monitor, and effectively handle these interactions in order to enhance patient outcomes. In Egypt, DDIs are poorly addressed, with no reports for DDIs in primary care. In our cross-sectional, retrospective, observational study, we collected a total of five thousand, eight hundred and twenty prescriptions across eight major governorates in Egypt. Prescriptions were collected over a span of 15 months between 1 June 2021 and 30 September 2022. These prescriptions were analyzed for potential DDIs using the Lexicomp drug interactions tool. The prevalence of DDIs was found to be 18%, with 22% of the prescriptions having two or more potential DDIs. Moreover, we found 1447 DDIs of categories C (monitoring therapy recommended), D (therapy modification suggested), and X (avoid combination). The most commonly interacting drugs in our study were diclofenac, aspirin, and clopidogrel, while non-steroidal anti-inflammatory drugs (NSAIDs) were the most reported therapeutic class implicated in pharmacologic DDIs. Pharmacodynamic agonistic activity was the most common mechanism of interaction. Therefore, it is crucial to conduct screenings, detect early signs, and closely monitor drug-drug interactions (DDIs) to enhance patients' overall health outcomes, medication responses, and safety. In this regard, the clinical pharmacist assumes a vital role in implementing these preventive measures.
在临床实践中,药物相互作用(DDIs)给大量患者带来了重大风险。因此,医疗保健提供者必须认真识别、监测并有效处理这些相互作用,以改善患者的治疗效果。在埃及,药物相互作用问题未得到充分解决,初级保健中没有关于药物相互作用的报告。在我们的横断面、回顾性观察研究中,我们在埃及八个主要省份共收集了5820份处方。这些处方是在2021年6月1日至2022年9月30日的15个月期间收集的。使用Lexicomp药物相互作用工具对这些处方进行潜在药物相互作用分析。发现药物相互作用的发生率为18%,22%的处方有两种或更多潜在的药物相互作用。此外,我们发现了1447种C类(建议监测治疗)、D类(建议调整治疗)和X类(避免联合使用)的药物相互作用。我们研究中最常相互作用的药物是双氯芬酸、阿司匹林和氯吡格雷,而非甾体抗炎药(NSAIDs)是药物相互作用中报告最多的治疗类别。药效学激动活性是最常见的相互作用机制。因此,进行筛查、发现早期迹象并密切监测药物相互作用对于提高患者的整体健康状况、药物反应和安全性至关重要。在这方面,临床药师在实施这些预防措施中起着至关重要的作用。