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Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán

2021, Number 1

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Rev Biomed 2021; 32 (1)

Pilot study: Impact of the pharmacist on identification and evaluation of potential drug-drug interactions in Internal Medicine inpatient prescriptions

Vázquez-Alvarez AO, Pedroza-Gómez C, Uribe-Sánchez A, Huerta-Olvera SG

Language: Spanish
References: 29
Page: 1-11
PDF size: 245.42 Kb.


ABSTRACT

Introduction. Potential drug interactions can contribute to therapeutic failures and/or possible iatrogenesis when prescribed with two or more drugs that may interact. In Mexico, there are few studies that allow establishing the current panorama and their importance in the validation of the prescription by the pharmacist.
Objective. To evaluate the impact of the pharmacist in the identification and evaluation of potential drug-drug interactions in prescriptions of hospitalized patients of Internal Medicine
Material and methods. Observational, cross-sectional, retrospective, continuous inclusion study. Complete prescription sheets, indistinct diagnosis, and ≥2 prescribed drugs were evaluated. Interactions were detected through the micromedex 2.0 software. They were grouped by frequency, severity and pharmacological group. Secondarily, potential laboratory parameter drug interactions were recorded.
Results. In 94 patients, 743 different medications, an average of 8±3 medications/patient, with analgesics being the most prescribed. 141 potential drug-drug interactions (IPFF) were found. 47.9 % of the patients presented some interaction, of which 38.3 % were severe; percentage that decreased to 11.4 % after pharmacist evaluation as clinically relevant. Potential laboratory parameter drug interactions were identified, 8.3 % were severe. An index of 1.5 IPFF/patient was observed, which was reduced to 0.20 IPFF/patient after their evaluation by the pharmacist.
Conclusions. 47.9 % presented IPFF, which, regardless of its severity, constitutes an unrecognized problem during hospital care. Identifying those potential interactions, validating their clinical relevance by the clinical pharmacist, showed a reduction of 88.7 % of the observed interactions; allowing for more targeted surveillance.


REFERENCES

  1. Almodóvar AS, Nahata MC. Associations Between Chronic Disease, Polypharmacy, and Medication-Related Problems Among Medicare Beneficiaries. J Manag Care Spec Pharm. 2019;25(5):573-577. doi:10.18553/ jmcp.2019.25.5.573

  2. Wai Yin Lam and Paula Fresco. Medication Adherence Measures: An Overview. BioMed Research International, Volume 2015, Article ID 217047, 12 pages. http://dx.doi. org/10.1155/2015/217047

  3. Introducción a las interacciones farmacológicas. Sociedad Española de Farmacia Hospitalaria; SEFH. 1 edición, diciembre 2013. ISBN: 978-84-695-9254- 0. Disponible en:https://www.sefh.es/bibliotecavirtual/ interacc2014/InteraccionesFarmacoloigicas_pr.pdf

  4. Beers M., Storrie M., Lee G. Potential adverse drug interactions in the emergency room. An issue in the quality of care. Ann intern Med 1990; 112: 61-64.

  5. Kwan T.C., Nahba W.W., Wildeman R.A. Drug interactions: a prospective study of its epidemiology, clinical significance and influence upon hospitalization. Can J Hosp Pharm 1979; 32: 12-16.

  6. El Morabet N, Uitvlugt EB, van den Bemt BJF, van den Bemt PMLA, Janssen MJA, Karapinar-Çarkit F. Prevalence and Preventability of Drug-Related Hospital Readmissions: A Systematic Review. J Am Geriatr Soc. 2018;66(3):602-608. doi:10.1111/jgs.15244.

  7. Borda l.T., Sloane D., Jick H. Assessement of adverse reactions with a drug surveillance program. JAMA 1968; 205: 645-647.

  8. Vargas E., Navarro M.l., Laredo L., Garcia-Arenillas M., Garcia-Mateos M., Moreno A. Effect of drug interactions on the development of adverse drug reactions. Clin Drug lnvest 1997; 13 (5): 282-289.

  9. Jacobi Judith, ACCP, MCCM, BCPS, BCCCP. Farmacéuticos clínicos: Profesionales esenciales del equipo de atención clínica. Revista Médica Clínica Las Condes 2016; Vol. 27(5): 578-584.

  10. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990; Mar, 47(3): 533-43.

  11. Dudik Néstor H, Osicka Rosa M. Atención farmacéutica: un modelo de ejercicio profesional. Comunicaciones Científicas y Tecnológicas 2006. Disponible en: http:// www.unne.edu.ar/unnevieja/Web/cyt/cyt2006/08- Exactas/2006-E-047.pdf.

  12. Riu-Viladoms G, Carcelero San Martín E, Martín-Conde MT, Creus N. Drug interactions with oral antineoplastic drugs: The role of the pharmacist. Eur J Cancer Care (Engl). 2019;28(1): e12944. doi:10.1111/ecc.12944

  13. Diario Oficial de la Federación. Reforma del primer párrafo del artículo 79 de la Ley General de Salud. Consultado el 21 de agosto 2020. Disponible en: https:// dof.gob.mx/nota_detalle.php?codigo=5584753&fec ha=24/01/2020

  14. Ibáñeza A. Interacciones medicamentosas en pacientes de un servicio de medicina interna. Farmacia Hospitalaria. España 2008; 32(5): 293.

  15. Ikäheimo I, Karjalainen M, Tiihonen M, et al. Clinically relevant drug-drug interactions and the risk for drug adverse effects among home-dwelling older persons with and without type 2 diabetes. J Clin Pharm Ther. 2019;44(5):735-741. doi:10.1111/jcpt.12854

  16. Arthur, C. Guyton; John, E. Hall. Tratado de fisiología médica. Décimo tercera edición. Editorial Elsevier. España 2017; (22): 255-257.

  17. Darren Dookeeram, Satesh Bidaisee, Joanne F. Paul, et. al. Polypharmacy and potential drug–drug interactions in emergency department patients in the Caribbean. Int J Clin Pharm (2017) 39:1119–1127. (doi:10.1007/s11096- 017-0520-9

  18. Stockley, H, I. Interacciones farmacológicas; Pharma Editores; Barcelona España 2007; (2) 6:135.

  19. Klinkhardt U, Kirchmaier CM, Westrup D, Graff J, Mahnel R, Breddin HK, Harder S “Ex vivo-in vitro interaction between aspirin, clopidogrel, and the glycoprotein IIb/IIIa inhibitors abciximab and SR121566A.” Clin Pharmacol Ther 2000; 67: 305-13.

  20. Price AJ, Frcpath DO. Is there a clinical interaction between low molecular weight heparin and non-steroidal analgesics after total hip replacement? Ann R Coll Surg Eng 1995; 77: 395.

  21. Fitzmaurice, M.G., Wong, A., Akerberg, H. et al. Evaluation of Potential Drug–Drug Interactions in Adults in the Intensive Care Unit: A Systematic Review and Meta-Analysis. Drug Saf 42, 1035–1044 (2019). https://doi.org/10.1007/s40264-019-00829-y

  22. Chimowitz MI, Lynn MJ, Howlett-Smith H, Stern BJ, Hertzberg VS, Frankel MR, et al. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med. 2005;352(13):1305–16.

  23. Thalia S. Field, Makoto Nakajima, Oscar R Benavete. Combination Aspirin and Clopidrogrel for Secondary Prevention of Schemic Stroke. Curr Treat Options Cardiovasc Med. 2014; 15(3): 348-359.

  24. Juurlink DN, Mandani M, Lee D, Kopp A, Austin PC, Laupacis A, et al. Rates of Hyperkalemia after Publication of the Randomized Aldactone Evaluation Study. N Engl J Med 2004; 351: 543-51.

  25. Zanchetti A, Hansson L, Leonetti G, et al. Low-dose aspirin does not interfere with the blood pressurelovwering effects of antihypertensive therapy. J Hypertens 2002; 20: 1015-1022.

  26. Stockley, H, I. Interacciones farmacológicas. Pharma Editores. 11va edición. Barcelona España 2016; (2)30: 846-847.

  27. Laboratorios Rubio S.A. Ficha técnica Hydrapres (Hidrocloruro de hidralazina). Agencia española de medicamentos y productos sanitarios. Disponible en www.aemps.gob.es/cima/pdfs/es/ft/55961/FT_55961. pdf . Fecha de revisión del texto el 01 de marzo de 2020.

  28. Andersson T, Cederberg C, Edvardsson G, et al. Effect of omeprazole treatment on diazepam plasma levels in slow versus normal rapid metabolizers of omeprazole. Clin Pharmacol Ther 1990; 47: 79-85.

  29. Dinko Reki´c, Kellie S. Reynolds, Ping Zhao, et. al. Clinical Drug-Drug Interaction Evaluations to Inform Drug Use and Enable Drug Access. Journal of Pharmaceutical Sciences 106 (2017) 2214-2218. DOI:https://doi.org/10.1016/j.xphs.2017.04.016




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