EXPLORATION OF PRESCRIPTIONS CONTAINING DRUG-DRUG INTERACTIONS IN MULTISPECIALITY HOSPITALS

D.KRISHNARAJAN; A.SRINIVASAN; P.VASUDEVAN; K.R.RAJA

Volume : VIII, Issue : I, January - 2019

EXPLORATION OF PRESCRIPTIONS CONTAINING DRUG-DRUG INTERACTIONS IN MULTISPECIALITY HOSPITALS

D. Krishnarajan, A. Srinivasan, P. Vasudevan, K. R. Raja

Abstract :

Objective: To determine the drug–drug interaction with the management of adverse drug interactions (ADIs) in elderly population. Methods: The prospective observational study include all inpatients taking at least two medications who were admitted to General wards of a Multi specialty hospital and were followed until discharge. DDIs were identified using standard references. Results: A total of 233 drug–drug interactions were detected from 109 patients over the six month study period. In 109 patients, 64 (58.71%) were male patients and 45 (41.28%) were female patients, that (41–60 years) age group had 46 patients which contributes (42.20%) followed by (61–80 years) age group had 28 patients which contributes (25.68%) in the total study population. Many interactions were observed in elder patients, In 902 drugs were prescribed to 109 patients. The average number per patient was 8.25. 72(66.04%) were using 6–10 medications followed by 20(18.34%) patients were using more than 10 medications and 17(15.59%) patients were using 3–5 medications has found. Severity shows that 107(45.92%) were moderate interactions followed by 104(44.63%) were major drug interactions and 22(9.44%) were minor drug interactions. In mechanism 108 (46.35%) were pharmacodynamic drug interaction followed by 94 (40.34%) were pharmacokinetic drug interaction and 31 (13.30%) were unknown mechanism in the total interactions. not specified onset of action were 121(51.93%) and the delayed onset of interactions was found to be 78(33.47%) on the rapid onset of interactions were 34(14.59%). Among 233 pDDIs, there are 47 adverse drug interactions were observed and recorded during the study period. The percentage of adverse drug interactions was found to be 20.17% Anti–hypertensive agents, Anti–coagulants and NSAIDS are most common drug which were present in observed drug interactions. Table 6.11 shows that based on clinical effects hypotension 6(12.76%) was most important effect followed by hyperkalemia 4(8.51%) and bleeding 4(8.51%). In the adverse drug interactions, 21(44.68%) interactions were PD and 17(30.17%) were pharmacokinetic interactions. From that adverse interactions, 31(65.95%) were moderate interactions followed by 10(21.27%) were major interactions and 6(12.76%) were minor interactions respectively. The monitoring for the adverse drug effects 168(72.10%) was the most popular intervention followed by dose adjustment 25(10.72%) and avoid concurrent use 16(6.86%) following potential drug–drug interactions. interventions to 233 drug interactions, in which the suggestion was accepted to 64 (27.46%) pDDIs and suggestion was not accept to 169(72.53%) pDDIs. In that 64 (27.46%) pDDIs has managed by dose adjustment, administration time change and drug alteration with in same pharmacological class. Conclusion: Clinicians need to be aware of most common DDIs occurring in the clinical practice and should be cautious in using the medications especially inpatients as they are more susceptible to DDIs. Clinical pharmacist can play a vital role in the detection, prevention and management of DDIs which can result in improved therapeutic outcomes and decreased unnecessary healthcare expenditure