Frequency, Levels and Predictors of Potential Drug-Drug Interactions in a Pediatrics Ward of a Teaching Hospital in Pakistan
Date
2013-07-06
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Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, Nigeria
Abstract
Description
Purpose: To identify the frequency, levels and predictors of potential
drug-drug interactions (pDDIs) in a pediatrics ward of a teaching
hospital in Pakistan. Methods: Medication profiles of 400 pediatric
patients were evaluated for pDDIs using Micromedex Drug-Reax®
software. Logistic regression was used to identify association of pDDIs
with hospital-stay, patient’s gender, and number of medications.
Results: In total, 86 interacting drug-combinations resulting in 260
pDDIs were identified. Overall, 25.8 % patients were exposed to at
least one pDDI regardless of severity-type, 10.7 % to at least one
major-pDDI, 15.2 % to at least one moderate-pDDI, and 12.5 % to at
least one minor-pDDI. Of 260 pDDIs, most were of moderate severity
(41.5 %) followed by minor (35.4 %) and major severity (21.9 %); good
(76.9 %) or fair (16.5 %) type of scientific evidence; and delayed
onset (46.5 %). Some widespread major or moderate interactions included
rifampin + pyrazinamide (14 cases), phenobarbital + diazepam (14),
dexamethasone + rifampin (8), amikacin + furosemide (7), furosemide +
captopril (7), dexamethasone + phenobarbital (6), phenobarbital +
divalproex sodium (6), isoniazid + rifampin (5) amikacin + ibuprofen
(5), digoxin + furosemide (4), and acetaminophen + phenytoin sodium
(4). There was significant association of the occurrence of pDDIs with
five or more prescribed medications (p < 0.001). Conclusion: PDDIs
are less prevalent in the pediatrics ward of the hospital studied. Most
of the interactions were of moderate severity. Patients with increased
number of prescribed medications were more exposed to these
interactions.
Keywords
Drug-drug interactions, Prescription screening, Drug related problems
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