Clinical weighting of drug-drug interactions in hospitalized elderly
Juárez-Cedillo, T; Martinez-Hernández, C; Hernández-Constantino, A; Garcia-Cruz, JC; Avalos-Mejia, AM; Sánchez-Hurtado, LA; Islas Perez, V; Hansten, PD
HERO ID
4948629
Reference Type
Journal Article
Year
2016
Language
English
PMID
| HERO ID | 4948629 |
|---|---|
| In Press | No |
| Year | 2016 |
| Title | Clinical weighting of drug-drug interactions in hospitalized elderly |
| Authors | Juárez-Cedillo, T; Martinez-Hernández, C; Hernández-Constantino, A; Garcia-Cruz, JC; Avalos-Mejia, AM; Sánchez-Hurtado, LA; Islas Perez, V; Hansten, PD |
| Journal | Basic & Clinical Pharmacology & Toxicology Online Pharmacology Online |
| Volume | 118 |
| Issue | 4 |
| Page Numbers | 298-305 |
| Abstract | Adverse drug reactions impact on patient health, effectiveness of pharmacological therapy and increased health care costs. This investigation intended to detect the most critical drug-drug interactions in hospitalized elderly patients, weighting clinical risk. We conducted a cross-sectional study between January and April 2014; all patients 70 years or older, hospitalized for >24 hr and prescribed at least one medication were included in the study. Drug-drug interactions were estimated by combining Stockley's, Hansten and Tatro drug interactions. Drug-drug interactions were weighted using a risk-analysis method based on failure modes, effects and criticality analysis. We calculated a criticality index for each drug involved in the drug-drug interactions based on the severity of the interaction mechanism, the frequency the drug was involved in drug-drug interactions and the risk of drug-drug interactions in patients with impaired renal function. The average number of drugs consumed in the hospital was 6 ± 2.69, involving 160 active ingredients. The most frequent were as follows: Furosemide, followed by Enalapril. Of drug-drug interactions, 2% were classified as contraindicated, 14% advised against and 83% advised caution during the hospital stay. Thirty-four drug-drug interactions were assessed, of which 23 were pharmacodynamic drug-drug interactions and 12 were pharmacokinetic drug-drug interactions (1 was both). The clinical risk calculated for each drug-drug interaction included heparins + non-steroidal anti-inflammatory drugs (NSAIDs) or Digoxin + Calcium Gluconate, cases which are pharmacodynamic drug-drug interactions with agonist effect and clinical risk of bleeding, one of the most common clinical risks in the hospital. An index of clinical risk for drug-drug interactions can be calculated based on severity by the interaction mechanism, the frequency that the drug is involved in drug-drug interactions and the risk of drug-drug interactions in an elderly patient with impaired renal function. |
| Doi | 10.1111/bcpt.12495 |
| Pmid | 26432499 |
| Wosid | WOS:000372917600007 |
| Is Certified Translation | No |
| Dupe Override | No |
| Is Public | Yes |
| Language Text | English |
| Keyword | Index Medicus |
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