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CC BY-NC-ND 4.0 · Avicenna J Med 2015; 05(02): 29-35
DOI: 10.4103/2231-0770.154194
ORIGINAL ARTICLE

Assessment of drug-drug interactions in hypertensive patients at a superspeciality hospital

Divya Sivva
Department of Pharmacy Practice, St. Peter′s Institute of Pharmaceutical Sciences, Kakatiya University, Hanamkonda, Warangal, Andhra Pradesh, India
,
Uday Venkat Mateti
Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, Karnataka, India
,
Venu Madhav Neerati
Pharmaceutical Analysis, St. Peter′s Institute of Pharmaceutical Sciences, Kakatiya University, Hanamkonda, Warangal, Andhra Pradesh, India
,
Nimbagiri Swamy Thiruthopu
Department of Pharmacy Practice, St. Peter′s Institute of Pharmaceutical Sciences, Kakatiya University, Hanamkonda, Warangal, Andhra Pradesh, India
,
Srinivas Martha
Department of Pharmacology, Balaji Institute of Pharmacy, Laknepally, Narsampet, Warangal, Telangana, India
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Abstract

Objective: The objective of the study was to assess the incidence and pattern of drug-drug interactions (DDIs) in hypertensive patients by using Micromedex and Medscape databases. Materials and Methods: A prospective observational study was carried out in a superspeciality hospital setting in South India for period of 9 months. Hypertensive patients who admitted into the hospital with the age more than 18 years, received more than 3 drugs per prescription and length of hospital stay for more than 24 hours were included in the study. An appropriate data was collected and assessed for DDIs with the help of Micromedex and Medscape databases. Results: A total of 227 patients were enrolled during the study period. Among the 227 patients, 48 of them developed 53 clinically significant DDIs. Out of 48 patients, most of them were in the age-group of 50-60 years [18 (37.49%)]. The percentage of DDIs were higher in males [30 (62.5%)] compared to females [18 (37.5%)]. The most common drugs responsible for DDIs in the present study were Insulin [18 (33.96%)] followed by Metoprolol [10 (18.86%)], Torsemide [8 (15.09%)], and Hydrochlorothiazide [8 (15.09%)]. The most commonly interacting pairs were Ciprofloxacin-Insulin [6 (11.32%)], followed by Metoprolol-Insulin [4 (7.54%)] and Atenolol-Insulin [4 (7.54%)]. The most common consequences of interacting pairs were reduced serum potassium levels and hyperglycemia. Conclusion: The overall incidence rate of DDIs was found to be 21.14% and the increasing number of co-morbidities ( P ≤ 0.003) and polypharmacy ( P ≤ 0.002) were the risk factor for the development of significant number of DDIs.

Keywords

Drug-drug interactions - hypertension - incidence - micromedex - medscape


Publication History

Article published online:
09 August 2021

© 2015. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Morales-Olivas FJ, Estañ L. Antihypertensive drug-drug interactions. Med Clin 2005;124:782-9.
  • 2 Gupta R. Burden of coronary heart disease in India. Indian Heart J 2005;57:632-8.
  • 3 Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens 2004;18:73-8.
  • 4 Jankel C, Fitterman LK. Epidemiology of drug-drug interactions as a cause of hospital admissions. Drug Saf 1993;9:51-9.
  • 5 Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, et al. Adverse drug reactions as a cause of admission to hospital: Prospective analysis of 18 820 patients. BMJ 2004;329:15-9.
  • 6 Patel VK, Acharya LD, Rajakannan T, Surulivelrajan M, Guddattu V, Padmakumar R. Potential drug interactions in patients admitted to cardiology wards of a South Indian teaching hospital. Australas Med J 2011;4:9-14.
  • 7 World Health Organization ATC/DDD Index 2012. WHO collaborating centre for drug statistics methodology. Available from: http://en.wikipedia.org/wiki/Anatomical_Therapeutic_Chemical_Classification_System. [Last accessed on 2012 July].
  • 8 World Health Organization ATCvet Index 2012. WHO collaborating centre for drug statistics methodology. Available from: http://en.wikipedia.org/wiki/Anatomical_Therapeutic_Chemical_Classification_System. [Last accessed on 2012 Aug].
  • 9 Chauhan N, Moin S, Pandey A, Mittal A, Bajaj U. Indian aspects of drug information resources and impact of drug information centre on community. J Adv Pharm Technol Res 2013;4:84-93.
  • 10 DRUGDEX® System [database on CD-ROM]. Version 5.1. Greenwood Village, Colorado: Thomson Reuters (Healthcare).
  • 11 WebMD LLC Copyright© in 1994-2012. Available from: http://reference.medscape.com/drug-interactionchecker [Last accessed on 2012 Mar].
  • 12 Arvind K, Umesh, Shobha M. Assessment of drug-drug interactions in hospitalised patients in India. Asian J Pharm Clin Res 2011;4:62-5.
  • 13 Dinesh K, Subish P, Pranaya M, Ravi Shankar P, Anil S, Durga B. Pattern of potential drug-drug interactions in diabetic out-patients in a tertiary care teaching hospital in Nepal. Med J Malaysia 2007;62:294-8.
  • 14 Roughead EE, Kalisch LM, Barratt JD, Gilbert AL. Prevalence of potentially hazardous drug interactions amongst Australian veterans. Br J Clin Pharmacol 2010;70:252-7.
  • 15 Mateti U, Rajakannan T, Nekkanti H, Rajesh V, Mallaysamy S. Drug-drug interactions in hospitalized cardiac patients. J Young Pharm 2011;3:329-33.
  • 16 Herrlinger C, Klotz U. Drug metabolism and drug interaction in the elderly. Best Pract Res Clin Gastroenterol 2001;15:897-918.
  • 17 Vonbach P, Dubied A, Krahenbuhl S, Beer JH. Prevalence of drug-drug interactions at hospital entry and during hospital stay of patients in internal medicine. Eur J Intern Med 2008;19:413-20.
  • 18 Aparasu R, Baer R, Aparasu A. Clinically important potential drug-drug interactions in outpatient settings. Res Social Adm Pharm 2007;3:426-37.