Öz
Amaç: Polifarmasi, ilaç-ilaç etkileşimlerine bağlı yaşamı tehdit eden yan etkilere neden olabilmektedir. Çoklu ilaç kullanımını gerektiren
birçok ko-morbid hastalığı olduğu bilinen obez hastalarda polifarmasiye bağlı ilaç-ilaç etkileşimlerini gözlemlemek muhtemeldir. Bu
çalışmanın amacı, obez hastalarda olası ilaç-ilaç etkileşimlerinin sıklığını ve şiddetini belirlemektir.
Gereç ve Yöntemler: Bu kesitsel çalışmada, 1 Nisan 2016- 1 Temmuz 2017 tarihleri arasında üçüncü basamak bir hastanenin obezite
polikliniğine başvuran hastaların reçete verilerini analiz edildi. İlaç-ilaç etkileşimlerinin şiddeti, Lexi-comp® ilaç etkileşimi veri tabanı
kullanılarak yorumlandı. Hastaların demografik özellikleri [cinsiyet (erkek/kadın), yaş kategorileri (18-44, 45-64 ve ≥65 yaş),VKİ’leri
(30-34,9, 35-39,9 ve ≥40 kg/m2)], eşlik eden hastalıkları ve ilaç sayısına göre ilaç ilaç etkileşimi varlığının karşılaştırılması için ki-kare
testi uygulandı. p <0,05 değeri istatistiksel olarak anlamlı kabul edildi.
Bulgular: Değerlendirilen 476 hasta verisinde, toplam 781 ilaç reçete edildi. İki veya daha fazla ilaç reçete edilen 190 hasta arasında, 35
(%18,4) hastada bir veya daha fazla olası ilaç-ilaç etkileşimi vardı. 48 (%70,6) C, 12 (%17,6) B, 7 (%10,3) D ve 1 (%1,5) X risk kategorisi
ilaç-ilaç etkileşimi tespit edildi. En sık olası ilaç-ilaç etkileşimi metformin ve nonsteroidal antiinflamatuvar ilaçlar arasındaydı (%7,4).
Olası ilaç-ilaç etkileşimlerinin varlığı, reçete edilen ilaçların sayısı ile anlamlı düzeyde ilişkiliydi (p<0,001).
Sonuç: Obezite polikliniğindeki olası ilaç-ilaç etkileşimlerinin oranı nispeten düşüktü. Bununla birlikte, ilaç-ilaç etkileşimlerini en aza
indirmek için, hekimlerin obezite polikliniğinde sık reçete edilen ilaçlar arasındaki etkileşimlerin farkında olması ve ilaçların güvenli
kullanımı için hastaları izlemesi hayati önem taşımaktadır.
Anahtar Kelimeler
Proje Numarası
-
Kaynakça
- 1. Nusair MB, Al-Azzam SI, Arabyat RM, Amawi HA, Alzoubi KH, Rabah AA. The prevalence and severity of potential drug-drug interactions among adult polypharmacy patients at outpatient clinics in Jordan. Saudi Pharmaceutical Journal 2020; 28: 155–60.
- 2. İdrizoğlu MG, Küçükibrahimoğlu E, Karaalp A, Sarikaya O, Demirkapu M, Onat F, et al. Potential drug–drug interactions in a medical intensive care unit of a university hospital. Turk J Med Sci 2016; 46: 812-9.
- 3. Morales-RõÂos O, Jasso-GutieÂrrez L, Reyes-LoÂpez A, Garduño-Espinosa J, Muñoz-HernaÂndez O. Potential drugdrug interactions and their risk factors in pediatric patients admitted to the emergency department of a tertiary care hospital in Mexico. PLoS ONE 2018; 13(1): e0190882.
- 4. De Palencia Espinosa MAF, Carrasco MSD, Soler JLF, Merino GR, De la Rubia Nieto MA, Miro AE. Pharmacoepidemiological study of drug-drug interactions in onco-hematological pediatric patients. Int J Clin Pharm. 2014; 36:1160-1169.
- 5. Al-Ramahi R, Raddad AR, Rashed AO, Bsharat A, Abu- Ghazaleh D, Yasin E, Shehab O. Evaluation of potential drugdrug interactions among Palestinian hemodialysis patients. MC Nephrol. 2016;17:96.
- 6. Noor S, Ismail M, Ali Z. Potential drug-drug interactions among pneumonia patients: do these matter in clinical perspectives? BMC Pharmacol Toxicol. 2019;20(1):45.
- 7. Hanlon JT, Perera S, Newman AB, Thorpe JM, Donohue JM, Simonsick EM, Shorr RI, Bauer DC, Marcum ZA; Health ABC Study. Potential drug-drug and drug-disease interactions in well-functioning community-dwelling older adults. J Clin Pharm Ther. 2017;42(2):228-233.
- 8. Fadare JO, Ajayi AE, Adeoti AO, Desalu OO, Obimakinde AM, Agboola SM. Potential drug‑drug interactions among elderly patients on anti‑hypertensive medications in two tertiary healthcare facilities in Ekiti State, South‑West Nigeria. Sahel Med J. 2016;19:32-37.
- 9. Mistry M, Gor A, Ganguly B. Potential drug-drug interactions among prescribed drugs in paediatric outpatients department of a tertiary care teaching hospital. J Young Pharm. 2017;9(3): 371.
- 10. Moura C, Acurcio F, Belo N. Drug-drug interactions associated with length of stay and cost of hospitalization. Pharm Pharmaceut Sci. 2009; 12(3): 266-272.
- 11. Korucu FC, Senyigit E, Kostek O, Demircan NC, Bulent Erdogan B, Uzunoglu S, Cicin İ. A retrospective study on potential drug interactions: A single center experience. Journal of Oncological Sciences. 2018; 4: 80e84.
- 12. Goren Z, Demirkapu MJ, Acet GA, Cali S, Idrizoglu MG. Potential drug-drug interactions among prescriptions for elderly patients in primary health care. Turk J Med Sci. 2017; 47: 47-54.
- 13. Fermini B, Bell DC. On the perspective of an aging population and its potential impact on drug attrition and pre-clinical cardiovascular safety assessment. J Pharmacol Toxicol. Methods 2022;117:107184.
- 14. Al-Musawe L, Torre C, Guerreiro JP, Rodrigues AT, Raposo JF, Mota-Filipe H, Martins AP. Polypharmacy, potentially serious clinically relevant drug-drug interactions, and inappropriate medicines in elderly people with type 2 diabetes and their impact on quality of life. Pharmacol Res Perspect. 2020;8(4):e00621.
- 15. Abolhassani N, Castioni J, Marques-Vidal P, Vollenweider P, Waeber G. Determinants of change in polypharmacy status in Switzerland: the population based CoLaus study. Eur J Clin Pharmacol. 2017;73:1187-94.
- 16. UpToDate, Inc. Lexi-Interact Online. https://www.uptodate. com/drug-interactions/#di-druglist, 2020.
- 17. Carpenter M, Berry H, Pelletier AL. Clinically relevant drug-drug interactions in primary care. Am Fam Physician. 2019;99(9):558-564.
- 18. Oshikoya KA, Oreagba IA, Godman B, Oguntayo FS, Fadare J, Orubu S, Massele A, Senbanjo IO. Potential drug-drug interactions in paediatric outpatient prescriptions in Nigeria and implications for the future. Expert Rev Clin Pharmacol. 2016;9(11):1505-1515.
- 19. Shetty V, Chowta MN, Chowta K N, Shenoy A, Kamath A, Kamath P. Evaluation of potential drug-drug interactions with medications prescribed to geriatric patients in a tertiary care hospital. J Aging Res. 2018;2018:5728957.
- 20. Onyedikachi EA, Ogochukwu AM, Chinwendu AK. Evaluation of drug-drug interactions among chronic kidney disease patients of nephrology unit in the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State. J Basic Clin Pharma. 2017; 8: S049-S053.
- 21. Adibe MO, Ewelum PC, Amorha KC. Evaluation of drug-drug interactions among patients with chronic kidney disease in a South-Eastern Nigeria tertiary hospital: A retrospective study. Pan Afr Med J. 2017;28:199.
- 22. Marquito AB, da Silva Fernandes NM, Colugnati FAB, de Paula RB. Identifying potential drug interactions in chronic kidney disease patients. J Bras Nefrol. 2014; 36(1): 26-34.
- 23. de Araújo MF, dos Santos Alves Pde J, Veras VS, de Araújo TM, Zanetti ML, Damasceno MM. Drug interactions in Brazilian type 2 diabetes patients. Int J Nurs Pract. 2013;19(4):423-430.
- 24. Mibielli P, Rozenfeld S, Matos GC, Acurcio Fde A. Interações medicamentosas potenciais entre idosos em uso dos antihipertensivos da Relação Nacional de Medicamentos Essenciais do Ministério da Saúde do Brasil [Potential drugdrug interactions among elderly using antihypertensives from the Brazilian List of Essential Medicines]. Cad Saude Publica. 2014;30(9):1947-56.
- 25. Doubova Dubova SV, Reyes-Morales H, Torres-Arreola Ldel P, Suárez-Ortega M. Potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age in family medicine clinics in Mexico City. BMC Health Serv Res. 2007;7:147.
- 26. Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230.
- 27. Olsen RM, Sletvold H. Potential drug-to-drug interactions: A cross sectional study among older patients discharged from hospital to home care. Saf Health. 2018; 4(1):8.
- 28. Johnell K, Klarin I. The relationship between number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register. Drug Saf. 2007;30(10):911-8.
- 29. Navaratinaraja TS, Kumanan T, Siraj S, Sreeharan N. Potential drug-drug interactions among hospitalised elderly patients in Northern Sri Lanka, a lower middle-income country: A retrospective analysis. Drugs Real World Outcomes. 2023;10(1):83-95.
Öz
Aim: Polypharmacy may cause life-threatening adverse effects due to drug-drug interactions (DDIs). It is possible to observe DDIs due
to polypharmacy in obese patients who is known to have many co-morbid diseases that necessitates multiple drug use. The aim of the
present study is to determine the frequency and severity of potential DDIs (pDDIs) in obese patients.
Material and Methods: This cross-sectional study analyzed the patient charts that admitted to obesity outpatient clinic of tertiary care
hospital from April 1, 2016 to July 1, 2017. The severity of DDIs was interpreted using the Lexi-comp® drug interaction database. A chisquare
test was performed for the comparison of the presence of DDIs based on patients’ demographic characteristics [gender (male/
female), age categories (18-44, 45-64 and ≥65 years) and BMI (30-34.9, 35-39.9 and ≥40 kg/m2)], co-morbid clinical conditions and
number of drugs. The comparisons were considered as statistically significant at p< 0.05.
Results: Out of 476 patient data evaluated, a total of 781 drugs were prescribed. Among 190 patients who were prescribed two or more
drugs, 35 (18.4%) patients had one or more pDDIs. We determined 48 (70.6%) C, 12 (17.6%) B, 7 (10.3%) D and 1 (1.5%) X risk category
interactions. The most common pDDIs were between metformin and nonsteroidal anti-inflammatory drugs (7.4%). The presence of
pDDIs was significantly associated with the number of prescribed drugs (p<0.001).
Conclusion: The pDDIs in obesity outpatient clinic were relatively low. Nevertheless, in order to minimize DDIs, it is vital for physicians
to be aware of the interactions between the frequently prescribed drugs in obesity outpatient clinic and monitor patients for the safe use
of drugs.
Anahtar Kelimeler
Destekleyen Kurum
Yok
Proje Numarası
-
Teşekkür
-
Kaynakça
- 1. Nusair MB, Al-Azzam SI, Arabyat RM, Amawi HA, Alzoubi KH, Rabah AA. The prevalence and severity of potential drug-drug interactions among adult polypharmacy patients at outpatient clinics in Jordan. Saudi Pharmaceutical Journal 2020; 28: 155–60.
- 2. İdrizoğlu MG, Küçükibrahimoğlu E, Karaalp A, Sarikaya O, Demirkapu M, Onat F, et al. Potential drug–drug interactions in a medical intensive care unit of a university hospital. Turk J Med Sci 2016; 46: 812-9.
- 3. Morales-RõÂos O, Jasso-GutieÂrrez L, Reyes-LoÂpez A, Garduño-Espinosa J, Muñoz-HernaÂndez O. Potential drugdrug interactions and their risk factors in pediatric patients admitted to the emergency department of a tertiary care hospital in Mexico. PLoS ONE 2018; 13(1): e0190882.
- 4. De Palencia Espinosa MAF, Carrasco MSD, Soler JLF, Merino GR, De la Rubia Nieto MA, Miro AE. Pharmacoepidemiological study of drug-drug interactions in onco-hematological pediatric patients. Int J Clin Pharm. 2014; 36:1160-1169.
- 5. Al-Ramahi R, Raddad AR, Rashed AO, Bsharat A, Abu- Ghazaleh D, Yasin E, Shehab O. Evaluation of potential drugdrug interactions among Palestinian hemodialysis patients. MC Nephrol. 2016;17:96.
- 6. Noor S, Ismail M, Ali Z. Potential drug-drug interactions among pneumonia patients: do these matter in clinical perspectives? BMC Pharmacol Toxicol. 2019;20(1):45.
- 7. Hanlon JT, Perera S, Newman AB, Thorpe JM, Donohue JM, Simonsick EM, Shorr RI, Bauer DC, Marcum ZA; Health ABC Study. Potential drug-drug and drug-disease interactions in well-functioning community-dwelling older adults. J Clin Pharm Ther. 2017;42(2):228-233.
- 8. Fadare JO, Ajayi AE, Adeoti AO, Desalu OO, Obimakinde AM, Agboola SM. Potential drug‑drug interactions among elderly patients on anti‑hypertensive medications in two tertiary healthcare facilities in Ekiti State, South‑West Nigeria. Sahel Med J. 2016;19:32-37.
- 9. Mistry M, Gor A, Ganguly B. Potential drug-drug interactions among prescribed drugs in paediatric outpatients department of a tertiary care teaching hospital. J Young Pharm. 2017;9(3): 371.
- 10. Moura C, Acurcio F, Belo N. Drug-drug interactions associated with length of stay and cost of hospitalization. Pharm Pharmaceut Sci. 2009; 12(3): 266-272.
- 11. Korucu FC, Senyigit E, Kostek O, Demircan NC, Bulent Erdogan B, Uzunoglu S, Cicin İ. A retrospective study on potential drug interactions: A single center experience. Journal of Oncological Sciences. 2018; 4: 80e84.
- 12. Goren Z, Demirkapu MJ, Acet GA, Cali S, Idrizoglu MG. Potential drug-drug interactions among prescriptions for elderly patients in primary health care. Turk J Med Sci. 2017; 47: 47-54.
- 13. Fermini B, Bell DC. On the perspective of an aging population and its potential impact on drug attrition and pre-clinical cardiovascular safety assessment. J Pharmacol Toxicol. Methods 2022;117:107184.
- 14. Al-Musawe L, Torre C, Guerreiro JP, Rodrigues AT, Raposo JF, Mota-Filipe H, Martins AP. Polypharmacy, potentially serious clinically relevant drug-drug interactions, and inappropriate medicines in elderly people with type 2 diabetes and their impact on quality of life. Pharmacol Res Perspect. 2020;8(4):e00621.
- 15. Abolhassani N, Castioni J, Marques-Vidal P, Vollenweider P, Waeber G. Determinants of change in polypharmacy status in Switzerland: the population based CoLaus study. Eur J Clin Pharmacol. 2017;73:1187-94.
- 16. UpToDate, Inc. Lexi-Interact Online. https://www.uptodate. com/drug-interactions/#di-druglist, 2020.
- 17. Carpenter M, Berry H, Pelletier AL. Clinically relevant drug-drug interactions in primary care. Am Fam Physician. 2019;99(9):558-564.
- 18. Oshikoya KA, Oreagba IA, Godman B, Oguntayo FS, Fadare J, Orubu S, Massele A, Senbanjo IO. Potential drug-drug interactions in paediatric outpatient prescriptions in Nigeria and implications for the future. Expert Rev Clin Pharmacol. 2016;9(11):1505-1515.
- 19. Shetty V, Chowta MN, Chowta K N, Shenoy A, Kamath A, Kamath P. Evaluation of potential drug-drug interactions with medications prescribed to geriatric patients in a tertiary care hospital. J Aging Res. 2018;2018:5728957.
- 20. Onyedikachi EA, Ogochukwu AM, Chinwendu AK. Evaluation of drug-drug interactions among chronic kidney disease patients of nephrology unit in the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State. J Basic Clin Pharma. 2017; 8: S049-S053.
- 21. Adibe MO, Ewelum PC, Amorha KC. Evaluation of drug-drug interactions among patients with chronic kidney disease in a South-Eastern Nigeria tertiary hospital: A retrospective study. Pan Afr Med J. 2017;28:199.
- 22. Marquito AB, da Silva Fernandes NM, Colugnati FAB, de Paula RB. Identifying potential drug interactions in chronic kidney disease patients. J Bras Nefrol. 2014; 36(1): 26-34.
- 23. de Araújo MF, dos Santos Alves Pde J, Veras VS, de Araújo TM, Zanetti ML, Damasceno MM. Drug interactions in Brazilian type 2 diabetes patients. Int J Nurs Pract. 2013;19(4):423-430.
- 24. Mibielli P, Rozenfeld S, Matos GC, Acurcio Fde A. Interações medicamentosas potenciais entre idosos em uso dos antihipertensivos da Relação Nacional de Medicamentos Essenciais do Ministério da Saúde do Brasil [Potential drugdrug interactions among elderly using antihypertensives from the Brazilian List of Essential Medicines]. Cad Saude Publica. 2014;30(9):1947-56.
- 25. Doubova Dubova SV, Reyes-Morales H, Torres-Arreola Ldel P, Suárez-Ortega M. Potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age in family medicine clinics in Mexico City. BMC Health Serv Res. 2007;7:147.
- 26. Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230.
- 27. Olsen RM, Sletvold H. Potential drug-to-drug interactions: A cross sectional study among older patients discharged from hospital to home care. Saf Health. 2018; 4(1):8.
- 28. Johnell K, Klarin I. The relationship between number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register. Drug Saf. 2007;30(10):911-8.
- 29. Navaratinaraja TS, Kumanan T, Siraj S, Sreeharan N. Potential drug-drug interactions among hospitalised elderly patients in Northern Sri Lanka, a lower middle-income country: A retrospective analysis. Drugs Real World Outcomes. 2023;10(1):83-95.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Proje Numarası | - |
| Yayımlanma Tarihi | 31 Ağustos 2023 |
| Kabul Tarihi | 6 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 7 Sayı: 2 |
Kaynak Göster
Zonguldak Bülent Ecevit Üniversitesi Obezite ve Diyabet Uygulama ve Araştırma Merkezi’nin bilimsel yayım organıdır.
Web: https://obdm.beun.edu.tr/ Twitter: https://twitter.com/obezite_diyabet Instagram: https://www.instagram.com/zbeuobezitediyabet/