Intensive care unit, Monitoring and assessment, Potential drug–drug interaction
Citation Information :
Wagh BR, Godbole DD, Deshmukh SS, Deshpande PR. Identification and Assessment of Potential Drug–Drug Interactions in Intensive Care Unit Patients. Indian J Crit Care Med 2019; 23 (4):170-174.
Context: Intensive care unit (ICU) patients suffer from various comorbidities and usually receive complex pharmacotherapy which increases the risk of drug–drug interactions (DDIs).
Aim: To identify and assess potential DDIs (pDDIs) in ICU patients.
Settings and design: A prospective observational study conducted in ICU of a tertiary care hospital for a period of 6 months.
Materials and methods: Patient information was noted in the data collection form and pDDIs were assessed using Micromedex® database.
Statistical analysis used: Chi-square test was used to find correlation of pDDIs with patient parameters. p value was calculated keeping the significance level 0.05.
Results: Total 400 subjects were included; having an average age of 55.99 ± 15.62 years with a higher percentage of males (61.75%). About 305 (76.25%) patients were found with pDDIs, showing an average of 2.93 pDDIs/patient. The findings of this study were as follows: Total interactions = 1171, contraindicated = 6 (1%), major = 715 (61%), moderate = 428 (36%), and minor = 22 (2%) pDDIs. Further, majority of pDDIs had onset of action “not specified”; documentation “fair” and probable mechanism “pharmacodynamic” in nature. Significant association of occurrence of pDDIs was found with number of drugs prescribed to patients in ICU.
Conclusion: This study demonstrated a high prevalence of pDDI in ICU due to the complexity of pharmacotherapy which showed major pDDIs as the most evident (61%) while contraindicated were 1%. Further studies are needed to better explore this area which may help in realizing the goal of good clinical practice and may offer a methodology to further increase drug safety.
Rodrigues A, Stahlschmidt R, et al. Prevalence of potential drug-drug interactions in the intensive care unit of a Brazilian teaching hospital. Braz J Pharm Sci 2017;53(1):1–8.
Lima R, Cassiani S. Potential drug interactions in intensive care patients at a teaching hospital. Rev Lat Am Enfermagem 2009;17(2):222–227.
Gupta M, Chincholkar A, et al. A study of potential drug-drug interactions among critically ill patients at a tertiary care hospital. Int J Basic Clin Pharmacol 2016;5(4):1281–1285.
IBM. (2018). Micromedex®. [online] Available from https://www. micromedexsolutions.com/home/dispatch/ssl/true [Last accessed April, 2019].
Math Is Fun. (2016). Chi square calculator. [online] Available from https://www.mathsisfun.com/data/index.html [Last accessed April, 2019].
Raosoft. (2004). Sample size calculator. [online] Available from http:// www.raosoft.com/samplesize.html [Last accessed April, 2019].
Siddiqui M, Roshini A, et al. Assessment of the prevalence of drugdrug interactions in the medical intensive care unit of a tertiary care teaching hospital in India. Ijppr. Human 2015;4(3):102–112.
Abideen S, Vivekanandan K, et al. Assessment of prevalence of potential drug- drug interactions in medical intensive care unit of a tertiary care hospital in India. Asian J Pharm Clin Res 2015;8(1):125–130.
Hamidy M, Fauzia D. Significant drug interactions among intensive care unit patients. Asian J Pharm Clin Res 2017;10(14):35–38.
Reis A, Cassiani S. Prevalence of potential drug interactions in patients in an intensive care unit of a university hospital in Brazil. Clinics 2011;66(1):9–15.
Rodrigues A, Stahlschmidt R, et al. Clinical relevancy and risks of potential drug–drug interactions in intensive therapy. Saudi Pharm J 2015;23(4):366–370.
Tâmara Natasha Gonzaga De Andrade, et al. Pharmaceutical intervention assessment in the identification and management of drug interactions in an intensive care unit. J Appl Pharm Sci. 2015;5(1):13–18.
Alvim MM, Silva LA, et al. Adverse events caused by potential drugdrug interactions in an intensive care unit. Rev Bras TerIntensiva 2015;27(4):353–359.
Oðlu M, Oðlu E, et al. Potential drug–drug interactions in a medical intensive care unit of a university hospital. Turk J Med Sci 2016; 46: 812–819.
Rafiei H, Arab M, et al. The prevalence of potential drug interactions in Intensive Care Units. IJCCN 2012;4(4):191–196.
Almeida S, Gama C, et al. Prevalence and classification of drug-drug interactions in intensive care patients. Einstein 2007; 5(4):347–351.