جستجوی مقالات مرتبط با کلیدواژه « drug interactions » در نشریات گروه « پزشکی »

Patients with cardiovascular disorders (CVD) are at higher risk for potential drug-drug interactions (pDDIs) due to complex treatment regimens. This study aimed to evaluate pDDI patterns in physicians’ prescriptions in a specialized heart center using simple software.

This cross-sectional study identified severe and related interactions during a 2-stage survey of experts. The data collected included age, sex, the date of admission and discharge, the length of hospital stay, drug names, inpatient wards, and the final diagnosis. The extracted drug interactions were used as a source of software knowledge. The software was designed using the SQL Server and the C # programming language.

Of 24 875 patients included in the study, 14 695 (59.1%) were male. The average age was 62 years. Based on the survey of experts, only 57 pairs of severe pDDIs were identified. The designed software evaluated 185 516 prescriptions. The incidence of pDDIs was 10.5%. The average number of prescriptions per patient was 7.5. The highest frequency of pDDIs was detected in patients with diseases of the lymphatic system (15.0%). Aspirin with heparin (14.3%) and heparin with clopidogrel (11.7%) were the most common documented pDDIs.

This study reports the prevalence of pDDIs in a cardiac center. Patients with lymphatic system disorders, male patients, and older patients were at higher risk of pDDIs. This study shows that pDDIs are common among CVD patients and highlights the need to use computer software to screen patients’ prescriptions to assist in detection and prevention.

Hospitalized infants and children are usually treated with many medications in the hospital. Concurrent use of multiple drugs, known as polypharmacy, is inevitable in critically ill patients. This study aims to investigate the possible interactions as well as their type and number, and their effect on the treatment process plus the duration of hospital stay of patients. 

 In this descriptive study, the medical records of 189 patients admitted to the ICU ward of Mofid Children's Educational Hospital in Tehran were prospectively studied over six months. The collected data included disease diagnosis, patient medication information, age and gender, and treatment interventions. Interactions between drugs were identified using Up-to-date database, with the results analyzed by SPSS software. 

The results revealed that hospitalization increased with an increasing number of drugs. The findings also indicated a direct relationship between the number of drug interactions and the duration of hospital stay. After examining the relationship between intensive care unit (ICU) outcome and the number of drug items as well as the number of drug interactions, it was found that there is a direct relationship between the two. There was also a direct relationship between Class D plus X interactions and mortality rate along with duration of stay. 

This study showed a direct relationship between drug interactions and the duration of hospitalization. In other words, as drug interactions increased, so did the duration of hospital stay.

During the first wave of the COVID-19 pandemic, severe patients were treated with the off-label drugs hydroxychloroquine and lopinavir/ritonavir. The aim of the study was to determine the prevalence of potential drug-drug interactions (DDIs) between hydroxychloroquine, lopinavir/ritonavir and concomitant medications used by hospitalized patients treated for COVID-19 in Costa Rica.

We included all patients that received lopinavir/ritonavir or hydroxychloroquine as treatment for COVID-19. Clinical pharmacists reviewed the prescription profile of each patient and determined the probability and severity of any DDI through two databases (The Lexi-Interact program) and the Micromedex online interaction checker. A logistic regression model was used to identify variables associated with the occurrence of potential DDIs.

We identified a total of 108 potential DDIs in 34 inpatients (n=34). At least one of these DDIs occurred in 27 patients (79.4%; 95% CI: 65.8-92.9%). A total of 70 DDIs (64.8%) were classified as clinically relevant (grade D or X) by the clinical pharmacists. Only the number of concomitant drugs was associated with the occurrence of a probable DDI. The most common drugs associated with any DDI were fentanyl (n=12, 11.1%), midazolam (n=11, 10.2%), and insulin (n=10, 10.2%).

A large proportion of patients treated with hydroxychloroquine and lopinavir/ritonavir for severe COVID-19 were at risk for clinical meaningful DDIs.

The objective of this study was to record and analyze the adverse drug reactions (ADRs) due to psychotropic drugs and the potential drug-drug interactions (pDDIs) amongst different psychotropic drugs as well as pDDIs between psychotropic drugs and other co-prescribed drugs by using Medscape software (online).

A cross sectional study was carried out in patients visiting the Psychiatric Outpatient Department of a Tertiary Care Teaching Hospital. Total 500 prescriptions were analysed for the ADRs and pDDIs.

Total 37 ADRs were observed in 32 (6.4%) patients. Antipsychotics was the most common group and olanzapine was the most common psychotropic drug suspected of causing ADRs. Tremors was the most common ADR observed. All of the ADRs were nonserious and were in a “Recovering” state when the data was collected. Total 1051 pDDIs were observed in all the 500 prescriptions surveyed, out of which 361 prescriptions were showing at least one pDDI.

The overall incidence of ADRs was not very high (6.4%), which reiterates the judicious use of the drugs in the study setting. Majority of prescriptions had only 1-2 pDDIs per prescription.

The occurrence of drug–drug interactions (DDIs) and insufficient attention to medication reconciliation is one of the important challenges of pharmacotherapy in hospitalized patients. The aim of this study was to determine the extent of drug–drug interactions in patients based on medication reconciliation strategy.

This descriptive cross-sectional study was performed for six months in patients admitted to Imam Reza Hospital in Amol, North of Iran. The data were obtained by using a medication reconciliation tool through a random sampling of patients admitted in Hospital wards from May 2014 until October 2014. A total of 200 patients were enrolled in the study. All patients had a history of medication use before admission. The drug interactions have been checked according to Drug Interaction Facts between newly prescribed drug and medication patient using before admission. The number and frequency of data were summarized by SPSS21 statistical software.

Major and Moderate DDIs were found in 7.5% and 64% of prescriptions. The most frequent DDIs were seen in those who were taking psychiatric drugs (33%) and cardiovascular drugs (30%). Most DDIs occurred among women over 60 years of age. The most frequently occurring DDIs was pharmacokinetics interaction between clopidogrel and atorvastatin (n=9). Other frequent interactions were between ceftriaxone and heparin (n=8) and metoprolol and insulin (n=3).

This study showed a high rate of drug interactions and especially confirms the importance of medication reconciliation in providing a comprehensive drug history and exploring drug interactions.

Green tea (GT) is among the most common drinks in the world. There are some reports on interactions between GT and some drugs. This paper attempts to provide a comprehensive review of this subject. The data are collected by searching PubMed, Scopus, Web of science, and Embase. The keywords used as search terms are "camellia sinensis", "pharmacodynamics", "pharmacokinetic", "EGCG", and "drug interaction". We have found 24 eligible articles. Finally, the related papers are given in our review. GT is containing polyphenols that interfere with many drugs. The most important of these polyphenol compounds is epigallocatechin-3-gallate (EGCG), which most of the reported interactions are due to the presence of EGCG. Interaction of GT with different drugs occurs in the context of both pharmacodynamics and pharmacokinetics that includes drug absorption, metabolism, and renal excretion. The mechanisms of these interactions consist of increase in the concentration included several medications such as melatonin, midazolam, and amlodipine consuming after GT; these interactions can be toxic. Additionally, it has been reported that serum levels of several drugs such as nadolol, digoxin, amoxicillin, and clozapine are decreased and their efficacy are reduced when they simultaneously administer with GT. The serum concentration of rhodamin 123, quinidine, and doxorubicin have increased when these drugs were co-administered with GT. GT has pharmacodynamics interactions with a few drugs such as a hydrochlorothiazide. As proposed and discussed here, GT has the potential for interactions with numerous other drugs and thus clinicians should be aware of reported and potential interaction of GT with various medications in order to avoid adverse reactions and achieve expected clinical response.

Chemotherapy agents can cause ovarian dysfunction and eventually lead to infertility. This study investigated the effect of nasturtium officinale extract on the ovarian function following the toxicity induced by doxorubicin in female rats.

Forty eight female Wistar rats (180-210g) were randomly divided in six groups as follows: Group I, normal rats receiving 1ml normal saline; Group II and III receiving 25 and 75 mg/kg of the extract daily by gavage for 21 days. Groups IV, V and VI receiving 10 mg/kg doxorubicin intraperitoneally on the first day. In addition, Group IV and V received 25 and 75 mg/kg of the extract, respectively. The serum levels of estrogen, progesterone, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH) and ovarian Malondialdehyde (MDA) were determined after 21 days of treatment. The mean numbers of various graafian follicles and corpus lutea were recorded after treatment.

The mean serum FSH level in Group VI (0.11±0.01) significantly reduced compared to those in Groups II (0.21±0.05) and III (0.23±0.01), (P<0.05). The mean serum LH and estrogen levels in Group VI (0.16±0.08) reduced insignificantly compared to those in the controls (0.21±0.02), and in Groups II (0.23±0.03) and III (0.22±0.09). A significant reduction in the number of primary, secondary and graafian follicles were observed in Group VI compared to the control group (P<0.05). The serum MDA level significantly declined in Group V compared to that in Group VI (P<0.05).

The nasturtium officinale extract attenuated the toxic effect of doxorubicin on the rat ovaries and protected the cell division in the follicles and the oocytes maturation.

Number of patients undergoing kidney transplantation is ever increasing. Drug-drug interactions (DDIs) can complicate transplant patient’s treatment course.

To investigate patterns and factors associated with potential DDIs in kidney transplant recipients under maintenance immunosuppressive regimen at a referral transplantation center in Shiraz, Iran.

390 eligible kidney transplant outpatients referred to Motahhari clinic and one of the attending nephrologist’s private office during an18-month period were assessed for DDIs. Using the Lexi-Interact online drug interactions software, the prescribed drugs were assessed for the number and type of potential DDIs. Only type D and X interactions were considered eligible for inclusion.

During the study period, 344 DDIs were detected of which, 290 were type D; 54 were type XDDIs. 81% of the detected DDIs were pharmacokinetics. Interaction between cyclosporine + mycophenolic acid (32.3%) was the most frequent DDIs followed by cyclosporine + atorvastatin (11.3%). Immunosuppressant (43.44%) was the most frequently used medication responsible for DDIs. Number of co-administered medications (OR: 1.34, 95% CI: 1.12–1.51) and cyclosporine as main immunosuppressive main drug (OR: 10.43, 95% CI: 6.24–17.42) were identified as independent risk factors for DDIs.

Major DDIs were common in kidney transplant recipients. Considering the importance of DDIs in kidney transplant patients, more attention is warranted in this regard by health care members, especially physicians and pharmacists.

Allium Sativum L. is a plant with different nutritional and medicinal principles. Despite the valuable medicinal effects that have been reported for the garlic plant, but drug interactions with chemical drugs have been reported. Garlic interacts with antihypertensive drugs, Saquinavir, hypoglycemics, general anesthetics, and anticoagulants, so associated use of garlic with mentioned chemical drugs should be used with caution to prevent drug interactions and side effects.

Nitrovasodilators are used to treat many conditions including coronary artery disease, chronic congestive heart failure, and arterial hypertension. They induce smooth muscle relaxation by increasing intracellular cyclic Guanosine Monophosphate (cGMP) concentrations and activating K+ channels through the release of Nitric Oxide (NO). Thus, they could interact with the drugs preventing the breakdown or increasing the synthesis of cGMP and induce the accumulation of cGMP resulting in excessive vasodilation and severe hypotension. Pharmacologically relevant drug interactions of Nitrovasodilators are discussed in this review. Coadministration of Nitrovasodilators and the drugs preventing the breakdown of cGMP like Phosphodiesterase 5 (PDE5) inhibitors or the drugs increasing the synthesis of cGMP like Riociguat could induce the accumulation of cGMP resulting in excessive vasodilation and severe hypotension. The prescribers and pharmacists are required to be aware of the drugs interacting with Nitrates to predict and prevent the adverse drug interactions.

Drug-drug interaction (DDI) is a complication that results from the combined use of two or more drugs. DDIs can create problems and increase drug toxicity. In some DDIs, a drug can reduce the effectiveness of other drugs. The treatment regimen of hematologic malignancies includes various medicines. Patients may have another disease and receive other medicines in their treatment regimen, resulting in an elevation of DDI rate. This study was aimed to study the rate, pattern, and probable risk factors for moderate and major interactions. Subjects and

In this cross-sectional study, data including type of administrated drugs, type of malignancies, and patients’ demographic data were obtained from medical records of patients referred to Tohid Hospital, Sanandaj, Iran, between 2011 and 2015. Major or moderate interactions were considered eligible for further analysis and minor interactions were excluded. DDIs were identified by Lexicomp software and Drug Interaction Facts book. Data analysis was carried out by descriptive statistics.

A total of 441 DDIs (moderate to major) were identified in 76 patients. DDIs in men were higher compared to women. In addition, most of the interactions in terms of intensity were moderate (62% of total interactions) and in terms of mechanism were pharmacodynamic (60% of total interactions). Interaction between acetaminophen and granisetron had the highest frequency. Among cancer drugs, cyclophosphamide (7% of total interactions) and among non-cancer drugs, granisetron (10% of total interactions) had the highest frequencies.

Moderate or major DDIs occurred frequently in patients with blood cancer or related diseases. Most of the found DDIs were categorized as moderate with regard to severity. DDIs identification by the treatment team and replacement of treatment regimen will impose fewer complications on patients and increase patients’ survival.

This study aim to evaluate and compare type and prevalence of drug‑drug interactions (DDIs) in prescriptions dispensed in both community and hospital setting in Zabol, Iran.

A total of 2796 prescriptions were collected from community and inpatient and outpatient pharmacy of Amir‑al‑momenin only current acting hospital in Zabol, Iran. The prescriptions were processed using Lexi‑Comp drug interaction software. The identified DDIs were categorized into five classes (A, B, C, D, X).

Overall 41.6% of prescriptions had at last one potential DDI. The most common type of interactions was type C (66%). The percentage of drug interactions in community pharmacies were significantly lower than hospital pharmacies (P < 0.0001).

Our results indicate that patients in Zabol are at high risk of adverse drug reactions caused by medications due to potential DDIs. Appropriate education for physicians about potentially harmful DDIs, as well as active participation of pharmacists in detection and prevention of drug‑related injuries, could considerably prevent the consequence of DDIs among patients.

Opiates are the second most prevalent abused illicit sub stance after cannabis in the world. The latest United Nations Office on Drugs and Crime (UNODC) report estimated 30% increment in opium cultivation worldwide. High prevalence of opium consumption in eastern countries may be due to the high availability and traditional misconceptions. Opium consumption has been linked to hypertension, diabetes mellitus, dyslipidemia, and coronary artery diseases (CAD). In this review, we will review the association between opium use, cardiovascular diseases, and clinical outcomes. The present evidence suggests that chronic opiate consumption may increase the risk of cardiovascular diseases and related mortality.

The primary cytotoxic effects of anticancer drugs like idarubicin, a chemotherapeutic agent, are not limited to neoplastic cells; they also produce similar effects in normal cells. In this study, we hypothesized that the combination of idarubicin-bromelain could make cancer cells more susceptible to cytotoxicity and genotoxicity. To test our hypothesis, the optimal concentrations of idarubicin and bromelain were combined and incubated in the HL-60 cancer cell line and normal human mononuclear leukocytes (PBMC) for 24, 48, and 72 hr. Cytotoxicity and genotoxicity were evaluated by measurement of ATP cell viability test, DNA damage, Caspase-3, Acridine orange/ethidium bromide (AO/EB), and DAPI fluorescent dyes in both cell types. The combination of idarubicin-bromelain significantly reduced cell proliferation in the more potent HL-60 compared to PBMC in all incubation times (P<0.05). DNA damage and Caspase-3 levels (except for 24 hr) were also higher in the HL-60 cell line in comparison with PBMC and were statistically significant (P<0.05). The percentages of apoptotic images obtained by DAPI and AO / EB morphological examination were increased in both cells, depending on the combination dose. Based on these results, it can be concluded that idarubicin combined with bromelain produces more cytotoxic effects in low concentrations in comparison with when it was used per se in the HL-60 cells. Conversely, it was found that this combination in PBMC caused less cytotoxicity and less genotoxicity. Taken together, it can be said that this new combination makes cancer cells more sensitive to conventional therapy.