|
|
Research Article
Potential
Drug-Drug Interactions in Psychiatric Ward of a Tertiary
Care Hospital: Prevalence, Levels and Association with
Risk Factors
Mohammad Ismail1, Zafar
Iqbal1*, Muhammad Bilal Khattak2,
Arshad Javaid3, Muhammad Imran Khan4,
Tahir Mehmood Khan5 and Syed Muhammad Asim6
1
Department of Pharmacy, University of Peshawar,
Peshawar, 2Ayub Teaching Hospital (ATH),
Abbottabad,
3Post Graduate Medical Institute (PGMI),
Lady Reading Hospital (LRH), Peshawar, 4Ayub
Medical College, Abbottabad, KPK, Pakistan, 5College
of Clinical Pharmacy,
King Faisal University,
Al-Ahsa, Kingdom of Saudi Arabia, 6Department
of Statistics, University of Peshawar, Peshawar, KPK,
Pakistan
*For correspondence:
Email:
zafar_iqbal@upesh.edu.pk Tel:
+92-91-9216750; Fax: +92-91-9218131
Received: 12 July
2011
Revised accepted: 23 February 2012
Tropical
Journal of Pharmaceutical Research, April 2012;
11(2):
289-296
http://dx.doi.org/10.4314/tjpr.v11i2.17
Abstract
Purpose:
To
identify the prevalence of potential drug-drug
interactions (pDDIs) in a psychiatric ward, their levels
and association with risk factors.
Methods:
This study was conducted in the psychiatric ward of Ayub
Teaching Hospital, Abbottabad, Pakistan. Medical records
of 415 patients were retrospectively reviewed for pDDIs
using Micromedex Drug-Reax software. Logistic regression
was applied to determine association of pDDIs with age,
gender, hospital stay and number of drugs.
Results:
In
our study, we identified total number of 825 pDDIs of
126 types, with median number of 1 pDDIs per patient.
Overall 64.8 % of the patients had at least one pDDI;
27.2 % at least one major pDDI; and 58.5 % patients at
least one moderate pDDI. Among 825 identified pDDIs,
most were of moderate (75.6 %) or major (20.8 %)
severity, good (66.4 %) or fair (29 %) type of
scientific evidence; and delayed onset (71 %). The most
frequent major and moderate pDDIs included haloperidol +
procyclidine (127 cases), haloperidol + olanzapine (49),
haloperidol + promethazine (47), haloperidol +
fluphenazine (41), diazepam + divalproex sodium (40),
haloperidol + trihexyphenidyl (37), lorazepam +
divalproex sodium (34), fluphenazine + procyclidine (33)
and olanzapine + divalproex sodium (32). There was
significant association of occurrence of pDDIs with
hospital stay of 7 days or longer (p = 0.005) and taking
7 or more drugs (p < 0.001).
Conclusion:
A
high prevalence of pDDIs in the psychiatric ward was
recorded, a majority of which were of moderate severity.
Patients with long hospital stay and increased number of
drugs were more exposed to pDDIs.
Keywords:
Drug-drug interactions, Potential drug-drug interaction,
Prescriptions screening, Drug-related problems, Clinical
pharmacy. |
