Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Frequency, Levels and Predictors of Potential Drug-Drug Interactions in a Pediatrics Ward of a Teaching Hospital in Pakistan

Mohammad Ismail¹, Zafar Iqbal¹ , Muhammad I Khan², Arshad Javaid³, Hassan Arsalan⁴, Farhadullah ⁴, Faramoz Khan⁵, Amir Z Khan¹, Fazli Nasir¹, Jamshaid A Khan¹

¹Department of Pharmacy, University of Peshawar, Peshawar; ²Ayub Medical College, Abbottabad, Khyber Pakhtunkhwa; ³Post Graduate Medical Institute, Lady Reading Hospital (LRH), Peshawar; ⁴Department of Pharmacy, Sarhad University of Science & Information Technology, Peshawar; ⁵Medical-B Unit, Khyber Teaching Hospital, Peshawar, Pakistan.

For correspondence:- Zafar Iqbal Email: zafariqbal@upesh.edu.pk Tel:+92919216750

Received: 13 August 2012 Accepted: 16 April 2013 Published: 12 June 2013

Citation: Ismail M, Iqbal Z, Khan MI, Javaid A, Arsalan H, F, et al. Frequency, Levels and Predictors of Potential Drug-Drug Interactions in a Pediatrics Ward of a Teaching Hospital in Pakistan. Trop J Pharm Res 2013; 12(3):401-406 doi: 10.4314/tjpr.v12i3.19

© 2013 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To identify the frequency, levels and predictors of potential drug-drug interactions (pDDIs) in a pediatrics ward of a teaching hospital in Pakistan.

Methods: Medication profiles of 400 pediatric patients were evaluated for pDDIs using Micromedex Drug-Reax® software. Logistic regression was used to identify association of pDDIs with hospital-stay, patient’s gender, and number of medications.

Results: In total, 86 interacting drug-combinations resulting in 260 pDDIs were identified. Overall, 25.8 % patients were exposed to at least one pDDI regardless of severity-type, 10.7 % to at least one major-pDDI, 15.2 % to at least one moderate-pDDI, and 12.5 % to at least one minor-pDDI. Of 260 pDDIs, most were of moderate severity (41.5 %) followed by minor (35.4 %) and major severity (21.9 %); good (76.9 %) or fair (16.5 %) type of scientific evidence; and delayed onset (46.5 %). Some widespread major or moderate interactions included rifampin + pyrazinamide (14 cases), phenobarbital + diazepam (14), dexamethasone + rifampin (8), amikacin + furosemide (7), furosemide + captopril (7), dexamethasone + phenobarbital (6), phenobarbital + divalproex sodium (6), isoniazid + rifampin (5) amikacin + ibuprofen (5), digoxin + furosemide (4), and acetaminophen + phenytoin sodium (4). There was significant association of the occurrence of pDDIs with five or more prescribed medications (p < 0.001).

Conclusion: PDDIs are less prevalent in the pediatrics ward of the hospital studied. Most of the interactions were of moderate severity. Patients with increased number of prescribed medications were more exposed to these interactions.

Keywords: Drug-drug interactions, Prescription screening, Drug related problems