title: Prevalence and clinical significance of potential drug-drug interaction in hematopoietic stem cell transplantation.
abstract: Patients undergoing hematopoietic stem cell transplantation (HSCT) are at risk of developing potential drug-drug interactions (PDDIs). The aim of this study was to assess the prevalence of PDDIs that occur in HSCT patients on the day of hematopoietic stem cell infusion. We performed a cross-sectional study based on the evaluation of prescriptions to HSCT patients on the day of infusion (day 0). The PDDIs were analyzed using the DRUG-REAX(®) system and classified according to the severity level, available scientific evidence, time of onset, and potential clinical impact. Forty patients undergoing HSCT were included in this study; 33 patients (82.5%) were exposed to at least one major and one contraindicated PDDI in a concomitant manner. All patients exposed to PDDIs had an increased risk of cardiotoxicity. Most cases of PDDIs were classified as being of major severity (80.9%), with time of onset not specified (61.9%), and with good or excellent scientific evidence (52.4%). HSCT patients have a high prevalence of clinically significant PDDIs. The management of PDDIs requires an approach that includes biochemical tests, installation of cardiac monitors, periodic electrocardiograms, implementation of electronic prescriptions with a PDDI alert system, and availability of the PDDI databases.
authors.affiliation: Faculty of Nursing, University of Campinas, Rua: Tessália Vieira de Camargo, 126 Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-970, Brazil, ddtrevisan@gmail.com.
authors.forename: Danilo D
authors.initials: DD
authors.lastname: Trevisan
authors.forename: Juliana B
authors.initials: JB
authors.lastname: Silva
authors.forename: Henrique C
authors.initials: HC
authors.lastname: Oliveira
authors.forename: Silvia R
authors.initials: SR
authors.lastname: Secoli
authors.forename: Maria Helena M
authors.initials: MH
authors.lastname: Lima
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D019317:Evidence-Based Medicine; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D015995:Prevalence
chemical_list: D000970:Antineoplastic Agents