title: Potential drug-drug interactions in medical intensive care unit of a tertiary care hospital in Pakistan.
abstract: Background Patients admitted to intensive care unit (ICU) present with severe and life-threatening illnesses. Most of them suffer from various comorbidities. They usually receive complex pharmacotherapy with large number of medicines which increase the risk of drug-drug interactions (DDIs). Objective The present report aimed to investigate prevalence and levels of potential DDIs (pDDIs) in medical ICU. Methods Medications profiles of 416 patients were checked for pDDIs using Micromedex Drug-Reax(®). Prevalence, levels of severity and levels of documentation were reported. Results Of total 416 patients, 310 were exposed to pDDIs (overall prevalence = 74.5 %). Likewise, a prevalence rate of 13.9 % was recorded for contraindicated pDDIs, 52.2 % for major pDDI and 58.4 % for moderate pDDI. This study reported 740 interacting drug pairs that were presented in total 1686 pDDIs. Of 1686 pDDIs, 4.3 % were of contraindicated severity, 33.8 % of major severity and 49.6 % of moderate severity, whereas 45.5 % were of fair scientific evidence and 41.4 % of good scientific evidence. Conclusion In this study, pDDIs were found highly prevalent in ICU patients at a rate of 74.5 %. Most of the pDDIs had moderate severity; however, substantial number of interactions (38.1 %) had major and contraindicated severity.
authors.affiliation: Department of Pharmacy, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan. ismailrph@upesh.edu.pk.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ismail
authors.affiliation: Department of Pharmacy, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Farmanullah
authors.initials: F
authors.lastname: Khan
authors.affiliation: Department of Pharmacy, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Sidra
authors.initials: S
authors.lastname: Noor
authors.affiliation: Medical Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
authors.forename: Iqbal
authors.initials: I
authors.lastname: Haider
authors.affiliation: Department of Pharmacy, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Inam-Ul
authors.initials: IU
authors.lastname: Haq
authors.affiliation: Department of Pharmacy, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Zahid
authors.initials: Z
authors.lastname: Ali
authors.affiliation: Department of Pharmacy, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Zahir
authors.initials: Z
authors.lastname: Shah
authors.affiliation: Department of Pharmacy, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Mohsin
authors.initials: M
authors.lastname: Hassam
mesh_terms: D004347:Drug Interactions / Q000502:physiology; D016903:Drug Monitoring / Q000639:trends*; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000639:trends*
keywords: Adverse drug event; Clinical pharmacy; Drug interaction; Drug-related problem; Intensive care unit; Pakistan-Potential drug–drug interaction