title: Occurrence of drug-drug interactions in Adama Referral Hospital, Adama city, Ethiopia.
abstract: OBJECTIVE
  Many medications have potential interactions with other drugs or substances when prescribed together. This study was intended to investigate the extent of poly-pharmacy, event of drug-drug interactions and associated ADRs in Adama Referral Hospital, Oromia regional State, Ethiopia to create awareness of potential drug interactions and for development of clinical strategies to prevent the occurrence of DDIs.
  
  
  METHODS
  A retrospective study was done at Adama Referral hospital, Adama city, Ethiopia during March-May 2014. Medscape online were used for DDIs and ADRs detection purposes.
  
  
  RESULTS
  The average number of drugs prescribed per person (encounter) in this study was found to be 2.6, showing the presence of poly-pharmacy prescribing practice based on WHO recommendations (1.4-2.4). With 788 medications prescribed, 267 DDIs were found in this study and 62 (20.7%) were categorized as serious DDIs, 95 (31.7%) as significant DDIs, and 110 (36.7%) as minor DDIs. DDIs occurrence was also categorized according to the mechanisms, Pharmacokinetic and pharmacodynamic interactions; the highest frequency of DDIs was observed in 85 (31.8%), attributable to metabolism interaction followed by Antagonistic effect in 51 (21.4%), and Synergistic/Additive effect in 44 (16.5%). It was observed that serious DDIs most often caused possible cardiovascular ADRs.
  
  
  CONCLUSIONS
  The results of the study showed the high number of drugs per person compared to the WHO-reported average number of drugs per person and occurrence of DDIs associated with severe cardiovascular risk ADRs in the Adama Referral Hospital. This study recommends that the drug information center facilities and drug prescription validation is done by the pharmacist and the development of pharmacotherapeutic guidelines supporting selection of drugs in Ethiopian hospitals for preventing DDIs and ADRs.
authors.affiliation: Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
authors.forename: Thirumurugan
authors.initials: T
authors.lastname: Gunasekaran
authors.affiliation: Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
authors.forename: Natsanet
authors.initials: N
authors.lastname: Dejene
authors.affiliation: Research Lab, GIET School of Pharmacy, Chaitanya Nagar, Rajahmundry, AP, India.
authors.forename: Vanapalli V
authors.initials: VV
authors.lastname: Satyaveni
authors.affiliation: Research Lab, GIET School of Pharmacy, Chaitanya Nagar, Rajahmundry, AP, India.
authors.forename: Magharla Dasaratha
authors.initials: MD
authors.lastname: Dhanaraju
keywords: Adama referral hospital; Adverse drug reaction; Drug; Ethiopia; Polypharmacy; drug interaction