drug interactions

Assessment of drug interaction in patients with rheumatoid arthritis” evaluates drug interactions in rheumatoid arthritis patients, focusing on those receiving anti-rheumatic drugs. RA, a chronic autoimmune disorder causing joint and other body parts inflammation, managed with DMARDs, NSAIDs, glucocorticoids, and biologics, with methotrexate being a key treatment component. The study was conducted at the Department of General Medicine, Govt. Medical College Hospital Kozhikode, over four months, enrolling 119 patients who met specific inclusion criteria. The results revealed that drug interactions (DIs) are common among RA patients, particularly those receiving methotrexate. Moderate drug interactions were noted between methotrexate and Leflunomide, Tofacitinib, and sulfasalazine, while minor interactions were observed with Hydroxychloroquine. The study also highlighted frequent interactions between methotrexate and NSAIDs, with meloxicam, Etoricoxib, and Etodolac being the most common interacting drugs. Additionally, interactions between methotrexate and gastro protective agents like pantoprazole and omeprazole were noted. Interactions between methylprednisolone and NSAIDs, as well as between Hydroxychloroquine and hypoglycemic agents, were also identified. Demographically, most patients with drug interactions were in the age group of 40-49 years. Gender-wise, drug interactions were more prevalent among female patients (39.49%). Awareness about drug interactions varied, with middle age groups showed higher levels of awareness. However, a significant portion of the patient population remained unaware of potential drug interactions. To minimize drug interaction, this study suggests possible methods including adjustment of medication timing, prevention of moderate drug interaction by prescribing alternate medications within the same category and prescription auditing with the assistance of pharmacy profession.

In India the clinical pharmacy services are yet at the infancy stage, very few private hospitals were adopted this system while these services are totally scarce in government hospitals. The aim of the study was to demonstrate the role and importance of clinical pharmacist and to assess the clinical pharmacy services provided. A Prospective analysis of the documented clinical pharmacy services performed by Pharm D interns were assessed for a period of 6 months. A total of 334 past medication history interviews, 333 patient counseling, 325 prescription auditing, 302 drug interactions, 55 medication errors and 23 Drug information queries were provided. Among 272 drug-drug interactions, 60.66% moderate drug-drug interactions and a least of 8.08% major drug-drug interactions and most common management plan recommended was dose adjust­ments (23.52%). Majority of the patients were counseled regarding the name and purpose of the prescribed medicines (96.39 %) and 34.83% reported barriers during their counseling. Among Past medication history interviews, 32.63% of patients had a history of medication intake. 59.38% of prescriptions were not prescribed drugs in their generic names. Maximum number of injections prescribed per prescription was three (20%), antibiotics per prescription were one (44.3%) and 91% of drugs were prescribed from the essential drug list. Of 55 prescribing errors reported majority of errors were belonging to category A (72.72%). It was found that 65.21% queries were to update the requestor’s knowledge and 52.71% used primary sources to respond the queries. The study stresses impeccable role of clinical pharmacist in patient’s care.

Although pharmacotherapy in cardiovascular diseases can improve the well being, its benefit can be compromised by drug-related problems (DRPs). The objectives of the present study were to examine the number and nature of drug related problems in patients with cardiovascular diseases and to demonstrate the role of pharmacist in ensuring safe and efficient use of medicines in daily practice in the inpatient settings. A prospective cross sectional study was carried out for 8 months in the general medicine department of a 640 bedded multi-specialty private corporate hospital. The nature, prevalence and incidence of DRPs were studied and documented using the PCNE (Pharmaceutical Care Network Europe Foundation) classification system. A total of 1051 drugs were prescribed during the study period. Most commonly prescribed categories of drugs were antihypertensive (21.05%), anticoagulants and antiplatelet drugs (11.13%), antiulcers (8.84%), insulin and oral hypoglycemic agents (6.95%) and anti infectives (5.42%). Drug interactions (46.19%), drug over dosage (17.26%) and drug duplication (11.17%) were the most frequently occurring DRPs. Most common clinical risk factors identified were polypharmacy (66.21%) and diabetes mellitus (20.31%). Antihypertensive presented the highest drug risk ratio. Statistical analysis showed positive correlation between age and number of DRPs in the study population. Pharmacist interventions were mostly on drug interactions, dosing and drug choice and 59% of them were accepted, resulting in prevention of DRP occurrence. The current study demonstrated the importance of routine medication review and the need of a pharmacist in a multidisciplinary team in treating cardiovascular diseases. Key words: Drug related problems; cardiovascular diseases; drug interactions; clinical risk factors