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Potential Drug-Drug Interactions in Pediatric Patients of a Teaching Hospital In Northern Cyprus: A Retrospective Study

Year 2024, Volume: 44 Issue: 1, 9 - 17, 01.03.2024
https://doi.org/10.52794/hujpharm.1265185

Abstract

Hospitalized infants and children are exposed to various medications, leading to potential drug-drug interactions (pDDIs). A retrospective observational study was conducted in a Northern Cyprus tertiary hospital to determine the frequency, types, and associated factors of pDDIs in hospitalized pediatric patients. All charts of pediatric patients hospitalized between September 1st, 2017, and August 30, 2018, were reviewed. Medications used concomitantly during hospitalization were screened for pDDIs using three DDI databases; Lexicomp TM 3.0.2, drugs.com, and Medscape. Of the 332 patients examined, 230 (69.2%) patient files met the inclusion criteria. The prevalence rates of pDDIs were 27.8%, 24.8%, and 23%, according to Lexicomp, Drugs.com, and Medscape databases, respectively. Young children (aged 2-6) had the highest percentage of pDDIs with a significant difference between databases (P < 0.05).Patients with pDDIs had longer hospital stays and were on more medications than those without (P < 0.05). Our study revealed that moderate severity pDDIs were common, and there were significant variations between databases. While severe pDDIs are rare, they may be life threatening. Collaborative efforts involving pediatricians and clinical pharmacists are necessary to address pDDIs in pediatric medication management. Utilizing multiple databases to enhance pDDI identification and prevention is also crucial.

References

  • 1. Ansari J. Drug interaction and pharmacist. J Young Pharm. 2010;2(3):326-31. https://doi.org/10.4103/0975-1483.66807
  • 2. Wilson JT. An update on the therapeutic orphan. Pediatrics. 1999;104(3 Pt 2):585-90.
  • 3. Pirmohamed M. Drug-drug interactions and adverse drug reactions: separating the wheat from the chaff. Wien Klin Wochenschr. 2010;122(3-4):62-4. https://doi.org/10.1007/s00508-010-1309-1
  • 4. Feudtner C, Dai D, Hexem KR, Luan X, Metjian TA. Prevalence of polypharmacy exposure among hospitalized children in the United States. Arch Pediatr Adolesc Med. 2012;166(1):9-16. https://doi.org/10.1001/archpediatrics.2011.161
  • 5. Langerová P, Prokes M, Konvalinka M, Furstová J, Urbánek K. Incidence of potential drug interactions in medication prescriptions for children and adolescents in the University Hospital Olomouc, Czech Republic. Eur J Pediatr. 2013;172(5):631-8. https://doi.org/10.1007/s00431-013-1933-7
  • 6. Yeh ML, Chang YJ, Yeh SJ, et al. Potential drug-drug interactions in pediatric outpatient prescriptions for newborns and infants. Comput Methods Programs Biomed. 2014;113(1):15-22. https://doi.org/10.1016/j.cmpb.2013.07.016
  • 7. Dai D, Feinstein JA, Morrison W, Zuppa AF, Feudtner C. Epidemiology of Polypharmacy and Potential Drug-Drug Interactions Among Pediatric Patients in ICUs of U.S. Children’s Hospitals.Pediatr Crit Care Med. 2016;17(5):e218-28. https://doi.org/10.1097/PCC.0000000000000684
  • 8. Gonzalez D, Sinha J. Pediatric Drug-Drug Interaction Evaluation: Drug, Patient Population, and Methodological Considerations. J Clin Pharmacol. 2021;61 Suppl 1(Suppl 1):S175-S187. https://doi.org/10.1002/jcph.1881
  • 9. Salerno SN, Burckart GJ, Huang SM, Gonzalez D. Pediatric Drug-Drug Interaction Studies: Barriers and Opportunities. Clin Pharmacol Ther. 2019;105(5):1067-1070. https://doi.org/10.1002/cpt.1234
  • 10. Horace AE, Ahmed F. Polypharmacy in pediatric patients and opportunities for pharmacists’ involvement. Integr Pharm Res Pract. 2015;4:113-126. https://doi.org/10.2147/IPRP.S64535
  • 11. Baniasadi S, Farzanegan B and Alehashem M. Important drug classes associated with potential drug–drug interactions in critically ill patients: highlights for cardiothoracic intensivists. Ann Intensive Care. 2015;5(44). https://doi.org/10.1186/s13613-015-0086-4
  • 12. Getachew H, Assen M, Dula F, BhagavathulaAS. Potential drug–drug interactions in pediatric wards of Gondar University Hospital, Ethiopia: A cross sectional study. Asian Pacific Journal of Tropical Biomedicine. 2016;6(6):534-8. https://doi.org/10.1016/j.apjtb.2016.04.002
  • 13. Bebitoğlu BT, Oğuz E, Nuhoğlu Ç, Dalkılıç AEK, Çirtlik P, Temel F, Hodzic A. Evaluation of potential drug-drug interactions in a pediatric population. Turk Pediatri Ars. 2020;9;55(1):30-38. https://doi.org/10.14744/TurkPediatriArs.2019.60938
  • 14. Medina-Barajas F, Vázquez-Méndez E, Pérez-Guerrero EE, Sánchez-López VA, Hernández-Cañaveral II, Gabriel A RO, Huerta-Olvera SG. Pilot study: Evaluation of potential drugdrug interactions in hospitalized pediatric patients. Pediatr Neonatol. 2020;61(3):279-289. https://doi.org/10.1016/j.pedneo.2019.11.006
  • 15. Ismail M, Iqbal Z, Khattak MB, Javaid A, Khan TM. Prevalence, types and predictors of potential drug-drug interactions in pulmonology ward of a tertiary care hospital. Afr J Pharm Pharmacol. 2011;5(10):1303-9. https://doi.org/10.5897/AJPP11.408
  • 16. Hassanzad M, Tashayoie NS, Mahboobipour AA, Salem F., Baniasadi S. Potential drug-drug interactions in hospitalized pediatric patients with respiratory disorders: A retrospective review of clinically important interactions. Drug Metab Pers Ther. 2020;35(1). https://doi.org/10.1515/dmpt-2019-0012
  • 17. Masukawa YM, Veríssimo GB, Vianello Richtzenhain MH, Alessandra L. Drug interactions in children with respiratory diseases in the pediatric unit of a teaching hospital in Brazil. Rev Cubana Pediatr. 2016; 88:166−81.
  • 18. Abideen S. Assessment of prevalence of potential drug-drug interactions in medical intensive care unit of a tertiary care hospital in india. Asian J Pharm Clin Res. 2015;8(1):125-30.
  • 19. Aziz G, Ahmed W, Latif MF, Saddique MA. Potential Role of Community Pharmacists in Managing Drug Interactions; a Public Perspective. Adv Pharm Ethnomed. 2014;2(1):7-9. https://doi.org/10.14737/journal.ape/2014/2.1.7.9
  • 20. Krupicka MI, Bratton SL, Sonnenthal K, Goldstein B. Impact of a pediatric clinical pharmacist in the pediatric intensive care unit. Crit Care Med. 2002;30(4):919-21. https://doi.org/10.1097/00003246-200204000-00035
  • 21. Hincapie AL, Warholak TL, Hines LE, Taylor AM, Malone DC. Impact of a drug-drug interaction intervention on pharmacy and medical students’ knowledge and attitudes: a 1-year follow-up. Res Social Adm Pharm. 2012;8(5):472-7. https://doi.org/10.1016/j.sapharm.2011.11.003
  • 22. Simpao AF, Ahumada LM, Desai BR, et al. Optimization of drug-drug interaction alert rules in a pediatric hospital’s electronic health record system using a visual analytics dashboard. J Am Med Inform Assoc. 2015;22(2):

Potential Drug-Drug Interactions in Pediatric Patients of a Teaching Hospital In Northern Cyprus: A Retrospective Study

Year 2024, Volume: 44 Issue: 1, 9 - 17, 01.03.2024
https://doi.org/10.52794/hujpharm.1265185

Abstract

Hospitalized infants and children are exposed to various medications, leading to potential drug-drug interactions (pDDIs). A retrospective observational study was conducted in a Northern Cyprus tertiary hospital to determine the frequency, types, and associated factors of pDDIs in hospitalized pediatric patients. All charts of pediatric patients hospitalized between September 1st, 2017, and August 30, 2018, were reviewed. Medications used concomitantly during hospitalization were screened for pDDIs using three DDI databases; Lexicomp TM 3.0.2, drugs.com, and Medscape. Of the 332 patients examined, 230 (69.2%) patient files met the inclusion criteria. The prevalence rates of pDDIs were 27.8%, 24.8%, and 23%, according to Lexicomp, Drugs.com, and Medscape databases, respectively. Young children (aged 2-6) had the highest percentage of pDDIs with a significant difference between databases (P < 0.05).Patients with pDDIs had longer hospital stays and were on more medications than those without (P < 0.05). Our study revealed that moderate severity pDDIs were common, and there were significant variations between databases. While severe pDDIs are rare, they may be life threatening. Collaborative efforts involving pediatricians and clinical pharmacists are necessary to address pDDIs in pediatric medication management. Utilizing multiple databases to enhance pDDI identification and prevention is also crucial.

References

  • 1. Ansari J. Drug interaction and pharmacist. J Young Pharm. 2010;2(3):326-31. https://doi.org/10.4103/0975-1483.66807
  • 2. Wilson JT. An update on the therapeutic orphan. Pediatrics. 1999;104(3 Pt 2):585-90.
  • 3. Pirmohamed M. Drug-drug interactions and adverse drug reactions: separating the wheat from the chaff. Wien Klin Wochenschr. 2010;122(3-4):62-4. https://doi.org/10.1007/s00508-010-1309-1
  • 4. Feudtner C, Dai D, Hexem KR, Luan X, Metjian TA. Prevalence of polypharmacy exposure among hospitalized children in the United States. Arch Pediatr Adolesc Med. 2012;166(1):9-16. https://doi.org/10.1001/archpediatrics.2011.161
  • 5. Langerová P, Prokes M, Konvalinka M, Furstová J, Urbánek K. Incidence of potential drug interactions in medication prescriptions for children and adolescents in the University Hospital Olomouc, Czech Republic. Eur J Pediatr. 2013;172(5):631-8. https://doi.org/10.1007/s00431-013-1933-7
  • 6. Yeh ML, Chang YJ, Yeh SJ, et al. Potential drug-drug interactions in pediatric outpatient prescriptions for newborns and infants. Comput Methods Programs Biomed. 2014;113(1):15-22. https://doi.org/10.1016/j.cmpb.2013.07.016
  • 7. Dai D, Feinstein JA, Morrison W, Zuppa AF, Feudtner C. Epidemiology of Polypharmacy and Potential Drug-Drug Interactions Among Pediatric Patients in ICUs of U.S. Children’s Hospitals.Pediatr Crit Care Med. 2016;17(5):e218-28. https://doi.org/10.1097/PCC.0000000000000684
  • 8. Gonzalez D, Sinha J. Pediatric Drug-Drug Interaction Evaluation: Drug, Patient Population, and Methodological Considerations. J Clin Pharmacol. 2021;61 Suppl 1(Suppl 1):S175-S187. https://doi.org/10.1002/jcph.1881
  • 9. Salerno SN, Burckart GJ, Huang SM, Gonzalez D. Pediatric Drug-Drug Interaction Studies: Barriers and Opportunities. Clin Pharmacol Ther. 2019;105(5):1067-1070. https://doi.org/10.1002/cpt.1234
  • 10. Horace AE, Ahmed F. Polypharmacy in pediatric patients and opportunities for pharmacists’ involvement. Integr Pharm Res Pract. 2015;4:113-126. https://doi.org/10.2147/IPRP.S64535
  • 11. Baniasadi S, Farzanegan B and Alehashem M. Important drug classes associated with potential drug–drug interactions in critically ill patients: highlights for cardiothoracic intensivists. Ann Intensive Care. 2015;5(44). https://doi.org/10.1186/s13613-015-0086-4
  • 12. Getachew H, Assen M, Dula F, BhagavathulaAS. Potential drug–drug interactions in pediatric wards of Gondar University Hospital, Ethiopia: A cross sectional study. Asian Pacific Journal of Tropical Biomedicine. 2016;6(6):534-8. https://doi.org/10.1016/j.apjtb.2016.04.002
  • 13. Bebitoğlu BT, Oğuz E, Nuhoğlu Ç, Dalkılıç AEK, Çirtlik P, Temel F, Hodzic A. Evaluation of potential drug-drug interactions in a pediatric population. Turk Pediatri Ars. 2020;9;55(1):30-38. https://doi.org/10.14744/TurkPediatriArs.2019.60938
  • 14. Medina-Barajas F, Vázquez-Méndez E, Pérez-Guerrero EE, Sánchez-López VA, Hernández-Cañaveral II, Gabriel A RO, Huerta-Olvera SG. Pilot study: Evaluation of potential drugdrug interactions in hospitalized pediatric patients. Pediatr Neonatol. 2020;61(3):279-289. https://doi.org/10.1016/j.pedneo.2019.11.006
  • 15. Ismail M, Iqbal Z, Khattak MB, Javaid A, Khan TM. Prevalence, types and predictors of potential drug-drug interactions in pulmonology ward of a tertiary care hospital. Afr J Pharm Pharmacol. 2011;5(10):1303-9. https://doi.org/10.5897/AJPP11.408
  • 16. Hassanzad M, Tashayoie NS, Mahboobipour AA, Salem F., Baniasadi S. Potential drug-drug interactions in hospitalized pediatric patients with respiratory disorders: A retrospective review of clinically important interactions. Drug Metab Pers Ther. 2020;35(1). https://doi.org/10.1515/dmpt-2019-0012
  • 17. Masukawa YM, Veríssimo GB, Vianello Richtzenhain MH, Alessandra L. Drug interactions in children with respiratory diseases in the pediatric unit of a teaching hospital in Brazil. Rev Cubana Pediatr. 2016; 88:166−81.
  • 18. Abideen S. Assessment of prevalence of potential drug-drug interactions in medical intensive care unit of a tertiary care hospital in india. Asian J Pharm Clin Res. 2015;8(1):125-30.
  • 19. Aziz G, Ahmed W, Latif MF, Saddique MA. Potential Role of Community Pharmacists in Managing Drug Interactions; a Public Perspective. Adv Pharm Ethnomed. 2014;2(1):7-9. https://doi.org/10.14737/journal.ape/2014/2.1.7.9
  • 20. Krupicka MI, Bratton SL, Sonnenthal K, Goldstein B. Impact of a pediatric clinical pharmacist in the pediatric intensive care unit. Crit Care Med. 2002;30(4):919-21. https://doi.org/10.1097/00003246-200204000-00035
  • 21. Hincapie AL, Warholak TL, Hines LE, Taylor AM, Malone DC. Impact of a drug-drug interaction intervention on pharmacy and medical students’ knowledge and attitudes: a 1-year follow-up. Res Social Adm Pharm. 2012;8(5):472-7. https://doi.org/10.1016/j.sapharm.2011.11.003
  • 22. Simpao AF, Ahumada LM, Desai BR, et al. Optimization of drug-drug interaction alert rules in a pediatric hospital’s electronic health record system using a visual analytics dashboard. J Am Med Inform Assoc. 2015;22(2):
There are 22 citations in total.

Details

Primary Language English
Subjects Pharmacology and Pharmaceutical Sciences
Journal Section Research Articles
Authors

Rım Dırı 0009-0005-2857-1694

Meryem Deniz Aydın 0009-0006-2142-9975

Abdikarim Mohamed Abdi 0000-0002-5064-7094

Publication Date March 1, 2024
Acceptance Date March 30, 2023
Published in Issue Year 2024 Volume: 44 Issue: 1

Cite

Vancouver Dırı R, Aydın MD, Abdi AM. Potential Drug-Drug Interactions in Pediatric Patients of a Teaching Hospital In Northern Cyprus: A Retrospective Study. HUJPHARM. 2024;44(1):9-17.