Drug-Drug Interactions in the Red Zone of the Emergency Department: A Retrospective Study

Abstract

Aim: This study aimed to assess the potential for drug-drug interactions in adult patients admitted to the emergency departments. Material and Methods: This cross-sectional study included 410 patients who were admitted to the red zone of the emergency departments, examined, treated, and received multiple medications. Drug-drug interaction analysis was conducted using LexiInteract software. Results: The median age of patients was 63 (range, 19-96) years, with 55.4% (n=227) being female and 44.6% (n=183) were male. A total of 1,230 medications were identified among the patients. In 181 (44.1%) patients, 330 possible drug-drug interactions were detected. While there was no significant difference in the rate of drug-drug interactions between male and female patients (p=0.658), this rate was higher in patients aged 65 years and over (p=0.048) and patients with polypharmacy (p<0.001). Also, the interaction rates were higher in patients admitted with cerebrovascular disease (p=0.038) and trauma (p=0.002). According to the Lexicomp© drug information system, potential drug-drug interactions were classified into risk category C (n=299, 72.9%), risk category D (n=22, 5.4%), and risk category X (n=9, 2.2%). The most frequently interacting drug pairs were Furosemide-Salbutamol in category C, Enoxaparin-Acetylsalicylic acid in category D, and Dexketoprofen-Acetylsalicylic acid in category X. Conclusion: Nearly half of the patients treated in the red zone of the emergency department were at risk of drug interactions. Assessing the risk of drug-drug interactions is essential before initiating medical instructions in critical areas of emergency department patient care, and follow-up should be organized about potential adverse effects.

Keywords

• Drug interaction
• emergency service
• red zone
• clinical pharmacist

Acil Servis Kırmızı Alanda İlaç-İlaç Etkileşimleri: Retrospektif Bir Çalışma

Abstract

Amaç: Bu çalışmanın amacı, acil servislere başvuran yetişkin hastalarda ilaç-ilaç etkileşimi potansiyelini değerlendirmektir. Gereç ve Yöntemler: Bu kesitsel çalışmaya, acil servisin kırmızı bölgesine kabul edilen, muayene edilen, tedavi edilen ve birden fazla ilaç alan 410 hasta dahil edilmiştir. İlaç-ilaç etkileşimi analizi LexiInteract yazılımı kullanılarak gerçekleştirilmiştir. Bulgular: Hastaların ortanca yaşı 63 (aralık, 19-96) yıl olup %55,4'ü (n=227) kadın ve %44,5’i (n=183) erkektir. Hastalar arasında toplam 1.230 ilaç tespit edilmiştir. 181 (%44,1) hastada 330 adet olası ilaç-ilaç etkileşimi tespit edilmiştir. Erkek ve kadın hastalar arasında ilaç-ilaç etkileşimi oranları bakımından anlamlı bir fark bulunmazken (p=0,658), 65 yaş ve üzeri hastalarda (p=0,048) ve çoklu ilaç kullanımı olan hastalarda (p<0,001) bu oran daha yüksekti. Ayrıca, serebrovasküler hastalık (p=0,038) ve travma (p=0,002) ile başvuran hastalarda da etkileşim oranları daha yüksek idi. Lexicomp© ilaç bilgi sistemine göre, olası ilaç-ilaç etkileşimleri risk kategorisi C (n=299, %72,9), risk kategorisi D (n=22, %5,4) ve risk kategorisi X (n=9, %2,2) olarak sınıflandırıldı. En sık etkileşime giren ilaç çiftleri, C kategorisinde Furosemid-Salbutamol, D kategorisinde Enoksaparin-Asetilsalisilik asit ve X kategorisinde Deksketoprofen-Asetilsalisilik asit idi. Sonuç: Acil servisin kırmızı bölgesinde tedavi edilen hastaların neredeyse yarısı ilaç etkileşimi riski altındaydı. Acil servis hasta bakımının kritik alanlarında tıbbi talimatlara başlamadan önce ilaç-ilaç etkileşimi riskinin değerlendirilmesi esastır ve potansiyel yan etkilerle ilgili olarak takip düzenlenmelidir.

Keywords

• İlaç etkileşimi
• acil servis
• kırmızı bölge
• klinik eczacı

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