Assessment of Potential Drug-Drug Interactions in Obese Patients

Öz

Aim: Polypharmacy may cause life-threatening adverse effects due to drug-drug interactions (DDIs). It is possible to observe DDIs due to polypharmacy in obese patients who is known to have many co-morbid diseases that necessitates multiple drug use. The aim of the present study is to determine the frequency and severity of potential DDIs (pDDIs) in obese patients. Material and Methods: This cross-sectional study analyzed the patient charts that admitted to obesity outpatient clinic of tertiary care hospital from April 1, 2016 to July 1, 2017. The severity of DDIs was interpreted using the Lexi-comp® drug interaction database. A chisquare test was performed for the comparison of the presence of DDIs based on patients’ demographic characteristics [gender (male/ female), age categories (18-44, 45-64 and ≥65 years) and BMI (30-34.9, 35-39.9 and ≥40 kg/m2)], co-morbid clinical conditions and number of drugs. The comparisons were considered as statistically significant at p< 0.05. Results: Out of 476 patient data evaluated, a total of 781 drugs were prescribed. Among 190 patients who were prescribed two or more drugs, 35 (18.4%) patients had one or more pDDIs. We determined 48 (70.6%) C, 12 (17.6%) B, 7 (10.3%) D and 1 (1.5%) X risk category interactions. The most common pDDIs were between metformin and nonsteroidal anti-inflammatory drugs (7.4%). The presence of pDDIs was significantly associated with the number of prescribed drugs (p<0.001). Conclusion: The pDDIs in obesity outpatient clinic were relatively low. Nevertheless, in order to minimize DDIs, it is vital for physicians to be aware of the interactions between the frequently prescribed drugs in obesity outpatient clinic and monitor patients for the safe use of drugs.

Anahtar Kelimeler

• Drug interactions
• polypharmacy
• obesity

Obez Hastalarda Olası İlaç-İlaç Etkileşimlerinin Değerlendirilmesi

Öz

Amaç: Polifarmasi, ilaç-ilaç etkileşimlerine bağlı yaşamı tehdit eden yan etkilere neden olabilmektedir. Çoklu ilaç kullanımını gerektiren birçok ko-morbid hastalığı olduğu bilinen obez hastalarda polifarmasiye bağlı ilaç-ilaç etkileşimlerini gözlemlemek muhtemeldir. Bu çalışmanın amacı, obez hastalarda olası ilaç-ilaç etkileşimlerinin sıklığını ve şiddetini belirlemektir. Gereç ve Yöntemler: Bu kesitsel çalışmada, 1 Nisan 2016- 1 Temmuz 2017 tarihleri arasında üçüncü basamak bir hastanenin obezite polikliniğine başvuran hastaların reçete verilerini analiz edildi. İlaç-ilaç etkileşimlerinin şiddeti, Lexi-comp® ilaç etkileşimi veri tabanı kullanılarak yorumlandı. Hastaların demografik özellikleri [cinsiyet (erkek/kadın), yaş kategorileri (18-44, 45-64 ve ≥65 yaş),VKİ’leri (30-34,9, 35-39,9 ve ≥40 kg/m2)], eşlik eden hastalıkları ve ilaç sayısına göre ilaç ilaç etkileşimi varlığının karşılaştırılması için ki-kare testi uygulandı. p <0,05 değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: Değerlendirilen 476 hasta verisinde, toplam 781 ilaç reçete edildi. İki veya daha fazla ilaç reçete edilen 190 hasta arasında, 35 (%18,4) hastada bir veya daha fazla olası ilaç-ilaç etkileşimi vardı. 48 (%70,6) C, 12 (%17,6) B, 7 (%10,3) D ve 1 (%1,5) X risk kategorisi ilaç-ilaç etkileşimi tespit edildi. En sık olası ilaç-ilaç etkileşimi metformin ve nonsteroidal antiinflamatuvar ilaçlar arasındaydı (%7,4). Olası ilaç-ilaç etkileşimlerinin varlığı, reçete edilen ilaçların sayısı ile anlamlı düzeyde ilişkiliydi (p<0,001). Sonuç: Obezite polikliniğindeki olası ilaç-ilaç etkileşimlerinin oranı nispeten düşüktü. Bununla birlikte, ilaç-ilaç etkileşimlerini en aza indirmek için, hekimlerin obezite polikliniğinde sık reçete edilen ilaçlar arasındaki etkileşimlerin farkında olması ve ilaçların güvenli kullanımı için hastaları izlemesi hayati önem taşımaktadır.

Anahtar Kelimeler

• ilaç etkileşimleri
• polifarmasi
• obezite

Kaynakça

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