A COMPREHENSIVE ANALYSIS OF ANTIDIABETIC DRUG INTERACTIONS IN GERIATRIC NON-INSULIN DEPENDENT DIABETES MELLITUS PATIENTS

Authors

  • RAHMI YOSMAR Department of Pharmacology and Clinical Pharmacy. Faculty of Pharmacy. Universitas Andalas Padang-¬25175, Indonesia
  • EUGENIA SHEPANY Department of Pharmacology and Clinical Pharmacy. Faculty of Pharmacy. Universitas Andalas Padang-¬25175, Indonesia
  • NAJMIATUL FITRIA Department of Pharmacology and Clinical Pharmacy. Faculty of Pharmacy. Universitas Andalas Padang-¬25175, Indonesia https://orcid.org/0000-0002-3255-1961

DOI:

https://doi.org/10.22159/ijap.2024.v16s1.12

Keywords:

Potential drug interactions, Type 2 DM, Geriatrics, Antidiabetic

Abstract

Objective: Type 2 diabetes mellitus (DM) is a disease that is the leading cause of blindness, heart disease, and kidney failure. Geriatric patients with type 2 DM and complications require multiple medications (polypharmacy), contributing to drug-drug interactions (DDIs). DDIs can affect the clinical outcome of patients. This study aims to analyze potential drug-drug interactions based on the mechanism and severity, determine the relationship between the number of medications and potential drug interaction, and determine the relationship between polypharmacy and the severity of clinical outcomes.

Methods: This was an analytical observational with retrospective data collection through patient medical records of hospitalized patients treated with an antidiabetic and one or more other drugs that met the inclusion criteria, involving 81 patients using total sampling.

Results: The result showed that out of 81 patients, there were 59 patients who potentially experienced drug-drug interactions (72.8%) with a total of 162 cases of drug interactions, and the most prevalent interaction mechanism was pharmacodynamic (84.0%) with a moderate severity level (57.4%). There was a significant relationship between the number of medications and potential drug-drug interactions (p<0.05). At the same time, there was no meaningful relationship between polypharmacy and the severity of drug interactions with clinical outcomes (p>0.05).

Conclusion: An increase in the number of drugs is a predictor of drug interactions. Although drug interactions may theoretically occur, not all interactions will significantly affect patients.

Downloads

Download data is not yet available.

References

Mawaw PM, Yav T, Mukuku O, Lukanka O, Kazadi PM, Tambwe D. Prevalence of obesity, diabetes mellitus, hypertension and associated risk factors in a mining workforce, Democratic Republic of Congo. Pan Afr Med J. 2017;28:282. doi: 10.11604/pamj.2017.28.282.14361, PMID 29942414.

International diabetic federation diabetic Atlas. 10th ed. 2021. doi: 10.1016/j.diabres.2013.10.013.

Linnenkamp U, Guariguata L, Beagley J, Whiting DR, Cho NH. The IDF diabetes atlas methodology for estimating global prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract. 2014;103(2):186-96. doi: 10.1016/j.diabres.2013.11.004, PMID 24300016.

Kemenkes RI. National institute of health research and development. Laporan Provinsi Sumatera Barat Riskesdas. 2018.

Ministry of Health, Tahun PK. Kota Padang. Vol. 2021; 2020.

Fitria N, Wulansari S, Sari YO. Potential interactions analysis of antihypertensive drugs used in geriatric. Int J App Pharm. 2023;15Special Issue 1:29-33. doi: 10.22159/ijap.2023.v15s1.47503.

Garin N, Sole N, Lucas B, Matas L, Moras D, Rodrigo Troyano A, et al. Drug-related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions. Sci Rep. 2021;11(1):883. doi: 10.1038/s41598-020-80560-2, PMID 33441854.

Sheppard JP, Burt J, Lown M, Temple E, Lowe R, Fraser R. Effect of antihypertensive medication reduction vs usual care on short-term blood pressure control in patients with hypertension aged 80 y and older: the optimise randomized clinical trial. JAMA. 2020;323(20):2039-51. doi: 10.1001/jama.2020.4871, PMID 32453368.

Blenkinsopp A, Bond C, Raynor DK. Medication reviews. Br J Clin Pharmacol. 2012;74(4):573-80. doi: 10.1111/j.1365-2125.2012.04331.x, PMID 22607195.

Diaconu CC, Cozma MA, Dobrica EC, Gheorghe G, Jichitu A, Ionescu VA. Polypharmacy in the management of arterial hypertension-friend or foe? Medicina (Kaunas). 2021;57(12). doi: 10.3390/medicina57121288, PMID 34946233.

Rambhade S, Chakarborty A, Shrivastava A, Patil UK, Rambhade A. A survey on polypharmacy and use of inappropriate medications. Toxicol Int. 2012;19(1):68-73. doi: 10.4103/0971-6580.94506, PMID 22736907.

Sankar V, Saaed Y, Joseph RM, Azizi H, Thomas PM. Serious drug-drug interactions in the prescriptions of diabetic patients. Med Sci (Basel). 2015;3(4):93-103. doi: 10.3390/medsci3040093, PMID 29083394.

Preston CL. Stockley’s drug interactions: 2015 pocket companion. Great Britain: Pharmaceutical Press; 2015.

Drug interactions checker. Cherner multum, Inc, Denver, CO; 2000.

Andy F. Discover statistics using SPSS-third edition; 2011.

Fitria N, Idrus L, Putri AR, Sari YO. The usability testing of the integrated electronic healthcare services for diabetes mellitus patients during the pandemic in Indonesia. Digit Health. 2023;9:20552076231173227. doi: 10.1177/20552076231173227, PMID 37152237.

American Diabetes Association. Economic costs of diabetes in the U.S. In: 2007. Diabetes Care. 2008;31(3):596-615. doi: 10.2337/dc08-9017, PMID 18308683.

Feingold KR, Brinton EA, Grunfeld C. The effect of endocrine disorders on lipids and lipoproteins. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K. editors. South. MA: Dartmouth Publishing; 2000.

Wells JCK. The new ”obstetrical dilemma”: stunting, obesity and the risk of obstructed labour. Anat Rec (Hoboken). 2017;300(4):716-31. doi: 10.1002/ar.23540, PMID 28297186.

Fitria N, van Asselt ADI, Postma MJ. Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review. Eur J Health Econ. 2019;20(3):407-17. doi: 10.1007/s10198-018-1006-y, PMID 30229375.

Fitria N, Fitri Anggraini L, Oktavia Sari Y. Cost-effectiveness analysis of the combination of metformin-insulin glargine and metformin-glimepiride in type 2 diabetes mellitus patients in rupit hospital. Purwokerto; 2023.

Waugh N, Pearson D, Royle P. Screening for hyperglycaemia in pregnancy: consensus and controversy. Best Pract Res Clin Endocrinol Metab. 2010;24(4):553-71. doi: 10.1016/j.beem.2010.06.004, PMID 20832736.

Sekowski K, Grudziaż Sekowska J, Pinkas J, Jankowski M. Public knowledge and awareness of diabetes mellitus, its risk factors, complications, and prevention methods among adults in Poland-a 2022 nationwide cross-sectional survey. Front Public Health. 2022;10:1029358. doi: 10.3389/fpubh.2022.1029358, PMID 36620244.

Fitria N, Sari YO, Putry AR, Putrizeti F, Sukma A. Future challenge on probiotics uses from fermented milk on the endocrine disorder in human. IOP Conf Ser.: Earth Environ Sci. 2021;888(1). doi: 10.1088/1755-1315/888/1/012047.

Masnoon N, Shakib S, Kalisch Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230. doi: 10.1186/s12877-017-0621-2, PMID 29017448.

Nuraini B. Risk factors of hypertension. J Major. 2015;4(5):10-9.

Zelko E, Klemenc Ketis Z, Tusek Bunc K. Medication adherence in elderly with polypharmacy living at home: a systematic review of existing studies. Mater Sociomed. 2016;28(2):129-32. doi: 10.5455/msm.2016.28.129-132, PMID 27147920.

Ohara N, Kaneko M, Yano T, Sato N, Usuda H, Miyakoshi M. Type 1 diabetes mellitus and pernicious anemia in an elderly Japanese patient: a case report and literature review. Intern Med. 2015;54(18):2361-5. doi: 10.2169/internalmedicine.54.4621, PMID 26370862.

Indonesian Society of Endocrinology. Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia. Jakarta. PB Perkeni. 1st ed; 2021.

Madjd A, Taylor MA, Mousavi N, Delavari A, Malekzadeh R, Macdonald IA. Comparison of the effect of daily consumption of probiotic compared with low-fat conventional yogurt on weight loss in healthy obese women following an energy-restricted diet: a randomized controlled trial. Am J Clin Nutr. 2016;103(2):323-9. doi: 10.3945/ajcn.115.120170, PMID 26702123.

Mousavi S, Ghanbari G. Potential drug-drug interactions among hospitalized patients in a developing country. Caspian J Intern Med. 2017;8(4):282-8. doi: 10.22088/cjim.8.4.282, PMID 29201319.

Chandrasekhar D, Joseph E, Ghaffoor FA, Thomas HM. Role of pharmacist-led home medication review in community setting and the preparation of medication list. Clin Epidemiol Glob Heal. 2019;7(1):66-70. doi: 10.1016/j.cegh.2018.01.002.

Published

15-02-2024

How to Cite

YOSMAR, R., SHEPANY, E., & FITRIA, N. (2024). A COMPREHENSIVE ANALYSIS OF ANTIDIABETIC DRUG INTERACTIONS IN GERIATRIC NON-INSULIN DEPENDENT DIABETES MELLITUS PATIENTS. International Journal of Applied Pharmaceutics, 16(1), 62–65. https://doi.org/10.22159/ijap.2024.v16s1.12

Issue

Section

Original Article(s)