POTENTIAL DRUG INTERACTIONS IN HYPERTENSIVE PATIENTS IN LIWA DISTRICT HOSPITAL, LAMPUNG BARAT, INDONESIA
DOI:
https://doi.org/10.22159/ijpps.2017v9i6.18003Keywords:
Drug interaction, Hypertension, Antihypertensive agentAbstract
Objective: Patients with hypertension often suffer from other comorbidities, resulting in prescriptions of multiple drugs to treat the conditions. Multiple drug treatment is potentially associated with drug interactions. This aim of the study was to assess potential drug interactions in hypertensive patients in Liwa District Hospital.
Methods: The design of the study was cross-sectional. The prescriptions for in-patients with essential hypertension in the Internal Medicine Unit in Liwa District Hospital during April-December 2012 were collected. Potential drug interactions were analyzed with the Drug Interaction Facts version 4.0, and classified into minor, significant, and serious.
Results: A total of 60 hypertensive patients were included. They were prescribed 265 prescriptions, with a median total of 6 (range 1-21) drugs prescribed per prescription. There were 1616 potential drug interactions, with 6 (1-31) potential interactions per prescription. Most interactions (75.6%) were classified as significant. Serious potential interactions were most common in the combinations of diltiazem-amlodipine and spironolactone-potassium chloride, while significant potential interaction may occur most often with the combinations of calcium chloride-amlodipine and bisoprolol-amlodipine.
Conclusion: Numerous potential drug interactions might occur in hypertensive patients, and most interactions were significant in severity. The largest proportion of the interactions occurred between antihypertensive agents and other drugs.
Â
Downloads
References
Ministry of the Health Republic of Indonesia. Information: Hypertension. Jakarta: Kemenkes RI; 2014.
Thawornchaisit P, de Looze F, Reid CM, Seubsman SA, Sleigh A. Thai Cohort Study Team. Health risk factors and the prevalence of hypertension: cross-sectional findings from a national cohort of 87,143 Thai Open University students. Glob J Health Sci 2013;5:126-41.
Dong F, Wang D, Pan L, Yu Y, Wang K, Li L, et al. Disparities in hypertension prevalence, awareness, treatment and control between bouyei and han: results from a bi-ethnic health survey in developing regions from South China. Int J Environ Res Public Health 2016;13:233.
Omole MK, Oke GO. A ten-year study of the pharmacotherapy of hypertension at a tertiary hospital in South Western Nigeria. Asian J Pharm Clin Res 2012;5 Suppl 1:26-9.
Kousalya K, Chirumamilla S, Manjunath S, Ramalakshmi S, Saranya P, Chamundeeswari D. Prescribing trend of antihypertensive drugs in hypertensive and diabetic hypertensive patients. Asian J Pharm Clin Res 2012;5:22-3.
Modesti PA, Perruolo E, Parati G. Need for better blood pressure measurement in developing countries to improve prevention of cardiovascular disease. J Epidemiol 2015;25:91-8.
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311:507-20.
Byrd JB, Zeng C, Tavel HM, Magid DJ, O'Connor PJ, Margolis KL, et al. Combination therapy as initial treatment for newly diagnosed hypertension. Am Heart J 2011;162:340-6.
Lewanczuk R, Tobe SW. More medications, fewer pills: combination medications for the treatment of hypertension. Can J Cardiol 2007;23:573-6.
Hess G, Hill J, Lau H, Dastani H, Chaudhari P. Medication Utilization patterns and hypertension-related expenditures among patients who were switched from fixed-dose to free-combination antihypertensive therapy. P T 2008;33:652-66.
Mannucci PM, Nobili A. REPOSI Investigators. Multimorbidity and polypharmacy in the elderly: lessons from REPOSI. Intern Emerg Med 2014;9:723-34.
Song J, Sheng CS, Huang QF, Li LH, Ma CS, Guo XH, et al. Management of hypertension and diabetes mellitus by cardiovascular and endocrine physicians: a China registry. J Hypertens 2016;34:1648-53.
Johnell K, Klarin I. The relationship between a number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the swedish prescribed drug register. Drug Saf 2007;30:911-84.
Hanlon JT, Perera S, Newman AB, Thorpe JM, Donohue JM, Simonsick EM, et al. Potential drug-drug and drug-disease interactions in well-functioning community-dwelling older adults. J Clin Pharm Ther 2017;42:228-33.
Kothari N, Ganguly B. Potential drug-drug interactions among medications prescribed to hypertensive patients. J Clin Diagn Res 2014;8:HC01-4.
Bacic-Vrca V, Marusic S, Erdeljic V, Falamic S, Gojo-Tomic N, Rahelic D. The incidence of potential drug-drug interactions in elderly patients with arterial hypertension. Pharm World Sci 2010;32:815-21.
Neto VC, Garcia VP, de Santa Helena ET. Possible pharmacological interactions in hypertensive and/or diabetic elderly in family health units at Blumenau (SC). Brazilian J Pharm Sci 2010;46:795-804.
Carter BL, Lund BC, Hayase N, Chrischilles E. The extent of potential antihypertensive drug interactions in a medicaid population. Am J Hypertens 2002;15:953-7.
Nag KA, Umesh M, Churi S. Assessment of drug-drug interactions in hospitalized patients in India. Asian J Pharm Clin Res 2011;4 Suppl 1:62-5.
Uijtendaal EV, van Harssel LL, Hugenholtz GW, Kuck EM, Zwart-van Rijkom JE, Cremer OL, et al. Analysis of potential drug-drug interactions in medical intensive care unit patients. Pharmacotherapy 2014;34:213-9.
Robertson J, Walkom E, Pearson SA, Hains I, Williamsone M, Newby D. The impact of pharmacy computerized clinical decision support on prescribing, clinical and patient outcomes: a systematic review of the literature. Int J Pharm Pract 2010;18:69-87.
Nabovati E, Vakili-Arki H, Taherzadeh Z, Saberi MR, Medlock S, Abu-Hanna A, et al. Information technology-based interventions to improve drug-drug interaction outcomes: a systematic review on features and effects. J Med Syst 2017;41:12.
Ferrández O, Urbina O, Grau S, Mateu-de-Antonio J, Marin-Casino M, Portabella J, et al. Computerized pharmacy surveillance and alert system for drug-related problems. J Clin Pharm Ther 2017;42:201-8.