TY  - CONF
AU  - Kovačević, Milena
AU  - Vezmar-Kovačević, Sandra
AU  - Radovanović, Slavica
AU  - Stevanović, Predrag
AU  - Miljković, Branislava
PY  - 2021
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3826
AB  - Background Exposure to anticholinergic and sedative drugs have been associated with adverse health outcomes in the elderly population, which can be measured in an individual patient using Drug Burden Index (DBI). Higher DBI values were associated with poorer cognitive and physical performance, which may negatively influence cardiovascular disease (CVD) therapy outcomes.

Purpose The aim was to assess the anticholinergic and sedative drug prevalence and burden in CVD patients.

Method A retrospective observational study was conducted on the Cardiology ward of University Hospital Medical Center. Data were collected from medical records. DBI was used to calculate the exposure, based on the therapy used before the hospital admission. Descriptive and statistical analysis was performed using IBM SPSS® Statistics ver. 22.

Findings A total of 254 patients aged ≥65 were included in the analysis. Patients were comorbid (Charlson Comorbidity Index, mean ± S.D., 3.18 ± 1.63), with the average number of drugs above 6 (6.21 ± 2.78). Anticholinergic or sedative drugs were used by 23 (9.1%) patients, with identified 19 different drugs. The highest frequency was observed for doxazosin (6; 2.4%), sertraline (6; 2.4%), memantine (4; 1.6%), clonazepam (3; 1.2%) and diazepam (3; 1.2%). The majority of patients had only one drug (15; 5.9%), 2 patients (0.8%) used 2, 4 patients (1.6%) used 3, and 2 patients (0.8%) used 4 different drugs with anticholinergic or sedative effects. Patients who were exposed to those drugs had longer length of hospital stay (15.74 vs 9.41 days, p<0.05), and higher total number of drugs (7.61 vs 6.07, p<0.05). The average DBI value equalled 1.11 ± 0.74 (total range 0.33-2.60). DBI <1 was present in 13 (5.1%) patients, and higher DBI≥1 in 10 (4%) patients.

Conclusion The study revealed lower than expected exposure to anticholinergic or sedative drugs. The results could be seen as beneficial, as the minimization of anticholinergic burden in CVD patients is highly recommended.
PB  - Springer Nature
C3  - International Journal of Clinical Pharmacy, 12th PCNE working conference ‘Partnering for better patient outcomes: challenges and opportunities 3–6 February 2021, University of Basel, Switzerland (was held online)
T1  - Anticholinergic and sedative drug burden in elderly patients with cardiovascular diseases (oral presentation)
IS  - 459
DO  - 10.1007/s11096-021-01269-4
ER  - 

@conference{
author = "Kovačević, Milena and Vezmar-Kovačević, Sandra and Radovanović, Slavica and Stevanović, Predrag and Miljković, Branislava",
year = "2021",
abstract = "Background Exposure to anticholinergic and sedative drugs have been associated with adverse health outcomes in the elderly population, which can be measured in an individual patient using Drug Burden Index (DBI). Higher DBI values were associated with poorer cognitive and physical performance, which may negatively influence cardiovascular disease (CVD) therapy outcomes.

Purpose The aim was to assess the anticholinergic and sedative drug prevalence and burden in CVD patients.

Method A retrospective observational study was conducted on the Cardiology ward of University Hospital Medical Center. Data were collected from medical records. DBI was used to calculate the exposure, based on the therapy used before the hospital admission. Descriptive and statistical analysis was performed using IBM SPSS® Statistics ver. 22.

Findings A total of 254 patients aged ≥65 were included in the analysis. Patients were comorbid (Charlson Comorbidity Index, mean ± S.D., 3.18 ± 1.63), with the average number of drugs above 6 (6.21 ± 2.78). Anticholinergic or sedative drugs were used by 23 (9.1%) patients, with identified 19 different drugs. The highest frequency was observed for doxazosin (6; 2.4%), sertraline (6; 2.4%), memantine (4; 1.6%), clonazepam (3; 1.2%) and diazepam (3; 1.2%). The majority of patients had only one drug (15; 5.9%), 2 patients (0.8%) used 2, 4 patients (1.6%) used 3, and 2 patients (0.8%) used 4 different drugs with anticholinergic or sedative effects. Patients who were exposed to those drugs had longer length of hospital stay (15.74 vs 9.41 days, p<0.05), and higher total number of drugs (7.61 vs 6.07, p<0.05). The average DBI value equalled 1.11 ± 0.74 (total range 0.33-2.60). DBI <1 was present in 13 (5.1%) patients, and higher DBI≥1 in 10 (4%) patients.

Conclusion The study revealed lower than expected exposure to anticholinergic or sedative drugs. The results could be seen as beneficial, as the minimization of anticholinergic burden in CVD patients is highly recommended.",
publisher = "Springer Nature",
journal = "International Journal of Clinical Pharmacy, 12th PCNE working conference ‘Partnering for better patient outcomes: challenges and opportunities 3–6 February 2021, University of Basel, Switzerland (was held online)",
title = "Anticholinergic and sedative drug burden in elderly patients with cardiovascular diseases (oral presentation)",
number = "459",
doi = "10.1007/s11096-021-01269-4"
}

Kovačević, M., Vezmar-Kovačević, S., Radovanović, S., Stevanović, P.,& Miljković, B.. (2021). Anticholinergic and sedative drug burden in elderly patients with cardiovascular diseases (oral presentation). in International Journal of Clinical Pharmacy, 12th PCNE working conference ‘Partnering for better patient outcomes: challenges and opportunities 3–6 February 2021, University of Basel, Switzerland (was held online)
Springer Nature.(459).
https://doi.org/10.1007/s11096-021-01269-4

Kovačević M, Vezmar-Kovačević S, Radovanović S, Stevanović P, Miljković B. Anticholinergic and sedative drug burden in elderly patients with cardiovascular diseases (oral presentation). in International Journal of Clinical Pharmacy, 12th PCNE working conference ‘Partnering for better patient outcomes: challenges and opportunities 3–6 February 2021, University of Basel, Switzerland (was held online). 2021;(459).
doi:10.1007/s11096-021-01269-4 .

Kovačević, Milena, Vezmar-Kovačević, Sandra, Radovanović, Slavica, Stevanović, Predrag, Miljković, Branislava, "Anticholinergic and sedative drug burden in elderly patients with cardiovascular diseases (oral presentation)" in International Journal of Clinical Pharmacy, 12th PCNE working conference ‘Partnering for better patient outcomes: challenges and opportunities 3–6 February 2021, University of Basel, Switzerland (was held online), no. 459 (2021),
https://doi.org/10.1007/s11096-021-01269-4 . .

TY  - JOUR
AU  - Kovačević, Milena
AU  - Vezmar-Kovačević, Sandra
AU  - Radovanović, Slavica
AU  - Stevanović, Predrag
AU  - Miljković, Branislava
PY  - 2020
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3616
AB  - Background Drug–drug interactions represent one of the causes of adverse therapy outcomes through deteriorated efficacy or safety. However, the true extent of harm related to drug–drug interactions is not well established due to a lack of recognition and understanding. Objective The aim of this study was to investigate the association of potential drug–drug interactions with patients variables recorded at admission. Setting A cross-sectional correlation study was performed on the Cardiology ward of the University Clinical Hospital Center in Belgrade, Serbia. Method Data were retrospectively obtained from medical records and LexiInteract was used as the screening tool for potential drug–drug interactions. Main outcome measure Clinical and laboratory parameters recorded at the patients admission. Results A total of 351 patient records entered the analysis, with the mean age of 70 ± 10 years. The prevalence of potentially relevant drug–drug interactions was 61% (N = 213). After controlling for patient characteristics, nine potential drug–drug interactions were significantly associated with laboratory values outside the range and five potential drug–drug interactions with inadequate clinical parameter values. Potential drug–drug interactions were associated with abnormalities in blood count, metabolic parameters, electrolyte imbalance and renal function parameters. Association with inadequate control of systolic, diastolic blood pressure, as well as heart rhythm was also shown. Conclusion Drug–drug interactions were associated with patients clinical and laboratory findings. Our findings may assist in the identification of patients with increased likelihood of suboptimal therapy outcomes. Generating evidence through post-marketing drug–drug interactions research would lead to improvement in clinical decision-support systems, increased effectiveness and utilization in everyday clinical practice.
PB  - Springer
T2  - International Journal of Clinical Pharmacy
T1  - Potential drug–drug interactions associated with clinical and laboratory findings at hospital admission
VL  - 42
IS  - 1
SP  - 150
EP  - 157
DO  - 10.1007/s11096-019-00951-y
ER  - 

@article{
author = "Kovačević, Milena and Vezmar-Kovačević, Sandra and Radovanović, Slavica and Stevanović, Predrag and Miljković, Branislava",
year = "2020",
abstract = "Background Drug–drug interactions represent one of the causes of adverse therapy outcomes through deteriorated efficacy or safety. However, the true extent of harm related to drug–drug interactions is not well established due to a lack of recognition and understanding. Objective The aim of this study was to investigate the association of potential drug–drug interactions with patients variables recorded at admission. Setting A cross-sectional correlation study was performed on the Cardiology ward of the University Clinical Hospital Center in Belgrade, Serbia. Method Data were retrospectively obtained from medical records and LexiInteract was used as the screening tool for potential drug–drug interactions. Main outcome measure Clinical and laboratory parameters recorded at the patients admission. Results A total of 351 patient records entered the analysis, with the mean age of 70 ± 10 years. The prevalence of potentially relevant drug–drug interactions was 61% (N = 213). After controlling for patient characteristics, nine potential drug–drug interactions were significantly associated with laboratory values outside the range and five potential drug–drug interactions with inadequate clinical parameter values. Potential drug–drug interactions were associated with abnormalities in blood count, metabolic parameters, electrolyte imbalance and renal function parameters. Association with inadequate control of systolic, diastolic blood pressure, as well as heart rhythm was also shown. Conclusion Drug–drug interactions were associated with patients clinical and laboratory findings. Our findings may assist in the identification of patients with increased likelihood of suboptimal therapy outcomes. Generating evidence through post-marketing drug–drug interactions research would lead to improvement in clinical decision-support systems, increased effectiveness and utilization in everyday clinical practice.",
publisher = "Springer",
journal = "International Journal of Clinical Pharmacy",
title = "Potential drug–drug interactions associated with clinical and laboratory findings at hospital admission",
volume = "42",
number = "1",
pages = "150-157",
doi = "10.1007/s11096-019-00951-y"
}

Kovačević, M., Vezmar-Kovačević, S., Radovanović, S., Stevanović, P.,& Miljković, B.. (2020). Potential drug–drug interactions associated with clinical and laboratory findings at hospital admission. in International Journal of Clinical Pharmacy
Springer., 42(1), 150-157.
https://doi.org/10.1007/s11096-019-00951-y

Kovačević M, Vezmar-Kovačević S, Radovanović S, Stevanović P, Miljković B. Potential drug–drug interactions associated with clinical and laboratory findings at hospital admission. in International Journal of Clinical Pharmacy. 2020;42(1):150-157.
doi:10.1007/s11096-019-00951-y .

Kovačević, Milena, Vezmar-Kovačević, Sandra, Radovanović, Slavica, Stevanović, Predrag, Miljković, Branislava, "Potential drug–drug interactions associated with clinical and laboratory findings at hospital admission" in International Journal of Clinical Pharmacy, 42, no. 1 (2020):150-157,
https://doi.org/10.1007/s11096-019-00951-y . .

TY  - JOUR
AU  - Kovačević, Milena
AU  - Vezmar-Kovačević, Sandra
AU  - Radovanović, Slavica
AU  - Stevanović, Predrag
AU  - Miljković, Branislava
PY  - 2019
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3733
AB  - Objective: Cardiovascular disease (CVD) drugs have been frequently implicated in adverse drug reaction (ADR)-related hospitalizations. Drug-drug interactions (DDIs) are common preventable cause of ADRs, but the impact of DDIs in the CVD population has not been investigated. Hence, the primary aim of the study was to identify DDIs associated with ADRs in CVD patients at hospital admission. The second aim was to develop a simple tool to identify high-risk patients for DDI-related adverse events. Methods: An observational study was conducted on the Cardiology Ward of University Clinical Hospital Center. Data were obtained from medical charts. A clinical panel identified DDIs implicated in ADRs, using LexiInteract database and Drug Interaction Probability Scale. Statistics were performed using PASW 22 (SPSS Inc.). Results: DDIs contributed to hospital admission with a total prevalence of 9.69%. DDI-related ADRs affected mainly cardiac function (heart rate or rhythm, 41.07%); bleeding and effect on blood pressure were equally distributed (17.86%). Non-cardiovascular ADRs were found in 23.21% of DDIs. After admission, 73% of the identified DDIs led to changes in prescription. Prediction ability of calculated DDI adverse event probability scores was rated as good (AUC = 0.80, p < .001). Conclusions: CVD patients are highly exposed to adverse DDIs; about one in ten patients hospitalized with CVD might have a DDI contributing to the hospitalization. Given the high prevalence of CVD, DDI-related harm might be a significant burden worldwide. Identification of patients with high DDI adverse event risk might ease the recognition of DDI-related harm and improve the use of electronic databases in clinical practice.
PB  - Taylor and Francis Ltd
T2  - Current Medical Research and Opinion
T1  - Adverse drug reactions caused by drug–drug interactions in cardiovascular disease patients: introduction of a simple prediction tool using electronic screening database items
VL  - 35
IS  - 11
SP  - 1873
EP  - 1883
DO  - 10.1080/03007995.2019.1647021
ER  - 

@article{
author = "Kovačević, Milena and Vezmar-Kovačević, Sandra and Radovanović, Slavica and Stevanović, Predrag and Miljković, Branislava",
year = "2019",
abstract = "Objective: Cardiovascular disease (CVD) drugs have been frequently implicated in adverse drug reaction (ADR)-related hospitalizations. Drug-drug interactions (DDIs) are common preventable cause of ADRs, but the impact of DDIs in the CVD population has not been investigated. Hence, the primary aim of the study was to identify DDIs associated with ADRs in CVD patients at hospital admission. The second aim was to develop a simple tool to identify high-risk patients for DDI-related adverse events. Methods: An observational study was conducted on the Cardiology Ward of University Clinical Hospital Center. Data were obtained from medical charts. A clinical panel identified DDIs implicated in ADRs, using LexiInteract database and Drug Interaction Probability Scale. Statistics were performed using PASW 22 (SPSS Inc.). Results: DDIs contributed to hospital admission with a total prevalence of 9.69%. DDI-related ADRs affected mainly cardiac function (heart rate or rhythm, 41.07%); bleeding and effect on blood pressure were equally distributed (17.86%). Non-cardiovascular ADRs were found in 23.21% of DDIs. After admission, 73% of the identified DDIs led to changes in prescription. Prediction ability of calculated DDI adverse event probability scores was rated as good (AUC = 0.80, p < .001). Conclusions: CVD patients are highly exposed to adverse DDIs; about one in ten patients hospitalized with CVD might have a DDI contributing to the hospitalization. Given the high prevalence of CVD, DDI-related harm might be a significant burden worldwide. Identification of patients with high DDI adverse event risk might ease the recognition of DDI-related harm and improve the use of electronic databases in clinical practice.",
publisher = "Taylor and Francis Ltd",
journal = "Current Medical Research and Opinion",
title = "Adverse drug reactions caused by drug–drug interactions in cardiovascular disease patients: introduction of a simple prediction tool using electronic screening database items",
volume = "35",
number = "11",
pages = "1873-1883",
doi = "10.1080/03007995.2019.1647021"
}

Kovačević, M., Vezmar-Kovačević, S., Radovanović, S., Stevanović, P.,& Miljković, B.. (2019). Adverse drug reactions caused by drug–drug interactions in cardiovascular disease patients: introduction of a simple prediction tool using electronic screening database items. in Current Medical Research and Opinion
Taylor and Francis Ltd., 35(11), 1873-1883.
https://doi.org/10.1080/03007995.2019.1647021

Kovačević M, Vezmar-Kovačević S, Radovanović S, Stevanović P, Miljković B. Adverse drug reactions caused by drug–drug interactions in cardiovascular disease patients: introduction of a simple prediction tool using electronic screening database items. in Current Medical Research and Opinion. 2019;35(11):1873-1883.
doi:10.1080/03007995.2019.1647021 .

Kovačević, Milena, Vezmar-Kovačević, Sandra, Radovanović, Slavica, Stevanović, Predrag, Miljković, Branislava, "Adverse drug reactions caused by drug–drug interactions in cardiovascular disease patients: introduction of a simple prediction tool using electronic screening database items" in Current Medical Research and Opinion, 35, no. 11 (2019):1873-1883,
https://doi.org/10.1080/03007995.2019.1647021 . .

TY  - CONF
AU  - Kovačević, Milena
AU  - Vezmar-Kovačević, Sandra
AU  - Radovanović, Slavica
AU  - Stevanović, Predrag
AU  - Miljković, Branislava
PY  - 2019
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3259
PB  - Springer
C3  - European Journal of Clinical Pharmacology
T1  - Clinically significant drug-drug interactions in cardiovascular diseases: comparing the prevalence and prescribing patterns between inpatient and outpatient settings
VL  - 75, Suppl. 1
SP  - S38
EP  - S39
DO  - 10.1007/s00228-019-02685-2
ER  - 

@conference{
author = "Kovačević, Milena and Vezmar-Kovačević, Sandra and Radovanović, Slavica and Stevanović, Predrag and Miljković, Branislava",
year = "2019",
publisher = "Springer",
journal = "European Journal of Clinical Pharmacology",
title = "Clinically significant drug-drug interactions in cardiovascular diseases: comparing the prevalence and prescribing patterns between inpatient and outpatient settings",
volume = "75, Suppl. 1",
pages = "S38-S39",
doi = "10.1007/s00228-019-02685-2"
}

Kovačević, M., Vezmar-Kovačević, S., Radovanović, S., Stevanović, P.,& Miljković, B.. (2019). Clinically significant drug-drug interactions in cardiovascular diseases: comparing the prevalence and prescribing patterns between inpatient and outpatient settings. in European Journal of Clinical Pharmacology
Springer., 75, Suppl. 1, S38-S39.
https://doi.org/10.1007/s00228-019-02685-2

Kovačević M, Vezmar-Kovačević S, Radovanović S, Stevanović P, Miljković B. Clinically significant drug-drug interactions in cardiovascular diseases: comparing the prevalence and prescribing patterns between inpatient and outpatient settings. in European Journal of Clinical Pharmacology. 2019;75, Suppl. 1:S38-S39.
doi:10.1007/s00228-019-02685-2 .

Kovačević, Milena, Vezmar-Kovačević, Sandra, Radovanović, Slavica, Stevanović, Predrag, Miljković, Branislava, "Clinically significant drug-drug interactions in cardiovascular diseases: comparing the prevalence and prescribing patterns between inpatient and outpatient settings" in European Journal of Clinical Pharmacology, 75, Suppl. 1 (2019):S38-S39,
https://doi.org/10.1007/s00228-019-02685-2 . .

TY  - CONF
AU  - Kovačević, Milena
AU  - Vezmar-Kovačević, Sandra
AU  - Miljković, Branislava
AU  - Radovanović, Slavica
AU  - Stevanović, Predrag
PY  - 2017
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2990
PB  - Wiley, Hoboken
C3  - Pharmacotherapy
T1  - The prevalence of potential drug-drug interactions in hospital setting: cardiovascular diseases versus comorbidities
VL  - 37
IS  - 6
SP  - e38
EP  - e38
DO  - 10.1002/phar.1964
ER  - 

@conference{
author = "Kovačević, Milena and Vezmar-Kovačević, Sandra and Miljković, Branislava and Radovanović, Slavica and Stevanović, Predrag",
year = "2017",
publisher = "Wiley, Hoboken",
journal = "Pharmacotherapy",
title = "The prevalence of potential drug-drug interactions in hospital setting: cardiovascular diseases versus comorbidities",
volume = "37",
number = "6",
pages = "e38-e38",
doi = "10.1002/phar.1964"
}

Kovačević, M., Vezmar-Kovačević, S., Miljković, B., Radovanović, S.,& Stevanović, P.. (2017). The prevalence of potential drug-drug interactions in hospital setting: cardiovascular diseases versus comorbidities. in Pharmacotherapy
Wiley, Hoboken., 37(6), e38-e38.
https://doi.org/10.1002/phar.1964

Kovačević M, Vezmar-Kovačević S, Miljković B, Radovanović S, Stevanović P. The prevalence of potential drug-drug interactions in hospital setting: cardiovascular diseases versus comorbidities. in Pharmacotherapy. 2017;37(6):e38-e38.
doi:10.1002/phar.1964 .

Kovačević, Milena, Vezmar-Kovačević, Sandra, Miljković, Branislava, Radovanović, Slavica, Stevanović, Predrag, "The prevalence of potential drug-drug interactions in hospital setting: cardiovascular diseases versus comorbidities" in Pharmacotherapy, 37, no. 6 (2017):e38-e38,
https://doi.org/10.1002/phar.1964 . .

TY  - JOUR
AU  - Kovačević, Milena
AU  - Vezmar-Kovačević, Sandra
AU  - Miljković, Branislava
AU  - Radovanović, Slavica
AU  - Stevanović, Predrag
PY  - 2017
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2874
AB  - Aim: The aim was to describe the type and prevalence of potentially relevant drug-drug interactions (pDDIs) in a population of patients admitted for cardiovascular diseases (CVD), and management strategies for reducing the occurrence of pDDIs. Methods: A retrospective cross-sectional study was performed on Cardiology ward of University Clinical Hospital Center in Belgrade, Serbia. A total of 527 patients, with more than one prescription during hospital stay, were enrolled in this study. Data were obtained from medical records. LexiInteract was used as the screening tool. Results: At least one potentially relevant pDDI was identified in 83.9% of patients. Occurrence was significantly more prevalent in patients with higher number of drugs, multimorbidity, longer length of stay, arrhythmia, heart failure, infectious and respiratory disease. About 13% of pDDIs exposures were accompanied with concurrent renal or liver disease, as an additional risk for DDI manifestation. Among CVD, patients with a history of myocardial infarction possessed the highest additional risk. The most common potential clinical outcome was the effect on cardiovascular system 48.5%, renal function and/or potassium 22.3%, bleeding 9.5%, impaired glucose control 6.8% and digoxin toxicity 4.6%. Main management strategies to avoid X or D class included using paracetamol instead of NSAID or alternative NSAID (38%), alternative antibiotic or antifungal (20.4%), H-2 receptor antagonist instead of PPI (8.3%), avoiding therapeutic duplication (7.3%), and alternative HMG-CoA reductase inhibitor (7%). Heart rate, blood pressure, electrolytes/potassium and blood glucose could have been employed in monitoring for potential consequence of 72.2% C class pDDIs. Conclusions: Use of drug interaction screening tools can be beneficial risk mitigation strategy for potentially relevant pDDIs in CVD patients. DDI screening software could be linked to the patient's laboratory results or clinical data regarding renal or liver function, as an approach to reinforce DDIs alert quality.
PB  - Wiley, Hoboken
T2  - International Journal of Clinical Practice
T1  - The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study
VL  - 71
IS  - 10
DO  - 10.1111/ijcp.13005
ER  - 

@article{
author = "Kovačević, Milena and Vezmar-Kovačević, Sandra and Miljković, Branislava and Radovanović, Slavica and Stevanović, Predrag",
year = "2017",
abstract = "Aim: The aim was to describe the type and prevalence of potentially relevant drug-drug interactions (pDDIs) in a population of patients admitted for cardiovascular diseases (CVD), and management strategies for reducing the occurrence of pDDIs. Methods: A retrospective cross-sectional study was performed on Cardiology ward of University Clinical Hospital Center in Belgrade, Serbia. A total of 527 patients, with more than one prescription during hospital stay, were enrolled in this study. Data were obtained from medical records. LexiInteract was used as the screening tool. Results: At least one potentially relevant pDDI was identified in 83.9% of patients. Occurrence was significantly more prevalent in patients with higher number of drugs, multimorbidity, longer length of stay, arrhythmia, heart failure, infectious and respiratory disease. About 13% of pDDIs exposures were accompanied with concurrent renal or liver disease, as an additional risk for DDI manifestation. Among CVD, patients with a history of myocardial infarction possessed the highest additional risk. The most common potential clinical outcome was the effect on cardiovascular system 48.5%, renal function and/or potassium 22.3%, bleeding 9.5%, impaired glucose control 6.8% and digoxin toxicity 4.6%. Main management strategies to avoid X or D class included using paracetamol instead of NSAID or alternative NSAID (38%), alternative antibiotic or antifungal (20.4%), H-2 receptor antagonist instead of PPI (8.3%), avoiding therapeutic duplication (7.3%), and alternative HMG-CoA reductase inhibitor (7%). Heart rate, blood pressure, electrolytes/potassium and blood glucose could have been employed in monitoring for potential consequence of 72.2% C class pDDIs. Conclusions: Use of drug interaction screening tools can be beneficial risk mitigation strategy for potentially relevant pDDIs in CVD patients. DDI screening software could be linked to the patient's laboratory results or clinical data regarding renal or liver function, as an approach to reinforce DDIs alert quality.",
publisher = "Wiley, Hoboken",
journal = "International Journal of Clinical Practice",
title = "The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study",
volume = "71",
number = "10",
doi = "10.1111/ijcp.13005"
}

Kovačević, M., Vezmar-Kovačević, S., Miljković, B., Radovanović, S.,& Stevanović, P.. (2017). The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study. in International Journal of Clinical Practice
Wiley, Hoboken., 71(10).
https://doi.org/10.1111/ijcp.13005

Kovačević M, Vezmar-Kovačević S, Miljković B, Radovanović S, Stevanović P. The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study. in International Journal of Clinical Practice. 2017;71(10).
doi:10.1111/ijcp.13005 .

Kovačević, Milena, Vezmar-Kovačević, Sandra, Miljković, Branislava, Radovanović, Slavica, Stevanović, Predrag, "The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study" in International Journal of Clinical Practice, 71, no. 10 (2017),
https://doi.org/10.1111/ijcp.13005 . .

TY  - JOUR
AU  - Bojić, Suzana
AU  - Kotur-Stevuljević, Jelena
AU  - Kalezić, Nevena
AU  - Stevanović, Predrag
AU  - Jelić-Ivanović, Zorana
AU  - Bilanović, Dragoljub
AU  - Memon, Lidija
AU  - Damnjanović, Mladen
AU  - Kalaba, Zdravko
AU  - Simić-Ogrizović, Sanja
PY  - 2015
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2313
AB  - Sepsis-associated acute kidney injury (SA-AKI) severely impacts morbidity and mortality in surgical patients with sepsis. Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix rnetalloproteinase-1 (TIMP-1) have an important role in pathophysiology of sepsis but they have been unexplored in SA-AKI. We aimed to investigate the role of MMP-9 and TIMP-1 in septic surgical patients with SA-AKI and to evaluate them as diagnostic biomarkers of SA-AKI. This prospective observational study compared 53 major abdominal surgery patients with sepsis divided into SA-AKI (n = 37) and non-SA-AKI (n = 16) group to 50 controls without sepsis matched by age, gender, comorbidities and type of surgery. Blood and urine samples from septic patients were collected on admission to ICU and 24, 48, 72 and 96 h later and once from the controls. The levels of MMP-9, TIMP-1, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, urea and creatinine were measured. MMP-9/TIMP-1 ratio and disease severity scores, such as Sequential Organ Failure Assessment (SOFA), were calculated. Septic patients with SA-AKI had higher serum TIMP-1 levels and lower serum MMP-9 levels and lower MMP-9/TIMP ratio, compared to septic patients without SA-AKI and controls. The levels of these biomarkers did not change significantly over time. MMP-9, TIMP-1 and MMP-9/TIMP-1 ratio correlated with urea, creatinine, NGAL, and SOFA scores. Moreover, using the area under ROC curve, we showed that TIMP-1 and MMP-9/TIMP-1 ratio, but not MMP-9, were good diagnostic biomarkers of SA-AKI. We report for the first time the potential diagnostic value of TIMP-1 and MMP-9/TIMP-1 ratio in SA-AKI.
PB  - Tohoku Univ Medical Press, Sendai
T2  - Toxicological and Environmental Chemistry
T1  - Diagnostic Value of Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 in Sepsis-Associated Acute Kidney Injury
VL  - 237
IS  - 2
SP  - 103
EP  - 109
DO  - 10.1620/tjem.237.103
ER  - 

@article{
author = "Bojić, Suzana and Kotur-Stevuljević, Jelena and Kalezić, Nevena and Stevanović, Predrag and Jelić-Ivanović, Zorana and Bilanović, Dragoljub and Memon, Lidija and Damnjanović, Mladen and Kalaba, Zdravko and Simić-Ogrizović, Sanja",
year = "2015",
abstract = "Sepsis-associated acute kidney injury (SA-AKI) severely impacts morbidity and mortality in surgical patients with sepsis. Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix rnetalloproteinase-1 (TIMP-1) have an important role in pathophysiology of sepsis but they have been unexplored in SA-AKI. We aimed to investigate the role of MMP-9 and TIMP-1 in septic surgical patients with SA-AKI and to evaluate them as diagnostic biomarkers of SA-AKI. This prospective observational study compared 53 major abdominal surgery patients with sepsis divided into SA-AKI (n = 37) and non-SA-AKI (n = 16) group to 50 controls without sepsis matched by age, gender, comorbidities and type of surgery. Blood and urine samples from septic patients were collected on admission to ICU and 24, 48, 72 and 96 h later and once from the controls. The levels of MMP-9, TIMP-1, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, urea and creatinine were measured. MMP-9/TIMP-1 ratio and disease severity scores, such as Sequential Organ Failure Assessment (SOFA), were calculated. Septic patients with SA-AKI had higher serum TIMP-1 levels and lower serum MMP-9 levels and lower MMP-9/TIMP ratio, compared to septic patients without SA-AKI and controls. The levels of these biomarkers did not change significantly over time. MMP-9, TIMP-1 and MMP-9/TIMP-1 ratio correlated with urea, creatinine, NGAL, and SOFA scores. Moreover, using the area under ROC curve, we showed that TIMP-1 and MMP-9/TIMP-1 ratio, but not MMP-9, were good diagnostic biomarkers of SA-AKI. We report for the first time the potential diagnostic value of TIMP-1 and MMP-9/TIMP-1 ratio in SA-AKI.",
publisher = "Tohoku Univ Medical Press, Sendai",
journal = "Toxicological and Environmental Chemistry",
title = "Diagnostic Value of Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 in Sepsis-Associated Acute Kidney Injury",
volume = "237",
number = "2",
pages = "103-109",
doi = "10.1620/tjem.237.103"
}

Bojić, S., Kotur-Stevuljević, J., Kalezić, N., Stevanović, P., Jelić-Ivanović, Z., Bilanović, D., Memon, L., Damnjanović, M., Kalaba, Z.,& Simić-Ogrizović, S.. (2015). Diagnostic Value of Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 in Sepsis-Associated Acute Kidney Injury. in Toxicological and Environmental Chemistry
Tohoku Univ Medical Press, Sendai., 237(2), 103-109.
https://doi.org/10.1620/tjem.237.103

Bojić S, Kotur-Stevuljević J, Kalezić N, Stevanović P, Jelić-Ivanović Z, Bilanović D, Memon L, Damnjanović M, Kalaba Z, Simić-Ogrizović S. Diagnostic Value of Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 in Sepsis-Associated Acute Kidney Injury. in Toxicological and Environmental Chemistry. 2015;237(2):103-109.
doi:10.1620/tjem.237.103 .

Bojić, Suzana, Kotur-Stevuljević, Jelena, Kalezić, Nevena, Stevanović, Predrag, Jelić-Ivanović, Zorana, Bilanović, Dragoljub, Memon, Lidija, Damnjanović, Mladen, Kalaba, Zdravko, Simić-Ogrizović, Sanja, "Diagnostic Value of Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 in Sepsis-Associated Acute Kidney Injury" in Toxicological and Environmental Chemistry, 237, no. 2 (2015):103-109,
https://doi.org/10.1620/tjem.237.103 . .

TY  - JOUR
AU  - Stevanović, Predrag
AU  - Petrova, Guenka
AU  - Miljković, Branislava
AU  - Šćepanović, Radisav
AU  - Perunović, Radoslav
AU  - Stojanović, Dragos
AU  - Dobrasinović, Janja
PY  - 2008
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/1033
AB  - Background: Laparoscopic surgery is widely recognized as a well-tolerated and effective method for cholecystectomy. It is also considered cost saving because it has been associated with a decreased hospital length of stay. Variables that might lead to increased costs in laparoscopic surgery are the technique and drugs used in anesthesia. Objective: The goal of this study was to compare the costs of 2 anesthetic techniques used in laparoscopic cholecystectomy (LC)-balanced versus IV anesthesia- from the standpoint of an outpatient surgical department, with a time horizon of 1 year. Methods: Patients scheduled to undergo elective LC were enrolled in this prospective case study. Patients were randomly allocated to receive balanced anesthesia, administered as low fresh gas flow (LFGF) with inhalational sevoflurane and IV sufentanil in a target controlled infusion (LFGF SS group), or IV anesthesia, administered as IV propofol/sufentanil in a target controlled infusion (TCI group). We used a microcosting procedure to measure health care resource utilization in individual patients to detect treatment differences. The costs of medications used for the induction and maintenance of anesthesia during surgery were considered for LFGF SS and TCI. Other end points included duration of anesthesia; mean times to early emergence, tracheal extubation, orientation, and postanesthesia discharge (PAD); pain intensity before first analgesia; number of analgesics required in the first 24 hours after surgery; and prevalences of nausea, vomiting, and agitation. Results: A total of 60 patients were included in this analysis (male/female ratios in the LFGF SS and TCI groups: 11/19 and 12/18, respectively; mean [SD] ages, 48 [7.9] and 47 [8.6] years; and mean [SD] body mass indexes, 26 [2.0] and 26 [3.0] kg/m(2)). The costs of anesthetics were significantly lower with LFGF SS compared with TCI (is an element of 17.40 [is an element of 2.66] vs is an element of 22.01 [is an element of 2.50] [2006 euros]). Times to early emergence and tracheal extubation were significantly shorter with LFGF SS than TCI (5.97 [1.16] vs 7.73 [1.48] minutes and 7.57 [1.07] vs 8.87 [1.45] minutes, respectively). There were no significant between-group differences in mean duration of anesthesia; times to orientation and PAD; pain intensity before first analgesia; number of analgesics required in the first 24 hours; or prevalences of nausea, vomiting, and agitation. Because no clinically significant differences in the anesthetic results were observed, a cost-minimization analysis was conducted and found that using LFGF SS, the outpatient surgical department could realize a budget savings of is an element of 454 per 100 patients. For the nearly 1000 expected patients per year, the savings for the department was calculated as is an element of 4540. Conclusion: The results from this cost analysis in these patients who underwent elective LC suggest that the use of sevoflurane through the LFGF technique would be cost saving in this outpatient surgical department. (Clin Ther. 2008;30:1714-1725)
PB  - Elsevier, Bridgewater
T2  - Clinical Therapeutics
T1  - Low Fresh Gas Flow Balanced Anesthesia Versus Target Controlled Intravenous Infusion Anesthesia in Laparoscopic Cholecystectomy: A Cost-Minimization Analysis
VL  - 30
IS  - 9
SP  - 1714
EP  - 1725
DO  - 10.1016/j.clinthera.2008.09.009
ER  - 

@article{
author = "Stevanović, Predrag and Petrova, Guenka and Miljković, Branislava and Šćepanović, Radisav and Perunović, Radoslav and Stojanović, Dragos and Dobrasinović, Janja",
year = "2008",
abstract = "Background: Laparoscopic surgery is widely recognized as a well-tolerated and effective method for cholecystectomy. It is also considered cost saving because it has been associated with a decreased hospital length of stay. Variables that might lead to increased costs in laparoscopic surgery are the technique and drugs used in anesthesia. Objective: The goal of this study was to compare the costs of 2 anesthetic techniques used in laparoscopic cholecystectomy (LC)-balanced versus IV anesthesia- from the standpoint of an outpatient surgical department, with a time horizon of 1 year. Methods: Patients scheduled to undergo elective LC were enrolled in this prospective case study. Patients were randomly allocated to receive balanced anesthesia, administered as low fresh gas flow (LFGF) with inhalational sevoflurane and IV sufentanil in a target controlled infusion (LFGF SS group), or IV anesthesia, administered as IV propofol/sufentanil in a target controlled infusion (TCI group). We used a microcosting procedure to measure health care resource utilization in individual patients to detect treatment differences. The costs of medications used for the induction and maintenance of anesthesia during surgery were considered for LFGF SS and TCI. Other end points included duration of anesthesia; mean times to early emergence, tracheal extubation, orientation, and postanesthesia discharge (PAD); pain intensity before first analgesia; number of analgesics required in the first 24 hours after surgery; and prevalences of nausea, vomiting, and agitation. Results: A total of 60 patients were included in this analysis (male/female ratios in the LFGF SS and TCI groups: 11/19 and 12/18, respectively; mean [SD] ages, 48 [7.9] and 47 [8.6] years; and mean [SD] body mass indexes, 26 [2.0] and 26 [3.0] kg/m(2)). The costs of anesthetics were significantly lower with LFGF SS compared with TCI (is an element of 17.40 [is an element of 2.66] vs is an element of 22.01 [is an element of 2.50] [2006 euros]). Times to early emergence and tracheal extubation were significantly shorter with LFGF SS than TCI (5.97 [1.16] vs 7.73 [1.48] minutes and 7.57 [1.07] vs 8.87 [1.45] minutes, respectively). There were no significant between-group differences in mean duration of anesthesia; times to orientation and PAD; pain intensity before first analgesia; number of analgesics required in the first 24 hours; or prevalences of nausea, vomiting, and agitation. Because no clinically significant differences in the anesthetic results were observed, a cost-minimization analysis was conducted and found that using LFGF SS, the outpatient surgical department could realize a budget savings of is an element of 454 per 100 patients. For the nearly 1000 expected patients per year, the savings for the department was calculated as is an element of 4540. Conclusion: The results from this cost analysis in these patients who underwent elective LC suggest that the use of sevoflurane through the LFGF technique would be cost saving in this outpatient surgical department. (Clin Ther. 2008;30:1714-1725)",
publisher = "Elsevier, Bridgewater",
journal = "Clinical Therapeutics",
title = "Low Fresh Gas Flow Balanced Anesthesia Versus Target Controlled Intravenous Infusion Anesthesia in Laparoscopic Cholecystectomy: A Cost-Minimization Analysis",
volume = "30",
number = "9",
pages = "1714-1725",
doi = "10.1016/j.clinthera.2008.09.009"
}

Stevanović, P., Petrova, G., Miljković, B., Šćepanović, R., Perunović, R., Stojanović, D.,& Dobrasinović, J.. (2008). Low Fresh Gas Flow Balanced Anesthesia Versus Target Controlled Intravenous Infusion Anesthesia in Laparoscopic Cholecystectomy: A Cost-Minimization Analysis. in Clinical Therapeutics
Elsevier, Bridgewater., 30(9), 1714-1725.
https://doi.org/10.1016/j.clinthera.2008.09.009

Stevanović P, Petrova G, Miljković B, Šćepanović R, Perunović R, Stojanović D, Dobrasinović J. Low Fresh Gas Flow Balanced Anesthesia Versus Target Controlled Intravenous Infusion Anesthesia in Laparoscopic Cholecystectomy: A Cost-Minimization Analysis. in Clinical Therapeutics. 2008;30(9):1714-1725.
doi:10.1016/j.clinthera.2008.09.009 .

Stevanović, Predrag, Petrova, Guenka, Miljković, Branislava, Šćepanović, Radisav, Perunović, Radoslav, Stojanović, Dragos, Dobrasinović, Janja, "Low Fresh Gas Flow Balanced Anesthesia Versus Target Controlled Intravenous Infusion Anesthesia in Laparoscopic Cholecystectomy: A Cost-Minimization Analysis" in Clinical Therapeutics, 30, no. 9 (2008):1714-1725,
https://doi.org/10.1016/j.clinthera.2008.09.009 . .