The impact of treatment choices on potential drug–drug interactions in hypertensive patients
Abstract
Aims: The aim of this study was to analyse potential drug–drug interactions (pDDIs) and their potential adverse drug reactions (ADRs) among hypertensive patients. Moreover, we investigated the possibility of reducing pDDIs with different treatment choices. Methods: This was a cross-sectional study including all outpatients with hypertension and two or more medications, treated in a university hospital in Serbia. Lexicomp Interact (Lexi-Comp, Inc., Hudson, OH) was used for identification of pDDIs and potential ADRs. Treatment choices were explored according to patient characteristics, treatment guidelines and the interacting potential of drugs. Data were analysed using descriptive analysis and multiple logistic regression. Results: A total of 350 patients were included in this study, with average age (77 [36–98] years and 6.1 [2.5]) medications. The majority of patients (86.0%) had at least one clinically significant pDDI, and the average was 3.78 (3.90) (range 1–25). Suggestions for tr...eatment change aimed mainly at eliminating drug duplications, reducing the use of thiazide diuretics, sulfonylureas, alpha-lipoic acid and pentoxifylline and increasing the use of calcium-channel blockers, when appropriate. pDDIs would have decreased to 2.10 (2.52), P <.001, yet male gender, ≥6 medications, cardiovascular diseases, diabetes, benign prostatic hyperplasia, would be predictive of two or more pDDIs. The main potential adverse outcomes of pDDIs were hypotension, renal failure, hypoglycaemia, bradycardia and lactic acidosis. Conclusion: Careful choice of drugs can reduce but not eliminate pDDIs and their potential ADRs in hypertensive patients. Close monitoring for hypotension, renal failure, hypoglycaemia, bradycardia and lactic acidosis is necessary.
Keywords:
adverse drug reactions / drug–drug interactions / hypertension / treatment choicesSource:
British Journal of Clinical Pharmacology, 2021, 88, 5, 2340-2348Publisher:
- John Wiley and Sons Inc
Funding / projects:
DOI: 10.1111/bcp.15168
ISSN: 0306-5251
WoS: 000731326700001
Scopus: 2-s2.0-85121427360
Collections
Institution/Community
PharmacyTY - JOUR AU - Perić, Aneta AU - Udilović, Ana AU - Dobrić, Silva AU - Vezmar-Kovačević, Sandra PY - 2021 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/4017 AB - Aims: The aim of this study was to analyse potential drug–drug interactions (pDDIs) and their potential adverse drug reactions (ADRs) among hypertensive patients. Moreover, we investigated the possibility of reducing pDDIs with different treatment choices. Methods: This was a cross-sectional study including all outpatients with hypertension and two or more medications, treated in a university hospital in Serbia. Lexicomp Interact (Lexi-Comp, Inc., Hudson, OH) was used for identification of pDDIs and potential ADRs. Treatment choices were explored according to patient characteristics, treatment guidelines and the interacting potential of drugs. Data were analysed using descriptive analysis and multiple logistic regression. Results: A total of 350 patients were included in this study, with average age (77 [36–98] years and 6.1 [2.5]) medications. The majority of patients (86.0%) had at least one clinically significant pDDI, and the average was 3.78 (3.90) (range 1–25). Suggestions for treatment change aimed mainly at eliminating drug duplications, reducing the use of thiazide diuretics, sulfonylureas, alpha-lipoic acid and pentoxifylline and increasing the use of calcium-channel blockers, when appropriate. pDDIs would have decreased to 2.10 (2.52), P <.001, yet male gender, ≥6 medications, cardiovascular diseases, diabetes, benign prostatic hyperplasia, would be predictive of two or more pDDIs. The main potential adverse outcomes of pDDIs were hypotension, renal failure, hypoglycaemia, bradycardia and lactic acidosis. Conclusion: Careful choice of drugs can reduce but not eliminate pDDIs and their potential ADRs in hypertensive patients. Close monitoring for hypotension, renal failure, hypoglycaemia, bradycardia and lactic acidosis is necessary. PB - John Wiley and Sons Inc T2 - British Journal of Clinical Pharmacology T1 - The impact of treatment choices on potential drug–drug interactions in hypertensive patients VL - 88 IS - 5 SP - 2340 EP - 2348 DO - 10.1111/bcp.15168 ER -
@article{ author = "Perić, Aneta and Udilović, Ana and Dobrić, Silva and Vezmar-Kovačević, Sandra", year = "2021", abstract = "Aims: The aim of this study was to analyse potential drug–drug interactions (pDDIs) and their potential adverse drug reactions (ADRs) among hypertensive patients. Moreover, we investigated the possibility of reducing pDDIs with different treatment choices. Methods: This was a cross-sectional study including all outpatients with hypertension and two or more medications, treated in a university hospital in Serbia. Lexicomp Interact (Lexi-Comp, Inc., Hudson, OH) was used for identification of pDDIs and potential ADRs. Treatment choices were explored according to patient characteristics, treatment guidelines and the interacting potential of drugs. Data were analysed using descriptive analysis and multiple logistic regression. Results: A total of 350 patients were included in this study, with average age (77 [36–98] years and 6.1 [2.5]) medications. The majority of patients (86.0%) had at least one clinically significant pDDI, and the average was 3.78 (3.90) (range 1–25). Suggestions for treatment change aimed mainly at eliminating drug duplications, reducing the use of thiazide diuretics, sulfonylureas, alpha-lipoic acid and pentoxifylline and increasing the use of calcium-channel blockers, when appropriate. pDDIs would have decreased to 2.10 (2.52), P <.001, yet male gender, ≥6 medications, cardiovascular diseases, diabetes, benign prostatic hyperplasia, would be predictive of two or more pDDIs. The main potential adverse outcomes of pDDIs were hypotension, renal failure, hypoglycaemia, bradycardia and lactic acidosis. Conclusion: Careful choice of drugs can reduce but not eliminate pDDIs and their potential ADRs in hypertensive patients. Close monitoring for hypotension, renal failure, hypoglycaemia, bradycardia and lactic acidosis is necessary.", publisher = "John Wiley and Sons Inc", journal = "British Journal of Clinical Pharmacology", title = "The impact of treatment choices on potential drug–drug interactions in hypertensive patients", volume = "88", number = "5", pages = "2340-2348", doi = "10.1111/bcp.15168" }
Perić, A., Udilović, A., Dobrić, S.,& Vezmar-Kovačević, S.. (2021). The impact of treatment choices on potential drug–drug interactions in hypertensive patients. in British Journal of Clinical Pharmacology John Wiley and Sons Inc., 88(5), 2340-2348. https://doi.org/10.1111/bcp.15168
Perić A, Udilović A, Dobrić S, Vezmar-Kovačević S. The impact of treatment choices on potential drug–drug interactions in hypertensive patients. in British Journal of Clinical Pharmacology. 2021;88(5):2340-2348. doi:10.1111/bcp.15168 .
Perić, Aneta, Udilović, Ana, Dobrić, Silva, Vezmar-Kovačević, Sandra, "The impact of treatment choices on potential drug–drug interactions in hypertensive patients" in British Journal of Clinical Pharmacology, 88, no. 5 (2021):2340-2348, https://doi.org/10.1111/bcp.15168 . .