• Title, Summary, Keyword: Drug interaction

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Drug Interaction Review of Prescriptions for Outpatients at General Hospital (종합병원의 외래환자 처방전에 대한 약물상호작용 검토)

  • Cho, Jin Hoan;Choi, Byung Chul;Sohn, Uy Dong
    • YAKHAK HOEJI
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    • v.49 no.5
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    • pp.399-404
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    • 2005
  • To investigate drug interaction, 23,536 prescriptions published for 1 year were investigated with 'Drug Inter­action Fact 2002'. Dispensing records and a database file written in a local general hospital in South Korea were used as a sample. The number of total cases of drug interaction was 3,238 ($13.76\%$) out of 23,536 prescriptions. The incidence of drug interaction in each prescription the children, the adults, and the elderly were $1.33\%,\;10.97\%,\;25.50\%$, respectively. The incidences of drug interaction per each prescription were $22.03\%,\;20.52\%,\;0.51\%,\;and\;0.36\%$ in neurosurgery, internal med­icine, pediatrics, and orthopedics, respectively. In neurosurgery and internal medicine, risk-high drugs of drug interaction such as antihypertensive drugs, diuretics, and cimetidine were used very often in elderly. In this paper, several suggestions to reduce drug interaction were postulated with regard to the usage of analgesics, non-steroidal antiinflammatory drugs, and antibiotics.

Initiation of Pharmaceutical Care Service in Medical Intensive Care Unit with Drug Interaction Monitoring Program (내과계 중환자실 약료 서비스 도입과 약물상호작용 모니터링)

  • Choi, Jae Hee;Choi, Kyung Sook;Lee, Kwang Seup;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.138-144
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    • 2015
  • Objective: It is to evaluate the drug interaction monitoring program as a pilot project to develop a pharmaceutical care model in a medical intensive care unit and to analyze the influencing factors of drug interactions. Method: Electronic medical records were retrospectively investigated for 116 patients who had been hospitalized in a medical intensive care unit from October to December in 2014. The prevalence of adverse reaction with risk rating higher than 'D' was investigated by Lexi-$Comp^{(R)}$ Online database. The factors related with potential drug interaction and with treatment outcomes were analyzed. Results: The number of patients with a potential interaction of drug combination was 92 (79.3%). Average ages, the length of stay in the intensive care unit and the numbers of prescription drugs showed significant differences between drug interaction group and non-drug interaction group. Opioids (14.4%), antibiotics (7.2%), and diuretics (7.2%) were most responsible drug classes for drug interactions and the individual medications included furosemide (6.4%), tramadol (4.9%), and remifentanil (4.5%). There were 950 cases with a risk rating of 'C' (84.6%), 142 cases with a risk rating of 'D' (12.6%), and 31 cases with a risk rating of 'X' (avoid combination) (2.8%). The factors affecting drug interactions were the number of drugs prescribed (p < 0.0001) and the length of stay at intensive care unit (p < 0.01). The patients in intensive care unit showed a high incidence of adverse reactions related to potential drug interaction. Therefore, drug interaction monitoring program as a one of pharmaceutical care services was successfully piloted and it showed to prevent adverse reaction and to improve therapeutic outcomes. Conclusion: Active participation of a pharmacist in the drug management at the intensive care unit should be considered.

Proposed Mechanisms and Further study for Korean Traditional medicines-Drug Interaction in a view of Toxicology (한약의 약물상호작용 기전과 연구방향 - 독성학적인 측면을 중심으로 -)

  • Park, Yeong-Chul;Kim, Myung-Dong;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.15 no.1
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    • pp.1-16
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    • 2011
  • Objectives : The mechanisms for korean traditional medicine-drug interaction has not been well reviewed in spite that the chance for co-administration with western drugs or diet supplements has been increased. Especially, it is well known that various cytochrome P450s play a major role in drug-drug interaction. Of course, Korean traditional medicines is not excluded in a view of metabolism or biotransformation by cytochrome P450. This article was focused on reviewing the possible roles of cytochrome P450 in Korean traditional medicine-drug interaction, Also, the directions for further studies were suggested in terms of Korean traditional medicine-drug interaction. Methods : New studies for korean traditional medicine-drug interaction were reviewed and summarized in terms of cytochrome P450 activities by various Korean traditional medicines and western drugs. Results and Conclusions : Even if a few studies related to Korean traditional medicine-drug interactions was carried out, almost no studies for Korean traditional medicine-drug interactions has been found in a view of cytochrome P450. It was suggested that Korean traditional medicines and their decoction should be analyzed that how they effects on cytochrome P450, expecially CYP 1, 2, 3 families and how they interact with western drugs.

Pharmacodynamic Drug-Drug Interactions Considered to be Added in the List of Contraindications with Pharmacological Classification in Korea (약물군-약물군 조합으로 도출한 약력학적 기전의 추가 병용금기성분)

  • Je, Nam Kyung;Kim, Dong-Sook;Kim, Grace Juyun;Lee, Sukhyang
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.2
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    • pp.120-129
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    • 2015
  • Objectives: Drug utilization review program in Korea has provided 'drug combinations to avoid (DCA)' alerts to physicians and pharmacists to prevent potential adverse drug events or inappropriate drug use. Seven hundred and six DCA pairs have been announced officially by the Ministry of Food and Drug Safety (MFDS) by March, 2015. Some DCA pairs could be grouped based on the drug interaction mechanism and its consequences. This study aimed to investigate the drug-drug interaction (DDI) pairs, which may be potential DCAs, generated by the drug class-drug class interaction method. Methods: Eleven additive/synergistic and one antagonistic drug class-drug class interaction groups were identified. By combining drugs of two interacting drug class groups, numerous DDI pairs were made. The status and severity of DDI pairs were examined using Lexicomp and Micromedex. Also, the DCA listing rate was calculated. Results: Among 258 DDI pairs generated by the drug class-drug class interaction method, only 142 pairs were identified as official DCA pairs by the MFDS. One hundred and four pairs were identified as potential DCA pairs to be listed. QT prolonging agents-QT prolonging agents, triptans-ergot alkaloids, tricyclic antidepressants-monoamine oxidase inhibitors, and dopamine agonists-dopamine antagonists were identified as drug class-drug class interaction groups which have less than 50 % DCA listing rate. Conclusion: To improve the clinicians' adaptability to DCA alerts, the list of DCA pairs needs to be continuously updated.

Drug-herb interactions: Mechanisms involved and clinical implications of five commonly and traditionally used herbs

  • Ong, Chin Eng;Pan, Yan
    • CELLMED
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    • v.4 no.3
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    • pp.17.1-17.8
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    • 2014
  • Herbal remedies are commonly used by patients worldwide. Because these herbal preparations share the same metabolic and transport proteins with prescribed medicines, the potential for a drug-herb interaction is substantial and is an issue of significant concern. This review paper summarizes drug-herb interactions involving inhibition or induction of cytochrome P450 enzymes, drug transporters as well as modulation of drug pharmacodynamics. An increasing number of in vitro and animal studies, case reports and clinical trials evaluating such interactions have been reported, and implications of these studies are discussed in this review. The most commonly implicated drugs in the interaction include anticoagulants, antiplatelets, immunosuppressants, anti-neoplastics, protease inhibitors, and some antidepressants. Pharmacokinetic and/or pharmacodynamic interactions of five commonly used herbal remedies (danshen, garlic, Ginkgo biloba, ginseng, and St John's wort) with these drugs are presented, with focus of discussion being the potentials for interaction, their mechanisms and clinical implications. There is a necessity for adequate pharmacovigilance to be carried out in minimizing unanticipated but often preventable drug-herb interactions.

Relation Extraction of Drug-Drug Interaction using Multi-Channel PCNN Model (Multi-Channel PCNN 모델을 활용한 약물-약물 상호작용 관계 추출)

  • Park, Chanhee;Cho, Minsoo;Park, Jangwon;Park, Sanghyun
    • Proceedings of the Korean Society of Computer Information Conference
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    • pp.33-36
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    • 2019
  • DDI 추출은 생물 의학 문헌으로부터 약물-약물 상호작용(Drug-Drug Interaction) 관계를 추출하는 작업으로, 기존에 알려지지 않은 인체 내 약물 간의 효과 또는 부작용 정보를 제공하는데 중요한 역할을 한다. 본 연구에서는 PCNN 모델을 활용하여 특징 추출 과정을 자동화하고 약물 개체 간의 구조 정보를 포착해 개체 간 관계를 효율적으로 추출하였으며, 생물 의학 문헌에서 쓰이는 생소한 용어를 보다 풍부하게 표현하기 위해 5가지 버전의 단어 임베딩을 PCNN의 채널로 사용하였다. 본 연구에서 제안하는 MC-PCNN 모델의 성능 평가를 위해 DDI'13 Corpus 데이터를 사용하여 비교 실험을 진행하였으며, 그 결과 기존 연구보다 $F_1$ 점수 기준 최대 2.05%p 향상된 성능을 보이며 DDI 관계 추출에서 효과적인 방법론임을 확인하였다.

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Potential Drug Interactions in Cancer Patients on Oral Kinase Inhibitors (경구용 활성효소 억제제 복용 암환자의 잠재적 약물상호작용 연구)

  • Jung, Eun-Hee;Bang, Joon Seok;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.129-136
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    • 2013
  • Objectives: Among many new drugs that are under investigation with intent to treat cancer, oral kinase inhibitors are proven to be effective in numerous clinical trials and easy to administer. Due to these advantages the use of oral kinase inhibitors is increasing. Oral kinase inhibitors are metabolized by CYP450 which can result either increase of adverse effect or decrease of drug effect by drug interaction when used concurrently with other agents. In this research, the medication records of patients on oral kinase inhibitors from Oct. 2010 to Nov. 2011 were reviewed to investigate potential drug interactions. Methods: From Oct. 2010 to Nov. 2011, cancer patients in Inha University Hospital who took oral kinase inhibitors more than once were included. The patients' medication records were reviewed to list out concurrent medications that have interaction potential with oral kinase inhibitors, the frequency of concurrent use, and the severity of interaction result using Micromedex$^{(R)}$ and Lexicomp-online$^{(R)}$ as references. Results: As a result, 90 cases of drug with interaction potential were prescribed by Micromedex$^{(R)}$ and 179 cases by Lexicomp-online$^{(R)}$ data. In case of severity, 33.3% by Micromedex$^{(R)}$ and 26.3% by Lexicomp-online$^{(R)}$ were categorized as Major and 65.6% by Micromedex$^{(R)}$ and 72.6% by Lexicomp-online$^{(R)}$ as Moderate. The number of adverse events was 92 cases which 58.7% were on skin and 19.6% on Gastro-intestinal tract. Conclusions: Considerable number of drug with interaction potential was used though each oral kinase inhibitors showed differences in extent. Hence there exists the risk of drug interaction in patients taking oral kinase inhibitors with other drugs.

Drug-Drug Interactions : Mood Stabilizers and Anti-Anxiety Drugs (약물상호작용 : 기분안정제와 항불안제)

  • Kim, Young Hoon;Rhee, Jung Goo
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.34-45
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    • 2000
  • Pharmacotherapy of bipolar disorder is a rapidly evolving field. Mood stabilizers and anticonvulsants have varying biochemical profiles which may predispose them to different adverse effects and drug-drug interactions. Several of the new anticonvulsants appear less likely to have the problems with drug-drug interaction. To provide more effective combination pharmacotherapies, clinicians should be allowed to anticipate and avoid pharmacokinetic and pharmacodynamic drug-drug interactions. We reviewed the role of cytochrome P450 isozymes in the metabolism of the drugs and their interactions. The drug-drug interactions of several classes of drugs which used as mood stabilizers and new anticonvulsants, some of which may have psychotropic profiles, are discussed mainly in this article. Finally, potential pharmacokinetic interactions between the benzodiazepines and other coadministered drugs are discussed briefly.

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Antidepressants and Related Drug Interactions (항우울제와 연관약물의 약물상호작용)

  • Lee, Min Soo
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.21-33
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    • 2000
  • As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. This review provides a better understanding of drug-drug interactions often encountered in pharmacotherapy of depression. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In this review, emphasis is placed on antidepressant medications, how they are metabolized by the P450 system, and how they alter the metabolism of other drugs. When prescribing antidepressant medications, the clinician must consider the drug-drug interactions that are potentially problematic.

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Investigation of the Regulatory Effects of Saccharin on Cytochrome P450s in Male ICR Mice

  • Jo, Jun Hyeon;Kim, Sunjoo;Jeon, Tae Won;Jeong, Tae Cheon;Lee, Sangkyu
    • Toxicological Research
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    • v.33 no.1
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    • pp.25-30
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    • 2017
  • Saccharin, the first artificial sweetener, was discovered in 1879 that do not have any calories and is approximately 200~700 times sweeter than sugar. Saccharin was the most common domestically produced sweetener in Korea in 2010, and it has been used as an alternative to sugar in many products. The interaction between artificial sweeteners and drugs may affect the drug metabolism in patients with diabetes, cancer, and liver damage, this interaction has not been clarified thus far. Here, we examined the effects of the potential saccharin-drug interaction on the activities of 5 cytochrome P450 (CYPs) in male ICR mice; further, we examined the effects of saccharin (4,000 mg/kg) on the pharmacokinetics of bupropion after pretreatment of mice with saccharin for 7 days and after concomitant administration of bupropion and saccharin. Our results showed saccharin did not have a significant effect on the 5 CYPs in the S9 fractions obtained from the liver of mice. In addition, we observed no differences in the pharmacokinetic parameters of bupropion between the control group and the groups pretreated with saccharin and that receiving concomitant administration of saccharin. Thus, our results showed that saccharin is safe and the risk of saccharin-drug interaction is very low.