INTERPRETATION DRUG INTERACTIONS IN HOSPITALIZED CARDIAC PATIENTS

Objective: The present study is aimed to identify potential drug-drug interactions in cardiac patients and document any observed interaction. It was also planned to evaluate the demographics of patients and correlate it with drug drug interactions in Lahore General Hospital, Lahore. Methodology: It is a prospective observational study conducted in inpatient setting. The data collected in pre design data collection form for 220 patients, who are assessed for the period of six months. The cardiac patients who were taking at least two cardiac drugs and had a hospital stay of 48 hours were considered for this study. The collected data included demographics; cardiac drugs usage pattern and safety analysis data. The data was compiled in excel and analysed using Micromedex. Result: A total of 220 patients were included in the study out of which 140 patients prescriptions contains pDDI. A total of 234 pDDIs were identified during the study period with median of 1.67 potential drug-drug interactions. Extensive (97.85%) poly pharmacy was observed in study population. The median hospital stay was 7 days. The incidence rate was found to be 63.64%. Majority of interactions were of moderate severity, delayed onset, and pharmacodynamics in nature. Total 28 actual interactions were observed in the observed cases. Out 234 drug interactions, aspirin/clopidogrel (16) and clopidogrel/atorvastatin (16) were most common drug interaction pairs observed among prescribed medications. Of the 234 interventions proposed, the most frequent suggestion was on monitoring for adverse effect (44.01%) followed by dose adjustment (15.81%). 25.64% of interventions were accepted and therapy was changed. Most of the adverse drug interaction observed resulted in bleeding. The causality assessment as per Naranjo and WHO scale were probable in most of observed drug interactions. Conclusion: The present study identified pDDIs and also documented interactions in cardiovascular patients. It was found that the incidence rate of pDDI was high and associated with old age, poly pharmacy and increased lengths of hospital stay. This study highlights the need for screening prescriptions of cardiovascular patients for pDDIs and proactive monitoring of patients who have identified risk factors; this helps in detection and prevention of possible adverse drug interactions