Personal Injury Law

Drug Interaction Prevention Is An Ongoing Process For Doctors And Patients

By Tom Lamb

An Introduction Using Examples And Facts Relevant To Avoiding Drug-Drug Interaction Risks

(Posted by Tom Lamb at DrugInjuryWatch.com)

Patients who require multiple prescription drugs at one time, i.e., concomitant use, are sometimes placed at risk for developing drug-drug interactions (DDIs), where one drug alters the effect of another drug. In turn, drug-drug interactions can lead to decreased therapeutic benefit or efficacy, adverse effects of varying degrees, or even patient death.

To further complicate this type of situation, non-prescription medications and herbal preparations or supplements can contribute to the potential for developing DDIs.

The following examples and facts are intended to help doctors and patients avoid drug interactions and their potentially serious, even fatal, consequences.  They are taken from an educational article, "Managing Drug-Drug Interaction Risks" (free site registration required), which is intended for physicians, pharmacists, nurse practitioners, physician assistants, nurses, and other healthcare workers -- but the information therein could be helpful to patients and their families.

• DDIs contribute to patient morbidity and may cause emergency department visits, hospitalizations, and re-admissions.Examples of patient morbidity caused by DDIs include gastrointestinal (GI) bleeding, renal dysfunction, electrolyte imbalance, hypertension, hypotension, bradycardia, arrhythmia, drug toxicity, and decreased drug effect.
• Examples from the literature of mortality associated with DDIs include ciprofloxacin in fatal seizures, moclobemide-clomipramine overdose in fatal serotonin syndrome,and fatal outcome from a warfarin and nonsteroidal anti-inflammatory drug (NSAID) interaction.
• [T]he risk for DDIs increases significantly after 44 years of age and is greatest for patients over 74 years of age. The need for multiple medications often arises with advancing age that may further the risk for DDIs.
• Patients taking 2 medications had a 13% risk while patients taking 5 medications had a 38% risk for DDIs. Patients taking 7 or more medications had an 82% risk of developing adverse drug interactions.
• Other patient-related risks for DDIs... include very young age, female sex, genetics, decreased organ function, use of a medication having a narrow therapeutic range (eg, warfarin, digoxin, and cyclosporine), major organ impairment, metabolic or endocrine risk conditions (eg, hypothyroidism, hypoproteinemia), and acute medical issues (eg, dehydration).

In the U.S., with our aging population and an ever-increasing use of prescription medications, it seems safe to say that the more one knows about the how to avoid possible drug-drug interactions, the better.

If you are aware of any additional guidance or resources regarding how to avoid drug interactions, please let us know by submitting a Comment, below.

Full post as published by Drug Injury Watch on April 15, 2009 (boomark / email).