Drug-drug interactions of non-steroidal anti-inflammatory drugs with other drugs in patients with rheumatic diseases

Peláez-Ballestasa, I.; Meléndez-Mercado, C.; Hernández-Garduño, A.; Viramontes-Madrid, J.L.; Burgos-Vargas, R.

doi:10.1016/S1699-258X(05)72724-8

Información del artículo

Resumen

Bibliografía

Descargar PDF

Estadísticas

Objective

To determine the prevalence of and identify drug-drug interactions (DDI) between non-steroidal anti-inflammatory drugs (NSAID) and other drugs in a prescription database of patients with rheumatic iseases.

Material and methods

This is a cross-sectional study of a drug prescription database saving information on 35,000 individuals who benefited from a pre-paid medical system serving bank employees and their relatives. The analysis included one year period (from January to December 1998). NSAID-DDI were listed and classified into 3 levels (1: minor; 2: moderate, and 3: high health risk or death risk) according to DRUGDEX(r) as well as MEDLINE and EMBASE search.

Results

We analyzed 3,207 NSAID prescriptions (1.7±1.6 per patient) to 1,855 rheumatic patients (adults: 76.7%; geriatric: 20.2%, and pediatric: 3.0%; soft tissue rheumatism: 52%; osteoarthritis: 19%, and rheumatoid arthritis: 10%). There were 648 (20.20%) NSAID-DDI prescriptions: 594 (91.66%) corresponded to level 1; 46 (7.09%) to level 2, and 8 (1.23%) to level 3. In addition, 96 (2.99%) prescriptions included NSAID duplications. Interestingly, we found no NSAID-DDI with anticoagulants, anticonvulsants, and oral hypoglycemiants were found.

Conclusions

The prevalence of NSAID-DDI prescriptions to 1,855 rheumatic patients was 20.20% in one year. NSAID-DDI was mostly (91.66%) level 1, and rarely (1.23%) level 3. NSAID duplications were found in 2.99%. These results provides information on the frequency of prescriptions with DDI, which might potentially produce harmful effects and data, which may help in the development of studies searching for the clinical relevance of NSAID-DDI.

Key words:

NSAID

Drug-drug interactions

Drug database

Rheumatic diseases

Prescriptions

Objetivo

Determinar la prevalencia e identificar las interacciones (INTMED) entre antiinflamatorios no esteroideos (AINE) y otros fármacos en una base de atos de prescripción a enfermos reumáticos.

Material y métodos

Se trata de un estudio transversal de una base de datos de prescripción de 35.000 beneficiarios de un sistema de atención médica de prepago para trabajadores bancarios y sus familiares. El análisis abarca un año (de enero a diciembre de 1998). La lista y la clasificación de las AINE-INTMED en 3 niveles (1: mínimo; 2: moderado, y 3: alto riesgo para la salud/peligro de muerte) se hicieron de acuerdo con DRUGDEX® y búsquedas en MEDLINE y EMBASE.

Resultados

Se analizaron 3.207 prescripciones de AINE (1,7±1,6 por paciente) a 1.855 pacientes reumáticos (el 76,7% adultos, el 20,2% geriátricos y el 3,0% pediátricos; reumatismo extraarticular: 52%; osteoartrosis: 19%; artritis reumatoide: 10%). Se encontraron 648 (20,20%) AINE-INTMED, de las que 594 (91,66%) correspondieron al nivel 1, 46 (7,09%) al nivel 2 y 8 (1,23%) al nivel 3. Además, encontramos 96 (2,99%) prescripciones con duplicación de AINE. No encontramos AINE-INTMED con anticoagulantes, anticonvulsionantes o hipoglucemiantes orales.

Conclusiones

La prevalencia de AINE-INTMED en prescripciones a 1.855 pacientes reumáticos en un año fue del 20,20%. La mayoría (91,66%) fue del nivel 1 y aramente del 3 (1,23%). El 2,99% de ellas tuvieron duplicaciones de AINE. Nuestros resultados proporcionan información de la prevalencia de INTMED que potencialmente podrían producir daños al individuo y datos que podrían influir en el desarrollo de estudios de la importancia clínica de las AINE-INMED.

Palabras clave:

AINE

Interacciones medicamentosas

Bases de datos

Enfermedades reumáticas

Prescripciones

El Texto completo está disponible en PDF

Bibliografía

[1.]

L. Bergendal, A. Friberg, A. Schaffrath.

Potential drug-drug interactions in 5,125 mostly elderly out-patients in Gothenburg, Sweden.

Pharm World Sci, 17 (1995), pp. 152-157

Medline

[2.]

J. Merlo, H. Liedholm, U. Lindblad, A. Bjorck-Linne, J. Falt, G. Lindberg, et al.

Prescriptions with potential drug interactions dispensed at Swedish pharmacies in January 1999: cross sectional study.

BMJ, 323 (2001), pp. 427-428

Medline

[3.]

C.A. Jankel, L.K. Fitterman.

Epidemiology of drug-drug interactions as a cause of hospital admissions.

Drug Saf, 9 (1993), pp. 51-59

Medline

[4.]

R.M. Goldberg, J. Mabee, L. Chan, S. Wong.

Drug-drug and drug-disease interactions in the ED: analysis of high-risk population.

Am J Emerg Med, 14 (1996), pp. 447-450

http://dx.doi.org/10.1016/S0735-6757(96)90147-3 | Medline

[5.]

R.A. Hamilton, L.L. Briceland, M.H. Andritz.

Frequency of hospitalizations after exposure to known drug-drug interactions in a Medicaid population.

Pharmacotherapy, 18 (1998), pp. 1112-1120

Medline

[6.]

D.N. Juurlink, M. Mamdani, A. Kopp, A. Laupacis, D.A. Redelmeier.

Drugdrug interactions among elderly patients hospitalized for drug toxicity.

JAMA, 289 (2003), pp. 1652-1658

http://dx.doi.org/10.1001/jama.289.13.1652 | Medline

[7.]

I. Buajordet, J. Ebbesen, J. Erikssen, O. Bors, T. Hilberg.

Fatal adverse drug events: the paradox of drug treatment.

J Intern Med, 250 (2001), pp. 327-341

Medline

[8.]

P.A. Insel.

Analgesics-antipyretics and antiinflammatory agents; drugs employed in the treatment of rheumatoid arthritis and gout.

Goodman & Gilman's The pharmacological basis of therapeutics, pp. 638-681

[9.]

K.N. Van Dijk, C.S. De Vries.

Occurrence of potential drug-drug interactions in nursing home residents.

Inter J Pharmacy Pract, 9 (2001), pp. 45-52

[10.]

N.R. Crowther, A.M. Holbrook, R. Kenwright, M. Kenwright.

Drug interactions among commonly used medications. Chart simplifies data from critical literature review.

Can Fam Physic, 43 (1997), pp. 1972-1976

[11.]

J.U. Rosholm, L. Bjerrum, J. Hallas, J. Worm, L.F. Gram.

Polypharmacy and the risk of drug-drug interactions among Danish elderly. A prescription database study.

Danish Med Bull, 45 (1998), pp. 210-213

Medline

[12.]

D.B. Hogan, N.R. Campbell, R. Crutcher, P. Jennett, N. MacLeod.

Prescription of nonsteroidal anti-inflammatory drugs for elderly people in Alberta.

CMAJ, 151 (1994), pp. 315-322

Medline

[13.]

A.S. Nies.

Principles of therapeutics.

Goodman & Gilman's The pharmacological basis of therapeutics, pp. 62-83

[14.]

J.M. Kremer.

Toward a better understanding of methotrexate.

Arthritis Rheum, 50 (2004), pp. 1370-1382

http://dx.doi.org/10.1002/art.20278 | Medline

[15.]

R.L. Williams, R.O. Davies, R.S. Berman, G.I. Holmes, P. Huber, W.L. Gee, et al.

Hydrochlorothiazide pharmacokinetics and pharmacologic effect: the influence of indomethacin.

J Clin Pharmacol, 22 (1982), pp. 32-41

Medline

[16.]

E. Steiness, S. Waldorff.

Different interactions of indomethacin and sulindac with thiazides in hypertension.

Br Med J, 285 (1982), pp. 1702-1703

[17.]

W.M. O’Brien.

Adverse reactions to non-steroidal anti-inflammatory drugs. Diclofenac compared with other non-steroidal anti-inflammatory drugs.

Am J Med, 80 (1986), pp. 70-80

Medline

[18.]

T.R. Fulda, R.J. Valuck.

Disagreement among drug compendia on inclusion and ratings of drug-drug interaction.

Curr Therap Res Clin Exp, 1 (2000), pp. 540-548

[19.]

H. Halkin, I. Katzir, I. Kurman, J. Jan, B.B. Malkin.

Preventing drug interactions by online prescription screening in community pharmacies and medical practices.

Clin Pharmacol Ther, 69 (2001), pp. 260-265

http://dx.doi.org/10.1067/mcp.2001.114228 | Medline

Indexada en:

Síguenos:

Suscribirse:

Indexada en:

Síguenos:

Suscribirse:

Suscríbase a la newsletter