Potential drug-drug interactions in ICU patients: a retrospective study

Iyad Ali; Alaa Bazzar; Nadine Hussein; Emile Sahhar

doi:10.1515/dmpt-2020-0114

Article

Potential drug-drug interactions in ICU patients: a retrospective study

Iyad Ali , Alaa Bazzar , Nadine Hussein and Emile Sahhar

Published/Copyright: July 20, 2020

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From the journal Drug Metabolism and Personalized Therapy Volume 35 Issue 3

Abstract

Objectives

A “potential drug-drug interaction” (pDDI) is the possibility one drug has to alter the effects of another when both are administered simultaneously. Intensive care unit (ICU) patients are especially prone to these pDDIs. This study aimed to determine the frequency and severity of pDDIs during the hospitalization of patients in the ICU.

Methods

This study was conducted retrospectively in three hospitals, including both governmental and non-governmental hospitals in Nablus, Palestine, over the course of six months; starting in January 2018 and ending in June 2018. The sample size included 232 ICU patients, and medications prescribed during the hospitalization of these patients were evaluated for pDDIs using the drugs.com application.

Results

A total of 167 patients (72%) were found to have at least one pDDI, while the total number of pDDIs in the study was 422, resulting in an average of 1.82 pDDIs per patient. Out of the total identified pDDIs, 41 interactions (9.7%) were major interactions, 281 (66.6%) were moderate interactions and 100 (23.7%) were minor interactions. The past medical history of these patients showed that many had hypertension (29%), diabetes mellitus (25%) and ischemic heart disease (10%). A serious combination, enoxaparin and aspirin, was found in six patients. Furthermore, as the number of administered drugs increased, the number of interactions increased as well.

Conclusions

The pDDIs are common in ICU patients. The most common and clinically most important pDDIs require special attention. Polypharmacy significantly increases the number and level of pDDIs, especially in patients with multiple chronic illnesses. Adequate knowledge regarding the most common pDDIs is necessary to enable healthcare professionals to implement ICU strategies that ensure patient safety.

Keywords: drug-drug interaction; intensive care unit; Palestine; patient

Corresponding author: Iyad Ali, Department of Biochemistry, Faculty of Medicine and Health Sciences, An-Najah National University, 7, Nablus, Palestine, E-mail: iyadali@najah.edu

Funding source: An-Najah National University

Acknowledgments

We thank Shatha Abutaha for providing comments and assistance.

Research funding: An-Najah National University.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study design was based on guidelines of the World Health Organization (WHO) and ethical approval was obtained from the Institutional Review Board at An-Najah National University, Nablus, Palestine.

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Received: 2020-04-11

Accepted: 2020-05-29

Published Online: 2020-07-20

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Articles in the same Issue

https://doi.org/10.1515/dmpt-2020-0114

Keywords for this article

drug-drug interaction; intensive care unit; Palestine; patient