ABSTRACT
Drug-drug interactions [DDIs] can lead to increased toxicity or reduction in therapeutic efficacy. This study was designed to assess the incidence of potential drug interactions [PDI] and rank their clinical value in post coronary care unit [Post-CCU] of a teaching hospital in Tehran, Iran
In this prospective study, three pharmacists with supervision of a clinical pharmacist actively gathered necessary information for detection of DDIs. Data were tabulated according to the combinations of drugs in treatment chart. Verification of potential drug interactions was carried out using the online Lexi-Interact[TM] 2011
A total of 203 patients [113 males and 90 females] were enrolled in the study. The mean age of patients was 61 +/- 12.55 years [range = 26-93]. A total of 90 drugs were prescribed to 203 patients and most prescribed drugs were atorvastatin, clopidogrel and metoprolol. Mean of drugs was 11.22 per patient. A total of 3166 potential drug interactions have been identified by Lexi- Interact[TM], 149 [4.71%] and 55 [1.73%] of which were categorized as D and X, respectively. The most serious interactions were clopidogrel+omeprazole and metoprolol+salbutamol
Drug interactions leading to serious adverse effects are to be cautiously watched for when multiple drugs are used simultaneously. In settings with multiple drug use attendance of a pharmacist or clinical pharmacist, taking the responsibility for monitoring drug interactions and notifying the physician about potential problems could decrease the harm in patient and increase the patient safety
ABSTRACT
To study the resistance to standard dosage of clopidogrel among Iranian patients following percutaneous coronary intervention measured by platelet aggregation test
Patients undergoing percutaneous coronary intervention in Imam Hussein Medical center, Tehran, Iran, who were under treatment with aspirin, but had no history of clopidogrel usage, entered the study. Patients received standard dosage of clopidogrel [Plavix®, Sanofi, France, 600 mg loading dose and 75 mg/day afterward]. Platelet aggregation was measured using light transmission aggregometer. The response to the drug was categorized as complete resistance [platelet aggregation decreased less than 10%], intermediate resistance [platelet aggregation decreased between 10 to 30%] and complete response [platelet aggregation decreased to 30% or more]. All patients were evaluated for major adverse cardio vascular events one month after the angioplasty based on MACE criteria by phone contact
Thirty-one patients with a mean age of 59 +/- 13 entered the study. Sixty-five percent of patients showed complete response to clopidogrel [95% CI: 45% to 81%], 22% showed intermediate resistance [95% CI: 10-41%] and 13% showed complete resistance [95% CI: 4-30%]. One month after the angioplasty, no major adverse cardiovascular event was recorded
Based on our findings, it seems that there is no major difference between Iranian population and other studies regarding the resistance to clopidogrel. Due to the limited number of participants in our study, further investigations with higher number of patients are recommended to more precisely calculate the percentage of resistance among Iranian patients