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Drug-Drug Interactions and Prescription Appropriateness at Hospital Discharge: Experience with COVID-19 Patients.
Cattaneo, Dario; Pasina, Luca; Maggioni, Aldo Pietro; Oreni, Letizia; Conti, Federico; Pezzati, Laura; Casalini, Giacomo; Bonazzetti, Cecilia; Morena, Valentina; Ridolfo, Annalisa; Antinori, Spinello; Gervasoni, Cristina.
  • Cattaneo D; Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli-Sacco University Hospital, Milan, Italy.
  • Pasina L; Unit of Clinical Pharmacology, ASST Fatebenefratelli-Sacco University Hospital, Milan, Italy.
  • Maggioni AP; Department of Neurosciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
  • Oreni L; ANMCO Research Center, Florence, Italy.
  • Conti F; Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy.
  • Pezzati L; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
  • Casalini G; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
  • Bonazzetti C; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
  • Morena V; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
  • Ridolfo A; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
  • Antinori S; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
  • Gervasoni C; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
Drugs Aging ; 38(4): 341-346, 2021 04.
Article in English | MEDLINE | ID: covidwho-1107914
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Polypharmacy ADMINISTERED_TO Old age
Subject
Polypharmacy
Predicate
ADMINISTERED_TO
Object
Old age
3. Comorbidity PROCESS_OF Old age
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Old age
4. Patients LOCATION_OF CD69 protei
Subject
Patients
Predicate
LOCATION_OF
Object
CD69 protei
5. CD69 protei PREDISPOSES C0687133
Subject
CD69 protei
Predicate
PREDISPOSES
Object
C0687133
6. Pharmaceutical Preparations TREATS 2019 novel coronavirus
Subject
Pharmaceutical Preparations
Predicate
TREATS
Object
2019 novel coronavirus
7. heparin AUGMENTS Drug Interactions
Subject
heparin
Predicate
AUGMENTS
Object
Drug Interactions
8. Prescribed medications TREATS COVID-19
Subject
Prescribed medications
Predicate
TREATS
Object
COVID-19
9. Prescribed medications TREATS Patients
Subject
Prescribed medications
Predicate
TREATS
Object
Patients
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Polypharmacy ADMINISTERED_TO Old age
Subject
Polypharmacy
Predicate
ADMINISTERED_TO
Object
Old age
12. Comorbidity PROCESS_OF Old age
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Old age
13. Patients LOCATION_OF CD69 protein, human|CD69
Subject
Patients
Predicate
LOCATION_OF
Object
CD69 protein, human|CD69
14. CD69 protein, human|CD69 PREDISPOSES Drug Interactions
Subject
CD69 protein, human|CD69
Predicate
PREDISPOSES
Object
Drug Interactions
15. Pharmaceutical Preparations TREATS 2019 novel coronavirus
Subject
Pharmaceutical Preparations
Predicate
TREATS
Object
2019 novel coronavirus
16. heparin AUGMENTS Drug Interactions
Subject
heparin
Predicate
AUGMENTS
Object
Drug Interactions
17. Prescribed medications TREATS COVID-19
Subject
Prescribed medications
Predicate
TREATS
Object
COVID-19
18. Prescribed medications TREATS Patients
Subject
Prescribed medications
Predicate
TREATS
Object
Patients
ABSTRACT

BACKGROUND:

Patients with coronavirus disease 2019 (COVID-19) are often elderly, with comorbidities, and receiving polypharmacy, all of which are known factors for potentially severe drug-drug interactions (DDIs) and the prescription of potentially inappropriate medications (PIMs).

OBJECTIVE:

The aim of this study was to assess the risk of DDIs and PIMs in COVID-19 patients at hospital discharge.

METHOD:

Patients with a proven diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were hospitalized between 21 February and 30 April 2020, treated with at least two drugs, and with available information regarding pharmacological treatments upon admission and at discharge were considered. The appropriateness of drug prescriptions was assessed using INTERcheck®.

RESULTS:

A significant increase in the prescription of proton pump inhibitors and heparins was found when comparing admission with hospital discharge (from 24 to 33% [p < 0.05] and from 1 to 17% [p < 0.01], respectively). The increased prescription of heparins at discharge resulted in a highly significant increase in the potentially severe DDIs mediated by this class of drugs. 51% of COVID-19 patients aged > 65 years had at least one PIM upon admission, with an insignificant increment at discharge (58%).

CONCLUSION:

An increased number of prescribed drugs was observed in COVID-19 patients discharged from our hospital. The addition of heparins is appropriate according to the current literature, while the use of proton pump inhibitors is more controversial. Particular attention should be paid to the risk of bleeding complications linked to heparin-based DDIs.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Limits: Aged / Female / Humans / Male Language: English Journal: Drugs Aging Journal subject: Geriatrics / Drug Therapy Year: 2021 Document Type: Article Affiliation country: S40266-021-00840-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Limits: Aged / Female / Humans / Male Language: English Journal: Drugs Aging Journal subject: Geriatrics / Drug Therapy Year: 2021 Document Type: Article Affiliation country: S40266-021-00840-y