Safety of Pharmacotherapy in COVID-19 Patients: A Literature Review
Safety and Risk of Pharmacotherapy
; 10(4):326-344, 2022.
Article
in Russian
| EMBASE | ID: covidwho-2242341
ABSTRACT
The safety of COVID-19 pharmacotherapy is a relevant issue, first of all, because of the current lack of experience with using particular medicinal products and with off-label prescribing. The aim of the study was to analyse information on potential adverse drug reactions (ADRs) and their predictors in etiology- and pathogenesis-oriented COVID-19 therapy. According to literature data, the main clinically significant risk factors for COVID-19 patients to develop an ADR are the duration of their hospital stay, combined use of antivirals, polypharmacy, and their history of drug allergies. The most common adverse reactions to antivirals, to virus-neutralising antibodies, and to human anti-COVID-19 immunoglobulin and convalescent plasma are, respectively, gastrointestinal and hepatobiliary disorders;gastrointestinal disorders, neurological disorders, and allergic reactions;and transfusion reactions (fever, chills, etc.). For pathogenesis-oriented therapy with systemic glucocorticosteroids, the most characteristic ADR is hyperglycaemia. Janus kinase inhibitors and interleukin inhibitors are most often associated with gastrointestinal disorders and hypertransaminasemia;neutropenia is also characteristic of a number of interleukin inhibitors. Haemostatic adverse reactions to anticoagulants depend on the patient's dosing regimen and condition. Drug-drug interactions are a common problem in COVID-19 treatment, with the combination of nirmatrelvir and ritonavir showing the largest number of significant interactions attributed to their pharmacokinetics. Currently, there is data on the role of pharmacogenetic biomarkers in the safety and clinical outcomes of COVID-19 therapy. Thus, to improve the safety of COVID-19 therapy, an integrated approach is needed that will take into account both the clinical, demographic, and pharmacogenetic predictors of ADRs and the risk of drug-drug interactions.
adult; allergy; blood transfusion reaction; chill; clinical outcome; controlled study; coronavirus disease 2019; demography; drug combination; drug hypersensitivity; fever; gastrointestinal disease; hepatobiliary disease; hospitalization; human; hyperglycemia; hypertransaminasemia; neurologic disease; neutropenia; outcome assessment; pharmacogenetics; pharmacokinetics; pharmacovigilance; polypharmacy; review; risk assessment; risk factor; anticoagulant agent; antivirus agent; biological marker; convalescent plasma; cytokine receptor antagonist; endogenous compound; immunoglobulin; Janus kinase inhibitor; neutralizing antibody; nirmatrelvir; ritonavir
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Reviews
Language:
Russian
Journal:
Safety and Risk of Pharmacotherapy
Year:
2022
Document Type:
Article
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