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Drug-Drug Interactions and Prescription Appropriateness in Patients with COVID-19: A Retrospective Analysis from a Reference Hospital in Northern Italy.
Cattaneo, Dario; Pasina, Luca; Maggioni, Aldo Pietro; Giacomelli, Andrea; Oreni, Letizia; Covizzi, Alice; Bradanini, Lucia; Schiuma, Marco; Antinori, Spinello; Ridolfo, Annalisa; 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.
  • Giacomelli A; ANMCO Research Center, Florence, Italy.
  • Oreni L; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.
  • Covizzi A; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
  • Bradanini L; Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, Via GB Grassi 74, 20157, Milan, Italy.
  • Schiuma M; 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.
  • Ridolfo A; 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 ; 37(12): 925-933, 2020 12.
Article in English | MEDLINE | ID: covidwho-910373
Semantic information from SemMedBD (by NLM)
1. Hospitals LOCATION_OF Analysis
Subject
Hospitals
Predicate
LOCATION_OF
Object
Analysis
2. Drug Interactions PROCESS_OF Patients
Subject
Drug Interactions
Predicate
PROCESS_OF
Object
Patients
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Polypharmacy ADMINISTERED_TO Patients
Subject
Polypharmacy
Predicate
ADMINISTERED_TO
Object
Patients
5. Therapeutic procedure TREATS COVID-19
Subject
Therapeutic procedure
Predicate
TREATS
Object
COVID-19
6. CD69 protei PREDISPOSES C0687133
Subject
CD69 protei
Predicate
PREDISPOSES
Object
C0687133
7. Pharmaceutical Preparations TREATS COVID-19
Subject
Pharmaceutical Preparations
Predicate
TREATS
Object
COVID-19
8. Drug Interactions NEG_ASSOCIATED_WITH tocilizumab
Subject
Drug Interactions
Predicate
NEG_ASSOCIATED_WITH
Object
tocilizumab
9. Drug Interactions NEG_ASSOCIATED_WITH remdesivir
Subject
Drug Interactions
Predicate
NEG_ASSOCIATED_WITH
Object
remdesivir
10. hydroxychloroquine TREATS COVID-19
Subject
hydroxychloroquine
Predicate
TREATS
Object
COVID-19
11. lopinavir / ritonavir TREATS COVID-19
Subject
lopinavir / ritonavir
Predicate
TREATS
Object
COVID-19
12. hydroxychloroquine TREATS Patients
Subject
hydroxychloroquine
Predicate
TREATS
Object
Patients
13. lopinavir / ritonavir TREATS Patients
Subject
lopinavir / ritonavir
Predicate
TREATS
Object
Patients
14. Hospitals LOCATION_OF Analysis
Subject
Hospitals
Predicate
LOCATION_OF
Object
Analysis
15. Drug Interactions PROCESS_OF Patients
Subject
Drug Interactions
Predicate
PROCESS_OF
Object
Patients
16. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
17. Polypharmacy ADMINISTERED_TO Patients
Subject
Polypharmacy
Predicate
ADMINISTERED_TO
Object
Patients
18. Therapeutic procedure TREATS COVID-19
Subject
Therapeutic procedure
Predicate
TREATS
Object
COVID-19
19. CD69 protein, human|CD69 PREDISPOSES Drug Interactions
Subject
CD69 protein, human|CD69
Predicate
PREDISPOSES
Object
Drug Interactions
20. Pharmaceutical Preparations TREATS COVID-19
Subject
Pharmaceutical Preparations
Predicate
TREATS
Object
COVID-19
21. Drug Interactions NEG_ASSOCIATED_WITH tocilizumab
Subject
Drug Interactions
Predicate
NEG_ASSOCIATED_WITH
Object
tocilizumab
22. Drug Interactions NEG_ASSOCIATED_WITH remdesivir
Subject
Drug Interactions
Predicate
NEG_ASSOCIATED_WITH
Object
remdesivir
23. hydroxychloroquine TREATS COVID-19
Subject
hydroxychloroquine
Predicate
TREATS
Object
COVID-19
24. lopinavir / ritonavir TREATS COVID-19
Subject
lopinavir / ritonavir
Predicate
TREATS
Object
COVID-19
25. hydroxychloroquine TREATS Patients
Subject
hydroxychloroquine
Predicate
TREATS
Object
Patients
26. lopinavir / ritonavir TREATS Patients
Subject
lopinavir / ritonavir
Predicate
TREATS
Object
Patients
ABSTRACT

BACKGROUND:

Patients hospitalised with severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2; coronavirus 2019 disease (COVID-19)] infection are frequently older with co-morbidities and receiving polypharmacy, all of which are known risk factors for drug-drug interactions (DDIs). The pharmacological burden may be further aggravated by the addition of treatments for COVID-19.

OBJECTIVE:

The aim of this study was to assess the risk of potential DDIs upon admission and during hospitalisation in patients with COVID-19 treated at our hospital.

METHODS:

We retrospectively analysed 502 patients with COVID-19 (mean age 61 ± 16 years, range 15-99) treated at our hospital with a proven diagnosis of SARS-CoV-2 infection hospitalised between 21 February and 30 April 2020 and treated with at least two drugs.

RESULTS:

Overall, 68% of our patients with COVID-19 were exposed to at least one potential DDI, and 55% were exposed to at least one potentially severe DDI. The proportion of patients experiencing potentially severe DDIs increased from 22% upon admission to 80% during hospitalisation. Furosemide, amiodarone and quetiapine were the main drivers of potentially severe DDIs upon admission, and hydroxychloroquine and particularly lopinavir/ritonavir were the main drivers during hospitalisation. The majority of potentially severe DDIs carried an increased risk of cardiotoxicity. No potentially severe DDIs were identified in relation to tocilizumab and remdesivir.

CONCLUSIONS:

Among hospitalised patients with COVID-19, concomitant treatment with lopinavir/ritonavir and hydroxychloroquine led to a dramatic increase in the number of potentially severe DDIs. Given the high risk of cardiotoxicity and the scant and conflicting data concerning their efficacy in treating SARS-CoV-2 infection, the use of lopinavir/ritonavir and hydroxychloroquine in patients with COVID-19 with polypharmacy needs to be carefully considered.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Prescriptions / Referral and Consultation / COVID-19 / Hospitals Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Drugs Aging Journal subject: Geriatrics / Drug Therapy Year: 2020 Document Type: Article Affiliation country: S40266-020-00812-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Prescriptions / Referral and Consultation / COVID-19 / Hospitals Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Drugs Aging Journal subject: Geriatrics / Drug Therapy Year: 2020 Document Type: Article Affiliation country: S40266-020-00812-8