Suboptimal use of gastroprotective medication in elderly antiplatelet users.

BACKGROUND: Use of acetylsalicylic acid (ASA) or thienopyridines in monotherapy or combination of both drugs is associated with increased risk of gastrointestinal (GI) bleeding. The administration of drugs inhibiting gastric acid production represents an effective way to avoid GI disorders associated with antiplatelet therapy. OBJECTIVES: The aim of our study was to evaluate the use of gastroprotective medication in elderly antiplatelet users in relation to risk factors for GI bleeding. METHODS: Patients (n = 428) aged ≥ 65 years who were prescribed low dose ASA or clopidogrel in monotherapy or combination at hospital discharge were enrolled in the study. RESULTS: Only 39.7 % of patients with 2 or more risk factors for GI bleeding were prescribed gastroprotective medication at hospital discharge. The probability of elderly antiplatelet drug user for prescription of gastroprotective medication was improved with following risk factors: age ≥ 85 years (OR = 2.99); history of peptic ulcer disease/ GI bleeding (OR = 15.79); other GI disorders (OR = 15.48); concomitant therapy with drugs increasing the risk of GI bleeding - systemic corticosteroids (OR = 29.03) and NSAIDs (OR = 4.79). CONCLUSION: Results of our study indicate the necessity to increase the awareness of GI bleeding risk in long-term antiplatelet users among prescribing physicians.

[Drug-drug interactions in diabetic patients at the Department of Clinical Pharmacology]. / Liekové interakcie u diabetikov na oddelení klinickej farmakológie.

Drug-drug interactions in diabetic patients could be serious, even life threatening. Possible manifestation of hypo/hyperglycemia as a consequence of drug-drug interactions are often wrong interpreted as a nonadherence to the diabetic diet or polymorbidity of the patient. Drug-drug interactions are not taken into account. The risk of drug-drug interactions is exponentially increasing with the number of taken drugs. In the group of diabetic patients is good to prevent the combinations of drugs, which can lead to drug-drug interactions and use alternative therapy with lower potential of drug-drug interactions. In this paper we present the possibilities of clinical pharmacist from the Department of clinical pharmacology to prevent and solve the drug-drug interactions in diabetic patients.