INTRODUCTIONDrug-drug interacting drug combinations can additionally increase

INTRODUCTIONDrug-drug interactions (DDIs) represent a special category of adverse drug reactions on concurrent administration of other drugs. Thus either limits therapeutic value or induce toxicity. Overall, 1% of hospital admissions and 16% of admissions due to ADRs can be attributed to DDIs.1,2Approximately 37 – 60% of patients admitted to hospital may have one or more potential interaction due to drug combinations. In ICU patients, the risk of having potentially interacting drug combinations can additionally increase because of new drugs are often added to the existing drug therapy. DDIs are a concern for patients and providers, as polypharmacy is becoming more common in managing complex diseases or comorbidities and the consequences can range from untoward effects to drug-related morbidity and mortality. Healthcare professional’s ability to recognize potential DDIs is important in reducing their potential risks and adverse consequences.3Studies have revealed that DDIs are a major clinical problem along with other adverse drug reactions especially in the hospitalized ICU patients. The possible reason behind higher DDI rate in ICU patients include elder age, multiple drug regimen, and pharmacokinetic or pharmacodynamic nature of drugs that are used. Hence, this study was conducted to evaluate the pattern of potential drug-drug interactions and to identify the associated risk factors among hospitalized ICU patients in Sri Chamarajendra Hospital.METHODSSetting and study designAfter obtaining Institutional Ethics Committee approval, this prospective observational study is carried out in Sri Chamarajendra District Hospital attached to HIMS, HASSAN.Study populationPatients aged 18 years or older admitted to the ICU unit with a hospital stay of at least 24 hours and thosewjpmr, 2018,4(2), XXX-XXXSJIF Impact Factor: 4.103Research ArticleISSN 2455-3301WJPMRWORLD JOURNAL OF PHARMACEUTICALAND MEDICAL*Corresponding Author: Dr. Nuthan Kumar U. S.India.Email ID: [email protected],ABSTRACTBackground: Drug-drug interactions (DDIs) are a major cause for concern in ICU patients due to multiple co-existing conditions and the wide class of drugs they receive. The objective of our study is to identify potential drug-drug interactions among hospitalized ICU patients and to identify the risk factors associated with these interactions. Methods: After obtaining approval from Institutional Ethics Committee, a prospective observational study was carried out among 150 ICU patients in Hassan Institute of Medical Sciences attached to Sri Chamarajendra district hospital, HASSAN. As ICU Patients requires stay of more than 24 hour duration were enrolled into the study. The prescriptions were analysed for potential DDIs using MEDSCAPE multidrug interaction checker tool. Descriptive statistics, Students’ test, ANOVA and Pearson correlation coefficient were used to analyse the results. Results: The incidence of potential DDIs was 98% with 150 prescriptions having at least one potential DDI. A total of 38 potentially interacting drug pairs were identified among which majority were of significant grade while only 3 were serious. Majority of interactions were pharmacodynamic (76.3%) in nature. Aspirin/clopidogrel (71.1%) and pantoprazole/clopidogrel (69.8%) were the most common interacting pairs. Drugs most commonly involved were Aspirin, Clopidogrel, Heparin, Pantoprazole and Ramipril. The potential associated risk factors for drug to drug interactions are related with age, gender, polypharmacy and co-morbid conditions with prolonged hospital stay. Conclusions: As all ICU patients need continuous monitoring with proper therapeutic plan. Hence by using the online DDI database will improve the drug therapy and avoid potential interactions leading to adverse effects.KEYWORDS: DDIs, ICU, MEDSCAPE, Polypharmacy, Risk factors