Drug interaction: Difference between revisions
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====List of resources==== | ====List of resources==== | ||
* [http://www.firstdatabank.com/products/evaluations/ First Databank] | * [http://www.firstdatabank.com/products/evaluations/ First Databank] | ||
* http://www.gsm.com | |||
* http://www.epocrates.com | |||
* [http://www.certs.hhs.gov/centers/centers.htm Centers for Education & Research on Therapeutics] (CERTs). These are sponsored in the [[United States]] by the [[Agency for Healthcare Research and Quality]]. | |||
** http://drug-interactions.com - [[Cytochrome P-450]] | |||
** http://www.arizonacert.org - [[QT interval]] prolongation | |||
===Medical order entry system=== | ===Medical order entry system=== | ||
Revision as of 09:37, 7 July 2009
In pharmacology, drug interactions are "the action of a drug that may affect the activity, metabolism, or toxicity of another drug."[1]
Mechanisms
Protein binding
These interactions are usually transient and mild until a new steady state is achieved.[2][3] These are mainly for drugs without much first-pass liver metabolism. The principle plasma proteins for drug binding are:[4]
- albumin
- α1-acid glycoprotein
- lipoproteins
Some drug interactions with warfarin are due to changes in protein binding.[4]
Cytochrome P450
Patients have abnormal metabolism by cytochrome P-450 due to either inheriting abnormal alleles or due to drug interactions. Tables are available to check for drug interactions due to cytochrome P-450 interactions.[5].
Prevention
Resources about drug interactions
In detecting drug-drug interactions, the accuracy of software used by hospital pharmacies range from:[6][7]
In detecting drug-drug interactions, the accuracy of PDA-based software range from:[8]
- Sensitivity 84% to 100%
- Specificity 68% to 95%
List of resources
- First Databank
- http://www.gsm.com
- http://www.epocrates.com
- Centers for Education & Research on Therapeutics (CERTs). These are sponsored in the United States by the Agency for Healthcare Research and Quality.
Medical order entry system
Perhaps due to imperfect specificity of drug interaction resources, health care providers overide 49% to 96% of alerts.[9]
Efforts are being made to improve drug safety alerts.[10]
References
- ↑ Anonymous (2024), Drug interaction (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ DeVane CL (2002). "Clinical significance of drug binding, protein binding, and binding displacement drug interactions". Psychopharmacology bulletin. 36 (3): 5–21. PMID 12473961. [e]
- ↑ Benet LZ, Hoener BA (2002). "Changes in plasma protein binding have little clinical relevance". Clin. Pharmacol. Ther. 71 (3): 115–21. DOI:10.1067/mcp.2002.121829. PMID 11907485. Research Blogging. OVID full text summary table at OVID
- ↑ 4.0 4.1 Sands CD, Chan ES, Welty TE (2002). "Revisiting the significance of warfarin protein-binding displacement interactions". The Annals of pharmacotherapy 36 (10): 1642–4. PMID 12369572. [e]
- ↑ Drug-Interactions.com. Retrieved on 2007-09-18.
- ↑ 6.0 6.1 6.2 Abarca J, Colon LR, Wang VS, Malone DC, Murphy JE, Armstrong EP (June 2006). "Evaluation of the performance of drug-drug interaction screening software in community and hospital pharmacies". J Manag Care Pharm 12 (5): 383–9. PMID 16792445. [e]
- ↑ 7.0 7.1 7.2 Hazlet TK, Lee TA, Hansten PD, Horn JR (2001). "Performance of community pharmacy drug interaction software". J Am Pharm Assoc (Wash) 41 (2): 200–4. PMID 11297332. [e]
- ↑ Robinson RL, Burk MS (March 2004). "Identification of drug-drug interactions with personal digital assistant-based software". Am. J. Med. 116 (5): 357–8. DOI:10.1016/j.amjmed.2003.09.025. PMID 14984827. Research Blogging.
- ↑ van der Sijs H, Aarts J, Vulto A, Berg M (2006). "Overriding of drug safety alerts in computerized physician order entry". J Am Med Inform Assoc 13 (2): 138–47. DOI:10.1197/jamia.M1809. PMID 16357358. PMC 1447540. Research Blogging.
- ↑ van Roon EN, Flikweert S, le Comte M, et al. (2005). "Clinical relevance of drug-drug interactions : a structured assessment procedure". Drug Saf 28 (12): 1131–9. PMID 16329715. [e]