DRUG INTERACTION FACTS 2013 PDF
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David S. Tatro's most popular book is Drug Interaction Facts The Authority on Drug Inte David S. Tatro. avg rating — 83 ratings — published pdf | on mar 1, , hina hasnain and others published drug-drug interaction; Drug Interaction Facts by Tatro, David S. and a great selection of Drug Interaction Facts The Authority on Drug Interactions David S. Tatro PharmD . PDF | On Mar 1, , Hina Hasnain and others published DRUG-DRUG A, Fatima R. Drug-drug interaction; facts and comparisons with national and Pharmacology & Pharmacotherapeutics. ;. 4(Suppl1):SS
The prevalence of diabetes reported by the elderly people interviewed in the survey was Of the elderly diabetics interviewed, Thumbnail Table 1 Behavior related to health according to the presence of diabetes among the elderly.
With respect to health conditions and use of health-care services, a higher percentage of elderly diabetics ranked their health as poor or very bad at the time of the survey.
The use of health-care services, the presence of three or more chronic diseases and specific pathologies was also significantly higher among the diabetics interviewed Table 2.
There was no statistical difference in relation to affiliation with a health coverage plan data not presented in table form. Thumbnail Table 2 Health condition and use of health services, according to the presence of diabetes among the elderly.
In terms of their knowledge and practices as to treatment options for diabetes, excluding two elderly people who did not know or were unable to answer the questions put to them, it was verified that almost two thirds For controlling diabetes, the chief strategies reportedly used were as follows: routine use of oral medication and insulin, as well as following a regular food diet.
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It was further ascertained that Table 3 Knowledge and practices regarding options of treatment for diabetes among the elderly. On the other hand, participation in discussion groups on the subject of the disease was infrequent As to the use of medicines in elderly diabetics, The average number of medicines used by the elderly interviewed was 3. In relation to the pharmacological groups, as shown in Table 4 , greater frequency was noted for the medicines that act on the Cardiovascular System Next come the medicines that act on the Digestive System and Metabolism Then come those affecting the Blood and Hemopoietin organs 8.
Table 5 describes the10 moderate interactions most frequently encountered, all ranked as moderate risks, along with their potential risk. For potentially serious interactions, the pharmaceuticals most involved were as follows: amiodarone, which interacts with amlodipine, atenolol, amitriptyline, fluoxetine, digoxinand nepheline; aspirin or acetylsalicylic acid ASA , which interacts with ginkgo biloba and warfarin; digoxin, which interacts with calcium, hydrochlorothiazide and spironolactone; simvastatin, which interacts with amlodipine, diltiazem, phenofibrate, verapamil; fluoxetine, which interacts with amitriptyline, haloperidol anddiclofenac data not presented in table form.
Rev Saude Publica ; 39 6 It was likewise similar to that of persons stricken with chronic diseases in the areas covered by basic health-care units in the Southern and Northeastern Regions of Brazil Rev Saude Publica ; 43 4 Overweightness was accentuated in individuals with DM2 and who had resistance to insulin, chiefly from the age of Lifestyle intervention and 3 year results on diet and physical activity.
Diabetes Care ; 26 12 Fagard RH. Effects of exercise, diet and their combinations on blood pressure. J Hum Hypertens ; 19 Supl. Behavioral and biological correlates of medicine use in type 2 diabetic patients attended by Brazilian public healthcare system. Nonetheless, counseling patients to engage in physical activity in Brazil is still not very effective among professionals, not just as a health education strategy in the basic network, but also as support for treatment of hypertension, diabetes, cardiovascular diseases, depression, etc.
Cad Saude Publica ; 27 6 Among the main pathologies reported among elderly diabetics, arterial hypertension had a percentage similar to that found by Viegas-Pereira et al. Rev Saude Publica ; 38 6 Longitudinal association between self-rated health and timed gait among older persons.
Latham K, Peek CW. Self-rated health and morbidity onset among late midlife U. It can be supposed that the good perception of health among the elderly persons studied is due to the fact that most of them are asymptomatic, without complications such as target organ injuries cardiovascular apparatus, kidney, retina, peripheral nervous system , in that functional decline resulting from limitations of the disease can have a direct relationship to the health perceived Cardiol ; 89 5 In this study, Some studies indicate that self-reported information regarding arterial hypertension, DM, cerebral vascular accidents and strokes can be considered valid, while information on cardiac insufficiency, obstructive pulmonary disease and duodenal ulcers tend to be less accurate Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure.
J Clin Epidemiol ; 57 10 Self- reported hypertension: validation in a representative cross-sectional survey.
Cad Saude Publica ; 25 11 According to Barros et al. Cien Saude Colet ; 16 9 Rev Saude Publica ; 41 6 In this study, drug treatment for the control of diabetes also entails access to medical services and professionals in Campinas. As to the medicines, almost all of the elderly diabetics surveyed Use of medicines by the elderly population in general is high Rev Saude Publica ; 38 4 Rev Saude Publica ; 42 4 In this study, just 3. The anatomic-functional groups most used were precisely those corresponding to the most prevalent co-morbidities, that is, those that act on the cardiovascular system, which encompass several classes of pharmaceuticals, such as distinct anti-hypertensive and anti-arrhythmic drugs that act on cardiac and hypolipidemicfunctions.
This fact probably collaborated to the greater prevalence in relation to the second group, relating to acting on the digestive system, the pharmaceuticals most used for which are those specific for DM oral anti-hypoglycemiadrugs and insulin. Such data is similar to that found in Brazilian studies conducted in Porto Alegre To our knowledge, there are no studies conducted in children assessing potential DDIs and DDIs frequency, and the relevance of potential DDIs in the clinical context may therefore come to be controversial, which in addition leaves an important line of investigation open.
The potential DDIs severity classification Contraindicated, Serious, Significant and Minor can help doctors to identify potential DDIs clinical manifestations that require additional care and surveillance, since treatment efficacy can be compromised if the use of certain drugs is avoided owing to unfounded potential DDIs.
For example, it can be stated that, in the present study, Therefore, the decision on actions to be taken by doctors to minimize potential DDIs impact on their patients should be determined on an individual basis, and this requires careful evaluation of the risk-benefit ratio between treatment discontinuation vs. An elevated discrepancy has been reported between the number of DDIs detected with electronic systems and the number of clinically relevant DDIs evaluated by doctors, which might favor the likelihood for prescribing physicians to ignore information on the possibility of DDIs occurrence [ 29 ].
However, in clinical practice, it will always be important being informed about potential DDIs, out of which Table 3 offers the most relevant examples found in pediatric EDs.
To the best of our knowledge, this is the first study to estimate the magnitude of the covariates effect on the number of observed events total and severity-stratified potential DDIs using a statistical model that is appropriate for count variables such as ZIP and ZINB. On the other hand, the association of age with potential DDIs has already been previously reported [ 10 ]. The observed effect by the number of administered drugs was as expected, according to observations reported in other studies [ 14 , 16 ].
This can be observed in the Count Equation-Not always 0 model where, for each additional administered drug, the odds of a larger number of potential DDIs to occur are increased by 1. A similar situation is observed in the group of diseases of the blood DD89 , since the main reason for admission to the ED are hemorrhagic episodes in patients with hemophilia, the treatment protocol of which limits multi-drug therapy and is perfectly defined.
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In patients with Congenital Malformations and Diseases of the Nervous System, an increase was observed in the odds of potential DDIs in comparison with the Other Diagnoses group, which has already been previously reported [ 10 , 16 ].
This is important, since patients exposed to potential DDIs have been reported to have ADRs [ 38 ], which highlights the importance of conducting prospective studies evaluating potential DDIs clinical importance in children, using at least patient medical records.
Only three studies were interventional, and all showed significant reduction in potential DDIs.
Actual DDIs are interactions that actually lead to adverse clinical events in patients. Espinosa-Bosch et al. Our findings in accordance with those from studies in developed countries confirm that there is little evidence of the incidence of actual DDIs in comparison to potential DDIs in the literature.
The adverse events from DDIs are either not identified or not documented accurately.
It should be noted that due to inherent and recall biases and also ethical considerations, the conduction of study designs for assessing actual DDIs may be challenging. The high incidence of DDIs may be associated with high number of drugs per prescription.
The mean number of drugs per prescription in Iran is relatively high [ 58 ]. This mean number for the outpatient setting was 3. No similar review aggregated the reported incidence of DDIs in the general population.
The other review studies on DDIs have been conducted on either a specific group of patients, e. The aggregation and comparison of the results of the included studies showed a wide variability of DDIs incidence estimates in the Iranian healthcare community. Relatively few studies which were performed in the general population in developed countries also showed a wide variability of estimates on incidence of DDIs i.
Moreover, a systematic review on incidence of medication errors in Iran showed a wide variability of estimates [ 60 ].
Reducing drug–herb interaction risk with a computerized reminder system
Different study methods, various drug interaction databases, diverse study populations, different sample sizes, and some other factors have caused this considerable variability; therefore, direct comparison between the studies is impossible. The high number of prescribed drugs and also frequent prescribing of some drugs with many possible DDIs may cause the high incidence of DDIs in this group of patients.
One included study in our review reported the incidence of potential DDIs among cancer patients as Supporting the results of these studies, a review on DDIs among cancer patients reported that approximately one-third of cancer patients are susceptible to DDIs [ 21 ].
High growth in the number of new anti-cancer drugs may be one of the main reasons for this. Incidence of DDIs may be associated with characteristics of patients, prescribers and pharmacists, or some barriers such as insufficient communication between these groups.
Good communication between prescribers and pharmacists is crucial to reduce the risks of DDIs [ 63 ]. The Iranian studies showed that having heart disease, being old, and receiving digoxin were the main patient factors associated with high incidence of DDIs.
Similarly, the findings from another review on the incidence of DDIs in a developed country highlighted these risk factors [ 19 ]. Many studies have emphasized that the high incidence of DDIs in the elderly is due to physiological changes related to age, suffering from multiple diseases, and a high rate of medication use.
The results reported by Juurlink et al.
This may be due to the fact that male and busy physicians may less consider the possibility of DDIs during the prescription phase. So far, no study has assessed pharmacological knowledge of prescribers specifically about DDIs.However, at the same time, it can improve the quality of the information in relation to medicine without prescription. If you want to download this book, click link in the next page 5. Evaluate resources to determine appropriateness of information.
Although the use of medicines bea relevant issue in all age brackets, research on the subject has often been devoted to elderly patients, due to the peculiarities of this age group There was no statistical difference in relation to affiliation with a health coverage plan data not presented in table form. Refresh and try again.
Studied have indicated variation and deficiencies in DDI screening programs.