Analysis of the potential adverse drug interactions in statins prescriptions in outpatient and emergency departments
10.3760/cma.j.issn.1008-5734.2018.06.004
- VernacularTitle:含他汀类药物门急诊处方中潜在不良药物相互作用分析
- Author:
Zhiyuan FANG
1
;
Qian LI
1
;
Jing LUO
1
;
Jiangping LIAN
1
;
Nan ZHOU
1
Author Information
1. 陕西省人民医院药学部,西安,710068
- Publication Type:Journal Article
- Keywords:
Atorvastatin calcium;
Simvastatin;
Drug interactions;
Cytochrome P-450 CYP3A;
Inappropriate prescribing
- From:
Adverse Drug Reactions Journal
2018;20(6):413-418
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analysis the rationality of atorvastatin calcium and simvastatin in outpatient and emergency departments from the perspective of drug interactions. Methods All prescrip-tions comprising atorvastatin calcium and simvastatin in the outpatient and emergency departments in Shaanxi Provincial People′s Hospital from July 1 to December 31,2017 were collected. The potential adverse drug interactions in these prescriptions were analyzed and the rationality of drug uses was determined by referring to the drug labels and relevant domestic and foreign guidelines. Results A total of 3 647 prescriptions in the outpatient and emergency departments were collected,of which 2 730 (74.9%)comprised atorvastatin calcium and 917 (25. 1%)comprised simvastatin. Among the 3 647 prescriptions,3 221 (88. 3%) comprised more than one drug,of which 2 432 (75.5%)comprised atorvastatin calcium and 789 (24.5%) comprised simvastatin. In the 3 221 co-prescriptions comprising statins,878 (27.3%)comprised other substrates of cytochrome P450 (CYP)3A4,mainly including adenosine diphosphate receptor inhibitors, calcium channel blockers,and proton pump inhibitors,of which clopidogrel and nifedipine were used more frequently;311 (9.7%)comprised CYP 3A4 inhibitors,mainly including calcium channel blockers,anti-arrhythmia agents,immunosuppressive agents,and antibacterial drugs,of which amlodipine and diltiazem were used more frequently;17 (0. 5%) comprised CYP3A4 inductions,including pioglitazone and carbamazepine. Among the co-prescriptions of statins and CYP 3A4 inhibitors,6 prescriptions comprised incompatibility drugs (simvastatin combined with clarithromycin)and 15 prescriptions comprised simvastatin or atorvastatin calcium with dose higher than the recommended. Conclusion Drug combination of atorvastatin calcium or simvastatin in some prescriptions of Shaanxi Provincial People′s Hospital is unreasonable,mainly shown as being combined with drugs having potential adverse interactions or overdosage when combined with CYP 3A4 inhibitors.
