Occurrence of medical orders with drug-drug interactions of voriconazole in hospitalized patients
10.3760/cma.j.cn114015-20231124-00842
- VernacularTitle:住院患者中伏立康唑相关药物相互作用医嘱的发生情况分析
- Author:
Tingting CHEN
1
;
Qingquan ZHANG
1
;
Zhiqiang LIN
1
Author Information
1. 福建省泉州市第一医院药剂科，泉州 362000
- Publication Type:Journal Article
- Keywords:
Voriconazole;
Drug interactions;
Therapeutic drug monitoring;
Plasma concentration;
Cytochrome P450
- From:
Adverse Drug Reactions Journal
2024;26(8):454-459
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the occurrence of drug-drug interaction (DDI) in medical orders and the relevant common medications of hospitalized patients treated with voriconazole.Methods:The treatment information of hospitalized patients treated with voriconazole and had blood trough concentration ( Cmin) results in Quanzhou First Hospital, Fujian Province from May 2018 to August 2023 was collected through the hospital information system. Descriptive statistical analysis was conducted on the incidence of DDI medical orders, the drugs involved in DDI, the types and risk levels of DDI, the departments where DDI occurred, and the Cmin changes of voriconazole in patients with 1 or 2 type of voriconazole-related DDI medical orders (including drugs not recommended in combination with voriconazole or voriconazole dose needs to be adjusted when combined) during voriconazole treatment. Results:A total of 752 patients were included, of which 592 (78.7%) had 1 344 medical orders with voriconazole-related DDI, involving 28 drugs. Among them, 67.7% (401/592) of patients used 2 or more DDI drugs. Glucocorticoids [91.6% (542/592)], followed by proton pump inhibitors [87.8% (520/592)], were most frequently involved in the medical orders of DDI with voriconazole. Among the 28 voriconazole-related DDI drugs, 5 were involved in type 1 or 2 DDI, including rifampicin, nirmatrelvir/ritonavir, phenobarbital, phenytoin sodium, and rifabutin. The 5 drugs involved 33 patients, of whom 51.5% (17 patients) had voriconazole Cmi n<1.0 mg/L; rifampicin involved the most patients (17 patients), followed by nirmatrelvir/ritonavir (10 patients). When voriconazole was combined with rifampicin, rifabutin, phenobarbital and phenytoin sodium, its Cmin in most patients decreased significantly. The incidence of medical orders with voriconazole-related DDI was highest in the Intensive Care Unit, followed by the Department of Respiratory and Critical Care Medicine. Conclusions:Medical orders with DDI are very common in the clinical application of voriconazole, and most patients have used two or more DDI drugs, in which glucocorticoids and proton pump inhibitors appeared more common. It is necessary to be alert to the occurrence of DDI between voriconazole and rifampicin, rifabutin, phenobarbital and phenytoin sodium in clinic.
