Abstract
Introduction: Little is known about potential drug-drug interactions (pDDIs) in pediatric settings. Further, complexity of pharmacotherapy in pediatric intensive care unit (PICU) is an increasing risk factor of pDDIs.
Aims: Current study aimed to assess the rate, mechanism, clinical significance, and management of pDDIs in the PICU of a university-affiliated pulmonary hospital.
Methods: Through a prospective observational study, the data related to the pharmacotherapy of PICU-admitted patients was assessed by a clinical pharmacologist using Lexi-Interact database. Interacting drugs, severity, reliability, mechanism, potential outcome, and clinical management were identified for each interaction.
Results: Seventy eight prescriptions were evaluated during a 4-month period of the study. Pneumonia was the main reason for the hospitalization (20.1%) followed by bronchitis (11.4%), tracheal stenosis (11.4%), and exacerbation of cystic fibrosis (11.4%). The rate of pDDIs was 485.9 DDIs/100 patients. In regards to severity, 30.6% of the interactions were considered minor, 60.2% moderate, 8.7% major, and 0.5 % contraindicated. The most often potential outcomes of the clinically important interactions were prolongation of QTc interval related to combination of domperidone (14.2%) and ondansetron (5.7%) with other QTc prolonging agents (diphenhydramine, salbutamol, tizanidine, and azitromycin).
Conclusions: Life-threatening drug interactions may develop in pediatric patients hospitalized in the PICU. Clinical managements such as avoiding combination, close monitoring, and considering related risk factors could prevent the consequences of these interactions.
- Copyright ©the authors 2016
