THE PHARMACOLOGICAL MAZE: UNCOVERING DRUG INTERACTION PATTERNS IN HYPERTENSIVE AND DIABETIC REGIMENS
Main Article Content
Keywords
Polypharmacy, Drug interactions, Hypertension (HTN), Diabetes mellitus (DM), Pharmacokinetic, Pharmacodynamic, Adverse effects, Pharmacotherapy, chemically purified drugs, Genetic variations, Drug efficacy, Drug safety, Patient outcomes, Lexicomp, Prescription management, Pharmacovigilance, Personalized medicine, Contraindicated interactions, Healthcare costs, Pharmacist review
Abstract
Introduction: This assessment studied potential drug interactions in polypharmacy among diabetic and hypertensive (HTN) patients. Chemically purified drugs have significantly improved healthcare, but genetic variations among patients pose challenges in drug metabolism and response. Polypharmacy, common in managing chronic conditions like hypertension and diabetes mellitus (DM), increases the risk of drug-drug interactions (DDIs), altering drug efficacy or safety and complicating clinical management. DDIs can be pharmacokinetic, affecting drug absorption, distribution, metabolism, or elimination, or pharmacodynamic, involving synergistic or antagonistic effects at drug target sites. Hypertension and diabetes frequently coexist, increasing treatment complexity and the risk of adverse events.
Material & Method: Managing these conditions often requires multiple medications, raising the likelihood of DDIs and severe adverse effects. A study analyzed 500 prescriptions from hospitals in Lahore, Gujranwala, and Gujarat using the Lexicomp application to investigate potential DDIs (pDDIs).
Result: The analysis found that 81.56% of prescriptions contained at least one interaction, with 59.68% involving both DM and HTN. The average number of drugs per prescription was 3.68, and the average number of interactions was 4.46. C-type interactions, requiring monitoring, were most common at 66.53%, and moderate severity interactions constituted 60.22%. Notably, 3.36% were contraindicated, posing a high risk of severe adverse effects.
Conclusion: The findings highlight the need for vigilant prescription management in DM and HTN patients. Healthcare providers must carefully consider drug combinations, and pharmacovigilance is essential. Personalized medicine, tailoring treatments to individual genetic profiles, can help mitigate polypharmacy risks. Pharmacists play a key role by analyzing prescriptions, adjusting doses, and recommending alternatives when necessary to improve patient outcomes and reduce healthcare costs.
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Asfia Arooje
Department of Pharmacy, The University of Chenab, Gujrat, Pakistan;
Zill-e-Huma
Rashid Latif Medical College, Punjab, Lahore, Pakistan
Maimoona Mushtaq
Department of Pharmacy, International Institute of Science, Art and Technology (IISAT);
Tassawer-e-Meran
Faculty of Pharmacy, Superior University, Lahore, Pakistan
Waqar Siddique
Riphah Institute of Pharmaceutical Sciences, Riphah International University Lahore Campus, 54000, Lahore, Pakistan
Hassan Umar
Riphah Institute of Pharmaceutical Sciences, Riphah International University Lahore Campus, 54000, Lahore, Pakistan
Aqna Malik
Department of Pharmacy, The University of Chenab, Gujrat, Pakistan;
Muhammad Naeem
Chief Drugs Controller Office, Punjab, Lahore, Pakistan
Zainab Saddiqua
Department of Pharmacy, The University of Chenab, Gujrat, Pakistan;
Faiza Tabbasum
Department of Pharmacy, The University of Chenab, Gujrat, Pakistan;
Amir Jalal
Sahara Medical College Narowal, Pakistan.