| Drug interactions with the potential to prevent prodrug activation as a common source of irrational prescribing in hospital inpatients. | |
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MedLine Citation:
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PMID: 15592335 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Our objective was to investigate the frequency of potential drug-drug interactions between the prodrugs losartan, codeine, and tramadol and drugs known to inhibit their activation in hospitalized patients. METHODS: The frequency of coadministration between losartan and well-established cytochrome P450 (CYP) 2C9 inhibitors, as well as codeine and tramadol and CYP2D6 inhibitors, was studied by use of data from a university hospital medication database. The study population comprised all patients treated in internal medicine, pulmonary medicine, oncology, and neurology wards (105,533 treatment periods and 65,526 patients) between July 1, 1996, and June 30, 2002 (6 years). RESULTS: Every fifth patient receiving losartan, codeine, or tramadol was concomitantly taking another drug that has the potential to inhibit the activation of these drugs. During the 6-year time period, 1999 patients were exposed to a potential interaction. Interactions occurred more commonly in internal medicine wards (odds ratio, 2.3; 95% confidence interval, 2.1-2.5) and in women (odds ratio, 1.5; 95% confidence interval, 1.4-1.7). CONCLUSIONS: Coadministration of drugs that potentially result in inhibition of prodrug activation present a common and unrecognized source of irrational prescribing. |
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Authors:
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Tuire Tirkkonen; Kari Laine |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical pharmacology and therapeutics Volume: 76 ISSN: 0009-9236 ISO Abbreviation: Clin. Pharmacol. Ther. Publication Date: 2004 Dec |
Date Detail:
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Created Date: 2004-12-13 Completed Date: 2005-01-14 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0372741 Medline TA: Clin Pharmacol Ther Country: United States |
Other Details:
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Languages: eng Pagination: 639-47 Citation Subset: AIM; IM |
Affiliation:
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Department of Pharmacology and Clinical Pharmacology, University of Turku, FIN-20520 Turku, Finland. tuire.trikkonen@utu.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Analgesics, Opioid / pharmacokinetics, pharmacology Antihypertensive Agents / pharmacokinetics, pharmacology Aryl Hydrocarbon Hydroxylases / antagonists & inhibitors Biotransformation / drug effects Codeine / pharmacokinetics, pharmacology Cytochrome P-450 CYP2D6 / antagonists & inhibitors Databases, Nucleic Acid Drug Interactions* Drug Prescriptions / economics, statistics & numerical data* Enzyme Inhibitors / pharmacology Female Humans Losartan / pharmacokinetics, pharmacology Male Medication Errors Medication Systems, Hospital Middle Aged Prodrugs / metabolism* Sex Factors Tramadol / pharmacokinetics, pharmacology |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 0/Antihypertensive Agents; 0/Enzyme Inhibitors; 0/Prodrugs; 114798-26-4/Losartan; 27203-92-5/Tramadol; 76-57-3/Codeine; EC 1.14.14.1/Aryl Hydrocarbon Hydroxylases; EC 1.14.14.1/CYP2C9 protein, human; EC 1.14.14.1/Cytochrome P-450 CYP2D6 |
| Comments/Corrections | |
Comment In:
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Clin Pharmacol Ther. 2005 Jul;78(1):93
[PMID:
16003301
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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