Document Detail


Drug interactions with the potential to prevent prodrug activation as a common source of irrational prescribing in hospital inpatients.
MedLine Citation:
PMID:  15592335     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Tuire Tirkkonen; Kari Laine
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical pharmacology and therapeutics     Volume:  76     ISSN:  0009-9236     ISO Abbreviation:  Clin. Pharmacol. Ther.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-13     Completed Date:  2005-01-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0372741     Medline TA:  Clin Pharmacol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  639-47     Citation Subset:  AIM; IM    
Affiliation:
Department of Pharmacology and Clinical Pharmacology, University of Turku, FIN-20520 Turku, Finland. tuire.trikkonen@utu.fi
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MeSH Terms
Descriptor/Qualifier:
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:
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:
Clin Pharmacol Ther. 2005 Jul;78(1):93   [PMID:  16003301 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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