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首页> 美国卫生研究院文献>Pharmaceutics >Prevalence and Clinical Significance of Drug–Drug and Drug–Dietary Supplement Interactions among Patients Admitted for Cardiothoracic Surgery in Greece
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Prevalence and Clinical Significance of Drug–Drug and Drug–Dietary Supplement Interactions among Patients Admitted for Cardiothoracic Surgery in Greece

机译：患有患者患者患者患者患者的患病率及临床意义对希腊进行心脏病手术的患者

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Background: Drug interactions represent a major issue in clinical settings, especially for critically ill patients such as those with cardiovascular disease (CVD) who require cardiothoracic surgery (CTS) and receive a high number of different medications. Methods: A cross-sectional study aimed at evaluating the exposure and clinical significance of drug–drug (DDIs) and drug–dietary supplement interactions (DDSIs) in patients admitted for CTS in the University Hospital of Crete Greece. DDIs were evaluated regarding underlying pharmacological mechanisms upon admission, preoperation, postoperation, and discharge from CTS clinic. Additionally, upon admission, the use of dietary supplements (DSs) and if patients had informed their treating physician that they were using these were recorded with subsequent analysis of potential DDSIs with prescribed medications. Results: The study employed 76 patients who were admitted for CTS and accepted to participate. Overall, 166 unique DDIs were identified, with 32% of them being related to pharmacokinetic (PK) processes and the rest (68%) were related to possible alterations of pharmacodynamic (PD) action. CVD medications and drugs for central nervous system disorders were the most frequently interacting medications. In total, 12% of the identified DDIs were of serious clinical significance. The frequency of PK-DDIs was higher during admission and discharge, whereas PD-DDIs were mainly recorded during pre- and postoperation periods. Regarding DS usage, 60% of patients were using DSs and perceived them as safe, and the majority had not informed their treating physician of this or sought out medical advice. Analysis of medical records showed 30 potential combinations with prescribed medications that could lead in DDSIs due to modulation of PK or PD processes, and grapefruit juice consumption was involved in 38% of them. Conclusions: An increased burden of DDIs and DDSIs was identified mostly upon admission for patients in CTS clinics in Greece. Healthcare providers, especially prescribing physicians in Greece, should always take into consideration the possibility of DDIs and the likely use of DS products by patients to promote their well-being; this should only be undertaken after receiving medical advice and an evidenced-based evaluation.
机译：背景：药物相互作用代表临床环境中的一个主要问题，特别是对于患有心血管疾病（CVD）的患者，尤其是需要心肌手术（CTS）并获得大量不同药物的患者。方法：旨在评估克里特郡希腊大学医院患者患者患者的药物 - 药物（DDIS）和药物 - 膳食补充相互作用（DDSIS）的接触和临床意义的横截面研究。在CTS诊所入院，术前，术后和排出时，评估DDIS关于潜在的药理学机制。此外，在入院后，使用膳食补充剂（DSS）以及如果患者向治疗医生通知他们使用的医生，随后对具有规定药物的潜在DDSIS进行了随后的潜在DDSIS进行了记录。结果：该研究采用了76名患者，被CTS承认并被接受参加。总体而言，鉴定了166个独特的DDI，其中32％与药代动力学（PK）过程有关，其余（68％）与药效学（PD）作用的可能改变有关。 CVD药物和中枢神经系统疾病的药物是最常相互作用的药物。总共12％的鉴定的DDIS具有严重的临床意义。在入院和放电期间PK-DDI的频率较高，而PD-DDIS主要在预先和术前期间记录。关于DS使用量，60％的患者使用DSS并将其视为安全，并且大多数人并没有告知他们对此或寻求医疗建议的医生。医疗记录分析显示，由于PK或PD工艺的调节，可以在DDSIS中导致DDSIS的规定药物，并且葡萄柚汁消耗涉及其中38％。结论：在希腊CTS诊所的患者入院时，大多确定了DDIS和DD​​SIS的增加。医疗保健提供者，特别是希腊的处方医生，应始终考虑DDIS的可能性，并通过患者促进其福祉的DS产品的可能性;这只应该在收到医疗建议后和基于证明的评估后进行。

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