Kasım TURGUT, Ali GÜR, Abdullah Keyfo KAMA, Mehmet Gökhan TURTAY, Hakan OĞUZTÜRK

Retrospective analysis of possible drug interactions in prescriptions written by branch and emergency physicians

Amaç: Aynı hasta tarafından birden fazla ilaç yenildiğinde ilaç-ilaç etkileşimleri oluşabilir. Bu etkileşimler ilaçların etkinliğini arttırma, azaltma veya engelleme şeklinde olabilir. Bu çalışmada, branş ve acil hekimlerinin yazdığı reçeteler incelenerek olası ilaç etkileşimleri incelendi. Gereç ve Yöntem: Temmuz- Aralık 2019 arasını kapsayan 6 aylık sürede hem acil servisten hem de dahiliye veya kardiyoloji poliklinikten reçete düzenlenen 65 yaş üstü hastalar belirlendi. Belirlenen hastalara, yazılan ilaçların isimleri, ilaç sayısı, hastalara ait yaş, cinsiyet gibi bilgiler kaydedildi. Sonrasında Drug Interaction Checker- Medscape programı kullanarak yazılan reçetelerdeki ilaç etkileşimleri araştırıldı. Bulgular: Çalışmaya yaş ortalaması 73.5 ve 57%’si kadın olan 93 hasta dahil edildi. Branş hekimlerinin yazdığı reçetelerde en yüksek sayıda aspirin-ramipril arasında olmak üzere toplam 11 ciddi etkileşim görüldü. İki hekimin reçeteleri arasında en fazla ibuprofen-aspirin olmak üzere 33 ciddi düzeyde etkileşim tespit edildi. Branş hekimlerinin reçetelerinde en fazla aspirin-B bloker arasında etkileşim görüldü. Acil hekimlerinin reçetelerinde en fazla NSAID-NSAID arasında görüldü. İki hekimin reçeteleri arasında ise 28 etkileşim ile ne yüksek NSAID-B bloker arasında görüldü. Sonuç: Acil hekimleri, ileri yaş hastalara özellikle NSAID grubu ilaçları yazarken hastanın kullandığı raporlu ilaçlarla ilgili ayrıntılı öykü almalıdır.

Anahtar Kelimeler:

ilaç etkileşimi, acil, aspirin, NSAID

Retrospective analysis of possible drug interactions in prescriptions written by branch and emergency physicians

Objectives: Drug-drug interactions may occur when more than one drug is taken by the same patient. These interactions can result in increasing, decreasing or preventing the effectiveness of drugs. In this study, prescriptions given by branch and emergency physicians were examined in terms of possible drug interactions. Material and Methods: Patients over 65 years of age who received a prescription from both the emergency department and the internal medicine or cardiology outpatient clinic were screened over a period of six months from July to December 2019. For the selected patients, information on the name and number of drugs prescribed, age, and gender were recorded. Then, the interactions between the drugs included in the prescriptions were investigated using Drug Interaction Checker-Medscape software. Results: The study included 93 patients (57% females), with a mean age of 73.5 years. A total of eleven serious interactions, with the highest number belonging to the interaction of aspirin-ramipril were observed in the prescriptions given by branch physicians. Comparing the prescriptions of the branch and emergency physicians, 33 serious interactions, mostly that of ibuprofen-aspirin, were detected. Among the prescriptions of branch physicians, the majority of interactions were observed between aspirin and B blockers. For the emergency physicians, the highest number of interactions were seen in NSAID-NSAIDs. In the comparison of the prescriptions of the branch and emergency physicians, the highest number of interactions was 28, observed between NSAID and beta-blockers. Conclusion: Emergency physicians should take a detailed history of elderly patients, especially concerning their regularly renewed prescriptions when prescribing NSAID-group drugs.

Keywords:

Drug interaction, emergency, aspirin, NSAIDs,

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