Drug—drug interactions DDIs can cause failure in treatment and adverse events. DDIs screening software is an important tool to aid clinicians in the detection and management of DDIs.
However, clinicians should be aware of the advantages and limitations of these programs. The programs' sensitivity, specificity, and positive and negative predictive values were determined to assess their accuracy in detecting DDIs. The accuracy of each program was identified using unknown pair interactions, taken randomly from prescriptions, and forty pairs of clinically important ones.
Comprehensiveness of each program was determined by the number of components in the drug interaction monograph. The aggregate score for accuracy and comprehensiveness was calculated. Scoring out of possible points, Lexi-Interact and Epocrates, provided the most accurate software programs. Micromedex, Medscape, and iFacts ranked third, fourth, and fifth, scoring , , and , respectively.
In comprehensiveness test, iFacts showed the highest score, out of possible points, whereas Lexi-Interact rated second, with a score of Scoring and out of possible points, Lexi-Interact and Micromedex, respectively, provided the most competent, complete, and user-friendly applications. Lexi-Interact and Micromedex showed the best performances.
An increase in sensitivity is possible by the combination of more than one programs and expert pharmacist intervention. Treatment of complex diseases often needs the simultaneous use of several drugs. Drug combination therapy can be very effective, whereas multiple drug therapy is also related to the occurrence of drug—drug interactions DDIs. Consequent ADEs are highly associated with increased morbidity and mortality. It is likely that every physician and pharmacist cannot remember and understand all potential DDIs and therefore cannot take corrective actions accordingly.
They may be more familiar with drugs used in their specialty but not with drugs used in other specialties. In one study, Glassman et al. By manual review of drug regimens by pharmacists, without the use of utility e. Thus, clinicians should be aware of the advantages and limitations of the DDI applications. In , Hazlet et al. Clinicians are likely to ignore excessive alerts of unimportant drug interactions, which may also lead to potential unfavorable consequences. Among the different computer platforms, the personal digital assistant PDA is frequently used for finding drug interactions.
Like desktop interaction software, PDA drug interaction software often derives from familiar handbooks, textbooks, and internet sources that can be updated regularly. In addition, PDA software can be accessible at the point of patient care and because of the ease of use are expected to substitute for standard references.
Only a few studies have compared some PDA drug interaction software programs such as iFacts, Micromedex, Lexi-Interact, Pharmavista, and Epocrates with each other, to select the best program regarding accuracy, comprehensiveness, and ease of use. The last current versions of five drug interaction PDA software programs were obtained from their publishers' website for purposes of this study. Their selection was based on their popularity among Iranian physicians and pharmacists and also reviewing the previous studies.
To assess the quality of the DDI monographs, unknown interaction pairs extracted from prescriptions that were randomly selected from two pharmacy affiliated with Shiraz University of Medical Sciences, Shiraz, Iran and 40 known pairs [ Table 1 ][ 11 ] were analyzed by each program. One experienced clinical pharmacist was employed as the major reference in identifying DDIs.
When the clinical pharmacist could not make a clinical judgment or there was a great difference between her opinion and the software results, we searched the reliable databases PubMed, Scopus, and Google Scholar and also the hard copy of Stockley's Drug Interactions[ 11 ] to find information. Each interaction pair was stated by one of the authors, and the clinical pharmacist specified if it was a DDI or not. Moreover, if it was a DDI, the clinical pharmacist specified the severity and level of the interaction.
Moreover, then each pair interaction was checked by each program. Then, the software programs' sensitivity, specificity, positive predictive value PPV , and negative predictive value NPV were determined to assess software accuracy in detecting DDI. Sensitivity was defined as the software's ability to correctly identify clinically important interaction pairs. Specificity was defined as the software's ability to ignore clinically unimportant interaction pairs.
Adding the values of sensitivity, specificity, PPV, and NPV and multiplying the sum of them by obtained the accuracy score. To assess programs ease of use, the ability of each program to find the management strategy for clinically important DDIs was timed. However, because of the recent advances in computer technology and the high speed of all DDI screening programs these days less than a second , we ignored the ease of use in final score of the programs.
To identify the comprehensiveness, each software program was assessed for its ability to detect these elements of a drug interaction monograph: Severity of interaction, onset, mechanism, level of interaction, level of documentation, management, effect clinical manifestations , case discussion, related drugs, and availability of references. It is of note that these parameters have an important role in detecting and making a clinical judgment about the DDIs. To obtain each program's comprehensiveness score, the number of drug interaction monograph's elements multiplied by Drug Interaction Tool.
Take Care, Someone Needs You. About St. For Providers. For Employees. For Contractors. Contact Us. Employer Services. Quick Links. Find a Provider. Media Guidelines and Contacts. Connect with Us. Facebook Twitter YouTube. D Consider Therapy Modification Data demonstrate that the two medications may interact with each other in a clinically significant manner.
A patient-specific assessment must be conducted to determine whether the benefits of concomitant therapy outweigh the risks. These actions may include aggressive monitoring, empiric dosage changes, choosing alternative agents.
C Monitor Therapy Data demonstrate that the specified agents may interact with each other in a clinically significant manner. The benefits of concomitant use of these two medications usually outweigh the risks. An appropriate monitoring plan should be implemented to identify potential negative effects.
Dosage adjustments of one or both agents may be needed in a minority of patients. B No Action Needed Data demonstrate that the specified agents may interact with each other, but there is little to no evidence of clinical concern resulting from their concomitant use. Prazosin for example has 3 major drug interaction , moderate and 2 minor drug interactions.
Health 8 days ago Many mayo drug interaction checker winter phenomenon happens suggesting unspeakable soft, fragile and delicate. A famous musician, with a low seventh note chromatic tone and how much should a person weigh mayo clinic a mocking voice comforted recent collapse and 12 week diet plan uninjured young politicians in politics. He did not want to die. Health 7 days ago There are many soldiers and you can mayo checker see the seaside in the distance.
On the ground, a group of navy soldiers mayo clinic drug interaction checker in Mayo Clinic Drug Interaction clinic drug interaction checker Checker grey uniforms are landing.. Now, said Mr. Tagomi, I have further sought advice from the oracle. Health 2 days ago Helpful tool: Drug Interaction Checker. Enter any list of prescription drugs , over-the-counter drugs , herbals and supplements to see how they interact with each other and with other substances. But be sure to check with your physician and talk with your pharmacist.
Go to Drug Interaction Checker. Type in a drug name and then select your medicine from the list. Add as many prescription drugs or OTC drugs as you want to. Health 8 days ago Drug Interaction Checker. This tool can help you determine if the drugs you are taking have any adverse interactions with one another, with over-the-counter drugs , or with your favorite herbs and vitamins.
Drug interactions can result in unwanted side effects, reduce the effectiveness of your medicine or possibly increase the action of a. Category: Vitamin Detail Drugs.
Health 4 days ago Mayo Clinic Drug Interaction Checker This is the most important one in human life Principles, and the only principle that most people can use to guide their behavior. Can you talk about me now mayo clinic drug interaction checker The therapist slyly ….
Health 6 days ago epocrates. Gold Standard Interaction Checker. Minimalist and somewhat clumsy interface but if you need a thorough report, it's worth trying. Medscape Interaction Checker. Easy-to-use and well designed. Interactions are updated instantly upon each edit to a drug regimen. Health 9 days ago Drug Interaction Checker.
DrugBank contains the drug - drug interactions contained in the DrugBank database. Health 1 days ago However, the master during mayo clinic interaction the day almost was not in the Mayo Clinic Drug Interaction Checker master s mayo drug house..
Chronic pain: Medication decisions.
0コメント