Statement of the Problem: Given the increase in the population of the elderly patients and the risk of systemic diseases in these individuals, the prevalence of the intake of various drugs is higher in elderly patients, which exposes them to the side effects of drugs including potential drug-drug interactions (DDIs).
Purpose: Therefore, the present study is an attempt to evaluate the drug interactions between the drugs used by the elderly patients visiting Kerman School of Dentistry and the common dental drugs in 2020.
Materials and Method: This cross-sectional study was conducted on the elderly patients (≥60 years (who referred to Kerman School of Dentistry for dental problems. After obtaining the oral informed consent and collecting demographic information, the drugs used by the patients and their systemic diseases were questioned, listed, and compared with the drugs mentioned in their files. The drug interactions with the common dental drugs were studied in the elderly patients using the www.drugs.com website. Chi-square, T, ANOVA, Kruskal-Wallis, and Mann-Whitney tests were used to compare the variables. The significance level was 0.05.
Results: Of participants included in this study, 78 (52%) were female and 72(48%) were male. The average age of these patients was 71.27 6.32 years. The most common systemic diseases were hypertension (57.3%), heart diseases (42.0%), and diabetes mellitus (40.7%). Our analysis of the DDIs between 11 commonly prescribed dental drugs and 95 drugs used by the patients revealed 212 DDIs (21.7% minor, 68.3% moderate, and 9.9% major interactions). There was a significant relationship between the number of drugs and DDIs, whereas DDIs had no significant relationship with gender and educational level.
Conclusion: The results reflected the high percentage of DDIs among the patients. In addition, there was a significant relationship between polypharmacy, which is highly prevalent among the elderly patients, and drug interactions. |
- United Nations. World population ageing, population division and UN: New York, 2007. Available at: https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2017_Report.pdf
- Petersen PE, Kandelman D, Arpin S, Ogawa H. Global oral health of older people-call for public health action. Community Dent Health. 2010; 27:2 57-267.
- Gujjarlamudi HB. Polytherapy and drug interactions in elderly. J Midlife Health. 2016; 7: 105-107.
- Pagno AR, Gross CB, Gewehr DM, Colet CdF, Berlezi EM. Drug therapy, potential interactions and iatrogenesis as factors related to frailty in the elderly. Rev Bras Geriatr Gerontol. 2018; 21: 588-596.
- Fulton MM, Riley Allen E. Polypharmacy in the elderly: a literature review. J Am Acad Nurse Pract. 2005; 17: 123-132.
- Guthrie B, Makubate B, Hernandez-Santiago V, Dreischulte T. The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995–2010. BMC Med. 2015; 13: 74.
- Fung KW, Kapusnik-Uner J, Cunningham J, Higby-Baker S, Bodenreider O. Comparison of three commercial knowledge bases for detection of drug-drug interactions in clinical decision support. J Am Med Inform Assoc. 2017; 24: 806-812.
- Becker ML, Kallewaard M, Caspers PW, Visser LE, Leufkens HG, Stricker BH. Hospitalisations and emergency department visits due to drug–drug interactions: a literature review. Pharmacoepidemiol Drug Saf. 2007; 16: 641-651.
- Merel SE, Paauw DS. Common drug side effects and drug‐drug interactions in elderly adults in primary care. J Am Geriatr Soc. 2017; 65: 1578-1585.
- Krippendorff BF, Lienau P, Andreas R, Huisinga W. Optimizing classification of drug-drug ineraction potentioal for CYP450 isoenzyme inhibbition assays in early drug discovery. J Biomol Screen. 2007; 12: 92-99.
- Kramarow EA. Dental care among adults aged 65 and over, 2017. NCHS Data Brief. 2019; 337: 1-8.
- Lauber C, Lalh SS, Grace M, Smith MH, MacDougall K, West P, et al. Antibiotic prophylaxis practices in dentistry: a survey of dentists and physicians. J Can Dent Assoc. 2007; 73: 245.
- Zacharias M, Hunter KM, Baker AB. Effectiveness of preoperative analgesics on postoperative dental pain: a study. Anesth Prog. 1996; 43: 92-96.
- Hargreaves K, Abbott PV. Drugs for pain management in dentistry. Australian Dent J. 2005; 50(4 Suppl. 2): S14-S22.
- Ribeiro LN, Franz-Montan M, Breitkreitz MC. Nanostructured lipid carriers as robust systems for topical lidocaine-prilocaine release in dentistry. Eu J Pharm Sci. 2016; 93: 192-202.
- Prasad S, Sung B, Aggarwal BB. Age-associated chronic diseases require age-old medicine: role of chronic inflammation. Prev Med. 2012; 5 (Suppl): S29-S37.
- Torkashvand M, Esnaashari F, Mehrpoya M, Fariba F, Nadi F, Zeraati F. Evaluation of Potential Drug Interactions and Related Factors in Patients Admitted in Department of Cardiology of Farshchian Heart Hospital of Hamadan. Avicenna J Clin Med. 2018; 25: 105-111.
- Alkan A, Yaşar A, Karcı E, Köksoy EB, Ürün M, Şenler FÇ, et al. Severe drug interactions and potentially inappropriate medication usage in elderly cancer patients. Supportive Care Cancer. 2017; 25: 229-236.
- Murtaza G, Khan MY, Azhar S, Khan SA, Khan TM. Assessment of potential drug-drug interactions and its associated factors in the hospitalized cardiac patients. Saudi Pharm J. 2015; 24: 220-225.
- Mousavi S, Norouzi M, Ashouri A, Javadi MR, Gholami K, Hadjibabaie M. Study of Potential Drug-Drug Interactions in Prescriptions of University Based Pharmacies. J Pharm Care. 2014; 2: 60-65.
- Rashidi K, Senobar Tahaee SN. Assessment of drug interactions in medical insurance prescriptions in Kurdistan province in 2000. Sci J Kurdistan Univ Med Sci. 2005; 10: 78-84.
- Schneider KL, Kastenmüller K, Weckbecker K, Bleckwenn M, Böhme M, Stingl JC. Potential drug-drug interactions in a cohort of elderly, polymedicated primary care patients on antithrombotic treatment. Drugs Aging. 2018; 35: 559-568.
- Mizokami F, Koide Y, Noro T, Furuta K. Polypharmacy with common diseases in hospitalized elderly patients. Am J Geriatr Pharmacother. 2012; 10: 123-128.
- Carvalho MFC, Romano-Lieber NS, Bergsten-Mendes G, Secoli SR, Ribeiro E, Lebrão ML, et al. Polypharmacy among the elderly in the city of São Paulo, Brazil-SABE Study. Revista Brasileira de Epidemiologia. 2012; 15: 817-827.
- Ahmadi BAM, Mahmoodi M. Polypharmacy among older adults in Tehran. Tehran Univ Med J. 2006; 64: 65-71.
- Yavari H SM, Delbari A, Bakhshi E, Sahhaf R. Prevalence of Poly pharmacy among the Elderly residents of Kahrizak Charity Foundation (KCF), Tehran, 2010-2011. J Sabzevar Univ Med Sci. 2013; 20: 42-50.
- Haider SI, Johnell K, Thorslund M, Fastbom J. Analysis of the association between polypharmacy and socioeconomic position among elderly aged≥ 77 years in Sweden. Clin Ther. 2008; 30: 419-427.
- Huang AR, Mallet L, Rochefort CM, Eguale T, Buckeridge DL, Tamblyn R. Medication-related falls in the elderly. Drugs Aging. 2012; 29: 359-376.
- Koh Y, Kutty FBM, Li SC. Drug-related problems in hospitalized patients on polypharmacy: the influence of age and gender. Ther Clin Risk Manag. 2005; 1: 39-48.
- Castioni J, Marques-Vidal P, Abolhassani N, Vollenweider P, Waeber G. Prevalence and determinants of polypharmacy in Switzerland: Data from the CoLaus study. BMC Health Serv Res. 2017; 17: 840.
- Sánchez-Fidalgo S, Guzmán-Ramos MI, Galván-Banque-ri M, Bernabeu-Wittel M, Santos-Ramos B. Prevalence of drug interactions in elderly patients with multimorbidity in primary care. Int J Clin Pharm. 2017; 39: 343-353.
- George AS, Ramesh M, Sebastian J. Adverse drug interactions in elderly hospitalized patients: a prospective analysis. Int J Pharm Sci Res. 2018; 9: 1913-1920.
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