Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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Pharmacodynamic Drug-Drug Interactions Considered to be Added in the List of Contraindications with Pharmacological Classification in Korea

약물군-약물군 조합으로 도출한 약력학적 기전의 추가 병용금기성분

  • Je, Nam Kyung (College of Pharmacy, Pusan National University) ;
  • Kim, Dong-Sook (Research Department, Health Insurance Review & Assessment Service) ;
  • Kim, Grace Juyun (Department of Biomedical Science, College of Medicine, Seoul National University) ;
  • Lee, Sukhyang (College of Pharmacy, Ajou University)
  • 제남경 (부산대학교 약학대학) ;
  • 김동숙 (건강보험심사평가원 연구조정실) ;
  • 김주연 (서울대학교 의과대학) ;
  • 이숙향 (아주대학교 약학대학)
  • Received : 2015.04.16
  • Accepted : 2015.06.03
  • Published : 2015.06.30
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Abstract

Objectives: Drug utilization review program in Korea has provided 'drug combinations to avoid (DCA)' alerts to physicians and pharmacists to prevent potential adverse drug events or inappropriate drug use. Seven hundred and six DCA pairs have been announced officially by the Ministry of Food and Drug Safety (MFDS) by March, 2015. Some DCA pairs could be grouped based on the drug interaction mechanism and its consequences. This study aimed to investigate the drug-drug interaction (DDI) pairs, which may be potential DCAs, generated by the drug class-drug class interaction method. Methods: Eleven additive/synergistic and one antagonistic drug class-drug class interaction groups were identified. By combining drugs of two interacting drug class groups, numerous DDI pairs were made. The status and severity of DDI pairs were examined using Lexicomp and Micromedex. Also, the DCA listing rate was calculated. Results: Among 258 DDI pairs generated by the drug class-drug class interaction method, only 142 pairs were identified as official DCA pairs by the MFDS. One hundred and four pairs were identified as potential DCA pairs to be listed. QT prolonging agents-QT prolonging agents, triptans-ergot alkaloids, tricyclic antidepressants-monoamine oxidase inhibitors, and dopamine agonists-dopamine antagonists were identified as drug class-drug class interaction groups which have less than 50 % DCA listing rate. Conclusion: To improve the clinicians' adaptability to DCA alerts, the list of DCA pairs needs to be continuously updated.

Keywords

References

  1. Sandusky M. Michigan drug utilization review and OBRA 90. Mich Med 1993;92:38-9.
  2. Heo JH, Suh DC, Kim S, et al. Evaluation of the pilot program on the real-time drug utilization review system in South Korea. Int J Med Inform 2013.
  3. Park JY, Park KW. The contraindication of comedication drugs and drug utilization review. J Korean Med Assoc 2012;55:484-90. https://doi.org/10.5124/jkma.2012.55.5.484
  4. Yakup Shinmoon. Sep 25, 2003. Available from https://yakup.com/news/index.html?mode=view&pmode=&cat=all&cat2=&cat3=&nid=27184&num_start=110055. Accessed March 15, 2015.
  5. National Archives of Korea. Korean drug utilization review system. November 2014. Available from http://www.archives.go.kr/next/search/listSubjectDescription.do?id=009535&pageFlag=. Accessed February26, 2015.
  6. Korea Institute of Drug Safety & Risk Management. Press Release. March 2015. http://www.drugsafe.or.kr/iwt/ds/ko/bbs/EgovBbs.do;jsessionid=922bNDgoNDGmJjtslPQHj36aeEYEWsVQF9oanjSQOTSgNLzuqjxs1EKagcK801cl.webint_2_servlet_engine1?bbsId=BBSMSTR _000000000101&nttId=1315&pageIndex=1&searchCnd=&search- Wrd=. Accessed March 15, 2015.
  7. Ministry of Food and Drug Safety. Press Release. March 2015. http://www.mfds.go.kr/index.do?mid=688&seq=26716. Accessed March 15, 2015.
  8. Cascorbi I. Drug interactions--principles, examples and clinical consequences. Dtsch Arztebl Int 2012;109:546-55; quiz 56.
  9. Strandell J, Wahlin S. Pharmacodynamic and pharmacokinetic drug interactions reported to VigiBase, the WHO global individual case safety report database. Eur J Clin Pharm 2011;67:633-41. https://doi.org/10.1007/s00228-010-0979-y
  10. Drug interactions result from a number of underlying pharmacokinetic and pharmacodynamic mechanisms. Drugs Ther Perspect 2013;29: 217-22. https://doi.org/10.1007/s40267-013-0047-7
  11. Thompson R. PPI therapy: Clopidrogel-PPI drug interaction may not be a class effect. Nat Rev Gastroenterol Hepatol 2011;8(6):302.
  12. Rolan PE. Drug Interactions with Triptans. CNS Drugs 2012;26:949-57. https://doi.org/10.1007/s40263-012-0002-5
  13. Mehrotra N, Gupta M, Kovar A, et al. The role of pharmacokinetics and pharmacodynamics in phosphodiesterase-5 inhibitor therapy. Int J Impot Res 2007;19:253-64. https://doi.org/10.1038/sj.ijir.3901522
  14. Paterno MD, Maviglia SM, Gorman PN, et al. Tiering drug-drug interaction alerts by severity increases compliance rates. J Am Med Inform Assoc 2009;16:40-6. https://doi.org/10.1197/jamia.M2808