Analysis of polypharmacy events and drug-drug interaction in COVID-19 therapy

Authors

  • Anna Pradiningsih University of Muhammadiyah Mataram, West Nusa Tenggara, Indonesia
  • Nurul Qiyaam University of Muhammadiyah Mataram, West Nusa Tenggara, Indonesia
  • Baiq Leny Nopitasari University of Muhammadiyah Mataram, West Nusa Tenggara, Indonesia https://orcid.org/0000-0001-6228-545X

DOI:

https://doi.org/10.46542/pe.2023.232.133138

Keywords:

COVID-19, Drug interaction, Polypharmacy

Abstract

Background: Polypharmacy is the use of five or more types of drugs in a therapy simultaneously. The use of polypharmacy therapy increases the potential for drug-drug interactions. In COVID-19 therapy, the use of varied antiviral and non-antiviral medications allow for increased polypharmacy and potential drug interactions.

Objective: To determine the relationship between polypharmacy and drug-drug interactions in COVID-19 therapy.

Method: This is an analytical observational study with retrospective data retrieval using secondary data sources. The sampling technique used purposive sampling with a total of 91 samples. Tracing potential drug interactions was reviewed through the Micromedex 2.0 application and the results obtained were analysed with the Spearman correlation analysis test.

Result: The results of data obtained from non-polypharmacy events was 3.20% and polypharmacy events was 96.80%. The potential for drug interactions was at the Contraindicated category (3.78%), the Major Category (66.19%), the Moderate category (27.87%) and the Minor category (2.16%). The results from the test showed a very strong positive correlation between polypharmacy and potential drug interactions characterised by a p-value of 0.0001 and a correlation coefficient of 0.874.

Conclusion: The higher the increase in polypharmacy, the higher the potential for drug interactions. Handling of drug interactions that occur can be given by giving a pause in the time of drug use, dose adjustment, and drug turnover.

Author Biographies

Anna Pradiningsih, University of Muhammadiyah Mataram, West Nusa Tenggara, Indonesia

Department of Clinical Pharmacy and Pharmacology, Faculty of Health Sciences

Nurul Qiyaam, University of Muhammadiyah Mataram, West Nusa Tenggara, Indonesia

Department of Clinical Pharmacy and Pharmacology, Faculty of Health Sciences

Baiq Leny Nopitasari, University of Muhammadiyah Mataram, West Nusa Tenggara, Indonesia

Department of Clinical Pharmacy and Pharmacology, Faculty of Health Sciences

References

Adondis, J., Mongi, J., Tiwow, G. A. R., & Palandi, R. R. (2019). Study of potential drug interactions in heart failure patients in the inpatient installation of Manado Adventist Hospital. Tropical Biopharmaceuticals, 2(2), 124–135. https://doi.org/10.55724/jbiofartrop.v2i2.125

Anggiswari, K., Angela, P., & Sutarka, I. N. (2021). The Role of Vitamin D Immunomodulating Effects on COVID-19 Management. 10(2), 927–933

Bartlett, J. G. (2004). Global susceptibility patterns for 21 commonly utilized antimicrobial agents tested against 48,440 Enterobacteriaceae in the SENTRY antimicrobial surveillance program (1997-2001). Infectious Diseases in Clinical Practice, 12(2),142–143. https://doi.org/10.1097/01.idc.0000121033.62151.b2

Beakley, B. D., Kaye, A. M., & Kaye, A. D. (2015). Tramadol, pharmacology, side effects, and serotonin syndrome: A review. Pain Physician, 18(4), 395–400. https://doi.org/10.36076/ppj.2015/18/395

BPOM. (2020). COVID-19 Drug Informatorium in Indonesia

Burhan, E., Susanto, A. D., Nasution, S. A., Ginanjar, E., Pitoyo, C. W., Susilo, A., Firdaus, I., Santoso, A., Juzar, D. A., Arif, S. K., Wulung, N. G. H. L., Damayanti, T., Wiyono, W. H., Prasenohadi, Afiatin, Wahyudi, E. R., Tarigan, T. J. E., Hidayat, R., Muchtar, F., & IDAI, T. C.-19. (2020). COVID-19 Confirmed Patient Management Protocol

Elviani, R., Anwar, C., & Januar Sitorus, R. (2021). Overview of age at the incidence of COVID-19. Journal of Medicine and Health, 9(1), 204–209. https://doi.org/10.22437/jmj.v9i1.11263

Emyr Jones, Bevan, A., & Pugh-Jone, J. (2014). Polypharmacy : Guidance for Prescribing. All Wales Medicines Strategy Group, July, 1–36. http://ukclinicalpharmacy.org/wp-content/uploads/2017/07/All_Wales_Medicines_Strategy_Group_Polypharmacy_Guidance_for_prescribing_2014.pdf

Ernawati, A. (2021). Overview of COVID - 19 Cases by Gender, Age Group, and Population Density in Pati Regency. Litbang Journal: Media Information Research, Development and IPTEK, 17(2), 131–146

Kitazawa, F., Fuchida, S. I., Kado, Y., Ueda, K., Kokufu, T., Okano, A., Hatsuse, M., Murakami, S., Nakayama, Y., Takara, K., & Shimazaki, C. (2017). Pharmacokinetic interaction between tacrolimus and fentanyl in patients receiving allogeneic hematopoietic stem cell transplantation. Annals of Transplantation, 22, 575–580. https://doi.org/10.12659/AOT.904505

Moffett, P. M., Cartwright, L., Grossart, E. A., O’Keefe, D., & Kang, C. S. (2016). Intravenous ondansetron and the qt interval in adult emergency department patients: An observational study. Academic Emergency Medicine, 23(1), 102–105. https://doi.org/10.1111/acem.12836

Nachimuthu, S., Assar, M. D., & Schussler, J. M. (2012). Drug-induced QT interval prolongation: Mechanisms and clinical management. Therapeutic Advances in Drug Safety, 3(5), 241–253. https://doi.org/10.1177/2042098612454283

Psomas, G., & Kessissoglou, D. P. (2013). Quinolones and non-steroidal anti-inflammatory drugs interacting with copper(ii), nickel(ii), cobalt(ii) and zinc(ii): Structural features, biological evaluation and perspectives. Dalton Transactions, 42(18), 6252–6276. https://doi.org/10.1039/c3dt50268f

Putra, A. M. P., Wasiaturrahmah, Y., Rahmah, N., & Nahdha. (2021). Potential drug interactions in COVID-19 patients in one of the hospitals in South Kalimantan province. Pharmaceutical and Pharmacology Magazine, 25(3), 94–97. https://doi.org/10.20956/mff.v25i3.18238

Shakir Mahmood Alwan. (2022). Al-Akidi Therapeutic Protocol for Severe Infections Associated with COVID-19: Potential and Effective Treatment by Levofloxacin and Vitamin D3 and Zinc (Part 1). Journal of Pharmacy and Pharmacology, 10(4), 105–118. https://doi.org/10.17265/2328-2150/2022.04.001

Simanjuntak, N., Tewu, Y. S. T., & Makawimbang, R. (2020). Suitability of Vitamin C and Antiviral Pharmacological Therapy Management for Moderate Category COVID Patients at Bitung Regional General Hospital, North Sulawesi Province. Indonesian Journal of Pharmaceutical Science and Technology, X(1), 61–74

Smith, T., Bushek, J., Leclaire, A., & Prosser, T. (2020). COVID-19 Drug Therapy What’s been updated : Highlights : Elsevier

Sultana, N., Arayne, M. S., & Sharif, S. (2004). Levofloxacin interactions with essential and trace elements. Pakistan Journal of Pharmaceutical Sciences, 17(2), 67–76. http://www.ncbi.nlm.nih.gov/pubmed/16414598

Suryaningsih, N. P. A., Reganata, G. P., Sutema, I. A. M. P., & Putri, D. W. B. (2021). Rationality in Vitamin C Self-medication during the Covid-19 Pandemic in Denpasar City. Bali Medika Journal, 8(2), 180–190

Tisdale, J. E., Jaynes, H. A., Kingery, J. R., Mourad, N. A., Trujillo, T. N., Overholser, B. R., & Kovacs, R. J. (2013). Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circulation: Cardiovascular Quality and Outcomes, 6(4), 479–487. https://doi.org/10.1161/CIRCOUTCOMES.113.000152

Wise, B. L., Peloquin, C., Choi, H., Lane, N. E., & Zhang, Y. (2012). Impact of age, sex, obesity, and steroid use on quinolone-associated tendon disorders. American Journal of Medicine, 125(12), 1228.e23-1228.e28. https://doi.org/10.1016/j.amjmed.2012.05.027

Wulandari, A., & dkk. (2020). The relationship between individual characteristics and knowledge about the prevention of Coronavirus Disease 2019 in the community in Pungging Mojokerto District. Indonesian Journal of Public Health, 15(1), 42–46. https://doi.org/10.52646/snj.v4i1.97

Yasin, T., Ahmed, S., Ahmed, M., & Yoshii, F. (2005). Effect of concentration of polyfunctional monomers on physical properties of acrylonitrile-butadiene rubber under electron-beam irradiation. Radiation Physics and Chemistry, 73(3), 155–158. https://doi.org/10.1016/j.radphyschem.2004.07.009

Yuniar, Y., Ramadhiani, A. R., Asyifa, D., Ade Putri, W. K., & Apriliana, W. S. (2022Potential Drug Interactions in Confirmed COVID-19 Patients with Comorbidities in the Ogan Ward of Dr. Mohammad Hoesin Hospital Palembang for the April-June 2021 period. Farmaseutics Magazine, 18(1), 43. https://doi.org/10.22146/farmaseutik.v18i1.71910

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Published

15-05-2023

How to Cite

Pradiningsih, A., Qiyaam, N., & Nopitasari, B. L. (2023). Analysis of polypharmacy events and drug-drug interaction in COVID-19 therapy. Pharmacy Education, 23(2), p. 133–138. https://doi.org/10.46542/pe.2023.232.133138

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Special Edition