Potential drug-drug interactions in acute poisonings managed in the intensive care unit: Occurrence, risk factors and relationship to patient severity on admission.

Abstract

Beyond the direct toxicity resulting from each drug in the poisoned patient, additional toxicities may result from drug-drug interactions (DDIs). We aimed to determine the frequency of potential DDIs in the poisoned patient and investigate whether DDIs are associated with severity. We conducted a 1-year cohort study in a toxicological ICU. DDIs were identified using an electronic interaction-checker tool. Among our 354 ICU poisoned patients, 134 (38%) presented at least one potential DDI between acute poisoning drugs and 180 (51%) at least one potential DDI between acute poisoning and long-term treatment drugs. Using multivariate analyses, previous suicide attempt was associated with the presence of potential DDIs between acute poisoning drugs in suicide attempt patients (P = 0.014). Chronic alcoholism (P = 0.005) and tobacco smoking (P = 0.022) were associated with the presence of potential DDIs between acute poisoning and long-term treatment drugs in recreational drug users. Presence of potential DDIs between acute poisoning and long-term treatment drugs was associated with catecholamine infusion (P = 0.022) in suicidal self-exposure patients. Presence of potential pharmacodynamic DDIs between acute poisoning and long-term treatment drugs was associated with aspiration pneumonia onset in recreational drug users (P = 0.03). ICU poisoned patients present a high rate of potential DDIs that may influence the outcome.

• Authors: Beatrice Mainoli, Nilza Gonçalves, Joaquim J Ferreira, Bruno Mégarbane
• Journal: Basic & clinical pharmacology & toxicology (Basic Clin Pharmacol Toxicol) Vol. 130 Issue 2 Pg. 337-345 (Feb 2022) ISSN: 1742-7843 [Electronic] England
• PMID: 34873835 (Publication Type: Journal Article)
• Copyright: © 2021 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society). Published by John Wiley & Sons Ltd.

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Alcoholism (epidemiology)
• Cohort Studies
• Drug Interactions
• Female
• Humans
• Intensive Care Units (statistics & numerical data)
• Male
• Middle Aged
• Patient Admission
• Pneumonia, Aspiration (epidemiology, etiology)
• Poisoning (epidemiology)
• Risk Factors
• Severity of Illness Index
• Substance-Related Disorders (epidemiology)
• Suicide, Attempted (statistics & numerical data)
• Tobacco Smoking (epidemiology)
• Young Adult