The Frequency of Drug Interactions in Patients in the Intensive Care Units of Alzahra Hospital, Isfahan, Iran

Document Type : Original Article (s)


1 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran


Background: The morbidity and mortality rates are increased in patients with drug interactions. Patients in the intensive care units are at risk for developing drug interactions for various reasons including impaired absorption, reduced metabolism, and renal failure, which are common in these patients. In this study, we aimed to investigate the frequency of drug interactions in patients admitted to intensive care units.Methods: In this retrospective study, the prescriptions of 195 patients admitted to intensive care units of Alzahra hospital, Isfahan, Iran, were investigated. Drug interactions were determined using Lexi-Comp application and the textbook of Drug Interaction Facts. Statistical analysis was performed using SPSS software.Findings: The frequency and mean drug reactions were 88.2% and 10.49 ± 9.88, respectively. There were significant correlations between number of drug interactions and age, duration of hospitalization, and the number of prescribed medications and physicians (P < 0.01 for all). The mean mild, moderate, and sever drug interactions were 1.63 ± 2.16, 8.05 ± 7.80, and 0.81 ± 1.019, respectively.Conclusion: Significant drug reactions as potential risks of health were prevalent in patients in intensive care units. Detection of drug interactions, replacing of interacting drug with other drugs as much as possible, awareness of highly interacting drugs, and diminishing number of prescribed drugs can reduce the number of potential drug reactions and minimize their adverse events.


  1. Ewig CLY, Cheung HM, Kam KH, Wong HL, Knoderer CA. Occurrence of potential adverse drug events from prescribing errors in a pediatric intensive and high dependency unit in Hong Kong: An observational study. Paediatr Drugs 2017; 19(4): 347-55.
  2. Shehab N, Lovegrove MC, Geller AI, Rose KO, Weidle NJ, Budnitz DS. US Emergency Department visits for outpatient adverse drug events, 2013-2014. JAMA 2016; 316(20): 2115-25.
  3. Trinkley KE, Weed HG, Beatty SJ, Porter K, Nahata MC. Identification and characterization of adverse drug events in primary care. Am J Med Qual 2016.
  4. Rekic D, Reynolds KS, Zhao P, Zhang L, Yoshida K, Sachar M, et al. Clinical drug-drug interaction evaluations to inform drug use and enable drug access. J Pharm Sci 2017; 106(9): 2214-8.
  5. Desai A, Yamazaki T, Dietz AJ, Kowalski D, Lademacher C, Pearlman H, et al. Pharmacokinetic and pharmacodynamic evaluation of the drug-drug interaction between isavuconazole and warfarin in healthy subjects. Clin Pharmacol Drug Dev 2017; 6(1): 86-92.
  6. Armstrong EP, Wang SM, Hines LE, Gao S, Patel BV, Malone DC. Evaluation of a drug-drug interaction: fax alert intervention program. BMC Med Inform Decis Mak 2013; 13(1): 32.
  7. Leonard JB, Nair V, Diaz CJ, Penoyar JB, Goode PA. Potential drug interaction with opioid agonist in the setting of chronic low-dose opioid antagonist use. Am J Emerg Med 2017; 35(8): 1209.
  8. Rahimi B, Gharabaghi N, Hesari Z, Balanji S, Alinia T. Prevalence of potential drug interactions in patients in the intensive care unit of urmia taleghani hospital. J Urmia Univ Med Sci 2013; 24 (2):133-45. [In Persian].
  9. Rafiei H, Arab M, Ranjbar H, Sepehri GR, Arab N, Amiri M. The prevalence of potential drug interactions in Intensive Care Units. Iran J Crit Care Nurs 2012; 4(4): 191-6.
  10. Vanham D, Spinewine A, Hantson P, Wittebole X, Wouters D, Sneyers B. Drug-drug interactions in the intensive care unit: Do they really matter? J Crit Care 2017; 38: 97-103.
  11. Almeida S, Scatena Gama C, Akamine N. Prevalence and classification of drug-drug interactions in intensive care patients. Einstein 2007; 5(4):347-51.