INTRODUCTION:
A drug–drug interaction (DDI) arises when one medication influences the pharmacological activity either pharmacokinetically or pharmacodynamicall y of another, potentially diminishing its effectiveness or increasing the likelihood of adverse outcomes.1 In some cases, these interactions can lead to severe side effects that require hospitalization. Studies estimate that DDIs are responsible for up to 3% of all hospital admissions. Moreover, between 37% and 60% of hospitalized patients may already be prescribed at least one pair of drugs with the potential to interact. The risk of such interactions escalates during hospitalization as additional drugs are commonly introduced to existing treatment plans.
The growing prevalence of polypharmacy, particularly among individuals managing multiple chronic conditions, has made DDIs a pressing issue in healthcare. These interactions can result in a wide spectrum of negative effects, from minor symptoms to serious complications that can impact a patient’s health or lead to fatal outcomes.2 For this reason, it is critical that healthcare professionals actively identify and assess potential DDIs to minimize adverse effects and enhance treatment outcomes. Routine screening for DDIs and recognizing patients at higher risk can play a vital role in improving medication safety and the overall quality of pharmaceutical care.3
Ultimately, when multiple medications are required, their combined benefits should be weighed against the possibility of harmful interactions. If a specific combination offers substantial clinical benefit and no safer alternatives exist, it may be justifiable to continue treatment despite the known risks, provided appropriate monitoring is in place.
Mechanisms of Drug Interactions:
1. Behavioral drug-drug interaction: altered compliance:
When the effect of one medication influences a patient's behavior in a way that changes how they adhere to another prescribed treatment.
Example: depressed patient taking an antidepressant drug may become more compliant to the drug as symptoms improve.
2. Pharmaceutic drug-drug interactions: outside the body
It is a physicochemical interaction that occurs when drugs are mixed with intravenous causing precipitation before patient before administration
Example: precipitation of Sodium thiopentanne with an IV Dose.
3. Pharmacokinetic Drug–Drug Interactions: Changes in Drug Levels or Duration:
These types of interactions happen when one drug affects the absorption, distribution, metabolism, or excretion of another, leading to changes in its concentration in the body. This can influence how much of the drug reaches the target site and how long it stays active. In contrast, pharmacodynamic interactions involve two or more drugs acting on the same physiological system, either enhancing each other’s effects (additive or synergistic) or working against each other, potentially reducing or neutralizing the overall effect.
Types of Drug interaction:
1. Drug Drug Interacrtion:
Types of Drug Interactions: Important types of drug interactions are:
1. Drug-drug interactions
2. Drug-food interactions
3. Drug-chemical interactions
4. Drug-laboratory test interactions
5. Drug disease interaction
6. Drug-disease interactions
The overall drug interaction is:
1. Generally quantitative - increased or decreased effect.
2. Seldom qualitative - rapid or slower effect.
3. Precipitation of newer or increased adverse effect 5,6
Methodology:
1. Identification of Adult Patient:
The observational study was carried out from Dec 2023 in Mahesh Dhanwantari Clinic Rahuri. The study was done after getting the approval from Dr. Kiran Shelke (BHMS The patient with more than two drug prescribed is selected.
2. Collection of Patient information:
The patient information was collected using Patient patient medical record used for study.
3. Study of Prescription:
The drugs prescribed to patient is mainly studied, the combination of drugs effect, drugs mechanism of action, dose of drug etc is studied.
4. Analysis of Drug - Drug interaction using Software
Figure 1: Drug Drug Interaction Software
DDIs were checked using drug interaction checker at www.drugs.com database which is powered by four medical information suppliers like Woltes Kluwer health.
RESULT AND DISCUSSION:
1. Identification of adult female Patient:
The observational study was carried in Mahesh Dhanwantari Clinic Rahuri.and after of Dr. kiran shelke (BHMS) The patient with more than two drug prescribed is selected.
The adult patient Mrs Shobha Mate was selected for Drug Drug interaction Study.
2. Collection of Patient information:
The patient information was collected using Patient observation records like patient medical record used for study.
a. Personal information:
Table No 1: Personal information
|
Name |
Shobha Mate |
|
Age |
32 years |
|
Adress |
A/p Rahuri Tal- Rahuri Dist-Ahmednagar |
|
Birth Date |
15/05/1992 |
|
Weight |
45 kg |
b. Patient observation Sheet:
Table No 2: Patient observation Sheet
|
Parameter |
Observation |
|
Weight |
45 kg |
|
Blood pressure |
110/70 mm hg |
|
Body Temperature |
100 |
|
Breathing |
Normal |
|
Other |
The patient has body pain, joint pain, |
3. Study of Prescription:
Figure 2: Prescription
The drugs prescribed to patient studied, the following drugs prescribed to patients.
Table No 3: Prescribed Drug
|
Sr. No. |
Brand Name |
Drug Content |
|
1 |
Orsara RD Cap |
Rabeprazole sodium 20mg and domperidone 30mg |
|
2 |
Zerodol tab |
Acelofeanc 100mg Serratopeptidase 15mg, Paracetamol 325mg |
|
3 |
Cap Inflavin |
Salai guggul nirgudi extract, Tripala |
1. Rebvoid:
Rabvoid DSR 30/20 mg used as combination medicine in treatment of GRD (Acid Reflux)
Uses: GRD (Acid Reflux)
Directions: Take before food and swallow whole with a glass of water.
Side effect: Headache
2. Zerodol tab:
Zerodol Tablet is a pain-relieving medicine. It alleviates osteoarthritis.
Uses: Pain relief
Directions: Taking Zerodol with nimusuide can modify the effect of either of them and cause some undesirable side effects
Side effect: Constipitation, nausea, stomach pain, indigestion.
3. Cab Inflavin
Cab Inflavan 10mg is Painkiller medicine used in treatment of osteoarthritis.
Uses: Pain relief
Directions: Take this medicine in the dose and direction as advised by your doctor. Inflavan 20mg Capsule is taken after food.
Side effect: Dizziness, vomiting, diarrhea, indigestion.
3. Analysis of Drug - Drug interaction using Software
Drug –Drug Interaction checked using drug interaction checker at www.drugs.com.
The result of study of prescribed drug drug interaction is as follows.
Table No 4: Drug - Drug interaction
|
Drug – Drug Interaction |
Severity |
Description |
|
|
Aceclofenac |
Rabeprazole sodium |
Minor |
Aceclofenac may decrease the excretion rate of Rabeprazole which could result in a higher serum level. . |
CONCLUSION:
The study is done to check DDI in Female adult patient patients. The result shows there is drug drug interaction seen bu using software but actual the drug prescribed to patient but there were no Drug drug interaction or side effects seen. The frequency of DDI was less with branded drugs and study highlights prescriber to improve awareness of DDI and their management in improving clinical outcome.
REFERENCE:
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4. Ankur R, Ashutosh P, Singhraj Y. Drug interaction: A Succinct Review. Int J Pharm Chem Sci. 2013; 1(2): 297-302.
5. Costa AJ. Potential drug interactions in an ambulatory adult female population. Fam Pract. 1991; 8(3): 234-36.
6. Shinde, G. S., R. S. Jadhav, R. B. Kote, A. J. Kadam, and A. A. Bankar. Bioanalytical method development and validation of UV spectrophotometric method for estimation of metformin hydrochloride in urine sample. 2024; 17(2): 93-96.
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Received on 17.03.2025 Revised on 12.05.2025 Accepted on 19.06.2025 Published on 22.07.2025 Available online from July 26, 2025 Res.J. Pharmacology and Pharmacodynamics.2025;17(3):175-177. DOI: 10.52711/2321-5836.2025.00028 ©A and V Publications All right reserved
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