Assessment of Adverse Drug Reactions and Drug Interactions Caused By Art with Other Co-Morbid Conditions


Authors : Sreshi Kumari; Tana Donyi Tara; Pooja Ajit Sonawane; Dr. Beulah Milton

Volume/Issue : Volume 9 - 2024, Issue 11 - November


Google Scholar : https://tinyurl.com/msu7hk95

Scribd : https://tinyurl.com/46wztnrx

DOI : https://doi.org/10.38124/ijisrt/IJISRT24NOV966

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Objective: The aim of the study focuses on the assessment Of Drug –Interactions and Adverse Drug Reactions caused by ART with other Co-Morbid Conditions. Method: This was a prospective observational study carried out in the ART Center, MVJ Medical College, and Research Hospital, Hoskote from April 2023 to September 2023. The study enrolled a total of 164 patients suffering from HIV infection associated with co- morbid diseases The patient's demographic details were obtained from WHITE cards in ART Center. Liverpool HIV DDI website was used to define each DDI and specific grade. CHI-SQUARE TEST was used to determine the association of Adverse Drug Reactions Result: Out of 162 patients, 16 were identified as drug-drug interactions, further of which 3 were categorized as red flagged and the remaining 13 were amber flagged interactions. Also, 3 ADRs were identified with a low incidence rate of 0.6%. The chi-square study shows a strong association between Drug-Drug Interactions, Age- CD4/Viral Count, and Age- Drug Interaction these factors can be taken into consideration to prevent DDI. Conclusion: As per our study we conclude that Therapeutic Drug Monitoring (TDM) and the involvement of clinical pharmacists can address these issues. TDM optimizes drug dosages to avoid interactions and adverse effects, ensuring safer and more effective treatment. Clinical pharmacists are crucial in identifying potential DDIs and ADRs, providing tailored interventions, and educating patients and healthcare providers. Their expertise is essential in improving health outcomes for PLWHA by ensuring the safe and effective use of medications, thereby overcoming the limitations we faced in our study.

Keywords : ART, ADR, DDI's, Liverpool HIV DDI, TDM.

References :

  1. Solomon S, Solomon SS, Ganesh AK. AIDS in India. Postgrad Med J. 2006.
  2. NACO. National Guidelines for HIV Care and Treatment 2021.
  3. So-Armah K, Benjamin LA, Bloomfield GS, Feinstein MJ, Hsue P, Njuguna B, Freiberg MS. HIV and cardiovascular disease. Lancet. 2020.
  4. Rukmangathen R,Brahmanapalli VD, Thammisetty DP, Pemmasani D, Gali SD, Atmakuru RB. Study of adverse drug reactions to antiretroviral therapy in a tertiary care hospital, Tirupati. PerspectClin Res. 2020.
  5. Bandyopadhyay A, Chaurasia RC, Palepu S, Yadav RK. A study of adherence to antiretroviral therapy in a tertiary care hospital at Allahabad, India. Indian J Sex Transm Dis AIDS. 2019.
  6. Palleria C, Di Paolo A, Giofrè C, Caglioti C, Leuzzi G, Siniscalchi A, De Sarro G, Gallelli L. Pharmacokinetic drug-drug interaction and their implication in clinical management. J Res Med Sci. 2013.
  7. Sherfa A, Haile D, Yihune M, Sako S. Incidence and predictors of Adverse Drug Reaction (ADR) among adult HIV positive patients on anti-retroviral treatment in Arba Minch town public health facilities, southern Ethiopia: A retrospective cohort study, 2020. PLoS One. 2021.
  8. Anbessa O,Hawulte B, Dingeta T, Birhanu A. Incidence and predictors of severe adverse drug reactions among patients on antiretroviral drugs in Harari Regional State, Eastern Ethiopia. Can J Infect Dis. 2024.
  9. Ruellan AL,Bourneau-Martin D, Joyau C, Secher S, Fialaire P, Hitoto H, Leautez S, Michau C, Vatan R, Billaud E, Briet M. Assessment of drug–drug interaction in an elderly human immunodeficiency virus population: Comparison of 3 expert databases. Br J Pharmacol. 2020.
  10. Ahmed A,Tanveer M, Dujaili JA, Chuah LH, Hashmi FK, Awaisu A. Pharmacist-Involved Antiretroviral Stewardship Programs in People Living with HIV/AIDS: A Systematic Review. AIDS Patient Care STDs. 2023; PMID: 36626156.
  11. Barcelo C,Aouri M, Courlet P, Guidi M, Braun DL, Günthard HF, Piso RJ, Cavassini M, Buclin T, Decosterd LA, Csajka C. Population pharmacokinetics of dolutegravir: influence of drug-drug interactions in a real-life setting. J AntimicrobChemother. 2019 Sep.
  12. Schlaeppi C,Vanobberghen F, Sikalengo G, Glass TR, Ndege RC, Foe G, Kuemmerle A, Paris DH, Battegay M, Marzolini C, Weisser M. Prevalence and management of drug–drug interactions with antiretroviral treatment in 2069 people living with HIV in rural Tanzania: a prospective cohort study. HIV Med. 2020 Jan;21(1):53-63
  13. Jha AK,Gadgade A, Shenoy AK, Chowta MN, Ramapuram JT. Evaluation of adverse drug reactions in HIV positive patients in a tertiary care hospital. PerspectClin Res. 2015 Jan-Mar;6.
  14. Cattaneo D, Baldelli S, Cozzi V, Clementi E, Marriott DJE, Gervasoni C. Impact of Therapeutic Drug Monitoring of Antiretroviral Drugs in Routine Clinical Management of People Living With HIV: A Narrative Review. Ther Drug Monit. 2020 Feb;42(1):64-74.
  15. López-Centeno B,Badenes-Olmedo C, Mataix-Sanjuan Á, McAllister K, Bellón JM, Gibbons S, Balsalobre P, Pérez-Latorre L, Benedí J, Marzolini C, Aranguren-Oyarzábal A, Khoo S, Calvo-Alcántara MJ, Berenguer J. Polypharmacy and Drug–Drug Interactions in People Living With Human Immunodeficiency Virus in the Region of Madrid, Spain: A Population-Based Study. Clin Infect Dis. 2020;71(2):15 July.
  16. Xia H, Gao L, Gong X, Zaongo SD, Zhang T, Wu H, Ma P, Huang X. The Challenge of Potential Drug–Drug Interactions Among People Living With HIV on Antiretroviral Therapy: A Cross-Sectional Study in Selected Provinces in China. Front Pharmacol. 2020.
  17. de Oliveira Costa J, Lau S, Medland N, Gibbons S, Schaffer AL, Pearson SA. Potential drug–drug interactions due to concomitant medicine use among people living with HIV on antiretroviral therapy in Australia. Br J ClinPharmacol. 2023 May;89(5):1541-53.
  18. Peng A-T, Huang S-H, Lee H-Y, Wu P-Y, Kuo H-Y, Hung C-C. Polypharmacy and potential drug–drug interactions among people living with HIV in the era of integrase strand transfer inhibitor-based antiretroviral therapy. Int J Antimicrob Agents. 2024;63(2).
  19. Back D, Marzolini C. HIV treatment in an era of polypharmacy. J Int AIDS Soc. 2020.
  20. More SA, Atal S, Mishra PS. Inter-rater agreement between WHO-Uppsala Monitoring Centre system and Naranjo algorithm for causality assessment of adverse drug reactions. J PharmacolToxicol Methods. 2024.
  21. McHugh ML. The Chi-square test of independence. Biochem Med (Zagreb). 2013.

Objective: The aim of the study focuses on the assessment Of Drug –Interactions and Adverse Drug Reactions caused by ART with other Co-Morbid Conditions. Method: This was a prospective observational study carried out in the ART Center, MVJ Medical College, and Research Hospital, Hoskote from April 2023 to September 2023. The study enrolled a total of 164 patients suffering from HIV infection associated with co- morbid diseases The patient's demographic details were obtained from WHITE cards in ART Center. Liverpool HIV DDI website was used to define each DDI and specific grade. CHI-SQUARE TEST was used to determine the association of Adverse Drug Reactions Result: Out of 162 patients, 16 were identified as drug-drug interactions, further of which 3 were categorized as red flagged and the remaining 13 were amber flagged interactions. Also, 3 ADRs were identified with a low incidence rate of 0.6%. The chi-square study shows a strong association between Drug-Drug Interactions, Age- CD4/Viral Count, and Age- Drug Interaction these factors can be taken into consideration to prevent DDI. Conclusion: As per our study we conclude that Therapeutic Drug Monitoring (TDM) and the involvement of clinical pharmacists can address these issues. TDM optimizes drug dosages to avoid interactions and adverse effects, ensuring safer and more effective treatment. Clinical pharmacists are crucial in identifying potential DDIs and ADRs, providing tailored interventions, and educating patients and healthcare providers. Their expertise is essential in improving health outcomes for PLWHA by ensuring the safe and effective use of medications, thereby overcoming the limitations we faced in our study.

Keywords : ART, ADR, DDI's, Liverpool HIV DDI, TDM.

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe