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. 1997 Nov;43:1972-6, 1979-81.

Drug interactions among commonly used medications. Chart simplifies data from critical literature review.

N R Crowther 1, A M Holbrook 1, R Kenwright 1, M Kenwright 1
PMCID: PMC2255205  PMID: 9386884

Abstract

OBJECTIVE: To simplify risk assessment, we have developed a way to present critically appraised drug interaction information through a chart. DATA SOURCES: Fifty drugs most frequently prescribed by Canadian family physicians and 16 drugs and substances that frequently interact with these drugs were the basis for a literature review. Drug interaction textbooks and MEDLINE (from 1966 to 1994) were searched for documented interactions. Reports of additive effects and animal or in vitro studies were excluded. STUDY SELECTION: All reports of interactions were evaluated for clinical effect, clinical significance, and quality of evidence. SYNTHESIS: Of the 464 drug-drug or drug-substance pairs evaluated, 387 (83.4%) demonstrated an interaction, 59 (12.7%) documented no effect, and 18 (3.9%) pairs had conflicting evidence. Five percent of interactions were of major clinical significance; only 1.3% were of major clinical significance and supported by good-quality evidence. By using symbols, colours, and legends in a "grid-map" format, a large amount of drug interaction information was reduced to a single-page chart suitable for a desk reference or wall mounting. CONCLUSIONS: Our chart organizes a large amount of drug interaction information in a format that allows for rapid appreciation of outcome, clinical significance, and quality of evidence.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barillot M. J., Sarrut B., Doreau C. G. Evaluation of drug interaction document citation in nine on-line bibliographic databases. Ann Pharmacother. 1997 Jan;31(1):45–49. doi: 10.1177/106002809703100106. [DOI] [PubMed] [Google Scholar]
  2. Cadieux R. J. Drug interactions in the elderly. How multiple drug use increases risk exponentially. Postgrad Med. 1989 Dec;86(8):179–186. doi: 10.1080/00325481.1989.11704506. [DOI] [PubMed] [Google Scholar]
  3. Connelly D. P., Rich E. C., Curley S. P., Kelly J. T. Knowledge resource preferences of family physicians. J Fam Pract. 1990 Mar;30(3):353–359. [PubMed] [Google Scholar]
  4. Cook D. J., Guyatt G. H., Laupacis A., Sackett D. L., Goldberg R. J. Clinical recommendations using levels of evidence for antithrombotic agents. Chest. 1995 Oct;108(4 Suppl):227S–230S. doi: 10.1378/chest.108.4_supplement.227s. [DOI] [PubMed] [Google Scholar]
  5. Costa A. J. Potential drug interactions in an ambulatory geriatric population. Fam Pract. 1991 Sep;8(3):234–236. doi: 10.1093/fampra/8.3.234. [DOI] [PubMed] [Google Scholar]
  6. Ely J. W., Burch R. J., Vinson D. C. The information needs of family physicians: case-specific clinical questions. J Fam Pract. 1992 Sep;35(3):265–269. [PubMed] [Google Scholar]
  7. Holbrook A. M., MacLeod S. M., Fisher P., Levine M. A. Developing a Canadian prescribing practices network. Network Development Committee of the Canadian Prescribing Practices Network Project. CMAJ. 1996 May 1;154(9):1325–1331. [PMC free article] [PubMed] [Google Scholar]
  8. Jankel C. A., Fitterman L. K. Epidemiology of drug-drug interactions as a cause of hospital admissions. Drug Saf. 1993 Jul;9(1):51–59. doi: 10.2165/00002018-199309010-00005. [DOI] [PubMed] [Google Scholar]
  9. Kurfees J. F., Dotson R. L. Drug interactions in the elderly. J Fam Pract. 1987 Nov;25(5):477–488. [PubMed] [Google Scholar]
  10. Lamy P. P. The elderly and drug interactions. J Am Geriatr Soc. 1986 Aug;34(8):586–592. doi: 10.1111/j.1532-5415.1986.tb05764.x. [DOI] [PubMed] [Google Scholar]
  11. Levine M., Walter S., Lee H., Haines T., Holbrook A., Moyer V. Users' guides to the medical literature. IV. How to use an article about harm. Evidence-Based Medicine Working Group. JAMA. 1994 May 25;271(20):1615–1619. doi: 10.1001/jama.271.20.1615. [DOI] [PubMed] [Google Scholar]
  12. McNamara R. M., Rousseau E., Sanders A. B. Geriatric emergency medicine: a survey of practicing emergency physicians. Ann Emerg Med. 1992 Jul;21(7):796–801. doi: 10.1016/s0196-0644(05)81024-8. [DOI] [PubMed] [Google Scholar]
  13. Poirier T. I., Giudici R. Evaluation of drug interaction microcomputer software: an updated comparison. Hosp Pharm. 1995 Oct;30(10):888-90, 893-4. [PubMed] [Google Scholar]
  14. Wells P. S., Holbrook A. M., Crowther N. R., Hirsh J. Interactions of warfarin with drugs and food. Ann Intern Med. 1994 Nov 1;121(9):676–683. doi: 10.7326/0003-4819-121-9-199411010-00009. [DOI] [PubMed] [Google Scholar]

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