Currently there are three main drug groups for the prevention and treatment of fungal infections: polyenes amphotericin B deoxycholate or its lipid formulations , azoles fluconazole, itraconazole or posaconazole and echinocandins caspofungin, micafungin and anidulafungin. However, a major characteristic to be evaluated when choosing an antifungal agent —apart from antifungal spectrum, pharmacokinetics and adverse effects— is the absence of significant drug interactions. Amphotericin B lacks interactions but may cause renal dysfunction, leading to the accumulation of renally metabolized drugs. Nephrotoxicity is significantly lower with lipid formulations, especially with liposomal amphotericin B. Azoles modify the metabolism of a wide range of drugs by inhibiting their biotransformation or altering their distribution and elimination. These drugs are metabolized in the liver through the P cytochrome complex, inhibiting several isoenzymes, especially CYP3A4, the main drug-metabolizing enzyme.
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Rev Med Chile ; Drug interactions and adverse events induced by drugs used in an intensive care unit. Background: Eleven percent of hospitalized patients experience drug-drug interactions DDIs , elevating morbidity, mortality and health care costs. Polypharmacy is very common in intensive care units ICUs , increasing the risks of drug adverse events AEs. Statistically signifcant associations were only found for midazolam-fentanyl-propofol with bradycardia and hypotension and amphotericin B-vancomycin and vancomycin-amikacin with acute renal failure ARF.
Relative risks were The odds ratios were Conclusions: DDIs associated with risk of AEs were fentanyl, propofol and midazolam for bradycardia and hypotension and amphotericin B-vancomycin and vancomycin-amikacin for ARF.
Key words: Drug interactions; Intensive care units; Polypharmacy. Por otra parte, no evaluamos en forma rutinaria estos riesgos. Los datos mencionados se encuentran en la Tabla 2. La frecuencia de los EA encontrados esta descrita en la Tabla 4.
Con los 4 casos restantes se evaluaron ambas IEF, observando un aumento gradual en los valores de creatinina comenzado el tratamiento.
De esta manera podemos optimizar las terapias y buscar mejores soluciones para ellos. The Uppsala Monitoring Centre. The importance of pharmacovigilance, safety monitoring of medicinal products. Ginebra International drug monitoring: the role of national centers. Technical Reports Series, Wolff RM. Rev Chil Infect ; 19 Suplemento 1. Food and Drug Administration. Drug Development and Drug Interactions Farmaco-vigilancia en Chile y el mundo.
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Agosto Recibido el 16 de marzo de , aceptado el 30 de Marzo de Correspondencia a: Julio Plaza D. Fax: Servicios Personalizados Revista. Referencias 1.
2015, Número S1
Original Research Relationship between drug interactions and drug-related negative clinical outcomes. Drug interactions may represent an iatrogenic risk that should be controlled in community pharmacies at the dispensing level. Aim: We analyzed the association between potential drug-drug interactions DDIs and negative clinical outcomes. Methods: We used dispensing data from two community pharmacies: instances where drug dispensing was associated with a potential DDI and a comparison group of randomized dispensing operations with no potential DDI. In cases where potential DDIs were detected, we analyzed the underlying negative clinical outcomes. Age and gender data were included in the analysis.
Tratamiento del VIH
Rev Med Chile ; Drug interactions and adverse events induced by drugs used in an intensive care unit. Background: Eleven percent of hospitalized patients experience drug-drug interactions DDIs , elevating morbidity, mortality and health care costs. Polypharmacy is very common in intensive care units ICUs , increasing the risks of drug adverse events AEs.
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