Assessment of Prevalence, Drug Utilization Pattern and Potential Drug-Drug Interactions Among Hepatic Impairment Patients

The majority of drugs are metabolised in liver and are known to be hepatotoxic. So, the Drug Utilization Evaluation (DUE) studiesbecome potential tool in hepatic impairment patient to ensure drugs are used appropriately, safely and effectively in order to improve overall health of patient. Drug-Drug Interactions are major cause of concern among hepatic impairment patients due to co-morbidity conditions and wide class of drugs they receive. The clinical result of DDI may manifest as synergism, antagonism or idiosyncratic. This study is aimed to generate data on drug utilization pattern and to assess the prevalence of potential drug-drug interactions (pDDIs) among hospitalised hepatic impairment patients. A prospective observational study was carried out for six months among inpatients of the medicine department of Chigateri District Hospital, Karnataka, India. Potential drug-drug interactions (pDDIs) were analysed using Lexicomp, Medscape drug interaction checker, Stockley’s drug interaction checker. Overall 135 patients were enrolled the study. In this study, 80.68% patients were male. The most common affected age group was 40-59 years. Alcoholic liver disease (46.66%) and chronic liver disease (27.40%) were the most prevalent hepatic condition. Anemia and portal hypertension were the most likely associated comorbidities. Out of 1097 drugs, 569 drugs were used specifically for hepatic impairment. Diuretics (23.02%) were the most frequently prescribed drugs followed by gallstone dissolution agents (18.27%). Total of 264 pDDIs, were identified, of which 76(28.78%) were minor, 180(68.18%) were moderate and 8(3.03%) were major. Potential DDIs were significantly higher in patients taking ?9 medicines (63.63%), hospitalization ?7 days (67.64%) and with one co-morbidity conditions (43.18%). Pharmacodynamic interaction 197 (74.62%) was observed more than that of pharmacokinetic interactions 67(25.37%). The prevalence of alcoholic liver disease in this study was reported th