Evaluation of Pharmacokinetic Drug Interactions in Prescriptions of Intensive Care Unit (ICU) in a Teaching Hospital

Concomitant use of several drugs by icu( intensive care unit) patients is oftenunavoidable. in these patients, pharmacokinetic drug interactions are very likely. the currentstudy was designed to evaluate these interactions in patients hospitalized in an icu of ateaching hospital in tehran, iran.a questionnaire was designed and used to collect study data. the study was done in theicu of a teaching hospital affiliated to the shaheed beheshti medical university. overallinformation extracted from 567 icu prescriptions from march 2005 to december 2005.the extent of occurrence and frequency of potential pharmacokinetic interactions werecategorized based on the reference text drug interactions facts. all of the pharmacokineticdrug interactions were extracted and evaluated in terms of mechanism, significance, severity,documentation and onset.there were 413 pharmacokinetic interactions in 567 studied prescriptions, which weredivided into 64 types of pharmacokinetic interactions. the most observed interaction wasbetween ciprofloxacin and sucralfate. mechanisms of the pharmacokinetic interactions wererelated to metabolism (%60.05), absorption (% 38.26), elimination (%0.97) and distribution(%0.73). there was a direct relationship between the number of drugs per prescription andthe frequency ofpharmacokinetic interactions (p(less than)o.ool, r =0.98)findings obtained in this study revealed that there is a significant number of rapidoccurring, moderate, probable and definite interactions among the icu prescriptions. thishighlights the necessity for the presence of a drug specialist (i.e. clinical pharmacist) torationalize the therapy and minimize major interactions