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Multidrug Interactions: Why Do They Occur and How to Handle?
Pamela Dow1, Veronique Michaud2, Jacques Turgeon3
1Tabula Rasa HealthCare, Precision Pharmacotherapy Research and Development Institute, Orlando, Florida, USA.
Clinical Therapeutics
|January 22, 2023
Summary
Nonoptimized medication therapy (NOMT) events, often caused by drug interactions in polypharmacy patients, can be prevented. Strategies include clinical decision support, medication reconciliation, and pharmacogenomics to optimize drug regimens and improve patient safety.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Drug Safety
Background:
- Nonoptimized medication therapy (NOMT) events are iatrogenic hazards linked to medications, frequently causing severe patient harm.
- These events are often associated with multidrug interactions in patients with polypharmacy, highlighting a critical area for intervention.
Approach:
- Utilizing advanced clinical decision support systems and interventions like timed drug administration can mitigate NOMT events.
- Individual-level strategies include medication reconciliation and considering intersubject variability in drug response for regimen optimization.
- Integrating patient pharmacogenomic status with phenoconversion probability offers enhanced value for optimizing drug therapy in polypharmacy.
Key Points:
- Pharmacogenomics provides crucial insights into drug response variability.
- Phenoconversion probability is essential for interpreting pharmacogenomic data in polypharmacy.
- Population-level approaches, such as virtual drug addition and medication risk scores, can predict NOMT event risks.
Conclusions:
- This review examines mechanisms of multidrug interactions and their link to drug safety and NOMTs.
- The impact of polypharmacy on patient outcomes is discussed.
- The value of pharmacogenomics and simulation studies, including virtual drug addition with real-world data, is assessed for predicting and preventing NOMT events.
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