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Drug interactions and multiple drug administration

F E May, R B Stewart, L E Cluff

    Clinical Pharmacology and Therapeutics
    |September 1, 1977
    PubMed
    Summary
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    Patients taking multiple medications, especially anticoagulants and antihypertensives, face a higher risk of adverse drug reactions. This study highlights potential dangers from drug interactions in polypharmacy.

    Area of Science:

    • Pharmacology
    • Clinical Medicine
    • Patient Safety

    Background:

    • Polypharmacy, the concurrent use of multiple medications, is common in hospitalized patients.
    • Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality.
    • Understanding the impact of drug combinations on ADRs is crucial for patient care.

    Purpose of the Study:

    • To investigate the relationship between the number of drugs administered and the incidence of adverse drug reactions.
    • To identify specific drug classes associated with a higher risk of ADRs in a polypharmacy setting.

    Main Methods:

    • Retrospective analysis of 10,518 hospitalized patients over five years.
    • Inclusion of nine major drug groups: analgesic, antacid, antiarrhythmic, antimicrobic, anticoagulant, antihypertensive, anti-inflammatory, diuretic, and sedative-tranquilizer.

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  • Classification of ADRs based on the number of concurrently administered drugs.

    • Main Results:

    • Anticoagulant and antihypertensive drug groups showed a significantly higher average number of ADRs (p < 0.05) compared to other drug groups.
    • The rate of ADRs for anticoagulant and antihypertensive medications was notably higher (p < 0.001) than for other studied drug classes.
    • A clear trend indicated an increased risk of ADRs with a greater number of concurrent medications.

    Conclusions:

    • Patients receiving multiple drugs, particularly anticoagulants and antihypertensives, are at an elevated risk for adverse drug reactions.
    • Drug interactions are a likely contributing factor to the increased ADR risk observed in polypharmacy.
    • These findings underscore the importance of careful medication management and monitoring in patients on multiple drug regimens.