| Abstract | Cilj istraživanja: Istražiti učestalost i vrstu potencijalnih interakcija inhibitora protonske
pumpe s drugim istodobno korištenim lijekovima, na uzorku pacijenata iz četiri najveća grada
u Republici Hrvatskoj – Zagreba, Splita, Rijeke i Osijeka te istražiti moguće razlike među
njima.
Ispitanici i metode: U istraživanje je uključeno 718 pacijenata iz javne ljekarne, koji su uz
inhibitor protonske pumpe u terapiji također imali najmanje još jedan propisan receptni lijek.
Podatci o terapijama prikupljeni su pomoću zapisa o podizanju terapije dostupnog u
elektroničkim bazama uključenih ljekarni. Interakcije su identificirane pomoću baze podataka
Lexicomp®, Lexi-InteractTM online.
Rezultati: Prosječna dob ispitanika u gradu Zagrebu iznosi 67,36 (SD=14,35), u Splitu 65,11
(SD=14,97), u Rijeci 65,50 (SD=14,49) te u Osijeku 65,23 (SD=12,86) godine. U svim je
gradovima uključeno više žena nego muškaraca, a prosječan broj istodobno korištenih lijekova
jest 5 (SD=2,4). Najčesće korišteni lijekovi uz inhibitore protonske pumpe bili su lijekovi s
djelovanjem na kardiovaskularni sustav, anksiolitici te NSAID. Incidencija pojavnosti klinički
značajnih interakcija inhibitora protonske pumpe na ukupnom uzorku iznosila je 8,2%. Nisu
uočene statistički značajne razlike između pojedinih regija Republike Hrvatske. Također,
najčešće propisivan inhibitor protonske pumpe kako u ukupnom uzorku, tako i u svakom
pojedinom gradu, bio je pantoprazol. U svim promatranim regijama, najviše uočenih interakcija
bilo je stupnja kliničke značajnosti C, a lijekovi s kojima je zabilježen najveći broj interakcija
jesu klopidogrel, nadomjesni pripravci željeza te bisfosfonati.
Zaključak: Incidencija pojavnosti klinički značajnih interakcija inhibitora protonske pumpe na
ukupnom uzorku iznosila je 8,2%. Nisu uočene statistički značajne razlike između pojedinih
regija Republike Hrvatske. Inhibitori protonske pumpe imaju tendenciju za ulazak u klinički
značajne interakcije pri čemu najčešće dolazi do smanjene koncentracije i smanjenog
terapijskog učinka istodobno primijenjenog lijeka. Kako bismo pacijentima osigurali sigurnu i
učinkovitu farmakoterapiju, potrebno je pravovremeno uočiti potencijalnu prisutnost istih. |
| Abstract (english) | Objectives: The aim of this research was to investigate the frequency and types of clinically
significant interactions of proton pump inhibitors in patients who were prescribed a proton
pump inhibitor with other concomitantly used drugs on a sample of patients from four largest
cities in Croatia – Zagreb, Split, Rijeka and Osijek.
Patients and methods: The study included 718 patients from a public pharmacy, who in
addition to a proton pump inhibitor in therapy also had at least one other prescribed drug. Patient
therapies were reviewed using an electronic pharmacotherapy database of the pharmacies
involved. Interactions were identified using the Lexicomp® database, Lexi-InteractTM online.
Results: The average age of respondents in the city of Zagreb was 67.36, in Split 65.11, in
Rijeka 65.50 and in Osijek 65.23. In all cities involved, more women than men were included.
The average number of concomitant drugs was 5. The most used drugs in addition to proton
pump inhibitors were drugs with effects on the cardiovascular system, anxiolytics and NSAIDs.
The incidence of clinically significant proton pump inhibitor interactions in the total sample
was 8.2%. No statistically significant differences were observed between individual regions of
Croatia. Also, the most prescribed proton pump inhibitor both in the total sample and in each
individual city was pantoprazole. In all observed regions, the most observed interactions were
of grade C clinical significance, and the drugs with the highest number of interactions were
clopidogrel, iron replacement preparations and bisphosphonates.
Conclusion: The incidence of clinically significant proton pump inhibitor interactions in the
total sample was 8.2%. No statistically significant differences were observed between
individual regions of Croatia. Proton pump inhibitors tend to enter into clinically significant
interactions and the most common results of interactions are reduced concentration and reduced
therapeutic effect of the co-administered drug. In order to provide patients with safe and
effective pharmacotherapy, it is necessary to detect their potential presence in a timely manner. |
