Potencijalne reakcije statina

Abstract

Cilj istraživanja: Istražiti pojavnost i vrste potencijanih klinički značajnih interakcija statina kod pacijenata, koji u svojoj terapiji imaju propisan statin i barem još jedan lijek propisan na recept i analizirati značaj klinički značajnih interakcija statina. Ispitanici i metode: U istraživanje je uključeno 153 pacijenata iz javne ljekarne, koji su u terapiji uz statin, imali i najmanje još jedan propisani lijek. Terapije su uzete iz baze farmakoterapija, elektronički pohranjenih u ljekarni. Interakcije su identificirane pomoću Lexicomp® Lexi-Interact Online programa. Rezultati: Prosječna životna dob ispitanika iznosila je 65,5 godina, od čega je bilo 52,3% ţena. Uz statin, koristili su prosječno 4 lijeka na recept. Najčešće korišteni lijekovu u komedikaciji sa statinom bili su antihipertenzivi, oralni antidijabetici i diuretici. Identificirane su 62 potencijalne klinički značajne interakcije, od toga 74,2% C i 25,8% D stupnja značajnosti, koje zahtijevaju dodatno praćenje i/ili prilagodbu terapije, dok interakcije X stupnja nisu utvrđene. U propisanoj farmakoterapiji 34% ispitanika imalo je najmanje jednu potencijalno klinički značajnu interakciju statina, pri čemu je kod 6,5 % ispitanika zabilježeno po dvije interakcije sa statinom. Atorvastatin je bio najčešće korišten statin, na kojeg se odnosio i najveći broj zabiljeţenih interakcija, njih čak 56,5%. Sa simvastatinom je zabilježeno 18, a s rosuvastatinom 9 potencijalnih klinički značajnih interakcija. Zaključak: U propisanoj farmakoterapiji 34% ispitanika imalo je najmanje jednu potencijalnu klinički značajnu interakciju statina, a većina njih za posljedicu moţe imati povećanje rizika nastanka i razvoja miopatije/miolize. Nadzor terapije u cilju identifikacije i prevencije interakcija, važan je dio ljekarničke skrbi o pacijentima na terapiji statinima.Objectives: The aim of this paper was to explore prevalence and types of clinically significant interactions of statins in patients who were prescribed a statin and at least one more drug and to analyse the importance of potential drug interaction with statins. Patients and methods: This research has retrospectively analysed the prescribed, on a one-time basis issued pharmacotherapy for 153 patients, from public pharmacy, who had the statin prescribed in their therapy. Therapies were taken from the official register of issued pharmacotherapies stored in the electronic database of a public pharmacy. Interactions were identified via Lexicomp® Lexi-InteractTM Online program. Results: The average age of the subjects was 65.5 years , of which 52.3 % were women . In addition to a statin, subjects used 4 prescribed drugs in average. The most commonly used drugs in co-medication of statins were antihypertensives, oral anti-diabetic drugs and diuretics. In total, 62 potential, clinically significant interactions were identified, of which 46 (74.2%) of C degree and 16 (25.8%) of D degree which require additional monitoring and/or adjustment of therapy, while interactions of X degree have not been identified. In the prescribed pharmacotherapy, 34 % of subjects had at least one potential clinically significant interaction of statin. In 6.5 % of subjects, two interactions with statins were identified. Atorvastatin was the most commonly used statin, to which the largest number of recorded interactions referred to (56.5 %). 18 potential clinically significant interactions were identified with simvastatin and 9 with rosuvastatin. Conclusion: In the prescribed pharmacotherapy, 34 % of subjects had at least one potential clinically significant interaction of statin and the majority of them can result in increasing the risk of developing myopathy/myolysis. Therapy control, with the aim to identify and prevent interaction, is an important part of pharmaceutical care for patients on a statin therapy