Detection and analysis of potential drug-drug interactions among patients admitted to the cardiac care unit in a tertiary care hospital

OBJECTIVE: This study aimed to estimate how prevalent potential drug-drug interactions (pDDIs) were in patients with cardiovascular diseases who were hospitalized for more than 24 hours, and to determine the risk factors associated with these pDDIs. PATIENTS AND METHODS: A prospective observational study was conducted on patients admitted to the cardiac care unit in a tertiary care hospital. We included two hundred medical records of cardiovascular disease patients who were prescribed more than one drug. These medical records were analyzed for pDDIs using the Micromedex drug interaction checker database. Data were analyzed using Descriptive statistics. Chi-square test and the Pearson correlation coefficient were applied. RESULTS: PDDIs were prevalent in 95% of the analyzed medical records, with at least one detected pDDI per record. Within the 200 medical records, 430 potentially interacting drug pairs were identified, with the majority resulting in moderate and major interactions. Aspirin/clopidogrel (111), furosemide/aspirin (89), enoxaparin/clopidogrel (89) and Lisinopril/aspirin (60) were the most common interacting pairs. Whereas, aspirin, heparin, clopidogrel, furosemide, ranitidine and Lisinopril were the most frequently implicated drugs in DDIs. CONCLUSIONS: PDDIs were common among hospitalized cardiovascular patients. PDDIs were associated with age and number of drugs prescribed. The routine integration of an online drug interactions screening tool may improve the ability of pharmacists to identify cardiac patients at higher risk of potential drug interactions and conduct appropriate interventions thereafter

Identification of a Direct-Acting Antiviral Agent Targeting RNA Helicase via a Graphene Oxide Nanobiosensor

Dengue virus (DENV), an arbovirus transmitted by mosquitoes, causes infectious diseases such as dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. Despite the dangers posed by DENV, there are no approved antiviral drugs for treatment of DENV infection. Considering the potential for a global dengue outbreak, rapid development of antiviral agents against DENV infections is crucial as a preemptive measure; thus, the selection of apparent drug targets, such as the viral enzymes involved in the viral life cycle, is recommended. Helicase, a potential drug target in DENV, is a crucial viral enzyme that unwinds double-stranded viral RNA, releasing single-stranded RNA genomes during viral replication. Therefore, an inhibitor of helicase activity could serve as a direct-acting antiviral agent. Here, we introduce an RNA helicase assay based on graphene oxide, which enables fluorescence-based analysis of RNA substrate-specific helicase enzyme activity. This assay demonstrated high reliability and ability for high-throughput screening, identifying a new helicase inhibitor candidate, micafungin (MCFG), from an FDA-approved drug library. As a direct-acting antiviral agent targeting RNA helicase, MCFG inhibits DENV proliferation in cells and an animal model. Notably, in vivo, MCFG treatment reduced viremia, inflammatory cytokine levels, and viral loads in several tissues and improved survival rates by up to 40% in a lethal mouse model. Therefore, we suggest MCFG as a potential direct-acting antiviral drug candidate.N