From Geriatric Pharmacy Intern Angela M Antuna, PharmD (c) Palm Beach Atlantic University Lloyd L. Gregory School of Pharmacy
The American Society of Consultant Pharmacist ( ASCP ) and the American Medical Directors Association ( AMDA ) have teamed up to create a list of the top ten drug interactions in long-term care. Their purpose is to make all health professionals join forces to improve prescribing, administering, and monitoring of drug therapy in long-term care. The residents in long-term care facilities are usually on multiple drug regimens. This increases their chances for having a medication-related problem. The most effective way to prevent a medication-related problem from occurring is by documenting the error. When a medication error is reported it educates others of such error. However, medication errors still occur regardless of the reporting systems. In addition, it is important for all health professionals to be educated on medication errors. Although this list is not all inclusive, it identifies the most commonly seen drug interactions in long-term care facilities. List of Top Ten Drug Interactions in Long-Term Care 1. Warfarin — NSAIDs * 2. Warfarin — Sulfa drugs 3. Warfarin — Macrolides 4. Warfarin — Quinolones ** 5. Warfarin — Phenytoin 6. ACE inhibitors — Potassium supplements 7. ACE inhibitors — Spironolactone 8. Digoxin — Amiodarone 9. Digoxin — Verapamil 10. Theophylline — Quinolones ** * NSAID class does not include COX-2 inhibitors ** Quinolones that interact include: ciprofloxacin, enoxacin, norfloxacin, and ofloxacin The Multidisciplinary Management Project (www.scoup.net/M3Project/topten/index.htm)
The American Society of Consultant Pharmacist ( ASCP ) and the American Medical Directors Association ( AMDA ) have teamed up to create a list of the top ten drug interactions in long-term care. Their purpose is to make all health professionals join forces to improve prescribing, administering, and monitoring of drug therapy in long-term care. The residents in long-term care facilities are usually on multiple drug regimens. This increases their chances for having a medication-related problem.
The most effective way to prevent a medication-related problem from occurring is by documenting the error. When a medication error is reported it educates others of such error. However, medication errors still occur regardless of the reporting systems. In addition, it is important for all health professionals to be educated on medication errors. Although this list is not all inclusive, it identifies the most commonly seen drug interactions in long-term care facilities.
List of Top Ten Drug Interactions in Long-Term Care
1. Warfarin — NSAIDs *
2. Warfarin — Sulfa drugs
3. Warfarin — Macrolides
4. Warfarin — Quinolones **
5. Warfarin — Phenytoin
6. ACE inhibitors — Potassium supplements
7. ACE inhibitors — Spironolactone
8. Digoxin — Amiodarone
9. Digoxin — Verapamil
10. Theophylline — Quinolones **
* NSAID class does not include COX-2 inhibitors
** Quinolones that interact include: ciprofloxacin, enoxacin, norfloxacin, and ofloxacin The Multidisciplinary Management Project (www.scoup.net/M3Project/topten/index.htm)