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Medication surveillance on intravenous cytotoxic agents: a retrospective study

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Abstract

Background Medication surveillance is not commonly performed for cytotoxic agents. Cytotoxic agents generally have a narrow therapeutic range and therefore it might be necessary to adjust the dose. Interactions may not only cause supratherapeutic ranges, but can also lead to subtherapeutic levels. Up till now, only a few studies have demonstrated the value and importance of medication surveillance in ambulatory cancer patients. Objective The objective of this study is to determine the prevalence and relevance of interactions with cytotoxic agents in ambulant cancer patients receiving one or more intravenous cytotoxic administrations. Setting This retrospective study was undertaken in the Orbis Medical Centre in Sittard, the Netherlands. Methods All ambulatory cancer patients receiving one or more intravenous cytotoxic treatments during the period October 2008 to April 2010 were included. Cytotoxic agent related information was determined using the hospital information system and medication history was determined using the Electronic Prescribing System (EPS) and an open care information system. Medication was entered into the EPS and medication surveillance was performed electronically using the G-standard. All alerts were generated retrospectively. Main outcome measure The prevalence and relevance of interactions between cytotoxic agents and other drugs in ambulatory cancer patients. Results A total of 527 ambulatory cancer patients was enrolled. The mean age of the patients was 63.6 years and 303 were female (55 %). In 24 patients a total of 58 cytotoxic agent-related interactions was detected of whom five were clinically relevant. The most frequent cytotoxic agent-related interaction was with acenocoumarol; the most relevant interactions were with antiepileptic drugs. Conclusion A total of 58 potential cytotoxic agent-related interactions was found. This corresponds to 11 cytotoxic agent-related interactions per 100 ambulatory cancer patients, of which one was indicated clinically relevant and should have required an intervention. The most frequently involved drug was acenocoumarol. Most drug-related interactions with cytotoxic agents are manageable and can be monitored. Prospective studies are needed to confirm the relevance of medication surveillance on cytotoxic agents.

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References

  1. Riechelmann RP, Tannock IF, Wang L, Saad ED, Taback NA, Krzyzanowska MK. Potential drug interactions and duplicate prescriptions among cancer patients. J Natl Cancer Inst. 2007;99:592–600.

    Article  PubMed  Google Scholar 

  2. McDonnel PJ, Jacobs MR. Hospital admissions resulting from preventable adverse drug reactions. Ann Pharmacother. 2002;36:1331–6.

    Article  Google Scholar 

  3. Riechelmann RP, Moreira F, Smaletz O, Saad ED. Potential for drug interactions in hospitalized cancer patients. Cancer Chemother Pharmacol. 2005;56:286–90.

    Article  PubMed  Google Scholar 

  4. Kannan G, Anitha R, Rani VN, Thennarasu P, Alosh J, Vasantha J, Martin JR, Uma M. A study of drug–drug interactions in cancer patients of a south Indian tertiary care teaching hospital. J Postgrad Med. 2011;57:206–10.

    Article  PubMed  CAS  Google Scholar 

  5. Voll ML, Yap KD, Terpstra WE, Crul M. Potential drug–drug interactions between anti-cancer agents and community pharmacy dispensed drugs. Pharm World Sci. 2010;32(5):575–80.

    Article  PubMed  CAS  Google Scholar 

  6. Lemachatti J, Levêque D, Beretz L, Bergerat JP. Potential pharmacokinetic interactions affecting antitumor drug disposition in cancer patients. Anticancer Res. 2009;29:4741–4.

    PubMed  CAS  Google Scholar 

  7. van Roon EN, Flikweert S, le Comte M, Langendijk PNJ, Kwee-Zuiderwijk WJM, Smits P, Brouwers JRBJ. Clinical relevance of drug–drug interactions. Drug Saf. 2005;28(12):1131–9.

    Article  PubMed  Google Scholar 

  8. Stoop AP, Bal R, Berg M. OZIS and the politics of safety: using ICT to create a regionally accessible patient medication record. Int J Med Inform. 2007;76(supp 1):S229–35.

    Article  PubMed  Google Scholar 

  9. Farmacotherapeutisch Kompas, FK, Interacties, http://www.fk.cvz.nl/. Accessed 7 Dec 2010.

  10. KNMP, G-standaard, http://www.knmp.nl/producten-diensten/g-standaard/algemeen/the-g-standaard-the-medicines-standard-in-healthcare. Accessed 7 Dec 2010.

  11. KNMP, Besliskaart interactiebeoordeling (November 2010), http://www.knmp.nl/downloads/producten-diensten/g-standaard-1/medicatiebewaking/Besliskaartinteracties_2010_november.pdf. Accessed 9 Dec 2010.

  12. Yap KY, Chui WK, Chan A. Drug interactions between chemotherapeutic regimens and antiepileptic. Clin Ther. 2008;30(8):1385–407.

    Article  PubMed  CAS  Google Scholar 

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No special funding was received.

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The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Clinical Pharmacy and Toxicology, Orbis Medical Center, Dr. H. van der Hoffplein 1, 6162 BG, Sittard, Geleen, The Netherlands

    Brigit van Oijen, Rob Janknegt, Hugo de Wit & Hugo van der Kuy

  2. Department of Hematology and Oncology, Orbis Medical Center, Dr. H. van der Hoffplein 1, 6162 BG, Sittard, The Netherlands

    Frank Peters

  3. Division of Hematology, Department of Internal Medicine, University Hospital Maastricht, Postbus 5800, 6202 AZ, Maastricht, The Netherlands

    Harry Schouten

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  1. Brigit van Oijen
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  2. Rob Janknegt
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  3. Hugo de Wit
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  4. Frank Peters
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  5. Harry Schouten
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  6. Hugo van der Kuy
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Correspondence to Brigit van Oijen.

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van Oijen, B., Janknegt, R., de Wit, H. et al. Medication surveillance on intravenous cytotoxic agents: a retrospective study. Int J Clin Pharm 35, 554–559 (2013). https://doi.org/10.1007/s11096-012-9723-2

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  • DOI: https://doi.org/10.1007/s11096-012-9723-2

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