The pharmacist plays an important role in preventing and managing drug interactions. Through taking a thorough medication history, checking for interactions, educating patients, and monitoring treatment, the pharmacist can help avoid dangerous interactions. In one case study, a patient suffered an accident due to an interaction between Xanax and Ultram that was prescribed by different doctors. It is important for pharmacists to be aware of a patient's full drug history to catch potential interactions and ensure safe usage of medications.

1. ROLE OF
PHARMACIST IN
PREVENTION &
MANAGEMENT
OF DRUG
INTERACTIONS
BY: Komal Haleem
Pharm-D

2. DRUG
INTERACTIONS

3. The modulation of the pharmacologic activity of
one drug (i.e. the object drug) by the prior or
concomitant administration of
•Food
•Another drug or
•Herbal product.

4. ROLE OF PHARMACIST IN
PREVENTION
OF DRUG INTERACTIONS

5. CASE STUDY:
A patient named G.W.
He was prescribed the following medications by 4 different
physicians:
•Inderal and Lasix for high blood pressure. (Internal)
•Tricyclic antidepressants, for depression. (Psychiatrist)
•Xanax for sleep. (Family Doctor)
•Propoxyphene for chronic pain. (Orthopedist)
•Prilosec for stomach irritation. (Internal)
•Over-the-counter Tylenol from time to time. (Self)
•Recently he was prescribed Ultram (analgesic for moderate
pain) by a second opinion orthopedist.
Suffered major
automobile
accident due
to excessive
dizziness and
drowsiness
resulting from
drug
interaction
between
ultram and
xanax

6. 1. Take a MEDICATION HISTORY(AVOID
mistakes)
2. Remember high risk patients
•Any patient taking 2 medications
•Anticonvulsants, antibiotics, digoxin, warfarin,
amiodarone, etc
3. Check pocket reference
4. Check up-to-date computer program

7. 5. Documenting the care delivered
6. COUNSELING the patients
7. Monitoring and evaluating the patient’s
response to therapy
8. Work with health care practitioners to
eliminate unnecessary medications

8. 9.Maintaining patient data base
including:
•patient’s gender,
•age,
•vital signs,
•medical diagnosis(es),
•drug allergies,
•relevant laboratory tests,
•a complete listing of medication being taken
routinely or taken on an as-needed basis

9. •Allergies?
•Vitamins and herbs?
•Old drugs & OTC? as well as current
•Interactions?
•Dependence?
•Mendel: family history of benefits or
problems with any drugs?

10. 1. Only take medication that has been specifically
prescribed for you by your physician;
2. Medication must be taken properly to ensure its
safety and effectiveness;
3. Unless otherwise instructed, take medicine on
an empty stomach to achieve a faster onset of
action;

11. 4. When taking medicine with food or around a meal
time is not recommended, take medicine one
hour before meal/food or two hours after meals or
eating food;
5. Take your medicine with a full glass (1 cupful or 8
oz.) of water;
6. Avoid concurrent use of alcohol with medicine;
7. Avoid consuming excessive quantities of
chocolate and beverages containing caffeine
(coffee, tea, colas);

12. 8. If you have any questions / concerns about your
medicine or you believe you are having an adverse
drug reaction or drug interaction, consult your
pharmacist or physician immediately. If there is a
problem, your pharmacist can contact your physician,
who can prescribe other medication to avoid the risk

13. ROLE OF PHARMACIST IN
MANAGEMENT
OF DRUG INTERACTIONS

14. Avoiding the combination entirely
Adjusting the dose of the object drug
Spacing dosing times to avoid the interaction
Monitoring for early detection
Provide information on patient risk factors that
increases the chance of an adverse outcome

15. Improve computerized screening systems
Excessive number of drug interactions on the
systems
Drug class differences not handled correctly

16. •http://www.fda.gov/drugs/developmentapprovalprocess/developmentreso
urces/druginteractionslabeling/ucm110632.htm
•http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964764/
•http://legacy.uspharmacist.com/oldformat.asp?url=newlook/files/Feat/mar
00druginteractions.cfm&pub_id=8&article_id=522
•http://online.wsj.com/article/SB1000142405270230476530457748303361
4613256.html
•http://www.environmentaldiseases.com/article-drug-interactions.html