Drug interactions involving psychoactive drugs

涉及精神活性药物的药物相互作用

• 批准号: 10533804
• 负责人: Charles Edward Leonard
• 金额: $ 45.74万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10533804
• 关键词: Accident and Emergency department; Accidental Injury; Address; Adverse drug event; Age; Aging; American; Antidepressive Agents; Benzodiazepines; Brain; Cessation of life; Clinical; Clinical Decision Support Systems; Communities; Computer software; Computerized Medical Record; Consumption; Data; Dizziness; Dose; Drowsiness; Drug Interactions; Drug Kinetics; Drug Prescriptions; Elderly; Faculty; Fracture; Growth; Health; Health system; Healthcare; Hospitalization; Individual; Information Dissemination; Injury; Institution; Insurance Carriers; Investigation; Knowledge; Measures; Methodology; Methods; Morbidity - disease rate; Muscle relaxants; Nonprofit Organizations; Opioid; Patient risk; Patients; Persons; Pharmaceutical Preparations; Pharmacodynamics; Pharmacoepidemiology; Phase; Polypharmacy; Population; Predisposition; Principal Investigator; Psychotropic Drugs; Public Health; Research; Research Personnel; Risk; Risk Factors; Screening Result; Series; Signal Transduction; Subgroup; Time; Traumatic injury; Vehicle crash; Vendor; clinical care; clinically actionable; clinically significant; disability; experience; high risk; innovation; knowledgebase; member; multidisciplinary; multiple chronic conditions; novel; pharmacologic; prevent; response; screening; side effect

Commonly-used psychoactive prescription drugs such as opioids, antidepressants, benzodiazepines, and muscle relaxants are associated with unintentional traumatic injury—a major cause of morbidity, disability, and death. Given the increasing use of psychoactive prescription drugs, upsurge in persons with multiple chronic conditions, growth of polypharmacy, and aging of the US population, drug interactions are a major contributor to psychoactive drug-induced unintentional traumatic injury. Drug interactions cause significant preventable patient harm and represent a serious public health problem, especially in older adults, since age and polypharmacy are major risk factors. Known drug interactions are responsible for 13% of evident adverse drug events (ADEs) and 5% of hospital admissions in older adults, and >25% of community-residing elders will, in their lifetime, experience a clinically-significant ADE due to an interaction. Further, the risk of drug interactions is not limited to older adults, as one in four Americans has multiple chronic conditions, which drive polypharmacy. Therefore, the clinical and public health burden of drug interactions will continue to grow if not curtailed. This project's broad objective is to produce clinically-actionable and biologically-relevant knowledge about which medications interact with psychoactive prescription drugs to increase the risk of unintentional traumatic injury, as well as elucidate dose-response effects, duration-response effects, and subgroups most susceptible to the interactions. We will achieve this objective by: i) conducting high-throughput automated screening of longitudinal healthcare data to identify potential drug-drug and drug-drug-drug interactions involving opioids, antidepressants, benzodiazepines, and muscle relaxants that increase the risk of unintentional traumatic injury; ii) convene a multidisciplinary Expert Panel to review screening results, prioritize signals for further investigation, and set a priori hypotheses buttressed by putative mechanisms; and iii) conduct a series of rigorous pharmacoepidemiologic studies to inform causal inferences and thereby generate clinically-actionable evidence on drug interactions to prevent instances of unintentional traumatic injury.

常用的精神活性处方药，例如阿片类药物，抗抑郁药，苯二氮卓类药物和 肌肉松弛剂与无意的外伤性损伤有关，这是发病率，残疾和 死亡。考虑到越来越多的精神处方药的使用，有多个慢性的人兴高采烈 条件，多药的增长以及美国人口的老化，药物相互作用是主要贡献者 精神药物引起的无意外伤性损伤。药物相互作用可预防 患者伤害并代表严重的公共卫生问题，尤其是在老年人中，从年龄和 多药是主要的危险因素。已知的药物互动是13％的证据广告药物 老年人的事件（ADE）和5％的住院入院，> 25％的社区保留长者将在 由于相互作用，他们的寿命，经历了临床上重要的ADE。此外，毒品相互作用的风险 不限于老年人，因为四分之一的美国人有多种慢性病 多药。因此，如果没有 削减了。 该项目的广泛目标是产生临床上的和生物学上与生物学的知识 关于哪些药物与精神活性处方药相互作用，以增加无意的风险 创伤性损伤，以及最大的剂量反应效应，持续时间反应效应和亚组 容易受到相互作用。我们将通过以下方式实现这一目标：i）进行高通量自动化 筛查纵向医疗保健数据，以识别潜在的药物和药物药物相互作用 涉及阿片类药物，抗抑郁药，苯二氮卓类药物和肌肉放松剂，以增加 无意的创伤伤害； ii）召集一个多学科专家小组以审查筛查结果，优先考虑 信号进行进一步调查，并设置了被推定的机制支撑的先验假设；和iii） 进行一系列严格的药物ePIDEMIologic研究，以告知因果推断，从而产生 关于药物相互作用的临床可行证据，以防止无意间创伤性损伤实例。