Mannitol Prescribing with Cisplatin Before and After an Educational Newsletter Intervention
Oral antineoplastics (OAs) have become an emerging and rapidly growing field in cancer treatment. As with any chemotherapeutic agent, clinicians must be aware of potential drug interactions. Drug information databases are a common resource utilized to check for interactions between OAs and patient’s home medications. A major concern with OAs is that they are usually taken at home as well as picked up at a pharmacy by the patient themselves. The objective of this study was to determine the reliability of these databases for identifying potential interactions with OAs in a real-world setting. Hospital records were used to identify patients with common malignancies (leukemia, sarcoma, colon, lung, thyroid, prostate, kidney and liver cancers) treated with OAs from 2013 to 2014. To be included patients must have started an OA during the study period and have adequate records to evaluate OA use as well as home medications. The patient’s regimen is then entered into Drugs.com and Lexicomp™ interaction databases. In addition to documenting the number of interactions flagged by both databases, the severity of the interaction and disagreements between databases were analyzed. A major interaction was defined as either a “D” or “X” by Lexicomp™ and “major” by Drugs.com. As of this preliminary analysis, 407 of 876 subjects have been screened. Of the 407 screened, 9 patients (one patient with 3 different OAs) have been enrolled. Lexicomp™ flagged 34 interactions, of which 10 were major interactions. Drugs.com flagged 34 interactions, of which 6 were major interactions. Between the 2 databases there was only 60% agreement in flagging major interactions. These discrepancies are of concern in that clinicians hope resources they utilize are congruent with one another and allow them to practice in the safest manner in terms to avoid clinically significant drug interactions OA.
New Orleans, LA
Corbin, M. M.; and Bossaer, John B.. 2015. Mannitol Prescribing with Cisplatin Before and After an Educational Newsletter Intervention. Trainee Mentored Presentation. American Society of Health-Systems Pharmacists Midyear Clinical Meeting, New Orleans, LA.