Drug-Drug Interactions in Patients with Acute Respiratory Distress Syndrome

Thorsten Bischof; Christoph Schaller; Nina Buchtele; Thomas Staudinger; Roman Ullrich; Felix Kraft; Marine L Andersson; Bernd Jilma; Christian Schoergenhofer

doi:10.3390/pharmaceutics16030303

Drug-Drug Interactions in Patients with Acute Respiratory Distress Syndrome

Pharmaceutics. 2024 Feb 21;16(3):303. doi: 10.3390/pharmaceutics16030303.

Authors

Thorsten Bischof¹, Christoph Schaller¹, Nina Buchtele², Thomas Staudinger², Roman Ullrich³, Felix Kraft³, Marine L Andersson⁴, Bernd Jilma¹, Christian Schoergenhofer¹

Affiliations

¹ Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria.
² Intensive Care Unit 13i2, Department of Medicine 1, Medical University of Vienna, 1090 Vienna, Austria.
³ Department of Anesthesiology, Medical University of Vienna, 1090 Vienna, Austria.
⁴ Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, 141 86 Stockholm, Sweden.

Abstract

Acute respiratory distress syndrome (ARDS) is a potential life-threatening, heterogenous, inflammatory lung disease. There are no data available on potential drug-drug interactions (pDDIs) in critically ill patients with ARDS. This study analyzed pDDIs in this specific cohort and aimed to investigate possible associations of coronavirus disease 2019 (COVID-19) as an underlying cause of ARDS and treatment with extracorporeal membrane oxygenation (ECMO) with the occurrence of pDDIs. This retrospective study included patients ≥18 years of age diagnosed with ARDS between January 2010 and September 2021. The Janusmed database was used for the identification of pDDIs. A total of 2694 pDDIs were identified in 189 patients with a median treatment duration of 22 days. These included 323 (12%) clinically relevant drug combinations that are best avoided, corresponding to a median rate of 0.05 per day. There was no difference in the number of pDDIs between COVID-19- and non-COVID-19-associated ARDS. In patients treated with ECMO, the rate of the most severely graded pDDIs per day was significantly higher compared with those who did not require ECMO. PDDIs occur frequently in patients with ARDS. On average, each patient may encounter at least one clinically relevant drug combination that should be avoided during their intensive care unit stay.

Keywords: acute respiratory distress syndrome; coronavirus disease 2019; extracorporeal membrane oxygenation; intensive care unit; potential drug–drug interactions.

Grants and funding

This work is part of the ACOVACT study of the Medical University of Vienna and is financially supported by the Austrian Federal Ministry of Education, Science and Research.