Full transcript
0:01hello and welcome to the pharmacy
0:02informatics professor 2020 with your
0:04host dr armand simonian
0:06i ran across an interesting article
0:09recently in pharmacist letter
0:11and it was about a drug drug interaction
0:14and on the face of it this is not a
0:16pharmacy informatics topic or article
0:20but as a pharmacy informaticist i did
0:23immediately think of our drug databases
0:26and our clinical decision support
0:27systems and i knew that eventually this
0:30is going to have an impact on how our
0:32systems uh set up our setup and how they
0:35operate
0:36so
0:37i wanted to discuss this article in this
0:40journal club episode and
0:43let's see what the implications are
0:46so let me bring up the presentation
0:49and share this with you
0:53okay
0:57so this is a metronome interaction
1:03and here is the heading on the article
1:06and for the longest time we've been
1:10taught in pharmacy school that
1:13metronodizol has
1:15a disulfram like reaction so
1:18if the patient is taking metronidazole
1:21and also consuming alcohol then you can
1:23have a lot of
1:25really nasty side effects
1:27and that would be
1:28intentional if you were trying to
1:32administer disulfiram itself and stop
1:35the patient from
1:37wanting to consume alcohol but in this
1:39case it's a unintended interaction
1:42and
1:44and we've been taught that
1:46the two should not go together
1:49but recent research has shown that maybe
1:52this is not really a true interaction
1:55so
1:57what they found recently
1:59was metronidazole does not inhibit
2:02aldehyde dehydrogenase
2:04so it probably does not have that
2:06disulfiram like
2:09reaction
2:10okay
2:11and
2:12they're postulating that the reaction
2:15that does occur in some patients
2:17is either due to
2:19excessive alcohol intake at the time
2:22that the med is being taken
2:24or the side effects of metronidazole
2:27which include headache or a combination
2:29of these two so it's not a direct
2:31interaction
2:33between the two drugs it's really um
2:36kind of the side effects of each drug
2:39itself combined that seem to make it a
2:42disulfiram like reaction
2:45so now the cdc is saying that there's no
2:48need to avoid alcohol while taking
2:50metronidazole
2:52there's no convincing evidence of the
2:55interaction
2:57but at the same time there's no
2:59convincing research or evidence to rule
3:01out the interaction
3:03so
3:04if you go to the package insert you read
3:07about metronidazole it will still have
3:09this interaction listed
3:12now as a pharmacy informaticist i was
3:15thinking boy if this is not really a
3:18true
3:19drug drug interaction
3:21then why not turn it off in our systems
3:24so that if alcohol is listed as an
3:27ingredient
3:28as a drug in our database or ingredient
3:31that could be
3:33flagged during drug drug interaction
3:35checks
3:37or if your system is doing
3:40food drug
3:41interactions
3:42and alcohol that glass of wine
3:46is listed
3:47on the diet list
3:48and it might be on the patient's
3:51diet profile
3:53so again if your system is doing food
3:55drug interactions you could have an
3:57alert with these two medications
4:01so
4:02my tendency would be to try and go to p
4:04t and say
4:06here's the
4:07new guideline
4:09from the cdc
4:11and these two drugs are okay to be taken
4:13together
4:14and let's look into turning off this
4:18drug drug interaction or food drug
4:19interaction on our system and in this
4:22way we can decrease alert fatigue
4:26so these are the types of things that i
4:28think about
4:30as a
4:31as a nerd pharmacy informaticist
4:34when i see these articles
4:36anything having to do with
4:39interactions or allergies or other
4:41things that might affect our clinical
4:43decision support system and might
4:45provide an opportunity to decrease alert
4:47fatigue then i'm very interested and
4:50would take the steps then to make sure
4:53that this is put in place
4:54and it happens
5:00so if this was a interesting discussion
5:02for you please like the video
5:04and subscribe to my channel and i will
5:06uh thank you for that
5:09and in the meantime
5:10stay safe
5:11stay healthy
5:13look after the health of others and i'll
5:15continue to work on more episodes and i
5:17hope to see you next time take care