학술논문
Drug Interactions in Space: a Cause for Concern?
Research Paper
Research Paper
Document Type
Academic Journal
Author
Source
Pharmaceutical Research. August 2019, Vol. 36 Issue 8
Subject
Language
English
ISSN
0724-8741
Abstract
Author(s): Erez Berman [sup.1], Sara Eyal [sup.1] Author Affiliations: (1) 0000 0004 1937 0538, grid.9619.7, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University, , Ein [...]
Purpose Crewmembers aboard the International Space Station (ISS) have free access to an increasing number of medications within medical kits. The aim of the current study was to assess the number, severity and reliability of potential drug-drug interactions (DDIs) involving those medications. Methods We evaluated the information obtained from clinical decision support systems. Searches for potential DDIs were applied to published lists of medications available to US astronauts in medical kits aboard the ISS. Results A total of 311 potential DDIs were identified by Lexi-Interact, of which approximately half were recognized by Micromedex as well. Major, moderate and minor interactions consisted 23.5%, 68.5% and 8.0% of entries, respectively. The reliability of 71.1% of alerts was fair. Commonly used drugs, including zolpidem and zaleplon, were involved in multiple potential interactions that were classified as major based on additive CNS depression. Conclusions Most potential DDIs likely to be encountered in space are unestablished even in terrestrial medicine and their assignment is based on class-effects. Yet, some drug combinations may be associated with clinically-relevant consequences. Future DDI rating should be adjusted to space-related outcomes. Until that happens, it would be advisable to avoid non-established drug combinations in space when possible.
Purpose Crewmembers aboard the International Space Station (ISS) have free access to an increasing number of medications within medical kits. The aim of the current study was to assess the number, severity and reliability of potential drug-drug interactions (DDIs) involving those medications. Methods We evaluated the information obtained from clinical decision support systems. Searches for potential DDIs were applied to published lists of medications available to US astronauts in medical kits aboard the ISS. Results A total of 311 potential DDIs were identified by Lexi-Interact, of which approximately half were recognized by Micromedex as well. Major, moderate and minor interactions consisted 23.5%, 68.5% and 8.0% of entries, respectively. The reliability of 71.1% of alerts was fair. Commonly used drugs, including zolpidem and zaleplon, were involved in multiple potential interactions that were classified as major based on additive CNS depression. Conclusions Most potential DDIs likely to be encountered in space are unestablished even in terrestrial medicine and their assignment is based on class-effects. Yet, some drug combinations may be associated with clinically-relevant consequences. Future DDI rating should be adjusted to space-related outcomes. Until that happens, it would be advisable to avoid non-established drug combinations in space when possible.