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The risk of hypotension following co-prescription of macrolide antibiotics and calcium-channel blockers. Jovan Deas. Author Affiliations. Alissa J. Wright- the Departments of Medicine and Health Policy Tara Gomes- Institute for Clinical Evaluative Sciences
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The risk of hypotension following co-prescription of macrolide antibiotics and calcium-channel blockers Jovan Deas
Author Affiliations • Alissa J. Wright- the Departments of Medicine and Health Policy • Tara Gomes- Institute for Clinical Evaluative Sciences • Muhammad M. Mamdani-Management and Evaluation • John R. Horn-Pharmacy and Pharmacy Services • David N. Juurlink-Medicine and Health Policy
Introduction • Hypotension- Low blood pressure occurs when pressure during each heartbeat is lower • Calcium channel blockers- used for treating high blood pressure • Macrolide antibiotics- a particular type of antibiotic used to treat, and sometimes prevent, a wide variety of bacterial infections
Introduction • Calcium channel blockers- By dilating the arteries, CCBs reduce the pressure in the arteries. This makes it easier for the heart to pump blood, and, as a result, the heart needs less oxygen. • Macrolide antibiotics- stop bacteria multiplying by preventing them from being able to produce proteins that are essential for their growth.
Methods (data collection) • Population based study from residents of Ontario that were 66 or older. • Drug records collected from Ontario Drug Benefit Claims Database • Canadian Institute for Health Information’s Discharge Abstract Database. • Registered Persons Database • These databases are commonly used for analyzing the effects of drug interactions
Methods (data analysis) • Case crossover design used to avoid concerns about unresolved confounding. ( a longitudinal study in which subjects receive a sequence of different treatments) • Each person serves as their own control • The threshold for statistical significance was set at a two-tailed type I error rate of 0.05
Results • 999,234 patients were identified to use a single calcium channel blocker • 7,100 patients were admitted to the hospital for the treatment of hypotension • More than half of these patients were women • The median age was 77 years old • There was an association of using erythromycin as well as dihyydropyridine to admission to a hospital for treatment of hypotension
Conclusion • This study found that older patients taking a calciumchannel blocker were at increased risk of admission to hospital for the treatment of hypotension or shock following the use of clarithromycin or erythromycin.
Critique • This was a well written easy to read journal • The results could have more detail and explain the trends better • Variables could have been identified better as well
Relevancy • This is relevant to my research because I have considered using a calcium channel blocker as on of my own variables. I also hope to use this article to base my next years project off of.
Bibliography • Wright, A. (2011). The risk of hypotension following co-prescription of macrolide antibiotics and calcium-channel blockers. CMA, doi: 10.1503 /cmaj.100702