**4. Conclusion**

Accumulated knowledge of pharmacokinetic interactions of antihypertensive drugs with citrus juices was mentioned in this chapter. Furthermore, characteristics and mechanisms of the interactions were described with the latest results in the research studies. Drug-citrus juice interactions are a complicated phenomenon, with increasing and decreasing drug concentrations in plasma which is dependent on the combinations of drugs and juices. However, I believe that applicable instruction based on an understanding of the mechanisms for patients undergoing pharmaceutical therapies, will be useful. This will enable them to avoid such interactions.

### **5. References**


**Hesperidin Orange Juice**

**Control**

**01234**

**Time (h)**

Dose of celiprolol was 5 mg/kg body weight. Each point and vertical bar represents the mean and S.E.,

Accumulated knowledge of pharmacokinetic interactions of antihypertensive drugs with citrus juices was mentioned in this chapter. Furthermore, characteristics and mechanisms of the interactions were described with the latest results in the research studies. Drug-citrus juice interactions are a complicated phenomenon, with increasing and decreasing drug concentrations in plasma which is dependent on the combinations of drugs and juices. However, I believe that applicable instruction based on an understanding of the mechanisms for patients undergoing pharmaceutical therapies, will be useful. This will

Ameer, B. and Weintraub, RA. (1997). Drug interactions with grapefruit juice. *Clin* 

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Fig. 19. Plasma concentration-time curves for celiprolol after it was administered into the duodenum of rats with water (control, white circle), orange juice (black circle) and 207.7

respectively (n=4 - 5). This figure was cited from the literature (Uesawa & Mohri, 2008a).

**0**

enable them to avoid such interactions.

μg/mL hesperidin aqueous solution (black triangle).

**0.05**

**0.1**

**0.15**

**celiprolol (**

**4. Conclusion** 

**5. References** 

**μg/mL)**

**0.2**

**0.25**

**0.3**

**0.35**

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**7** 

*Brazil* 

**Drug Interaction Exposures in an Intensive Care** 

**Unit: Population Under Antihypertensive Use** 

Mônica Cristina Toffoli-Kadri1,\*, Leandro dos Santos Maciel Cardinal2

*1Center of Biological and Health Sciences, Federal University of Mato Grosso do Sul,* 

A potential drug-drug interaction (DDI) is related to the possibility of a drug to alter the effect of another drug simultaneously administered. It can occur before or after drug administration (Almeida et al., 2007). DDI are considered predictable and thus avoidable

Many of these interactions have slow onset clinical manifestations that can be diagnosed as new diseases and handled wrongly (Correr et al., 2007). Drug interactions are estimated to occur between 3% and 5% in patients to whom few drugs are prescribed and 20% among those who use 10 to 20 drugs simultaneously (Ferreira Sobrinho et al., 2006). The incidence of drug interactions is directly proportional to the increase in the number of drugs prescribed (Matos et al., 2009). It is known that a prescription containing eight or more

Drug interactions incidence in Intensive Care Unit (ICU) is higher than hospital rates in general probably due to patient disease severity admitted in this unit (Almeida et al., 2007). ICU patients usually need great number of administered drugs and they are under risk of 44.3% to 95.0% of potential drug interactions occurrence (Sierra et al., 1997; Meneses & Monteiro, 2000). New drugs availability and prescription of fixed drug combinations difficult potential interactions identification (Trato, 2005). Thereby, this study aimed to discuss the risk of DDI in medical prescriptions of adult inpatients in ICU under use of

Commonly used drugs in ICU are vasoconstrictors and cardiotonic agents, antimicrobials, coronary vasodilators, direct vasodilators, antisecretory drugs, anticoagulants, sedatives-

**1. Introduction** 

antihypertensive drugs.

Corresponding Author

 \*

and manageable (Cruciol-Souza et al., 2006).

drugs will present at least one interaction (Almeida et al., 2007).

Érica Freire de Vasconcelos-Pereira1,

*Federal University of Mato Grosso do Sul,* 

and Vanessa Terezinha Gubert de Matos3

*2Multiprofessional Health Residence – Critical Care Patient, 3Section of Hospital Pharmacy, University Medical Centre,* 

