Contribution of Pharmaceutical Interventions in the Therapeutic Monitoring of Renal Transplants under Tacrolimus: Experience of the Pharmacovigilance Service at Ehu Oran-Algeria

The clinical pharmacy approach consists of a direct pharmaceutical intervention “PI” on the prescription, based on the pharmaceutical analysis of the latter, proposing, if necessary, modifications of the drug therapy. It is accompanied by pharmaceutical advice and the targeted dissemination of information to the prescriber. The objective of this work is to evaluate the pharmaceutical analysis and its impact on the improvement of the drug treatment of the kidney transplant under Tacrolimus. This is a descriptive retrospective study, over a period of three months, of Tacrolimus-treated kidney transplant recipients who received therapeutic monitoring at the EHU pharmacovigilance department Oran- Algeria. The collection of information was based on the analysis of patient file summary sheets using a PI form prepared by the Therapeutic Opinion Service Unit. For the pharmaceutical analysis of prescriptions, various bibliographic references have been used: VIDALExpert®, Drugs.com, THERIAQUE,... The study involved 60 kidney transplant recipients aged 16 to 55 with a sex ratio of 1: 1. The most common age group was 30 to 40 years old. The majority of cases treated came from the kidney transplant unit (80%) for a transplant exceeding one year (85%). Only 8% of the renal transplant recipients studied was switched to Ciclosporin following the onset of side effects. The problems detected are mainly related to drug interactions (48.35%), followed by overdose (36.65%) and underdosing (11.65%). Most AMIs is of low severity (82%).The most common drug combination was: Tacrolimus + Cellcept + Corticoid + antihypertensive (46.70%). Among the observed side effects, the most common were: increased tacrolemia (35.15%), increased muscle IA and rash at equal percentages (22.45%). The most common pharmaceutical intervention was to re-administer Tacrolimus and recheck tacrolemia in 32% of cases. It was accepted by clinicians in 86.65% of the cases studied. Pharmaceutical intervention in the context of therapeutic monitoring allows, after a careful pharmacotherapeutic analysis, to identify the existing problems and to propose thereafter appropriate therapeutic opinions.