Potential drug‐drug interactions in acute poisonings managed in the intensive care unit: Occurrence, risk factors and relationship to patient severity on admission.

Beyond the direct toxicity resulting from each drug in the poisoned patient, additional toxicities may result from drug‐drug interactions (DDIs). We aimed to determine the frequency of potential DDIs in the poisoned patient and investigate whether DDIs are associated with severity. We conducted a 1‐year cohort study in a toxicological ICU. DDIs were identified using an electronic interaction‐checker tool. Among our 354 ICU poisoned patients, 134 (38%) presented at least one potential DDI between acute poisoning drugs and 180 (51%) at least one potential DDI between acute poisoning and long‐term treatment drugs. Using multivariate analyses, previous suicide attempt was associated with the presence of potential DDIs between acute poisoning drugs in suicide attempt patients (P = 0.014). Chronic alcoholism (P = 0.005) and tobacco smoking (P = 0.022) were associated with the presence of potential DDIs between acute poisoning and long‐term treatment drugs in recreational drug users. Presence of potential DDIs between acute poisoning and long‐term treatment drugs was associated with catecholamine infusion (P = 0.022) in suicidal self‐exposure patients. Presence of potential pharmacodynamic DDIs between acute poisoning and long‐term treatment drugs was associated with aspiration pneumonia onset in recreational drug users (P = 0.03). ICU poisoned patients present a high rate of potential DDIs that may influence the outcome. [ABSTRACT FROM AUTHOR]