not-yet-known not-yet-known not-yet-known unknown Aim: Drug interactions are a significant healthcare concern frequently encountered in intensive care units. Our study aims to acquire more up-to-date data and raise awareness of drug interactions. Methods: A retrospective analysis was performed on the data of 163 patients admitted to the intensive care unit in 2019. The patients’ medication lists were evaluated on a daily basis, and drug information was analyzed using three different online databases: Micromedex, Lexicomp, and Drugs.com. Results: The length of hospital stay ranged from 1 to 50 days, and a total of 1,834 medication orders were analyzed. The most common admission diagnoses were pneumonia, acute renal failure, and gastrointestinal bleeding. Comorbidities were present in 81.6% of patients. The number of interactions increased significantly with increasing comorbidities and number of drugs. This association was particularly evident for cardiovascular diseases. The number of interactions was higher in men. Interactions were identified in 82.9% of orders in Micromedex, 92.5% in Lexicomp, and 95.5% in Drugs.com. The most common contraindicated interaction was between linezolid and tramadol, while the most common major interaction was between aspirin and enoxaparin. Linezolid, fluconazole, and metoclopramide were the most common drugs contributing to contraindicated interactions, while enoxaparin, aspirin, and clopidogrel were the main contributors to major interactions. Albuterol, norepinephrine, and pantoprazole were associated with more moderate interactions. Conclusion: Assessment of drug interactions can lead to improved patient outcomes and avoidance of unnecessary economic burden. Clinicians should use several sources when performing such assessments. There are significant differences between databases.

Aim: Current literature lacks clear recommendations for the clinical management of pregnancies in which fathers are exposed to methotrexate prior and during conception. This highlights the need to expand the evidence regarding the fetal safety of paternal methotrexate exposure. Objective of this meta-analysis was to explore whether there is an association between major congenital malformations and other adverse pregnancy outcomes following paternal methotrexate exposure through a systematic review and meta-analysis. Methods: PubMed, Web of Science, and Reprotox databases were searched through December 2023. Cohort and case-control studies with paternal exposure to methotrexate were included. Results: The primary outcome of interest was the major congenital malformations following paternal methotrexate exposure during preconception and at conception. Secondary outcomes were the occurrence of cardiac malformations, spontaneous abortion, live birth, elective terminations, stillbirth, and preterm birth. Among the outcomes, only major congenital malformations, stillbirth, and preterm birth were eligible for quantitative analysis. No significant increases in the risk of major congenital malformations (aOR 1.00; [%95CI 0.62, 1.61]) (I2=%0, P=0.81), stillbirth (OR 0.85; [95%CI 0.11, 6.45]) (I2=%0, P=0.65) or preterm birth(OR 0.95; [%95CI 0.59, 1.53]) (I2=%26, P=0.26) were observed following paternal methotrexate exposure. Conclusion: These findings indicate that paternal methotrexate exposure does not significantly increase the risk of major congenital malformations, stillbirth, preterm birth. In addition, it was not ssociated with consistent or repetitive pattern of malformations. These findings suggest reassurance following paternal methotrexate exposure.