How to Check Medications for Contraindications
I understand you're asking about the technical process of entering medications into drug interaction checking systems, but I need to clarify that your question appears to be about using a software interface rather than a clinical question about contraindications themselves.
Using Drug Interaction Checking Tools
To check medications for contraindications and interactions, utilize online drug interaction databases by entering your complete medication list into interactive web-based resources. 1
Recommended Online Resources
- University of Liverpool HIV Drug Interactions tool: https://www.hiv-druginteractions.org/ 1
- ClinicalInfo.HIV.gov: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/drug-interactions-overview 1
- Drugs.com interaction checker 2
- Lexicomp® online database 2
- Medscape drug interaction checker 2
Step-by-Step Process
1. Gather Complete Medication Information 1
- List all prescription medications with exact names and doses 1
- Include over-the-counter medications 1
- Document herbal supplements and vitamins 1
- Note the timing and frequency of each medication 1
2. Enter Medications into the Database 3, 2
- Input each drug name individually into the online checker 3
- Most systems allow you to add multiple medications to create a comprehensive interaction profile 3
- The system will automatically cross-reference all entered medications 3
3. Review Generated Alerts 1
- Check for drug-drug interactions (DDIs) 1
- Review contraindications based on severity ratings 4
- Assess drug-disease interactions 1
- Identify duplicate therapies 1
Important Caveats
Different drug interaction databases provide significantly discrepant results, with only 66% overall agreement among major programs. 5, 2 The agreement is "fair" overall but improves to "substantial" only for severe-category interactions 5.
Always check more than one interaction database program when making critical clinical decisions. 5 The three most commonly used programs (Drugs.com, Lexicomp®, and Medscape) showed poor agreement for highest-grade interactions 2.
Specific Populations Requiring Enhanced Screening
Elderly patients require comprehensive drug interaction screening using specialized criteria. 1
- Apply Beers criteria for high-risk drugs in older adults 1
- Use STOPP/START criteria for potentially inappropriate medications 1
- Screen for anticholinergics, benzodiazepines, opioids, and hypoglycemics 1
Patients on anticoagulants require specific interaction monitoring. 1
- Screen for CYP450 3A4 and P-glycoprotein modulators when using DOACs 1
- Check for CYP2C9 and CYP3A4 inhibitors/inducers with warfarin 1
- Monitor for antiplatelet and NSAID combinations 1
Limitations of Electronic Systems
Electronic drug interaction checkers cannot replace clinical judgment and may generate new types of errors. 1 These systems require proper implementation and systematic use by healthcare providers 1.
No national standard exists for critical DDIs that should be routinely checked in electronic health record systems. 4 This lack of standardization contributes to variability in interaction detection across different platforms 4.