@article{Iqbal_2020, title={The Impact of Concurrent Use of Diuretics, RAAS Inhibitors with Non-steroidal Anti-inflammatory Drugs “Triple Whammy” on Renal Function}, volume={14}, url={http://asiapharmaceutics.info/index.php/ajp/article/view/3824}, DOI={10.22377/ajp.v14i4.3824}, abstractNote={<p>Objective: This study aimed to evaluate the concomitant use of diuretics, angiotensin-converting-enzyme inhibitors/<br />angiotensin receptor blocker (ACEIs/ARBs) and non-steroidal anti-inflammatory drugs, frequently termed as<br />“Triple Whammy,” prescribed among out-patients. It also aimed to determine the impact of this combination<br />on patients’ renal function. Methodology: A retrospective and observational study was conducted in a hospital<br />located in the state of Selangor, Malaysia. Patients who were receiving two or more of triple whammy agents were<br />reviewed and analyzed. The associations between the prescriptions and patients’ demographics and comorbidities<br />were tested using the Chi-square test. On the other hand, a paired sample t-test was used to determine the impact<br />of prescriptions on renal function with a consideration of statistical significance when P < 0.05. Results: Out<br />of 412 prescriptions (60.2% male) were included in this study, 407 prescriptions were containing two of the<br />mentioned medication with only 5 prescriptions for triple whammy. The majority of prescriptions had (64.1%)<br />ACEIs/ARBs and diuretics, and it was mainly prescribed to hypertensive patients (98.5%) aged less than 65 years<br />old (38.3%). Furthermore, males were more likely to receive this combination of ACEIs/ARB and diuretics than<br />females (P < 0.001) due to the fact that the male gender is considered as a risk factor for cardiovascular conditions<br />that require ACEIs/ARBs + diuretics. In addition, there was a statistically significant decrease in CrCl after these<br />risky combinations were initiated. Conclusion: The prescribing trend of triple whammy during the period of data<br />collection was low compared to prescriptions of two risky combinations. This is indeed a good predictor of safe<br />prescribing of drugs among physicians, as concomitant use of these three medications may impair renal functions.</p>}, number={4}, journal={Asian Journal of Pharmaceutics (AJP)}, author={Iqbal, Muhammad Shahid}, year={2020}, month={Nov.} }