Characterization of adverse drug reactions causing admission to an intensive care unit

Aims: This study aimed to determine the occurrence of adverse drug reactions (ADRs) that caused admission to the intensive care unit (ICU) of a university hospital. Methods: Clinical records were reviewed for patients meeting the inclusion criteria who were admitted to the ICU between September and December 2012. Suspected cases of ADRs were documented. Nine researchers later evaluated causality using the Naranjo Algorithm, preventability using the Schumock and Thornton criteria, and clinical classification based on the dose–time–susceptibility system. Results: In total, 96 patients presented 108 cases of ADR (13.8%, 95% confidence interval 11.2–16.4%) as the cause of admission. The most frequent ADRs were bradyarrhythmias and upper gastrointestinal bleeding (12%). Therapeutic failure accounted for 20%. The most commonly associated medications were acetylsalicylic acid (16%) and losartan (10%). Forty-six cases were categorized as possible, and only one as definite. According to the dose–time–susceptibility classification, in 82% of the cases, the dosage was collateral (within the therapeutic range), and 90% were independent of time; the factors most associated with susceptibility to ADRs were comorbidities (42%) and age (49%). Forty-four percent of the ADRs were considered possibly preventable. Conclusions: ADRs contribute significantly to ICU admissions, and a significant number of ADRs are preventable. National studies are needed to assess their incidence and to establish classification standards to reduce their clinical impact. © 2016 The British Pharmacological Society

• Fecha de publicación: 2017
• Institución: Universidad del Rosario
• Repositorio: Repositorio EdocUR - U. Rosario
• Idioma: eng
• OAI Identifier: oai:repository.urosario.edu.co:10336/23609
• Acceso en línea: https://doi.org/10.1111/bcp.13199; https://repository.urosario.edu.co/handle/10336/23609
• Palabra clave: Acetylsalicylic acid; Amlodipine; Bromocriptine; Capecitabine; Carbamazepine; Carvedilol; Clonidine; Clopidogrel; Contrast medium; Dalteparin; Digoxin; Enalapril; Enoxaparin; Etanercept; Furosemide; Hydrochlorothiazide plus spironolactone; Ibuprofen; Isophane insulin; Losartan; Methylprednisolone; Metoprolol; Morphine; Mycophenolic acid; Naproxen; Nebivolol; Phenobarbital; Phenytoin; Pig insulin; Unindexed drug; Valproic acid; Adolescent; Adult; Adverse drug reaction; Aged; Algorithm; Article; Ascites; Bradycardia; Cerebrovascular disease; Chronic kidney failure; Classification; Comorbidity; Delirium; Diabetic ketoacidosis; Disease exacerbation; Drug treatment failure; Female; Gastrointestinal hemorrhage; Groups by age; Heart block; Hospital admission; Human; Hyperkalemia; Hypoglycemia; Hypotension; Immune deficiency; Intensive care unit; Leukopenia; Major clinical study; Male; Priority journal; Respiration depression; Seizure; Subarachnoid hemorrhage; Subdural hematoma; Thrombocytopenia; University hospital; Upper gastrointestinal bleeding; Very elderly; Adverse drug reaction; Dose response; Hospitalization; Middle aged; Retrospective study; Time factor; Young adult; Adolescent; Adult; Aged; Aged, 80 and over; Drug-related side effects and adverse reactions; Female; Hospitalization; Humans; Intensive care units; Male; Middle aged; Retrospective studies; Time factors; Young adult; Drug-related side effects and adverse reactions; Intensive care units; Patient admissions; Pharmacovigilance; Postmarketing; Product surveillance; drug; university; Dose-response relationship; Hospitals
• License: Abierto (Texto Completo)