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Results of forty years Yellow Card reporting for commonly used perioperative analgesic drugs
Author(s) -
Richardson Jennifer,
Holdcroft Anita
Publication year - 2007
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1403
Subject(s) - medicine , remifentanil , alfentanil , fentanyl , pethidine , anesthesia , perioperative , ketorolac , nalbuphine , analgesic , opioid , adverse effect , pharmacology , propofol , receptor
Background A variety of analgesics are used perioperatively and associated adverse drug reactions (ADRs) may complicate anaesthesia and recovery. Methods We aimed to measure the demographics of reported suspected ADRs to alfentanil, fentanyl, ketorolac, morphine, nalbuphine, papaveretum, pethidine and remifentanil. We report a retrospective analysis of Yellow Card reports of suspected ADRs from 1965–2004 as classified in the Adverse Drug Reaction On‐line Tracking database (ADROIT) of the Medicines and Healthcare products Regulatory Agency (MHRA). Results In total, 1312 reactions were retrieved. A single drug was reported in 908, 39 were fatal and 219 categorised as ‘allergic’. Allergic phenomenon varied from 2/33 (6%) for remifentanil to 11/53 (21%) for alfentanil. ‘Cardiovascular’ reactions were reported frequently with remifentanil (18/33, 55%) and alfentanil (19/53, 36%) and these generated a signal for possible hazards from proportional reporting ratios (PRRs). The opioid fentanyl was associated with similar hazard signals for muscular and psychiatric ADRs. Conclusions Perioperative vigilance may reduce morbidity and mortality from preventable ADRs to analgesic drugs. Denominator and diagnostic data are essential for prospective studies. Copyright © 2007 John Wiley & Sons, Ltd.