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Characterization of adverse drug reactions causing admission to an intensive care unit
Author(s) -
RojasVelandia Camilo,
RuizGarzón Jair,
MoscosoAlcina JuanCarlos,
VallejosNarvaéz Álvaro,
CastroCanoa Jenny,
BustosMartínez Yuri,
FlórezCutiva Max,
ContrerasMuñoz Mabel,
GómezGil JullyCarolina,
CalderónOspina CarlosAlberto
Publication year - 2017
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13199
Subject(s) - medicine , intensive care unit , incidence (geometry) , confidence interval , emergency medicine , drug reaction , adverse effect , adverse drug reaction , drug , pediatrics , intensive care medicine , pharmacology , physics , optics
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.