Abstract
The aim of the present survey was to evaluate different aspects of cardiovascular drug adverse reactions in a cardiac care unit (CCU). All patients admitted to CCU during a 16 months period were recruited into this study. Detection of adverse drug reactions (ADRs) was based on daily chart review and face to face interview with patients. Causality assessment was performed by the World Health Organization (WHO) probability criteria. Seriousness of ADRs was determined by WHO definition. Schumock and Thornton scale was applied to assess preventability of ADRs. Statistical analysis was performed. Among 740 cardiovascular patients admitted to CCU, 70 ADRs were recorded from 44 patients. Headache (15.71%) was the most frequent ADR. The highest ADR rates were attributed to digoxin (44.29%) and atenolol (12.86%). Fifty five (78.57%) of ADRs were serious. The rate of preventable ADRs was 62.86%. Regarding outcome, one (1.43%) ADR led to death. Multivariate logistic regression showed that length of CCU stay (OR = 1.09, 95%CI = 1.02-1.17) and non-ischemic heart diseases (OR = 3.26, 95% CI = 1.57-6.78) were risk factors for ADR occurrence. Cardiovascular drugs could develop fatal adverse reactions in CCU patients. Primary admission diagnosis and duration of CCU stay were risk factors for ADR development.
Highlights
Adverse drug reactions (ADRs) are an important cause of morbidity and mortality (Ramirez et al, 2009)
Cardiovascular medication group is defined as drug classes including diuretics, peripheral and central adrenergic inhibitors, direct vasodilators, calcium channel blockers, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers, positive inotropic agents, antiarrhythmics, anticoagulants, fibrinolytics, and antiplatelets
The World Health Organization (WHO) definition of adverse drug reactions (ADRs) was used in this study: “Any noxious or unintended response to a drug, which occurs at doses normally used in human for the prophylaxis, diagnosis or treatment of disease or for the modification of physiological function” (Edwards and Aronson, 2000)
Summary
Adverse drug reactions (ADRs) are an important cause of morbidity and mortality (Ramirez et al, 2009). Current studies reveal that ADRs occur in 6.5% to more than 20% of hospitalized patients. These result in prolonged hospitalization, increased cost and complicated treatment (Classen, 2003). According to results of a study on 8,208,960 medicare patients admitted to the United States (US) hospitals in 1998, 141,398 patients The drug classes most frequently associated with ADRs in that study include cardiotonic glycosides, adrenal corticosteroids, antineoantineoplastic agents, anticoagulants and analgesics
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