Abstract
Adverse drug reactions (ADRs) are associated with morbidity, mortality, and can contribute to increased healthcare costs. This study was conducted to identify the occurence, types, and management of ADRs, as well as analyze the causal relationship, severity, and preventability of ADRs. The study was observational analysis with concurrent data collection from patients with Coronary Artery Disease-ST segment Elevation Myocardial Infarction (CAD-STEMI) treated in the Cardiac Intensive Care Unit (CICU) at a hospital in Bandung Indonesia, during the period of December 2013 to March 2014. The occurence of identified ADRs was assessed using the probability scale of Naranjo, while the severity by the scale of Hartwig and their preventability was evaluated using the scale of Schumock-Thornton. 49 ADRs were identified in 29 patients. Organ systems most affected by the ADRs were the cardiovascular and body electrolyte, each accounting for 20.41%. The hematology and gastrointestinal systems each contributed 18.37% to ADR occurrences. The causal relationship was mostly classified as “probable,” accounting for 69.39%. With regard to severity, most ADRs were classified as “moderate” at level 3, contributing to 53.06% of the occurence. In terms of preventability, most of the ADRs fell into the “non-preventable” category (79.59%). The most widely applied ADRs management was administration of an antidote or other treatments (40.82%). Further analysis revealed that the average number of drug types and duration of hospitalization significantly affected the presence of ADRs. Taken together, most patients with CAD STEMI treated in the CICU of the studied hospital experienced non-preventable ADRs and were treated with antidote or other treatments.
Highlights
An estimated number of 17.3 million of patients died from cardiovascular diseases in 2008, representing 30% of all deaths globally
This study further evaluated causal relationship, severity and preventability of the Adverse drug reactions (ADRs)
The present study revealed that organ systems most often affected by the ADRs were the cardiovascular system and the body electrolyte, followed by hematology and digestive systems
Summary
An estimated number of 17.3 million of patients died from cardiovascular diseases in 2008, representing 30% of all deaths globally. Eighty percent of deaths from cardiovascular disease occurs in countries with low and middle incomes, and occur almost between male and female [1]. Drug is a type of therapy most commonly used and associated with adverse events, which most frequent in the intensive care unit. Patients with critical illness are at high risk of experiencing adverse events related to the use of drugs [5]. A number of studies demonstrated that the ADR was one the major problems in health service, related to morbidity and mortality and associated with increased healthcare costs [7]. The present study was aimed to identify the occurence, types, and management of ADRs in CAD STEMI patients. This study will provide information about the ADRs in the pertinent field, for the monitoring and prevention of the occurrence of the ADRs as well as providing educational materials for health professionals
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