Safety Of Drug Therapy Research Articles

Association and pharmacological synergism of the triple drug therapy baricitinib/remdesivir/rhACE2 for the management of COVID-19 infection.

A massive vaccination campaign against the global COVID-19 pandemic caused by SARS-CoV-2 virus began worldwide in January 2021. However, studies continue to investigate the most effective and safe drug therapies to manage the various stages of viral infection. It is critical in the therapeutic management of the patient, with ongoing COVID-19 infection, to reduce viral load and replication, and to regulate the generalized hyperinflammatory state caused by the cytokine storm that occurs in the most severe phases. Probably the right drug therapy is represented by the use of different drugs acting in different modalities and on different targets, to avoid also viral drug resistance. In this article, we describe an interesting scientific pharmacological hypothesis arising from the evidence in the literature; we believe that the association of baricitinib/remdesivir/rhACE2, administered at the right time and dose, represents an important pharmacological synergism that can be therapeutically more effective for the treatment of COVID-19 infection than the single administration of drugs and avoid the phenomenon of drug resistance caused by the virus.

Pharmacotherapy of COVID-19: Considerations for Pregnancy and Breastfeeding

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a chief concern of the international community. As of May 2021, more than 150 million cases and 3.2 million deaths have been recorded. Considering the early struggle in treating COVID-19 patients, the researchers and clinicians have decided to try the previously available drugs according to their mechanisms of action. This article aims to review the potential drugs for COVID-19 patients during pregnancy and breastfeeding and their safety. PubMed and Scopus databases and Google Scholar engine were searched with the proper combination of the free keywords and MeSH Terms of COVID-19, SARS-CoV-2, Pregnancy, Breastfeeding, Treatment, Pharmacotherapy, Drug Therapy, and Drug Safety. All relevant clinical studies published until the end of 2020 were included in this review. Many antivirals, antibiotics, antiparasitics, and antipyretics have been proposed, but most of them are not registered for COVID-19 or have demonstrated little effect on the disease. Since there is still a long way to find an effective drug for the treatment of COVID-19, prevention is currently the most effective way. Also, prescribing drugs to these two groups of patients should be done according to the safety recommendations.

Drug-induced pancreatitis: focus on drugs used to treat cardiovascular disease

Cardiovascular diseases (CVD) are the leading cause of death worldwide and in Russia. Therefore, the question of safe and rational drug therapy is acute. But, like most drugs, drugs for the treatment of CVD have a number of adverse reactions, in particular, the development of acute pancreatitis. This adverse reactions can be both dose-dependent and depend on the duration of administration of these groups of drugs. The purpose of this review is to analyze the literature data on drugs intended for the treatment of СVD that can lead to the development of drug-induced pancreatitis (LIP), on the mechanisms of development of this pathology against the background of taking specific drugs, diagnosis, treatment and prevention. The development of LIP is associated with the use of diuretics, both loop (furosemide, etacric acid, bumetamide), and thiazide/thiazide-like (chlorothiazide, hydrochlorothiazide and chlorthalidone), antihypertensive drugs of central action (methyldopa), angiotensin converting enzyme inhibitors and angiotensin II receptor blockers, statins, antiarrhythmic drugs (amiodarone, procainamide). Literature data on the development of LIP are presented in most publications with the description of clinical case/series of cases, however, in the case of LIP associated with the use of ACEI and statins, there are also data from cohort, retrospective observational, prospective case-control, randomized controlled trials, and meta-analyses. With timely diagnosis, and the cancellation of drugs that have caused the development of OP, the symptoms of the disease regress until they completely disappear and develop serious consequences.

Alcohol as a risk factor for drug-induced diseases

Administration of a rational and safe drug therapy is one of the most challenging issues for healthcare professionals. The frequency of hospitalizations due to the adverse drug reactions in the years 2000 — 2015 was estimated at 6.3 (3.3—11.0 %) for developed countries and 5.5 % (1.1—16.9 %) for developing countries. It is known that alcohol intake is a risk factor for many socially significant diseases, including arterial hypertension, coronary heart disease, chronic heart failure, etc., however, many doctors pay insufficient attention to the fact that many drugs, for example, beta-blockers, antidepressants, bezodisepines, calcium antagonists, can interact with alcohol when consumed simultaneously and, thus, increase the risks of adverse drug reactions. There are 2 main types of interactions between alcohol and drugs: pharmacokinetic (at the stage of absorption, distribution, metabolism and elimination) and pharmacodynamic (at the stage of effects and receptors). For example: the simultaneous intake of alcohol and paracetamol leads to the formation of toxic metabolites due to the induction of cytochrome P450 isoenzymes by alcohol. Another example is decrease in presystemic elimination and stimulation of the metabolism of tricyclic antidepressants; an increase in the elimination of imipramine and desipramine in patients with chronic alcoholism after detoxification therapy, and so on. In this article, the authors analyzed and systematized data from open literature sources in order to inform health care professionals about the possible risks associated with the interaction of alcohol and drugs and various pharmacological groups.

Telmisartan Induced Myotoxicity: A Case-Report

The precise incidence of drug-induced myopathy is still not known, only few reports with the use of Telmisartan. There are likely around 150 agents that are associated to cause myotoxicity like statins, corticosteroids, anti-retroviral, and immunosuppressants. Therefore, as recommended by the guidelines, therapeutic drug monitoring of Telmisartan is required after the initiation of the therapy. However, the rise in serum creatinine up to 20-30% is accepted. But if serum creatinine level increases >30% then withdrawal of the therapy is recommended.
 Suspicious with the previous therapy of Tab. Telmisartan as no other pathology could be detected. A causality analysis was done using the Naranjo’s algorithm and WHO-UMC Scale and the present ADR was found to be ‘Probable’ with Telmisartan. Tab. Telmisartan was withdrawn completely and was switched by another Antihypertensive -Tab. Enalapril (5mg). Gradually, the condition of the patient showed improvement in terms of both- the clinical symptoms and laboratory abnormalities. However, re-challenge of the drug was not performed in order to avoid further toxicity. After 15 days, the patient had visited Medicine Outpatient Department (OPD) again the creatinine and uric acid levels where checked which were normal and further advised to follow up every month. To be conclude, adverse drug reaction of myotoxicity associated with telmisartan is rare but quite significant. So, close monitoring is necessary to ensure safety of drug therapy especially in long term use.

Safety of pharmacotherapy in a psychiatric inpatient setting and the QT interval

Background; Events associated with a risk of death are the most serious complications of pharmacotherapy; One of these complications is prolongation of the QT interval leading to Torsades de Pointes, a life-threatening condition that can result in asystole and sudden death. Factors contributing to the development of the long QT syndrome include heredity, structural abnormalities of the heart, electrolyte disorders, female gender, advanced age, use of drugs with certain electrophysiological properties, and drug-drug interactions. Consideration of all these factors can help achieve the most accurate and objective assessment of the risk of these rhythm disturbances.
 Aims to assess the risk of prolongation of the QT interval and the development of Torsades de Pointes in psychiatric inpatients.
 Methods. The study enrolled 500 patients who received medical care in a psychiatric inpatient setting. The risk of QT interval prolongation and development of Torsades de Pointes was assessed using the MedSafety Scan medical decision support system.
 Results. Of the 500 patients treated in the psychiatric inpatient setting, 224 had a risk of QT interval prolongation and developing Torsades de Pointes; the incidence was highest in the group of elderly patients. The mean risk score was 7.59 3.29 in general, 6.02 3.14 in patients aged under 65 years, and 9.16 2.62 in subjects over 65 years of age. An analysis of the frequencies of risk factors for prolongation of the QT interval and Torsades de Pointes revealed that patients aged over 65 years most commonly had atrial fibrillation, chronic heart failure, heart valve disorders, hypertension, and a history of myocardial infarction. Patients under 65 years of age more commonly received medicinal products prolonging the QT interval and drug combinations that can lead to potential drug-drug interactions of relevant clinical significance.
 Conclusion. The obtained results indicate the importance of assessing the risk of QT interval prolongation and development of Torsades de Pointes in psychiatric inpatients as an affordable preventive tool that can increase the safety of drug therapy.

Drug-Related Problems on a Palliative Care Unit

Pharmacotherapy is essential in palliative medicine. Besides potential benefits, pharmacotherapy also poses potential risks that need to be minimized for patient safety. Pharmacists can play an important role in identifying, solving, and avoiding drug-related problems (DRPs). The aim of this study was to evaluate pharmaceutical interventions on safety of drug therapy in patients in an inpatient palliative care unit. All patients admitted to a palliative care unit over a 12-month period were screened for eligibility (ie, life expectancy >4 weeks). To identify and assess DRPs, patients’ pharmacotherapy was evaluated by a pharmacist according to various aspects (eg, drug selection, dose selection, or treatment duration according to the Pharmaceutical Care Network Europe classification for DRPs). During the 12-month period, 41 patients were included. Patients received a median of 11 (range, 1–22) different drugs. Overall, 207 DRPs were documented (median 5 DRPs/patient). After recording a DRP, the pharmacist directly intervened 290 times in order to solve the DRP, which was successful in 181/207 (88%). Clinically relevant DRPs are common in palliative medicine. The systematic assessment can support therapy decisions. This can result in optimized drug therapy, subsequently having a positive effect on symptom control and quality of life.

Особливості патогенезу і перебігу цукрового діабету 2 типу та коморбідної з ним кардіоваскулярної патології у пацієнтів літнього віку

The features of the pathogenesis and course of type 2 diabetes mellitus and diseases of the cardiovascular system comorbid with it are considered in patients of elderly and old age – coronary artery disease, arterial hypertension, chronic heart failure. The leading role of insulin resistance, hyperglycemia and dyslipidemia in the development of metabolic, homeostatic disorders, the formation of oxidative stress and endothelial dysfunction, which, together with age-related changes in the body, contribute to the progression of type 2 diabetes mellitus and microvascular complications, primarily diabetic cardiomyopathy. Particular attention is paid to the relationship between cognitive impairment, type 2 diabetes mellitus and chronic heart failure. The main factors that worsen the course and prognosis of type 2 diabetes mellitus in elderly patients, in particular, hypertension, atrial fibrillation, diabetic polyneuropathy, nephropathy, and other concomitant diseases, have been identified. Lack of compensation for type 2 diabetes due to metabolic disorders leads to the development of diabetic cardiovascular autonomic neuropathy, diabetic cardiomyopathy along with the progression of atherosclerotic lesions of different localization. The course of type 2 diabetes in these patients is often complicated by geriatric syndrome, which contains a set of cognitive impairment, senile weakness, depression, functional disorders, polymorbidity. Cognitive disorders negatively affect the course of type 2 diabetes and its complications, significantly disrupting the process of teaching patients the methods of self-control, following the advice of a doctor. It is noted that the management of this category of patients should be individual and include adequate correction of hyperglycemia to prevent microvascular complications and hypoglycemic conditions, as well as reduce cardiovascular mortality and maintain quality of life. Rational selection of drugs, taking into account the factors that determine their impact on the body of elderly patients with type 2 diabetes mellitus and possible adverse drug reactions, will increase the effectiveness and safety of drug therapy in such patients. Optimizing therapeutic approaches for elderly patients with type 2 diabetes requires effective changes in the health care system to provide them with comprehensive medical and social care according to their special needs

First report on efficacy of Citrus limetta seed oil in controlling cattle tick Rhipicephalus microplus in red Sahiwal calves

The objective of the study was to evaluate the acaricidal activity of Citrus limetta seed oil (CLO) for controlling the cattle tick Rhipicephalus microplus. C. limetta seeds were collected as a waste product from different juice corners. CLO was obtained after extraction of seeds on soxhlet apparatus using n-hexane as solvent. It was characterized through Gas Chromatography-High Resolution Mass Spectroscopy (GC-HRMS) to determine the presence of active constituents. In vitro bioassays were performed using adult immersion test (AIT) and larval packet test (LPT). In vivo acaricidal efficacy of CLO was performed on red Sahiwal calves using ear bag method. Clinical safety of CLO was evaluated by observing haematological parameters and skin irritancy assay. Results of GC-HRMS showed that mainly fatty acids such as linoleic acid, stearic acid, oleic acid, palmitic acid, and linolenic acid were present in the CLO. CLO in the concentration of 125 mg/mL (CLO8) exhibited 100 % mortality in both AIT and LPT. CLO significantly (p < 0.001) reduced the number of ticks from 35 to 5.05 and 3.24 on 144 h after treatment with CLO7 and CLO8, respectively. CLO was found clinically safe without producing erythema and edema on skin. Haematological parameters such as haemoglobin (11.48 g/100 mL), total leucocytes count (4.32 106/cumm), total erythrocytes count (6.80 106/cumm), and packed cell volume (34.39 %) were normal and controlled. CLO may be used as effective and safe drug therapy for controlling R. microplus ticks.

MONITORING DRUG THERAPY IN X’s PHARMACY IN BADUNG REGENCY

Background: Monitoring drug therapy based on Permenkes RI No. 73 of 2016 is one of the pharmaceutical care standards in pharmacy practice. Monitoring drug therapy is a process that includes activities to ensure safe, effective and rational drug therapy for patients. Patients who receive drug therapy are at risk of experiencing drug-related problems. Objective: This study aims to determine the implementation of monitoring drug therapy in one pharmacy in Badung Regency. Methods: The type of research is a descriptive observational study conducted by interview session one pharmacist in X Pharmacy, then analyzed descriptively according to Permenkes RI No 73 of 2016. Results: The results showed that in January-June 2020 there were 34 patients with disease categories requiring monitoring drug therapy: 27 patients with asthma (79%), six patients with diabetes (18%), and one patient with tuberculosis (3%). Patients with the largest visits were geriatric, which were 19 out of 34 patients. Conclusion: The monitoring of drug therapy at Pharmacy X has fulfilled all the parameters in the Standard Operating Procedure (SOP) for the implementation of in Pharmacy based on Permenkes RI No.73 of 2016.Keywords: Monitoring drug therapy, Implementation, Pharmacy, Pharmacist

Considerations for Drug Dosing in Premature Infants.

In premature infants, effective and safe drug therapy depends on optimal dose selection and requires a thorough understanding of the underlying disease(s) of these fragile infants as well as the pharmacokinetics and pharmacodynamics of the drugs selected to treat their diseases. Differences in gestational and postnatal age or weight are the major determinants of the observed variability in drug disposition and effect in these infants. This article presents an outline on how to translate the results of a population pharmacokinetic/pharmacodynamic study into rational dosing regimens, and how physiologically based pharmacokinetic modeling, electronic health records, and the abundantly available data of vital functions of premature infants during their stay in the neonatal intensive care unit for evaluation of their pharmacotherapy can be used to tailor the most safe and effective dose in these infants.

Locomotive syndrome: from paradigms to clinical reality

Locomotive syndrome is an unsatisfactory condition of patients over 60 years of age who need or may require outside help in the near future due to functional deterioration of the musculoskeletal system, including pathology of bone tissue, joints, muscles and nervous tissue. In real clinical practice, one often has to deal with the following manifestations of locomotive syndrome: osteoarthritis, sarcopenia, balance disorders, chronic musculoskeletal pain. Today, there is a clear understanding that drug therapy should be long-term, include comprehensive support for muscle tissue, balance training, and mandatory cognitive-behavioral therapy. Maximum safety of long-term drug therapy can be ensured by the use of vital micronutrients, which include highly purified forms of chondroitin sulfate and glucosamine sulfate, which have a wide range of anti-inflammatory and regenerative effects.

Preparing and administering medications via enteral feeding tubes: a guideline for clinical pharmacists and multi-professional team

Objective: To identify the most prescribed drugs by enteral feeding tube in a public hospital and to a guideline for safe medication preparation and administration via enteral feeding tubes. Methods: A cross-sectional study with analysis of the daily prescriptions of patients exclusively using an enteral catheter in intensive care units and inpatients of the medical clinic specialty, in which descriptive statistics were used to identify the prevalence of medication use by tube. In a second step, a protocol was developed for the situation in which oral medications are prescribed to patients with a tube in the digestive tract. Results: A total of 1.810 medications prescribed by enteral feeding tube, of these 1.810, 291 (16%) were prescribed in liquid pharmaceutical form (suspension, solution, syrup) e 1.519 (84%) were prescribed in solid pharmaceutical form (tablets, capsule). 52 medications were selected for the protocol, and 14 of them (26.9%) with the recommendation of not crushing and administering via enteral feeding tube. Conclusion: Our results highlights the performance of clinical pharmacist in monitoring patients with enteral feeding tubes and guidance of multi-professional team. The protocol elaboration will guide for preparation and administration medication through the enteral feeding tube, reducing possible adverse events and ensuring the safety and efficacy of drug therapy.&#x0D;

Motor dysfunction in elderly patients with chronic musculoskeletal system diseases (locomotive syndrome)

Locomotive syndrome (LS) is defined as an unsatisfactory condition in patients after the age of 60 years, in which they require or may require physical assistance soon due to deterioration in the functional state of the musculoskeletal system, including pathology of bone tissue, joints, muscles, and the nervous system. The problem of LS treatment in elderly patients is relevant for all countries over the world. The presence of chronic somatic and neurological diseases in most older adults can complicate LS assessment and reduce treatment effectiveness. The patient's functional status and ability to continue activities of daily living should be assessed at the first visit to determine the degree of independence, the level of need for caregivers, and the overall quality of life. LS treatment should be permanent and include kinesiotherapy, professional psychological support, and complex drug therapy. The use of vital micronutrients, which include highly purified forms of chondroitin sulfate and glucosamine sulfate, which have a wide range of anti-inflammatory and regenerative effects, can provide the safety of long-term drug therapy.

The RACE to the EAST. In pursuit of rhythm control therapy for atrial fibrillation-a dedication to Harry Crijns.

The RACE trial was one of the first landmark trials to establish whether restoring and maintaining sinus rhythm could reduce morbidity and mortality in patients with atrial fibrillation (AF). Its neutral outcome shaped clinical decision-making for almost 20 years. However, there were two important treatment-related factors associated with mortality of rhythm control therapy at that time: One was safety of antiarrhythmic drug therapy, and the other one withdrawal of anticoagulation after restoration of sinus rhythm. Both concerns have been overcome, and, moreover, important knowledge considering the importance of time for the treatment of AF has been gained. These insights led to the concept of the EAST-AFNET 4 trial, and after more than two decades in the pursuit of ongoing therapeutic improvement, early rhythm control therapy has demonstrated to reduce a composite of cardiovascular death, stroke, and hospitalization for worsening of HF or acute coronary syndrome, by 21% (first primary outcome, absolute reduction 1.1 per 100 patient-years). For this entire period, Harry Crijns characterized the treatment of AF patients, and contributed decisively to realizing the benefit of rhythm control therapy. It is almost easier to list the clinical trials without Harry's involvement than to list those which he co-designed and led.

Assessment of Acetylcholinesterase Inhibition and Anti-inflammatory Activity of Ethanolic Extract of Evolvulus alsinoides Linn.

Objectives: The objective of present study is to determine the efficacy of ethanolic extract of Evolvulus alsinoides Linn. for therapeutics at various doses. One more purpose is also to determine anti-inflammatory effects of E. alsinoides which are highly associated with CNS disease. Methods: Ethanolic extract of E. alsinoides has been used for estimation of acetylcholinesterase inhibitory activity at dose of 100, 200, 300 mg/kg on rat. For estimation of acetylcholinesterase, Ellman’s method is used which is based on absorbance. Anti-inflammatory activity was evaluated by two in vitro experimental models i.e. heat induced hemolysis and hypotonic solution-induced hemolysis. Results: Ethanolic extract of E. alsinoides at the dose of 200mg/kg is more effective than 100 and 300. In heat hemolysis, inflammation was significantly reduced at 50 and 100 μg/ml in EA while hypotonic solution induced inhibition was shown significant at 50, 100 and 200 μg/ml in EA. Extract was effective in inhibition of hemolysis in a dose-dependent manner due to its membrane stabilizing action. Thus, E. alsinoides may be employed as alternative and safe drug therapy against inflammation. Conclusion: Several natural products have been used for medicinal purposesin which E. alsinoides is also one of them. It is traditionally claimed for memory enhancement and will help as therapeutics for brain related problems.

The value of assessing cerebrovascular reactivity in hypertension and comorbid pathology

The review presents the rationale for the importance of studies on the reactivity of cerebral vessels, the classification of cerebrovascular reactivity (CVR) and the threshold values of quantitative indicators of the reserve phase and autoregulation of cerebral blood flow in healthy volunteers. Features of CVR in hypertension are described depending on the clinical course, daily blood pressure profile, the presence of comorbid pathology, the treatment approaches in treatment CVR disorders. We discuss the evidence-based data on the role of CVR assessment in diagnosing latent cerebral circulation insufficiency, prediction of cerebrovascular complications, monitoring the effectiveness and safety of drug and devise-based therapy of hypertension associated with abnormal CVR.

Targeted therapy of human leukemia xenografts in immunodeficient zebrafish

Personalized medicine holds tremendous promise for improving safety and efficacy of drug therapies by optimizing treatment regimens. Rapidly developed patient-derived xenografts (pdx) could be a helpful tool for analyzing the effect of drugs against an individual’s tumor by growing the tumor in an immunodeficient animal. Severe combined immunodeficiency (SCID) mice enable efficient in vivo expansion of vital tumor cells and generation of personalized xenografts. However, they are not amenable to large-scale rapid screening, which is critical in identifying new compounds from large compound libraries. The development of a zebrafish model suitable for pdx could facilitate large-scale screening of drugs targeted against specific malignancies. Here, we describe a novel strategy for establishing a zebrafish model for drug testing in leukemia xenografts. We used chronic myelogenous leukemia and acute myeloid leukemia for xenotransplantation into SCID zebrafish to evaluate drug screening protocols. We showed the in vivo efficacy of the ABL inhibitor imatinib, MEK inhibitor U0126, cytarabine, azacitidine and arsenic trioxide. We performed corresponding in vitro studies, demonstrating that combination of MEK- and FLT3-inhibitors exhibit an enhanced effect in vitro. We further evaluated the feasibility of zebrafish for transplantation of primary human hematopoietic cells that can survive at 15 day-post-fertilization. Our results provide critical insights to guide development of high-throughput platforms for evaluating leukemia.

Potentially Inappropriate Medication of Nursing Home Residents: An Analysis of Risk Factors Based on National Claims Data (AOK) for 2017

The aim of this study was to assess risk factors for prescription of potentially inappropriate medication (PIM) to nursing home residents using the PRISCUS list in 2017. Using claims data (AOK) we analysed insured nursing home residents aged 65 or older in 2017. The PRISCUS list was used to identify PIMs. A multivariate logistic regression analysis was performed to analyse risk factors. The study population in 2017 included 259 328 nursing home residents, out of them 25.5% received at least one potentially inappropriate medication (women: 25.6%/men: 24.9%). Female and younger aged nursing home residents had a higher risk for at least one PRISCUS prescription. Polypharmacy, an increasing number of attending physicians, and hospital stays were additional risk factors for a PRISCUS prescription. Furthermore, regional (Bundesland) variations contributed to differences in PRISCUS prescriptions. The frequent PIM prescriptions in nursing home residents are a relevant topic regarding drug therapy safety. Regional differences, which cannot be explained by nursing home resident characteristics, show options for modifications and the need for further research.

Multicenter point prevalence evaluation of the utilization and safety of drug therapies for COVID-19 at the onset of the pandemic timeline in the United States.

Key pointsIn a multicenter point-prevalence study, we found that the rate of supportive care was high; among those receiving COVID-19 drug therapies, adverse reactions occurred in 12% of patients.PurposeThere are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period.MethodsWe conducted a noninterventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19–targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs).ResultsA total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19–directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028).ConclusionWhile we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments.