Adverse drug reactions leading to hospital admission.
This article describes the implementation of a simple method of drug surveillance set up at a hospital emergency ward. From a total of 48,678 patients admitted, the medical records of those presenting with one or more of a pre-established list of admission diagnoses (n = 7728; 15.8%) were checked. Of these 554 (1.1%) were diagnosed as experiencing an adverse drug reaction. When the medical record suggested an adverse drug reaction, drugs taken before admission were ascertained by interviewing the patients with a structured questionnaire. After excluding upper gastrointestinal bleeding (226 cases) and certain bone marrow blood dyscrasias (42 cases), 286 patients with drug-induced events leading to hospital admission were identified in 2 years. Fatal adverse drug reactions, previously undescribed reactions, and some specific examples, such as digoxin-amiodarone interaction, drug-induced pancreatitis, nicardipine-induced AV block, severe skin reactions, and NSAID-induced bronchospasm, are described. Basically, this method consists of assembling series of cases systematically, and is therefore devoid of selective bias. In addition, it allows a more in-depth clinical and anamnesic study of specific diseases, as compared with voluntary reporting.
Ibáñez
L
L
Servei de Farmacologia Clínica, HU Vall d'Hebron, Universitat Autonoma de Barcelona, Spain.
Laporte
J R
JR
Carné
X
X
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064420:Drug-Related Side Effects and Adverse Reactions; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011358:Product Surveillance, Postmarketing / Q000379:methods*