Monitoring abnormal laboratory values as antecedents to drug-induced injury.
BACKGROUND
Clinical abnormalities associated with drug therapy may lead to injury if untreated. Detection of preceding drug-related hazardous conditions (DRHCs) may provide the opportunity to prevent injury. This study evaluated the frequency of abnormal laboratory values attributed to the effect of drugs.


METHODS
A total of 590 patients consecutively admitted to a surgical intensive care unit during a 3-month period were prospectively studied. Serum electrolyte, platelet, creatinine, glucose, magnesium, and liver enzyme concentrations were classified as either normal or abnormal using standard criteria. DRHCs were abnormal laboratory results determined to be caused by drugs.


RESULTS
DRHCs were detected in 16.4% of patients, reflecting a rate of 47 events per 1,000 patient days. 66%, 22%, and 12% of DRHCs were categorized as either definite, probable, or possible, respectively. In 97% of suspected DRHCs, clinicians responded by ordering additional laboratory tests or changing drug regimens.


CONCLUSIONS
Monitoring laboratory values and assessing the association to medications may reduce the risk of injury consequent to adverse drug events.
Kane-Gill
Sandra L
SL
Department of Pharmacy and Therapeutics, University of Pittsburgh, Pittsburgh, Pennsylvania 15101, USA. KaneSL@msx.upmc.edu
Dasta
Joseph F
JF
Schneider
Philip J
PJ
Cook
Charles H
CH
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003404:Creatinine / Q000097:blood*; D003422:Critical Care; D064420:Drug-Related Side Effects and Adverse Reactions / Q000097:blood*; D004573:Electrolytes / Q000097:blood*; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies
D001786:Blood Glucose; D004573:Electrolytes; D003404:Creatinine