title: Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care hospital in South India.
abstract: OBJECTIVE
  Studies regarding pattern of adverse drug reactions (ADRs) in cancer chemotherapy patients are scarce in India. This study was conducted to evaluate the pattern of occurrence of ADRs due to cancer chemotherapy in hospitalized patients and to assess the causality, severity, predictability, and preventability of these reactions.
  
  
  METHODS
  This was a retrospective, descriptive study and the occurrence and nature of ADR, suspected drug, duration of hospital stay and outcome were noted from case records. These ADRs were assessed for causality using both World Health Organization (WHO) causality assessment scale and Naranjo's algorithm. The severity and preventability of the reported reactions were assessed using modified Hartwig and Siegel scale and modified Schumock and Thornton scale respectively.
  
  
  RESULTS
  Five hundred ADRs were recorded from 195 patients. Most common ADRs were infections (22.4%), nausea/vomiting (21.6%) and febrile neutropenia (13%). Platinum compounds, nitrogen mustards, taxanes, antibiotics and 5-fluorouracil were the most common drugs causing ADRs. WHO causality assessment scale showed 65% of the reactions to be "probable" and 35% to be "possible", while Naranjo's algorithm indicated that 65.6% of ADRs were "probable" and 34.4% were "possible". Modified Hartwig and Siegel scale showed most reactions (41.4%) to be of "moderate level 4(a)" severity, while 30.6% of reactions were of "mild level 1" severity. About 30.8% of the ADRs were "definitely preventable" according to the modified Schumock and Thornton scale.
  
  
  CONCLUSIONS
  ADRs are most important causes of morbidity and mortality and increase the economic burden on patient and society. By careful ADR monitoring, their incidence can be decreased.
authors: Department of Pharmacology, Pondicherry Institute of Medical Sciences, Puducherry, India.
authors: Ajitha
authors: A
authors: Sharma
authors: Department of Pharmacology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India.
authors: K Meena
authors: KM
authors: Kumari
authors: Department of Pharmacology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India.
authors: Hasitha Diana
authors: HD
authors: Manohar
authors: Department of Pharmacology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India.
authors: K L
authors: KL
authors: Bairy
authors: Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India.
authors: Joseph
authors: J
authors: Thomas
keywords: Adverse drug reactions; causality; chemotherapy; pharmacovigilance