Biomaterial Database

Admissions to a medical intensive care unit related to adverse drug reactions. 2007

Anastasia Rivkin

Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, NY 11201, USA. anastasia.rivkin@liu.edu

OBJECTIVE The frequency, severity, and preventability of adverse drug reactions (ADRs) leading to admission in a medical intensive care unit (MICU) were studied. METHODS A prospective consecutive 19-week observational study was conducted between December 2004 and May 2005 in the department of critical care medicine at a tertiary care teaching hospital. Patients admitted to the MICU because of an ADR were followed prospectively until hospital discharge or death. The causality, severity, and preventability of each ADR were determined. Duration of MICU stay and overall duration of hospital stay were also assessed. RESULTS A total of 281 patients were admitted to the MICU over the 19-week study period. Of these, 21 (7.5%) admissions were ADR related. Of the 21 ADRs analyzed, 3 (14%) were moderate, 14 (67%) were severe, and 4 (19%) were fatal. A total of 18 ADRs (86%) were deemed preventable. Drug interactions were the cause of 12 ADRs (57%), 100% of which were preventable. Aspirin was the most commonly implicated medication (28.6%). Bleeding was the most common ADR admission diagnosis (gastrointestinal bleeding accounted for 33% of all ADRs). ADR-related admissions resulted in an additional 119 total days of MICU stay and an additional 114 days of medical ward stay. CONCLUSIONS The majority of the ADRs for which patients were admitted to an MICU were deemed preventable. Bleeding caused by some combination of nonsteroidal antiinflammatory drugs (NSAIDs), cyclooxygenase-2-selective NSAIDS, aspirin, and clopidogrel was the most common reason for ADR-related MICU admissions.

UI	MeSH Term	Description	Entries
D007362	Intensive Care Units	Hospital units providing continuous surveillance and care to acutely ill patients.	ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D008297	Male		Males
D010975	Platelet Aggregation Inhibitors	Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.	Antiaggregants, Platelet,Antiplatelet Agent,Antiplatelet Agents,Antiplatelet Drug,Blood Platelet Aggregation Inhibitor,Blood Platelet Antagonist,Blood Platelet Antiaggregant,PAR-1 Antagonists,Platelet Aggregation Inhibitor,Platelet Antagonist,Platelet Antagonists,Platelet Antiaggregant,Platelet Antiaggregants,Platelet Inhibitor,Protease-Activated Receptor-1 Antagonists,Antiplatelet Drugs,Blood Platelet Aggregation Inhibitors,Blood Platelet Antagonists,Blood Platelet Antiaggregants,Platelet Inhibitors,Agent, Antiplatelet,Aggregation Inhibitor, Platelet,Antagonist, Blood Platelet,Antagonist, Platelet,Antiaggregant, Blood Platelet,Antiaggregant, Platelet,Drug, Antiplatelet,Inhibitor, Platelet,Inhibitor, Platelet Aggregation,PAR 1 Antagonists,Platelet Antagonist, Blood,Platelet Antiaggregant, Blood,Protease Activated Receptor 1 Antagonists
D005260	Female		Females
D006470	Hemorrhage	Bleeding or escape of blood from a vessel.	Bleeding,Hemorrhages
D006760	Hospitalization	The confinement of a patient in a hospital.	Hospitalizations
D006784	Hospitals, Teaching	Hospitals engaged in educational and research programs, as well as providing medical care to the patients.	Hospital, Teaching,Teaching Hospital,Teaching Hospitals
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077144	Clopidogrel	A ticlopidine analog and platelet purinergic P2Y receptor antagonist that inhibits adenosine diphosphate-mediated PLATELET AGGREGATION. It is used to prevent THROMBOEMBOLISM in patients with ARTERIAL OCCLUSIVE DISEASES; MYOCARDIAL INFARCTION; STROKE; or ATRIAL FIBRILLATION.	Clopidogrel Besilate,Clopidogrel Besylate,Clopidogrel Bisulfate,Clopidogrel Hydrochloride,Clopidogrel Napadisilate,Clopidogrel Sandoz,Clopidogrel, (+)(S)-isomer,Clopidogrel-Mepha,Iscover,PCR 4099,PCR-4099,Plavix,SC 25989C,SC 25990C,SR 25989,Clopidogrel Mepha
D000894	Anti-Inflammatory Agents, Non-Steroidal	Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions. They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.	Analgesics, Anti-Inflammatory,Aspirin-Like Agent,Aspirin-Like Agents,NSAID,Non-Steroidal Anti-Inflammatory Agent,Non-Steroidal Anti-Inflammatory Agents,Nonsteroidal Anti-Inflammatory Agent,Anti Inflammatory Agents, Nonsteroidal,Antiinflammatory Agents, Non Steroidal,Antiinflammatory Agents, Nonsteroidal,NSAIDs,Nonsteroidal Anti-Inflammatory Agents,Agent, Aspirin-Like,Agent, Non-Steroidal Anti-Inflammatory,Agent, Nonsteroidal Anti-Inflammatory,Anti-Inflammatory Agent, Non-Steroidal,Anti-Inflammatory Agent, Nonsteroidal,Anti-Inflammatory Analgesics,Aspirin Like Agent,Aspirin Like Agents,Non Steroidal Anti Inflammatory Agent,Non Steroidal Anti Inflammatory Agents,Nonsteroidal Anti Inflammatory Agent,Nonsteroidal Anti Inflammatory Agents,Nonsteroidal Antiinflammatory Agents