Adverse Drug Reactions Of Cardiovascular Drugs In Intensive Cardiac Care Unit In A Tertiary Care Hospital: A Prospective Study

Abstract

Cardiovascular diseases are prevalent in developing countries like India. Patients with cardiovascular diseases are prescribed multiple drugs, hence polypharmacy may attribute to higher incidence of adverse drug reactions in these patients. To monitor and to analyze the pattern of occurrence of adverse drug reactions reported with cardiovascular drugs in intensive cardiac care unit of a tertiary care hospital, Chennai. This was a prospective surveillance study carried out for a period of 6 months. Analysis of various adverse drug reactions reported were done using various assessment scales. Descriptive statistics was used and values were expressed in numbers and percentage. During the study period, 282 adverse reactions were reported from 389 patientsat includes 232 males and 157 females. The average age of the patients included in this study was 58.1± 16.8 years . The most common ADRs observed were electrolyte imbalance (14.89%), headache (13.12%) and gastritis (12.41%). Assessment using WHO Causality assessment scale revealed 60.28% were possible, 18.43% probable, 12.76% certain and 8.51% unlikely. According to Schumock and Thornton scale 65.9% of ADRs were preventable and 34% non preventable. Analysis with Hartwig and Seigel’s scale 62.05% of ADRs were moderate in severity, 27.95% mild and 10.99% severe. Drugs attributing to highest ADRs were Digoxin and Furosemide. The common ADRs due to cardiovascular drugs can be reduced by improving the prescription pattern. Intense monitoring and reporting of ADRs could help in minimizing the preventable ADRs, among the health care professionals.

Prevalence and factors associated with adverse drug reactions among heart failure patients hospitalized at Mbarara Regional Referral Hospital, Uganda

“…In our study, hypotension (11.5%) was mainly caused by the combination of anti-hypertensive agents and IV diuretics. This was in line with previous studies [ 23 , 37 , 43 ].…”

“…Over half (52.4%) of the ADRs were mild, while 40.2 and 7.3% were moderate and severe, respectively. The proportion of severe ADRs in this study was comparable with previous studies of 10.9% & 13.5% in India [ 23 , 37 ], 9.1% in UAE [ 43 ] and 4.9% in Italy [ 39 ].…”

“…The Naranjo causality scale rated over two-thirds (71.9%) of the ADRs as probable. The probable causality was considerably higher than those in other studies including, 58.3% in UAE [ 17 ], 56.7% & 18.4% in India [ 23 , 37 ], and 33.3% in Iran [ 40 ]. Additionally, Lupitaningrum et al reported 41.9% of probable ADRs in Indonesia among hospitalized HF patients [ 38 ].…”

“…In the current study, almost two-thirds (59.3%) of the HF patients had at least one ADR during their hospital stay. The current prevalence is comparable with 53.2% [ 37 ] and 67% [ 23 ] in India and 69% in Indonesia [ 38 ].…”

“…Additionally, Lupitaningrum et al reported 41.9% of probable ADRs in Indonesia among hospitalized HF patients [ 38 ]. The deviation with some of the studies could possibly be because of the method used to assess the causality, which was the WHO classification of causality [ 37 , 40 ]. In the present study, however, daily monitoring of patients, laboratory investigation review, and physical assessment added an objective proof for the ADRs and increased the probability of ADRs.…”