An assessment of pattern of adverse drug reactions of cardiovascular drugs in a tertiary care institute

Abstract

INTRODUCTIONWorldwide, the number of deaths from cardiovascular diseases (CVDs) was estimated at 17.3 million per year, and it is expected to increase to approximately 23.6 million patients by 2030.1 While the prevalence and mortality due to CHD is declining in the developed nations the same cannot be held true for developing countries. There has been an alarming increase over the past two decades in the prevalence of CHD and cardiovascular mortality in India and other south Asian countries. 2 The incidence of cardiovascular diseases has been increasing in recent decade. It is the most common cause of death in the developed as well as developing countries. Over 30% of all deaths every year attributed to cardiovascular disease. Currently, important interventions to prevent and to treat CVD are available, e.g. pharmacological treatment of elevated low density lipoprotein (LDL) cholesterol levels elevated blood pressure and inhibiting platelet function with statins, anti-hypertensive agents (thiazides, beta blockers, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, or angiotensin II receptor blockers (ARBs), etc. and antiplatelet agents e.g. Low dose aspirin, respectively. [4][5][6][7][8][9] In this scenario, the large number of cardiovascular agents are used in population worldwide. Considering the increased use of cardiovascular drugs and its limitations in pre-marketing ABSTRACT Background: Cardiovascular disease is very prevalent in India. So, use of cardiovascular drugs is also more. So, it is very important to keep watch on adverse drug reactions. Aim of this study was to assess the pattern of adverse drug reactions (ADRs) reported with cardiovascular drugs in a tertiary care institute. Methods: The study was carried out in medicine department of a tertiary care hospital over a period of one year. Each ADR was analysed for demographic data, causality, relationship between frequency of ADRs and the number of drugs used etc. In statistical analysis Microsoft excel 2013, SPSS software was used. Results: A total of 136 patients, 58 (43%) men and 78 (57%) women, using cardiovascular medications reported ADRs during the entire study period. Total 168 ADRs were reported out of which, Amlodipine (causing headache and edema feet) was the most common drug with 51 (30.3%) ADR's followed by Enalapril, Aspirin and Isosorbide Dinitrate with 37 (22%), 24 (14.2%), 23 (13.6%) ADRs respectively. Most common ADR was headache (due to amlodipine and Isosorbide di nitrate) affecting 38 (22.62%) cases followed by dry cough 37 (22.02%) cases, edema feet 36 (21.43%), gastritis 24 (14.29%) and 10 (5.95%) of nausea. Conclusions: Monitoring ADRs in patients using cardiovascular drugs is a matter of importance since this class of medicines are mostly used as multidrug therapy and always prone for ADRs.

Pattern of Pharmacotherapy and Assessment of Drug Related Problems in Ischemic Heart Disease Patients

“…This finding is similar to the study done by Wankhede et al, where they report the most ADRs were scored as possible (96%). 42 Most of the patients had moderate ADRs (60%) and mild (40%) according to severity scale which is comparable to the study conducted by Sriram S et al, where they observed the severity of 49% of reactions (using Hartwig scale) was reported as moderate. 43 Most of the ADRs were not preventable (60%) followed by preventable (40%) according to the Schumock and Thornton.…”

Identifikasi Penyebab ADR (Adverse Drug Reactions) pada Pasien CHF (Congestive Heart Failure)

“…Gagal jantung kongestif adalah sindrom klinis progresif yang disebabkan oleh ketidakmampuan jantung dalam memompa darah untuk memenuhi kebutuhan metabolisme tubuh (Wells, Dipiro, Schwinghammer, & Dipiro, 2015). Gagal jantung adalah sindrom yang umum, membutuhkan biaya yang mahal dan dapat menyebabkan kelemahan bagi pasienn yang dikaitkan dengan rejimen obat yang sangat kompleks dan banyaknya komorbiditas (Wankhede, Pardeshi, Ghorpade, & Ghongane, 2018) Obat-obat yang digunakan untuk penatalaksanaan penyakit kardiovaskular tidak serta merta tanpa efek samping, tetapi justru dapat menyebabkan konsekuensi yang merugikan jika tidak dipantau dengan benar. Meningkatnya jumlah obat pada pasien jantung menimbulkan adanya kecenderungan untuk menyebabkan masalah terkait obat seperti ADRs, interaksi obat antar obat, dll.…”