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Adverse drug events in an intensive care unit of a university hospital

European Journal of Clinical Pharmacology volume 67, pages 625–632 (2011)Cite this article

Abstract

Purpose

Adverse drug events (ADEs) are harmful and occur with alarming frequency in critically ill patients. Complex pharmacotherapy with multiple medications increases the probability of a drug interaction (DI) and ADEs in patients in intensive care units (ICUs). The objective of the study is to determine the frequency of ADEs among patients in the ICU of a university hospital and the drugs implicated. Also, factors associated with ADEs are investigated.

Methods

This cross-sectional study investigated 299 medical records of patients hospitalized for 5 or more days in an ICU. ADEs were identified through intensive monitoring adopted in hospital pharmacovigilance and also ADE triggers. Adverse drug reactions (ADR) causality was classified using the Naranjo algorithm. Data were analyzed through descriptive analysis, and through univariate and multiple logistic regression.

Results

The most frequent ADEs were ADRs type A, of possible causality and moderate severity. The most frequent ADR was drug-induced acute kidney injury. Patients with ADEs related to DIs corresponded to 7% of the sample. The multiple logistic regression showed that length of hospitalization (OR = 1.06) and administration of cardiovascular drugs (OR = 2.2) were associated with the occurrence of ADEs.

Conclusion

Adverse drug reactions of clinical significance were the most frequent ADEs in the ICU studied, which reduces patient safety. The number of ADEs related to drug interactions was small, suggesting that clinical manifestations of drug interactions that harm patients are not frequent in ICUs.

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Affiliations

  1. Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Adriano Max Moreira Reis

  2. Ribeiro Preto College of Nursing, University of São Paulo, Ribeiro Preto, SP, Brazil

    Silvia Helena De Bortoli Cassiani

Authors
  1. Adriano Max Moreira Reis
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  2. Silvia Helena De Bortoli Cassiani
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Correspondence to Adriano Max Moreira Reis.

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Reis, A.M.M., Cassiani, S.H.D.B. Adverse drug events in an intensive care unit of a university hospital. Eur J Clin Pharmacol 67, 625–632 (2011). https://doi.org/10.1007/s00228-010-0987-y

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  • DOI: https://doi.org/10.1007/s00228-010-0987-y

Keywords

  • Drug interactions
  • Intensive care units
  • Safety management
  • Adverse effect
  • Drug therapy
  • Adverse drug event