[Detection and analysis of adverse drug reactions in a general hospital's emergency department]. / Detección y análisis de reacciones adversas a medicamentos en el servicio de urgencias de un hospital general.

OBJECTIVE: To detect and analyze adverse drug reactions (ADR) leading to emergency room visits in our hospital, as well as their severity and outcome, and medications most commonly involved, from selected alerting diagnoses. METHOD: A retrospective study for the period from January 2003 to December 2004, where all reports by the emergency department including our wanted diagnoses were reviewed. RESULTS: A total of 1,626 reports with alerting diagnoses were found, of which 444 (27.3%) were confirmed as potential adverse drug reactions. Of 444 cases, 345 (77.7%) were discharged to their homes and 90 (20%) were admitted. In all, 52.9% of adverse drug reactions were considered moderate, and 19.6% were considered serious. The major age group involved was that of patients older than 65 years (65.1%), and was involved in 83.9% of adverse drug reactions. Drugs most commonly involved included insulins (26.1%), diuretics (17.3%), digoxin (10.9%), and oral antidiabetics (9.5%). Major organs and systems involved included the endocrine system (55.6%), musculoskeletal system (11%) and cardiovascular system (10.8%). CONCLUSIONS: Drugs commonly used in clinical practice, including insulins, diuretics or oral antidiabetics induce many of the adverse reactions that lead patients to visit emergency departments. A closer monitoring of therapies is still needed to prevent adverse drug reactions.

Detección y análisis de reacciones adversas a medicamentos en el servicio de urgencias de un hospital general / Detection and analysis of adverse drug reactions in a general hospital's emergency department

Objetivo: Detectar y analizar a partir de unos diagnósticos alertantes seleccionados las reacciones adversas a medicamentos (RAM) que ocasionaron consultas al servicio de urgencias de nuestro hospital, su gravedad y la evolución de los pacientes afectados, así como los fármacos más comúnmente implicados en las mismas. Método: Estudio retrospectivo perteneciente al periodo enero 2003-diciembre 2004, en el que se revisaron todos aquellos informes elaborados por el servicio de urgencias en los que figuraban los diagnósticos buscados. Resultados: Se encontraron un total de 1.626 informes con los diagnósticos alertantes, de los cuales 444 (27,3%) se confirmaron como posibles reacciones adversas a medicamentos. De los 444 casos, 345 (77,7%) recibieron el alta domiciliaria y 90 (20%)fueron ingresados. El 52,9% de las reacciones adversas fueron consideradas moderadas y el 19,6% graves. El principal grupo de edad afectado fue el de los mayores de 65 años (65,1%) y estuvo implicado en el 83,9% de las reacciones adversas graves. Los fármacos más comúnmente implicados fueron las insulinas (26,1%), los diuréticos (17,3%), la digoxina (10,9%) y los antidiabéticos orales (9,5%). Los principales órganos y aparatos afectados fueron el sistema endocrino (55,6%), el aparato músculo esquelético (11%) y el aparato cardiovascular (10,8%). Conclusiones: Fármacos de uso muy habitual en la práctica clínica como las insulinas, diuréticos o antidiabéticos orales ocasionan muchas de las reacciones adversas que llevan a los pacientes a los servicios de urgencias. El control más estrecho de los tratamientos sigue siendo necesario para prevenir la aparición de reacciones adversas a medicamentos

Objective: To detect and analyze adverse drug reactions (ADR) leading to emergency room visits in our hospital, as well as their severity and outcome, and medications most commonly involved, from selected alerting diagnoses. Method: A retrospective study for the period from January 2003 to December 2004, where all reports by the emergency department including our wanted diagnoses were reviewed. Results: A total of 1,626 reports with alerting diagnoses were found, of which 444 (27.3%) were confirmed as potential adverse drug reactions. Of 444 cases, 345 (77.7%) were discharged to their homes and 90 (20%) were admitted. In all, 52.9% of adverse drug reactions were considered moderate, and 19.6% were considered serious. The major age group involved was that of patients older than 65 years (65.1%), and was involved in 83.9% of adverse drug reactions. Drugs most commonly involved included insulins (26.1%), diuretics (17.3%), digoxin (10.9%), and oral antidiabetics (9.5%). Major organs and systems involved included the endocrine system (55.6%), musculo skeletal system (11%) and cardiovascular system (10.8%). Conclusions: Drugs commonly used in clinical practice, including insulins, diuretics or oral antidiabetics induce many of the adverse reactions that lead patients to visit emergency departments. A closer monitoring of therapies is still needed to prevent adverse drug reactions