Assessment of Adverse Effects of Most Commonly Prescribed Anticancer Drugs in a Tertiary Care Teaching Hospital

Abstract

Background: Chemotherapeutic agents account for high inclination towards adverse drug reactions due to its narrow therapeutic window, increased toxicity and highly complex regimen making pharmacovigilance studies essential in oncology. Aim:The aim of the study is to assess the adverse effects of most commonly prescribed anticancer drugs in a tertiary care teaching hospital and to evaluate its causality, severity and preventability. Materials and methods: A prospective observational study was conducted on 200 patients taking chemotherapy in oncology unit. Patient information was obtained using a data collection form and data was collected using a structured questionnaire. Assessment of adverse drug reactions were analyzed using WHO -UMC causalilty assessment scale, Hartwig -Siegel severity assessment scale and modified schumock and thornton preventability scale. Results: Cyclophosphamide (10.62%) was the most commonly prescribed anticancer drug. A total of 450 ADRs were observed from 109 patients. Females (60.55%) were more prone to ADRs than males. The most frequent adverse reaction was vomiting (10%) followed by anaemia (9.11%), alopecia (7.11%), fatigue (6.67%). WHO causality assessment scale showed 45.78% of the reactions to be "possible", 40.44% to be "probable", 12.89% to be "unlikely" and 0.89% to be "certain". Modified Hartwig and Siegel scale showed most reactions, 54.13% to be mild, 44.95% to be moderate and 0.92% to be severe reactions. According to modified Schumock and Thornton scale, 46.22% of the ADRs were "definitely preventable", 20.67% were "probably preventable" and 33.11% were "not preventable". Conclusion: Chemotherapeutic agents are highly associated with adverse reactions. Measures should be undertaken to improve ADR monitoring and reporting, thereby decrease the incidence of ADR, improve patient's quality of life and ensure safe use of drugs.

<p>Chemotherapy-Related Adverse Drug Reaction and Associated Factors Among Hospitalized Paediatric Cancer Patients at Hospitals in North-West Ethiopia</p>

“…This is due to the fact that most of the study population in our study took cyclophosphamide, doxorubicin, and vincristine based drug regimen that have a higher risk of emetogenic effect. A consistent finding was also reported from the Kumaun region (17.5%), 5 West Rajasthan (10.34%), 38 and North Eastern parts of India (15.09%). 40 Among the different type of cancer, almost a quarter of ADRs, 23.8% (95% CI: 16.9-30.7%) were reported from patient diagnoses with acute lymphoblastic leukaemia (ALL).…”

“…2 It affects the recovery rate of patients and decreases the quality of life. [3][4][5][6] The effect of drug reaction given for treatment varies from a simple inconvenience to permanent disability and death. 7 As a result of its health implications, it has become one of the major causes of morbidity associated with higher hospital admission rates and poor outcomes of treatment.…”

“…4,9 The World Health Organization (WHO), aware of the burden of the problem, has set up a pharmacovigilance system to detect, assess and prevent adverse drug reactions. 5,36,37 Thirty-five African countries, including Ethiopia, cumulatively submitted almost 103,499 ADR cases to the global pharmacovigilance database in this system up to 2015, representing only 0.88% of global ADRs. 36 The prevalence of chemotherapy-related ADRs and associated risk factors in paediatric cancer patients in Ethiopia, where selfmedication and poor adherence to treatment is high, is not well studied.…”

Adverse Drug Reaction Monitoring of Anticancer Drugs in Hematology Department

“…-To monitor ADRs in the Indian population -To create awareness among healthcare professionals about the importance of ADRs reporting in India -To generate independent evidence-based recommendations on the safety of medicines -To monitor benefit-risk profiles of medicines among others [8][9][10].…”

Nutraceuticals and Herbals as Adjuvants in the Chemotherapy of Cancer? A Review

“…In India, there are no extensive published data regarding the adverse effects of anticancer agents [4]. The cancer patients immensely suffered from adverse effects since chemotherapy regimens are highly complicated, and oncology patients are the inclined population with little tolerance [5]. The most common anticancer drugs causing adverse effects are imatinib, docetaxel, gemcitabine, paclitaxel, oxaliplatin, capecitabine, 5-fluorouracil, vincristine, 6-mercaptopurine, and gefitinib [6] which can cause cardiovascular toxicity, hepatotoxicity, neurotoxicity, nephrotoxicity gastrointestinal toxicity, and dermatological toxicity [7].…”