Epidemiological Studies of Adverse Drug Reactions

Seidl, Larry G.; Thornton, George F.; Cluff, Leighton E.

doi:10.2105/ajph.55.8.1170

Cited by 94 publications

(28 citation statements)

References 2 publications

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“…In another study, Seidl et al 2 conducted an active search for events and estimated their frequency at 13.6% among inpatients. Since then, numerous studies have been published, although with widely varying estimates of frequency.…”

Section: Introductionmentioning

confidence: 99%

Adverse drug events in hospitals: a systematic review

Cano

Rozenfeld

2009

Cad. Saúde Pública

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Section: Introductionmentioning

confidence: 99%

Adverse drug events in hospitals: a systematic review

Cano

Rozenfeld

2009

Cad. Saúde Pública

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“…The contribution of drug related hospital admissions (DRH) to the admission rates of medical wards has been the subject of a number of studies (Bergman & Wiholm, 1981; Caranasos et al, 1974;Ghose, 1980;Hallas et al, 1990aHallas et al, ,b, 1991Hurwitz, 1969;Levy et al, 1980;Miller, 1974;Seidl et al, 1966). Quite varying results have been reported.…”

Section: Introductionmentioning

confidence: 99%

Drug related admissions to medical wards: a population based survey.

Hallas¹,

Gram²,

Grodum³

et al. 1992

Brit J Clinical Pharma

185

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1. In total 1999 consecutive admissions to six medical wards were subjected to a prospective high‐intensity drug event monitoring scheme to assess the extent and pattern of admissions caused by adverse drug reactions (ADRs) or dose related therapeutic failures (TF), in a population‐based design. The wards were sub‐specialised in general medicine, geriatrics, endocrinology, cardiology, respiratory medicine and gastroenterology. 2. Considering definite, probable and possible drug events, the prevalence of drug related hospital admissions was 11.4% of which 8.4% were caused by ADRs and 3.0% by TFs. There were large inter‐department differences. 3. The six classes of drugs most frequently involved in admissions caused by ADRs were anti‐rheumatics and analgesics (27%), cardiovascular drugs (23%), psychotropic drugs (14%), anti‐diabetics (12%), antibiotics (7%), and corticosteroids (5%). Noncompliance accounted for 66% of the TFs with diuretics and anti‐asthmatics most frequently involved. 4. The pattern of drugs involved in ADRs was compared with the regional drug sales statistics. Drugs with a particularly high rate of ADR related admissions per unit dispensed were nitrofurantoin and insulin (617 and 182 admissions per 1,000,000 defined daily doses), while low rates were seen for diuretics and benzodiazepines (10 and 7 admissions per 1,000,000 defined daily doses). Confidence intervals were wide. 5. Patients who had their therapy prescribed by a hospital doctor had a slightly higher prevalence of drug events than those who were treated by a general practitioner (12.6% vs 11.8%). The reverse applied for drug events assessed as avoidable (3.3% vs 4.6%). Although these differences were not statistically significant, it may suggest general practitioners as the appropriate target for interventive measures.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…However, hyponatremia may occur late in the course of treatment with SSRIs. Ratio of spontaneous reports is identical for hyponatremia or SIADH by WHO, on any of SSRIs (47). Predisposing factors, including volume, taking diuretics, or concomitant use of other drugs that cause SIADH, may predispose an individual to hyponatremia (10).…”

Section: Discussionmentioning

confidence: 95%

“…For this patient, diazepam was prescribed. It is suggested to prescribe Cyproheptadine for patients in moderate and severe cases, although there are no randomized controlled trials about severe cases (47,48). Diazepam is a GABA mimetic, which has been studied more and blunts the hyper-adrenergic symptoms of serotonin syndrome (42,49,50).…”

Section: Discussionmentioning

confidence: 99%

Concurrent Serotonin Syndrome and Hyponatremia: A Case Report and Review

Elyasi

Azizi

2017

Iran J Psychiatry Behav Sci

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Introduction: These days, selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed and used antidepressants. Serotonin syndrome is a potentially fatal complication with hyper-serotonergic situation. Its symptoms result from over activation of the central and peripheral receptors caused by high serotonin levels. The use of SSRIs is associated with the frequency of syndrome. Hyponatremia is one of the side effects of SSRIs, especially in elderly patients. The mechanism by which SSRIs cause hyponatremia is thought to be secondary to the development of the syndrome of inappropriate antidiuretic hormone (SIADH). Patients with hyponatremia secondary to SIADH have been reported with fluoxetine, paroxetine, sertraline, fluvoxamine, and citalopram. There are very few reports about the concurrent incidence of serotonin syndrome and hyponatremia. Case Presentation: The patient was a 66-year-old woman with rheumatoid arthritis. She was treated with a fixed dose of fluoxetine and buspirone added with the amount of 15 mg per day. The patient was hospitalized 8 weeks with symptoms of confusion, lack of insight into time and space, inability to stand and walk, continuous involuntary tremor, uncoordinated and uncontrolled movements of arms and legs, hyperreflexia, and mydriasis. She also showed severe hyponatremia in the experiments. She was admitted to an academic general hospital in Iran on 2014. Based on the clinical findings, taking buspirone aside fluoxetine, as well as old age of the patient, she was diagnosed with serotonin syndrome. Treatment was carried out after discontinuation of fluoxetine and buspirone, restriction of fluid therapy, as well as prescription of sodium chloride 5%, cyproheptadine, and diazepam. Conclusions: Consumers of SSRIs are at a higher risk of hyponatremia compared to those taking other antidepressants, especially if they are simultaneously treated by diuretics. Hyponatremia and SIADH need to be considered if a patient experiences disorientation receiving SSRIs. Physicians should be aware of the probability of acute hyponatremia and serotonin syndrome secondary to SSRIs in simultaneous use of fluoxetine and buspirone with diuretics. Moreover, physicians should note that serotonin toxicity is dose-dependent rather than idiosyncratic.

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Epidemiological Studies of Adverse Drug Reactions

Cited by 94 publications

References 2 publications

Adverse drug events in hospitals: a systematic review

Adverse drug events in hospitals: a systematic review

Drug related admissions to medical wards: a population based survey.

Concurrent Serotonin Syndrome and Hyponatremia: A Case Report and Review

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