Factors affecting the development of adverse drug reactions to β-blockers in hospitalized cardiac patient population

Abstract

The aim of the present study was to undertake a study on the prevalence of cytochrome P450 2D6 (CYP2D6) poor metabolizer alleles (*3, *4, *5, and *6) on a Montenegrin population and its impact on developing adverse drug reactions (ADRs) of β-blockers in a hospitalized cardiac patient population. A prospective study was conducted in the Cardiology Center of the Clinical Center of Montenegro and included 138 patients who had received any β-blocker in their therapy. ADRs were collected using a specially designed questionnaire, based on the symptom list and any signs that could point to eventual ADRs. Data from patients’ medical charts, laboratory tests, and other available parameters were observed and combined with the data from the questionnaire. ADRs to β-blockers were observed in 15 (10.9%) patients. There was a statistically significant difference in the frequency of ADRs in relation to genetically determined enzymatic activity (P<0.001), with ADRs’ occurrence significantly correlating with slower CYP2D6 metabolism. Our study showed that the adverse reactions to β-blockers could be predicted by the length of hospitalization, CYP2D6 poor metabolizer phenotype, and the concomitant use of other CYP2D6-metabolizing drugs. Therefore, in hospitalized patients with polypharmacy CYP2D6 genotyping might be useful in detecting those at risk of ADRs.

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“…For instance, aspirin is capable of increasing the risk of bleeding 4 ; the use of statins produces problems in muscle and liver 5,6 ; side-effects associated with the use of β-blockers include bradycardia, dizziness, headache, hypotension, cold lower extremities, and so forth. 7 There is unmet need to better understand of IHD, which will be helpful for development of innovative drugs for treating this disease.…”

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“…[ 11 ] In addition, combination of multiple medications increases the risk of adverse reactions in the patients. [ 13 , 14 ] Therefore, it is essential to find a method that can treat CHF effectively with less side effects.…”