Monitoring of adverse drug reactions associated with antihypertensive medicines at a university teaching hospital in New Delhi

Abstract

AimTo monitor the adverse drug reactions (ADRs) caused by antihypertensive medicines prescribed in a university teaching hospital.MethodsThe present work was an open, non-comparative, observational study conducted on hypertensive patients attending the Medicine OPD of Majeedia Hospital, Jamia Hamdard, New Delhi, India by conducting patient interviews and recording the data on ADR monitoring form as recommended by Central Drugs Standard Control Organization (CDSCO), Government of India.ResultsA total of 21 adverse drug reactions were observed in 192 hypertensive patients. Incidence of adverse drug reactions was found to be higher in patients more than 40 years in age, and females experienced more ADRs (n = 14, 7.29%) than males, 7 (3.64%). Combination therapy was associated with more number of adverse drug reactions (66.7%) as against monotherapy (33.3%). Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n = 7), followed by diuretics (n = 5), and β-blockers (n = 4). Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 7), followed by torasemide (n = 3). Adverse drug reactions associated with central nervous system were found to be the most frequent (42.8%) followed by musculo-skeletal complaints (23.8%) and gastro-intestinal disorders (14.3%).ConclusionsThe present pharmacovigilance study represents the adverse drug reaction profile of the antihypertensive medicines prescribed in our university teaching hospital. The above findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions.

Adverse drug reaction profile and prescription pattern of antihypertensive drug monotherapy at tertiary care hospital Nepalgunj, Nepal

“…Among all amlodipine was most commonly prescribed drug. These findings were similar to the study of Kumar et al, Khursid et al, Paudel et al, and Madhwar et al 4,5,9,16 In present study side effect gastro oesophageal reflux disease (GERD) was seen in 2 patients among amlodipine user. It is uncommon side effect noticed.…”

“…These side effects could be related to the fluid or electrolytes imbalance caused by these medicines, due to sodium ions depletion. 5 The side effects experienced by enalapril users were dry cough and urticaria. The cough is typically irritating, dry and non-productive and is not dose related.…”

“…International attention to patient safety has been growing significantly since the publication of the US Institute of Medicine report "To err is human: building a safer health system". 5 Hypertension is usually asymptomatic yet requires long-term therapy, consideration of potential undesirable effects of drugs used for its treatment is important for making the appropriate choice. In this context, a precise understanding of the efficacy and typical adverse reaction profiles of the different drugs is essential.…”

Adverse drug reactions of antihypertensive agents at tertiary care hospital in central Nepal

“…Among individual drugs amlodipine was found to be the commonest drug associated with ADRs (31.34%) with one third of total number of reported ADRs. 7,13 The most common systems associated with ADRs in our study were the CVS followed by CNS, respiratory and dermatological system. Similar finding was observed by Kumar et al 21 and Ahmad et al 22 The common complaints with the usage of amlodipine were: pedal oedema, postural hypotension dizziness, perspiration, fatigue, flushing and constipation.…”

“…These side effects could be related to the fluid or electrolytes imbalance caused by these medicines, due to sodium ions depletion. 7,27 Gynecomastia (three cases) and fatigue were observed with spironolactone. Spironolactone enhances the peripheral metabolism of testosterone resulting in increase in the ratio of conversion of testosterone to estradiol and by displacing estradiol from sex hormone binding globulin, increases both total and free estrogen levels .…”