Caracterización de las reacciones adversas a medicamentos como causa de ingreso a una unidad de cuidado intermedio en un hospital de tercer nivel de atención
Thesis
Objective: To determine the occurrence of adverse drug reactions (ADR) as a cause for admittance to an intermediate care unit in a university hospital. Materials and Methods: Clinical histories were reviewed for patients admitted to the Emergency Room – Intermediate Care Unit (ER) between September and December 2012 who met the inclusion criteria. Suspected cases of adverse drug reactions (ADR) were detected. Four researchers later evaluated causality using the Naranjo Algorithm, preventability using Shumock and Thornton criteria and clinical classifications based on the DoTS system. Results: A total of 96 patients presented 108 cases of ADR. The most frequent ADR were arrhythmias and hemorrhage of the upper digestive tract (12. 04%). Therapeutic failure accounted for 20. 3% of the cases. The most commonly associated medications were salicylic acetic acid (15. 74%) and Losartan (10. 19%). Forty-six cases were categorized as possible and only one as definitive. Using the DoTS classification, it was determined that in 82. 4% of the cases the dosage was collateral (within the therapeutic range), 89. 8% were independent of time, and the factors most associated with susceptibility to ADR included comorbilities (41. 7%) and age (49%), among others. Forty-four percent of the ADR were preventable. Conclusion: ADR is a significant cause of admittance to an intermediate care unit, for which different evaluation systems exist and a significant amount of ADR is preventable. More national studies are needed to evaluate the incidence of ADR and establish classification standards and measures to mitigate their effects.
