예측 불가능한 약물유해반응의 임상양상 및 약물 인과성 평가
Clinical Aspects of Unpredictable Adverse Drug Reaction and Assessment of Drug Casuality
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objective : The aim of this study was to provide basic data for predicting adverse drug reaction (ADR) by investigating drugs that cause type B ADR, the related clinical features and the frequency by age group. Methods : We retrospectively investigated the ADR reported from August 2015 to July 2016 at Chosun University Hospital Regional Drug Safety Center using electronic medical records. The type and clinical features of type B ADR were investigated. The Naranjo scale score was used to evaluate the ADR. Results : During the study period, 26,362 patients were hospitalized and 4,110 (15.6%) adverse drug reactions were reported. The incidence of Type B ADRs was rated as 6.6% (269 cases). Due to the results of casualty assessment with drug, 190 cases (70.6%) were categorized as “possible”, 61 cases (22.7%)“ probable”and 17 cases (6.3%)“ definite”. The incidence of type B ADR was slightly higher in females (140 cases, 52.0%) than in males (129 cases, 48.0%). According to the hypersensitivity, 117 cases (43.5%) showed true allergic reaction when 99 cases (36.8%) showed pseudoallergic reaction. Antibiotics (100 cases, 37.2%), contrast agents (55 cases, 20.4%) and analgesics (39 cases, 14.5%) were the causes of type B ADR. Moreover, type B ADR was mainly reported in the age groups of 40s (48 cases, 17.8%), 50s (62 cases, 23.0%), 60s (34 cases, 12.6%) and 70s (38 cases, 14.1%). Conclusions : When patients take medications that have a type B ADR risk of occurrence, it is necessary to evaluate the patient medication history. Based on this evaluation, an antibiotic skin test and sufficient pretreatment process should be carried out to prevent drug side effects. Furthermore, pharmacist’s efforts are needed to provide adequate information on ADR.
Abstract
Objective : The aim of this study was to provide basic data for predicting adverse drug reaction (ADR) by investigating drugs that cause type B ADR, the related clinical features and the frequency by age group. Methods : We retrospectively investigated the ADR reported from August 2015 to July 2016 at Chosun University Hospital Regional Drug Safety Center using electronic medical records. The type and clinical features of type B ADR were investigated. The Naranjo scale score was used to evaluate the ADR. Results : During the study period, 26,362 patients were hospitalized and 4,110 (15.6%) adverse drug reactions were reported. The incidence of Type B ADRs was rated as 6.6% (269 cases). Due to the results of casualty assessment with drug, 190 cases (70.6%) were categorized as “possible”, 61 cases (22.7%)“ probable”and 17 cases (6.3%)“ definite”. The incidence of type B ADR was slightly higher in females (140 cases, 52.0%) than in males (129 cases, 48.0%). According to the hypersensitivity, 117 cases (43.5%) showed true allergic reaction when 99 cases (36.8%) showed pseudoallergic reaction. Antibiotics (100 cases, 37.2%), contrast agents (55 cases, 20.4%) and analgesics (39 cases, 14.5%) were the causes of type B ADR. Moreover, type B ADR was mainly reported in the age groups of 40s (48 cases, 17.8%), 50s (62 cases, 23.0%), 60s (34 cases, 12.6%) and 70s (38 cases, 14.1%). Conclusions : When patients take medications that have a type B ADR risk of occurrence, it is necessary to evaluate the patient medication history. Based on this evaluation, an antibiotic skin test and sufficient pretreatment process should be carried out to prevent drug side effects. Furthermore, pharmacist’s efforts are needed to provide adequate information on ADR.
참고문헌 (13)
- WHO, "International drug monitoring: the role of national centres", Report of a WHO meeting. Tech Rep Ser WHO, 498, pp.1~25 (1972)
- Davies DM, "Comprehensive clinical drug information service: first year's experience", Br Med J, 1, pp.89~90 (1977)
- Lazarou J, "Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies", JAMA, 279, pp.1200~1205 (1998)
- Fattinger K, "Epidemiology of drug exposure and adverse reactions in two Swiss departments of internal medicine", Br J Clin Pharmacol, 49, pp.158~167 (2000)
- Thong BY, "Drug allergy in general hospital: results of novel prospective inpatient reporting system. Annals of Allergy", Asthma & Immunology, 34, pp.1597~1601 (2003)
- Dartnell JG, "Hospitalisation for adverse events related to drug therapy: incidence, avoidability and costs", Med J Aust, 164, pp.659~662 (1996)
- 김정미, "국내 한 상급종합병원의 입원환자 대상 약물이 상반응현황 분석", 병원약사회지, 32(4), pp.318~334 (2015), 한국병원약사회[DOI]
- Choi S, "Estimation of adverse drug reactions and methods to encourage the adverse drug monitoring in tertiary hospital", J. Kor. Soc. Health-Syst. Pharm, 18(1), pp.64~77 (2001)
- Na YS, "Reporting and Clinical Manifestations of Adverse Drug Reactions in a Single University Hospital", pp.2012
- Cho JA, "The surveillance of adverse drug reactions (ADR) reported in Samsung Medical Center", Kor. J. Clin. Pharm, 10(1), pp.30~37 (2000)
- Chen W, "Gender difference, sex hormones, and immediate type hypersensitivity reactions", Allergy, 63(11), pp.1418~1427 (2008)
- 최정희, "단일 3차 의료기관에서 약물 이상 반응의 빈도", 대한내과학회지, 67(3), pp.290~296 (2004), 대한내과학회
- 임혜리, "원내 약물부작용 보고 유형별 분석", 병원약사회지, 28(2), pp.1~9 (2011), 한국병원약사회[DOI]