내과계 중환자실의 다빈도 사용 약물에 의한 유해 사례 조사 연구

Abstract

The patients in the intensive care unit(ICU) are known to have more Adverse Drug Events(ADEs), but there are few voluntary ADE reports from ICU. The objective of this study was to form the basis of active ADE monitoring system by reviewing the charts of medical ICU patients who took high-use drugs in a university hospital ICU. We reviewed charts of patients who were in the MICU between January 1st and July 31st in 2007, and obtained ADEs for high-use drugs. High-use drugs were defined as the top fifty percent drugs of the quantities of prescription except for fluids, and they were dopamine, midazolam, salbutamol nebulizer, ipratropium nebulizer, vecuronium, furosemide, dobutamine, norepinephrine, nafamostat, NaHCO3, ambroxol and KCl. Adverse drug events were defined as adverse drug reactions on Drug Information Handbook and CCIS. Probability and the severity of the ADE were decided by the Naranjo algorithm and Common Terminology Criteria for Adverse Events(CTCAE) version 3. We checked patients who matched for the ADE laboratory test signal which was set in the hospital. 37(12.2%) of 303 patients went through 44 ADEs(10.6 events per 1000 patient days). The average age of ADE-suffering-patient was 65.1, 20(54.1%) patients were women. The medication which is associated with the most ADEs(14, 31.8%) was furosemide and the most frequent event(5, 11.4%) was hypokalemia. All the ADEs were possible or probable at Naranjo scale, and 36(81.8%) cases were moderate or severe in severity. There were 5(11.4%) cases that might be preventable Adverse Drug Events. Therefore it would be possible to use drugs more safely if Adverse Drug Events are monitored systemically in the ICU.