الفهرس 
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Abstract
As part of the global concern about drug related problems, the present work represents a pharmcovigilance study aiming to investigate adverse drug reactions, adverse drug-drug interactions and hypomagnesemia related to the pharmacotherapy used for treatment of patients admitted to the ICU departement.
The present work is a prospective observational study that was carried out in the ICU department, Benisuef teaching hospital, between August 2015 and December 2016. One hundred patients were included in the study.
Patients who experienced ADRs, patients who experienced adverse DDIs and patients who experienced ADRs and/or adverse DDIs were recorded. The ADRs were analyzed regarding the incidence, factors affecting the incidence, characteristics, organ system affected and causal drugs involved. Clinically relevant adverse DDIs were analyzed regarding the incidence, mechanism, causal drugs and management plans.
Out of the 100 patients, 88 (88%) patients experienced drug related problems in the form of ADRs, adverse DDIs or both. Patients who experienced ADRs only were 35 (35%), patients with both ADRs and adverse DDIs were 47 (47%) and patients who experienced adverse DDIs only were 6 (6%).
The incidence of ADRs were significantly higher in patients aging more than 40 years compared to younger adults and in patients with hospital stay more than 10 days compared to patients admitted for 10 days or less. There was a significant positive correlation with the number of drugs prescribed to patients. There was no significant difference in the incidence of ADRs between males and females.
The majority of ADRs were ”moderate”, ”preventable”, ”type A” (predictable) reactions, and concerning the causality, according to Naranjo most of the ADRs were considered ”probable”. ADRs mostly affected the cardiovascular system, while other systems; blood, metabolism, electrolytes, eye, gastrointestinal system, immune system, musculoskeletal system, skin, nervous system and respiratory system, were affected to a lesser extent. The drug most involved in ADRs was pantoprazol.
Regarding hypomagnesemia there was a significant increase with age more than 40 years, increased hospital stay of patients, increased incidence of mortality in relation to hypomagnesemia.
There were 7 different clinically relevant adverse DDIs recorded in the present study. All of which were pharmacodynamic and concerning the management plan the majority were classified as ”Modify treatment / Monitor”. The most commonly encountered adverse DDI was the augmented hypomagnesemia due to concomitant use of pantoprazol and frusemide.