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1.
Pharmaceuticals (Basel) ; 16(8)2023 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-37631076

RESUMO

This study aimed to determine the type of drugs reported as suspected of causing severe supraventricular arrhythmias from the Spanish Human Pharmacovigilance System database. A total of 1053 reports were analysed, of which 526 (50%) were on men and 516 (49%) were on women. The most affected age group was the over-65s, with 593 reports (56%). Of the 1613 drugs, those belonging to the cardiovascular system (ATC Group C) were the most numerous (414 reports, 26%), with digoxin being the most frequent drug (49 reports, 12%). Other common groups were antiinfectives for systemic use (ATC Group J; 306 reports, 19%), antineoplastic and immunomodulating agents (ATC Group L; 198 reports, 12%), and nervous system drugs (ATC Group N; 185 reports, 11%). The most common supraventricular arrhythmia was atrial fibrillation (561 reports, 51%). Regarding outcomes, 730 (66%) patients recovered, 76 (7%) did not recover, 25 (3%) recovered but with sequelae, and 23 (2%) resulted in death. This study revealed that certain drugs have reported to be associated more frequently to supraventricular arrhythmias as serious adverse reactions, especially in the older population. Proper clinical management and effective strategies to ensure medication appropriateness should always be considered to improve patient safety when prescribing drugs.

2.
Pharmaceuticals (Basel) ; 16(5)2023 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-37242555

RESUMO

Self-inflicted violence is a major and growing public health problem and its prediction and prevention is challenging for healthcare systems worldwide. Our aim was to identify prescribed drugs associated with self-directed violent behaviors in Spain. A descriptive, longitudinal and retrospective study of spontaneous reports of adverse drug reactions corresponding to self-directed violence was recorded in the Spanish Pharmacovigilance Database (FEDRA®) from 1984 to 31 March 2021. A total of 710 cases were reported in the study period. The mean age was 45.52 years (range 1-94). There were no gender differences except in children, where most reports were of male children. The main therapeutic groups that were involved included drugs for the nervous system (64.5%) and anti-infectives for systemic use (13.2%). The most commonly reported drugs were varenicline, fluoxetine, lorazepam, escitalopram, venlafaxine, veralipride, pregabalin, roflumilast and bupropion. There were reports of montelukast, hydroxychloroquine, isotretinoin, methylphenidate, infliximab, natalizumab, ribavirin and efavirenz, which were less known to be involved in self-directed violence. This study shows that self-directed violence is a rare adverse drug reaction, and can be related to the use of some medicines. It is important for healthcare professionals to consider this risk in their clinical praxis, implementing person-centred approaches. Further studies are needed, considering comorbidities and potential interactions.

3.
Rev Esp Salud Publica ; 912017 Dec 22.
Artigo em Espanhol | MEDLINE | ID: mdl-29269726

RESUMO

OBJECTIVE: Adverse drug reactions (ADR) are one of the ten main causes of mortality in the world, as a cause of hospital admissions or prolongation hospitalizations days created an important health and economic impact. This study aimed to detect incidence and characterize ADRs that occurred during hospitalization and associated with admission in Internal Medicine service. METHODS: Observational and prospective study of intensive RAM monitoring patients admitted in Internal Medicine services in a third level hospital over a twelve months period in 2014. The assessment consisted of a complete and protocol collecting information about the patients and related to suspected ADRs during hospitalization. Statistical analysis was performed using SPSS v.20.0. RESULTS: The study included 253 patients and in 54 (21,34%) ADR were detected, the risk of experiencing an ADR was associated with the age (p=0.012). ADR-related hospitalizations incidence were 7,11%, and fatal ADR incidence were 1,97%. With regard to severity 81,2% were severe. Gastrointestinal disorders represented the most common ADRs followed by metabolism and nutrition disorders and vascular disorders. The drugs most frequently associated with ADRs were cardiovascular agents, antiinfective drugs and central nervous system agents. 72.2% of the patients who suffered ADR had polypharmacy. CONCLUSIONS: In our study incidence of adverse drug reactions in hospitalized patients was 21,34%, this data and ADR´s related to admission to hospital or fatal ADR´s are mainly suffered by pluripathology and polymedicated elderly patients with worst renal function values. In these patients a more careful prescription should be made.


OBJETIVO: Las reacciones adversas a medicamentos de uso humano (RAM) son una de las diez principales causas de mortalidad a nivel mundial, siendo las que causan ingreso o prolongan la estancia hospitalaria las de mayor impacto sanitario y económico. Los objetivos de este estudio fueron conocer la incidencia y las características de las RAM en pacientes hospitalizados en los servicios de Medicina Interna. METODOS: Estudio observacional y prospectivo de monitorización intensiva de RAM de los pacientes ingresados en los servicios de Medicina Interna en un hospital de tercer nivel durante el año 2014. Se protocolizó la recogida de datos relativos al paciente así como las características de las RAM. El análisis estadístico se realizó con el software SPSS v.20.0. RESULTADOS: Se monitorizaron 253 pacientes. Se detectaron RAM en 54 pacientes (21,34%), encontrándose una asociación positiva entre la edad y la presencia de RAM (p=0.012). La incidencia de ingresos causados por una RAM fue de 7,11% y las RAM mortales fueron un 1,97%. Las RAM fueron graves en el 81,2% de los casos. Los órganos más afectados fueron el gastrointestinal, trastornos del metabolismo y de la nutrición y el vascular. Los grupos terapéuticos causantes de RAM más frecuentes fueron los agentes cardiovasculares, los antinfecciosos y los del sistema nervioso. El 72,2% de los pacientes que sufrieron RAM presentaban polimedicación. CONCLUSIONES: La incidencia de RAM en nuestro estudio se sitúa en el 21,34%. La carga de ingresos o de mortalidad derivados de una RAM la sufren, fundamentalmente, pacientes ancianos, pluripatológicos, polimedicados y con peores valores de función renal por lo que es en ellos en quien fundamentalmente se debería realizar una prescripción más cuidadosa.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Hospitalização , Polimedicação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastroenteropatias/induzido quimicamente , Gastroenteropatias/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologia , Adulto Jovem
6.
Rev. esp. salud pública ; 91: 0-0, 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-169298

RESUMO

Fundamentos: Las reacciones adversas a medicamentos de uso humano (RAM) son una de las diez principales causas de mortalidad a nivel mundial, siendo las que causan ingreso o prolongan la estancia hospitalaria las de mayor impacto sanitario y económico. Los objetivos de este estudio fueron conocer la incidencia y las características de las RAM en pacientes hospitalizados en los servicios de Medicina Interna. Métodos: Estudio observacional y prospectivo de monitorización intensiva de RAM de los pacientes ingresados en los servicios de Medicina Interna en un hospital de tercer nivel durante el año 2014. Se protocolizó la recogida de datos relativos al paciente así como las características de las RAM. El análisis estadístico se realizó con el software SPSS v.20.0. Resultados: Se monitorizaron 253 pacientes. Se detectaron RAM en 54 pacientes (21,34%), encontrándose una asociación positiva entre la edad y la presencia de RAM (p=0.012). La incidencia de ingresos causados por una RAM fue de 7,11% y las RAM mortales fueron un 1,97%. Las RAM fueron graves en el 81,2% de los casos. Los órganos más afectados fueron el gastrointestinal, trastornos del metabolismo y de la nutrición y el vascular. Los grupos terapéuticos causantes de RAM más frecuentes fueron los agentes cardiovasculares, los antinfecciosos y los del sistema nervioso. El 72,2% de los pacientes que sufrieron RAM presentaban polimedicación. Conclusión: La incidencia de RAM en nuestro estudio se sitúa en el 21,34%. La carga de ingresos o de mortalidad derivados de una RAM la sufren, fundamentalmente, pacientes ancianos, pluripatológicos, polimedicados y con peores valores de función renal por lo que es en ellos en quien fundamentalmente se debería realizar una prescripción más cuidadosa (AU)


Objectives: Adverse drug reactions (ADR) are one of the ten main causes of mortality in the world, as a cause of hospital admissions or prolongation hospitalizations days created an important health and economic impact. This study aimed to detect incidence and characterize ADRs that occurred during hospitalization and associated with admission in Internal Medicine service. Methods: Observational and prospective study of intensive RAM monitoring patients admitted in Internal Medicine services in a third level hospital over a twelve months period in 2014. The assessment consisted of a complete and protocol collecting information about the patients and related to suspected ADRs during hospitalization. Statistical analysis was performed using SPSS v.20.0. Results: The study included 253 patients and in 54 (21,34%) ADR were detected, the risk of experiencing an ADR was associated with the age (p=0.012). ADR-related hospitalizations incidence were 7,11%, and fatal ADR incidence were 1,97%. With regard to severity 81,2% were severe. Gastrointestinal disorders represented the most common ADRs followed by metabolism and nutrition disorders and vascular disorders. The drugs most frequently associated with ADRs were cardiovascular agents, antiinfective drugs and central nervous system agents. 72.2% of the patients who suffered ADR had polypharmacy. Conclusion: In our study incidence of adverse drug reactions in hospitalized patients was 21,34%, this data and ADR´s related to admission to hospital or fatal ADR´s are mainly suffered by pluripathology and polymedicated elderly patients with worst renal function values. In these patients a more careful prescription should be made (AU)


Assuntos
Humanos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Hospitalização/estatística & dados numéricos , Gestão da Segurança/organização & administração , Estudos Prospectivos , Dano ao Paciente/prevenção & controle , Estudos de Coortes
7.
Pharmacoepidemiol Drug Saf ; 20(12): 1287-94, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21702073

RESUMO

PURPOSE: This study evaluated the magnitude of underreporting of adverse drug reactions (ADRs) and investigated possible reporting patterns according to patient characteristics and the type of reaction based on the integration of information obtained from primary care electronic medical records (EMRs) and the Spanish Pharmacovigilance System. METHODS: This investigation was a descriptive retrospective study analysing ADRs recorded in 2005 in the EMRs from six health centers in Zaragoza (Aragon, Spain) with a covered population of 126,838 subjects. The associations between the probability of reporting and the reaction and drug type were studied using logistic regression models adjusted by age and sex. RESULTS: The total number of ADRs recorded in the EMRs was 543, of which 65.7% were reported to the Spanish Pharmacovigilance System. Positive associations were found between the probability of reporting an ADR and advanced age of patients (OR for ≥76 years = 2.0; 95%CI 1.1-3.6), involvement of the reproductive system (OR = 7.9; 95%CI 1.02-60.2) and involvement of psychiatric disorders (OR = 4.0; 95%CI 1.4-11.6). Negative associations were found between reporting an ADR and early age of patients (OR for 0-14 years = 0.2; 95%CI 0.1-0.6) and the use of antimicrobial drugs (OR = 0.6; 95%CI 0.4-0.9). CONCLUSIONS: This study tackles an important public health problem directly related to patients' safety and highlights the utility of EMRs for investigating the current significance of ADR underreporting. It also makes us think that primary care physicians seem to have selective reporting patterns based on their familiarity with the reaction type and the drug causing the reaction as well as on the age of patients.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Médicos de Atenção Primária/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Farmacovigilância , Estudos Retrospectivos , Espanha , Adulto Jovem
14.
Arch. Fac. Med. Zaragoza ; 46(1): 7-13, mar. 2006. ilus, tab
Artigo em Es | IBECS | ID: ibc-052878

RESUMO

Las reacciones adversas a medicamentos son una de las principales causas de morbimortalidad en los países desarrollados. La Farmacovigilancia se encarga de la detección, registro y evaluación de estas reacciones. El conocimiento de los efectos adversos observados en la práctica clínica diaria y su cuantificación se ha realizado tradicionalmente mediante el Programa de Notificación Espontánea a través de la Tarjeta Amarill. Actualmente la informatización progresiva de las consultas de AP a través del programa informático OMI-AP, ha facilitado el proceso de notificación mejorando la calidad y precisión de la información recogida. El objetivo de este trabajo ha sido comparar la cantidad y calidad de las notificaciones obtenidas antes y después de la informatización (durante 2004) en cuatro Centros de Salud de la regios: Delicias Sur, Valdefierro, Oliver y Monzón


Adverse drug reactions are one of the main morbimortality causes in developed countries. Pharmacovigilance is charge of detection registry and evaluation of these reactions. The knowledge and quantification of the observed adverse effects in clinical practice have been made traditionally by the Spontaneous Notification Program through the yellow card. At the moment, the progressive primary health care computerization through OMI-AP program, has facilitated the notification process improving the quality and precision of yellow card. The aim of this work has been to compare the amount and the quality of the spontaneous notifications obtained before and agter comuterization (during year 2004) in four regional Health Centres: Delicias Sur, Valdefierro, Oliver and Monzon


Assuntos
Masculino , Feminino , Humanos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Preparações Farmacêuticas/efeitos adversos , Farmacoepidemiologia/métodos , Farmacoepidemiologia/estatística & dados numéricos , Garantia da Qualidade dos Cuidados de Saúde/métodos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Causalidade , Indicadores de Morbimortalidade , Farmacoepidemiologia/tendências , Qualidade dos Medicamentos Homeopáticos , 25105
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