Analytic Statistics of Type A Pharmacological Adverse Drug Reactions at Srinagarind Hospital
DOI:
https://doi.org/10.64960/srimedj.v40i5.268795Keywords:
adverse drug reactions, high-alert drugs, Srinagarind Hospital, side effectAbstract
Background and Objectives: Adverse drug reactions (ADRs) are clinical issues that affect patient safety and can be classified into two types: A and B. Type A reactions, which relate to pharmacological effects, are usually preventable or their severity can be reduced. This study aimed to analyze the characteristics of Type A ADR reports in detail, identify patterns of severity and causative drugs, and explore opportunities for developing proactive strategies to create a prevention system and enhance patient safety.
Methods: This retrospective descriptive study was conducted among patients who experienced ADRs. Data were collected from Srinagarind hospital's information system between 2020 and 2024. Descriptive statistics, including frequency distributions and percentages, were used for data analysis.
Results: Over the 5-year study period, a total of 1,280 Type A ADRs were reported, making up 8.38% of all ADR reports (95% CI: 7.94–8.82). Most occurred in female patients (924 cases, 72.19%) and outpatients (914 cases, 71.41%). Among the causative drugs, amlodipine ranked first with 156 events (12.19%), mainly presenting as edema, followed by tramadol with 122 events (9.53%), which often caused nausea and vomiting. Importantly, the main concern was not just the most frequently reported drugs but the severity of the reactions. While most cases (1,221 events, 95.39%) were non-serious, 59 serious events (4.61%) were reported. Metformin was the primary cause of these serious events (15 events, 1.17%), leading to life-threatening metformin-induced lactic acidosis (MALA). Among patients without previous ADR history (new cases), serious events were not linked to drugs classified as high-risk but were instead caused by drugs not typically included in high-risk categories. Notably, dapsone had the highest incidence relative to its use, with one case (0.33%) of methemoglobinemia.
Conclusion: A total of 1,280 Type A ADRs (8.38%) were reported, which is lower than in other studies, and the quality of available data was insufficient for further detailed analysis and review. There is a need to establish a systematic ADR surveillance system, especially focusing on high-risk drugs, drugs linked to severe Type A ADRs, and preventable incidents, to improve medication safety.
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