|Files in This Item:|
|Title: ||Reports of side effects associated with the use of drugs 1987-1988|
|Publisher: ||National Drugs Advisory Board (NDAB)|
|Issue Date: ||1988 |
|Description: ||During 1987 the National Drugs Advisory Board received 1,288 reports concerning patients
who experienced adverse reactions associated with the use of medicines. From these reports 2,251
side effects were recorded.
Thirty-five percent of the reports were forwarded by general pract1t1oners, 21% by
pharmacists (about half of those were received from pharmacists conducting special surveys, one in
the Drug Information Centre. St. James's Hospital. and the other from a special research project.)
Hospital Consultants were the source of 15% of the reports while the Board's intensive
monitoring scheme provided 16% Pharmaceutical Companies' reports accounted for 10%. One
percent of the reports came from dentists.
Deaths Associated with Drugs
Twenty-one deaths were recorded as associated with ingestion of medicines. In s1x of these
cases the medications were not regarded as implicated aetiologically while two resulted from
overdosage (one of Paracetamol). In five other cases, drugs ingestion could possibly have contributed
to death primarily due to major pathology.
Of the eight remaining deaths two occurred with NSAID, one after a mass1ve gastrointestinal
haemorrhage and one following severe diarrhoea with consequent electrolyte imbalance - both patients
were over 75 years of age. One occurred with induction of anaesthesia, one followed the unexpected
development of malignant neuroleptic syndrome, one followed complete heart block consequent to the
use of an antiarrhythmic, one was consequent on renal failure produced in a patient on captopril with
thrombosis of a single renal artery.
An interaction between warfarin and miconazole led to a prolonged prothrombin time and
extensive cerebellar haemorrhage in a patient. Another interaction between a phenothiazine and a
tricyclic antidepressant led to epileptiform seizures and death.
Fourteen interactions were reported during 1987. In 5 the effect was additive
pharmacodynamic reaction, 2 with CNS depression, 1 with hypokalaemia, 1 negative inotropism, and 1
an anticoagulant effect.
Additive toxicity was noted in 6 cases, gastrointestinal damage in 1, CNS confusion in 1 and
tyramine reactions in 4.
Pharmacokinetic interactions were responsible in 3 cases, 2 a displacement from protein
binding and 1 from inhibition of hepatic microsomal enzymes.|
|Appears in Collections: ||National Drugs Advisory Board|
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